First-in-Canada clinical RNA sequencing platform may improve rare disease diagnostics in pediatrics

A clinical RNA sequencing platform at SickKids, the first of its kind in Canada, offers insights into complex genetic conditions and the future of precision diagnostics

Peer-Reviewed Publication

THE HOSPITAL FOR SICK CHILDREN

 

IMAGE: DR. KYOKO YUKI AND DR. LIANNA KYRIAKOPOULOU ARE MOVING THE NEEDLE ON PRECISION DIAGNOSTICS FOR RARE DISEASES THROUGH A NEW CLINICAL RNA SEQUENCING PLATFORM AT SICKKIDS. view more 

CREDIT: THE HOSPITAL FOR SICK CHILDREN (SICKKIDS)

A new clinical RNA sequencing platform at The Hospital for Sick Children (SickKids) is helping to facilitate research into rare genetic conditions and carve a path for Precision Child Health, a movement at SickKids to deliver individualized care for every patient.

RNA sequencing provides a different way of looking at the genes, by looking at how the body interprets the genetic code rather than looking directly at the genetic code itself. While DNA-based tests like genome sequencing take a picture of a person’s genetic code, scientists can better understand how the DNA is being read by also looking at RNA, which carries instructions for making proteins in our body.

Across the SickKids Research Institute, scientists have been working closely together over the last six years to build and incorporate RNA sequencing into the research pipeline. Now, championed by Dr. Lianna Kyriakopoulou, a Clinical Laboratory Director in the Division of Genome Diagnostics, and Laboratory Specialist Dr. Kyoko Yuki, this technology is, for the first time in Canada, validated to be used in the clinical space as a new tool for precision diagnostics.

“The clinical RNA sequencing platform at SickKids is helping to move the needle in achieving a diagnosis for patients with rare genetic conditions through patient-centred care, or what SickKids calls Precision Child Health,” says Dr. Lianna Kyriakopoulou. “Used together, genome sequencing and RNA sequencing can potentially further inform which findings are relevant to help guide clinical decision-making.”

Combined DNA and RNA sequencing offers improved diagnostic information for complex genetic conditions

Using this clinical RNA sequencing platform, a team of SickKids researchers, in collaboration with Dr. Panagiota Klentrou at Brock University, performed genome sequencing and RNA sequencing on 97 individuals from 39 different families in the Complex Care Program, a clinical program focused on diagnosis and care of children with unexplained medical complexity.

In a study published in the American Journal of Human Genetics, the RNA analysis provided useful diagnostic information for an additional eight per cent of the patients whose diagnosis was not confirmed using genome sequencing alone, either confirming or ruling out the impact of a DNA variant identified during genome sequencing.

“Our findings demonstrate a clear benefit to pairing RNA sequencing with genome sequencing in a cohort of children who are suspected to have a genetic diagnosis,” explains co-first author Dr. Ashish Deshwar, a resident physician in Medical Genetics & Genomics.  

This study is also one of the first to examine the utility of a trio-approach to RNA sequencing, a process which involves conducting RNA sequencing on the affected individual and both parents. While trio RNA sequencing with this population did not uncover any new genetic variants, it decreased the amount of time researchers needed to spend reviewing results and made the analysis more efficient.

Deshwar, alongside other first-authors Yuki and Dr. Huayun Hou, a Bioinformatician in the Wilson Lab, also noticed inherited RNA patterns between family members and are optimistic about its potential use in further research. 

“We hope that the results of our study will help support the inclusion of clinical based RNA-testing in diagnostic workflows for children with rare conditions,” say co-leads and physician-scientists Drs. Gregory Costain and Jim Dowling, Scientist-Track Investigator and Senior Scientist (respectively) in the Genetics & Genome Biology program.  

RNA sequencing platform sparks new research into genetic conditions

The study is just one of the many research programs harnessing RNA sequencing at SickKids.  

At The Centre for Applied Genomics (TCAG) in the SickKids Research Institute, automated screening platforms are also available to researchers thanks to a collaborative effort including the Wilson Lab, Dowling Lab, Costain Lab, Shlien Lab, Brudno Lab, and others as well as the equipment and expertise at The Centre for Computational Medicine (CCM).

