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| Open AccessA systematic comprehensive longitudinal evaluation of dietary factors associated with acute myocardial infarction and fatal coronary heart disease
Environmental and dietary factors are known to play a role in the development of coronary heart disease. Here the authors apply a genomic-inspired methodology to Nurses’ Health Study data to explore comprehensively and agnostically the association of 257 nutrients and 117 foods with coronary heart disease risk.
- Soodabeh Milanlouei
- , Giulia Menichetti
- & Albert-László Barabási
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| Open AccessPost-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China
Large-scale population screening can provide insights to levels of ongoing SARS-CoV-2 transmission. Here, the authors report a citywide screening of ~10,000,000 residents of Wuhan and show that SARS-CoV-2 infection prevalence was very low five to eight weeks after the end of lockdown.
- Shiyi Cao
- , Yong Gan
- & Zuxun Lu
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| Open AccessDominant subtype switch in avian influenza viruses during 2016–2019 in China
In this study, the authors present a genomic surveillance of avian influenza genomes sampled from live poultry markets in China. They report that a number of variants have emerged since 2016 that pose an increased risk to humans. They highlight the importance of continuous genome surveillance of circulating influenza strains.
- Yuhai Bi
- , Juan Li
- & Weifeng Shi
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Article
| Open AccessA cross-sectional study of cardiovascular disease risk clustering at different socio-geographic levels in India
Despite its importance for the targeting of interventions, little is known about the degree to which cardiovascular risk factors cluster within different socio-geographic levels in South Asia. Here the authors report on a cross-sectional study identifying wide variations in the clustering between risk factors and socio-geographic levels in India.
- Anne C. Bischops
- , Jan-Walter De Neve
- & Pascal Geldsetzer
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| Open AccessInfection fatality rate of SARS-CoV2 in a super-spreading event in Germany
Here the authors present a SARS-CoV2 seroepidemiological observational study from a random, household-based study population in a small town in Germany, showing the effect of a super-spreading event on infection rate, severity, and potentially infection fatality rate.
- Hendrik Streeck
- , Bianca Schulte
- & Gunther Hartmann
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| Open AccessRisk of yellow fever virus transmission in the Asia-Pacific region
Yellow fever is absent from the Asia/Pacific region, despite presence of the mosquito vector. Here, the authors demonstrate that mosquitoes collected from field sites across the region are capable of transmitting yellow fever virus, indicating that vector competence is not a barrier to disease spread.
- Lucy de Guilhem de Lataillade
- , Marie Vazeille
- & Pei-Shi Yen
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Article
| Open AccessAssociations between blood type and COVID-19 infection, intubation, and death
Recent evidence has suggested that blood type may be associated with severe COVID-19. Here, the authors use data from ~14,000 individuals tested for SARS-CoV-2 at a New York City hospital, and find that certain ABO and Rh blood types are associated with infection, intubation, and death.
- Michael Zietz
- , Jason Zucker
- & Nicholas P. Tatonetti
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| Open AccessLow SARS-CoV-2 seroprevalence in blood donors in the early COVID-19 epidemic in the Netherlands
The Netherlands is a country highly affected by the COVID-19 pandemic. In this study, Slot, Hogema and colleagues report a low SARS-CoV-2 seroprevalence one month into the outbreak and provide insights into virus exposure by region and age group when widespread non-pharmaceutical interventions are in place.
- Ed Slot
- , Boris M. Hogema
- & Hans L. Zaaijer
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Article
| Open AccessCollider bias undermines our understanding of COVID-19 disease risk and severity
Many published studies of the current SARS-CoV-2 pandemic have analysed data from non-representative samples from populations. Here, using UK BioBank samples, Gibran Hemani and colleagues discuss the potential for such studies to suffer from collider bias, and provide suggestions for optimising study design to account for this.
- Gareth J. Griffith
- , Tim T. Morris
- & Gibran Hemani
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| Open AccessModelling transmission and control of the COVID-19 pandemic in Australia
There is ongoing debate about the effective combination of strategies for COIVD-19 control. Here, the authors use an agent-based model to quantify and compare several intervention strategies, and identify minimal levels of social distancing compliance required to control the epidemic in Australia.
