93 research outputs found
Seasonality as a driver of pH1N12009 influenza vaccination campaign impact
Although the most recent respiratory virus pandemic was triggered by a Coronavirus, sustained and elevated prevalence of highly pathogenic avian influenza viruses able to infect mammalian hosts highlights the continued threat of pandemics of influenza A virus (IAV) to global health. Retrospective analysis of pandemic outcomes, including comparative investigation of intervention efficacy in different regions, provide important contributions to the evidence base for future pandemic planning. The swine-origin IAV pandemic of 2009 exhibited regional variation in onset, infection dynamics and annual infection attack rates (IARs). For example, the UK experienced three severe peaks of infection over two influenza seasons, whilst Australia experienced a single severe wave. We adopt a seasonally forced 2-subtype model for the transmission of pH1N12009 and seasonal H3N2 to examine the role vaccination campaigns may play in explaining differences in pandemic trajectories in temperate regions. Our model differentiates between the nature of vaccine- and infection-acquired immunity. In particular, we assume that immunity triggered by infection elicits heterologous cross-protection against viral shedding in addition to long-lasting neutralising antibody, whereas vaccination induces imperfect reduction in susceptibility. We employ an Approximate Bayesian Computation (ABC) framework to calibrate the model using data for pH1N12009 seroprevalence, relative subtype dominance, and annual IARs for Australia and the UK. Heterologous cross-protection substantially suppressed the pandemic IAR over the posterior, with the strength of protection against onward transmission inversely correlated with the initial reproduction number. We show that IAV pandemic timing relative to the usual seasonal influenza cycle influenced the size of the initial waves of pH1N12009 in temperate regions and the impact of vaccination campaigns
Monitoring university student response to social distancing policy during the SARS-CoV-2 pandemic using Bluetooth: the RADAR study
Aim: We use the Remote Assessment of Disease and Relapses platform (RADAR) to collect Bluetooth contact and location data from university students. We test the ability of this technology to objectively capture social interaction, explore the propensity of students to respond to changing COVID-19 regulations, and investigate associations between Bluetooth contact and mood.Methods: RADAR data are coded by time period to reflect shifting COVID-19 restrictions. Mean contacts per event across setting, student living arrangement and over time 20 are explored using non-parametric tests and generalised additive models. Individual-level associations between psychological measures of mood and Bluetooth contacts are considered.Results: Students in halls of residence had higher contacts than students in private accommodation. Mean contacts per event peak in lockdown, driven by a rise in outdoor 25 contacts. Indoor contacts peak during the earlier Tier 3 restrictions, similar to trends in Google Mobility data. We nd weak evidence of correlation between positive mood and Bluetooth contact amongst students based in halls.Conclusions: Passive tracking of Bluetooth contacts can provide insight into the behavioural response to changing public health interventions. Our results are consistent 30 with students responding to policy changes similarly to the wider community
SARS-CoV-2 infection in UK university students: lessons from September-December 2020 and modelling insights for future student return.
Funder: Isaac Newton Institute for Mathematical Sciences; Id: http://dx.doi.org/10.13039/501100005347Funder: Wellcome Trust; Id: http://dx.doi.org/10.13039/100004440Funder: Medical Research Council; Id: http://dx.doi.org/10.13039/501100000265Funder: UKRIFunder: University of Nottingham; Id: http://dx.doi.org/10.13039/501100000837In this paper, we present work on SARS-CoV-2 transmission in UK higher education settings using multiple approaches to assess the extent of university outbreaks, how much those outbreaks may have led to spillover in the community, and the expected effects of control measures. Firstly, we found that the distribution of outbreaks in universities in late 2020 was consistent with the expected importation of infection from arriving students. Considering outbreaks at one university, larger halls of residence posed higher risks for transmission. The dynamics of transmission from university outbreaks to wider communities is complex, and while sometimes spillover does occur, occasionally even large outbreaks do not give any detectable signal of spillover to the local population. Secondly, we explored proposed control measures for reopening and keeping open universities. We found the proposal of staggering the return of students to university residence is of limited value in terms of reducing transmission. We show that student adherence to testing and self-isolation is likely to be much more important for reducing transmission during term time. Finally, we explored strategies for testing students in the context of a more transmissible variant and found that frequent testing would be necessary to prevent a major outbreak.This work was supported by EPSRC grant no EP/R014604/1. The authors would also like to thank the Virtual Forum for Knowledge Exchange in Mathematical Sciences (V-KEMS) for the support during the workshop Unlocking higher education Spaces – What Might Mathematics Tell Us? where work on this paper was undertaken. K.J.B. acknowledges support from a University of Nottingham Anne McLaren Fellowship. E.L.F. acknowledges support via K.J.B.’s fellowship and the Nottingham BBSRC Doctoral Training Partnership. M.L.T. was supported by the UK Engineering and Physical Sciences Research Council (grant no. EP/N509620/1). E.B.-P., E.J.N., L.D., J.R.G. and M.J.T. were supported by UKRI through the JUNIPER modelling consortium (grant no. MR/V038613/1). E.M.H., L.D. and M.J.T. were supported by the Medical Research Council through the COVID-19 Rapid Response Rolling Call (grant no. MR/V009761/1). H.B.S. is funded by the Wellcome Trust and the Royal Society (grant no. 202562/Z/16/Z). J.E. is partially funded by the UK Engineering and Physical Sciences Research Council (grant no. EP/T004878/1)
Influence of Contact Definitions in Assessment of the Relative Importance of Social Settings in Disease Transmission Risk
