Estimates of disease burden caused by foodborne pathogens in contaminated dairy products in Rwanda.

BACKGROUND: The Girinka program in Rwanda has contributed to an increase in milk production, as well as to reduced malnutrition and increased incomes. But dairy products can be hazardous to health, potentially transmitting diseases such as bovine brucellosis, tuberculosis, and cause diarrhea. We analyzed the burden of foodborne disease due to consumption of raw milk and other dairy products in Rwanda to support the development of policy options for the improvement of the quality and safety of milk. METHODS: Disease burden data for five pathogens (Campylobacter spp., nontyphoidal Salmonella enterica, Cryptosporidium spp., Brucella spp., and Mycobacterium bovis) were extracted from the 2010 WHO Foodborne Disease Burden Epidemiology Reference Group (FERG) database and merged with data of the proportion of foodborne disease attributable to consuming dairy products from FERG and a separately published Structured Expert Elicitation study to generate estimates of the uncertainty distributions of the disease burden by Monte Carlo simulation. RESULTS: According to WHO, the foodborne disease burden (all foods) of these five pathogens in Rwanda in 2010 was like or lower than in the Africa E subregion as defined by FERG. There were 57,500 illnesses occurring in Rwanda owing to consumption of dairy products, 55 deaths and 3,870 Disability Adjusted Life Years (DALYs) causing a cost-of-illness of $3.2 million. 44% of the burden (in DALYs) was attributed to drinking raw milk and sizeable proportions were also attributed to traditionally (16-23%) or industrially (6-22%) fermented milk. More recent data are not available, but the burden (in DALYs) of tuberculosis and diarrheal disease by all causes in Rwanda has declined between 2010 and 2019 by 33% and 46%, respectively. CONCLUSION: This is the first study examining the WHO estimates of the burden of foodborne disease on a national level in Rwanda. Transitioning from consuming raw to processed milk (fermented, heat treated or otherwise) may prevent a considerable disease burden and cost-of-illness, but the full benefits will only be achieved if there is a simultaneous improvement of pathogen inactivation during processing, and prevention of recontamination of processed products.

Uncertainty Quantification with Experts: Present Status and Research Needs.

Expert elicitation is deployed when data are absent or uninformative and critical decisions must be made. In designing an expert elicitation, most practitioners seek to achieve best practice while balancing practical constraints. The choices made influence the required time and effort investment, the quality of the elicited data, experts' engagement, the defensibility of results, and the acceptability of resulting decisions. This piece outlines some of the common choices practitioners encounter when designing and conducting an elicitation. We discuss the evidence supporting these decisions and identify research gaps. This will hopefully allow practitioners to better navigate the literature, and will inspire the expert judgment research community to conduct well powered, replicable experiments that properly address the research gaps identified.

Attribution of Illnesses Transmitted by Food and Water to Comprehensive Transmission Pathways Using Structured Expert Judgment, United States.

Illnesses transmitted by food and water cause a major disease burden in the United States despite advancements in food safety, water treatment, and sanitation. We report estimates from a structured expert judgment study using 48 experts who applied Cooke's classical model of the proportion of disease attributable to 5 major transmission pathways (foodborne, waterborne, person-to-person, animal contact, and environmental) and 6 subpathways (food handler-related, under foodborne; recreational, drinking, and nonrecreational/nondrinking, under waterborne; and presumed person-to-person-associated and presumed animal contact-associated, under environmental). Estimates for 33 pathogens were elicited, including bacteria such as Salmonella enterica, Campylobacter spp., Legionella spp., and Pseudomonas spp.; protozoa such as Acanthamoeba spp., Cyclospora cayetanensis, and Naegleria fowleri; and viruses such as norovirus, rotavirus, and hepatitis A virus. The results highlight the importance of multiple pathways in the transmission of the included pathogens and can be used to guide prioritization of public health interventions.

COVID-19 and the scientific publishing system: growth, open access and scientific fields.

We model the growth of scientific literature related to COVID-19 and forecast the expected growth from 1 June 2021. Considering the significant scientific and financial efforts made by the research community to find solutions to end the COVID-19 pandemic, an unprecedented volume of scientific outputs is being produced. This questions the capacity of scientists, politicians and citizens to maintain infrastructure, digest content and take scientifically informed decisions. A crucial aspect is to make predictions to prepare for such a large corpus of scientific literature. Here we base our predictions on the Autoregressive Integrated Moving Average (ARIMA) and exponential smoothing models using the Dimensions database. This source has the particularity of including in the metadata information on the date in which papers were indexed. We present global predictions, plus predictions in three specific settings: by type of access (Open Access), by domain-specific repository (SSRN and MedRxiv) and by several research fields. We conclude by discussing our findings. Supplementary Information: The online version contains supplementary material available at 10.1007/s11192-022-04536-x.

Attribution of country level foodborne disease to food group and food types in three African countries: Conclusions from a structured expert judgment study.

