bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a Machine Learning Algorithm to Predict the Risk of Blood Transfusion after Total Hip Replacement in Patients with Femoral Neck Fractures: A Multicenter Retrospective Cohort Study
Authors: Zhu Jieyang , Xu Chenxi , Jiang Yi , Zhu Jinyu , Tu Mengyun , Yan Xiaobing , Shen Zeren , Lou Zhenqi
Published: July 2024

Objective

Total hip arthroplasty (THA) remains the primary treatment option for femoral neck fractures in elderly patients. This study aims to explore the risk factors associated with allogeneic blood transfusion after surgery and to develop a dynamic prediction model to predict post‐operative blood transfusion requirements. This will provide more accurate guidance for perioperative humoral management and rational allocation of medical resources.

Methods

We retrospectively analyzed data from 829 patients who underwent total hip arthroplasty for femoral neck fractures at three third‐class hospitals between January 2017 and August 2023. Patient data from one hospital were used for model development, whereas data from the other two hospitals were used for external validation. Logistic regression analysis was used to screen the characteristic subsets related to blood transfusion. Various machine learning algorithms, including logistic regression, SVA (support vector machine), K‐NN (k‐nearest neighbors), MLP (multilayer perceptron), naive Bayes, decision tree, random forest, and gradient boosting, were used to process the data and construct prediction models. A 10‐fold cross‐validation algorithm facilitated the comparison of the predictive performance of the models, resulting in the selection of the best‐performing model for the development of an open‐source computing program.

Results

BMI (body mass index), surgical duration, IBL (intraoperative blood loss), anticoagulant history, utilization rate of tranexamic acid, Pre‐Hb, and Pre‐ALB were included in the model as well as independent risk factors. The average area under curve (AUC) values for each model were as follows: logistic regression (0.98); SVA (0.91); k‐NN (0.87) MLP, (0.96); naive Bayes (0.97); decision tree (0.87); random forest (0.96); and gradient boosting (0.97). A web calculator based on the best model is available at: (https://nomo99.shinyapps.io/dynnomapp/).

Conclusion

Utilizing a computer algorithm, a prediction model with a high discrimination accuracy (AUC > 0.5) was developed. The logistic regression model demonstrated superior differentiation and reliability, thereby successfully passing external validation. The model's strong generalizability and applicability have significant implications for clinicians, aiding in the identification of patients at high risk for postoperative blood transfusion.
No End to Hypergamy when Considering the Full Married Population
Authors: Urbina Daniela R. , Frye Margaret , Lopus Sara
Published: July 2024

The worldwide expansion of female educational opportunities in recent decades has prompted demographers to assess the frequency with which women marry up (hypergamy) or down (hypogamy) with regard to education. A series of articles documented dramatic and nearly universal declines in hypergamy over time and across female educational advantage. However, this previous work investigated hypergamy only in the context of unequal educational pairings, excluding couples with equal levels of education (homogamy) from their analyses. Here, we argue that the prevalence of hypergamy should instead be assessed in relation to all marriages. We apply this approach to the case of Latin America, where women have made important gains in schooling relative to men. Using census microdata spanning 105 birth cohorts in 16 countries, we demonstrate that, rather than declining, hypergamy has increased in most countries over time and remains relatively stable across female educational advantage. Meanwhile, the prevalence of educational homogamy has declined considerably in most countries and across the axis of female educational advantage, an important trend that emerges only when homogamy is incorporated into the analysis.
Sedimentary dolomite in Western Australia and the dolomite problem: Genesis of channel and playa uranium deposits
Authors: Drummond Justin B. R. , Pufahl Peir K. , James Noel P. , Layton‐Matthews Daniel , Kyser T. Kurt
Published: July 2024

Quaternary to Recent sedimentary dolomite in groundwater calcrete and saltmarsh sediments of Lake Way and Lake Maitland, Western Australia, provide new information about the formation of low‐temperature dolomite. Dolomite can form through numerous pathways depending on the depositional and diagenetic environment. Many pathways involve microbial processes and/or the presence of a nucleation substrate which help overcome kinetic barriers preventing precipitation in the laboratory. Petrographic, mineralogical, hydrogeochemical and stable isotopic data in this study reveal the importance of Mg‐clays as nucleation sites for dolomite precipitation in a range of aquifer environments. There is also a close association between authigenic Mg‐clays, dolomite and the potassium–uranyl–vanadate ore mineral carnotite in channel and playa uranium deposits. It is interpreted that evaporation‐driven precipitation of dolomite establishes a positive feedback loop promoting the dissociation of aqueous uranyl–carbonate complexes and concomitant increase in carnotite saturation. Critical to this model is the presence of authigenic Mg‐clays because they facilitate dolomite precipitation and promote carnotite nucleation by concentrating potassium ions on clay surfaces via adsorption. This Mg‐clay–dolomite–carnotite relationship is widespread throughout Western Australian channel and playa uranium deposits and has been observed in similar deposits in Namibia and Botswana. In addition to this economic implication, Mg‐clay mediated nucleation of dolomite potentially has global relevance as a precipitation mechanism for low temperature dolomite in sedimentary deposits where detrital and/or authigenic Mg‐clays are present. Maturation of sedimentary dolomite from disordered high‐calcian dolomite to ordered low‐calcian dolomite occurs very early in the meteoric realm making it resistant to alteration during burial diagenesis. Diagenetic resistance may be further increased by early meteoric silicification related to the degradation of associated Mg‐clays. These findings indicate that Mg‐clay associated sedimentary dolomite has potential to retain a primary isotopic signature indicative of its origin, making it a useful recorder of palaeoenvironmental conditions.
Measuring and reducing implicit prejudice against Black women and people with intersectional identities
Authors: Phills Curtis E.
Published: July 2024

