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Spatial transcriptomics technologies permit the study of the spatial distribution of RNA at near-single-cell resolution genome-wide. However, the feasibility of studying spatial allele-specific expression (ASE) from these data remains uncharacterized. Here, we introduce spASE, a computational framework for detecting and estimating spatial ASE. To tackle the challenges presented by cell type mixtures and a low signal to noise ratio, we implement a hierarchical model involving additive mixtures of spatial smoothing splines. We apply our method to allele-resolved Visium and Slide-seq from the mouse cerebellum and hippocampus and report new insight into the landscape of spatial and cell type-specific ASE therein.
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Alelos , Cerebelo , Transcriptoma , Animais , Camundongos , Cerebelo/metabolismo , Hipocampo/metabolismo , Perfilação da Expressão Gênica , Análise de Célula ÚnicaRESUMO
Homeodomains (HDs) are the second largest class of DNA binding domains (DBDs) among eukaryotic sequence-specific transcription factors (TFs) and are the TF structural class with the largest number of disease-associated mutations in the Human Gene Mutation Database (HGMD). Despite numerous structural studies and large-scale analyses of HD DNA binding specificity, HD-DNA recognition is still not fully understood. Here, we analyze 92 human HD mutants, including disease-associated variants and variants of uncertain significance (VUS), for their effects on DNA binding activity. Many of the variants alter DNA binding affinity and/or specificity. Detailed biochemical analysis and structural modeling identifies 14 previously unknown specificity-determining positions, 5 of which do not contact DNA. The same missense substitution at analogous positions within different HDs often exhibits different effects on DNA binding activity. Variant effect prediction tools perform moderately well in distinguishing variants with altered DNA binding affinity, but poorly in identifying those with altered binding specificity. Our results highlight the need for biochemical assays of TF coding variants and prioritize dozens of variants for further investigations into their pathogenicity and the development of clinical diagnostics and precision therapies.
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Proteínas de Homeodomínio , Fatores de Transcrição , Humanos , Proteínas de Homeodomínio/metabolismo , Fatores de Transcrição/metabolismo , DNA/metabolismo , Mutação , Modelos MolecularesRESUMO
BACKGROUND: KRAS is among the most commonly mutated oncogenes in cancer, and previous studies have shown associations with survival in many cancer contexts. Evidence from both clinical observations and mouse experiments further suggests that these associations are allele- and tissue-specific. These findings motivate using clinical data to understand gene interactions and clinical covariates within different alleles and tissues. METHODS: We analyze genomic and clinical data from the AACR Project GENIE Biopharma Collaborative for samples from lung, colorectal, and pancreatic cancers. For each of these cancer types, we report epidemiological associations for different KRAS alleles, apply principal component analysis (PCA) to discover groups of genes co-mutated with KRAS, and identify distinct clusters of patient profiles with implications for survival. RESULTS: KRAS mutations were associated with inferior survival in lung, colon, and pancreas, although the specific mutations implicated varied by disease. Tissue- and allele-specific associations with smoking, sex, age, and race were found. Tissue-specific genetic interactions with KRAS were identified by PCA, which were clustered to produce five, four, and two patient profiles in lung, colon, and pancreas. Membership in these profiles was associated with survival in all three cancer types. CONCLUSIONS: KRAS mutations have tissue- and allele-specific associations with inferior survival, clinical covariates, and genetic interactions. IMPACT: Our results provide greater insight into the tissue- and allele-specific associations with KRAS mutations and identify clusters of patients that are associated with survival and clinical attributes from combinations of genetic interactions with KRAS mutations.