Current research already underway includes the study of allergic responses with Dr. Thomas Eiwegger and blood samples from individuals with lupus with Dr. Linda Hiraki.

Bridging clinical and research for the future of Precision Child Health

As more research is done into the benefits of RNA sequencing, scientists and clinicians are excited to better define the scenarios where clinical RNA sequencing can provide real insights for patients with rare genetic conditions, as well as other patient groups. This will be essential to providing the evidence needed to inform decisions about making RNA sequencing more broadly available for precision diagnostics.

“We have built a strong bridge between the research and clinical labs at SickKids which will benefit ongoing and future studies contributing to precision medicine becoming standard of care, as well as patients throughout the hospital,” says Dr. Michael Wilson, a Senior Scientist in the Genetics & Genome Biology program, who previously held a Canada Research Chair in Comparative Genomics. “By carefully sequencing and analysing RNA from diverse populations of sick and healthy children we have the potential to improve how we find diagnoses for patients with rare genetic conditions.” 

This research was funded by Genome Canada, SickKids Centre for Genetic Medicine, SickKids Research Institute and the University of Toronto McLaughlin Centre. Additional funding for the development of the RNA sequencing platform was provided by SickKids Innovators Fund.

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JOURNAL

American Journal of Human Genetics

DOI

10.1016/j.ajhg.2023.03.006 

ARTICLE TITLE

Trio RNA sequencing in a cohort of medically complex children

ARTICLE PUBLICATION DATE

Shift to ‘flash droughts’ as climate warms

Peer-Reviewed Publication

UNIVERSITY OF SOUTHAMPTON

Thursday, 13 April 2023

‘Flash droughts’ have become more frequent due to human-caused climate change and this trend is predicted to accelerate in a warmer future, according to research published today [13 April 2023] involving the University of Southampton.

The research published in Science shows that flash droughts, which start and develop rapidly, are becoming ‘the new normal’ for droughts, making forecasting and preparing for their impact more difficult.

Flash droughts can develop into severe droughts within a few weeks. They are caused by low precipitation and high evapotranspiration, which quickly depletes the soil of water. While they start quickly, the droughts can last for months, damaging vegetation and ecosystems, and triggering heat waves and wildfires.

A multinational group of researchers wanted to understand if there had been a transition from conventional ‘slow’ droughts to flash droughts and how this trend will develop under different carbon emission scenarios.

“Climate change has effectively sped up the onset of droughts,” says Professor Justin Sheffield, Professor of Hydrology and Remote Sensing at the University of Southampton and co-author of the paper.

“While it varies between different regions, there has been a global shift towards more frequent flash droughts during the past 64 years.”

The transition to flash droughts is most notable over East and North Asia, Europe, the Sahara, and the west coast of South America. Some areas, such as eastern North America, Southeast Asia and North Australia, saw fewer flash and slow droughts, but the speed of drought onset had increased. In the Amazon and West Africa, there was no evidence of a transition to flash droughts; the Amazon saw an increase in slow droughts and West Africa saw an increase in the frequency and extremity of both fast and slow droughts.

Professor Justin Sheffield added: “As we head towards a warmer future, flash droughts are becoming the new normal. Our models show that higher-emission scenarios would lead to a greater risk of flash droughts with quicker onset which pose a major challenge for climate adaptation.”

The transition to flash droughts may have irreversible impacts on ecosystems as they may not have enough time to adapt to a sudden lack of water and extreme heat. Forecasting flash droughts is also difficult as current approaches to predicting droughts use longer time scales.

The researchers say new approaches are needed to provide early warnings of flash droughts, as well as a better understanding of how natural ecosystems and humans will be impacted.

A global transition to flash droughts under climate change is published in Science.

Funding for the research was provided by the National Natural Science Foundation of China, the National Key R&D Program of China, the Natural Science Foundation of Jiangsu Province for Distinguished Young Scholars, and the UK-China Research & Innovation Partnership Fund through the Met Office Climate Science for Service Partnership (CSSP) China as part of the Newton Fund.

