Scale Of Epidemic Research Articles

Thymoquinone: shield and sword against SARS-CoV-2

<img src=" https://s3.amazonaws.com/production.scholastica/article/12984/large/prnano_472020_mailch_ga.jpg?1590225540"> Since its emergence, the epidemic scale of the new coronavirus (SARS-CoV-2) has increased at an extraordinary rate. Governments, medical personnel, researchers, and companies work to the limits of their capabilities, in attempts to combat the virus. Companies are giving up current pro-jects and changing their activities to help with fighting the virus. In this difficult time, every piece of useful information is valuable. Here, we bring to the attention of the scientific and medical community thymoquinone (TQ), a substance mostly unknown to experts in Western countries, which holds the promise to help treat people infected with this novel virus by (1) by inhibiting its proliferation, (2) by killing it, (3) by killing the bacteria associated with pneumonia, (4) with its anti-inflammatory and (5) with its immunomodulatory effect – perhaps acting synergistically, or even as a prophylactic remedy to prevent SARS-CoV-2 infection. However, due to its hydro-phobicity, the systemic bioavailability of TQ is low. Nanocarriers targeting the lungs exist, and TQ has already been successfully used in nanomedicines targeting different organs except the lungs. Thus, there is not a long way to go. This is the challenge for nanomedicine. It was an an-ecdotal case report that stimulated the investigation of the therapeutic effect of TQ and the deri-vation of a mechanism for its dual antiviral action, applicable to COVID-19. Furthermore, by exploiting the material published on the antiviral effect of TQ, we compared its antiviral mecha-nism with that of chloroquine (CQ) and hydroxychloroquine (HCQ). Our analysis indicates that the antiviral action of TQ is similar and most likely superior to that of CQ and HCQ, however, apparently without the adverse effects reported for CQ and HCQ. The broad antiviral spectrum and the mechanism by which TQ presumably neutralizes the new virus justifies the hypothesis that TQ is effective in treating COVID-19. [READ ARTICLE](https://doi.org/10.33218/001c.12984)

Possible environmental effects on the spread of COVID-19 in China

At the end of 2019, a novel coronavirus, designated as SARS-CoV-2, emerged in Wuhan, China and was identified as the causal pathogen of COVID-19. The epidemic scale of COVID-19 has increased dramatically, with confirmed cases increasing across China and globally. Understanding the potential affecting factors involved in COVID-19 transmission will be of great significance in containing the spread of the epidemic. Environmental and meteorological factors might impact the occurrence of COVID-19, as these have been linked to various diseases, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), whose causative pathogens belong to the same virus family as SARS-CoV-2. We collected daily data of COVID-19 confirmed cases, air quality and meteorological variables of 33 locations in China for the outbreak period of 29 January 2020 to 15 February 2020. The association between air quality index (AQI) and confirmed cases was estimated through a Poisson regression model, and the effects of temperature and humidity on the AQI-confirmed cases association were analyzed. The results show that the effect of AQI on confirmed cases associated with an increase in each unit of AQI was statistically significant in several cities. The lag effect of AQI on the confirmed cases was statistically significant on lag day 1 (relative risk (RR) = 1.0009, 95% confidence interval (CI): 1.0004, 1.0013), day 2 (RR = 1.0007, 95% CI: 1.0003, 1.0012) and day 3 (RR = 1.0008, 95% CI: 1.0003, 1.0012). The AQI effect on the confirmed cases might be stronger in the temperature range of 10 °C ≤ T < 20 °C than in other temperature ranges, while the RR of COVID-19 transmission associated with AQI was higher in the relative humidity (RH) range of 10% ≤ RH < 20%. Results may suggest an enhanced impact of AQI on the COVID-19 spread under low RH.

Personal prevention and control of outbreaks of 2019 novel coronavirus infection

The 2019 novel coronavirus (2019-nCoV) outbreaks in China. Because of the sudden outbreak, rapid development, large scale of the epidemic and the lack of specific drug treatment, all provinces and cities of our country have launched the first-level response mechanism for major public health emergencies, which has attracted the attention of the World Health Organization(WHO). This article discusses the prevention and control measures combined with clinical experience during the outbreak of t2019-nCoV, in order to provide a reference for people from all walks of life. Key words: novel coronavirus(ncov); public health event; vaccine; antiviral drug; epidemic

Evaluation of the Adjuvant Efficacy of Natural Herbal Medicine on COVID-19: A Retrospective Matched Case-Control Study.

