Association between community-based self-reported COVID-19 symptoms and social deprivation explored using symptom tracker apps: a repeated cross-sectional study in Northern Ireland.

OBJECTIVES: The aim of the study was to investigate the spatial and temporal relationships between the prevalence of COVID-19 symptoms in the community-level and area-level social deprivation. DESIGN: Spatial mapping, generalised linear models, using time as a factor and spatial-lag models were used to explore the relationship between self-reported COVID-19 symptom prevalence as recorded through two smartphone symptom tracker apps and a range of socioeconomic factors using a repeated cross-sectional study design. SETTING: In the community in Northern Ireland, UK. The analysis period included the earliest stages of non-pharmaceutical interventions and societal restrictions or 'lockdown' in 2020. PARTICIPANTS: Users of two smartphone symptom tracker apps recording self-reported health information who recorded their location as Northern Ireland, UK. PRIMARY OUTCOME MEASURES: Population standardised self-reported COVID-19 symptoms and correlation between population standardised self-reported COVID-19 symptoms and area-level characteristics from measures of multiple deprivation including employment levels and population housing density, derived as the mean number of residents per household for each census super output area. RESULTS: Higher self-reported prevalence of COVID-19 symptoms was associated with the most deprived areas (p<0.001) and with those areas with the lowest employment levels (p<0.001). Higher rates of self-reported COVID-19 symptoms within the age groups, 18-24 and 25-34 years were found within the most deprived areas during the earliest stages of non-pharmaceutical interventions and societal restrictions ('lockdown'). CONCLUSIONS: Through spatial regression of self-reporting COVID-19 smartphone data in the community, this research shows how a lens of social deprivation can deepen our understanding of COVID-19 transmission and prevention. Our findings indicate that social inequality, as measured by area-level deprivation, is associated with disparities in potential COVID-19 infection, with higher prevalence of self-reported COVID-19 symptoms in urban areas associated with area-level social deprivation, housing density and age.

Chronic kidney disease of unknown origin is associated with environmental urbanisation in Belfast, UK.

Chronic kidney disease (CKD), a collective term for many causes of progressive renal failure, is increasing worldwide due to ageing, obesity and diabetes. However, these factors cannot explain the many environmental clusters of renal disease that are known to occur globally. This study uses data from the UK Renal Registry (UKRR) including CKD of uncertain aetiology (CKDu) to investigate environmental factors in Belfast, UK. Urbanisation has been reported to have an increasing impact on soils. Using an urban soil geochemistry database of elemental concentrations of potentially toxic elements (PTEs), we investigated the association of the standardised incidence rates (SIRs) of both CKD and CKD of uncertain aetiology (CKDu) with environmental factors (PTEs), controlling for social deprivation. A compositional data analysis approach was used through balances (a special class of log contrasts) to identify elemental balances associated with CKDu. A statistically significant relationship was observed between CKD with the social deprivation measures of employment, income and education (significance levels of 0.001, 0.01 and 0.001, respectively), which have been used as a proxy for socio-economic factors such as smoking. Using three alternative regression methods (linear, generalised linear and Tweedie models), the elemental balances of Cr/Ni and As/Mo were found to produce the largest correlation with CKDu. Geogenic and atmospheric pollution deposition, traffic and brake wear emissions have been cited as sources for these PTEs which have been linked to kidney damage. This research, thus, sheds light on the increasing global burden of CKD and, in particular, the environmental and anthropogenic factors that may be linked to CKDu, particularly environmental PTEs linked to urbanisation.

Bacterial and ciliate biofilm community structure at different spatial levels of a salt lake meta-community.

Meta-communities are assembled along an ecological scale that determines local and regional diversity. Spatial patterns have been detected in planktonic bacterial communities at distances <20 m, but little is known about the occurrence of similar variation for other microbial groups and changes in microbial meta-community assembly at different levels of a meta-community. To examine this variation, the biofilm of eight saline ponds were used to investigate processes shaping diversity within ponds (ß) and between ponds (δ). Bacterial and ciliate communities were assessed using ARISA and T-RFLP respectively, while diversity partitioning methods were used to examine the importance of taxonomic turnover and variation partitioning was used to distinguish spatial from environmental determinants. The results show that turnover is important for determining ß- and δ-diversity of biofilms. Spatial factors are important drivers of bacterial ß-diversity but were unimportant for ciliate ß-diversity. Environmental variation was a strong determinant of bacterial and ciliate δ-diversity, suggesting sorting processes are important for assembling pond communities. Determinants of diversity in bacteria are not universal for ciliates, suggesting higher functional redundancy of bacteria or the greater niche breadth of ciliates may be important in discriminating assembly processes between the two organisms.

Health at the Sub-catchment Scale: Typhoid and Its Environmental Determinants in Central Division, Fiji.

