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Warren, J. L.

Publications and source records attributed to Warren, J. L..

7 recordsLinked to original sources

From Network Topology to Parameterization: An Optimized Model of Endothelial Mechanobiology

Endothelial cells integrate biomechanical and biochemical cues to regulate vascular function, which can be modeled using cell signaling networks. Yet, the extent to which their signaling behavior is determined by network topology versus reaction-specific parameterization remains unclear. We developed a continuous logic-based ordinary differential equation model of vascular endothelial signaling containing 70 species and 123 regulatory reactions assembled from the literature. Model predictions were evaluated against 78 literature-defined directional responses to increased wall stress, wall shear stress, hypoxia, and TNF. We first tested whether a single global parameter triplet describing reaction weight (w), Hill coefficient (n), and half-maximal activation (EC50) could reproduce these observations. Investigator-selected global parameters reproduced 62 of 78 responses (79.49%). Monte Carlo sampling of 100,000 globally constant parameter sets improved agreement to 69 of 78 responses (88.46%), indicating that network topology alone captured most qualitative signaling behavior but remained sensitive to parameter choice. Allowing reaction-specific parameters increased the best agreement to 75 of 78 responses (96.15%). We then used a genetic algorithm to identify the smallest subset of reactions requiring reaction-specific specification while retaining a common constant-parameter spine for the remainder of the network. Complete agreement (100%) with all 78 literature-defined responses was achieved with reaction-specific parameterization of only 10 of 123 reactions. The optimized model was subsequently used to simulate continuous changes in wall shear stress, revealing pathway-dependent nonlinear responses, including monotonic increases in nitric oxide and pSmad1/5, nonmonotonic responses in endothelin-1 and NF-{kappa}B, and a biphasic pSmad2/3 response. These findings show that most observed endothelial signaling behavior can be reproduced by a fixed network topology with broadly shared reaction parameters with only a limited subset of interactions requiring quantitative specialization. This framework provides a compact endothelial signaling model for investigating mechanobiological regulation and for future integration with multiscale models of vascular adaptation and disease.

bioengineering↗

A comparison of scalable approaches for the pairwise analysis of large pathogen genomic and spatial datasets: an application to studying Mycobacterium tuberculosis transmission

Pairwise analysis of genomic and spatial data offers opportunities to identify and estimate the associations between covariates and the transmission of pathogens between individuals. However, such pairwise analyses are computationally intensive, and may not be feasible to conduct given the high dyad count in even moderately sized datasets. Here we compare two approaches to increase the efficiency of pairwise analysis for large datasets. We quantify and compare the performance of divide-and-conquer Bayesian model fitting and pairwise case-control approaches for estimating associations between individual- and pair-level covariates and shared membership in a transmission cluster. We utilize a large dataset (n=4,154) of spatially-referenced, genomically-sequenced Mycobacterium tuberculosis isolates collected from a single city for this analysis. We find that the case-control approach produces unbiased estimates of effect sizes with expected credible interval coverage and is more robust than the divide-and-conquer method when effect sizes are large. Thus, we recommend using the case-control approach with at least three controls per case to downscale datasets for pairwise analysis when analysis of the entire dataset is not possible. This approach mitigates the computational challenges of pairwise Bayesian modeling on datasets that require significant computational resources while maintaining desired inferential properties. Author SummaryPairwise analyses of large datasets to study pathogen transmission are computationally demanding because they typically require simultaneous analysis of each possible pair of individuals in a dataset; as datasets become larger these analyses often are not feasible to conduct even with access to high-performance computing resources. In this work, we compare a case-control approach and divide-and-conquer approaches for more efficient pairwise analysis of large datasets. Using a large dataset of Mycobacterium tuberculosis isolates including genetic and spatial data, we investigate the performance of each method for estimating the associations between host covariates and genetic clustering of isolates. We find that the case-control approach is generally preferred over methods which first divide the data into subsets and then combine results. While additional extensions of these analyses are needed to test the generality of these findings to other data settings, this work provides a practical way forward for the pairwise analysis of large datasets to study pathogen transmission.

microbiology↗

Estimating serotype-specific efficacy of pneumococcal conjugate vaccines using hierarchical models

Pneumococcal conjugate vaccines (PCVs) target 10 or 13 specific serotypes. To evaluate vaccine efficacy for these products, the vaccine-targeted serotypes are typically aggregated into a single group to estimate an overall effect. However, it is often desirable to evaluate variations in effects for different serotypes. These serotype-specific estimates are often based on small numbers, resulting in a high degree of uncertainty and instability in the individual estimates. A better approach is to use a Bayesian hierarchical statistical model, which estimates an overall effectiveness of the vaccine across all vaccine-targeted serotypes but also allows the effect to vary by serotype. We re-analyzed published data from a large randomized controlled trial on the efficacy of PCV13 against non-bacteremic community-acquired pneumonia caused by vaccine-targeted serotype. This model provides a potential framework for obtaining more credible and stable estimates of serotype-specific vaccine efficacy and effectiveness.

