A Salmonid EST Genomic Study: Genes, Duplications, Phylogeny and Microarrays

Background: Salmonids are of interest because of their relatively recent genome duplication, and their extensive usein wild fisheries and aquaculture. A comprehensive gene list and a comparison of genes in some of the different speciesprovide valuable genomic information for one of the most widely studied groups of fish.Results: 298,304 expressed sequence tags (ESTs) from Atlantic salmon (69% of the total), 11,664 chinook, 10,813sockeye, 10,051 brook trout, 10,975 grayling, 8,630 lake whitefish, and 3,624 northern pike ESTs were obtained in thisstudy and have been deposited into the public databases. Contigs were built and putative full-length Atlantic salmonclones have been identified. A database containing ESTs, assemblies, consensus sequences, open reading frames, genepredictions and putative annotation is available. The overall similarity between Atlantic salmon ESTs and those of rainbowtrout, chinook, sockeye, brook trout, grayling, lake whitefish, northern pike and rainbow smelt is 93.4, 94.2, 94.6, 94.4,92.5, 91.7, 89.6, and 86.2% respectively. An analysis of 78 transcript sets show Salmo as a sister group to Oncorhynchusand Salvelinus within Salmoninae, and Thymallinae as a sister group to Salmoninae and Coregoninae within Salmonidae.Extensive gene duplication is consistent with a genome duplication in the common ancestor of salmonids. Using all of theavailable EST data, a new expanded salmonid cDNA microarray of 32,000 features was created. Cross-specieshybridizations to this cDNA microarray indicate that this resource will be useful for studies of all 68 salmonid species.Conclusion: An extensive collection and analysis of salmonid RNA putative transcripts indicate that Pacific salmon,Atlantic salmon and charr are 94–96% similar while the more distant whitefish, grayling, pike and smelt are 93, 92, 89 and86% similar to salmon. The salmonid transcriptome reveals a complex history of gene duplication that is consistent withan ancestral salmonid genome duplication hypothesis. Genome resources, including a new 32 K microarray, providevaluable new tools to study salmonids

Understanding COVID-19 Dynamics and the Effects of Interventions in the Philippines: A Mathematical Modelling Study

Background COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries; possibly because of differing demographics; socioeconomics; surveillance; and policy responses. Here; we investigate the role of multiple factors on COVID-19 dynamics in the Philippines; a LMIC that has had a relatively severe COVID-19 outbreak. Methods We applied an age-structured compartmental model that incorporated time-varying mobility; testing; and personal protective behaviors (through a “Minimum Health Standards” policy; MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon; Central Visayas; and the National Capital Region). We estimated effects of control measures; key epidemiological parameters; and interventions. Findings Population age structure; contact rates; mobility; testing; and MHS were sufficient to explain the Philippines epidemic based on the good fit between modelled and reported cases; hospitalisations; and deaths. The model indicated that MHS reduced the probability of transmission per contact by 13-27%. The February 2021 case detection rate was estimated at ~8%; population recovered at ~9%; and scenario projections indicated high sensitivity to MHS adherence. Interpretation COVID-19 dynamics in the Philippines are driven by age; contact structure; mobility; and MHS adherence. Continued compliance with low-cost MHS should help the Philippines control the epidemic until vaccines are widely distributed; but disease resurgence may be occurring due to a combination of low population immunity and detection rates and new variants of concern

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Regression analyses of the Philippine birth weight distribution

Low birth weight has both short-term and long-term effects. It can lead to complications among infants causing neonatal deaths. Several literatures also suggested relationships between low birth weight and delayed mental and physical development. These negative effects are further magnified in developing countries, one of which is the Philippines. In this paper, birth weight is analysed through logistic, ordinary least squares, and quantile regression techniques using a sample from the 2008 National Demographic and Health Survey. Quantile regression results offer a more dynamic picture of how these correlates affect the conditional distribution of birth weight. The estimates of the marginal effects of several demographical and maternal health correlates of birth weight suggest that socially and economically impoverished mothers are more likely to have low birth weight babies. These results would recommend a focus on improving maternal health care through proper education

