Early warning of vulnerable counties in a pandemic using socio-economic variables.
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ABSTRACT:
SUBMITTER: Ruck DJ
PROVIDER: S-EPMC8054145 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Comparison of whole blood DNA methylation in 45 year-old humans with low and high childhood and adulthood socio-economic position Background: Disadvantaged socio-economic position (SEP) in childhood is associated with increased adult mortality and morbidity. We aimed to establish whether childhood SEP was associated with differential methylation of adult DNA. Methods: Forty adult males from the 1958 British Birth Cohort Study were selected from SEP extremes in both early childhood and mid-adulthood. We performed genome-wide methylation analysis on blood DNA taken at 45y using MeDIP (methylated DNA immunoprecipitation). We mapped in triplicate the methylation state of promoters of ~20,000 genes and 400 microRNAs. Probe methylation scores were averaged across triplicates and differential methylation between groups of individuals was determined. Differentially methylated promoter sites of selected genes were validated using pyrosequencing of bisulfite-converted DNA. Results: 9,112 variably methylated probes (from N=223,359 on the microarray) corresponded to 6,176 gene promoters with at least one variable probe. Unsupervised hierarchical clustering of probes obtained from the 500 most variable promoters revealed a cluster enriched with high SEP individuals confirming that SEP differences contribute to overall epigenetic variation. Methylation levels for 1252 gene promoters were associated with childhood SEP vs 545 promoters for adulthood SEP. Functionally, associations with childhood SEP appear in promoters of genes enriched in key cell signalling pathways. The differentially methylated promoters associated with SEP cluster in megabase-sized regions of the genome. Conclusions: Adult blood DNA methylation profiles show more associations with childhood SEP than adult SEP. Organization of these associations across the genome suggests a well-defined epigenetic pattern linked to early socio-economic environment.
2016-05-25 | GSE31713 | GEO
Project description:Controlling the pandemic spread of newly emerging diseases requires rapid, targeted allocation of limited resources among nations. Critical, early control steps would be greatly enhanced if the key risk factors can be identified that accurately predict early disease spread immediately after emergence.Here, we examine the role of travel, trade, and national healthcare resources in predicting the emergence and initial spread of 2009 A/H1N1 influenza. We find that incorporating national healthcare resource data into our analyses allowed a much greater capacity to predict the international spread of this virus. In countries with lower healthcare resources, the reporting of 2009 A/H1N1 cases was significantly delayed, likely reflecting a lower capacity for testing and reporting, as well as other socio-political issues. We also report substantial international trade in live swine and poultry in the decade preceding the pandemic which may have contributed to the emergence and mixed genotype of this pandemic strain. However, the lack of knowledge of recent evolution of each H1N1 viral gene segment precludes the use of this approach to determine viral origins.We conclude that strategies to prevent pandemic influenza virus emergence and spread in the future should include: 1) enhanced surveillance for strains resulting from reassortment in traded livestock; 2) rapid deployment of control measures in the initial spreading phase to countries where travel data predict the pathogen will reach and to countries where lower healthcare resources will likely cause delays in reporting. Our results highlight the benefits, for all parties, when higher income countries provide additional healthcare resources for lower income countries, particularly those that have high air traffic volumes. In particular, international authorities should prioritize aid to those poorest countries where both the risk of emerging infectious diseases and air traffic volume is highest. This strategy will result in earlier detection of pathogens and a reduction in the impact of future pandemics.
| S-EPMC2939898 | biostudies-literature
Project description:Sex differences in mortality vary over time and place as a function of social, health, and medical circumstances. The magnitude of these variations, and their response to large socioeconomic changes, suggest that biological differences cannot fully account for sex differences in survival. Drawing on a wide swath of mortality data across countries and over time, we develop a set of empiric observations with which any theory about excess male mortality and its correlates will have to contend. We show that as societies develop, M/F survival first declines and then increases, a "sex difference in mortality transition" embedded within the demographic and epidemiologic transitions. After the onset of this transition, cross-sectional variation in excess male mortality exhibits a consistent pattern of greater female resilience to mortality under socio-economic adversity. The causal mechanisms underlying these associations merit further research.