This paper addresses a critical gap in measuring and reducing implicit prejudice: biases against Black women and people with intersectional identities. Though social psychologists have published many methods to measure and interventions to reduce implicit prejudice against Black people, these methods often target biases against Black people or Black men rather than Black women. Thus, these methods may leave Black women out because the mental representations of Black women and Black men differ and the mental representation of Black people is more similar to the mental representation of Black men than Black women. This paper advocates for an intersectional approach to measuring and reducing implicit prejudice that accounts for the unique prejudices faced by Black women. Specifically, this paper argues that researchers should tailor their methods to account for how the mental representations of Black women and Black men differ including differences in stereotypic content and ambivalence. The paper concludes by acknowledging the difficulties related to developing long‐lasting interventions, the need to move beyond reducing implicit prejudice, and the value of studying the men and women of additional racial and ethnic groups and other intersections like sexual orientation and socioeconomic status.
Hidden diversity of Aegla (Decapoda, Anomura) in a priority area for conservation
Authors: Mollmann Victor H. S. , Bartholomei‐Santos Marlise L. , Fernandes Gracieli , Puli Gislaine , Mossolin Emerson C. , Dalosto Marcelo M. , Santos Sandro
Published: July 2024

Aegla is a genus of freshwater anomuran crabs encompassing 94 described species occurring in meridional South America. Brazil harbours the greatest diversity of species, mainly in its southern region, which becomes a priority area for Aegla conservation due to high species richness and phylogenetic diversity, elevated endemism and threats to the Atlantic Forest. Here, we assessed Aegla richness and distribution in this priority area and tested the hypothesis of crypticism in the region's species. Sampling sites were distributed inside and in the surroundings of five protected areas, covering the major distribution range of several species described for southern Brazil. We applied three species delimitation methods to COI mitochondrial gene data, coupled with phylogenetic and morphological analyses. By integrating species delimitation based on the COI data and traditional taxonomy, we uncovered a high proportion of hidden diversity among Aegla in our study area and identified ten known species besides impressive 17 new putative species. Of these, eight are possible new taxonomic units that do not conform to any known species, and nine are divided into three cryptic groups: Aegla jarai complex, Aegla franciscana complex and Aegla camargoi complex. Most of these species have a narrow spatial distribution, making them highly vulnerable to habitat degradation. Despite the real richness of the genus still being largely unknown, the high diversity revealed here makes our study area the richest known region regarding the number of Aegla species within its distribution, making this area even more worthy for conservation efforts.
On torsion‐freeness of Kähler differential sheaves
Authors: Das Nilkantha , Roy Sumit
Published: July 2024

Let be a normal algebraic variety over an algebraically closed field . We prove that the Kähler differential sheaf of is torsion‐free if and only if any regular section of the ideal sheaf of the first order deformation of inside , defined outside the singular locus of , extends regularly to the singular locus.
Bayesian Model Updating of Multiscale Simulations Informing Corrosion Prognostics Using Conditional Invertible Neural Networks
Authors: Qian Guofeng , Zeng Jice , Hu Zhen , Todd Michael D.
Published: July 2024

Physics-based multiscale corrosion simulation plays a vital role in predicting the evolution of pitting corrosion on large civil infrastructure, contributing to a model-informed structural health monitoring strategy for risk-based asset health management. The physics-based analysis, however, may not accurately reflect the underlying true physics due to various uncertainty sources and needs to be updated using Bayesian inference methods based on observations to make the prediction closer to field observations. However, traditional Bayesian inference requires the evaluation of a likelihood function, which is often unavailable due to the complex model architecture and various surrogate models used in the analysis. Therefore, likelihood-free inference approaches are required for the updating of the multiscale corrosion simulation models. This paper meets this need by proposing a conditional invertible neural network (cINN)-based Bayesian model updating method for an existing corrosion simulation model. We first train a cINN model based on simulated observations generated from a high-fidelity forward corrosion analysis model. A convolutional neural network-based feature extraction algorithm is then employed to extract key features from corrosion images. After that, the extracted corrosion features are used as inputs of the cINN model to directly obtain posterior distributions of uncertain corrosion model parameters without evaluating the likelihood function. A case study of a miter gate structure is used to demonstrate the proposed approach. The results show that the proposed cINN-based model updating approach can provide more accurate inference results with a reduced computational cost in comparison to the classical approximate Bayesian computation (ABC) approach.
Exploring the Impact of HFO-1234YF Refrigerant on the Tribological Properties of Advanced Polymeric Coatings
Authors: Raut Ajinkya , Amiri Ahmad , Polycarpou Andreas A.
Published: July 2024