BACKGROUND: Realistic models of disease transmission incorporating complex population heterogeneities require input from quantitative population mixing studies. We use contact diaries to assess the relative importance of social settings in respiratory pathogen spread using three measures of person contact hours (PCH) as proxies for transmission risk with an aim to inform bipartite network models of respiratory pathogen transmission. METHODS AND FINDINGS: Our survey examines the contact behaviour for a convenience sample of 65 adults, with each encounter classified as occurring in a work, retail, home, social, travel or "other" setting. The diary design allows for extraction of PCH-interaction (cumulative time in face-face conversational or touch interaction with contacts)--analogous to the contact measure used in several existing surveys--as well as PCH-setting (product of time spent in setting and number of people present) and PCH-reach (product of time spent in setting and number of people in close proximity). Heterogeneities in day-dependent distribution of risk across settings are analysed using partitioning and cluster analyses and compared between days and contact measures. Although home is typically the highest-risk setting when PCH measures isolate two-way interactions, its relative importance compared to social and work settings may reduce when adopting a more inclusive contact measure that considers the number and duration of potential exposure events. CONCLUSIONS: Heterogeneities in location-dependent contact behaviour as measured by contact diary studies depend on the adopted contact definition. We find that contact measures isolating face-face conversational or touch interactions suggest that contact in the home dominates, whereas more inclusive contact measures indicate that home and work settings may be of higher importance. In the absence of definitive knowledge of the contact required to facilitate transmission of various respiratory pathogens, it is important for surveys to consider alternative contact measures
Recommended from our members
Individual common variants exert weak effects on the risk for autism spectrum disorders.
While it is apparent that rare variation can play an important role in the genetic architecture of autism spectrum disorders (ASDs), the contribution of common variation to the risk of developing ASD is less clear. To produce a more comprehensive picture, we report Stage 2 of the Autism Genome Project genome-wide association study, adding 1301 ASD families and bringing the total to 2705 families analysed (Stages 1 and 2). In addition to evaluating the association of individual single nucleotide polymorphisms (SNPs), we also sought evidence that common variants, en masse, might affect the risk. Despite genotyping over a million SNPs covering the genome, no single SNP shows significant association with ASD or selected phenotypes at a genome-wide level. The SNP that achieves the smallest P-value from secondary analyses is rs1718101. It falls in CNTNAP2, a gene previously implicated in susceptibility for ASD. This SNP also shows modest association with age of word/phrase acquisition in ASD subjects, of interest because features of language development are also associated with other variation in CNTNAP2. In contrast, allele scores derived from the transmission of common alleles to Stage 1 cases significantly predict case status in the independent Stage 2 sample. Despite being significant, the variance explained by these allele scores was small (Vm< 1%). Based on results from individual SNPs and their en masse effect on risk, as inferred from the allele score results, it is reasonable to conclude that common variants affect the risk for ASD but their individual effects are modest
Measurement of nuclear effects in neutrino-argon interactions using generalized kinematic imbalance variables with the MicroBooNE detector
We present a set of new generalized kinematic imbalance variables that can be measured in neutrino scattering. These variables extend previous measurements of kinematic imbalance on the transverse plane and are more sensitive to modeling of nuclear effects. We demonstrate the enhanced power of these variables using simulation and then use the MicroBooNE detector to measure them for the first time. We report flux-integrated single- and double-differential measurements of charged-current muon neutrino scattering on argon using a topology with one muon and one proton in the final state as a function of these novel kinematic imbalance variables. These measurements allow us to demonstrate that the treatment of charged current quasielastic interactions in genie version 2 is inadequate to describe data. Further, they reveal tensions with more modern generator predictions particularly in regions of phase space where final state interactions are important
A novel approach of homozygous haplotype sharing identifies candidate genes in autism spectrum disorder
Autism spectrum disorder (ASD) is a highly heritable disorder of complex and heterogeneous aetiology. It is primarily characterized by altered cognitive ability including impaired language and communication skills and fundamental deficits in social reciprocity. Despite some notable successes in neuropsychiatric genetics, overall, the high heritability of ASD (~90%) remains poorly explained by common genetic risk variants. However, recent studies suggest that rare genomic variation, in particular copy number variation, may account for a significant proportion of the genetic basis of ASD. We present a large scale analysis to identify candidate genes which may contain low-frequency recessive variation contributing to ASD while taking into account the potential contribution of population differences to the genetic heterogeneity of ASD. Our strategy, homozygous haplotype (HH) mapping, aims to detect homozygous segments of identical haplotype structure that are shared at a higher frequency amongst ASD patients compared to parental controls. The analysis was performed on 1,402 Autism Genome Project trios genotyped for 1 million single nucleotide polymorphisms (SNPs). We identified 25 known and 1,218 novel ASD candidate genes in the discovery analysis including CADM2, ABHD14A, CHRFAM7A, GRIK2, GRM3, EPHA3, FGF10, KCND2, PDZK1, IMMP2L and FOXP2. Furthermore, 10 of the previously reported ASD genes and 300 of the novel candidates identified in the discovery analysis were replicated in an independent sample of 1,182 trios. Our results demonstrate that regions of HH are significantly enriched for previously reported ASD candidate genes and the observed association is independent of gene size (odds ratio 2.10). Our findings highlight the applicability of HH mapping in complex disorders such as ASD and offer an alternative approach to the analysis of genome-wide association data
The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy
Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations.
Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves.
Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p 90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score.
Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care
- …