| S-EPMC5757782 | biostudies-literature
Project description:This study investigates the relationship between socio-economic determinants pre-dating the pandemic and the reported number of cases, deaths, and the ratio of deaths/cases in 199 countries/regions during the first months of the COVID-19 pandemic. The analysis is performed by means of machine learning methods. It involves a portfolio/ensemble of 32 interpretable models and considers the case in which the outcome variables (number of cases, deaths, and their ratio) are independent and the case in which their dependence is weighted based on geographical proximity. We build two measures of variable importance, the Absolute Importance Index (AII) and the Signed Importance Index (SII) whose roles are to identify the most contributing socio-economic factors to the variability of the COVID-19 pandemic. Our results suggest that, together with the established influence on cases and deaths of the level of mobility, the specific features of the health care system (smart/poor allocation of resources), the economy of a country (equity/non-equity), and the society (religious/not religious or community-based vs not) might contribute to the number of COVID-19 cases and deaths heterogeneously across countries.
| S-EPMC8334639 | biostudies-literature
Project description:Epilepsies of early childhood are frequently resistant to therapy and often associated with cognitive and behavioural comorbidity. Aetiology focused precision medicine, notably gene-based therapies, may prevent seizures and comorbidities. Epidemiological data utilizing modern diagnostic techniques including whole genome sequencing and neuroimaging can inform diagnostic strategies and therapeutic trials. We present a 3-year, multicentre prospective cohort study, involving all children under 3 years of age in Scotland presenting with epilepsies. We used two independent sources for case identification: clinical reporting and EEG record review. Capture-recapture methodology was then used to improve the accuracy of incidence estimates. Socio-demographic and clinical details were obtained at presentation, and 24 months later. Children were extensively investigated for aetiology. Whole genome sequencing was offered for all patients with drug-resistant epilepsy for whom no aetiology could yet be identified. Multivariate logistic regression modelling was used to determine associations between clinical features, aetiology, and outcome. Three hundred and ninety children were recruited over 3 years. The adjusted incidence of epilepsies presenting in the first 3 years of life was 239 per 100 000 live births [95% confidence interval (CI) 216-263]. There was a socio-economic gradient to incidence, with a significantly higher incidence in the most deprived quintile (301 per 100 000 live births, 95% CI 251-357) compared with the least deprived quintile (182 per 100 000 live births, 95% CI 139-233), χ2 odds ratio = 1.7 (95% CI 1.3-2.2). The relationship between deprivation and incidence was only observed in the group without identified aetiology, suggesting that populations living in higher deprivation areas have greater multifactorial risk for epilepsy. Aetiology was determined in 54% of children, and epilepsy syndrome was classified in 54%. Thirty-one per cent had an identified genetic cause for their epilepsy. We present novel data on the aetiological spectrum of the most commonly presenting epilepsies of early childhood. Twenty-four months after presentation, 36% of children had drug-resistant epilepsy (DRE), and 49% had global developmental delay (GDD). Identification of an aetiology was the strongest determinant of both DRE and GDD. Aetiology was determined in 82% of those with DRE, and 75% of those with GDD. In young children with epilepsy, genetic testing should be prioritized as it has the highest yield of any investigation and is most likely to inform precision therapy and prognosis. Epilepsies in early childhood are 30% more common than previously reported. Epilepsies of undetermined aetiology present more frequently in deprived communities. This likely reflects increased multifactorial risk within these populations.
