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Epidemiology and environmental risks of antibiotic resistant Enterobacterales isolates in different aquatic matrices from North-Western Romania 罗马尼亚西北部不同水生基质中抗生素耐药肠杆菌分离株的流行病学和环境风险
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-08-22 DOI: 10.1016/j.epidem.2025.100852
Anca Farkas , Rahela Carpa , Edina Szekeres , Adela Teban-Man , Cristian Coman , Anca Butiuc-Keul
The most menacing sources of environmental contamination with antibiotic resistant bacteria are effluents derived from anthropic activities. Even when wastewater treatment processes are implemented, conventional methods are not able to completely retain the antibiotic resistance determinants. We propose an antibiotic resistance risk assessment, incorporating the characterisation of ARB, ARGs and MGEs in different environmental compartments.
Antibiotic susceptibility testing of 678 Enterobacterales isolates revealed an increased degree of intrinsic resistance to erythromycin (77.9 %), high level of resistance to ampicillin (39.7 %), low frequency of carbapenem resistance (2.36 %), and a percentage of 34.4 % MDR strains. The most frequent resistance determinants were blaTEM-1 (26.5 %) and tetA (8.26 %), while the intI1 gene was found in 7.37 % of isolates. Resistant Enterobacterales from aquatic matrices with different degrees of contamination were identified as Citrobacter spp. (n = 46), Enterobacter spp. (n = 35), Klebsiella spp. (n = 54) and Escherichia coli (n = 107). A strong statistical correlation was observed between the presence of intI1 and the ARG index (0.768) in resistant Enterobacter spp.
Distinct clustering of strains was not observed across different environmental matrices, especially in those directly impacted by human-derived bacteria. Also, distribution of ARB patterns and diversity of ARGs was stable from the taxonomic perspective. Dendrogram analysis based on ERIC-PCR profiles confirmed the presence of strains with identical DNA fingerprints in non-related aquatic ecosystems. The epidemiology of resistant Citrobacter, Enterobacter, Klebsiella and Escherichia isolates confirmed an extensive migration and environmental dispersion of strains with human health significance, particularly important for water resources.
具有抗生素抗性细菌的最具威胁性的环境污染源是人类活动产生的污水。即使实施了废水处理过程,传统方法也不能完全保留抗生素耐药性决定因素。我们建议进行抗生素耐药风险评估,包括不同环境区室中ARB、ARGs和MGEs的特征。对678株肠杆菌进行药敏试验,发现对红霉素耐药程度增加(77.9% %),对氨苄西林耐药程度高(39.7% %),对碳青霉烯类耐药频率低(2.36 %),耐多药菌株比例为34.4% %。最常见的耐药决定因素是blatem1(26.5% %)和tetA(8.26% %),而intI1基因在7.37% %的分离株中发现。从不同污染程度的水生基质中鉴定出耐药肠杆菌为Citrobacter spp (n = 46)、Enterobacter spp (n = 35)、Klebsiella spp (n = 54)和Escherichia coli (n = 107)。耐药肠杆菌中intI1的存在与ARG指数(0.768)有较强的统计学相关性,但在不同的环境基质中,特别是在直接受人源性细菌影响的环境基质中,未观察到明显的菌群聚集性。从分类上看,arg的分布格局和多样性是稳定的。基于ERIC-PCR图谱的树形图分析证实,在非亲缘关系的水生生态系统中存在具有相同DNA指纹的菌株。耐药柠檬酸杆菌、肠杆菌、克雷伯氏菌和埃希氏菌分离株的流行病学证实了具有人类健康意义的菌株的广泛迁移和环境分散,对水资源尤其重要。
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引用次数: 0
Sequential Monte Carlo Squared for online inference in stochastic epidemic models 随机流行病模型在线推理的顺序蒙特卡罗平方
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-08-19 DOI: 10.1016/j.epidem.2025.100847
Dhorasso Temfack, Jason Wyse
Effective epidemic modeling and surveillance require computationally efficient methods that can continuously update parameter estimates as new data becomes available. This paper explores the application of an online variant of Sequential Monte Carlo Squared (O-SMC2) to the stochastic Susceptible–Exposed–Infectious–Removed (SEIR) model for real-time epidemic tracking. The advantage of O-SMC2 lies in its ability to update parameter estimates using a particle Metropolis–Hastings kernel by only utilizing a fixed window of recent observations. This feature enables timely parameter updates and significantly enhances computational efficiency compared to standard SMC2, which requires processing all past observations. First, we demonstrate the efficiency of O-SMC2 on simulated epidemic data, where both the true parameter values and the observation process are known. We then make an application to a real-world COVID-19 dataset from Ireland, successfully tracking the epidemic and estimating a time-dependent reproduction number of the disease. Our results show that O-SMC2 provides accurate online estimates of both static and dynamic epidemiological parameters while substantially reducing computational cost. These findings highlight the potential of O-SMC2 for real-time epidemic monitoring and supporting adaptive public health interventions.
