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| Open AccessAn analysis of 45 large-scale wastewater sites in England to estimate SARS-CoV-2 community prevalence
Wastewater surveillance could provide a means of monitoring SARS-CoV-2 prevalence that does not rely on testing individuals. Here, the authors report results from England’s national wastewater surveillance program, use it to estimate prevalence, and compare estimates with those from population-based prevalence surveys.
- Mario Morvan
- , Anna Lo Jacomo
- & Leon Danon
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| Open AccessStress-testing the resilience of the Austrian healthcare system using agent-based simulation
As mass quarantines, absences due to sickness, or other shocks thin out patient-physician networks, the system might be pushed to a tipping point where it loses its ability to deliver care. Here, the authors propose a data-driven framework to quantify regional resilience to such shocks via an agent-based model.
- Michaela Kaleta
- , Jana Lasser
- & Peter Klimek
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| Open AccessEmergency triage of brain computed tomography via anomaly detection with a deep generative model
Triage is essential for the early diagnosis and reporting of emergency patients in the emergency department. Here, the authors develop an anomaly detection algorithm with a deep generative model that reprioritizes radiology worklists and provides lesion attention maps for brain CT images with critical findings.
- Seungjun Lee
- , Boryeong Jeong
- & Namkug Kim
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| Open AccessThe Medical Segmentation Decathlon
International challenges have become the de facto standard for comparative assessment of image analysis algorithms. Here, the authors present the results of a biomedical image segmentation challenge, showing that a method capable of performing well on multiple tasks will generalize well to a previously unseen task.
- Michela Antonelli
- , Annika Reinke
- & M. Jorge Cardoso
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| Open AccessGenomic epidemiology of Delta SARS-CoV-2 during transition from elimination to suppression in Aotearoa New Zealand
Aotearoa New Zealand pursued a COVID-19 elimination strategy until October 2021 when it moved to a suppression strategy. In this genomic surveillance study, the authors describe spread of the virus during the transition between these strategies, with evidence of substantial undetected community transmission.
- Lauren Jelley
- , Jordan Douglas
- & Jemma L. Geoghegan
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| Open AccessThe effect of COVID certificates on vaccine uptake, health outcomes, and the economy
Many countries introduced COVID certificates that were required to access public venues. Here, the authors analyse data from France, Germany, and Italy, and estimate that these policies led to increased vaccine uptake of 6-13 percentage points with subsequent beneficial impacts on health and economic outcomes.
- Miquel Oliu-Barton
- , Bary S. R. Pradelski
- & Guntram B. Wolff
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| Open AccessPopulation genomics of ancient and modern Trichuris trichiura
The whipworm Trichuris trichiura is a soil-transmitted helminth that causes the neglected tropical disease trichuriasis in humans. Here, the authors produce whole genome sequences of modern and ancient samples from humans and non-human primates to characterise the genomic diversity and evolution of this pathogen.
- Stephen R. Doyle
- , Martin Jensen Søe
- & Christian Moliin Outzen Kapel
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| Open AccessInferring the epidemiological benefit of indoor vector control interventions against malaria from mosquito data
Estimating the effectiveness of malaria vector control interventions has typically relied on resource-intensive cluster randomised trials. Here, the authors estimate changes in malaria prevalence using entomological data from experimental hut trials, which may provide an alternative route to approval of interventions in some situations.
- Ellie Sherrard-Smith
- , Corine Ngufor
- & Thomas S. Churcher
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Article
| Open AccessSelf-evolving vision transformer for chest X-ray diagnosis through knowledge distillation
Although deep learning-based computer-aided diagnosis systems have recently achieved expert level performance, developing a robust model requires large, high-quality data with annotations. Here, the authors present a framework which can improve the performance of vision transformer simultaneously with self-supervision and self-training.
- Sangjoon Park
- , Gwanghyun Kim
- & Jong Chul Ye
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Article
| Open AccessRevisiting COVID-19 vaccine hesitancy around the world using data from 23 countries in 2021
Vaccine hesitancy is a public health challenge. Here the authors examine COVID-19 vaccine hesitancy in June 2021 using a survey including individuals from 23 countries, and report differences compared to a year earlier.
