Seroepidemiological studies before and after the epidemic wave of H1N1-2009 are useful for estimating population attack rates with a potential to validate early estimates of the reproduction number, R, in modeling studies.
Methodology/Principal Findings
Since the final epidemic size, the proportion of individuals in a population who become infected during an epidemic, is not the result of a binomial sampling process because infection events are not independent of each other, we propose the use of an asymptotic distribution of the final size to compute approximate 95% confidence intervals of the observed final size. This allows the comparison of the observed final sizes against predictions based on the modeling study (R = 1.15, 1.40 and 1.90), which also yields simple formulae for determining sample sizes for future seroepidemiological studies. We examine a total of eleven published seroepidemiological studies of H1N1-2009 that took place after observing the peak incidence in a number of countries. Observed seropositive proportions in six studies appear to be smaller than that predicted from R = 1.40; four of the six studies sampled serum less than one month after the reported peak incidence. The comparison of the observed final sizes against R = 1.15 and 1.90 reveals that all eleven studies appear not to be significantly deviating from the prediction with R = 1.15, but final sizes in nine studies indicate overestimation if the value R = 1.90 is used.
Conclusions
Sample sizes of published seroepidemiological studies were too small to assess the validity of model predictions except when R = 1.90 was used. We recommend the use of the proposed approach in determining the sample size of post-epidemic seroepidemiological studies, calculating the 95% confidence interval of observed final size, and conducting relevant hypothesis testing instead of the use of methods that rely on a binomial proportion.
Triple Negative Breast Cancer (TNBC), indicated by the absence of estrogen, progesterone and human epidermal growth factor receptor 2 (HER2), is the most aggressive form of breast cancer characterized by high rates of metastasis and low survival. Among those diagnosed with TNBC, 34% contain Inhibitor of Growth 4 (ING4) deletion that is associated with poor patient outcomes. We previously showed that ING4 negatively regulates NF-B in breast cancer. Previous studies show parthenolide, a compound found in feverfew (Tanacetum parthenium) to inhibit NF-B in cervical and gastric cancer. We hypothesized that parthenolide inhibits cytokine-induced activation of NF-B in ING4 deficient TNBC cells. To test the hypothesis, previously established vectors, v2, ING4 wildtype and v2h1, ING4-deleted were synthesized in MDA-MB 231, a TNBC cell line, using a CRISPR/Cas9 system. Inflammatory cytokines, IL-1 and TNF, were tested in ING4 wildtype or ING4 deleted cells for elicited phosphorylation of NF-B, proliferation, and migration in the presence or absence of parthenolide. The results showed that TNF or IL-1 induced translocation phosphorylation of NF-B regardless of ING4 deletion. ING4 inhibited proinflammatory cytokine induced pp65, consistent with previous studies demonstrating the negative regulation of NF-B in ING4-sufficent cell lines. We found the optimal working dose of parthenolide, 100nM, had no effect on cell proliferation in the presence or absence of IL-1. Parthenolide inhibited IL-1induced phosphorylation of NF-B regardless of ING4 deletion. Parthenolide inhibited TNF-induced phosphorylation of NF-B in ING4-deleted cell lines. Moreover, parthenolide induced migration of TNBC cells regardless of ING4 presence of absence. TNF and parthenolide treated samples in ING4-deleted cell lines were found to inhibit cell migration to basal level. These results demonstrate the difference in inhibitory mechanism of parthenolide in induced phosphorylation of NF-B through proinflammatory cytokines TNF or IL-1This is demonstrated by the exclusivity of parthenolide inhibition of TNF induced phosphorylation of NF-B in ING4-deleted TNBC cell line. In contrast, parthenolide inhibition of IL-1 induced phosphorylation of NF-B occurred regardless of ING4 deletion. These results may inhibit parthenolide as an alternative to those with ING4-deleted TNBC due to its role in inducing cancer phenotype cell migration.