Some zero inflated Poisson-Based combined exponentially weighted moving average control charts for disease surveillance

© 2008 Philippine Statistical Association, Inc. One of the main areas of public health surveillance is infectious disease surveillance. With infectious disease backgrounds usually being more complex, appropriate surveillance schemes must be in order. One such procedure is through the use of control charts. However, with most background processes following a zero-inflated Poisson (ZIP) distribution as brought about by the extra variability due to excess zeros, the control charting procedures must be properly developed to address this issue. Hence in this paper, drawing inspiration from the development of combined control charting procedures for simultaneously monitoring each ZIP parameter individually in the context of statistical process control (SPC), several combined exponentially weighted moving average (EWMA) control charting procedures were proposed (Bernoulli-ZIP and CRL-ZTP EWMA charts). Through an extensive simulation study involving multiple parameter settings and outbreak model considerations (i.e., different shapes, magnitude, and duration), some key results were observed. These include the applicability of performing combined control charting procedures for disease surveillance with a ZIP background using EWMA techniques. For demonstration purposes, application with an actual data, using confirmed measles cases in the National Capital Region (NCR) from January 1, 2010 to January 14 2015, revealed the comparability of the Bernoulli-ZIP EWMA scheme to historical limits method currently in use

Biosurveillance of measles using control charts: A case study using National Capital Region laboratory confirmed measles counts from January 2009 to January 2014

This paper aims to explore early outbreak detection methods for measles. Two methods adapted from statistical process control were modified and used to fit biosurveillance, namely Shewhart and Exponentially Weighted Moving Average (EWMA) charts. Seven variations of such control charts are proposed: two under Shewhart chart (normal-based and zero-inflated Poisson (ZIP)-based) and five under EWMA charts (λs of 0.05, 0.10, 0.15, 0.20, and 0.25). To study the proposed charts, daily counts of laboratory confirmed cases of measles in the National Capital Region from 2009 until 2014 were utilized to characterize both the disease background and outbreak equations. During this time span, three measles outbreaks have transpired. The proposed charts, set at average time between false signals (ATFSs) of both one and two months, were evaluated and compared using performance metrics such as conditional expected delay (CED), proportion of true signals (PTS), proportions of detections in an outbreak (PDO), and probability of successful detection (PSD), computed from 500 sets of simulated data. It was found that ZIP-based Shewhart and EWMA with a λ of 0.05 work best for ATFSs of one and two months, respectively. Health-governing bodies may seek to explore the possible utilization of these charts to improve measles surveillance

A Novel Method for Rapid Mapping of the Spatial Intensity of Influenza Epidemics

ObjectiveUsing the epidemic of influenza type A in 2016 in Australia, we demonstrated a simple but statistically sound adaptive method of automatically representing the spatial intensity and evolution of an influenza epidemic that could be applied to a laboratory surveillance count data stream that does not have a denominator.IntroductionSurveillance of influenza epidemics is a priority for risk assessment and pandemic preparedness. Mapping epidemics can be challenging because influenza infections are incompletely ascertained, ascertainment can vary spatially, and often a denominator is not available. Rapid, more refined geographic or spatial intelligence could facilitate better preparedness and response.MethodsWeekly counts of persons with laboratory confirmed influenza type A infections in Australia in 2016 were analysed by 86 sub-state geographical areas. Weekly standardised epidemic intensity was represented by a z-score calculated using the standard deviation of below-median counts in the previous 52 weeks. A geographic information system was used to present the epidemic progression.ResultsThere were 79,628 notifications of influenza A infections included. Of these, 79,218 (99.5%) were allocated to a geographical area. The maps indicated areas of elevated epidemic intensity across Australia by week and area, that were consistent with the observed start, peak and decline of the epidemic when compared with weekly counts aggregated at the state and territory level. An example is shown in Figure 1.ConclusionsThe methods could be automated to rapidly generate spatially varying epidemic intensity maps using a surveillance data stream. This could improve local level epidemic intelligence in a variety of settings and for other diseases. It may also increase our understanding of geographic epidemic dynamics.