bluuebunny/crossref_metadata_2025_split huggingface dataset:
DySurv: dynamic deep learning model for survival analysis with conditional variational inference
Authors: Mesinovic Munib , Watkinson Peter , Zhu Tingting 
Published: November 2024

Abstract

Objective
Machine learning applications for longitudinal electronic health records often forecast the risk of events at fixed time points, whereas survival analysis achieves dynamic risk prediction by estimating time-to-event distributions. Here, we propose a novel conditional variational autoencoder-based method, DySurv, which uses a combination of static and longitudinal measurements from electronic health records to estimate the individual risk of death dynamically.

Materials and Methods
DySurv directly estimates the cumulative risk incidence function without making any parametric assumptions on the underlying stochastic process of the time-to-event. We evaluate DySurv on 6 time-to-event benchmark datasets in healthcare, as well as 2 real-world intensive care unit (ICU) electronic health records (EHR) datasets extracted from the eICU Collaborative Research (eICU) and the Medical Information Mart for Intensive Care database (MIMIC-IV).

Results
DySurv outperforms other existing statistical and deep learning approaches to time-to-event analysis across concordance and other metrics. It achieves time-dependent concordance of over 60% in the eICU case. It is also over 12% more accurate and 22% more sensitive than in-use ICU scores like Acute Physiology and Chronic Health Evaluation (APACHE) and Sequential Organ Failure Assessment (SOFA) scores. The predictive capacity of DySurv is consistent and the survival estimates remain disentangled across different datasets.

Discussion
Our interdisciplinary framework successfully incorporates deep learning, survival analysis, and intensive care to create a novel method for time-to-event prediction from longitudinal health records. We test our method on several held-out test sets from a variety of healthcare datasets and compare it to existing in-use clinical risk scoring benchmarks.

Conclusion
While our method leverages non-parametric extensions to deep learning-guided estimations of the survival distribution, further deep learning paradigms could be explored.
Predicting the potential distribution of the invasive species, Ophelimus maskelli (Ashmead) (Hymenoptera: Eulophidae), and its natural enemy Closterocerus chamaeleon (Hymenoptera: Eulophidae), under current and future climate conditions
Authors: Cheng Lifang , Niu Minmin , Zhao Xiaojun , Cai Bo , Wei Jiufeng 
Published: November 2024

Abstract
Invasive species pose a threat to ecosystems and humans worldwide, which is exacerbated by climate change, causing the expansion of species distributions. Ophelimus maskelli (Ashmead) (Hymenoptera: Eulophidae) causes leaf drying and shedding in eucalyptus trees, forming blister-like galls that negatively impact the growth of the trees. Closterocerus chamaeleon (Hymenoptera: Eulophidae) is a recognized parasitoid of O. maskelli. This study used the MaxEnt and CLIMEX models to predict the potential distribution under current and future climate scenarios for O. maskelli and its natural enemy, C. chamaeleon. The MaxEnt model result indicated that isothermality was the most critical factor predicting the distribution of O. maskelli, while the mean temperature of the driest quarter was the most critical factor predicting the distribution of C. chamaeleon. Under current climate conditions, the CLIMEX model predicted a wider potential distribution for O. maskelli and a smaller distribution for C. chamaeleon than the MaxEnt model. MaxEnt and CLIMEX prediction results indicated that South America and Africa were suitable for O. maskelli and C. chamaeleon. The MaxEnt model indicated that under SSP245 climate conditions, the potentially suitable regions for these species expanded, while under the SSP126 climate scenario, the region contracted significantly. The CLIMEX model indicated that under the A1B and A2 climate scenarios, the marginally suitable areas increased, while the moderately and highly suitable areas decreased. This study provides a theoretical basis for creating early monitoring, quarantine, and control methods for invasive pests.
Application Barriers and the Socioeconomic Gap in Child Care Enrollment
Authors: Hermes Henning , Lergetporer Philipp , Peter Frauke , Wiederhold Simon 
Published: November 2024

Abstract
Why are children with lower socioeconomic status (SES) substantially less likely to be enrolled in child care? We study whether barriers in the application process work against lower-SES children—the group known to benefit strongest from child care enrollment. In an RCT in Germany with highly subsidized child care ($N=607$), we offer treated families information and personal assistance for applications. We find substantial, equity-enhancing effects of the treatment, closing half of the large SES gap in child care enrollment. Increased enrollment for lower-SES families is likely driven by altered application knowledge and behavior. We discuss scalability of our intervention and derive policy implications for the design of universal child care programs. (JEL: I21, J13, J18, J24, C93)
State-level disparities in cervical cancer prevention and outcomes in the United States: a modeling study
Authors: Alarid-Escudero Fernando , Gracia Valeria , Wolf Marina , Zhao Ran , Easterly Caleb W , Kim Jane J , Canfell Karen , de Kok Inge M C M , Barnabas Ruanne V , Kulasingam Shalini 
Published: November 2024

Abstract

Background
Despite human papillomavirus (HPV) vaccines’ availability for over a decade, coverage across the United States varies. Although some states have tried to increase HPV vaccination coverage, most model-based analyses focus on national impacts. We evaluated hypothetical changes in HPV vaccination coverage at the national and state levels for California, New York, and Texas using a mathematical model.