epidemiology↗

Challenges in estimating the impact of vaccination with sparse data

BackgroundThe synthetic control (SC) model is a powerful tool to quantify the population-level impact of vaccines, because it can adjust for trends unrelated to vaccination using a composite of control diseases. Because vaccine impact studies are often conducted using smaller subnational datasets, we evaluated the performance of SC models with sparse time series data. To obtain more robust estimates of vaccine effects from noisy time series, we proposed a possible alternative approach, \"STL+PCA\" method (seasonal-trend decomposition plus principal component analysis), which first extracts smoothed trends from the control time series and uses them to adjust the outcome.\n\nMethodsUsing both the SC and STL+PCA models, we estimated the impact of 10-valent pneumococcal conjugate vaccine (PCV10) on pneumonia hospitalizations among cases <12 months and 80+ years of age during 2004-2014 at the subnational level in Brazil. The performance of these models was also compared using simulation analyses.\n\nResultsThe SC model was able to adjust for trends unrelated to PCV10 in larger states but not in smaller states. The simulation analysis confirmed that the SC model failed to select an appropriate set of control diseases when the time series were sparse and noisy, thereby generating biased estimates of the impact of vaccination when secular trends were present. The STL+PCA approach decreased bias in the estimates for smaller populations.\n\nConclusionsEstimates from the SC model might be biased when data are sparse. The STL+PCA model provides more accurate evaluations of vaccine impact in smaller populations.

epidemiology↗

Differences in Pneumococcal Serotype Replacement in Individuals with and without Underlying Medical Conditions

BackgroundPneumococcal conjugate vaccines (PCVs) have had a well-documented impact on the incidence of invasive pneumococcal disease (IPD) worldwide. However, declines in IPD due to vaccine-targeted serotypes have been partially offset by increases in IPD due to non-vaccine serotypes. The goal of this study was to quantify serotype-specific changes in the incidence of IPD that occurred in different age groups, with or without certain co-morbidities, following the introduction of PCV7 and PCV13 in the childhood vaccination program in Denmark.\n\nMethodsWe used nationwide surveillance data for IPD in Denmark and a hierarchical Bayesian regression framework to estimate changes in the incidence of IPD associated with the introduction of PCV7 (2007) and PCV13 (2010) while controlling for serotype-specific epidemic cycles and unrelated secular trends.\n\nResults and ConclusionsFollowing the introduction of PCV7 and 13 in children, the net impact of serotype replacement varied considerably by age group and the presence of comorbid conditions. Serotype replacement offset a greater fraction of the decline in vaccine-targeted serotypes following the introduction of PCV7 compared with the period following the introduction of PCV13. Differences in the magnitude of serotype replacement were due to variations in the incidence of non-vaccine serotypes in the different risk groups before the introduction of PCV7 and PCV13. The relative increases in the incidence of IPD caused by non-vaccine serotypes did not differ appreciably in the post-vaccination period. Serotype replacement offset a greater proportion of the benefit of PCVs in strata in which the non-vaccine serotypes comprised a larger proportion of cases prior to the introduction of the vaccines. These findings could help to predict the impact of next-generation conjugate vaccines in specific risk groups.

epidemiology↗

Trends in CRP, D-dimer and fibrinogen during therapy for HIV associated multidrug resistant tuberculosis

BackgroundHIV positive adults on treatment for multidrug-resistant tuberculosis (MDR-TB) experience high mortality. Biomarkers of HIV/MDR-TB treatment response may enable earlier treatment modifications that improve outcomes.\n\nMethodsTo determine whether trends in C-reactive protein (CRP), D-dimer and fibrinogen predict treatment outcome among those with HIV/MDR-TB co-infection we studied 20 HIV positive participants initiating therapy for MDR-TB. Serum CRP, fibrinogen, and D-dimer were measured at baseline and serially while on treatment. Results: At baseline, all biomarkers were elevated with median CRP 86.15 mg/L (IQR 29.25-149.32), D-dimer 0.85 g/mL (IQR 0.34-1.80) and fibrinogen 4.11 g/L (IQR 3.75-6.31). CRP decreased significantly within 10 days of treatment initiation and fibrinogen within 28 days; D-dimer did not change significantly. 5 (25%) participants died. Older age (median age of 38y among survivors and 54y among deceased, p=0.008) and higher baseline fibrinogen (3.86 g/L among survivors and 6.37 g/L among deceased, p=0.02) were significantly associated with death. Higher CRP concentrations at the beginning of each measurement interval were significantly associated with a higher risk of death during that interval.\n\nConclusionTrends in fibrinogen and CRP may be useful for evaluating early response to treatment among individuals with HIV/MDR-TB co-infection.

immunology↗

SUCCESSIVE BLOODMEALS ENHANCE VIRUS DISSEMINATION WITHIN MOSQUITOES AND INCREASE TRANSMISSION POTENTIAL

SUMMARY PARAGRAPHThe recent Zika virus (ZIKV) and chikungunya virus (CHIKV) epidemics highlight the explosive nature of arthropod-borne (arbo) viruses transmitted by Aedes aegypti mosquitoes1,2. Vector competence and the extrinsic incubation period (EIP) are two key entomological parameters used to assess the public health risk posed by arboviruses3. These are typically measured empirically by offering mosquitoes an infectious bloodmeal and temporally sampling mosquitoes to determine infection and transmission status. This approach has been used for the better part of a century; however, it does not accurately capture the biology and behavior of many mosquito vectors which refeed frequently (every 2-3 days)4. Here we demonstrate that administration of a second non-infectious bloodmeal significantly shortens the EIP of ZIKV-infected Ae. aegypti by enhancing virus escape from the mosquito midgut. Similarly, a second bloodmeal increased the competence of this species for dengue virus and CHIKV. This effect was also observed for ZIKV in Aedes albopictus, suggesting that this species might be a more important vector than once thought and that this phenomenon may be common among other virus-vector pairings. Modeling of these findings reveals that a shortened EIP would result in a significant increase in the basic reproductive number, R0. This increase helps explain how Ae.aegypti can sustain an explosive epidemic like ZIKV despite its relatively poor vector competence in single-feed laboratory trials. Together, these data demonstrate a direct and unrecognized link between mosquito feeding behavior, EIP, and vector competence.

microbiology↗