35 research outputs found

    Global circulation patterns of seasonal influenza viruses vary with antigenic drift.

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    Understanding the spatiotemporal patterns of emergence and circulation of new human seasonal influenza virus variants is a key scientific and public health challenge. The global circulation patterns of influenza A/H3N2 viruses are well characterized, but the patterns of A/H1N1 and B viruses have remained largely unexplored. Here we show that the global circulation patterns of A/H1N1 (up to 2009), B/Victoria, and B/Yamagata viruses differ substantially from those of A/H3N2 viruses, on the basis of analyses of 9,604 haemagglutinin sequences of human seasonal influenza viruses from 2000 to 2012. Whereas genetic variants of A/H3N2 viruses did not persist locally between epidemics and were reseeded from East and Southeast Asia, genetic variants of A/H1N1 and B viruses persisted across several seasons and exhibited complex global dynamics with East and Southeast Asia playing a limited role in disseminating new variants. The less frequent global movement of influenza A/H1N1 and B viruses coincided with slower rates of antigenic evolution, lower ages of infection, and smaller, less frequent epidemics compared to A/H3N2 viruses. Detailed epidemic models support differences in age of infection, combined with the less frequent travel of children, as probable drivers of the differences in the patterns of global circulation, suggesting a complex interaction between virus evolution, epidemiology, and human behaviour.T.B. was supported by a Newton International Fellowship from the Royal Society and through NIH U54 GM111274. S.R. was supported by MRC (UK, Project MR/J008761/1), Wellcome Trust (UK, Project 093488/Z/10/Z), Fogarty International Centre (USA, R01 TW008246‐01), DHS (USA, RAPIDD program), NIGMS (USA, MIDAS U01 GM110721‐01) and NIHR (UK, Health Protection Research Unit funding). The Melbourne WHO Collaborating Centre for Reference and Research on Influenza was supported by the Australian Government Department of Health and thanks N. Komadina and Y.‐M. Deng. The Atlanta WHO Collaborating Center for Surveillance, Epidemiology and Control of Influenza was supported by the U.S. Department of 13 Health and Human Services. NIV thanks A.C. Mishra, M. Chawla‐Sarkar, A.M. Abraham, D. Biswas, S. Shrikhande, AnuKumar B, and A. Jain. Influenza surveillance in India was expanded, in part, through US Cooperative Agreements (5U50C1024407 and U51IP000333) and by the Indian Council of Medical Research. M.A.S. was supported through NSF DMS 1264153 and NIH R01 AI 107034. Work of the WHO Collaborating Centre for Reference and Research on Influenza at the MRC National Institute for Medical Research was supported by U117512723. P.L., A.R. & M.A.S were supported by EU Seventh Framework Programme [FP7/2007‐2013] under Grant Agreement no. 278433-­‐PREDEMICS and ERC Grant agreement no. 260864. C.A.R. was supported by a University Research Fellowship from the Royal Society.This is the author accepted manuscript. It is currently under infinite embargo pending publication of the final version

    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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    Trade-offs among planned versus performed activity patterns

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    This paper focuses on the development of a methodology to identify the latent factors leading to changes in the planned itineraries of travellers that result in their actual activity patterns. Specifically, we propose a way to utilise patterns of activities established by individuals across multiple days to generate possible alternative actions by these individuals when faced with conditions that produce a discrepancy between performed and planned patterns on a particular day. The choice alternatives, which are unobserved, are inferred by rules applied to comprehensive multiday data collected in Belgium, consisting of information regarding planned activity itineraries, performed activity/travel diaries, and demographics of travellers. These data are utilised to analyse and explore the underlying reasons preventing individuals from performing their planned activities on a given day, and to identify the influential parameters that lead individuals to trade their planned patterns with those actually performed. Using multiday data, we generate all possible combinations of categories of activities – mandatory, maintenance, discretionary, and pickup/drop off activities – that can form patterns for individuals. Under the assumption that the performed patterns have the closest utility to the planned patterns, we estimate the latent factors that influence travellers’ time use behaviour using a multinomial probit choice structure in which the covariance structure of the choice alternatives is specified in terms of the overlap in activities. We further identify the ‘costs’ associated with making changes in planned agenda (replacing, inserting, or deleting an activity). These penalty values are estimated using ‘Parallel Genetic Algorithm’, where the fitness function is the likelihood function estimated under the multinomial choice model structure. The results show that individuals’ mobility decisions related to mandatory activities are more robust than those associated with their non-mandatory counterparts
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