Health care

  • Article
    | Open Access

    Diarrhoea is a major cause of morbidity and mortality in China. Here, the authors present results from a large sentinel surveillance scheme from 217 hospitals in all 31 provinces in mainland China, including ~150,000 patients with acute diarrhoea and covering years 2009-2018.

    • Li-Ping Wang
    • , Shi-Xia Zhou
    •  & Jun Wang
  • Article
    | Open Access

    Sleep dysregulation has been linked to dementia, but it is unknown whether sleep duration earlier in life is associated with dementia risk. Here, the authors show higher dementia risk associated with short sleep duration (six hours or less) in a longitudinal study of middle and older age adults.

    • Séverine Sabia
    • , Aurore Fayosse
    •  & Archana Singh-Manoux
  • Article
    | Open Access

    Individuals vary considerably in how they are affected by stress. Here, the authors show that the severity of psychopathological symptoms triggered by prolonged real-life stress relate to fMRI-measured responsivity of the human brainstem arousal system and associated pupil responses.

    • Marcus Grueschow
    • , Nico Stenz
    •  & Birgit Kleim
  • Article
    | Open Access

    Estimating the effects of non-pharmaceutical interventions for COVID-19 is challenging, partly due to variations in testing. Here, the authors use viral sequence data as an alternative means of inferring intervention effects, and show that delays in implementation resulted in more severe epidemics.

    • Manon Ragonnet-Cronin
    • , Olivia Boyd
    •  & Erik Volz
  • Article
    | Open Access

    Large fissure eruptions can cause air pollution events when the volcanic plume returns to the same area after the initial advisory has been lifted. Here, the authors show that these events had a significant impact on health care usage in Iceland, and the impact was exacerbated when advisories were not issued successfully.

    • Hanne Krage Carlsen
    • , Evgenia Ilyinskaya
    •  & Thorolfur Gudnason
  • Article
    | Open Access

    Population-based studies of SARS-CoV-2 seroprevalence are needed to understand levels of immunity and antibody dynamics. Here, the authors show that the seroprevalence in Bonn, Germany was low (<1%) following the first epidemic wave, and that neutralising antibodies waned within a few months.

    • N. Ahmad Aziz
    • , Victor M. Corman
    •  & Monique M. B. Breteler
  • Article
    | Open Access

    COVID-19 has caused many healthcare systems to become overwhelmed, potentially impacting patient care. Here, the authors show that COVID-19-related in-hospital mortality rates in Israel increased in periods of moderate or high hospital load, independent of patient characteristics.

    • Hagai Rossman
    • , Tomer Meir
    •  & Malka Gorfine
  • Article
    | Open Access

    Contact tracing for a timely isolation of potentially infected individuals can be provided manually or via digital applications. Mancastroppa et al. show that in the combination of both procedures the manual tracing is dominant and allows for better detection of infection super-spreaders.

    • Marco Mancastroppa
    • , Claudio Castellano
    •  & Raffaella Burioni
  • Article
    | Open Access

    Radiographic imaging is routinely used to evaluate treatment response in solid tumors. Here, the authors present a multi-task deep learning approach that allows simultaneous tumor segmentation and response prediction from longitudinal images in a multi-center study on rectal cancer.

    • Cheng Jin
    • , Heng Yu
    •  & Ruijiang Li
  • Article
    | Open Access

    Favipiravir has broad-spectrum antiviral activity against a variety of RNA viruses. Here the authors investigate the safety, pharmacokinetics and anti-SARS-CoV-2 efficacy of different drug dosage in the a Syrian hamster model of infection and, combined with genetic analyses, they show that Favipiravir at high doses decrease viral infectivity while inducing the emergence of mutations in viral genomes, decreasing fitness.

    • Jean-Sélim Driouich
    • , Maxime Cochin
    •  & Antoine Nougairède
  • Article
    | Open Access

    Digital contact tracing is increasingly considered as one of the tools to control infectious disease outbreaks, in particular the COVID-19 epidemic. Here, the authors present a modeling framework informed by empirical high-resolution contact data to analyze the impact of digital contact tracing apps.

    • G. Cencetti
    • , G. Santin
    •  & B. Lepri
  • Article
    | Open Access

    The role of school-based contacts in the epidemiology of SARS-CoV-2 is incompletely understood. Here, the authors use an age-structured transmission model fitted to age-specific seroprevalence and hospital admission data to assess the effects of school-based measures during the COVID-19 pandemic in the Netherlands.