- Jeffrey V. Lazarus
- , Katarzyna Wyka
- & Ayman El-Mohandes
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| Open AccessEffect of vaccination on household transmission of SARS-CoV-2 Delta variant of concern
COVID-19 vaccines may reduce the susceptibility of an individual to infection and/or the infectiousness of breakthrough infections. Here, the authors use data from Denmark and estimate that vaccine effectiveness was 61% for susceptibility and 31% for infectiousness during a period of Delta variant dominance.
- Frederik Plesner Lyngse
- , Kåre Mølbak
- & Carsten Thure Kirkeby
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Article
| Open AccessTPGS-based and S-thanatin functionalized nanorods for overcoming drug resistance in Klebsiella pneumonia
Overproduction of efflux pumps represents an important mechanism of Klebsiella pneumonia resistance to tigecycline. Here, the authors design TPGS- and S-thanatin functionalized nanorods loaded with tigecycline to increase drug accumulation inside bacteria and overcome bacterial resistance.
- Xiaojuan Wang
- , Xiaoling Xu
- & Saiping Jiang
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| Open AccessCOVID-19 disease severity in US Veterans infected during Omicron and Delta variant predominant periods
Infection with the SARS-CoV-2 Omicron variant appears to cause milder disease in the general population than infection with Delta. Here the authors use data from the US Department of Veterans Affairs and demonstrate that this also applies to infection in an at-risk population of older age and with more co-morbidities.
- Florian B. Mayr
- , Victor B. Talisa
- & Adeel A. Butt
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Article
| Open AccessAge and sex-specific risks of myocarditis and pericarditis following Covid-19 messenger RNA vaccines
There have been reports of myocarditis and pericarditis following mRNA COVID-9 vaccination. Here, the authors use nationwide data from France and find increased risks of these outcomes in the first week following vaccination, for both the first and second dose, and present age- and sex-specific rates.
- Stéphane Le Vu
- , Marion Bertrand
- & Mahmoud Zureik
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| Open AccessEffective high-throughput RT-qPCR screening for SARS-CoV-2 infections in children
Dewald et al. combine a non-invasive sampling approach (Lolli-Test) with an RT qPCR-pool testing strategy to screen for SARS-CoV-2 infections in children and use the method for surveillance and infection control in > 4000 school and daycare settings.
- Felix Dewald
- , Isabelle Suárez
- & Florian Klein
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| Open AccessContribution of low population immunity to the severe Omicron BA.2 outbreak in Hong Kong
Hong Kong experienced a severe wave of SARS-CoV-2 in early 2022. Here, the authors use genomic and serosurveillance data and show that this wave was dominated by the Omicron BA.2 sublineage, and that low protective immunity, particularly in older age groups, contributed to its severity.
- Lin-Lei Chen
- , Syed Muhammad Umer Abdullah
- & Kelvin Kai-Wang To
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Article
| Open AccessAugmented ultrasonography with implanted CMOS electronic motes
Ultrasound has had tremendous success in medical imaging. Here, Zhang et al demonstrate a batteryless implantable CMOS mote, to further augment the potential of ultrasound, providing additional information via the backscattering of the acoustic waves used in ultrasound imaging.
- Yihan Zhang
- , Prashant Muthuraman
- & Kenneth L. Shepard
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Comment
| Open AccessOpportunities to tackle structural racism and ethnicity-based discrimination in recovering and rebuilding from the COVID-19 pandemic
The impact of COVID-19 has been disproportionately felt by populations experiencing structural racial- and ethnicity-based discrimination. Here, the authors describe opportunities for COVID-19 response and recovery efforts to help build more equal and resilient societies.
- Natalia Linos
- , Mary T. Bassett
- & Theadora Swift Koller
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| Open AccessWaning effectiveness of the third dose of the BNT162b2 mRNA COVID-19 vaccine
In this retrospective study, authors show that relative protection against SARS-CoV-2 infection wanes from 53.4% one month after vaccination to 16.5% three months after vaccination, suggesting that there is a significant waning of mRNA vaccine effectiveness against infection with the Omicron variant.
- Tal Patalon
- , Yaki Saciuk
- & Sivan Gazit
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| Open AccessMitigation of SARS-CoV-2 transmission at a large public university
Safely opening university campuses has been a major challenge during the COVID-19 pandemic. Here, the authors describe a program of public health measures employed at a university in the United States which, combined with other non-pharmaceutical interventions, allowed the university to stay open in fall 2020 with limited evidence of transmission.