- Sheryl L. Chang
- , Nathan Harding
- & Mikhail Prokopenko
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| Open AccessApplication of an analytical framework for multivariate mediation analysis of environmental data
Diverse toxicological mechanisms may mediate the impact of environmental toxicants on pregnancy outcomes. In this study the authors introduce an analytical framework for multivariate mediation analysis to identify mediation pathways in the relationship between environmental toxicants and gestational age at delivery.
- Max T. Aung
- , Yanyi Song
- & Bhramar Mukherjee
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| Open AccessRevealing fine-scale spatiotemporal differences in SARS-CoV-2 introduction and spread
In this study, the authors present an analysis of 247 full-genome SARS-CoV-2 sequences obtained from two communities in Wisconsin, USA, and report distinct patterns of viral spread. Their results suggest that patterns of SARS-CoV-2 transmission and spread may vary substantially, even between neighbouring communities.
- Gage K. Moreno
- , Katarina M. Braun
- & Thomas C. Friedrich
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| Open AccessFull genome viral sequences inform patterns of SARS-CoV-2 spread into and within Israel
In this study, Adi Stern and colleagues use full genome sequences of SARS-CoV-2 to look at the rate of infections in Israel. They report that social distancing had a significant effect on minimising the rate of transmission, and find evidence for transmission heterogeneity (superspreading events).
- Danielle Miller
- , Michael A. Martin
- & Adi Stern
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| Open AccessDisease burden and clinical severity of the first pandemic wave of COVID-19 in Wuhan, China
Here the authors analyze disease burden and clinical severity of COVID-19 during the first wave in Wuhan, China in comparison to past influenza virus pandemics and COVID-19 in the US and Canada. These estimates of symptomatic cases, medical consultations, hospitalizations and deaths should guide preparedness for this disease.
- Juan Yang
- , Xinhua Chen
- & Prof Hongjie Yu
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Article
| Open AccessMendelian randomization study of maternal influences on birthweight and future cardiometabolic risk in the HUNT cohort
Observationally, lower birthweight is a risk factor for cardiometabolic disease. Using Mendelian Randomization, the authors investigate whether maternal genetic factors that lower offspring birthweight also increase offspring cardiometabolic risk and show that the observational correlation is unlikely to be due to the intrauterine environment.
- Gunn-Helen Moen
- , Ben Brumpton
- & David M. Evans
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Article
| Open AccessThe seventh pandemic of cholera in Europe revisited by microbial genomics
Since 1970, several cholera outbreaks caused by the “seventh pandemic” (7PET) lineage have been reported in Europe. Here, the authors demonstrate that the outbreaks were caused by repeated introductions of 7PET into Europe, rather than local environmental sources.
- Mihaela Oprea
- , Elisabeth Njamkepo
- & François-Xavier Weill
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| Open AccessSynthesis and systematic review of reported neonatal SARS-CoV-2 infections
There are a growing number of reports of neonatal SARS-CoV-2 infections. Here, De Luca and colleagues systematically analyse 176 published cases to better understand the route of transmission, as well as the clinical features and outcomes of neonatal COVID-19.
- Roberto Raschetti
- , Alexandre J. Vivanti
- & Daniele De Luca
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| Open AccessSmell and taste changes are early indicators of the COVID-19 pandemic and political decision effectiveness
Syndromic surveillance for COVID-19 could help to identify areas with increasing transmission. Here, the authors show that increased reports of changes in smell and taste measured at the population level are correlated with the increased COVID-19-related hospital admissions.
- Denis Pierron
- , Veronica Pereda-Loth
- & Moustafa Bensafi
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| Open AccessSARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden
Healthcare workers may be at higher risk of SARS-CoV-2 infection than the general population. Here, the authors report 19% seroprevalence of SARS-CoV-2 antibodies among 2,149 employees in a Swedish hospital. Seroprevalence was associated with patient contact and higher than the seroprevalence in the community in same time period.
- Ann-Sofie Rudberg
- , Sebastian Havervall
- & Charlotte Thålin
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| Open AccessInference of person-to-person transmission of COVID-19 reveals hidden super-spreading events during the early outbreak phase
Although SARS-CoV-2 has spread rapidly, the contribution of super-spreading events to transmission is unclear. Here, the authors show that the number of secondary infections arising from an individual infection in the early phase of the outbreak was highly skewed, indicating that super-spreading events occurred.