ENDS

Notes for Editors

1. A global transition to flash droughts under climate change will be published by Science in print on Friday, 14 April 2023 and online at 19:00 (7:00 pm) BST on Thursday, 13 April 2023. More information, including a copy of the paper, can be found online at the Science press package at https://www.eurekalert.org/press/scipak/
2. For further information and interviews with Professor Justin Sheffield, Professor of Hydrology and Remote Sensing at the University of Southampton, please contact: Steve Williams, Media Relations, University of Southampton. press@soton.ac.uk 023 8059 3212.
3. The University of Southampton drives original thinking, turns knowledge into action and impact, and creates solutions to the world’s challenges. We are among the top 100 institutions globally (QS World University Rankings 2023). Our academics are leaders in their fields, forging links with high-profile international businesses and organisations, and inspiring a 22,000-strong community of exceptional students, from over 135 countries worldwide. Through our high-quality education, the University helps students on a journey of discovery to realise their potential and join our global network of over 200,000 alumni. www.southampton.ac.uk
    

www.southampton.ac.uk/news/contact-press-team.page

Follow us on twitter: http://twitter.com/unisouthampton

Like us on Facebook: www.facebook.com/unisouthampton

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JOURNAL

Science

DOI

10.1126/science.abn6301 

ARTICLE TITLE

A global transition to flash droughts under climate change

ARTICLE PUBLICATION DATE

14-Apr-2023

Free trade deal is a major threat to UK public health, warn experts

New deal will make it harder for the UK to regulate tobacco and alcohol or ban products like those containing harmful pesticides

Peer-Reviewed Publication

BMJ

The UK’s decision to join one of the world’s largest free trade agreements, known as the Comprehensive and Progressive Agreement on Trans-Pacific Partnership (CPTPP), poses a major threat to UK public health, warn experts in The BMJ today.

In acceding to the CPTPP, the government hopes to boost trade, improve economic growth, and strengthen the UK’s strategic position as a global rule setter. 

But Courtney McNamara and colleagues argue that free trade deals have serious and wide ranging implications for public health and policy making, as they commit countries to certain regulatory and legal obligations. 

As such, they call on the government to commission a health impact assessment before signing takes place later in 2023 to evaluate the potential benefits and harms of this deal.

The CPTPP poses several threats to public health in the UK, they explain. For example, it is likely to make it more difficult to enact policies to cut consumption of tobacco, alcohol, and unhealthy food and drinks through clauses that allow foreign corporations to contest any such regulations.

It also contains provisions that effectively rule out a precautionary approach to food safety, meaning that bans on products like those containing harmful pesticides can be challenged.

And while some workers might benefit from a boost in exports and demand, which might increase wages, they argue that those working in industries that are undercut by cheaper imports and unable to compete are likely to experience economic insecurity and potentially job losses, which carry huge consequences for health.

The UK government has said the agreement will not mean lower health or food standards in the UK, and the authors acknowledge that the gross domestic product (GDP) boosting consequences of a free trade agreement could conceivably have positive health effects.

Based on the UK government’s own calculations, however, they point out that the economic case for joining the CPTPP “amounts to no more than a 0.08% increase in the country’s GDP over a 15 year period.”

More problematically, the government’s calculations fail to account for the implementation costs of joining the agreement, they add. “To our knowledge, no national evaluation has been done to account for implementation costs with respect to changes in regulatory and dispute settlement rules.”

“If a priority of the government is to do no harm, a commitment made explicit during Brexit negotiations, then it should take account of the health implications of its trade policies,” they write.

“Even if it is unlikely that, given the government’s poor track record on public health, the findings would influence its decision to sign, evidence produced by the assessment will still be extremely valuable by pointing to populations at risk and communities whose health might be safeguarded during the agreement’s implementation,” they add.

If the government fails to undertake a health impact assessment, it will fall to public health scholars, professionals, and advocates to mobilise and act to undertake this important work, they conclude.