The global focus has shifted toward mitigating the impact of global warming, particularly in the air-conditioning and refrigeration sectors, where there is a strong emphasis on the use of environmentally friendly refrigerants. One such refrigerant that has gained increased usage is HFO-1234yf. The increasing use of HFO-1234yf as a refrigerant in automobile air-conditioning compressors presents new challenges in terms of material compatibility. In this research, we investigate the impact of HFO-1234yf in automobile compressor applications by comparing the tribological results of the same materials in air. We conducted tribological experiments under starved lubrication conditions using polyetheretherketone (PEEK)/polytetrafluoroethylene (PTFE) and aromatic thermosetting co-polyesters (ATSP)/PTFE-coated aluminum alloy samples. We found that the ATSP/PTFE coatings perform exceptionally well irrespective of the atmosphere, while the presence of HFO-1234yf refrigerant adversely affects the tribological performance of the PEEK/PTFE coatings, citing the lack of a stable tribofilm formation. These findings offer valuable insights for the development of materials and lubricants that are compatible with HFO-1234yf refrigerant applications.
Robust Visual SLAM in Dynamic Environment Based on Motion Detection and Segmentation
Authors: Yu Xin , Shen Rulin , Wu Kang , Lin Zhi
Published: July 2024

In this study, we propose a robust and accurate simultaneous localization and mapping (SLAM) method for dynamic environments. Our approach combines sparse optical flow with epipolar geometric constraints to detect motion, determining whether a priori dynamic objects are moving. By integrating semantic segmentation with this motion detection, we can effectively remove dynamic keypoints, eliminating the influence of dynamic objects. This dynamic object removal technique is integrated into ORB-SLAM2, enhancing its robustness and accuracy for localization and mapping. Experimental results on the TUM dataset demonstrate that our proposed system significantly reduces pose estimation error compared to ORB-SLAM2. Specifically, the RMSE and standard deviation (S.D.) of ORB-SLAM2 are reduced by up to 97.78% and 97.91%, respectively, in highly dynamic sequences, markedly improving robustness in dynamic environments. Furthermore, compared to other similar SLAM methods, our method reduces RMSE and S.D. by up to 69.26% and 73.03%, respectively. Dense semantic maps generated by our method also closely align with the ground truth.
Mentioned, Quoted, and Promoted: How Sports Journalists Constructed a Narrative of Athletes’ Value in the “Name, Image, and Likeness” Era
Authors: Scovel Shannon
Published: July 2024

Using theories of framing and agenda setting, this study explores how journalists covered women athletes during the first week of the National Collegiate Athletic Association’s new “name, image, and likeness” (NIL) policy. Athlete representation during this first week was critical, as it established precedent for which athletes, according to media members, held value and were worthy of publicity. The findings from this study show that journalists focused their reporting of NIL on U.S. male athletes, although women athletes such as Olivia Dunne, Haley Cavinder, and Hanna Cavinder were also frequently mentioned in relation to their large social media following, lifestyle, or appearance. Overall, reporters generally promoted a male-dominated NIL agenda, one that undervalued women athletes and minimized their potential role as sporting celebrities in the college sports space.
Impact of Sport Engagement and Social Support on the Health-Related Quality of Life of Youth Athletes With Physical Disabilities
Authors: Sur Myung Ha , Shapiro Deborah R. , Martin Jeffrey
Published: July 2024

Health-related quality of life (HRQOL) is a multidimensional concept focusing on the impact of health status on quality of life. The purpose of this study was to examine if sport engagement and sport-specific social support predicted HRQOL among adolescents with physical disabilities. Sixty-eight participants completed surveys assessing sport engagement, sport-specific social support, and HRQOL. Participants had moderate to high perceptions of sport engagement, social support, and HRQOL supporting the affirmation model of disability. Based on a canonical correlation, esteem, information, and tangible social support and sport engagement—confidence—were the strongest predictor variables of the sport engagement/social support variant, which was linked to the HRQOL variant predicted by emotional, social, and school functioning. The findings support the importance of social support and confidence in the sport context for the HRQOL of youth with physical disabilities.
Epidemiology of
Clostridioides difficile
infection at one hospital 10 years after an outbreak of the epidemic
C. difficile
strain BI/027: changing strain prevalence, antimicrobial susceptibilities, and patient antibiotic exposures
Authors: Wieczorkiewicz Jeffrey T. , Skinner Andrew M. , Cheknis Adam , Petrella Laurica A. , Stevens Vanessa W. , Wright Lorinda M. , Gerding Dale N. , Johnson Stuart
Published: July 2024