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Neoplasias Pulmonares , Neoplasias Pancreáticas , Animais , Humanos , Pulmão , Neoplasias Pulmonares/genética , Mutação , Pâncreas , Neoplasias Pancreáticas/genética , Proteínas Proto-Oncogênicas p21(ras)/genéticaRESUMO
Unsupervised clustering of single-cell RNA-sequencing data enables the identification of distinct cell populations. However, the most widely used clustering algorithms are heuristic and do not formally account for statistical uncertainty. We find that not addressing known sources of variability in a statistically rigorous manner can lead to overconfidence in the discovery of novel cell types. Here we extend a previous method, significance of hierarchical clustering, to propose a model-based hypothesis testing approach that incorporates significance analysis into the clustering algorithm and permits statistical evaluation of clusters as distinct cell populations. We also adapt this approach to permit statistical assessment on the clusters reported by any algorithm. Finally, we extend these approaches to account for batch structure. We benchmarked our approach against popular clustering workflows, demonstrating improved performance. To show practical utility, we applied our approach to the Human Lung Cell Atlas and an atlas of the mouse cerebellar cortex, identifying several cases of over-clustering and recapitulating experimentally validated cell type definitions.
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Algoritmos , Benchmarking , Humanos , Animais , Camundongos , Análise por Conglomerados , RNA , Análise de Célula Única/métodos , Análise de Sequência de RNA/métodos , Perfilação da Expressão Gênica/métodosRESUMO
A central problem in spatial transcriptomics is detecting differentially expressed (DE) genes within cell types across tissue context. Challenges to learning DE include changing cell type composition across space and measurement pixels detecting transcripts from multiple cell types. Here, we introduce a statistical method, cell type-specific inference of differential expression (C-SIDE), that identifies cell type-specific DE in spatial transcriptomics, accounting for localization of other cell types. We model gene expression as an additive mixture across cell types of log-linear cell type-specific expression functions. C-SIDE's framework applies to many contexts: DE due to pathology, anatomical regions, cell-to-cell interactions and cellular microenvironment. Furthermore, C-SIDE enables statistical inference across multiple/replicates. Simulations and validation experiments on Slide-seq, MERFISH and Visium datasets demonstrate that C-SIDE accurately identifies DE with valid uncertainty quantification. Last, we apply C-SIDE to identify plaque-dependent immune activity in Alzheimer's disease and cellular interactions between tumor and immune cells. We distribute C-SIDE within the R package https://github.com/dmcable/spacexr .
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Perfilação da Expressão Gênica , Transcriptoma , Perfilação da Expressão Gênica/métodosRESUMO
BACKGROUND: Individual and environmental health outcomes are frequently linked to changes in the diversity of associated microbial communities. Thus, deriving health indicators based on microbiome diversity measures is essential. While microbiome data generated using high-throughput 16S rRNA marker gene surveys are appealing for this purpose, 16S surveys also generate a plethora of spurious microbial taxa. RESULTS: When this artificial inflation in the observed number of taxa is ignored, we find that changes in the abundance of detected taxa confound current methods for inferring differences in richness. Experimental evidence, theory-guided exploratory data analyses, and existing literature support the conclusion that most sub-genus discoveries are spurious artifacts of clustering 16S sequencing reads. We proceed to model a 16S survey's systematic patterns of sub-genus taxa generation as a function of genus abundance to derive a robust control for false taxa accumulation. These controls unlock classical regression approaches for highly flexible differential richness inference at various levels of the surveyed microbial assemblage: from sample groups to specific taxa collections. The proposed methodology for differential richness inference is available through an R package, Prokounter. CONCLUSIONS: False species discoveries bias richness estimation and confound differential richness inference. In the case of 16S microbiome surveys, supporting evidence indicate that most sub-genus taxa are spurious. Based on this finding, a flexible method is proposed and is shown to overcome the confounding problem noted with current approaches for differential richness inference. Package availability: https://github.com/mskb01/prokounter.
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Bactérias , Microbiota , Artefatos , Bactérias/genética , Análise por Conglomerados , Microbiota/genética , RNA Ribossômico 16S/genéticaRESUMO
Single-cell RNA sequencing (scRNA-seq) quantifies gene expression for individual cells in a sample, which allows distinct cell-type populations to be identified and characterized. An important step in many scRNA-seq analysis pipelines is the annotation of cells into known cell types. While this can be achieved using experimental techniques, such as fluorescence-activated cell sorting, these approaches are impractical for large numbers of cells. This motivates the development of data-driven cell-type annotation methods. We find limitations with current approaches due to the reliance on known marker genes or from overfitting because of systematic differences, or batch effects, between studies. Here, we present a statistical approach that leverages public data sets to combine information across thousands of genes, uses a latent variable model to define cell-type-specific barcodes and account for batch effect variation, and probabilistically annotates cell-type identity from a reference of known cell types. The barcoding approach also provides a new way to discover marker genes. Using a range of data sets, including those generated to represent imperfect real-world reference data, we demonstrate that our approach substantially outperforms current reference-based methods, particularly when predicting across studies.