BACKGROUND: According to the World Health Organization, 600 million cases of foodborne disease occurred in 2010. To inform risk management strategies aimed at reducing this burden, attribution to specific foods is necessary. OBJECTIVE: We present attribution estimates for foodborne pathogens (Campylobacter spp., enterotoxigenic Escherichia coli (ETEC), Shiga-toxin producing E. coli, nontyphoidal Salmonella enterica, Cryptosporidium spp., Brucella spp., and Mycobacterium bovis) in three African countries (Burkina Faso, Ethiopia, Rwanda) to support risk assessment and cost-benefit analysis in three projects aimed at increasing safety of beef, dairy, poultry meat and vegetables in these countries. METHODS: We used the same methodology as the World Health Organization, i.e., Structured Expert Judgment according to Cooke's Classical Model, using three different panels for the three countries. Experts were interviewed remotely and completed calibration questions during the interview without access to any resources. They then completed target questions after the interview, using resources as considered necessary. Expert data were validated using two objective measures, calibration score or statistical accuracy, and information score. Performance-based weights were derived from the two measures to aggregate experts' distributions into a so-called decision maker. The analysis was made using Excalibur software, and resulting distributions were normalized using Monte Carlo simulation. RESULTS: Individual experts' uncertainty assessments resulted in modest statistical accuracy and high information scores, suggesting overconfident assessments. Nevertheless, the optimized item-weighted decision maker was statistically accurate and informative. While there is no evidence that animal pathogenic ETEC strains are infectious to humans, a sizeable proportion of ETEC illness was attributed to animal source foods as experts considered contamination of food products by infected food handlers can occur at any step in the food chain. For all pathogens, a major share of the burden was attributed to food groups of interest. Within food groups, the highest attribution was to products consumed raw, but processed products were also considered important sources of infection. CONCLUSIONS: Cooke's Classical Model with performance-based weighting provided robust uncertainty estimates of the attribution of foodborne disease in three African countries. Attribution estimates will be combined with country-level estimates of the burden of foodborne disease to inform decision making by national authorities.

A retrospective assessment of COVID-19 model performance in the USA.

Coronavirus disease 2019 (COVID-19) forecasts from over 100 models are readily available. However, little published information exists regarding the performance of their uncertainty estimates (i.e. probabilistic performance). To evaluate their probabilistic performance, we employ the classical model (CM), an established method typically used to validate expert opinion. In this analysis, we assess both the predictive and probabilistic performance of COVID-19 forecasting models during 2021. We also compare the performance of aggregated forecasts (i.e. ensembles) based on equal and CM performance-based weights to an established ensemble from the Centers for Disease Control and Prevention (CDC). Our analysis of forecasts of COVID-19 mortality from 22 individual models and three ensembles across 49 states indicates that-(i) good predictive performance does not imply good probabilistic performance, and vice versa; (ii) models often provide tight but inaccurate uncertainty estimates; (iii) most models perform worse than a naive baseline model; (iv) both the CDC and CM performance-weighted ensembles perform well; but (v) while the CDC ensemble was more informative, the CM ensemble was more statistically accurate across states. This study presents a worthwhile method for appropriately assessing the performance of probabilistic forecasts and can potentially improve both public health decision-making and COVID-19 modelling.

Task specialization across research careers.

Research careers are typically envisioned as a single path in which a scientist starts as a member of a team working under the guidance of one or more experienced scientists and, if they are successful, ends with the individual leading their own research group and training future generations of scientists. Here we study the author contribution statements of published research papers in order to explore possible biases and disparities in career trajectories in science. We used Bayesian networks to train a prediction model based on a dataset of 70,694 publications from PLoS journals, which included 347,136 distinct authors and their associated contribution statements. This model was used to predict the contributions of 222,925 authors in 6,236,239 publications, and to apply a robust archetypal analysis to profile scientists across four career stages: junior, early-career, mid-career and late-career. All three of the archetypes we found - leader, specialized, and supporting - were encountered for early-career and mid-career researchers. Junior researchers displayed only two archetypes (specialized, and supporting), as did late-career researchers (leader and supporting). Scientists assigned to the leader and specialized archetypes tended to have longer careers than those assigned to the supporting archetype. We also observed consistent gender bias at all stages: the majority of male scientists belonged to the leader archetype, while the larger proportion of women belonged to the specialized archetype, especially for early-career and mid-career researchers.

Comparison of Logistic Regression and Bayesian Networks for Risk Prediction of Breast Cancer Recurrence.

PURPOSE: For individualized follow-up, accurate prediction of locoregional recurrence (LRR) and second primary (SP) breast cancer risk is required. Current prediction models employ regression, but with large data sets, machine-learning techniques such as Bayesian Networks (BNs) may be better alternatives. In this study, logistic regression was compared with different BNs, built with network classifiers and constraint- and score-based algorithms. METHODS: Women diagnosed with early breast cancer between 2003 and 2006 were selected from the Netherlands Cancer Registry (NCR) ( N = 37,320). BN structures were developed using 1) Bayesian network classifiers, 2) correlation coefficients with different cutoffs, 3) constraint-based learning algorithms, and 4) score-based learning algorithms. The different models were compared with logistic regression using the area under the receiver operating characteristic curve, an external validation set obtained from the NCR from 2007 and 2008 ( N = 12,308), and subgroup analyses for a high- and low-risk group. RESULTS: The BNs with the most links showed the best performance in both LRR and SP prediction (c-statistic of 0.76 for LRR and 0.69 for SP). In the external validation, logistic regression generally outperformed the BNs in both SP and LRR (c-statistic of 0.71 for LRR and 0.64 for SP). The differences were nonetheless small. Although logistic regression performed best on most parts of the subgroup analysis, BNs outperformed regression with respect to average risk for SP prediction in low- and high-risk groups. CONCLUSIONS: Although estimates of regression coefficients depend on other independent variables, there is no assumed dependence relationship between coefficient estimators and the change in value of other variables as in the case of BNs. Nonetheless, this analysis suggests that regression is still more accurate or at least as accurate as BNs for risk estimation for both LRRs and SP tumors.