- Diana Rose E. Ranoa
- , Robin L. Holland
- & Martin D. Burke
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| Open AccessDisease-economy trade-offs under alternative epidemic control strategies
Pandemic control policy requires balancing economic and disease outcomes. This study develops a joint modeling approach that allows both aspects to be considered simultaneously and shows that targeted isolation is superior economically and can achieve similar disease outcomes to voluntary isolation or blanket lockdowns.
- Thomas Ash
- , Antonio M. Bento
- & Ana I. Bento
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| Open AccessCross-sectional seroprevalence surveys of SARS-CoV-2 antibodies in children in Germany, June 2020 to May 2021
Children are less likely to be infected with SARS-CoV-2 and develop less severe disease than adults, which makes estimation of infection rates challenging. Here, the authors conduct seroprevalence surveys of children in Germany, describe changes in prevalence over time, and identify risk factors for infection.
- Anna-Lisa Sorg
- , Leon Bergfeld
- & Horst Schroten
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| Open AccessUntangling the changing impact of non-pharmaceutical interventions and vaccination on European COVID-19 trajectories
Non-pharmaceutical interventions (NPIs) and COVID-19 vaccination have been implemented concurrently, making their relative effects difficult to measure. Here, the authors show that effects of NPIs reduced as vaccine coverage increased, but that NPIs could still be important in the context of more transmissible variants.
- Yong Ge
- , Wen-Bin Zhang
- & Shengjie Lai
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| Open AccessWhole genome sequencing reveals hidden transmission of carbapenemase-producing Enterobacterales
Carbapenemase-producing Enterobacterales cause healthcare-associated infections but modes of transmission are not well understood. Here, the authors find evidence of transmission without direct patient contact, indicating presence of undetected environmental reservoirs, whilst half of the transmission events are likely due to plasmid-mediated transmission.
- Kalisvar Marimuthu
- , Indumathi Venkatachalam
- & Oon Tek Ng
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| Open AccessA framework for reconstructing SARS-CoV-2 transmission dynamics using excess mortality data
Testing capacity continues to limit detection of COVID-19 infections and impacts reliability of mortality estimates. Here, the authors develop a statistical model to estimate COVID-19 attributable deaths using all-cause mortality data from Iran and estimate that around half of these deaths have been reported.
- Mahan Ghafari
- , Oliver J. Watson
- & Aris Katzourakis
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Article
| Open AccessNon-selective distribution of infectious disease prevention may outperform risk-based targeting
Pre-exposure prophylaxis (PrEP) is an effective HIV prevention measure but identifying those most at risk to target for treatment is challenging. Here, the authors demonstrate that non-selective PrEP distribution outperforms targeted strategies when use is not consistent, and/or prevalence of untreated HIV is high.
- Benjamin Steinegger
- , Iacopo Iacopini
- & Eugenio Valdano
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| Open AccessWireless implantable optical probe for continuous monitoring of oxygen saturation in flaps and organ grafts
Although continuous monitoring of tissue oxygenation is critically important after tissue/organ graft procedures, current technologies have key limitations. Here, the authors develop a miniaturized, minimally invasive, self-anchoring optical probe and demonstrate continuous monitoring of oxygenation in porcine flap and organ models.
- Hexia Guo
- , Wubin Bai
- & John A. Rogers
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Article
| Open AccessA lncRNA signature associated with tumor immune heterogeneity predicts distant metastasis in locoregionally advanced nasopharyngeal carcinoma
Long noncoding RNAs (lncRNAs) can be used for the development of prognostic signatures to predict tumour metastasis. Here the authors identify an immune-associated nine-lncRNA signature for predicting metastasis in a multicentre cohort of locoregionally advanced nasopharyngeal cancer patients.
- Ye-Lin Liang
- , Yuan Zhang
- & Na Liu
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| Open AccessCombining rapid antigen testing and syndromic surveillance improves community-based COVID-19 detection in a low-income country
Rapid antigen tests and syndromic surveillance for identification of COVID-19 cases are limited by low sensitivity and specificity, respectively. Here, the authors use data from Bangladesh and show that combining the two methods improves diagnostic accuracy in a range of epidemiological scenarios.