In contrast to the epidemiology 10 years earlier at our hospital when the epidemic restriction endonuclease analysis (REA) group strain BI accounted for 72% of
Clostridioides difficile
isolates recovered from first-episode
C. difficile
infection (CDI) cases, BI represented 19% of first-episode CDI isolates in 2013–2015. Two additional REA group strains accounted for 31% of isolates (Y, 16%; DH, 12%). High-level resistance to fluoroquinolones and azithromycin was more common among BI isolates than among DH, Y, and non-BI/DH/Y isolates. Multivariable analysis revealed that BI cases were 2.47 times more likely to be associated with fluoroquinolone exposure compared to non-BI cases (95% confidence interval [CI]: 1.12–5.46). In addition, the odds of developing a CDI after third- or fourth-generation cephalosporin exposure was 2.83 times for DH cases than for non-DH cases (95% CI: 1.06–7.54). Fluoroquinolone use in the hospital decreased from 2005 to 2015 from a peak of 113 to a low of 56 antimicrobial days/1,000 patient days. In contrast, cephalosporin use increased from 42 to 81 antimicrobial days/1,000 patient days. These changes correlated with a decrease in geometric mean MIC for ciprofloxacin (61.03 to 42.65 mg/L,
P
= 0.02) and an increase in geometric mean MIC for ceftriaxone (40.87 to 86.14 mg/L,
P
< 0.01) among BI isolates. The BI strain remained resistant to fluoroquinolones, but an overall decrease in fluoroquinolone use and increase in cephalosporin use were associated with a decrease in the prevalence of BI, an increased diversity of
C. difficile
strain types, and the emergence of strains DH and Y.
Six adenoviral vectored African swine fever virus genes protect against fatal disease caused by genotype I challenge
Authors: Portugal Raquel , Goldswain Hannah , Moore Rebecca , Tully Matthew , Harris Katie , Corla Amanda , Flannery John , Dixon Linda K. , Netherton Christopher L.
Published: July 2024

African swine fever virus causes a lethal hemorrhagic disease in domestic swine and wild boar for which currently licensed commercial vaccines are only available in Vietnam. Development of subunit vaccines is complicated by the lack of information on protective antigens as well as suitable delivery systems. Our previous work showed that a pool of eight African swine fever virus genes vectored using an adenovirus prime and modified vaccinia virus boost could prevent fatal disease after challenge with a virulent genotype I isolate of the virus. Here, we identify antigens within this pool of eight that are essential for the observed protection and demonstrate that adenovirus-prime followed by adenovirus-boost can also induce protective immune responses against genotype I African swine fever virus. Immunization with a pool of adenoviruses expressing individual African swine fever virus genes partially tailored to genotype II virus did not protect against challenge with genotype II Georgia 2007/1 strain, suggesting that different antigens may be required to induce cross-protection for genetically distinct viruses.

IMPORTANCE

African swine fever virus causes a lethal hemorrhagic disease in domestic pigs and has killed millions of animals across Europe and Asia since 2007. Development of safe and effective subunit vaccines against African swine fever has been problematic due to the complexity of the virus and a poor understanding of protective immunity. In a previous study, we demonstrated that a complex combination of eight different virus genes delivered using two different viral vector vaccine platforms protected domestic pigs from fatal disease. In this study, we show that three of the eight genes are required for protection and that one viral vector is sufficient, significantly reducing the complexity of the vaccine. Unfortunately, this combination did not protect against the current outbreak strain of African swine fever virus, suggesting that more work to identify immunogenic and protective viral proteins is required to develop a truly effective African swine fever vaccine.
Microbiome-informed study of the mechanistic basis of methane inhibition by
Asparagopsis taxiformis
in dairy cattle
Authors: Indugu Nagaraju , Narayan Kapil , Stefenoni Hannah A. , Hennessy Meagan L. , Vecchiarelli Bonnie , Bender Joseph S. , Shah Reeti , Dai Grace , Garapati Satvik , Yarish Charles , Welchez Sergio C. , Räisänen Susanna E. , Wasson Derek , Lage Camila , Melgar Audino , Hristov Alexander N. , Pitta Dipti W.
Published: July 2024

Copious amounts of methane, a major constituent of greenhouse gases currently driving climate change, are emitted by livestock, and efficient methods that curb such emissions are urgently needed to reduce global warming. When fed to cows, the red seaweed
Asparagopsis taxiformis
(AT) can reduce enteric methane emissions by up to 80%, but the achieved results can vary widely. Livestock produce methane as a byproduct of methanogenesis, which occurs during the breakdown of feed by microbes in the rumen. The ruminant microbiome is a diverse ecosystem comprising bacteria, protozoa, fungi, and archaea, and methanogenic archaea work synergistically with bacteria to produce methane. Here, we find that an effective reduction in methane emission by high-dose AT (0.5% dry matter intake) was associated with a reduction in methanol-utilizing
Methanosphaera
within the rumen, suggesting that they may play a greater role in methane formation than previously thought. However, a later spike in
Methanosphaera
suggested an acquired resistance, possibly via the reductive dehalogenation of bromoform. While we found that AT inhibition of methanogenesis indirectly impacted ruminal bacteria and fermentation pathways due to an increase in spared H
2
, we also found that an increase in butyrate synthesis was due to a direct effect of AT on butyrate-producing bacteria such as
Butyrivibrio
,
Moryella,
and
Eubacterium
. Together, our findings provide several novel insights into the impact of AT on both methane emissions and the microbiome, thereby elucidating additional pathways that may need to be targeted to maintain its inhibitory effects while preserving microbiome health and animal productivity.