[Ends] 

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JOURNAL

The BMJ

DOI

10.1136/bmj-2022-073302 

METHOD OF RESEARCH

Content analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

The CPTPP trade deal is a major threat to public health and warrants a health impact assessment

ARTICLE PUBLICATION DATE

12-Apr-2023

The hidden culprit behind nitrogen dioxide emissions

Peer-Reviewed Publication

POHANG UNIVERSITY OF SCIENCE & TECHNOLOGY (POSTECH)

 

IMAGE: RESEARCH IMAGE view more 

CREDIT: POSTECH

Nitrogen dioxide is one of the criteria air pollutants that plays an important role as a precursor gas of fine particulate matter and ozone. NO2 emissions are known to be primarily generated by industrial facilities or vehicle exhausts. Recently, a research team from POSTECH analyzed satellite remote sensing data from the European Space Agency (ESA) and released results showing that food processing facilities and high-rise apartments that are 10 stories or higher are significant sources of NO2 emissions. Their findings have drawn attention from NASA.

 

A POSTECH research team led by Professor Hyung Joo Lee used the TROPOspheric Monitoring Instrument (TROPOMI), an instrument on an Earth observation satellite that can monitor atmospheric composition, to analyze NO2 emissions from various types of properties in California. Their analysis suggests that NO2 emissions were highest at food processing facilities and residential complexes with high population density.   

 

The team estimated average NO2 concentrations at the spatial resolution of 500 m in California between 2018 and 2019 and assessed whether NO2 concentrations measured at ground monitors were representative of population exposures to NO2 in each county. They also evaluated which property types showed the highest NO2 emissions and therefore exposures. Their assessment revealed that the highest NO2 exposures were attributed to food processing facilities and high-rise apartments that are 10 stories or higher. The same results were obtained when traffic was taken into consideration.

 

Such high residential emissions are presumed to be attributed to combustion sources within the apartments, such as water boilers, space heaters, and other indoor-generated emissions vented outdoors. Residential combustion sources have not been considered significant sources of air pollution in previous research.

 

POSTECH Professor Hyung Joo Lee explained, “Highly populated residential areas, specifically high-rise apartments, have not been extensively studied. However, the research indicates that these areas should be regarded as crucial contributors to NO2 emissions in the formulation of environmental policies.”

 

He emphasized the significance of the research by stating, “The research demonstrates that satellite remote sensing can be effectively used to inform air quality management.”

 

The research was published in Science of the Total Environment, one of the most prestigious environmental journals, and was introduced in NASA Earth Observatory.

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JOURNAL

Science of The Total Environment

DOI

10.1016/j.scitotenv.2022.159342 

ARTICLE TITLE

Neighborhood-scale ambient NO2 concentrations using TROPOMI NO2 data: Applications for spatially comprehensive exposure assessment

Female healthworkers need better radiation protection to minimise breast cancer risk

Standard PPE does not fully protect breast tissue; Employers should invest in equipment that ensures the safety of all their staff

Peer-Reviewed Publication

BMJ

Women working in healthcare who are regularly exposed to radiation from x-rays and other imaging procedures need better ionising radiation protection to help minimise their risk of developing breast cancer, argue doctors in The BMJ today.

Ionising radiation is a known human carcinogen and breast tissue is highly radiation sensitive. As such, there are concerns that regular exposure to ionising radiation during image guided procedures may be linked to a higher risk of breast cancer in female healthcare workers.

Personal protective equipment (PPE) such as lead gowns are used to shield the body from harmful radiation during these procedures. But studies have shown that current radiation PPE provides inadequate protection to breast tissue as it leaves the area close to the armpit (known as the upper outer quadrant and axilla - the most common site of breast cancer) exposed.

“Providing adequate breast covering PPE could therefore reduce radiation exposure and potentially help prevent breast cancer in female healthcare workers,” write Isobel Pilkington and colleagues. 

They acknowledge that measuring the risk of occupational radiation induced breast cancer in women working in healthcare is challenging, but as the number of female trainees entering these specialties increases, they say “it is essential that the available evidence is considered and equipment provision improved to minimise this risk.”

They point to observational evidence suggesting an increase in breast cancer risk among female US orthopaedic surgeons compared with an age matched female population, and to a small Finnish study showing breast cancer at 1.7 times the expected rate in radiologists, surgeons, and cardiologists compared with female physicians not working with radiation.