- Liang Wang
- , Xavier Didelot
- & Yuhai Bi
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| Open AccessChanging travel patterns in China during the early stages of the COVID-19 pandemic
COVID-19-related travel restrictions were imposed in China around the same time as major annual holiday migrations, with unknown combined impacts on mobility patterns. Here, the authors show that restructuring of the travel network in response to restrictions was temporary, whilst holiday-related travel increased pressure on healthcare services with lower capacity.
- Hamish Gibbs
- , Yang Liu
- & Rosalind M. Eggo
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| Open AccessDeep phenotyping of 34,128 adult patients hospitalised with COVID-19 in an international network study
Detailed knowledge of the characteristics of COVID-19 patients helps with public health planning. Here, the authors use routinely-collected data from seven databases in three countries to describe the characteristics of >30,000 patients admitted with COVID-19 and compare them with those admitted for influenza in previous years.
- Edward Burn
- , Seng Chan You
- & Patrick Ryan
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| Open AccessSARS-CoV-2 seroprevalence and neutralizing activity in donor and patient blood
Highly accurate antibody tests for SARS-CoV-2 are needed for surveillance in low-prevalence populations. Here, the authors find seroprevalence of less than 1% in two San Francisco Bay Area populations at the beginning of April, and that seroreactivity is generally predictive of in vitro neutralising activity.
- Dianna L. Ng
- , Gregory M. Goldgof
- & Charles Y. Chiu
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| Open AccessReductions in commuting mobility correlate with geographic differences in SARS-CoV-2 prevalence in New York City
New York City is one of the areas most affected by the SARS-CoV-2 pandemic in the United States, and there has been large variation in rates of hospitalisation and death by city borough. Here, the authors show that boroughs with the largest reduction in daily commutes also had the lowest SARS-CoV-2 prevalence.
- Stephen M. Kissler
- , Nishant Kishore
- & Yonatan H. Grad
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| Open AccessEpidemiological and phylogenetic analysis reveals Flavobacteriaceae as potential ancestral source of tigecycline resistance gene tet(X)
Emergence of tigecycline-resistance tet(X) genes is of concern. Here, the authors determine tet(X) prevalence in more than 6,000 clinical Gram-negative bacterial isolates collected between 1994 to 2019 in hospitals in China and suggest that Flavobacteriaceae could be the potential ancestral source of the tigecycline resistance genes.
- Rong Zhang
- , Ning Dong
- & Sheng Chen
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| Open AccessA shared genetic contribution to breast cancer and schizophrenia
Schizophrenia has been associated with increased risk of breast cancer, yet the risk of schizophrenia following breast cancer is unclear. Here, the authors show a bidirectional association between breast cancer and schizophrenia in Sweden and a shared genetic contribution to both diseases.
- Donghao Lu
- , Jie Song
- & Unnur A. Valdimarsdóttir
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| Open AccessAn investigation of causal relationships between prediabetes and vascular complications
Prediabetes has been associated with diabetes complications, but these relationships may be confounded. Here the authors show, using genetic data in causal inference analyses, that prediabetes raises risk of coronary heart disease, but not other diabetes complications.
- Pascal M. Mutie
- , Hugo Pomares-Millan
- & Paul W. Franks
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Article
| Open AccessMiddle-aged individuals may be in a perpetual state of H3N2 influenza virus susceptibility
Influenza exposure in early childhood can affect the immune response to distinct viral strains later in life. Here, Gouma et al. show that contemporary 3c2.A H3N2 virus infections boost non-neutralizing H3N2 antibodies in middle-aged individuals, potentially leaving them vulnerable to recurrent infections.
- Sigrid Gouma
- , Kangchon Kim
- & Scott E. Hensley
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| Open AccessSubstantial underestimation of SARS-CoV-2 infection in the United States
Estimating the extent of SARS-CoV-2 infection in a population is challenging due to the limitations of testing. Here, the authors estimate that the true number of infections in the United States in mid-April was up to 20 times higher than the number of confirmed cases.
- Sean L. Wu
- , Andrew N. Mertens
- & Jade Benjamin-Chung
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| Open AccessDeveloping a COVID-19 mortality risk prediction model when individual-level data are not available
Identification of individuals at risk of severe COVID-19 disease could inform treatment and public health planning. Here, the authors develop and validate a risk prediction model for COVID-19 mortality in Israel by building a model for severe respiratory infection and recalibrating it using COVID-19 case fatality rates.