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Perfilação da Expressão Gênica , Análise de Célula Única , Expressão Gênica , Perfilação da Expressão Gênica/métodos , Humanos , RNA-Seq , Análise de Sequência de RNA/métodos , SoftwareRESUMO
Quantifying the impact of natural disasters or epidemics is critical for guiding policy decisions and interventions. When the effects of an event are long-lasting and difficult to detect in the short term, the accumulated effects can be devastating. Mortality is one of the most reliably measured health outcomes, partly due to its unambiguous definition. As a result, excess mortality estimates are an increasingly effective approach for quantifying the effect of an event. However, the fact that indirect effects are often characterized by small, but enduring, increases in mortality rates present a statistical challenge. This is compounded by sources of variability introduced by demographic changes, secular trends, seasonal and day of the week effects, and natural variation. Here, we present a model that accounts for these sources of variability and characterizes concerning increases in mortality rates with smooth functions of time that provide statistical power. The model permits discontinuities in the smooth functions to model sudden increases due to direct effects. We implement a flexible estimation approach that permits both surveillance of concerning increases in mortality rates and careful characterization of the effect of a past event. We demonstrate our tools' utility by estimating excess mortality after hurricanes in the United States and Puerto Rico. We use Hurricane Maria as a case study to show appealing properties that are unique to our method compared with current approaches. Finally, we show the flexibility of our approach by detecting and quantifying the 2014 Chikungunya outbreak in Puerto Rico and the COVID-19 pandemic in the United States. We make our tools available through the excessmort R package available from https://cran.r-project.org/web/packages/excessmort/.
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COVID-19 , Tempestades Ciclônicas , Humanos , Pandemias , Porto Rico/epidemiologia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: On July 15, 2021, with 58% of the population fully vaccinated, the start of a COVID-19 surge was observed in Puerto Rico. On July 22, 2021, the government of Puerto Rico started imposing a series of strict vaccine mandates. Two months later, over 70% of the population was vaccinated, more than in any US state, and laboratory-confirmed SARS-CoV-2 had dropped substantially. The decision to impose mandates, as well as current Department of Health recommendations related to boosters, were guided by the data and the effectiveness estimates presented here. METHODS: Between December 15, 2020, when the vaccination process began in Puerto Rico, and October 15, 2021, 2,276,966 individuals were fully vaccinated against COVID-19. During this period 112,726 laboratory-confirmed SARS-CoV-2 infections were reported. These data permitted us to quantify the outcomes of the immunization campaign and to compare effectiveness of the mRNA-1273 (Moderna), BNT162b2 (Pfizer), and Ad26.COV2.S (J&J) vaccines. We obtained vaccination status, SARS-CoV-2 test results, and COVID-19 hospitalizations and deaths, from the Department of Health. We fit statistical models that adjusted for time-varying incidence rates and age group to estimate vaccine effectiveness, since the time of vaccination, against lab-confirmed SARS-CoV-2 infection, and COVID-19 hospitalization and death. RESULTS: Two weeks after final dose, the mRNA-1273, BNT162b2, and Ad26.COV2.S vaccines had an effectiveness of 90% (95% CI: 88-91), 87% (85-88), and, 64% (58-69), respectively. After five months, effectiveness waned to about 70%, 50%, and 40%, respectively. We found no evidence that effectiveness was different after the Delta variant became dominant. For those infected, the vaccines provided further protection against COVID-19 hospitalization and deaths across all age groups, and this conditional effect did not wane in time. INTERPRETATION: The mRNA-1273 and BNT162b2 vaccines were highly effective across all age groups. They were still effective after five months although the protection against SARS-CoV-2 infection waned. The Ad26.COV2.S vaccine was effective but to a lesser degree compared to the mRNA vaccines. Although, conditional on infection, protection against adverse outcomes did not wane, the waning in effectiveness resulted in a decreased protection against serious COVID-19 outcomes across time. FUNDING: RAI's work was partly funded by NIH Grant R35GM131802.