- Fergus J. Chadwick
- , Jessica Clark
- & Ayesha Sania
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| Open AccessSeeking patterns of antibiotic resistance in ATLAS, an open, raw MIC database with patient metadata
Pathogens are typically classified as ‘antibiotic-resistant’ for clinical purposes based on cut-off values of minimum inhibitory concentrations (MICs). In this study, the authors explore quantitative values of MICs using the global ‘ATLAS’ database of pathogen-antibiotic pairs, describe trends in resistance, and compare results to other antibiotic resistance surveillance data.
- Pablo Catalán
- , Emily Wood
- & Robert E. Beardmore
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| Open AccessOff-season RSV epidemics in Australia after easing of COVID-19 restrictions
Non-pharmaceutical interventions for COVID-19 also reduced incidence of respiratory pathogens such as respiratory syncytial virus (RSV). Here, the authors report the resurgence of RSV in Australia following lifting of some of the restrictions and describe reduction in genetic diversity in circulating clades.
- John-Sebastian Eden
- , Chisha Sikazwe
- & Tyna Tran
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| Open AccessElimination of human rabies in Goa, India through an integrated One Health approach
Dog vaccination is an effective rabies prevention measure, but widespread vaccination campaigns are challenging in settings like India with large free-roaming dog populations. Here, the authors describe a One Health campaign in Goa state which led to a large reduction of cases in dogs and elimination in humans.
- A. D. Gibson
- , G. Yale
- & R. J. Mellanby
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| Open AccessLarge-scale GWAS of food liking reveals genetic determinants and genetic correlations with distinct neurophysiological traits
Genetic determinants of food consumption and food liking are likely to be distinct, although it has not been well studied. Here, the authors identify genetic variants associated with food-liking, finding that different food-liking traits correlate with different brain areas and other food consumption traits.
- Sebastian May-Wilson
- , Nana Matoba
- & Nicola Pirastu
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| Open AccessIntelligent wireless theranostic contact lens for electrical sensing and regulation of intraocular pressure
Towards intelligent treatment for glaucoma, here authors demonstrate integrated wireless theranostic contact lenses for in situ electrical sensing of intraocular pressure and on demand anti-glaucoma drug delivery.
- Cheng Yang
- , Qianni Wu
- & Xi Xie
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Comment
| Open AccessA broader perspective on the economics of malaria prevention and the potential impact of SARS-CoV-2
Economic evaluations of public health interventions to prevent malaria should consider the adoption of wider perspectives and the inclusion of non-health impacts, particularly economic development outcomes, such as education. This is especially relevant in malaria elimination settings and in the context of the current SARS-CoV-2 pandemic.
- Elisa Sicuri
- , Francesco Ramponi
- & Francisco Saúte
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| Open AccessHeterologous immunization with inactivated vaccine followed by mRNA-booster elicits strong immunity against SARS-CoV-2 Omicron variant
Emerging SARS-CoV-2 variants of concern (VOCs) raises concerns regarding vaccine efficacy. Here, the authors evaluate the neutralizing antibody, and cellular response elicited following inactivated vaccine immunization, and mRNA booster, against the Omicron variant.
- Fanglei Zuo
- , Hassan Abolhassani
- & Qiang Pan-Hammarström
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| Open AccessPrecisely translating computed tomography diagnosis accuracy into therapeutic intervention by a carbon-iodine conjugated polymer
Poly(diiododiacetylene)—PIDA—contains iodine atoms, which are commonly found in computed tomography contrast agents. Here, the authors find that PIDA can function as a contrast agent and can also be used as a visual marker to delineate tumour margins.
- Mingming Yin
- , Xiaoming Liu
- & Liang Luo
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| Open AccessSystematic review and meta-analysis of the effectiveness and perinatal outcomes of COVID-19 vaccination in pregnancy
Pregnant women have been disproportionately under-vaccinated against COVID-19, partly because they were excluded from initial trials. This systematic review and meta-analysis supports efficacy of vaccination in pregnancy, and finds no evidence of adverse maternal or perinatal outcomes.
- Smriti Prasad
- , Erkan Kalafat
- & Asma Khalil
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| Open AccessGenetic diversity of SARS-CoV-2 infections in Ghana from 2020-2021
In this genomic epidemiology study from Ghana, the authors sequence ~1,000 SARS-CoV-2 whole genomes from March 2020 to September 2021. They describe changes in the predominant circulating lineages over time and infer how variants of concern were likely introduced into the country.