IMPORTANCE

Livestock emits copious quantities of methane, a major constituent of the greenhouse gases currently driving climate change. Methanogens within the bovine rumen produce methane during the breakdown of feed. While the red seaweed
Asparagopsis taxiformis
(AT) can significantly reduce methane emissions when fed to cows, its effects appear short-lived. This study revealed that the effective reduction of methane emissions by AT was accompanied by the near-total elimination of methane-generating
Methanosphaera
. However,
Methanosphaera
populations subsequently rebounded due to their ability to inactivate bromoform, a major inhibitor of methane formation found in AT. This study presents novel findings on the contribution of
Methanosphaera
to ruminal methanogenesis, the mode of action of AT, and the possibility for complementing different strategies to effectively curb methane emissions.
The histamine receptor H1 acts as an alternative receptor for SARS-CoV-2
Authors: Yu Fei , Liu Xiaoqing , Ou Hailan , Li Xinyu , Liu Ruxin , Lv Xi , Xiao Shiqi , Hu Meilin , Liang Taizhen , Chen Tao , Wei Xuepeng , Zhang Zhenglai , Liu Sen , Liu Han , Zhu Yiqiang , Liu Guangyan , Tu Tianyong , Li Peiwen , Zhang Hui , Pan Ting , Ma Xiancai
Published: July 2024

Numerous host factors, in addition to human angiotensin-converting enzyme 2 (hACE2), have been identified as coreceptors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), demonstrating broad viral tropism and diversified druggable potential. We and others have found that antihistamine drugs, particularly histamine receptor H1 (HRH1) antagonists, potently inhibit SARS-CoV-2 infection. In this study, we provided compelling evidence that HRH1 acts as an alternative receptor for SARS-CoV-2 by directly binding to the viral spike protein. HRH1 also synergistically enhanced hACE2-dependent viral entry by interacting with hACE2. Antihistamine drugs effectively prevent viral infection by competitively binding to HRH1, thereby disrupting the interaction between the spike protein and its receptor. Multiple inhibition assays revealed that antihistamine drugs broadly inhibited the infection of various SARS-CoV-2 mutants with an average IC50 of 2.4 µM. The prophylactic function of these drugs was further confirmed by authentic SARS-CoV-2 infection assays and humanized mouse challenge experiments, demonstrating the therapeutic potential of antihistamine drugs for combating coronavirus disease 19.

IMPORTANCE

In addition to human angiotensin-converting enzyme 2, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can utilize alternative cofactors to facilitate viral entry. In this study, we discovered that histamine receptor H1 (HRH1) not only functions as an independent receptor for SARS-CoV-2 but also synergistically enhances ACE2-dependent viral entry by directly interacting with ACE2. Further studies have demonstrated that HRH1 facilitates the entry of SARS-CoV-2 by directly binding to the N-terminal domain of the spike protein. Conversely, antihistamine drugs, primarily HRH1 antagonists, can competitively bind to HRH1 and thereby prevent viral entry. These findings revealed that the administration of repurposable antihistamine drugs could be a therapeutic intervention to combat coronavirus disease 19.
mSphere of Influence: The power of observational research
Authors: Velle Katrina B.
Published: July 2024

Katrina Velle is a cell biologist who uses microscopy to study amoebae. In this mSphere of Influence article, she reflects on how a classic paper on
Listeria
by Tilney and Portnoy made an impact on her by highlighting how much we can learn from simply looking at cells.
Reflections: enhancing critical thinking in science education by implementing philosophy elements into training
Authors: Ciubotariu Ilinca I.
Published: July 2024

In this work, I describe the trajectory of philosophy and science as separate disciplines from their early days as quite overlapping fields to their clear divergence in the latest centuries. From personal experience, I discuss the benefits of exposure to philosophy and closely related courses in undergraduate studies and bring to the forefront the positive aspects of integrating philosophy of science courses in graduate science, technology, engineering, and mathematics (STEM) curriculum. I also briefly offer some additional steps institutions can take to foster unity between areas of science and philosophy by incorporating interdisciplinary activities.
Advancing equity in breast cancer care: natural language processing for analysing treatment outcomes in under-represented populations
Authors: Park Jung In , Park Jong Won , Zhang Kexin , Kim Doyop
Published: July 2024

Objective

The study aimed to develop natural language processing (NLP) algorithms to automate extracting patient-centred breast cancer treatment outcomes from clinical notes in electronic health records (EHRs), particularly for women from under-represented populations.

Methods

The study used clinical notes from 2010 to 2021 from a tertiary hospital in the USA. The notes were processed through various NLP techniques, including vectorisation methods (term frequency-inverse document frequency (TF-IDF), Word2Vec, Doc2Vec) and classification models (support vector classification, K-nearest neighbours (KNN), random forest (RF)). Feature selection and optimisation through random search and fivefold cross-validation were also conducted.

Results

The study annotated 100 out of 1000 clinical notes, using 970 notes to build the text corpus. TF-IDF and Doc2Vec combined with RF showed the highest performance, while Word2Vec was less effective. RF classifier demonstrated the best performance, although with lower recall rates, suggesting more false negatives. KNN showed lower recall due to its sensitivity to data noise.