有效的流行病建模和监测需要计算效率高的方法,这些方法可以在获得新数据时不断更新参数估计。本文探讨了序列蒙特卡罗平方(O-SMC2)的在线变体在随机易感-暴露-感染-去除(SEIR)模型中的应用,用于实时流行病跟踪。O-SMC2的优势在于它能够仅利用最近观测的固定窗口,使用粒子Metropolis-Hastings核来更新参数估计。与需要处理所有过去观测值的标准SMC2相比,该功能可以及时更新参数,并显著提高计算效率。首先,我们证明了O-SMC2在真实参数值和观测过程都已知的模拟流行病数据上的效率。然后,我们对来自爱尔兰的真实世界的COVID-19数据集进行了应用,成功地跟踪了疫情,并估计了该疾病的随时间变化的繁殖数量。我们的研究结果表明,O-SMC2提供了准确的在线估计静态和动态流行病学参数,同时大大降低了计算成本。这些发现突出了O-SMC2在实时流行病监测和支持适应性公共卫生干预方面的潜力。
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引用次数: 0
Transmission dynamics of Norovirus GII and Enterovirus in Switzerland during the COVID-19 pandemic (2021–2022) as evidenced in wastewater 2019冠状病毒病大流行期间(2021-2022年)诺如病毒GII和肠病毒在瑞士的传播动态——废水中的证据
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-08-08 DOI: 10.1016/j.epidem.2025.100851
Jana S. Huisman , Shotaro Torii , Htet Kyi Wynn , Charles Gan , Irene K. Voellmy , Michael Huber , Timothy R. Julian , Tamar Kohn
Noroviruses and enteroviruses are major causes of endemic gastrointestinal disease associated with substantial disease burden. However, viral gastroenteritis is often diagnosed based on symptoms, with etiology infrequently tested or reported, so little information exists on community-level transmission dynamics. In this study, we demonstrate that norovirus (NoV) genogroup II and enterovirus (EV) viral loads in wastewater reveal transmission dynamics of these viruses. We report NoV and EV concentrations in wastewater from 363 samples between December 5 2020 and October 10 2022 (sampled every second day). Virus concentrations in wastewater were low during 2021, and increased in 2022. Wastewater recapitulated periods of increased clinical cases, and also identified silent waves of transmission. We used the measured wastewater loads to estimate the effective reproductive number (Re). The Re for both NoV and EV peaked between 1.1 and 1.2. However, the usual seasonality of NoV transmission was upended by non-pharmaceutical interventions implemented to mitigate the COVID-19 pandemic, leading to correlated transmission dynamics of NoV GII and EV during 2021–2022. This highlights the use of wastewater to understand transmission dynamics of endemic enteric viruses and estimate relevant epidemiological parameters, including Re.
