ObjectiveTo characterise the clinical features of patients admitted to hospital with coronavirus disease 2019 (covid-19) in the United Kingdom during the growth phase of the first wave of this outbreak who were enrolled in the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) World Health Organization (WHO) Clinical Characterisation Protocol UK (CCP-UK) study, and to explore risk factors associated with mortality in hospital.DesignProspective observational cohort study with rapid data gathering and near real time analysis.Setting208 acute care hospitals in England, Wales, and Scotland between 6 February and 19 April 2020. A case report form developed by ISARIC and WHO was used to collect clinical data. A minimal follow-up time of two weeks (to 3 May 2020) allowed most patients to complete their hospital admission.Participants20 133 hospital inpatients with covid-19.Main outcome measuresAdmission to critical care (high dependency unit or intensive care unit) and mortality in hospital.ResultsThe median age of patients admitted to hospital with covid-19, or with a diagnosis of covid-19 made in hospital, was 73 years (interquartile range 58-82, range 0-104). More men were admitted than women (men 60%, n=12 068; women 40%, n=8065). The median duration of symptoms before admission was 4 days (interquartile range 1-8). The commonest comorbidities were chronic cardiac disease (31%, 5469/17 702), uncomplicated diabetes (21%, 3650/17 599), non-asthmatic chronic pulmonary disease (18%, 3128/17 634), and chronic kidney disease (16%, 2830/17 506); 23% (4161/18 525) had no reported major comorbidity. Overall, 41% (8199/20 133) of patients were discharged alive, 26% (5165/20 133) died, and 34% (6769/20 133) continued to receive care at the reporting date. 17% (3001/18 183) required admission to high dependency or intensive care units; of these, 28% (826/3001) were discharged alive, 32% (958/3001) died, and 41% (1217/3001) continued to receive care at the reporting date. Of those receiving mechanical ventilation, 17% (276/1658) were discharged alive, 37% (618/1658) died, and 46% (764/1658) remained in hospital. Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.ConclusionsISARIC WHO CCP-UK is a large prospective cohort study of patients in hospital with covid-19. The study continues to enrol at the time of this report. In study participants, mortality was high, independent risk factors were increasing age, male sex, and chronic comorbidity, including obesity. This study has shown the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.Study registrationISRCTN66726260.

Protein levels and function are poorly predicted by genomic and transcriptomic analysis of patient tumors. Therefore, direct study of the functional proteome has the potential to provide a wealth of information that complements and extends genomic, epigenomic and transcriptomic analysis in The Cancer Genome Atlas (TCGA) projects. Here we use reverse-phase protein arrays to analyze 3,467 patient samples from 11 TCGA “Pan-Cancer” diseases, using 181 high-quality antibodies that target 128 total proteins and 53 post-translationally modified proteins. The resultant proteomic data is integrated with genomic and transcriptomic analyses of the same samples to identify commonalities, differences, emergent pathways and network biology within and across tumor lineages. In addition, tissue-specific signals are reduced computationally to enhance biomarker and target discovery spanning multiple tumor lineages. This integrative analysis, with an emphasis on pathways and potentially actionable proteins, provides a framework for determining the prognostic, predictive and therapeutic relevance of the functional proteome.

medRxiv preprint 5 Structured abstractObjective -To characterize the clinical features of patients with severe COVID-19 in the UK.Design -Prospective observational cohort study with rapid data gathering and near realtime analysis, using a pre-approved questionnaire adopted by the WHO. Setting -166 UK hospitals between 6 th February and 18 th April 2020. Participants-16,749 people with COVID-19.Interventions -No interventions were performed, but with consent samples were taken for research purposes. Many participants were co-enrolled in other interventional studies and clinical trials. Results -The median age was 72 years [IQR 57, 82; range 0, 104], the median duration of symptoms before admission was 4 days [IQR 1,8] and the median duration of hospital stay was 7 days [IQR 4,12]. The commonest comorbidities were chronic cardiac disease (29%), uncomplicated diabetes (19%), non-asthmatic chronic pulmonary disease (19%) and asthma (14%); 47% had no documented reported comorbidity. Increased age and comorbidities including obesity were associated with a higher probability of mortality. Distinct clusters of symptoms were found: 1. respiratory (cough, sputum, sore throat, runny nose, ear pain, wheeze, and chest pain); 2. systemic (myalgia, joint pain and fatigue); 3. enteric (abdominal pain, vomiting and diarrhoea). Overall, 49% of patients were discharged alive, 33% have died and 17% continued to receive care at date of reporting. 17% required admission to High Dependency or Intensive Care Units; of these, 31% were discharged alive, 45% died and 24% continued to receive care at the reporting date. Of those receiving mechanical ventilation, 20% were discharged alive, 53% died and 27% remained in hospital.Conclusions -We present the largest detailed description of COVID-19 in Europe, demonstrating the importance of pandemic preparedness and the need to maintain readiness to launch research studies in response to outbreaks.

