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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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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Article
| 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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| 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
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Article
| Open AccessThe role of sex work laws and stigmas in increasing HIV risks among sex workers
HIV incidence among sex workers remains high in many settings. Here, the authors utilize individual-level data across ten countries in sub-Saharan Africa and suggest that increasingly punitive and non-protective laws are associated with HIV, and that stigmas and sex work laws may operate jointly in increasing HIV risk.
- Carrie E. Lyons
- , Sheree R. Schwartz
- & Stefan Baral
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Article
| Open AccessA robust and efficient method for Mendelian randomization with hundreds of genetic variants
Mendelian randomization (MR) is a method for inferring causal relationships between risk factors and outcomes via associated genetic variants. Here, Burgess et al. develop the contamination mixture method which yields robust MR results in the presence of invalid instrumental variables and groups variants by their effect estimates.
- Stephen Burgess
- , Christopher N Foley
- & Joanna M. M. Howson
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Article
| Open AccessAntimicrobial resistant enteric bacteria are widely distributed amongst people, animals and the environment in Tanzania
Spread of antimicrobial-resistant (AR) bacteria is a global concern, but contributing factors remain unclear. Here, authors analyze distribution of AR bacteria in households from three ethnic groups in Tanzania and find that livelihood factors are more strongly associated with AR prevalence than antibiotic use.
- Murugan Subbiah
- , Mark A. Caudell
- & Douglas R. Call
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Article
| Open AccessGenome-wide association and Mendelian randomisation analysis provide insights into the pathogenesis of heart failure
Heart failure is a complex syndrome that is associated with many different underlying risk factors. Here, to increase power, the authors jointly analyse cases of heart failure of different aetiologies in a genome-wide association study and identify 11 loci of which ten had not been previously reported.
- Sonia Shah
- , Albert Henry
- & R. Thomas Lumbers
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Article
| Open AccessSelecting likely causal risk factors from high-throughput experiments using multivariable Mendelian randomization
Multivariable Mendelian randomization (MR) extends the standard MR framework to consider multiple risk factors in a single model. Here, Zuber et al. propose MR-BMA, a Bayesian variable selection approach to identify the likely causal determinants of a disease from many candidate risk factors as for example high-throughput data sets.
- Verena Zuber
- , Johanna Maria Colijn
- & Stephen Burgess
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Article
| Open AccessHigh-resolution micro-epidemiology of parasite spatial and temporal dynamics in a high malaria transmission setting in Kenya
Here, Nelson et al. use amplicon next-generation sequencing of two P. falciparum polymorphic gene regions to investigate the genetic similarity of parasite populations across time and space in a pediatric cohort in Kenya. They identify both micro- and macro-scale structuring of malaria parasites in this high-transmission setting, which could inform future intervention strategies.
- Cody S. Nelson
- , Kelsey M. Sumner
- & Wendy P. O’Meara
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Article
| Open AccessResolving the cause of recurrent Plasmodium vivax malaria probabilistically
Relapse, reinfection and recrudescence can all cause recurrent infection after treatment of Plasmodium vivax malaria in endemic areas, but are difficult to distinguish. Here the authors show that they can be differentiated probabilistically and thereby demonstrate the high efficacy of primaquine treatment in preventing relapse.
- Aimee R. Taylor
- , James A. Watson
- & Nicholas J. White
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Article
| Open AccessDeclines in HIV incidence among men and women in a South African population-based cohort
Here, the authors investigate the outcome of prevention services scale-up on HIV incidence in a South African large population-based HIV surveillance cohort with over a decade of follow-up and associate a 43% reduction in incidence to earlier male medical circumcision and increased levels of antiretroviral therapy coverage.
- Alain Vandormael
- , Adam Akullian
- & Frank Tanser
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Article
| Open AccessHPV infection and the genital cytokine milieu in women at high risk of HIV acquisition
Cervicovaginal inflammation and human papillomavirus (HPV) are separately associated with increased risk of HIV acquisition. Here the authors longitudinally profile 48 cervicovaginal cytokines and HPV status in a large observational HIV high-risk cohort, and show the same cytokines associate with HPV infection and HIV risk.
- Lenine J. P. Liebenberg
- , Lyle R. McKinnon
- & Quarraisha Abdool Karim
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Article
| Open AccessGenetic evidence for assortative mating on alcohol consumption in the UK Biobank
From observational studies, alcohol consumption behaviours are known to be correlated in spouses. Here, Howe et al. use partners’ genotypic information in a Mendelian randomization framework and show that a SNP in the ADH1B gene associates with partner’s alcohol consumption, suggesting that alcohol consumption affects mate choice.
- Laurence J. Howe
- , Daniel J. Lawson
- & Gibran Hemani
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Article
| Open AccessMulti-ancestry sleep-by-SNP interaction analysis in 126,926 individuals reveals lipid loci stratified by sleep duration
Sleep duration is associated with an adverse lipid profile. Here, the authors perform genome-wide gene-by-sleep interaction analysis and find 49 previously unreported lipid loci when considering short or long total sleep time.
- Raymond Noordam
- , Maxime M. Bos
- & Susan Redline
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Article
| Open AccessIntestinal microbiome composition and its relation to joint pain and inflammation
Alterations to the microbiome are now associated with various diseases. Here the authors analyze microbiomes from a large population based cohort and show positive correlations between abundance of Streptococcus spp. and osteoarthritis-related knee pain.
- Cindy G. Boer
- , Djawad Radjabzadeh
- & Joyce B. J. van Meurs