Methods
We developed a new mathematical model of HPV transmission and cervical cancer, creating national- and state-level models, incorporating country- and state-specific vaccination coverage and cervical cancer incidence and mortality. We quantified the national- and state-level impact of increasing HPV vaccination coverage to 80% by 2025 or 2030 on cervical cancer outcomes and the time to elimination defined as less than 4 per 100 000 women.

Results
Increasing vaccination coverage to 80% in Texas over 10 years could reduce cervical cancer incidence by 50.9% (95% credible interval [CrI] = 46.6%-56.1%) by 2100, from 1.58 (CrI = 1.19-2.09) to 0.78 (CrI = 0.57-1.02) per 100 000 women. Similarly, New York could see a 27.3% (CrI = 23.9%-31.5%) reduction from 1.43 (CrI = 0.93-2.07) to 1.04 (CrI = 0.66-1.53) per 100 000 women, and California a 24.4% (CrI = 20.0%-30.0%) reduction from 1.01 (CrI = 0.66-1.44) to 0.76 (CrI = 0.50-1.09) per 100 000 women. Achieving 80% coverage in 5 years will provide slightly larger and sooner reductions. If the vaccination coverage levels in 2019 continue, cervical cancer elimination could occur nationally by 2051 (CrI = 2034-2064), but state timelines may vary by decades.

Conclusion
Targeting an HPV vaccination coverage of 80% by 2030 will disproportionately benefit states with low coverage and higher cervical cancer incidence. Geographically focused analyses can better inform priorities.
Inequities in palliative care delivery to patients with HIV and Stage IV cancers in the US (2004-2020)
Authors: Islam Jessica Y , Guo Yi , Turner Kea , Tabriz Amir Alishahi , Lin Yu Chen , Vidot Denise C , Vadaparampil Susan T , Coghill Anna E , ScD Marlene Camacho-Rivera , Suneja Gita 
Published: November 2024

Abstract

Background
People with HIV (PWH) diagnosed with stage-IV cancer are less likely to receive palliative care (PC) compared to those without HIV. Our objective was to evaluate inequities in PC receipt among PWH with stage IV cancer in the US.

Methods
We used the National Cancer Database (2004-2020), including adult (18-89 years) PWH with the 14 most common cancers that occur among PWH. PC was defined as treatment provided with non-curative intent. Our main exposures included % quartiles of adults without a high school degree (educational attainment) and median income quartiles within the patient's zip code. We used hierarchical multivariable Poisson regression to estimate adjusted prevalence ratios(aPR) with 95% confidence intervals (95% CI), adjusting for age, sex, year of diagnosis, race/ethnicity, and cancer type.

Results
Among the included 10,120 PWH with stage IV cancer, 72% were men, 51% were either non-Hispanic(NH)-Black or Hispanic/Latinx, 38% were aged ≥60 years, and 97% resided in urban areas. Fourteen percent received PC. NH-Black PWH living in zip-codes with lower quartiles of educational attainment were more likely to receive PC compared to those in the highest quartile (Q1vs.Q4: aPR:1.93;95% CI:1.29-2,86) For income overall, compared to those in the highest quartile (Q4) of income, those in the lowest quartile had 26% higher likelihood of receiving PC (Q1vs.Q4: aPR:1.26;95% CI:1.05-1.52), particularly among NH-Black adults (Q1vs.Q4: aPR:1.67;95% CI:1.25-2.22; Q2 vs.Q4; aPR:1.48;95% CI:1.09-2.01).

Conclusions
PC use among PWH with stage-IV cancer is low. Contextual poverty plays a role in PC delivery to PWH and cancer, particularly among NH-Black PWH.
“It’s chaos”: affective spaces of journalism in Istanbul
Authors: Miles Caitlin M 
Published: November 2024

Abstract
Based on 9 months of ethnographic fieldwork in Istanbul, Turkey, this article explores the affective attachments circulating around urban spaces of journalism in Istanbul, with particular attention to how experiences of urban life shape journalists’ imaginaries of their relationship to each other, the city, their audience, and the broader “public” of Turkey. This article considers how journalistic life and practice is a form of subjectivity that hinges upon spatialized affects and affective spaces. These affects emerge as the physical landscapes and spaces of journalism alter, whereby journalists attach and reflect on different spaces as they try to make sense of their professional lives amidst the uncertainties of spatial change. This article orients the narratives presented—which highlight themes of professional solidarity, dispossession, and social isolation—to argue that definitions and practices of journalism are “embedded in the changing rhythms and dynamics of urban life” (Rodgers et al., 2014: p. 106).
Promoting Antiviral Access and Adherence in the Expansion of Hepatitis B Prevention Programs: Insights From the Democratic Republic of Congo
Authors: Thahir Sahal , Morgan Camille E , Ngimbi Patrick , Kashamuka Melchior Mwandagalirwa , Ntambua Sarah , Matondo Jolie , Tabala Martine , Mbendi Charles , Kaba Didine , Yotebieng Marcel , Parr Jonathan B , Banek Kristin , Thompson Peyton 
Published: November 2024