| S-EPMC8557326 | biostudies-literature
Project description:BackgroundDisadvantaged socio-economic position (SEP) in childhood is associated with increased adult mortality and morbidity. We aimed to establish whether childhood SEP was associated with differential methylation of adult DNA.MethodsForty adult males from the 1958 British Birth Cohort Study were selected from SEP extremes in both early childhood and mid-adulthood. We performed genome-wide methylation analysis on blood DNA taken at 45 years using MeDIP (methylated DNA immunoprecipitation). We mapped in triplicate the methylation state of promoters of approximately 20,000 genes and 400 microRNAs. Probe methylation scores were averaged across triplicates and differential methylation between groups of individuals was determined. Differentially methylated promoter sites of selected genes were validated using pyrosequencing of bisulfite-converted DNA.ResultsVariably methylated probes (9112 from n = 223,359 on the microarray) corresponded to 6176 gene promoters with at least one variable probe. Unsupervised hierarchical clustering of probes obtained from the 500 most variable promoters revealed a cluster enriched with high SEP individuals confirming that SEP differences contribute to overall epigenetic variation. Methylation levels for 1252 gene promoters were associated with childhood SEP vs 545 promoters for adulthood SEP. Functionally, associations with childhood SEP appear in promoters of genes enriched in key cell signalling pathways. The differentially methylated promoters associated with SEP cluster in megabase-sized regions of the genome.ConclusionsAdult blood DNA methylation profiles show more associations with childhood SEP than adult SEP. Organization of these associations across the genome suggests a well-defined epigenetic pattern linked to early socio-economic environment.
| S-EPMC3304522 | biostudies-literature
Project description:Previous pandemics have rarely affected everyone equally and, so far, the COVID-19 pandemic is no exception. Emerging evidence has shown that incidence rate, hospitalisation rate, and mortality due to COVID-19 are higher among people in lower socio-economic position (SEP). In addition, first investigations indicate that not everyone is equally affected by this pandemic's collateral public health damage. Using a stratified random sample of 1,004 participants living in Vienna, a Central European city with approximately 1.9 million inhabitants, this study analysed the distribution of 10 adverse health-related and socio-economic outcomes attributable to the COVID-19 pandemic across socio-economic strata. To this end, we estimated differences in the incidence rate of these outcomes by SEP and each of its indicators using zero-inflated Poisson and logistic regression models, adjusted for age and gender. Data were collected during first lockdown measures between 27 April and 17 May 2020. Differences in the incidence rate between the two lowest and two highest SEP groups were clearly visible. Participants in the lowest SEP category had a 32.96% higher incidence rate (IRR = 1.333 [95% CI: 1.079-1.639]), and participants in the second lowest SEP category had a 44.69% higher incidence rate (IRR = 1.447 [95% CI: 1.190-1.760]) compared with participants in the highest SEP category. In sum, 6 out of 10 adverse COVID-19-related outcomes were, to a greater or lesser extent, disproportionately experienced by Viennese residents in lower SEP. Inequalities were most visible between income groups and for the outcomes job loss, worsening of the financial situation, and worse mental health. These results strengthen and extend the current evidence on the unequally distributed burden of the COVID-19 pandemic. In light of effect heterogeneity across SEP indicators, we encourage future investigators to pay increased attention to their operationalisation of SEP. Such awareness will help to correctly identify those in most urgent need of supportive polices.