诺如病毒和肠病毒是地方性胃肠道疾病的主要病因,与重大疾病负担相关。然而,病毒性肠胃炎通常是根据症状诊断的,很少检测或报告病因,因此关于社区层面传播动态的信息很少。在这项研究中,我们证明了诺如病毒(NoV)基因组II和肠病毒(EV)在废水中的病毒载量揭示了这些病毒的传播动力学。我们报告了2020年12月5日至2022年10月10日(每隔一天采样一次)期间363个样本的废水中NoV和EV浓度。2021年废水中的病毒浓度较低,2022年有所上升。废水重现了临床病例增加的时期,并确定了无声传播波。我们使用测量的废水负荷来估计有效繁殖数(Re)。NoV和EV的Re均在1.1 - 1.2之间达到峰值。然而,为缓解COVID-19大流行而实施的非药物干预措施颠覆了NoV传播的通常季节性,导致2021-2022年期间NoV GII和EV的相关传播动态。这强调了利用废水来了解地方性肠道病毒的传播动力学和估计相关的流行病学参数,包括Re。
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引用次数: 0
Characterizing potential interaction between respiratory syncytial virus and seasonal influenza in the U.S. 美国呼吸道合胞病毒与季节性流感之间潜在相互作用的特征
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-08-07 DOI: 10.1016/j.epidem.2025.100850
Jiani Chen , Deven V. Gokhale , Ludy Registre Carmola , Liang Liu , Pejman Rohani , Justin Bahl
RSV and seasonal influenza are two of the most prevalent causes of respiratory infection in the U.S. In this study, we used weekly positive case reports and genetic surveillance data to characterize the circulation of these viruses in the United States between 2011 and 2019 and a mathematical modeling approach to explore their potential interaction at a regional level. Our analyses showed that RSV and seasonal influenza co-circulate with different relative epidemic sizes and seasonal overlaps across regions and seasons. We found that RSV had a different evolutionary dynamic compared to seasonal influenza and that local persistence may play a role in underlying annual epidemics. Our analysis supports a potential competitive interaction between RSV and seasonal influenza in most regions across the United States. The multiple-pathogen modeling framework suggests that cross-immunity following infection of either virus might be one of the key drivers of viral competition. However, this finding is based on model-derived inferences and limited surveillance data; further investigation is needed to confirm its robustness and gain a better understanding of the underlying mechanisms. These findings underscore the importance of continued research into the immunological and ecological mechanisms of viral inference, which might be important for the development of more effective protective strategies against co-circulating respiratory viruses.
RSV和季节性流感是美国最常见的两种呼吸道感染原因。在本研究中,我们使用每周阳性病例报告和遗传监测数据来表征2011年至2019年期间这些病毒在美国的传播情况,并使用数学建模方法来探索它们在区域层面上的潜在相互作用。我们的分析表明,RSV和季节性流感共流行,不同地区和季节的相对流行规模和季节重叠程度不同。我们发现,与季节性流感相比,RSV具有不同的进化动态,并且局部持久性可能在潜在的年度流行中发挥作用。我们的分析支持在美国大部分地区RSV和季节性流感之间潜在的竞争性相互作用。多病原体建模框架表明,感染任一病毒后的交叉免疫可能是病毒竞争的关键驱动因素之一。然而,这一发现是基于模型推导的推论和有限的监测数据;需要进一步的研究来证实其稳健性并更好地理解其潜在机制。这些发现强调了继续研究病毒推断的免疫学和生态学机制的重要性,这可能对开发更有效的针对共循环呼吸道病毒的保护策略很重要。
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引用次数: 0
Explaining the stable coexistence of drug-resistant and -susceptible pathogens: the resistance acquisition purifying selection model 解释耐药和敏感病原体稳定共存:耐药性获得纯化选择模型
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-08-06 DOI: 10.1016/j.epidem.2025.100848
Pleuni S. Pennings
Drug resistance is a problem in many pathogens. While overall, levels of resistance have risen in recent decades, there are many examples where after an initial rise, levels of resistance have stabilized. The stable coexistence of resistance and susceptibility has proven hard to explain – in most evolutionary models, either resistance or susceptibility ultimately “wins” and takes over the population. Here, we show that a simple model, mathematically akin to mutation-selection balance theory, can explain several key observations about drug resistance: (1) the stable coexistence of resistant and susceptible strains (2) at levels that depend on population-level drug usage and (3) with resistance often due to many different strains (resistance is present on many different genetic backgrounds). The model is applicable to resistance due to both mutations and horizontal gene transfer (HGT). It predicts that new resistant strains should continuously appear (through mutation or HGT and positive selection within treated hosts) and disappear (due to a fitness cost of resistance). The result is that while resistance is stable, which strains carry resistance is constantly changing. We used data from a longitudinal genomic study on E. coli in Norway to test this prediction for resistance to five different drugs and found that, consistent with the model, most resistant strains indeed disappear quickly after they appear in the dataset. Having a model that explains the dynamics of drug resistance will allow us to plan science-backed interventions to reduce the burden of drug resistance.