The proper functioning of any living cell relies on complex networks of gene regulation. These regulatory interactions are not static but respond to changes in the environment and evolve during the life cycle of an organism. A challenging objective in computational systems biology is to infer these time-varying gene regulatory networks from typically short time series of transcriptional profiles. While homogeneous models, like conventional dynamic Bayesian networks, lack the flexibility to succeed in this task, fully flexible models suffer from inflated inference uncertainty due to the limited amount of available data. In the present paper we explore a semi-flexible model based on a piecewise homogeneous dynamic Bayesian network regularized by gene-specific inter-segment information sharing. We explore different choices of prior distribution and information coupling and evaluate their performance on synthetic data. We apply our method to gene expression time series obtained during the life cycle of Drosophila melanogaster, and compare the predicted segmentation with other state-of-the-art techniques. We conclude our evaluation with an ap-Editor: James Cussens.

Motivation: Networks are widely used as structural summaries of biochemical systems. Statistical estimation of networks is usually based on linear or discrete models. However, the dynamics of biochemical systems are generally non-linear, suggesting that suitable non-linear formulations may offer gains with respect to causal network inference and aid in associated prediction problems.Results: We present a general framework for network inference and dynamical prediction using time course data that is rooted in non-linear biochemical kinetics. This is achieved by considering a dynamical system based on a chemical reaction graph with associated kinetic parameters. Both the graph and kinetic parameters are treated as unknown; inference is carried out within a Bayesian framework. This allows prediction of dynamical behavior even when the underlying reaction graph itself is unknown or uncertain. Results, based on (i) data simulated from a mechanistic model of mitogen-activated protein kinase signaling and (ii) phosphoproteomic data from cancer cell lines, demonstrate that non-linear formulations can yield gains in causal network inference and permit dynamical prediction and uncertainty quantification in the challenging setting where the reaction graph is unknown.Availability and implementation: MATLAB R2014a software is available to download from warwick.ac.uk/chrisoates.Contact: c.oates@warwick.ac.uk or sach@mrc-bsu.cam.ac.ukSupplementary information: Supplementary data are available at Bioinformatics online.

Big data problems are becoming more prevalent for laboratory scientists who look to make clinical impact. A large part of this is due to increased computing power, in parallel with new technologies for high quality data generation. Both new and old techniques of artificial intelligence (AI) and machine learning (ML) can now help increase the success of translational studies in three areas: drug discovery, imaging, and genomic medicine. However, ML technologies do not come without their limitations and shortcomings. Current technical limitations and other limitations including governance, reproducibility, and interpretation will be discussed in this article. Overcoming these limitations will enable ML methods to be more powerful for discovery and reduce ambiguity within translational medicine, allowing data-informed decision-making to deliver the next generation of diagnostics and therapeutics to patients quicker, at lowered costs, and at scale.

The complexity of ecosystems is staggering, with hundreds or thousands of species interacting in a number of ways from competition and predation to facilitation and mutualism. Understanding the networks that form the systems is of growing importance, e.g. to understand how species will respond to climate change, or to predict potential knock-on effects of a biological control agent. In recent years, a variety of summary statistics for characterising the global and local properties of such networks have been derived, which provide a measure for gauging the accuracy of a mathematical model for network formation processes. However, the critical underlying assumption is that the true network is known. This is not a straightforward task to accomplish, and typi- * Corresponding author. Tel: +44 (0) cally requires minute observations and detailed field work. More importantly, knowledge about species interactions is restricted to specific kinds of interactions. For instance, while the interactions between pollinators and their host plants are amenable to direct observation, other types of species interactions, like those mentioned above, are not, and might not even be clearly defined from the outset. To discover information about complex ecological systems efficiently, new tools for inferring the structure of networks from field data are needed. In the present study, we investigate the viability of various statistical and machine learning methods recently applied in molecular systems biology: graphical Gaussian models, L1-regularised regression with least absolute shrinkage and selection operator (LASSO), sparse Bayesian regression and Bayesian networks. We have assessed the performance of these methods on data simulated from food webs of known structure, where we combined a niche model with a stochastic population model in a 2-dimensional lattice.We assessed the network reconstruction accuracy in terms of the area under the receiver operator characteristics (ROC) curve, which was typically in the range between 0.75 and 0.9, corresponding to the recovery of about 60% of the true species interactions at a false prediction rate of 5%. We also applied the models to presence/absence data for 39 European warblers, and found that the inferred species interactions showed a weak yet significant correlation with phylogenetic similarity scores, which tended to weakly increase when including bio-climate covariates and allowing for spatial autocorrelation. Our findings demonstrate that relevant patterns in ecological networks can be identified from large-scale spatial data sets with machine learning methods, and that these methods have the potential to contribute novel important tools for gaining deeper insight into the structure and stability of ecosystems.

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