| S-EPMC8444637 | biostudies-literature
Project description:BackgroundIn many countries, the worldwide spread of COVID-19 has led to a near total stop of non-urgent, elective surgeries across all specialties during the first wave's peak of the pandemic. For providers of aesthetic surgery procedures or minimal invasive cosmetic treatments, this led to a huge socio-economic impact worldwide. In order to evaluate valid clinical management strategies for future pandemic events and to overcome the challenges imposed by the current pandemic, it is paramount to analyse the socio-economic effects caused by the COVID-19 crisis.MethodsAn online survey comprising 18 questions was sent out five times by e-mail to all members of the International Society of Aesthetic Plastic Surgery (ISAPS) between June and August 2020. The data set was statistically analyzed and grouped into an overall group and into subgroups of countries with high (n = 251) vs. low (n = 440) gross domestic product per capita (GDP p.c.) and five defined world regions (Europe (n = 214); North America (NA; n = 97); South America (SA; n = 206); Asia and Oceania (Asia + OC; n = 99); Africa and Middle East (Africa + ME; n = 75)).ResultsA total of 691 recipients completed the survey. The majority of the participants experienced severe operating restrictions resulting in a major drop of income from surgical patients. Low GDP p.c. countries experienced a bigger negative economic impact with less aesthetic (non-) surgical procedures, whereas the high GDP p.c. subgroup was less affected by the COVID-19 crisis. Most of the survey participants had already adopted the ISAPS guidelines for patient (pre-) appointment screening and clinical/patient-flow management. For surgical and non-surgical aesthetic procedures, in the high GDP p.c. subgroup more basic-level PPE (surgical mask) was used, whereas the low GDP p.c. subgroup relied more on advanced-level PPE (N-95 respirator mask or higher). Comparing the different world regions, Europe and Africa used more basic-level PPE.ConclusionsMeasurable differences in the socio-economic impact and in the adaptation of safety protocols between high and low GDP p.c. subgroups and between different world regions were present. Since the COVID-19 pandemic is an international crisis, aligned, expedient and universal actions should be taken.Level of evidence vThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine Ratings, please refer to Table of Contents or online Instructions to Authors www.springer.com/00266 .
| S-EPMC8029606 | biostudies-literature
Project description:ObjectiveThe aim of this paper was to evaluate socio-economic factors associated to poor primary care utilization by studying two specific subjects: the hospital readmission rate, and the use of the Emergency Department (ED) for non-urgent visits.MethodsThe study was carried out by the analysis of administrative database for hospital readmission and with a specific survey for non-urgent ED use.ResultsAmong the 416,698 sampled admissions, 6.39% (95% CI, 6.32-6.47) of re-admissions have been registered; the distribution shows a high frequency of events in the age 65-84 years group, and in the intermediate care hospitals (51.97%; 95%CI 51.37-52.57). The regression model has shown the significant role played by age, type of structure (geriatric acute care), and deprivation index of the area of residence on the readmission, however, after adjusting for the intensity of primary care, the role of deprivation was no more significant. Non-urgent ED visits accounted for the 12.10%, (95%CI 9.38-15.27) of the total number of respondents to the questionnaire (N = 504). The likelihood of performing a non-urgent ED visit was higher among patients aged <65 years (OR 3.2, 95%CI 1.3-7.8 p = 0.008), while it was lower among those perceiving as urgent their health problem (OR 0.50, 95%CI 0.30-0.90).ConclusionsIn the Italian context repeated readmissions and ED utilization are linked to different trajectories, besides the increasing age and comorbidity of patients are the factors that are related to repeated admissions, the self-perceived trust in diagnostic technologies is an important risk factor in determining ED visits. Better use of public national health care service is mandatory, since its correct utilization is associated to increasing equity and better health care utilization.
| S-EPMC4468197 | biostudies-literature
Project description:In this study, the measured accelerations of a single smartphone were used to provide an earthquake early warning system. In the presented system, after the smartphone is triggered, the triggering event is then classified as an earthquake event or not. Once an earthquake event is detected, the peak ground acceleration is then predicted every second until 10 s after the trigger. These predictions are made by the neural network classifier and predictor embedded in the smartphone, and an alert can be issued if a large peak ground acceleration is predicted. The proposed system is unique among approaches that use crowdsourcing ideas for earthquake early warning because the proposed system provides on-site earthquake early warning. In general, the accuracy rates of the earthquake classifications and peak ground acceleration predictions of the system were quite high according to the results of large amounts of earthquake and non-earthquake data. More specifically, according to said earthquake data, 96.9% of the issued alerts would be correct and 61.9% of the earthquakes that exceeded the threshold would have resulted in an alert being issued before the arrival of the peak ground acceleration. Among the false negative cases, approximate 97.8% would occur because of negative lead time. Using the shake table tests of worldwide and Meinong earthquake datasets, the proposed approach is confirmed to be quite promising.
| S-EPMC7285340 | biostudies-literature