耐药性是许多病原体存在的问题。虽然总体而言,近几十年来耐药性水平有所上升,但有许多例子表明,在最初的上升之后,耐药性水平已经稳定下来。抗药性和易感染性的稳定共存已被证明是难以解释的——在大多数进化模型中,抗药性或易感性最终“胜出”并接管种群。在这里,我们展示了一个简单的模型,在数学上类似于突变选择平衡理论,可以解释关于耐药性的几个关键观察:(1)耐药菌株和敏感菌株的稳定共存(2)依赖于人群水平的药物使用水平;(3)通常由许多不同的菌株引起的耐药性(耐药性存在于许多不同的遗传背景)。该模型适用于突变和水平基因转移(HGT)引起的抗性。它预测新的耐药菌株将不断出现(通过突变或HGT和处理宿主内的阳性选择)并消失(由于抗性的适应度成本)。结果是,虽然抗性是稳定的,但哪些菌株携带抗性是不断变化的。我们使用来自挪威大肠杆菌纵向基因组研究的数据来测试对五种不同药物耐药性的预测,并发现,与模型一致,大多数耐药菌株在出现在数据集中后确实很快消失了。拥有一个解释耐药性动态的模型将使我们能够计划有科学依据的干预措施,以减轻耐药性的负担。
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引用次数: 0
Modelling the dynamics of SARS-CoV-2 during the first 14 days of infection 模拟SARS-CoV-2在感染的头14天内的动态
IF 2.4 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-07-22 DOI: 10.1016/j.epidem.2025.100843
Jingsi Xu , Martín López-García , Thomas House , Ian Hall
Interpreting the viral mechanism of SARS-CoV-2 based on the human body level is critical for developing more efficient interventions. Due to the limitation of data, limited models consider the viral dynamics of the early phase of infection. The Human Challenge Study (Killingley et al., 2022) enables us to obtain data from inoculation to the 14th day after infection, which provides an overview of the dynamics of SARS-CoV-2 infection within the host. In the Human Challenge Study, each volunteer was inoculated with 10TCID50, approximately 55PFU, of a wild-type of virus (Killingley et al., 2022), and the data indicates that the viral load reduced below the detectable level within a day.
The simplified within-host models developed by Xu et al. (2023) explain the data from the Human Challenge Study (Killingley et al., 2022). However, they do not explain the viral decay from Day 0 to Day 1. Hence, in this paper, we aim to develop a new viral mechanism to explain this phenomenon. Based on the simplified within-host models developed by Xu et al. (2023), we consider that the virus will first go through an adjustment phase and then start to replicate. A new dose-response model is developed to evaluate the probability of infection by constructing a boundary problem. We will discuss this viral mechanism and fit the model to the data of the Human Challenge Study (Killingley et al., 2022) by adopting AMC-SMC (approximate Bayesian computation-sequential Monte Carlo). Based on the results of parameter inference, we estimate that the adjusted viral load is around 1% of the inoculated viral load.