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Official COVID-19 mortality statistics are strongly influenced by local diagnostic capacity, strength of the healthcare and vital registration systems, and death certification criteria and capacity, often resulting in significant undercounting of COVID-19 attributable deaths. Excess mortality, which is defined as the increase in observed death counts compared to a baseline expectation, provides an alternate measure of the mortality shock-both direct and indirect-of the COVID-19 pandemic. Here, we use data from civil death registers from a convenience sample of 90 (of 162) municipalities across the state of Gujarat, India, to estimate the impact of the COVID-19 pandemic on all-cause mortality. Using a model fit to weekly data from January 2019 to February 2020, we estimated excess mortality over the course of the pandemic from March 2020 to April 2021. During this period, the official government data reported 10,098 deaths attributable to COVID-19 for the entire state of Gujarat. We estimated 21,300 [95% CI: 20, 700, 22, 000] excess deaths across these 90 municipalities in this period, representing a 44% [95% CI: 43%, 45%] increase over the expected baseline. The sharpest increase in deaths in our sample was observed in late April 2021, with an estimated 678% [95% CI: 649%, 707%] increase in mortality from expected counts. The 40 to 65 age group experienced the highest increase in mortality relative to the other age groups. We found substantial increases in mortality for males and females. Our excess mortality estimate for these 90 municipalities, representing approximately at least 8% of the population, based on the 2011 census, exceeds the official COVID-19 death count for the entire state of Gujarat, even before the delta wave of the pandemic in India peaked in May 2021. Prior studies have concluded that true pandemic-related mortality in India greatly exceeds official counts. This study, using data directly from the first point of official death registration data recording, provides incontrovertible evidence of the high excess mortality in Gujarat from March 2020 to April 2021.
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A limitation of spatial transcriptomics technologies is that individual measurements may contain contributions from multiple cells, hindering the discovery of cell-type-specific spatial patterns of localization and expression. Here, we develop robust cell type decomposition (RCTD), a computational method that leverages cell type profiles learned from single-cell RNA-seq to decompose cell type mixtures while correcting for differences across sequencing technologies. We demonstrate the ability of RCTD to detect mixtures and identify cell types on simulated datasets. Furthermore, RCTD accurately reproduces known cell type and subtype localization patterns in Slide-seq and Visium datasets of the mouse brain. Finally, we show how RCTD's recovery of cell type localization enables the discovery of genes within a cell type whose expression depends on spatial environment. Spatial mapping of cell types with RCTD enables the spatial components of cellular identity to be defined, uncovering new principles of cellular organization in biological tissue. RCTD is publicly available as an open-source R package at https://github.com/dmcable/RCTD .
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Análise de Célula Única , Transcriptoma , Animais , Camundongos , Análise de Sequência de RNA , Software , Transcriptoma/genética , Sequenciamento do ExomaRESUMO
High-dimensional biological data collection across heterogeneous groups of samples has become increasingly common, creating high demand for dimensionality reduction techniques that capture underlying structure of the data. Discovering low-dimensional embeddings that describe the separation of any underlying discrete latent structure in data is an important motivation for applying these techniques since these latent classes can represent important sources of unwanted variability, such as batch effects, or interesting sources of signal such as unknown cell types. The features that define this discrete latent structure are often hard to identify in high-dimensional data. Principal component analysis (PCA) is one of the most widely used methods as an unsupervised step for dimensionality reduction. This reduction technique finds linear transformations of the data which explain total variance. When the goal is detecting discrete structure, PCA is applied with the assumption that classes will be separated in directions of maximum variance. However, PCA will fail to accurately find discrete latent structure if this assumption does not hold. Visualization techniques, such as t-Distributed Stochastic Neighbor Embedding (t-SNE) and Uniform Manifold Approximation and Projection (UMAP), attempt to mitigate these problems with PCA by creating a low-dimensional space where similar objects are modeled by nearby points in the low-dimensional embedding and dissimilar objects are modeled by distant points with high probability. However, since t-SNE and UMAP are computationally expensive, often a PCA reduction is done before applying them which makes it sensitive to PCAs downfalls. Also, tSNE is limited to only two or three dimensions as a visualization tool, which may not be adequate for retaining discriminatory information. The linear transformations of PCA are preferable to non-linear transformations provided by methods like t-SNE and UMAP for interpretable feature weights. Here, we propose iterative discriminant analysis (iDA), a dimensionality reduction technique designed to mitigate these limitations. iDA produces an embedding that carries discriminatory information which optimally separates latent clusters using linear transformations that permit post hoc analysis to determine features that define these latent structures.