- Noam Barda
- , Dan Riesel
- & Noa Dagan
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Article
| Open AccessTracking the COVID-19 pandemic in Australia using genomics
Genome sequencing can be used to infer pathogen transmission dynamics and inform public health responses. Here, the authors sequence >1,200 SARS-CoV-2 samples from Victoria, Australia and find genomic support for the effectiveness of social restrictions in reducing transmission.
- Torsten Seemann
- , Courtney R. Lane
- & Benjamin P. Howden
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| Open AccessSerological identification of SARS-CoV-2 infections among children visiting a hospital during the initial Seattle outbreak
COVID-19 disease is less common in children than adults, but the extent to which SARS-CoV-2 infections are missed through symptom-driven testing is not well understood. In this study, the authors show that approximately 1% of children seeking care for reasons other than COVID-19 at a Seattle hospital in March/April 2020 were seropositive for SARS-CoV-2.
- Adam S. Dingens
- , Katharine H. D. Crawford
- & Jesse D. Bloom
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| Open AccessThe geography of COVID-19 spread in Italy and implications for the relaxation of confinement measures
Releasing COVID-19 lockdown measures risks increases in transmission. Here, the authors estimate the increase in transmission rate for different regions in Italy and estimate that isolation of 5.5% exposed and highly infectious individuals would be needed to compensate for a 40% increase in transmission.
- Enrico Bertuzzo
- , Lorenzo Mari
- & Andrea Rinaldo
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Article
| Open AccessFace mask use in the general population and optimal resource allocation during the COVID-19 pandemic
Recommendations regarding the use of face masks as a preventive measure for COVID-19 are inconsistent. Here, the authors show that optimal distribution of surgical-standard face masks in the population, or universal coverage of homemade face coverings, could reduce total infections and deaths.
- Colin J. Worby
- & Hsiao-Han Chang
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Matters Arising
| Open AccessReply to “Acid inhibitors and allergy: comorbidity, causation and confusion”
- Erika Jensen-Jarolim
- , Michael Kundi
- & Galateja Jordakieva
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Article
| Open AccessThe impact of the Syrian conflict on population well-being
The current Syrian conflict is considered a major humanitarian crisis. Here, the authors show a decline in population well-being with the onset of the conflict, and show how this decline compares to other populations experiencing wars, civil unrest or natural disasters.
- Felix Cheung
- , Amanda Kube
- & Gabriel M. Leung
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Article
| Open AccessModelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa
Plasmodium falciparum infection in pregnancy is a major cause of adverse pregnancy outcomes. Here, the authors combine performance estimates of standard rapid diagnostic tests with modelling to assess whether screening at antenatal visits improves upon current intermittent preventative therapy.
- Patrick G. T. Walker
- , Matt Cairns
- & Feiko O. ter Kuile
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Article
| Open AccessPatients with immune-mediated inflammatory diseases receiving cytokine inhibitors have low prevalence of SARS-CoV-2 seroconversion
Cytokine storm seems to be a common feature of severe COVID-19 pathology. Here, the authors show a reduced rate of SARS-CoV2 positivity in a large population of patients with immune-mediated inflammatory diseases if they are already being treated with cytokine or JAK inhibitors, indicating these treatments are safe to continue and are possibly protective against COVID19.
- David Simon
- , Koray Tascilar
- & Georg Schett
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Article
| Open AccessDecreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea
Malaria prevalence in Papua New Guinea has risen in recent years after almost a decade of decline. In this study, the authors demonstrate that long-lasting insecticidal nets used in the country that were manufactured since 2013 have significantly reduced bioefficacy.
- Rebecca Vinit
- , Lincoln Timinao
- & Stephan Karl
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Article
| Open AccessAvoiding dynastic, assortative mating, and population stratification biases in Mendelian randomization through within-family analyses
Family-based study designs have been applied to resolve confounding by population stratification, dynastic effects and assortative mating in genetic association analyses. Here, Brumpton et al. describe theory and simulations for overcoming such biases in Mendelian randomization through within-family studies.
