A comparison of dietary patterns derived by cluster and principal components analysis in a UK cohort of children

Background/Objectives: The objective of this study was to identify dietary patterns in a cohort of 7-year-old children through cluster analysis, compare with patterns derived by principal components analysis (PCA), and investigate associations with sociodemographic variables. Subjects/Methods: The main caregivers in the Avon Longitudinal Study of Parents and Children (ALSPAC) recorded dietary intakes of their children (8279 subjects) using a 94-item food frequency questionnaire. Items were then collapsed into 57 food groups. Dietary patterns were identified using k-means cluster analysis and associations with sociodemographic variables examined using multinomial logistic regression. Clusters were compared with patterns previously derived using PCA. Results: Three distinct clusters were derived: Processed (4177 subjects), associated with higher consumption of processed foods and white bread, Plant-based (2065 subjects), characterized by higher consumption of fruit, vegetables and non-white bread, and Traditional British (2037 subjects), associated with higher consumption of meat, vegetables and full-fat milk. Membership of the Processed cluster was positively associated with girls, younger mothers, snacking and older siblings. Membership of the Plant-based cluster was associated with higher educated mothers and vegetarians. The Traditional British cluster was associated with council housing and younger siblings. The three clusters were similar to the three dietary patterns obtained through PCA; each principal component score being higher on average in the corresponding cluster.Conclusions:Both cluster analysis and PCA identified three dietary patterns very similar both in the foods associated with them and sociodemographic characteristics. Both methods are useful for deriving meaningful dietary patterns. © 2011 Macmillan Publishers Limited All rights reserved

Changes in Invasive Pneumococcal Disease Caused by Streptococcus pneumoniae Serotype 1 Following Introduction of PCV10 and PCV13: Findings from the PSERENADE Project.

Streptococcus pneumoniae serotype 1 (ST1) was an important cause of invasive pneumococcal disease (IPD) globally before the introduction of pneumococcal conjugate vaccines (PCVs) containing ST1 antigen. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project gathered ST1 IPD surveillance data from sites globally and aimed to estimate PCV10/13 impact on ST1 IPD incidence. We estimated ST1 IPD incidence rate ratios (IRRs) comparing the pre-PCV10/13 period to each post-PCV10/13 year by site using a Bayesian multi-level, mixed-effects Poisson regression and all-site IRRs using a linear mixed-effects regression (N = 45 sites). Following PCV10/13 introduction, the incidence rate (IR) of ST1 IPD declined among all ages. After six years of PCV10/13 use, the all-site IRR was 0.05 (95% credibility interval 0.04–0.06) for all ages, 0.05 (0.04–0.05) for <5 years of age, 0.08 (0.06–0.09) for 5–17 years, 0.06 (0.05–0.08) for 18–49 years, 0.06 (0.05–0.07) for 50–64 years, and 0.05 (0.04–0.06) for ≥65 years. PCV10/13 use in infant immunization programs was followed by a 95% reduction in ST1 IPD in all ages after approximately 6 years. Limited data availability from the highest ST1 disease burden countries using a 3+0 schedule constrains generalizability and data from these settings are needed

The Four types of Tregs in malignant lymphomas

Regulatory T cells (Tregs) are a specialized subpopulation of CD4+ T cells, which act to suppress the activation of other immune cells. Tregs represent important modulators for the interaction between lymphomas and host microenvironment. Lymphomas are a group of serious and frequently fatal malignant diseases of lymphocytes. Recent studies revealed that some lymphoma T cells might adopt a Treg profile. Assessment of Treg phenotypes and genotypes in patients may offer prediction of outcome in many types of lymphomas including diffuse large B-cell lymphoma, follicular lymphoma, cutaneous T cell lymphoma, and Hodgkin's lymphoma. Based on characterized roles of Tregs in lymphomas, we can categorize the various roles into four groups: (a) suppressor Tregs; (b) malignant Tregs; (c) direct tumor-killing Tregs; and (d) incompetent Tregs. The classification into four groups is significant in predicting prognosis and designing Tregs-based immunotherapies for treating lymphomas. In patients with lymphomas where Tregs serve either as suppressor Tregs or malignant Tregs, anti-tumor cytotoxicity is suppressed thus decreased numbers of Tregs are associated with a good prognosis. In contrast, in patients with lymphomas where Tregs serve as tumor-killing Tregs and incompetent Tregs, anti-tumor cytotoxicity is enhanced or anti-autoimmune Tregs activities are weakened thus increased numbers of Tregs are associated with a good prognosis and reduced numbers of Tregs are associated with a poor prognosis. However, the mechanisms underlying the various roles of Tregs in patients with lymphomas remain unknown. Therefore, further research is needed in this regard as well as the utility of Tregs as prognostic factors and therapy strategies in different lymphomas