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Algoritmos , Humanos , Análise de Componente PrincipalRESUMO
While intestinal Th17 cells are critical for maintaining tissue homeostasis, recent studies have implicated their roles in the development of extra-intestinal autoimmune diseases including multiple sclerosis. However, the mechanisms by which tissue Th17 cells mediate these dichotomous functions remain unknown. Here, we characterized the heterogeneity, plasticity, and migratory phenotypes of tissue Th17 cells in vivo by combined fate mapping with profiling of the transcriptomes and TCR clonotypes of over 84,000 Th17 cells at homeostasis and during CNS autoimmune inflammation. Inter- and intra-organ single-cell analyses revealed a homeostatic, stem-like TCF1+ IL-17+ SLAMF6+ population that traffics to the intestine where it is maintained by the microbiota, providing a ready reservoir for the IL-23-driven generation of encephalitogenic GM-CSF+ IFN-γ+ CXCR6+ T cells. Our study defines a direct in vivo relationship between IL-17+ non-pathogenic and GM-CSF+ and IFN-γ+ pathogenic Th17 populations and provides a mechanism by which homeostatic intestinal Th17 cells direct extra-intestinal autoimmune disease.
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Autoimunidade , Intestinos/imunologia , Células-Tronco/metabolismo , Células Th17/imunologia , Animais , Movimento Celular , Células Clonais , Encefalomielite Autoimune Experimental/imunologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/metabolismo , Homeostase , Humanos , Interferon gama/metabolismo , Interleucina-17/metabolismo , Camundongos Endogâmicos C57BL , Especificidade de Órgãos , RNA/metabolismo , RNA-Seq , Receptores de Antígenos de Linfócitos T/metabolismo , Receptores CXCR6/metabolismo , Receptores de Interleucina/metabolismo , Reprodutibilidade dos Testes , Família de Moléculas de Sinalização da Ativação Linfocitária/metabolismo , Análise de Célula Única , Baço/metabolismoRESUMO
Multiple sources of variability can bias ChIP-seq data toward inferring transcription factor (TF) binding profiles. As ChIP-seq datasets increase in public repositories, it is now possible and necessary to account for complex sources of variability in ChIP-seq data analysis. We find that two types of variability, the batch effects by sequencing laboratories and differences between biological replicates, not associated with changes in condition or state, vary across genomic sites. This implies that observed differences between samples from different conditions or states, such as cell-type, must be assessed statistically, with an understanding of the distribution of obscuring noise. We present a statistical approach that characterizes both differences of interests and these source of variability through the parameters of a mixed effects model. We demonstrate the utility of our approach on a CTCF binding dataset composed of 211 samples representing 90 different cell-types measured across three different laboratories. The results revealed that sites exhibiting large variability were associated with sequence characteristics such as GC-content and low complexity. Finally, we identified TFs associated with high-variance CTCF sites using TF motifs documented in public databases, pointing the possibility of these being false positives if the sources of variability are not properly accounted for.