Since the outbreak of Corona Virus Disease 2019 (COVID-19) in Hubei province, the epidemic scale has increased rapidly, and no effective antiviral drug therapy has been identified yet. This study aimed to evaluate the adjuvant efficacy of Natural Herbal Medicine (NHM) combined with Western medicine in the treatment of COVID-19. We performed a retrospective, 1:1 matched, case-control study of the first cohort of hospitalized COVID-19-confirmed cases (January 17, 2020 to January 28, 2020). A total of 22 of the 36 confirmed patients were included in this study, split into two groups of 11: the NHM group (NHM combined standard Western medicine treatment) and control group (standard Western medicine treatment alone). All patients received appropriate supportive care and regular clinical and laboratory monitoring. Main evaluation indicators included improvement of clinical symptoms such as fever, cough and diarrhea after hospitalization; pathogen nucleic acid test result of respiratory tract and fecal specimens of the patient after hospitalization, and change of chest CT examination after hospitalization. The duration of fever in the NHM group ([Formula: see text] days) was significantly shorter than that in the control group ([Formula: see text] days) ([Formula: see text]). During the whole hospitalization period, the number of cases with diarrhea in the NHM group (two cases) was less than that in the control group (eight cases) ([Formula: see text]). Compared with the control group ([Formula: see text]), the duration for improvement (DI) of chest CT in the NHM group ([Formula: see text]) was significantly shorter ([Formula: see text]). Our results suggest that NHM could improve the clinical symptoms of COVID-19 patients and may be effective in treating COVID-19; thus, a larger, prospective, randomized, controlled clinical trial should be conducted to further evaluate the adjuvant efficacy of NHM in the treatment of COVID-19.

In vitro Antioxidant and Anti-obesity Activities of Freeze-dried Canarium sp., Averrhoa bilimbi L. and Malus domestica

BACKGROUND: The number of obesity cases is still increasing worldwide and has reached an epidemic scale. Plants are known to have a protection role in the development of obesity, however their antioxidant and anti-obesity activities have not widely known. This study was conducted to assess the in vitro antioxidant and anti-obesity activities of different types of freeze-dried fruits cultivated in Indonesia, especially Canarium sp., Averrhoa bilimbi L. and Malus domestica.METHODS: Total phenolic content of freeze-dried fruits was identified by Folin-Ciocalteu method, while the total flavonoid content was measured by aluminium chloride colorimetric assay. To assessed the antioxidant activity, 2,2-diphenyl 1-picrylhydrazyl (DPPH) scavenging activity assay and 2,2’-azino-bis (3-ethylbenzothiazoline6-sulphonic acid) (ABTS) reducing activity assay were performed. The α-amylase and lipase inhibitory activity assay were performed to assess the anti-obesity activity. For comparison, hydroxycitric acid (HCA) compound was also assessed with DPPH, ABTS, α-amylase and lipase assays.RESULTS: A. bilimbi had the highest total phenol content (6.35 µg GAE/mg), meanwhile M. domestica had the highest total flavonoid content (2.06 µg QE/mg). A. bilimbi also showed the highest antioxidant activity both in DPPH and ABTS assay, with inhibitory concentration (IC50)=279.99 µg/mL and 631.78 µg/mL, respectively. The freeze-dried M. domestica had the highest anti-α-amylase activity (IC50=258.85 µg/mL), while Canarium sp. had the highest anti-lipase activity (IC50=118.66 µg/mL).CONCLUSION: Freeze-dried fruits demonstrate in vitro benefits toward obesity. A. bilimbi has potent antioxidant activity and is beneficial against obesity-related adverse health effect by relieving oxidative stress. M. domestica and Canarium sp. hamper the fat accumulation by reducing the carbohydrate absorption and dietary lipid.KEYWORDS: antioxidant, anti-obesity, Canarium sp., Averrhoa bilimbi L., Malus domestica, hydroxycitric acid

Improving Integrated Disease Surveillance and Response Capacity in Guinea, 2015-2018

Improving Integrated Disease Surveillance and Response Capacity in Guinea, 2015-2018