- Collins M. Morang’a
- , Joyce M. Ngoi
- & Gordon A. Awandare
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| Open AccessUsing sero-epidemiology to monitor disparities in vaccination and infection with SARS-CoV-2
Continued monitoring of SARS-CoV-2 at the population level is important for identifying at-risk groups. Here the authors analyse data from a serological surveillance platform in San Francisco and find considerable variation in infection and vaccination history by race/ethnicity and socioeconomic status.
- Isobel Routledge
- , Saki Takahashi
- & Isabel Rodríguez-Barraquer
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| Open AccessComparative effectiveness over time of the mRNA-1273 (Moderna) vaccine and the BNT162b2 (Pfizer-BioNTech) vaccine
In this retrospective cohort study, Islam et al. estimate the effectiveness of two mRNA-based COVID-19 vaccines in over 3.5 million fully vaccinated individuals and find no differences in vaccine effectiveness for protection against hospitalization, ICU admission, or death/hospice transfer.
- Nazmul Islam
- , Natalie E. Sheils
- & Kenneth Cohen
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Article
| Open AccessTrends and associated factors for Covid-19 hospitalisation and fatality risk in 2.3 million adults in England
In this retrospective cohort study, the authors investigate the risk of hospitalisation and death for all adults in England who tested positive for COVID-19 from October 2020–April 2021. They find that the risk of hospitalisation and death varied substantially over time after taking into account individual risk factors.
- T. Beaney
- , A. L. Neves
- & J. Clarke
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Article
| Open AccessComparing COVID-19-related hospitalization rates among individuals with infection-induced and vaccine-induced immunity in Israel
The relative degree of immunity to SARS-CoV-2 provided by combinations of natural infection, vaccination, and booster doses is unknown. Here, the authors show that infection-induced immunity provides more protection against COVID-19-related hospitalization than non-recent vaccine immunity, but less than booster vaccination.
- Jacob G. Waxman
- , Maya Makov-Assif
- & Noam Barda
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Article
| Open AccessEconomic shocks predict increases in child wasting prevalence
Economic shocks may lead to food insecurity and therefore acute child malnutrition (wasting). Here, the authors use data from Demographic Health Surveys to estimate impacts of past economic shocks on wasting and project possible effects of shocks related to the COVID-19 pandemic.
- Derek D. Headey
- & Marie T. Ruel
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| Open AccessA fully automatic AI system for tooth and alveolar bone segmentation from cone-beam CT images
Accurate delineation of individual teeth and alveolar bones from dental cone-beam CT images is an essential step in digital dentistry for precision dental healthcare. Here, the authors present a deep learning system for efficient, precise, and fully automatic segmentation of real-patient CBCT images presenting highly variable appearances.
- Zhiming Cui
- , Yu Fang
- & Dinggang Shen
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Article
| Open AccessCommunication-efficient federated learning via knowledge distillation
This work presents a communication-efficient federated learning method that saves a major fraction of communication cost. It reveals the advantage of reciprocal learning in machine knowledge transfer and the evolutional low-rank properties of deep model updates.
- Chuhan Wu
- , Fangzhao Wu
- & Xing Xie
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Article
| Open AccessNon-metallic T2-MRI agents based on conjugated polymers
The toxicity of heavy metals for MRI contrast agents is an issue. Here, the authors report on the development of conjugated polymers nanoparticles based on paramagnetic polypyrrole to generate T2 MRI contrast effects by changing the interactions between polarons and water protons.
- Qinrui Lin
- , Yuhong Yang
- & Zhengzhong Shao
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Comment
| Open AccessAnalysing the relationship between the fields of thermo- and electrocatalysis taking hydrogen peroxide as a case study
Research in thermo- and electrocatalysis have often preceded in isolation, even for similar reactions. Here, the authors compare current trends in both fields and elaborate on the commonalities and differences with a specific focus on the production of hydrogen peroxide.
- Guilherme V. Fortunato
- , Enrico Pizzutilo
- & Marc Ledendecker
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| Open AccessProtection following BNT162b2 booster in adolescents substantially exceeds that of a fresh 2-dose vaccine
This study compares SARS-CoV-2 infection rates following a recent second or third dose of the BNT162b2 (Pfizer/BioNTech) vaccine. They use data from Israel for 12–14 year olds (second dose) and 16–18 year olds (third dose), and find a 3.7-fold higher risk in the second-dose group.
- Ofra Amir
- , Yair Goldberg
- & Ron Milo