基于人体水平解释SARS-CoV-2的病毒机制对于制定更有效的干预措施至关重要。由于数据的限制,有限的模型考虑了感染早期的病毒动力学。人类挑战研究(Killingley et al., 2022)使我们能够获得从接种到感染后第14天的数据,从而概述了宿主内SARS-CoV-2感染的动态。在人类挑战研究中,每位志愿者接种了10TCID50,约55PFU的野生型病毒(Killingley et al., 2022),数据表明病毒载量在一天内降至可检测水平以下。Xu等人(2023)开发的简化宿主内模型解释了人类挑战研究(Killingley等人,2022)的数据。然而,它们并不能解释病毒从第0天到第1天的衰减。因此,在本文中,我们的目标是建立一个新的病毒机制来解释这一现象。根据Xu等人(2023)开发的简化宿主内模型,我们认为病毒将首先经历一个调整阶段,然后开始复制。建立了一种新的剂量-反应模型,通过构造边界问题来评估感染的概率。我们将讨论这种病毒机制,并通过采用AMC-SMC(近似贝叶斯计算-顺序蒙特卡罗)将模型拟合到人类挑战研究(Killingley等人,2022)的数据中。根据参数推断的结果,我们估计调整后的病毒载量约为接种病毒载量的1%。
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引用次数: 0
Projecting the population-level impact of norovirus vaccines 预测诺如病毒疫苗对人群的影响
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-07-18 DOI: 10.1016/j.epidem.2025.100842
Katia Koelle , Brooke Lappe , Benjamin A. Lopman , Max S.Y. Lau , Emma Viscidi , Katherine B. Carlson
Norovirus diversity has major implications for vaccine design. The number of circulating genogroups and genotypes, and the way this viral diversity interacts at the population level, will factor into how many and which genotypes should be included in an effective vaccine. Here, we develop an age-stratified, multi-strain model for norovirus to project potential population-level impacts of different vaccine formulations on genotype-specific and overall annual attack rates. Our model assumes that vaccination impacts susceptibility to infection but not infectiousness or the risk of developing disease. We parameterize the baseline model (without vaccination) based on literature estimates and the ability to recover observed epidemiological patterns. We then simulate this model under seven different potential vaccine formulations, initially assuming only pediatric vaccination. While we find that increases in coverage result in declines in annual norovirus attack rates for all formulations considered, we also find that vaccine formulations that include genotype GII.4 would be most effective at lowering overall norovirus attack rates. Inclusion of additional genotypes in a vaccine would further lower attack rates but more incrementally, with the addition of GI.3, GII.2, GII.3, and GII.6 together having a similar impact to that of GII.4 alone on reducing overall norovirus incidence. We further find that transient dynamics are expected for 10-20 years following roll-out with any pediatric vaccine. During this time, there may be unanticipated changes in genotype circulation patterns, although long-term increases in non-vaccine genotype attack rates above baseline levels are not expected. Finally, we anticipate that annual vaccination of older-aged individuals with a GII.4-containing vaccine can, under certain conditions but not others, provide appreciable direct benefits to individuals in this age group beyond what pediatric vaccination affords. Together, our results indicate that there is a clear population-level benefit of primary pediatric vaccination with a GII.4-inclusive norovirus vaccine plus incremental value of other genotypes, with additional direct benefits of annual vaccination to older adults provided that vaccination results in a considerable (multi-month) duration of broadly protective immunity to infection. More empirical studies are needed to validate the structure of the model and refine its parameterization, both of which affect projections of vaccine impact.