- Ben Brumpton
- , Eleanor Sanderson
- & Neil M. Davies
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Article
| Open AccessSeroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital
Health care workers (HCW) are a high-risk population for SARS-CoV-2 infection. Here, the authors determine seroprevalence against SARS-CoV-2 in HCWs of a large Spanish reference hospital and find a cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) of 11%.
- Alberto L. Garcia-Basteiro
- , Gemma Moncunill
- & Carlota Dobaño
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Article
| Open AccessReconstructing Mayaro virus circulation in French Guiana shows frequent spillovers
Mayaro virus (MAYV) is an emerging arbovirus, but cross-reactivity with other alphaviruses makes analysis of its epidemiology difficult. Here, the authors develop an analytical framework to assess MAYV epidemiology and find evidence for an important sylvatic cycle and seroprevalences of up to 18% in some areas of French Guiana.
- Nathanaël Hozé
- , Henrik Salje
- & Simon Cauchemez
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Article
| Open AccessReversal of the seasonality of temperature-attributable mortality from respiratory diseases in Spain
Potential changes in the seasonality of temperature-attributable mortality due to climate warming have been poorly investigated. Here, the authors show that the projected decrease in the number of moderate and extreme cold days will not contribute to a further reduction of cold-attributable deaths.
- Hicham Achebak
- , Daniel Devolder
- & Joan Ballester
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Article
| Open AccessHigh residual carriage of vaccine-serotype Streptococcus pneumoniae after introduction of pneumococcal conjugate vaccine in Malawi
Impact of pneumococcal conjugate vaccines (PCV) in controlling carriage needs to be evaluated to inform vaccine policy. Here, Swarthout et al. show in a prospective rolling cross-sectional study in Malawi a high residual prevalence of vaccine-serotype S. pneumoniae 7 years after PCV introduction.
- Todd D. Swarthout
- , Claudio Fronterre
- & Robert S. Heyderman
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Article
| Open AccessThe phylogenetic landscape and nosocomial spread of the multidrug-resistant opportunist Stenotrophomonas maltophilia
Multidrug resistance of the opportunistic pathogen Stenotrophomonas maltophilia is an increasing problem. Here, analyzing strains from 22 countries, the authors show that the S. maltophilia complex is divided into 23 monophyletic lineages and find evidence for intra-hospital transmission.
- Matthias I. Gröschel
- , Conor J. Meehan
- & Thomas A. Kohl
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Article
| Open AccessGenome-wide association studies and Mendelian randomization analyses for leisure sedentary behaviours
Epidemiological studies have shown an association between sedentary behaviours and cardiovascular disease risk. Here, van de Vegte et al. perform GWAS for self-reported sedentary behaviours (TV watching, computer use, driving) and Mendelian randomization analyses to explore potential causal relationships with coronary artery disease.
- Yordi J. van de Vegte
- , M. Abdullah Said
- & Niek Verweij
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Article
| Open AccessMaternal carriage of Prevotella during pregnancy associates with protection against food allergy in the offspring
Incidence of food allergy in westernized populations is associated with low abundance of Prevotella. Here, the authors analyse the microbiome of a mother-infant prebirth cohort and find that maternal carriage, but not infant carriage, of P. copri during pregnancy predicts the absence of food allergy in the offspring.
- Peter J. Vuillermin
- , Martin O’Hely
- & Esther Bandala Sanchez
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Article
| Open AccessExploiting horizontal pleiotropy to search for causal pathways within a Mendelian randomization framework
In Mendelian randomization (MR) studies, one typically selects SNPs as instrumental variables that do not directly affect the outcome to avoid violation of MR assumptions. Here, Cho et al. present a framework, MR-TRYX, that leverages knowledge of such outliers of horizontal pleiotropy to identify putative causal relationships between exposure and outcome.
- Yoonsu Cho
- , Philip C. Haycock
- & Gibran Hemani
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Article
| Open AccessMigration, hotspots, and dispersal of HIV infection in Rakai, Uganda
HIV prevalence varies throughout Africa, but the contribution of migration remains unclear. Using population-based data from ~22,000 persons, Grabowski et al. show that HIV-positive migrants selectively migrate to high prevalence areas and that out-migrants from these areas geographically disperse.
- Mary Kate Grabowski
- , Justin Lessler
- & Ronald H. Gray