In a study using artificial female torsos to measure radiation exposure, researchers found inadequate upper outer quadrant protection and no statistically significant reduction in dose when standard PPE was compared with a torso without PPE.

Occupational radiation exposure has not been identified as a risk factor for male breast cancer. However, the Ionising Radiation Regulations 2017 state that the radiation dose delivered to all workers should be As Low As Reasonably Achievable (ALARA). The most effective way to achieve this, say the authors, is by reducing the duration of exposure, increasing the distance from the source, and shielding all workers with effective PPE.

They point to additional protection, such as capped sleeves and axillary wings, that can be worn under standard gowns to protect the upper outer quadrant of the breast, and say the European Society for Vascular Surgery 2023 Clinical Practice Guidelines on Radiation Safety have already recommended female operators consider adopting this extra protection. 

“Providing appropriate protection is a legal requirement of an employer, who has a duty of care to all workers exposed to radiation,” they write. “The female breast appears to be particularly vulnerable and it is therefore important employers invest in protective equipment that enhances the safety of all their staff.”

[Ends]

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JOURNAL

The BMJ

DOI

10.1136/bmj-2023-075406 

METHOD OF RESEARCH

Commentary/editorial

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Protecting female healthworkers from ionising radiation at work

ARTICLE PUBLICATION DATE

12-Apr-2023

New study demonstrates hospital safety climate and organizational characteristics predict healthcare-associated infections and occupational health outcomes

Findings provide first published evidence of relationship between standard precaution adherence and safety of both healthcare workers and patients

Peer-Reviewed Publication

ASSOCIATION FOR PROFESSIONALS IN INFECTION CONTROL

Arlington, Va., April 13, 2023 – New data published today in the American Journal of Infection Control (AJIC) provide the first published evidence that a positive safety climate and adherence to standard precautions predict key healthcare-associated infection (HAI) and occupational health outcomes among patients and health care workers, respectively. The findings highlight features within hospitals’ organizations and safety climates that could be modified to improve these outcomes.

“Despite the infection prevention and safety benefits associated with standard precautions, generating consistent adherence in the healthcare setting has been notoriously challenging, for reasons that are not completely clear,” said Amanda J. Hessels, PhD, MPH, RN, Assistant Professor, Columbia University School of Nursing and Nurse Scientist at Hackensack Meridian Health and the lead author on the published study. “To our knowledge, our study findings are the first to demonstrate an association between adherence, hospitals’ patient-safety climates, and outcomes, and should help to advance the state of the science in patient and occupational health and safety.”

Annually approximately 385,000 sharps injuries occur among America’s 5.6 million healthcare workers, and approximately 2 million hospitalized patients acquire one or more HAIs after receiving healthcare.  Standard precautions such as hand hygiene, use of appropriate personal protective equipment (PPE), and safe use and disposal of sharps, are federally regulated sets of actions designed to limit the risk of blood-borne and other infections among healthcare workers and prevent patient HAIs. Research shows that adherence to standard precautions happens less than 50% of the time.

Dr. Hessels and colleagues created a novel study to determine the relationships among patient safety climate, self-reported or observed standard precaution adherence, and HAIs or healthcare worker sharps and splash exposures.

The researchers surveyed 452 U.S.-based registered nurses about their hospital units’ patient safety climates, collected observational adherence data on 5,285 standard precautions using a standardized tool, and obtained corresponding unit-level data on patient HAIs and healthcare worker sharp and splash exposure data.

Results show:

• Overall adherence to all categories of standard precautions was 64.4%, with significant differences by provider role.
• Overall adherence was highest among nurses (69.1%), followed by other providers (62.1%) and physicians (58%).
• There is a positive correlation (p < 0.1) between patient safety climate in aggregate and reported standard precaution adherence.
• There is an additional, positive correlation between positive perceptions of a work environment that is conducive to standard precautions and reported adherence (p < 0.1).