The impact of environmental change on transmission patterns of waterborne enteric diseases is a major public health concern. This study concerns the burden and spatial nature of enteric fever, attributable to Salmonella Typhi infection in the Central Division, Republic of Fiji at a sub-catchment scale over 30-months (2013-2015). Quantitative spatial analysis suggested relationships between environmental conditions of sub-catchments and incidence and recurrence of typhoid fever. Average incidence per inhabited sub-catchment for the Central Division was high at 205.9/100,000, with cases recurring in each calendar year in 26% of sub-catchments. Although the numbers of cases were highest within dense, urban coastal sub-catchments, the incidence was highest in low-density mountainous rural areas. Significant environmental determinants at this scale suggest increased risk of exposure where sediment yields increase following runoff. The study suggests that populations living on large systems that broaden into meandering mid-reaches and floodplains with alluvial deposition are at a greater risk compared to small populations living near small, erosional, high-energy headwaters and small streams unconnected to large hydrological networks. This study suggests that anthropogenic alteration of land cover and hydrology (particularly via fragmentation of riparian forest and connectivity between road and river networks) facilitates increased transmission of typhoid fever and that environmental transmission of typhoid fever is important in Fiji.

Evaluation of geostatistical estimators and their applicability to characterise the spatial patterns of recreational fishing catch rates.

Western Australians are heavily engaged in recreational fishing activities with a participation rate of approximately 30%. An accurate estimation of the spatial distribution of recreational catch per unit effort (catch rates) is an integral component for monitoring fish population changes and to develop strategies for ecosystem-based marine management. Geostatistical techniques such as kriging can provide useful tools for characterising the spatial distributions of recreational catch rates. However, most recreational fishery data are highly skewed, zero-inflated and when expressed as ratios are impacted by the small number problem which can influence the estimates obtained from the traditional kriging. The applicability of ordinary, indicator and Poisson kriging to recreational catch rate data was evaluated for three aquatic species with different behaviours and distribution patterns. The prediction performance of each estimator was assessed based on cross-validation. For all three species, the accuracy plot of the indicator kriging (IK) showed a better agreement between expected and empirical proportions of catch rate data falling within probability intervals of increasing size, as measured by the goodness statistic. Also, indicator kriging was found to be better in predicting the latent catch rate for the three species compared to ordinary and Poisson kriging. For each species, the spatial maps from the three estimators displayed similar patterns but Poisson kriging produced smoother spatial distributions. We show that the IK estimator may be preferable for the spatial modelling of catch rate data exhibiting these characteristics, and has the best prediction performance regardless of the life history and distribution patterns of those three species.

Factor XII activation markers do not reflect FXII dependence of thrombin generation induced by polyvinylchloride.

The role of factor XII (FXII) as the main trigger of the coagulation cascade during haemodialysis has been recently challenged. Polyvinylchloride (PVC) is the standard polymer for haemodialysis circuit tubings, but its interaction with FXII has not been extensively characterized. In a modified Chandler tubing loop model using heparinized fresh human whole blood we selectively inhibited coagulation factors VII, X or XII with monospecific antibodies. Contact of whole blood with PVC induced a strong thrombin generation [thrombin-antithrombin complexes (TAT) 64 ± 24 µg/l, before <1 µg/l]. Despite this, levels of FXII coagulation activity, free FXIIa or FXIIa-C1 inhibitor complexes remained unchanged. The anti-FXII antibody abolished thrombin generation (TAT 8 ± 5 µg/l, P < 0.05) and made the free FXIIa undetectable. Inhibition of FVII did not affect coagulation activation (TAT 68 ± 26 µg/l). Our data provide definitive evidence that PVC triggers the coagulation system via FXII. However, all FXII activation markers in plasma failed to detect contact activation.

Trend analysis and short-term forecast of incident HIV infection in Ghana.

The study uses time-series modelling to determine and predict trends in incident HIV infection in Ghana among specific age groups. The HIV data for Ghana were grouped according to northern and southern spatial sectors as they exhibited slightly different data collection formats. The trend of the epidemic is modelled using moving-average smoothing techniques, and the Box-Jenkins ARIMA model is used to forecast cases of newly acquired (incident) HIV infection. Trend analysis of past growth patterns reveals an increase in new cases of HIV infection in the northern sector, with the greatest increase occurring among persons aged 30 years and over. The epidemic in the southern sector appears to have levelled off. However, incident HIV infection in the 20-39-year-old age group of females in the sector is estimated to increase in the next three years. Moreover, the estimates suggest a higher increase in incident cases than that predicted by the National AIDS Control Programme. Nevertheless, incident HIV infection among persons aged 19 and below is found to be relatively stable. Thus, if efforts are made to reduce or prevent an increase in the number of new infections in the northern sector, and for the 20-39 years age group in the southern sector, Ghana will have a brighter future with regard to its response to the HIV epidemic. These findings can assist with developing strategic-intervention policy planning for Ghana and other countries in sub-Saharan Africa.