Discussion

The study highlights the significance of using NLP in analysing clinical notes to understand breast cancer treatment outcomes in under-represented populations. The TF-IDF and Doc2Vec models were more effective in capturing relevant information than Word2Vec. The study observed lower recall rates in RF models, attributed to the dataset’s imbalanced nature and the complexity of clinical notes.

Conclusion

The study developed high-performing NLP pipeline to capture treatment outcomes for breast cancer in under-represented populations, demonstrating the importance of document-level vectorisation and ensemble methods in clinical notes analysis. The findings provide insights for more equitable healthcare strategies and show the potential for broader NLP applications in clinical settings.
How the COVID-19 pandemic affected infant vaccination trends in rural and urban communities in Ibadan, Nigeria: a cross-sectional study
Authors: Adegoke Awwal Adetunji , Balogun Folusho Mubowale
Published: July 2024

Objectives

This study compared the infant vaccination trends a year before and a year after the onset of the COVID-19 pandemic in selected urban and rural communities in Ibadan, Nigeria.

Design

This was a cross-sectional study in which data were extracted from infant vaccination records.

Setting

Two rural and three urban vaccination centres in primary health clinics at Ibadan Southeast and Olúyòlé local government areas, respectively.

Participants

Infant vaccination records 1 year before and 1 year after the onset of the COVID-19 pandemic (March 2019–February 2020 and March 2020–February 2021, respectively).

Outcome measures

Timeliness of vaccination (vaccination taken within 2 weeks of appointment) and vaccination completion according to the Nigerian routine infant vaccination schedule.

Results

2000 vaccination records were included in the study (1013 (50.6%) for male infants). 840 (42.0%) of the records were from the rural immunisation clinics. There were 1194 (59.7%) and 806 (40.3%) records from before and after the onset of the COVID-19 pandemic, respectively. Before the pandemic, birth dose vaccines were timelier among infants from urban communities, while vaccines given at 6 weeks were timelier in the rural areas. Following the onset of the pandemic, the rural communities had a higher proportion of infants with timelier and complete vaccination except for the birth dose vaccines. Overall, there was higher vaccination completion before the pandemic, and this was higher in the rural compared with the urban communities both before (54.8% vs 11.7%) and after (23.6% vs 1.0%) the onset of the pandemic.

Conclusions

A decline in infant vaccination uptake, timeliness and completion persisted 1 year after the COVID-19 pandemic onset, and urban communities were more affected. More efforts are required to ensure optimal infant vaccination, especially in urban communities, to forestall outbreaks of vaccine-preventable diseases.
Just-in-time adaptive interventions for adolescent and young adult health and well-being: protocol for a systematic review
Authors: Guan Kathleen W , Adlung Christopher , Keijsers Loes , Smit Crystal R , Vreeker Annabel , Thalassinou Eva , van Roekel Eeske , de Reuver Mark , Figueroa Caroline A
Published: July 2024

Introduction

Health behaviours such as exercise and diet strongly influence well-being and disease risk, providing the opportunity for interventions tailored to diverse individual contexts. Precise behaviour interventions are critical during adolescence and young adulthood (ages 10–25), a formative period shaping lifelong well-being. We will conduct a systematic review of just-in-time adaptive interventions (JITAIs) for health behaviour and well-being in adolescents and young adults (AYAs). A JITAI is an emerging digital health design that provides precise health support by monitoring and adjusting to individual, specific and evolving contexts in real time. Despite demonstrated potential, no published reviews have explored how JITAIs can dynamically adapt to intersectional health factors of diverse AYAs. We will identify the JITAIs’ distal and proximal outcomes and their tailoring mechanisms, and report their effectiveness. We will also explore studies’ considerations of health equity. This will form a comprehensive assessment of JITAIs and their role in promoting health behaviours of AYAs. We will integrate evidence to guide the development and implementation of precise, effective and equitable digital health interventions for AYAs.

Methods and analysis

In adherence to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines, we will conduct a systematic search across multiple databases, including CENTRAL, MEDLINE and WHO Global Index Medicus. We will include peer-reviewed studies on JITAIs targeting health of AYAs in multiple languages. Two independent reviewers will conduct screening and data extraction of study and participant characteristics, JITAI designs, health outcome measures and equity considerations. We will provide a narrative synthesis of findings and, if data allows, conduct a meta-analysis.

Ethics and dissemination

As we will not collect primary data, we do not require ethical approval. We will disseminate the review findings through peer-reviewed journal publication, conferences and stakeholder meetings to inform participatory research.

PROSPERO registration number

CRD42023473117.
Temporal trends and cohort variations of gender-specific major depressive disorders incidence in China: analysis based on the age-period-cohort-interaction model
Authors: Hu Xiyuan , Guo Chao
Published: July 2024

Background

Major depressive disorders (MDDs) impose substantial burdens on individuals and society; however, further detailed analysis is still needed for its long-term trends.