COMMUNICATIONS BARRIERS AS A RESULT OF HUMAN, NOT TECHNICAL LIMITATIONS IN THE WORKING ENVIRONMENT

In a world of mobile phone, video-conferencing and internet technologies, it is easy assume that our communication problems are over. This kind of technological optimism is, of course, actively promoted by those whose job it is to market the latest hardware and software. However, while technology provides ever faster and more portable communication channels, with increasing carrying capacity (or ‗band with‘), the quality and effectiveness of communication flowing through any channel depends ultimately on the communicative practices adopted by users As communicators, we are almost always over-optimistic about our messages, assuming they will survive unscathed, all the way from our own brains to those of the receiver. In fact, all messages are vulnerable to the phenomenon of ‗noise‘. We consider how insights from disciplines such as psychology, anthropology and ethics have informed our understanding of human communication processes. The original conceptualization of ‗noise‘ referred to technological problems, however, it will become clear that communication barriers are primarily the result of human limitations. Consequently, the key to avoiding communication failure is self-awareness on the part of the sender. Research suggests that our ability to communicate with one another is profoundly influenced by three inter-related mechanisms: alertness and attention: affecting what data our senses manage to pick up; perception: resulting in different interpretations of the same sensory data; memory: affecting the messages we retain and those we can subsequently recall. The key lesson is that the capabilities of different people will vary in each of these areas, affecting their ability to communicate. Furthermore, the same individual can display wide variations at different points in time. When receivers are repeatedly exposed to the same stimuli, they become ‗habituated‘ to it, the response is no longer activated, and the message blends into the background. This adaptation has important implications for communicators. The first relates to the social psychological phenomenon of conformity, a process in which the norms, values and behaviours of an individual begin to follow those of the wider group. The second concerns cultural differences, where individuals in one social group may have different norms, values or behaviour to individuals associated with another grouping. The third barrier is caused by ethical constraints exerted by the organization. So, in a word, barriers in communications are not so much caused by technology, but above all, by human limitation. Although, we all, think we are good communicators, misunderstandings, actually have an epidemic scale.

Breast cancer and Flammer syndrome: A linkage to better prediction, prevention and personalised medical approach

Introduction: Breast cancer (BC) epidemic is characterized by around half a million deaths and 1.7 million new cases registered annually worldwide. An epidemic scale of BC prevalence is actually recognized with increasing trends both in the post- and premenopausal BC prevalence and metastatic disease is major cause of death in this patient cohort. Particularly alarming is that the sporadic BC (90% of all patients) creates currently unpredictable subpopulations in terms of disease predisposition, development and progression. Despite broad discussions run since years in BC area, no any plausible approach has been suggested so far to get the overall situation better controlled in the populations.

OVERCOMING VITAMIN-D DEFICIENCY IN MALE GYMNASTS DURING PRETEEN YEARS

This paper addresses the issue of vitamin-D deficiency, which is approaching epidemic scale in the Asian countries. Lack of proper nutrition and awareness contributes to this problem. After an explanation of the mechanism of production of vitamin D, the authors list adverse effects of vitamin-D deficiency and propose mandatory testing of vitamin-D deficiency during physical examinations. The remedial measures to overcome this deficiency in the context of preteen male gymnasts include supplements, proper nutrition in the form of sun-ripe fruits and vegetables as well as guarded-graduated sun-exposure. The last two are preferred over supplements as the supplements may produce toxicity if taken in higher doses.

Assessment of epidemiological obesity among adults in EU countries.

Obesity is a serious health problem in nearly all regions of Europe. During the last four decades, the percentage of obese people increased four times among men and twice among women, reaching aglobalepidemic scale as the biggest health-related issue in the developed and developing countries. The aim was to assess the epidemiological situation of obesity, according to gender among adults in Europe, compared with other regions and selected worldwide countries, as well as to devise a forecast for the near future based on analysis results. An overview was performed of the World Health Organization (WHO) statistical database in 1999-2016, concerning obesity prevalence among people over the age of 20 across 28 countries of the European Union. A forecast for the years 2020 and 2030 was prepared by evaluation of gradients for trendline equations. Moreover, some of the world regions, as well as individual countries, five per region, were collated and analyzed to prepare the forecast. The percentage of obese people in the countries of the European Union continues to increase every year. The dynamics of obesity growth in Europe is greater for men than for women (3.09% per year vs. 1.92% per year). With the growth rate remaining at the estimated level, in 2030 there will probably be more obese men (38.1%) than women (32.7%) in Poland, and in Europe likewise - 36.6% and 32.0%, respectively. Obesity has become a major epidemiological problem and an undisputable health problem not only in Poland and other European countries, but worldwide.

The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study.

BackgroundSexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs.ObjectiveThis study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England’s national STI surveillance system.MethodsStaff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants’ own digital device. They recorded the number of attendees invited and participants’ clinic numbers, which were used to link survey data to the EHR. Participants’ online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data.ResultsPrior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics’ culture of prioritization of research and innovation and availability of resources for implementing the surveys. Of the 7367 attendees invited, 85.28% (6283) agreed to participate. Of these, 72.97% (4585/6283) consented to participate in the survey, and 70.62% (4437/6283) were eligible and completed it. Of these, 91.19% (4046/4437) consented to EHR linkage, which did not differ by age or gender but was higher among gay/bisexual men than heterosexual men (95.50%, 722/756 vs 88.31%, 1073/1215; P<.003) and lower among black Caribbeans than white participants (87.25%, 568/651 vs 93.89%, 2181/2323; P<.002). Linkage was achieved for 88.88% (3596/4046) of consenting participants.ConclusionsImplementing a bio-behavioral enhanced surveillance tool in sexual health clinics was feasible and acceptable to staff and groups at STI risk; however, ensuring participants’ confidentiality and anonymity and availability of resources is vital. Bio-behavioral enhanced surveillance tools could enable timely collection of detailed behavioral data for effective commissioning of sexual health services.

Temporal evolution of HIV sero-discordancy patterns among stable couples in sub-Saharan Africa.

IntroductionObjective was to examine the temporal variation of HIV sero-discordancy in select representative countries (Kenya, Lesotho, Mali, Niger, Tanzania, and Zimbabwe) in sub-Saharan Africa at different HIV epidemic scales. A sero-discordant couple is defined as a stable couple (SC) in which one partner is HIV-positive while the other is HIV-negative.MethodsA deterministic compartmental mathematical model was constructed to describe HIV transmission dynamics. The model was pair-based, that is explicitly modeling formation of SCs and infection dynamics in both SCs and in single individuals. The model accommodated for different forms of infection statuses in SCs. Using population-based nationally-representative epidemiologic and demographic input data, historical (1980–2014) and future (2015–2030) trends of sero-discordancy and other demographic and epidemiologic indicators were projected throughout HIV epidemic phases.ResultsAs the epidemics emerged, about 90% of SCs affected by HIV were sero-discordant. This proportion declined to 45%-88% at epidemic peak and stabilized as the epidemics started their natural decline. The largest reductions in sero-discordancy were in high HIV-prevalence countries. As the epidemics further declined with antiretroviral therapy (ART) scale-up, the proportion of sero-discordant couples among HIV-affected couples was projected to increase to 70%-92% by 2030. The proportion of sero-discordant couples among all SCs increased as the epidemics emerged and evolved, then peaked at 2%-20% as the epidemics peaked, and then declined as the epidemics declined to reach 0.3%-16% by 2030.ConclusionsSero-discordancy patterns varied with the evolution of the epidemics, and were affected by both epidemic phase and scale. The largest variations were found in high HIV-prevalence countries. The fraction of stable couples that are sero-discordant, as opposed to being sero-concordant positive, was projected to increase with ART scale-up and further HIV incidence decline over the coming two decades. These findings inform strategic planning and resource allocation for interventions among sero-discordant couples.

The neurological complications of chikungunya virus: A systematic review.

SummaryWe performed a systematic review on the neurological complications of chikungunya virus. Such complications are being reported increasingly, owing primarily to the scale of recent epidemics but also to a growing understanding of the virus' neurovirulence. We performed a thorough literature search using PubMed and Scopus databases, summating the data on all published reports of neurological disease associated with chikungunya virus. We appraised the data for each major condition in adults, children, and neonates, as well as evaluating the latest evidence on disease pathogenesis and management strategies. The review provides a comprehensive summary for clinicians, public health officials, and researchers tackling the challenges associated with this important emerging pathogen.

Estimating the annual risk of HIV transmission within HIV sero-discordant couples in sub-Saharan Africa

ObjectiveTo estimate the annual risk of HIV transmission (ϕ) within HIV sero-discordant couples in 23 countries in sub-Saharan Africa (SSA), by utilizing newly available national population-based data and accounting for factors known to potentially affect this estimation. MethodsWe used a recently developed pair-based mathematical model that accommodates for HIV-dynamics temporal variation, sexual risk-behavior heterogeneity, and antiretroviral therapy (ART) scale-up. ResultsEstimated country-specific ϕ (in absence of ART) ranged between 4.2% (95% uncertainty interval (UI): 1.9%-6.3%) and 47.4% (95% UI: 37.2%-69.0%) per person-year (ppy), with a median of 12.4%. ϕ was strongly associated with HIV prevalence, with a Pearson correlation coefficient of 0.92, and was larger in high- versus low-HIV-prevalence countries. ϕ increased by 1.31% (95% confidence interval: 1.00%-1.55%) ppy for every 1% increase in HIV prevalence. Conclusionsϕ estimates were similar to earlier estimates, and suggested considerable heterogeneity in HIV infectiousness across SSA. This heterogeneity may explain, partly, the differences in epidemic scales.