Additionally, researchers found that a group of variables comprising observed standard precaution adherence, overall patient safety climate, and multiple potential confounders – including hospital Magnet status, level of nurse staffing, hospital ownership, and teaching status -- reliably predicted:

• The rates of catheter-associated urinary tract infections (CAUTI; p = 0.2) and methicillin-resistant Staphylococcus aureus (MRSA; p = 0.3) among patients.

• Nurse mucotaneous exposures (p = 0.004), all staff mucotaneous exposures (p = 0.007), and all staff sharps and needle injuries (p = .001).

Finally, researchers concluded that these variables also explained the sizeable variance in MRSA (41%), CAUTI (23%), mucotaneous exposures (43%), and needlestick and sharps injuries (38%) among those units that reported positive patient safety climates and reliable adherence to standard precautions vs. those that did not.

“Keeping our healthcare workforce and patients safe is our number one priority as healthcare professionals,” said Patricia Jackson, RN, MA, CIC, FAPIC, 2023 APIC president. “The findings from this study provide important insights into the factors that impact HAIs and occupational injuries and will help infection preventionists design focused strategies for improvement.”

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org.

 

About AJIC

As the official peer-reviewed journal of APIC, The American Journal of Infection Control (AJIC) is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. Published by Elsevier, AJIC also publishes infection control guidelines from APIC and the CDC. AJIC is included in Index Medicus and CINAHL. Visit AJIC at ajicjournal.org.

NOTE FOR EDITORS

“Impact of patient safety climate on infection prevention practices and healthcare worker and patient outcomes,” by Amanda J. Hessels, Jingwen Guo, Cara T. Johnson, and Elaine Larson, was published online in AJIC on April 13, 2023. The article may be found at: https://doi.org/10.1016/j.ajic.2023.01.021

AUTHORS

Amanda J. Hessels, PhD, MPH, RN, CIC, CPHQ, FAPIC, FAAN (corresponding author: ah3269@cumc.columbia.edu; amanda.hessels@hmhn.org), Columbia University School of Nursing, New York, New York, USA; Hackensack Meridian Health, Ann May Center, Neptune, NJ

Jingwen Guo, MS

Columbia University Data Science Institute, New York, New York, USA

Cara T. Johnson, RN, MPH

Columbia University School of Nursing, New York, New York, USA

Elaine Larson, RN, PhD, FAAN, CIC

Columbia University School of Nursing, New York, New York, USA

 

Acknowledgments: This project was supported by the Research Scientist Development Award Agreement Number, 1K01OH011186, funded by the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Its contents are solely the responsibility

of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.               

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JOURNAL

American Journal of Infection Control

DOI

10.1016/j.ajic.2023.01.021 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Impact of patient safety climate on infection prevention practices and healthcare worker and patient outcomes

ARTICLE PUBLICATION DATE

13-Apr-2023

Major genetic study reveals how antibiotic resistance varies according to where you live, demographics, and diet

Women and those on higher incomes found to have more antibiotic resistance genes; living in cities also fuels resistance.

Reports and Proceedings

EUROPEAN SOCIETY OF CLINICAL MICROBIOLOGY AND INFECTIOUS DISEASES

**Note: the release below is from the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID 2023, Copenhagen, 15-18 April). Please credit the conference if you use this story**

A genetic study analysing the microbiome (bacteria in the gut) of a large nationally representative sample of the Finnish population finds that geographic, demographic, diet, and lifestyle factors are driving the spread of antibiotic resistance in the general population.

The most comprehensive study of its kind by Dr Katariina Pärnänen from the University of Turku in Finland and colleagues, being presented at this year’s European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Copenhagen, Denmark (15-18 April), highlights the urgent need for targeted interventions to reduce antibiotic resistance tailored to different demographics and lifestyles.

Antibiotic-resistant bacteria can spread through healthy adult populations and go largely unnoticed. Antimicrobial resistance poses a significant threat to humanity, and has become a leading cause of death worldwide, involved in an estimated 5 million deaths in 2019 and estimated to be the direct cause of 1.27 million deaths [1]. Estimates suggest that antimicrobial resistance will overtake cancer as the leading cause of death worldwide by 2050 [2].

