The primary focus of all sample surveys is on providing point estimates for the parameters of primary interest, and also estimating the variance associated with those point estimates to quantify the ...uncertainty. Larger samples and important measurement tools can help to reduce the point estimates’ uncertainty. Numerous effective stratification criteria may be used in survey to reduce variance within stratum. In fine stratification design, the population is divided into numerous small strata, each containing a relatively small number of sampling units as one or two. This is done to ensure that certain characteristics or subgroups of the population are well-represented in the sample. But with many strata, the sample size within each stratum can become small, potentially resulting in higher errors and less stable estimates. The variance estimation process becomes difficult when we only have one unit per stratum. In that case, the collapsed stratum technique is the classical methods for estimating variance. This method, however, is biased and results in an overestimation of the variance. This paper proposes a bootstrap-based variance estimator for the total population under fine stratification, which overcomes the drawbacks of the previously explored estimation approach. Also, the estimator’s properties were investigated. A simulation study and practical application on survey of mental health organizations data were done to investigate properties of the proposed estimators. The results show that the proposed estimator performs well.
Non-pharmaceutical interventions (NPIs) such as lockdown, social distancing and use of face coverings was adopted by the United Kingdom (UK) Armed Forces (AF) during the COVID-19 pandemic. This study ...assessed the impact of the use of NPIs on the incidence of influenza-like illness (ILI) in the UK AF.
A longitudinal study design was adopted, and secondary data was analysed retrospectively. Clinical Read codes for ILI was used to generate data for flu seasons before and during the COVID-19 pandemic (September 2017 to April 2021).
Before the COVID-19 pandemic, the rate of reporting ILI was ~ 4% across all flu seasons. The count of ILI was 2.9%, 2.2% and 3.1% during 2017-18, 2018-19 and 2019-20 flu seasons respectively. During the COVID-19 pandemic, both the rate of reporting ILI (0.6%) and the count of ILI (0.5%) were significantly smaller (p < .001). The rate of reporting ILI was positively correlated with the count of ILI (r (2) = .97, p = .014). Influenza vaccination rate increased by 1.3% during the COVID-19 pandemic. Vaccination rate was negatively correlated with the rate of reporting ILI (r (2) = -.52, p = 0.24) and the count of ILI (r (2) = -.61, p = 0.19). However, this correlation was not significant. The use of NPIs was negatively correlated with the rate of reporting ILI (r (2) = -.99, p = < .001) and the count of ILI (r (2) = -.95, p = 0.026). The overall multiple regression performed was statistically significant (R2 = 0.94, F (1, 2) = 33.628, p = 0.028). The rate of reporting ILI significantly predicted the count of ILI (β = 0.609, p = 0.028) while vaccination rate did not significantly predict the count of ILI (β = -0.136, p = 0.677).
The incidence of ILI in the UK AF was significantly reduced during the COVID-19 pandemic. The use of NPIs and the rate of reporting ILI significantly reduced the count of ILI. Being vaccinated for influenza did not significantly reduce the count of ILI.
Introduction Non-pharmaceutical interventions (NPIs) such as lockdown, social distancing and use of face coverings was adopted by the United Kingdom (UK) Armed Forces (AF) during the COVID-19 ...pandemic. This study assessed the impact of the use of NPIs on the incidence of influenza-like illness (ILI) in the UK AF. Methods A longitudinal study design was adopted, and secondary data was analysed retrospectively. Clinical Read codes for ILI was used to generate data for flu seasons before and during the COVID-19 pandemic (September 2017 to April 2021). Results Before the COVID-19 pandemic, the rate of reporting ILI was ~ 4% across all flu seasons. The count of ILI was 2.9%, 2.2% and 3.1% during 2017–18, 2018–19 and 2019–20 flu seasons respectively. During the COVID-19 pandemic, both the rate of reporting ILI (0.6%) and the count of ILI (0.5%) were significantly smaller (p < .001). The rate of reporting ILI was positively correlated with the count of ILI (r (2) = .97, p = .014). Influenza vaccination rate increased by 1.3% during the COVID-19 pandemic. Vaccination rate was negatively correlated with the rate of reporting ILI (r (2) = -.52, p = 0.24) and the count of ILI (r (2) = -.61, p = 0.19). However, this correlation was not significant. The use of NPIs was negatively correlated with the rate of reporting ILI (r (2) = -.99, p = < .001) and the count of ILI (r (2) = -.95, p = 0.026). The overall multiple regression performed was statistically significant (R2 = 0.94, F (1, 2) = 33.628, p = 0.028). The rate of reporting ILI significantly predicted the count of ILI (β = 0.609, p = 0.028) while vaccination rate did not significantly predict the count of ILI (β = -0.136, p = 0.677). Conclusions The incidence of ILI in the UK AF was significantly reduced during the COVID-19 pandemic. The use of NPIs and the rate of reporting ILI significantly reduced the count of ILI. Being vaccinated for influenza did not significantly reduce the count of ILI.