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The composition of the maternal vaginal microbiome influences the duration of pregnancy, onset of labor, and even neonatal outcomes. Maternal microbiome research in sub-Saharan Africa has focused on non-pregnant and postpartum composition of the vaginal microbiome. Here we aimed to illustrate the relationship between the vaginal microbiome of 99 laboring Ugandan women and intrapartum fever using routine microbiology and 16S ribosomal RNA gene sequencing from two hypervariable regions (V1-V2 and V3-V4). To describe the vaginal microbes associated with vaginal microbial communities, we pursued two approaches: hierarchical clustering methods and a novel Grades of Membership (GoM) modeling approach for vaginal microbiome characterization. Leveraging GoM models, we created a basis composed of a preassigned number of microbial topics whose linear combination optimally represents each patient yielding more comprehensive associations and characterization between maternal clinical features and the microbial communities. Using a random forest model, we showed that by including microbial topic models we improved upon clinical variables to predict maternal fever. Overall, we found a higher prevalence of Granulicatella, Streptococcus, Fusobacterium, Anaerococcus, Sneathia, Clostridium, Gemella, Mobiluncus, and Veillonella genera in febrile mothers, and higher prevalence of Lactobacillus genera (in particular L. crispatus and L. jensenii), Acinobacter, Aerococcus, and Prevotella species in afebrile mothers. By including clinical variables with microbial topics in this model, we observed young maternal age, fever reported earlier in the pregnancy, longer labor duration, and microbial communities with reduced Lactobacillus diversity were associated with intrapartum fever. These results better defined relationships between the presence or absence of intrapartum fever, demographics, peripartum course, and vaginal microbial topics, and expanded our understanding of the impact of the microbiome on maternal and potentially neonatal outcome risk.
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Bactérias/classificação , Trabalho de Parto , Microbiota , Vagina/microbiologia , Adulto , Bactérias/genética , Biodiversidade , Análise por Conglomerados , Feminino , Humanos , Lactobacillus/genética , Gravidez , RNA Ribossômico 16S/genética , UgandaRESUMO
OBJECTIVE: To estimate the direct and indirect effects of the covid-19 pandemic on mortality in 2020 in 29 high income countries with reliable and complete age and sex disaggregated mortality data. DESIGN: Time series study of high income countries. SETTING: Austria, Belgium, Czech Republic, Denmark, England and Wales, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, Latvia, Lithuania, the Netherlands, New Zealand, Northern Ireland, Norway, Poland, Portugal, Scotland, Slovakia, Slovenia, South Korea, Spain, Sweden, Switzerland, and United States. PARTICIPANTS: Mortality data from the Short-term Mortality Fluctuations data series of the Human Mortality Database for 2016-20, harmonised and disaggregated by age and sex. INTERVENTIONS: Covid-19 pandemic and associated policy measures. MAIN OUTCOME MEASURES: Weekly excess deaths (observed deaths versus expected deaths predicted by model) in 2020, by sex and age (0-14, 15-64, 65-74, 75-84, and ≥85 years), estimated using an over-dispersed Poisson regression model that accounts for temporal trends and seasonal variability in mortality. RESULTS: An estimated 979 000 (95% confidence interval 954 000 to 1 001 000) excess deaths occurred in 2020 in the 29 high income countries analysed. All countries had excess deaths in 2020, except New Zealand, Norway, and Denmark. The five countries with the highest absolute number of excess deaths were the US (458 000, 454 000 to 461 000), Italy (89 100, 87 500 to 90 700), England and Wales (85 400, 83 900 to 86 800), Spain (84 100, 82 800 to 85 300), and Poland (60 100, 58 800 to 61 300). New Zealand had lower overall mortality than expected (-2500, -2900 to -2100). In many countries, the estimated number of excess deaths substantially exceeded the number of reported deaths from covid-19. The highest excess death rates (per 100 000) in men were in Lithuania (285, 259 to 311), Poland (191, 184 to 197), Spain (179, 174 to 184), Hungary (174, 161 to 188), and Italy (168, 163 to 173); the highest rates in women were in Lithuania (210, 185 to 234), Spain (180, 175 to 185), Hungary (169, 156 to 182), Slovenia (158, 132 to 184), and Belgium (151, 141 to 162). Little evidence was found of subsequent compensatory reductions following excess mortality. CONCLUSION: Approximately one million excess deaths occurred in 2020 in these 29 high income countries. Age standardised excess death rates were higher in men than women in almost all countries. Excess deaths substantially exceeded reported deaths from covid-19 in many countries, indicating that determining the full impact of the pandemic on mortality requires assessment of excess deaths. Many countries had lower deaths than expected in children <15 years. Sex inequality in mortality widened further in most countries in 2020.