Breast cancer and Flammer syndrome: any symptoms in common for prediction, prevention and personalised medical approach?

An epidemic scale of the breast cancer (BC) prevalence is actually recognised as the reality of the early twenty-first century. Particularly alarming is that the sporadic BC (about 90% of all patients) creates currently unpredictable subpopulations in terms of disease predisposition, development and progression. Despite broad discussions run since years in BC area, no any plausible approach has been suggested so far to get the overall situation better controlled in the populations. Here, we present highly innovative concepts considering investigation of specific syndromes and symptoms underestimated till now in relationship with BC predisposition and development. Consequently, the purpose of our pilot project was to evaluate the prevalence of Flammer Syndrome (FS) in BC patient cohort. The results achieved here support the main hypothesis of the project clearly demonstrating the tendency of BC patients to the increased prevalence of FS symptoms compared to the disease-free individuals. Our study strongly indicates the relevance of FS symptoms for BC pathology such as feeling inadequately cold, deficient thermoregulation, altered sensitivity to different stimuli, potential dehydration, altered sleep patterns, tendency towards headache, migraine attacks and dizziness. Moreover, the symptoms’ appearance is specifically linked to the individual BC subtypes. Potential mechanisms interconnecting FS with BC pathology are discussed.

The effects of HIV on fertility by infection duration: evidence from African population cohorts before antiretroviral treatment availability.

To estimate the relationship between HIV natural history and fertility by duration of infection in east and southern Africa before the availability of antiretroviral therapy and assess potential biases in estimates of age-specific subfertility when using retrospective birth histories in cross-sectional studies. Pooled analysis of prospective population-based HIV cohort studies in Masaka (Uganda), Kisesa (Tanzania) and Manicaland (Zimbabwe). Women aged 15-49 years who had ever tested for HIV were included. Analyses were censored at antiretroviral treatment roll-out. Fertility rate ratios were calculated to see the relationship of duration of HIV infection on fertility, adjusting for background characteristics. Survivorship and misclassification biases on age-specific subfertility estimates from cross-sectional surveys were estimated by reclassifying person-time from the cohort data to simulate cross-sectional surveys and comparing fertility rate ratios with true cohort results. HIV-negative and HIV-positive women contributed 15 440 births and 86 320 person-years; and 1236 births and 11 240 000 person-years, respectively, to the final dataset. Adjusting for age, study site and calendar year, each additional year since HIV seroconversion was associated with a 0.02 (95% confidence interval 0.01-0.03) relative decrease in fertility for HIV-positive women. Survivorship and misclassification biases in simulated retrospective birth histories resulted in modest underestimates of subfertility by 2-5% for age groups 20-39 years. Longer duration of infection is associated with greater relative fertility reduction for HIV-positive women. This should be considered when creating estimates for HIV prevalence among pregnant women and prevention of mother-to-child transmission need over the course of the HIV epidemic and antiretroviral treatment scale up.

Navigating the Zika panic

The epidemics of Ebola virus in West Africa and Zika virus in America highlight how viruses can explosively emerge into new territories. These epidemics also exposed how unprepared we are to handle infectious disease emergencies. This is also true when we consider hypothesized new clinical features of infection, such as the associations between Zika virus infection and severe neurological disease, including microcephaly and Guillain-Barré syndrome. On the surface, these pathologies appear to be new features of Zika virus infection, however, causal relationships have not yet been established. Decades of limited Zika virus research are making us scramble to determine the true drivers behind the epidemic, often at the expense of over-speculation without credible evidence. Here we review the literature and find no conclusive evidence at this time for significant biological differences between the American Zika virus strains and those circulating elsewhere. Rather, the epidemic scale in the Americas may be facilitated by an abnormally warm climate, dense human and mosquito populations, and previous exposure to other viruses. Severe disease associated with Zika virus may therefore not be a new trait for the virus, rather it may have been overlooked due to previously small outbreaks. Much of the recent panic regarding Zika virus has been about the Olympics in Brazil. We do not find any substantial evidence that the Olympics will result in a significant number of new Zika virus infections (~10 predicted) or that the Olympics will promote further epidemic spread over what is already expected. The Zika virus epidemic in the Americas is a serious situation and decisions based on solid scientific evidence - not hyped media speculations - are required for effective outbreak response.

