A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A qualitative study: the perception on anti-smoking campaign among smokers in Kuantan

Smoking is an inevitably unhealthy habit among Malaysian that could harm not only the smokers but also the community. Even though there are a lot of anti-smoking campaign had been introduced by the government but the effectiveness is still marginal. Thus, the objectives of this study were to explore the main factor related to the failure of anti-smoking campaign in Malaysia, to explore the effectiveness of “Smoking Cessation Clinic” and to discover the best solution to ensure the campaign is effective in the future. This is a qualitative cross-sectional study. Interviews were conducted among five voluntary respondents which were smokers and ex-smoker at Public area and selected smoking cessation clinics in Kuantan. This study used thematic analysis to analyse the data. This study found that few contributing factors from the perspective of smokers need to be prioritised by higher authority for improvements. Those contribution factors are minimal creativity on managing anti-smoking promotion, low self-awareness about health, demand on energizer at workplace and poor stress management. Findings recommend that the campaign shall start from primary and secondary school, improvise warning sign of disease, widening the promotion area, provides reward during campaign and smokers to take initiative to involve in the program. Furthermore, the government also needs to focus on the prevention of start smoking rather than the intervention to quit smoking that may cost lots of financial demand

Challenges of anti-smoking campaign in Malaysia from the healthcare provider perspective

This study discovered challenging of the anti-smoking campaign from the perspective of healthcare providers in Kuantan. The objectives of this study were to explore the challenges of the anti-smoking campaign from healthcare providers’ views, to explore the awareness regarding the existence of Smoking Cessation Clinics and to explore the ways to improve anti-smoking campaigns. This study is important because it may aid Malaysian authorities to develop better strategies in promoting anti-smoking campaigns in the future. Purposive sampling was used in the collection of data and semi-structured interviews were conducted among five healthcare providers from three selected Smoking Cessation Clinics. This study found that healthcare provider felt that smokers who received treatment from the Health Centre had low understanding of the standard of procedure of smoking cessation procedure, low commitment and easily influenced by the public. Healthcare provider also felt that multidisciplinary task limited their focus to the client. Besides, they felt that the existence of smoking Cessation Clinic needs to be widely publicised to the community. Through the findings, the author recommend to improve the current approaches to reduce the number of smokers in Malaysia such as improving publicity to the public, enhancing the law of enforcement and providing incentives

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Prediction of permanent deformation in asphalt pavements using a novel symbiotic organisms search–least squares support vector regression

The prediction of asphalt performance can be very important in terms of increasing service life and performance while saving energy and money. In this study, a new hybrid artificial intelligence (AI) system, SOS-LSSVR, has been proposed to predict the permanent deformation potential of asphalt pavement mixtures. SOS-LSSVR utilizes the symbiotic organisms search (SOS) and the least squares support vector regression (LSSVR), which are seen as a complementary system. The prediction model can be established from all input and output data pairs for LSSVR, while SOS optimizes the systems tuning parameters. To avoid sampling bias and to partition the dataset into testing and training, a cross-validation technique was chosen. The results can be compared to those of previous studies and other predictive methods. Through the use of four error indicators, SOS-LSSVR accuracy was verified in predicting the permanent deformation behavior of an asphalt mixture. The present study demonstrates that the proposed AI system is a valuable decision-making tool for road designers. Additionally, the success of SOS-LSSVR in building an accurate prediction model suggests that the proposed self-optimized prediction framework has found an underlying pattern in the current database and thus can potentially be implemented in various disciplines