Adolescents’ beverage choice at school and the impact on sugar intake

Background/Objectives: To examine students’ beverage choice in school, with reference to its contribution to students’ intake of non-milk extrinsic (NME) sugars. Subjects/Methods: Beverage and food selection data for students aged 11–18 years (n=2461) were collected from two large secondary schools in England, for a continuous period of 145 (school A) and 125 (school B) school days. Descriptive analysis followed by cluster analysis of the beverage data were performed separately for each school. Results: More than a third of all items selected by students were beverages, and juice-based beverages were students’ most popular choice (school A, 38.6%; school B, 35.2%). Mean NME sugars derived from beverages alone was high (school A, 16.7 g/student-day; school B, 12.9 g/student-day). Based on beverage purchases, six clusters of students were identified at each school (school A: ‘juice-based’, ‘assorted’, ‘water’, ‘cartoned flavoured milk’, ‘bottled flavoured milk’, ‘high volume juice-based’; school B: ‘assorted’, ‘water with juice-based’, ‘sparkling juice/juice-based’, ‘water’, ‘high volume water’, ‘high volume juice-based’). Both schools included ‘high volume juice-based’ clusters with the highest NME sugar means from beverages (school A, 28.6 g/student-day; school B, 24.4 g/student-day), and ‘water’ clusters with the lowest. A hierarchy in NME sugars was found according to cluster; students in the ‘high volume juice-based’ cluster returned significantly higher levels of NME sugars than students in other clusters. Conclusions: This study reveals the contribution that school beverages combined with students’ beverage choice behaviour is making to students’ NME sugar intake. These findings inform school food initiatives, and more generally public health policy around adolescents’ dietary intake

Serotype distribution of remaining pneumococcal meningitis in the mature PCV10/13 period: Findings from the PSERENADE Project

Pneumococcal conjugate vaccine (PCV) introduction has reduced pneumococcal meningitis incidence. The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project described the serotype distribution of remaining pneumococcal meningitis in countries using PCV10/13 for least 5-7 years with primary series uptake above 70%. The distribution was estimated using a multinomial Dirichlet regression model, stratified by PCV product and age. In PCV10-using sites (N = 8; cases = 1141), PCV10 types caused 5% of cases <5 years of age and 15% among ≥5 years; the top serotypes were 19A, 6C, and 3, together causing 42% of cases <5 years and 37% ≥5 years. In PCV13-using sites (N = 32; cases = 4503), PCV13 types caused 14% in <5 and 26% in ≥5 years; 4% and 13%, respectively, were serotype 3. Among the top serotypes are five (15BC, 8, 12F, 10A, and 22F) included in higher-valency PCVs under evaluation. Other top serotypes (24F, 23B, and 23A) are not in any known investigational product. In countries with mature vaccination programs, the proportion of pneumococcal meningitis caused by vaccine-in-use serotypes is lower (≤26% across all ages) than pre-PCV (≥70% in children). Higher-valency PCVs under evaluation target over half of remaining pneumococcal meningitis cases, but questions remain regarding generalizability to the African meningitis belt where additional data are needed

Global landscape review of serotype-specific invasive pneumococcal disease surveillance among countries using PCV10/13: The pneumococcal serotype replacement and distribution estimation (PSERENADE) project

Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon

Feasibility of the Radner reading chards in low vision patients

Background: Being unable to read is a major problem for visually impaired patients. Since distance visual acuity (VA) does not adequately reflect reading ability, it is important to also evaluate near VA. The Radner Reading Charts (RRCs) are available to measure patients' reading performance. The present study tested the inter-chart and test-retest reliability of the RRCs in Dutch low-vision patients (i.e., visual acuity ≥0.3 logMAR) with various eye disorders. Methods: Thirty-eight patients read the three RRCs in random order. Then, about 1 month after the initial measurements, a test-retest procedure was performed in 15 of the 38 patients. Tested variables were reading acuity (logRAD), logRAD score, logRAD/logMAR ratio, maximum reading speed (MRS), and critical print size (CPS). Both MRS and CPS were calculated in two different ways. To determine the variability, a mixed-model analysis was used. Results: For all variables, the largest part of the variance was explained by the individual subject (86-89%) whereas the chart accounted for only 0-0.78% of the variability. Therefore, the inter-chart and test-retest reliability was high, except for the CPS which had a poor to moderate reliability (31-62%) when calculated in the two different ways. Conclusions: The inter-chart and test-retest results showed high reliability in patients with low vision due to various diseases; therefore, the charts are feasible to determine effects in large groups. © 2010 Springer-Verlag

A saturated map of common genetic variants associated with human height

Common single-nucleotide polymorphisms (SNPs) are predicted to collectively explain 40-50% of phenotypic variation in human height, but identifying the specific variants and associated regions requires huge sample sizes(1). Here, using data from a genome-wide association study of 5.4 million individuals of diverse ancestries, we show that 12,111 independent SNPs that are significantly associated with height account for nearly all of the common SNP-based heritability. These SNPs are clustered within 7,209 non-overlapping genomic segments with a mean size of around 90 kb, covering about 21% of the genome. The density of independent associations varies across the genome and the regions of increased density are enriched for biologically relevant genes. In out-of-sample estimation and prediction, the 12,111 SNPs (or all SNPs in the HapMap 3 panel(2)) account for 40% (45%) of phenotypic variance in populations of European ancestry but only around 10-20% (14-24%) in populations of other ancestries. Effect sizes, associated regions and gene prioritization are similar across ancestries, indicating that reduced prediction accuracy is likely to be explained by linkage disequilibrium and differences in allele frequency within associated regions. Finally, we show that the relevant biological pathways are detectable with smaller sample sizes than are needed to implicate causal genes and variants. Overall, this study provides a comprehensive map of specific genomic regions that contain the vast majority of common height-associated variants. Although this map is saturated for populations of European ancestry, further research is needed to achieve equivalent saturation in other ancestries.A large genome-wide association study of more than 5 million individuals reveals that 12,111 single-nucleotide polymorphisms account for nearly all the heritability of height attributable to common genetic variants