Objective To identify, in a non-hypothesis manner, novel genetic factors associated with nonsyndromic cleft lip with or without cleft palate (NSCL/P). Study design We performed a genome-wide ...association study in a pediatric cohort of European decent consisting of 111 NSCL/P cases and 5951 control subjects. All subjects were consecutively recruited from the Greater Philadelphia area from 2006 to 2009. High throughput genome-wide single nucleotide polymorphism genotyping was carried out with the Illumina Infinium II HumanHap550 BeadChip technology. Results We observed association at the genome-wide significance level with SNP rs987525 at a locus on 8q24, which harbors no characterized genes to date ( P = 9.18 × 10−8 ; odds ratio = 2.09, 95% confidence interval = 1.59 to 2.76). While searching for a replication cohort, the same genetic determinant was established through a genome-wide association study of NSCL/P in Germany, so this previous report acts as a de novo replication for our independent observation outlined here. Conclusions These results strongly suggest that a locus on 8q24 is involved in the pathogenesis of NSCL/P.
Occult hepatitis B virus (HBV) infection (OBI) is a phase of HBV infection characterised by the presence of HBV DNA in the absence of detectable hepatitis B surface antigen (HBsAg). OBI is of concern ...in the HIV-infected due to high prevalence and risk of HBV reactivation. The prevalence and clinico-demographic characteristics of OBI in anti-retroviral therapy (ART) naïve HIV infected adults in Kenya is unknown.
A cross sectional study carried was out at three sites in Kenya. HIV infected ART naïve adults were enrolled and demographic data collected. Blood samples were assayed for HBsAg, HBV DNA, alanine aminotransferase, aspartate aminotransferase, antibodies to hepatitis B surface antigen (anti-HBs) and hepatitis B core antigen (anti-HBc). Data on CD4 count, HIV viral load and platelet count were obtained from medical records.
Of 208 patients, 199 (95.7%) did not report HBV vaccination, 196 (94.2%) were HBsAg negative, 119 (57.2%) had no HBV markers, 58 (27.9%) had previous HBV infection (anti-HBc positive) and 11 (5.3%) had OBI. All 11 (100%) OBI patients were anti-HBc positive. OBI patients comprised 19.0% of HBsAg negative, anti-HBc positive patients. There was no difference in clinico-demographic characteristics between the overt HBV, OBI and HBV negative patients.
This was the first study on OBI in ART naïve HIV infected adults in Kenya. The lower OBI prevalence compared to other sub-Saharan African countries could be attributed to lower HBV exposure. Most patients were HBV unexposed and unimmunized, outlining the need to implement guideline recommended immunization strategies.
Visceral Leishmaniasis is a very dangerous form of leishmaniasis and, shorn of appropriate diagnosis and handling, it leads to death and physical disability. Depicting the spatiotemporal pattern of ...disease is important for disease regulator and deterrence strategies. Spatiotemporal modeling has distended broad veneration in recent years. Spatial and spatiotemporal disease modeling is extensively used for the analysis of registry data and usually articulated in a hierarchical Bayesian framework. In this study, we have developed the hierarchical spatiotemporal Bayesian modeling of the infected rate of Visceral leishmaniasis in Human (VLH). We applied the Stochastics Partial Differential Equation (SPDE) approach for a spatiotemporal hierarchical model for Visceral leishmaniasis in human (VLH) that involves a GF and a state process is associated with an autoregressive order one temporal dynamics and the spatially correlated error term, along with the effect of land shield, metrological, demographic, socio-demographic and geographical covariates in an endemic area of Amhara regional state, Ethiopia. The model encompasses a Gaussian Field (GF), affected by an error term, and a state process described by a first-order autoregressive dynamic model and spatially correlated innovations. A hierarchical model including spatially and temporally correlated errors was fit to the infected rate of Visceral leishmaniasis in human (VLH) weekly data from January 2015 to December 2017 using the R package R-INLA, which allows for Bayesian modeling using the stochastic partial differential equation (SPDE) approach. We found that the mean weekly temperature had a significant positive association with infected rate of VLH. Moreover, net migration rate, clean water coverage, average number of households, population density per square kilometer, average number of persons per household unit, education coverage, health facility coverage, mortality rate, and sex ratio had a significant association with the infected rate of visceral leishmaniasis (VLH) in the region. In this study, we investigated the dynamic spatiotemporal modeling of Visceral leishmaniasis in Human (VLH) through a stochastic partial differential equation approach (SPDE) using integrated nested Laplace approximation (INLA). Our study had confirmed both metrological, demographic, sociodemographic and geographic covariates had a significant association with the infected rate of visceral leishmaniasis (VLH) in the region.