Aims

This study aimed to analyse the gender-specific temporal trends and cohort variations of MDD incidence among Chinese residents over the past three decades.

Methods

Employing the age-period-cohort-interaction model and leveraging data from the Global Burden of Disease Study 2019, this research identified and analysed incidence trends of MDD among Chinese males and females aged 5–94 years from 1990 to 2019 across three dimensions, encompassing age, period and birth cohort.

Results

The analysis reveals age-related effects, indicating heightened MDD risk among adolescents and older adults. Specifically, individuals entering the older adulthood at the age of 65–69 significantly increased the risk of MDD by 64.9%. People aged 90–94 years witnessed a 105.4% increase in MDD risk for the overall population, with females and males in this age group experiencing a 75.1% and 103.4% increase, respectively. In terms of period effects, the risk of MDD displayed a decline from 1990 to 1994, followed by a rebound in 2008. Cohort effects demonstrated diverse generational patterns, with generation I and generation III manifesting opposing ‘age-as-level’ trends. Generation II and generation IV exhibited ‘cumulative disadvantage’ and ‘cumulative advantage’ patterns, respectively. Age effects indicated an overall higher risk of MDD incidence in females, while cohort effects showed greater variations of MDD incidence among females.

Conclusions

The study underscores the substantial effects of age, period and cohort on MDD across genders in China. Priority interventions targeting vulnerable populations, including children, adolescents, older adults, females and the post-millennium birth cohort, are crucial to mitigate the impact of MDD.
Trends in educational inequalities in smoking-attributable mortality and their impact on changes in general mortality inequalities: evidence from England and Wales, Finland, and Italy (Turin)
Authors: Van Hemelrijck Wanda Monika Johanna , Kunst Anton E , Sizer Alison , Martikainen Pekka , Zengarini Nicolas , Costa Giuseppe , Janssen Fanny
Published: July 2024

Background

Socioeconomic mortality inequalities are persistent in Europe but have been changing over time. Smoking is a known contributor to inequality levels, but knowledge about its impact on time trends in inequalities is sparse.

Methods

We studied trends in educational inequalities in smoking-attributable mortality (SAM) and assessed their impact on general mortality inequality trends in England and Wales (E&W), Finland, and Italy (Turin) from 1972 to 2017. We used yearly individually linked all-cause and lung cancer mortality data by educational level and sex for individuals aged 30 and older. SAM was indirectly estimated using the Preston-Glei-Wilmoth method. We calculated the slope index of inequality (SII) and performed segmented regression on SIIs for all-cause, smoking and non-SAM to identify phases in inequality trends. The impact of SAM on all-cause mortality inequality trends was estimated by comparing changes in SII for all-cause with non-SAM.

Results

Inequalities in SAM generally declined among males and increased among females, except in Italy. Among males in E&W and Finland, SAM contributed 93% and 76% to declining absolute all-cause mortality inequalities, but this contribution varied over time. Among males in Italy, SAM drove the 1976–1992 increase in all-cause mortality inequalities. Among females in Finland, increasing inequalities in SAM hampered larger declines in mortality inequalities.

Conclusion

Our findings demonstrate that differing education-specific SAM trends by country and sex result in different inequality trends, and consequent contributions of SAM on educational mortality inequalities. The following decades of the smoking epidemic could increase educational mortality inequalities among Finnish and Italian women.
Bendamustine is a safe and effective lymphodepletion agent for axicabtagene ciloleucel in patients with refractory or relapsed large B-cell lymphoma
Authors: Bharadwaj Sushma , Lau Eric , Hamilton Mark P , Goyal Anmol , Srinagesh Hrishi , Jensen Alexandria , Lee Dasom , Mallampet Jayasindhu , Elkordy Sarah , Syal Shriya , Patil Sunita , Latchford Theresa , Sahaf Bita , Arai Sally , Johnston Laura J , Lowsky Robert , Negrin Robert , Rezvani Andrew R , Shizuru Judith , Meyer Everett H , Shiraz Parveen , Mikkilineni Lekha , Weng Wen-Kai , Smith Melody , Sidana Surbhi , Muffly Lori , Maecker Holden T , Frank Matthew J , Mackall Crystal , Miklos David , Dahiya Saurabh
Published: July 2024

Background

Fludarabine in combination with cyclophosphamide (FC) is the standard lymphodepletion regimen for CAR T-cell therapy (CAR T). A national fludarabine shortage in 2022 necessitated the exploration of alternative regimens with many centers employing single-agent bendamustine as lymphodepletion despite a lack of clinical safety and efficacy data. To fill this gap in the literature, we evaluated the safety, efficacy, and expansion kinetics of bendamustine as lymphodepletion prior to axicabtagene ciloleucel (axi-cel) therapy.

Methods

84 consecutive patients with relapsed or refractory large B-cell lymphoma treated with axi-cel and managed with a uniform toxicity management plan at Stanford University were studied. 27 patients received alternative lymphodepletion with bendamustine while 57 received FC.