Despite the remarkable efforts to map the overall composition and health associations of the gut microbiome over the last decade, a deeper understanding of the factors driving the distribution of antimicrobial resistance within the general population is urgently needed.

To find out more, researchers investigated the extent to which demographic, dietary, health and geographic factors influence the abundance of antibiotic resistance genes (ARGs) in gut metagenome faecal samples from 7,098 symptomless adults taking part in the national FINKRISK study—a large representative Finnish population survey carried out every 5 years since 1972.

The FINRISK project collects extensive health and lifestyle data, including major diagnoses, blood measurements, habitual diet, and prescription drug use, that are proxies for the three ecological mechanisms that influence ARG abundance—acquisition of external ARGs from food; host health status (endemic resistance); and drug-mediated selection of resistant bacteria.

Researchers used shotgun metagenomes (untargeted genetic sequencing of all bacteria living in the gut) to examine the associations between participants’ antibiotic resistance gene load, diversity, and composition and geography, demography, lifestyle, and health factors.

As expected, the analyses found that antibiotic use was linked to higher ARG loads, but other drug classes, such as psycholeptic drugs (e.g., opioids and barbiturates), were also associated with higher abundance of ARGs.

The analyses also found that more frequent raw vegetable and poultry consumption (both foods containing high quantities of resistant bacteria) was associated with higher ARG loads and diversity.

What’s more, ARG loads, composition, and diversity were also associated with geography. For example, people living in western Finland had a higher abundance and more diverse ARGs than those living in the east. And higher population density was also associated with higher ARG load and diversity.

Interestingly, ARG loads had clear variation according to demographics, with women and participants on higher incomes having more resistance genes.

“Our findings clearly show that geography, demographics, and diet play an underappreciated role in antibiotic resistance,” says Dr Pärnänen. “This has important implications for the antibiotic resistance crisis as more and more people are living in densely populated areas and cities and are able to buy more expensive types of foods, such as meat, and fresh produce, and also medication. Reducing or preventing the spread of antimicrobial resistance will require action plans at national levels that go beyond regulating the misuse of antibiotic prescriptions.”

For interviews with the report authors, please contact Dr Katariina Pärnänen, University of Turku, Finland E) katariina.parnanen@utu.fi T) +35 8400 664 640

Alternative contact in the ECCMID Press Room: Tony Kirby T) + 44(0)7834 385827 E) tony@tonykirby.com

Notes to editors:

[1] Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis - The Lancet
[2] 160525_Final paper_with cover.pdf (amr-review.org)

The authors declare no conflicts of interest.

This research was supported in part by grants from the Finnish Foundation for Cardiovascular Research, the Emil Aaltonen Foundation, the Alhopuro foundation, the Paavo Nurmi Foundation, the Urmas Pekkala Foundation, the Finnish Medical Foundation, the Academy of Finland and the National Institutes of Health. Additional support was provided by Illumina Inc. and Janssen Pharmaceutica through their sponsorship of the Center for Microbiome Innovation at UCSD. Computation was done at CSC, the IT centre for Scientific computing.

This press release is based on abstract 04221 at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) annual meeting. The material has been peer reviewed by the congress selection committee. There is no full paper available at this stage and the work has not yet been submitted to a medical journal for publication.

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ARTICLE PUBLICATION DATE

14-Apr-2023

Estonian researchers developed a method for instant energy-performance label

Business Announcement

ESTONIAN RESEARCH COUNCIL

 