Navigating the Zika panic.

The epidemics of Ebola virus in West Africa and Zika virus in America highlight how viruses can explosively emerge into new territories. These epidemics also exposed how unprepared we are to handle infectious disease emergencies. This is also true when we consider hypothesized new clinical features of infection, such as the associations between Zika virus infection and severe neurological disease, including microcephaly and Guillain-Barré syndrome. On the surface, these pathologies appear to be new features of Zika virus infection, however, causal relationships have not yet been established. Decades of limited Zika virus research are making us scramble to determine the true drivers behind the epidemic, often at the expense of over-speculation without credible evidence. Here we review the literature and find no conclusive evidence at this time for significant biological differences between the American Zika virus strains and those circulating elsewhere. Rather, the epidemic scale in the Americas may be facilitated by an abnormally warm climate, dense human and mosquito populations, and previous exposure to other viruses. Severe disease associated with Zika virus may therefore not be a new trait for the virus, rather it may have been overlooked due to previously small outbreaks. Much of the recent panic regarding Zika virus has been about the Olympics in Brazil. We do not find any substantial evidence that the Olympics will result in a significant number of new Zika virus infections (~10 predicted) or that the Olympics will promote further epidemic spread over what is already expected. The Zika virus epidemic in the Americas is a serious situation and decisions based on solid scientific evidence - not hyped media speculations - are required for effective outbreak response.

Potential biomarker panels in overall breast cancer management: advancements by multilevel diagnostics.

Breast cancer (BC) prevalence has reached an epidemic scale with half a million deaths annually. Current deficits in BC management include predictive and preventive approaches, optimized screening programs, individualized patient profiling, highly sensitive detection technologies for more precise diagnostics and therapy monitoring, individualized prediction and effective treatment of BC metastatic disease. To advance BC management, paradigm shift from delayed to predictive, preventive and personalized medical services is essential. Corresponding step forwards requires innovative multilevel diagnostics procuring specific panels of validated biomarkers. Here, we discuss current instrumental advancements including genomics, proteomics, epigenetics, miRNA, metabolomics, circulating tumor cells and cancer stem cells with a focus on biomarker discovery and multilevel diagnostic panels. A list of the recommended biomarker candidates is provided.

Quantifying the role of weather on seasonal influenza.

BackgroundImproving knowledge about influenza transmission is crucial to upgrade surveillance network and to develop accurate predicting models to enhance public health intervention strategies. Epidemics usually occur in winter in temperate countries and during the rainy season for tropical countries, suggesting a climate impact on influenza spread. Despite a lot of studies, the role of weather on influenza spread is not yet fully understood. In the present study, we investigated this issue at two different levels.MethodsFirst, we evaluated how weekly (intra-annual) incidence variations of clinical diseases could be linked to those of climatic factors. We considered that only a fraction of the human population is susceptible at the beginning of a year due to immunity acquired from previous years. Second, we focused on epidemic sizes (cumulated number of clinical reported cases) and looked at how their inter-annual and regional variations could be related to differences in the winter climatic conditions of the epidemic years over the regions. We quantified the impact of fifteen climatic variables in France using the Réseau des GROG surveillance network incidence data over eleven regions and nine years.ResultsAt the epidemic scale, no impact of climatic factors was highlighted. At the intra-annual scale, six climatic variables had a significant impact: average temperature (5.54 ± 1.09 %), absolute humidity (5.94 ± 1.08 %), daily variation of absolute humidity (3.02 ± 1.17 %), sunshine duration (3.46 ± 1.06 %), relative humidity (4.92 ± 1.20 %) and daily variation of relative humidity (4.46 ± 1.24 %). Since in practice the impact of two highly correlated variables is very hard to disentangle, we performed a principal component analysis that revealed two groups of three highly correlated climatic variables: one including the first three highlighted climatic variables on the one hand, the other including the last three ones on the other hand.ConclusionsThese results suggest that, among the six factors that appeared to be significant, only two (one per group) could in fact have a real effect on influenza spread, although it is not possible to determine which one based on a purely statistical argument. Our results support the idea of an important role of climate on the spread of influenza.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3114-x) contains supplementary material, which is available to authorized users.