Results

Best complete response rates were similar (73.7% for FC and 74% for bendamustine, p=0.28) and there was no significant difference in 12-month progression-free survival or overall survival estimates (p=0.17 and p=0.62, respectively). The frequency of high-grade cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome was similar in both the cohorts. Bendamustine cohort experienced lower proportions of hematological toxicities and antibiotic use for neutropenic fever. Immune reconstitution, as measured by quantitative assessment of cellular immunity, was better in bendamustine cohort as compared with FC cohort. CAR T expansion as measured by peak expansion and area under the curve for expansion was comparable between cohorts.

Conclusions

Bendamustine is a safe and effective alternative lymphodepletion conditioning for axi-cel with lower early hematological toxicity and favorable immune reconstitution.
Mapping the complexity and diversity of tertiary lymphoid structures in primary and peritoneal metastatic gastric cancer
Authors: Groen-van Schooten Tessa S , Franco Fernandez Rosalia , van Grieken Nicole C T , Bos Emma N , Seidel Jens , Saris Job , Martínez-Ciarpaglini Carolina , Fleitas Tania C , Thommen Daniela S , de Gruijl Tanja D , Grootjans Joep , Derks Sarah
Published: July 2024

Background

Tertiary lymphoid structures (TLSs) are thought to stimulate antitumor immunity and positively impact prognosis and response to immune checkpoint blockade. In gastric cancers (GCs), however, TLSs are predominantly found in GC with poor prognosis and limited treatment response. We, therefore, hypothesize that immune cell composition and function of TLS depends on tumor location and the tumor immune environment.

Methods

Spatial transcriptomics and immunohistochemistry were used to characterize the phenotype of CD45+immune cells inside and outside of TLS using archival resection specimens from GC primary tumors and peritoneal metastases.

Results

We identified significant intrapatient and interpatient diversity of the cellular composition and maturation status of TLS in GC. Tumor location (primary vs metastatic site) accounted for the majority of differences in TLS maturity, as TLS in peritoneal metastases were predominantly immature. This was associated with higher levels of tumor-infiltrating macrophages and Tregs and less plasma cells compared with tumors with mature TLS. Furthermore, mature TLSs were characterized by overexpression of antitumor immune pathways such as B cell-related pathways, MHC class II antigen presentation while immature TLS were associated with protumor pathways, including T cell exhaustion and enhancement of DNA repair pathways in the corresponding cancer.

Conclusion

The observation that GC-derived peritoneal metastases often contain immature TLS which are associated with immune suppressive regulatory tumor-infiltrating leucocytes, is in keeping with the lack of response to immune checkpoint blockade and the poor prognostic features of peritoneal metastatic GC, which needs to be taken into account when optimizing immunomodulatory strategies for metastatic GC.
IFNγ mediates the resistance of tumor cells to distinct NK cell subsets
Authors: Hofman Tomáš , Ng Siu Wang , Garcés-Lázaro Irene , Heigwer Florian , Boutros Michael , Cerwenka Adelheid
Published: July 2024

Background

Immune checkpoint blockade targeting the adaptive immune system has revolutionized the treatment of cancer. Despite impressive clinical benefits observed, patient subgroups remain non-responsive underscoring the necessity for combinational therapies harnessing additional immune cells. Natural killer (NK) cells are emerging tools for cancer therapy. However, only subpopulations of NK cells that are differentially controlled by inhibitory receptors exert reactivity against particular cancer types. How to leverage the complete anti-tumor potential of all NK cell subsets without favoring the emergence of NK cell-resistant tumor cells remains unresolved.

Methods

We performed a genome-wide CRISPR/Cas9 knockout resistance screen in melanoma cells in co-cultures with human primary NK cells. We comprehensively evaluated factors regulating tumor resistance and susceptibility by focusing on NK cell subsets in an allogenic setting. Moreover, we tested therapeutic blocking antibodies currently used in clinical trials.

Results

Melanoma cells deficient in antigen-presenting or the IFNγ-signaling pathways were depleted in remaining NK cell-co-cultured melanoma cells and displayed enhanced sensitivity to NK cells. Treatment with IFNγ induced potent resistance of melanoma cells to resting, IL-2-cultured and ADCC-activated NK cells that depended onB2Mrequired for the expression of both classical and non-classical MHC-I. IFNγ-induced expression of HLA-E mediated the resistance of melanoma cells to the NKG2A+KIR−and partially to the NKG2A+KIR+NK cell subset. The expression of classical MHC-I by itself was sufficient for the inhibition of the NKG2A−KIR+, but not the NKG2A+KIR+NK cell subset. Treatment of NK cells with monalizumab, an NKG2A blocking mAb, enhanced the reactivity of a corresponding subset of NK cells. The combination of monalizumab with lirilumab, blocking KIR2 receptors, together with DX9, blocking KIR3DL1, was required to restore cytotoxicity of all NK cell subsets against IFNγ-induced resistant tumor cells in melanoma and tumors of different origins.

Conclusion

Our data reveal that in the context of NK cells, IFNγ induces the resistance of tumor cells by the upregulation of classical and non-classical MHC-I. Moreover, we reveal insights into NK cell subset reactivity and propose a therapeutic strategy involving combinational monalizumab/lirilumab/DX9 treatment to fully restore the antitumor response across NK cell subsets.