IMAGE: AT THE EHITUSE MÄEMAJA THE DIGIAUDIT PLATFORM WAS TESTED view more 

CREDIT: TALTECH

The researchers of the FinEst Centre for Smart Cities of Tallinn University of Technology (Estonia, Europe) developed the DigiAudit platform to monitor and analyse energy use and indoor climate indicators of buildings and large real estate portfolios in real time. Thinnect, an Estonian IoT start-up company, will help sell the solution and market it worldwide.  We can only reach zero-emission buildings when we have reliable data The European Union has set a target for all buildings to be zero-emission, or near-zero energy, by 2050. However, there is no reliable data on the energy consumption of many buildings, so it is not possible to monitor the condition of buildings or estimate their energy use. The DigiAudit platform solves this problem and also allows companies to simplify the additional reporting obligations imposed under the European Corporate Sustainability Reporting Directive (CSRD). In the pilot project, 25 educational buildings in Tallinn and Tartu were connected to the IoT platform. Continuous monitoring of energy, ventilation and air quality in hundreds of buildings generated big data, which analytics were developed to handle. It enables the monitoring and comparison of the condition of the buildings, as well as diagnostics and detection of errors in the technical systems of the buildings and the use of the buildings. Comparative overview of the energy consumption and indoor climate quality of large real estate portfolios The platform provides property owners with information on the total energy use, energy costs and carbon footprint of their portfolio of buildings. The energy labels and indoor climate classes of all buildings connected to the platform are also presented, which enables comparison with other similar buildings. According to DigiAudit's project lead, Professor Jarek Kurnitski, the uniqueness of the solution lies in the real-time energy labeling of the entire real estate portfolio. Improving the energy efficiency of buildings is crucial from the point of view of the Estonia 2035 strategy, as buildings already account for 53% of the final energy consumption. The platform gives building owners and managers a simple, comparable overview of the actual energy consumption of the various buildings in the entire portfolio, as well as the quality of the indoor climate. In the project, a method was developed to compare the energy efficiency of an individual building with other buildings of the same type. A data set containing energy efficiency indicators of 35,000 Estonian buildings was analyzed. Based on this, a model was developed that approximately shows the energy efficiency of a single building position. As a result of the study, the project team saw that energy efficiency measures to date have improved the performance of buildings, and if progress continues, 73 percent of new or renovated buildings could achieve carbon neutrality. DigiAudit platform solutions are based on data, and in order to achieve meaningful analysis results, it is crucial to assess the quality of the data. Building ventilation performance and air quality are assessed based on the carbon dioxide level measured in the premises. It turned out that the raw data collected by the installed building automation systems are sometimes unreliable. To solve the problem, a method was developed that corrects the data in such a way that they can be compared with the limit values of the carbon dioxide level specified in the indoor climate standards. Also, a method was made to automatically evaluate whether the room is in use or not. The impact of the methods on the assessment of the indoor climate was important, and the assessment of the period of use is particularly important. If nighttime and weekends are used in the analysis of air quality in schools and kindergartens, the situation appears more positive than it is. The platform separates capacity monitoring functions from maintenance-related automatic diagnostics. The user interface consists of three views, in which the detail of the information presented depends on the user. Dashboard views were created for the city government, city property board and those responsible for administration/maintenance according to their information needs.   At the Ehituse Mäemaja inside the ventilation systems were tested. CREDIT TalTech Scientists can solve multifaceted problems The goal of all pilot projects of FinEst Centre for Smart Cities is to create a functioning product or service that is usable in many cities. DigiAudit is one of the first examples where the goal has been successfully achieved. The cooperation with the start-up company Thinnect has been going on for some time and now the solution has been transferred with a licensing agreement and the first working product has been created. According to Jürgo Preden, the CEO of Thinnect (the company bringing the solution to the market), DigiAudit is a scientific breakthrough that has no competitor on the market today. ‘Nowadays, no building manager can keep track of where exactly energy is being used because buildings are so complex and their operation changes over time. This is where the DigiAudit system plays an important role – it helps understand where energy is being used and how to reduce the consumption,’ Preden said. BACKGROUND Thinnect is a start-up, predominantly owned by Estonian capital, offering IoT technology and services – namely, solutions that enable accurate monitoring and management of buildings. In addition to Estonia, the smart environment solutions of Thinnect are used in eight other countries. The systems developed by the company can be used for saving energy as well as for improving the ease of use and efficiency. The FinEst Centre for Smart Cities, located at Tallinn University of Technology (Estonia, Europe), has six pilot projects in operation where Estonian and Finnish cities develop and test innovative smart city solutions. The founders of the center are TalTech, Aalto University, the City of Helsinki innovation company Forum Virium and the Ministry of Economic Affairs and Communications. The creation of the center is funded by the European Commission and the Ministry of Education and Research through Horizon 2020 and the European Regional Development Fund.