    • Ganna Rozhnova
    • , Christiaan H. van Dorp
    •  & Mirjam E. Kretzschmar
  • Article
    | Open Access

    Effective use of antimicrobials in both humans and animals is essential to help slow the emergence of antimicrobial resistance. Here, Singleton et al. present a randomised controlled trial demonstrating the efficacy of social norm messaging to reduce antibiotic prescription frequency in veterinary surgeries.

    • David A. Singleton
    • , Angela Rayner
    •  & Gina L. Pinchbeck
  • Article
    | Open Access

    Tropical cyclones can cause severe damage and can thus have devastating impacts on societies. Here, the authors use Medicare data to show that tropical cyclone exposure in the United States is associated with increased hospitalization rates for older adults from many different acute causes.

    • Robbie M. Parks
    • , G. Brooke Anderson
    •  & Marianthi-Anna Kioumourtzoglou
  • Perspective
    | Open Access

    Pain management is an extremely important topic both medically and socio-economically. Here the authors offer an overview of the use of degrading polymeric materials for delivery of pharmaceutical agents for pain management and offer a perspective of the future directions of the field.

    • Natasha C. Brigham
    • , Ru-Rong Ji
    •  & Matthew L. Becker
  • Article
    | Open Access

    Nanoparticles have been used to reduce the toxicity associated with chemotherapeutic agents. Here, the authors report a Z-scheme SnS1.68-WO2.41 nanocatalyst for photocatalytic generation of oxidative holes and hydrogen molecules for drug-free therapeutic strategy.

    • Bin Zhao
    • , Yingshuai Wang
    •  & Qianjun He
  • Article
    | Open Access

    COVID-19 might occur together with other natural disasters but frameworks to quantify collective effects is lacking. Here, the authors investigated the readiness of a healthcare system in the face of wildfire during an epidemic by assuming the COVID-19 pandemic occurred around the same time with the Camp Fire case in Butte Country California 2018/2019.

    • Emad M. Hassan
    •  & Hussam N. Mahmoud
  • Article
    | Open Access

    It is still challenging to make accurate diagnosis of biliary atresia (BA) with sonographic gallbladder images particularly in rural areas without relevant expertise. Here, the authors develop a diagnostic deep learning model which favourable performance in comparison with human experts in multi-center external validation.

    • Wenying Zhou
    • , Yang Yang
    •  & Luyao Zhou
  • Article
    | Open Access

    Ticks are an important vector of disease in China, posing threats to humans, livestock and wild animals. Here, Zhao et al. compile a database of the distributions of the 124 tick species known in China and 103 tick-borne pathogens and predict the additional suitable habitats for the predominant vector species.

    • Guo-Ping Zhao
    • , Yi-Xing Wang
    •  & Li-Qun Fang
  • Article
    | Open Access

    Monitoring of cerebral function in human neonates remains challenging. Here, the authors propose a bedside monitoring technique using functional ultrasound to identify markers of cerebral activity based on intrinsic functional connectivity for early brain function monitoring.

    • Jerome Baranger
    • , Charlie Demene
    •  & Mickael Tanter
  • Article
    | Open Access

    Pelvic radiographs (PXRs) are essential for detecting proximal femur and pelvis injuries in trauma patients, but none of the currently available algorithms can detect all kinds of trauma-related radiographic findings. Here, the authors develop a multiscale deep learning algorithm trained with weakly supervised point annotation.

    • Chi-Tung Cheng
    • , Yirui Wang
    •  & Le Lu
  • Article
    | Open Access

    The role of children in the spread of COVID-19 is not fully understood, and the circumstances under which schools should be opened are therefore debated. Here, the authors demonstrate protocols by which schools in France can be safely opened without overwhelming the healthcare system.

    • Laura Di Domenico
    • , Giulia Pullano
    •  & Vittoria Colizza
  • Article
    | Open Access

    Global warming is expected to increase mortality due to heat stress in many regions. Here, the authors asses how mortality due to high temperatures changes in China changes for different demographic groups and show that heat-related excess mortality is increasing under climate change, a process that is strongly amplified by population ageing.

    • Jun Yang
    • , Maigeng Zhou
    •  & Qiyong Liu
  • Article
    | Open Access

    New Zealand has been relatively successful in controlling COVID-19 due to implementation of strict non-pharmaceutical interventions. Here, the authors demonstrate a striking decline in reports of influenza and other non-influenza respiratory pathogens over winter months in which the interventions have been in place.