诺如病毒多样性对疫苗设计具有重要意义。流行基因组和基因型的数量,以及这种病毒多样性在人群水平上相互作用的方式,将影响有效疫苗中应包括多少基因型和哪些基因型。在这里,我们开发了一个年龄分层的诺如病毒多毒株模型,以预测不同疫苗配方对基因型特异性和总体年发病率的潜在人群水平影响。我们的模型假设疫苗接种会影响对感染的易感性,但不会影响传染性或发展疾病的风险。我们根据文献估计和恢复观察到的流行病学模式的能力对基线模型(不接种疫苗)进行参数化。然后,我们在7种不同的潜在疫苗配方下模拟该模型,最初假设仅为儿科疫苗接种。虽然我们发现覆盖率的增加导致所考虑的所有配方的诺如病毒年攻击率下降,但我们还发现,包含基因型GII.4的疫苗配方在降低总体诺如病毒攻击率方面最有效。在疫苗中加入额外的基因型将进一步降低发病率,但这是渐进的,加入GII.3、GII.2、GII.3和GII.6在降低诺如病毒总体发病率方面的作用与单独加入GII.4类似。我们进一步发现,在任何儿科疫苗推出后,预计10-20年的短暂动态。在此期间,基因型循环模式可能会发生意想不到的变化,尽管预计非疫苗基因型发病率不会长期增加到基线水平以上。最后,我们预计,在某些条件下(但在其他条件下),老年人每年接种含有gii .4的疫苗可以为该年龄组的个人提供明显的直接益处,而不是儿科疫苗所能提供的益处。总之,我们的研究结果表明,儿童接种含gii .4的诺如病毒疫苗,加上其他基因型的增加值,具有明显的人群水平益处,如果接种疫苗能产生相当长(数月)时间的广泛保护性免疫,则每年接种一次对老年人有额外的直接益处。需要更多的实证研究来验证模型的结构并完善其参数化,这两者都会影响疫苗影响的预测。
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引用次数: 0
Robust phylodynamic inference and model specification for HIV transmission dynamics HIV传播动力学的鲁棒系统动力学推断和模型规范
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-07-16 DOI: 10.1016/j.epidem.2025.100846
Fabrícia F. Nascimento , Sanjay R. Mehta , Susan J. Little , Erik M. Volz
The robustness and statistical efficiency of phylodynamic models have been tested by many investigators. However, little attention has been given to model specification and inductive bias that can occur if the model is misspecified or provides an overly simplistic representation of the evolutionary process. Here, we carried out a study involving the simulation of HIV epidemics using a complex model and calibrated to men who have sex with men from San Diego, USA. We then used this epidemic trajectory to simulate genealogies, sequence alignments equivalent to HIV partial pol gene and the complete genome. We proceeded to estimate migration rates using a simplistic representation of the epidemiological model by testing model-based phylodynamics and phylogeographic methods. We observed that even though there were some biases on the estimates using a simplistic representation of the epidemiological model, we were still able to estimate the migration rates depending on the method and sample size used in the analyses.
系统动力学模型的稳健性和统计效率已经被许多研究者检验过。然而,很少有人关注模型规范和归纳偏差,如果模型被错误地指定或提供了一个过于简单的进化过程的表示,则可能发生归纳偏差。在这里,我们进行了一项研究,使用一个复杂的模型来模拟艾滋病毒的流行,并校准了来自美国圣地亚哥的男男性行为者。然后,我们使用这种流行轨迹来模拟家谱,序列比对相当于HIV部分pol基因和完整基因组。我们通过测试基于模型的系统动力学和系统地理学方法,使用流行病学模型的简化表示来估计迁移率。我们观察到,尽管使用流行病学模型的简单表示估计存在一些偏差,但我们仍然能够根据分析中使用的方法和样本量估计迁移率。
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引用次数: 0
Improving policy-oriented agent-based modeling with history matching: A case study 使用历史匹配改进面向策略的基于代理的建模:一个案例研究
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-07-16 DOI: 10.1016/j.epidem.2025.100845
David O’Gara , Cliff C. Kerr , Daniel J. Klein , Mickaël Binois , Roman Garnett , Ross A. Hammond
Advances in computing power and data availability have led to growing sophistication in mechanistic mathematical models of social dynamics. Increasingly these models are used to inform real-world policy decision-making, often with significant time sensitivity. One such modeling approach is agent-based modeling, which offers particular strengths for capturing spatial and behavioral realism, and for in-silico experiments (varying input parameters and assumptions to explore their downstream impact on key outcomes). To be useful in the real-world, these models must be able to qualitatively or quantitatively capture observed empirical phenomena, forming the starting point for subsequent experimentation. One recent example is the COVID-19 pandemic, where epidemiological agent-based models informed policy and response planning worldwide. Throughout, modeling teams often had to spend valuable time and effort aligning their models to data, also known as calibration. Since many agent-based models are computationally intensive, the calibration process constrains the questions and scenarios policymakers may explore in time-sensitive situations. In this paper, we combine history matching, heteroskedastic Gaussian process modeling, and approximate Bayesian computation to address this bottleneck, substantially increasing efficiency and thus widening the range of utility for policy models. We illustrate our approach with a case study using a previously published and widely used epidemiological model, the Covasim model.