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COVID-19/mortalidade , Países Desenvolvidos/estatística & dados numéricos , Mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Europa (Continente)/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Distribuição de Poisson , República da Coreia/epidemiologia , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The tumor immune microenvironment plays a critical role in cancer progression and response to immunotherapy in clear cell renal cell carcinoma (ccRCC), yet the composition and phenotypic states of immune cells in this tumor are incompletely characterized. We performed single-cell RNA and T cell receptor sequencing on 164,722 individual cells from tumor and adjacent non-tumor tissue in patients with ccRCC across disease stages: early, locally advanced, and advanced/metastatic. Terminally exhausted CD8+ T cells were enriched in metastatic disease and were restricted in T cell receptor diversity. Within the myeloid compartment, pro-inflammatory macrophages were decreased, and suppressive M2-like macrophages were increased in advanced disease. Terminally exhausted CD8+ T cells and M2-like macrophages co-occurred in advanced disease and expressed ligands and receptors that support T cell dysfunction and M2-like polarization. This immune dysfunction circuit is associated with a worse prognosis in external cohorts and identifies potentially targetable immune inhibitory pathways in ccRCC.
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Linfócitos T CD8-Positivos/imunologia , Carcinoma de Células Renais/genética , Regulação Neoplásica da Expressão Gênica/genética , Neoplasias Renais/genética , Biomarcadores Tumorais/genética , Carcinoma de Células Renais/imunologia , Regulação Neoplásica da Expressão Gênica/imunologia , Humanos , Imunoterapia/métodos , Neoplasias Renais/imunologia , Linfócitos do Interstício Tumoral/imunologia , Macrófagos/metabolismo , Microambiente Tumoral/imunologiaRESUMO
Population displacement may occur after natural disasters, permanently altering the demographic composition of the affected regions. Measuring this displacement is vital for both optimal postdisaster resource allocation and calculation of measures of public health interest such as mortality estimates. Here, we analyzed data generated by mobile phones and social media to estimate the weekly island-wide population at risk and within-island geographic heterogeneity of migration in Puerto Rico after Hurricane Maria. We compared these two data sources with population estimates derived from air travel records and census data. We observed a loss of population across all data sources throughout the study period; however, the magnitude and dynamics differ by the data source. Census data predict a population loss of just over 129,000 from July 2017 to July 2018, a 4% decrease; air travel data predict a population loss of 168,295 for the same period, a 5% decrease; mobile phone-based estimates predict a loss of 235,375 from July 2017 to May 2018, an 8% decrease; and social media-based estimates predict a loss of 476,779 from August 2017 to August 2018, a 17% decrease. On average, municipalities with a smaller population size lost a bigger proportion of their population. Moreover, we infer that these municipalities experienced greater infrastructure damage as measured by the proportion of unknown locations stemming from these regions. Finally, our analysis measures a general shift of population from rural to urban centers within the island. Passively collected data provide a promising supplement to current at-risk population estimation procedures; however, each data source has its own biases and limitations.
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An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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As of mid-August 2020, more than 170 000 U.S. residents have died of coronavirus disease 2019 (COVID-19); however, the true number of deaths resulting from COVID-19, both directly and indirectly, is likely to be much higher. The proper attribution of deaths to this pandemic has a range of societal, legal, mortuary, and public health consequences. This article discusses the current difficulties of disaster death attribution and describes the strengths and limitations of relying on death counts from death certificates, estimations of indirect deaths, and estimations of excess mortality. Improving the tabulation of direct and indirect deaths on death certificates will require concerted efforts and consensus across medical institutions and public health agencies. In addition, actionable estimates of excess mortality will require timely access to standardized and structured vital registry data, which should be shared directly at the state level to ensure rapid response for local governments. Correct attribution of direct and indirect deaths and estimation of excess mortality are complementary goals that are critical to our understanding of the pandemic and its effect on human life.