    • Q. Sue Huang
    • , Tim Wood
    •  & Richard J. Webby
  • Article
    | Open Access

    During the early phase of the COVID-19 pandemic there was a need for rapid dissemination of clinical findings. Here, Jung, Di Santo et al. perform a systematic review and cohort study providing evidence for lower methodological quality scores and faster time to publication of clinical studies related to COVID-19 than comparable studies.

    • Richard G. Jung
    • , Pietro Di Santo
    •  & Benjamin Hibbert
  • Article
    | Open Access

    Dexamethasone has been shown to have survival benefits for critically ill patients hospitalised with COVID-19 in the UK. Here, the authors estimated the number of lives that could be saved through a UK and global roll out of the drug and demonstrate that it is a cost-effective option.

    • Ricardo Águas
    • , Adam Mahdi
    •  & Mesulame Namedre
  • Article
    | Open Access

    Several strategies have been attempted to target immune suppressive populations in the tumor microenvironment. Here the authors show that folate receptor β-targeted CAR-T cells eliminate immunosuppressive tumor associated macrophages, promoting endogenous antitumor immune responses and adoptive T-cell therapy in pre-clinical models.

    • Alba Rodriguez-Garcia
    • , Rachel C. Lynn
    •  & Daniel J. Powell Jr.
  • Article
    | Open Access

    Spread of SARS-CoV-2 in the early phase of the pandemic has been driven by high population susceptibility, but virus sensitivity to climate may play a role in future outbreaks. Here, the authors simulate SARS-CoV-2 dynamics in winter assuming climate dependence is similar to an endemic coronavirus strain.

    • Rachel E. Baker
    • , Wenchang Yang
    •  & Bryan T. Grenfell
  • Article
    | Open Access

    Establishing the natural history of COVID-19 requires longitudinal data from population-based cohorts. Here, the authors use linked primary care, testing, and hospital data to describe the disease in ~100,000 individuals with a COVID-19 diagnosis among a population of ~5.5 million in Catalonia, Spain.

    • Edward Burn
    • , Cristian Tebé
    •  & Talita Duarte-Salles
  • Article
    | Open Access

    Test, trace, and isolate programmes are central to COVID-19 control. Here, Viola Priesemann and colleagues evaluate how to allocate scarce resources to keep numbers low, and find that if case numbers exceed test, trace and isolate capacity, there will be a self-accelerating spread.

    • Sebastian Contreras
    • , Jonas Dehning
    •  & Viola Priesemann
  • Article
    | Open Access

    The growing need for realism in addressing complex public health questions calls for accurate models of the human contact patterns that govern disease transmission. Here, the authors generate effective population-level contact matrices by using highly detailed macro (census) and micro (survey) data on key socio-demographic features.

    • Dina Mistry
    • , Maria Litvinova
    •  & Alessandro Vespignani
  • Article
    | Open Access

    Sparse testing early in the SARS-CoV-2 pandemic hinders estimation of the dates and origins of initial case importations. Here, the authors show that the main source of cases imported from China shifted from Wuhan to other Chinese cities by mid-February, especially for African locations.

    • Tigist F. Menkir
    • , Taylor Chin
    •  & Rene Niehus
  • Article
    | Open Access

    Pemphigoid diseases involve autoimmune mediated blistering and immunopathology of the upper dermis. Here, the authors implicate granzyme B in the immunopathology in multiple in vivo models of pemphigoid diseases and utilise a topical granzyme B inhibitor that attenuates disease phenotypes in vivo.

    • Sho Hiroyasu
    • , Matthew R. Zeglinski
    •  & David J. Granville
  • Article
    | Open Access

    Low-resource settings can face additional challenges in managing the COVID-19 pandemic. Here, the authors use mathematical modelling to investigate transmission in the state of Bahia, Brazil, and quantify control measures needed to prevent the hospital system becoming overwhelmed.

    • Juliane F. Oliveira
    • , Daniel C. P. Jorge
    •  & Roberto F. S. Andrade
  • Article
    | Open Access

    Contact tracing is critical to controlling COVID-19, but most protocols only “forward-trace” to notify people who were recently exposed. Using a stochastic branching-process model, the authors show that “bidirectional” tracing to identify infector individuals and their other infectees robustly improves outbreak control.

    • William J. Bradshaw
    • , Ethan C. Alley
    •  & Kevin M. Esvelt