计算能力和数据可用性的进步导致社会动态的机械数学模型越来越复杂。这些模型越来越多地用于为现实世界的政策决策提供信息,通常具有显著的时间敏感性。其中一种建模方法是基于代理的建模,它为捕获空间和行为现实性以及计算机实验(改变输入参数和假设以探索其对关键结果的下游影响)提供了特别的优势。为了在现实世界中发挥作用,这些模型必须能够定性或定量地捕捉到观察到的经验现象,形成后续实验的起点。最近的一个例子是COVID-19大流行,基于流行病学主体的模型为全球的政策和应对规划提供了信息。在整个过程中,建模团队经常不得不花费宝贵的时间和精力将他们的模型与数据对齐,也称为校准。由于许多基于智能体的模型是计算密集型的,校准过程限制了决策者在时间敏感的情况下可能探索的问题和场景。在本文中,我们结合历史匹配、异方差高斯过程建模和近似贝叶斯计算来解决这一瓶颈,大大提高了效率,从而扩大了政策模型的实用范围。我们通过一个案例研究来说明我们的方法,该案例研究使用了先前发表并广泛使用的流行病学模型Covasim模型。
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引用次数: 0
Learning associations of COVID-19 hospitalizations with wastewater viral signals by Markov modulated models 利用马尔可夫调制模型学习废水病毒信号与COVID-19住院的关联
IF 3 3区 医学 Q2 INFECTIOUS DISEASES Pub Date : 2025-07-14 DOI: 10.1016/j.epidem.2025.100840
K. Ken Peng , Charmaine B. Dean , X. Joan Hu , Robert Delatolla
Recent research highlights a strong correlation between COVID-19 hospitalizations and wastewater viral signals. Increases in wastewater viral signals may be early warnings of increases in hospital admissions. That indicates a promising opportunity to assess and predict the burden of infectious diseases and has driven the widespread adoption and development of wastewater monitoring tools by public health organizations. Previous studies utilize distributed lag models to explore associations of COVID-19 hospitalizations with lagged SARS-CoV-2 wastewater viral signals. However, the conventional distributed lag models assume the duration time of the lag to be fixed, which is not always plausible. This paper presents Markov-modulated models with distributed lasting time, treating the duration of the lag as a random variable defined by a hidden process. We evaluate exposure effects over the duration time and estimate the distribution of the lasting time using the wastewater data and COVID-19 hospitalization records from Ottawa, Canada during June 2020 to November 2022. The different COVID-19 pandemic waves are accommodated in the statistical learning. Moreover, two strategies for comparing the associations over different time intervals are exemplified using the Ottawa data. Of note, the proposed Markov modulated models, an extension of distributed lag models, are potentially applicable to many different problems where the lag time is not fixed.
最近的研究强调,COVID-19住院与废水病毒信号之间存在很强的相关性。废水中病毒信号的增加可能是入院人数增加的早期预警。这表明有机会评估和预测传染病的负担,并促使公共卫生组织广泛采用和开发废水监测工具。以往的研究利用分布式滞后模型来探索COVID-19住院与滞后的SARS-CoV-2废水病毒信号的关系。然而,传统的分布式滞后模型假设滞后的持续时间是固定的,这并不总是可信的。本文提出了具有分布持续时间的马尔可夫调制模型,将滞后的持续时间视为一个由隐藏过程定义的随机变量。我们利用2020年6月至2022年11月期间加拿大渥太华的废水数据和COVID-19住院记录,评估了持续时间内的暴露效应,并估计了持续时间的分布。统计学习中容纳了不同的COVID-19大流行波。此外,使用渥太华数据举例说明了在不同时间间隔内比较关联的两种策略。值得注意的是,所提出的马尔可夫调制模型是分布式滞后模型的扩展,它潜在地适用于延迟时间不固定的许多不同问题。
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