Phytochemical analysis of a methanol–dichloromethane (1:1) extract of the aerial parts of Tephrosialinearis led to the isolation of 18 compounds. Seven of these, namely, lineaflavones A–D (1–4), ...6-methoxygeraldone (5), 8″-acetylobovatin (6), and 5-hydroxy-7-methoxysaniculamin A (7) are new compounds. The compounds were characterized based on their NMR and HRMSn data. The anti-inflammatory effects of the crude extract and isolated compounds were evaluated by measuring the levels of interleukins (IL-1β, IL-2, and IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor-α (TNF-α) in lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMCs). The crude extract inhibited the release of all cytokines except IL-1β, which slightly increased in comparison to the LPS control. All the tested compounds suppressed the production of IL-2, GM-CSF, and TNF-α. Whereas compounds 1, 2, 4–8, 10–15, 17, and 18 decreased production of IL-6, compounds 1, 2, 4, 7, 10, 13–15, and 17 inhibited the release of IL-1β. It is worth noting that most of the compounds tested showed a superior reduction in cytokines release compared to the reference drug ibuprofen.
We analyze the potential effect of global warming levels (GWLs) of 1.5 °C and 2 °C above pre-industrial levels (1861−1890) on mean temperature and precipitation as well as intra-seasonal ...precipitation extremes over the Greater Horn of Africa. We used a large, 25-member regional climate model ensemble from the Coordinated Regional Downscaling Experiment and show that, compared to the control period of 1971−2000, annual mean near-surface temperature is projected to increase by more than 1 °C and 1.5 °C over most parts of the Greater Horn of Africa, under GWLs of 1.5 °C and 2 °C respectively. The highest temperature increases are projected in the northern region, covering most parts of Sudan and northern parts of Ethiopia, and the lowest temperature increases are projected over the coastal belt of Tanzania. However, the projected mean surface temperature difference between 2 °C and 1. 5 °C GWLs is higher than 0.5 °C over nearly all land points, reaching 0.8 °C over Sudan and northern Ethiopia. This implies that the Greater Horn of Africa will warm faster than the global mean. While projected changes in precipitation are mostly uncertain across the Greater Horn of Africa, there is a substantial decrease over the central and northern parts of Ethiopia. Additionally, the length of dry and wet spells is projected to increase and decrease respectively. The combined effect of a reduction in rainfall and the changes in the wet and dry spells will likely impact negatively on the livelihoods of people within the coastal cities, lake regions, highlands as well as arid and semi-arid lands of Kenya, Tanzania, Somalia, Ethiopia and Sudan. The probable impacts of these changes on key sectors such as agriculture, water, energy and health sectors, will likely call for formulation of actionable policies geared towards adaptation and mitigation of the impacts of 1.5 °C and 2 °C warming.
A genomewide association study involving children of Northern European ancestry who had asthma yielded an association with a locus on chromosome 1q31 that was replicated in two additional ...case–control series, one involving subjects of Northern European ancestry and the other, children of African ancestry. The implicated locus houses
DENND1B,
which is expressed by natural killer cells and dendritic cells of the immune system.
A genomewide association study involving children of Northern European ancestry who had asthma yielded an association with a locus on chromosome 1q31. The implicated locus houses DENND1B, which is expressed by natural killer cells and dendritic cells of the immune system.
Asthma is a heterogeneous and multifactorial disease manifested as episodes of wheezing, coughing, and shortness of breath. Both family-based and twin studies indicate that asthma is a complex genetic disorder.
1
Multiple genetic and environmental factors are also known to modulate the clinical expression of the disease and its associated phenotypes — bronchial hyperresponsiveness, atopy, and elevated IgE.
2
,
3
A genomewide association study showed that the 17q12-q21 locus, harboring the ORM1-like 3 (
ORMDL3
) gene, is associated with asthma, with a small population attributable risk. Therefore, it seems unlikely that there are common variants with a large effect on asthma. . . .
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