Abstract
Hepatitis B virus (HBV) antiviral administration and adherence are essential to reach the World Health Organization’s 2030 hepatitis elimination goals. As HBV treatment guidelines are now simplified and expanded, adherence to treatment will be critical, but challenges to adherence are poorly studied. After introducing tenofovir disoproxil fumarate (TDF) monotherapy to expectant mothers with high-risk HBV in Kinshasa, DRC, we conducted semi-structured interviews to understand medication adherence behaviors, to complement pill counts and measurement of TDF metabolite levels. Key facilitators of adherence identified included trust in healthcare workers, a better understanding of HBV, and family support. Identified barriers included fear of stigma and low health literacy. Knowledge about HBV disease remains low, underscoring the importance of ongoing education of clinic staff and patients alike.
Macrolide-Resistant Mycoplasma pneumoniae, North Dakota 2024
Authors: Douvoyiannis Miltiadis , Rothstein Tanner E , Patel Robin 
Published: November 2024

Abstract
A cluster of macrolide-resistant Mycoplasma pneumoniae -causing community-acquired pneumonia was observed in children in North Dakota in 2024. Suspicion was raised by non-response to macrolides, with confirmation via a polymerase-chain reaction assay. Prompt improvement occurred after the initiation of alternative antibiotics.
Doubly robust estimation of policy-relevant causal effects under interference
Authors: Hettinger Gary , Roberto Christina , Lee Youjin , Mitra Nandita 
Published: November 2024

Abstract
To comprehensively evaluate a public policy intervention, researchers must consider the effects of the policy not just on the implementing region, but also nearby, indirectly affected regions. For example, an excise tax on sweetened beverages in Philadelphia, Pennsylvania was shown to not only be associated with a decrease in volume sales of taxed beverages in Philadelphia, but also an increase in sales in nontaxed bordering counties. The latter association may be explained by cross-border shopping behaviours of Philadelphia residents and indicate a causal effect of the tax on nearby regions, which may drastically offset the total effect of the intervention. In this paper, we adapt doubly robust difference-in-differences methodology to estimate distinct causal effects on the implementing and neighbouring control regions when they are geographically separable and data exists from an unaffected control region. Our approach adjusts for potential confounding in quasi-experimental evaluations and relaxes standard assumptions on model specification while accounting for geographically separable interference, repeated observations, spatial correlation, and unknown effect heterogeneity. We apply these methods to evaluate the effect of the Philadelphia beverage tax on taxed beverage sales in 231 Philadelphia and bordering county stores. We also use our methods to explore effect heterogeneity across geographical features.
Anatomic maps of erogenous and aversive sensation zones of the breasts, vulva, and vagina: a questionnaire-based study
Authors: Stelmar Jenna , Zaliznyak Michael , Sandhu Sandeep , Isaacson Dylan , Duralde Erin , Smith Shannon M , Knudson Gail A , Garcia Maurice M 
Published: November 2024

Abstract

Background
Erogenous sensation zones (ESZs) elicit sexual pleasure upon stimulation. General ESZ maps exist, but they do not assess internal areas of the body, differentiate between individual structures, or quantify the importance of individual ESZs to sexual pleasure. Maps of aversive sensation zones (ASZs), or bodily areas individuals dislike having touched during sex, have not been described.

Aim
To create detailed erogenous and aversive sensory maps of the vulva, vagina, and breasts, and assess the importance of each erogenous structure to sexual pleasure.

Methods
An anonymous online questionnaire was administered to 441 sexually active cisgender women (mean age 48.9 ± 15.5 years) from March to June 2020 via Qualtrics. Respondents selected ESZs and ASZs from anatomic illustrations and rated each ESZ’s importance to their sexual pleasure. Respondents’ reasoning for choosing each ASZ was queried.

Outcomes
Heat maps of ESZ and ASZ selection frequency, ESZ importance ratings, and ASZ reasoning.

Results
More respondents selected ≧1 areas of the vulva as erogenous (82.0%), in comparison to the breasts (77.4%) and vagina (59.4%). The two most erogenous areas of the breast were also the most aversive: breast tissue (57.8% ESZ selection; 5.4% ASZ) and nipples (42.7%; 6.5%). Respondents most commonly reported these areas as aversive due to: “It’s overly sensitive” and “It hurts.”
The most frequently selected ESZs of the vulva were the vaginal introitus (50.8%), periurethra (42.6%), and glans clitoris (41.3%). The top ASZs were the anus (34.0%) and perineum (7.9%), with primary reasons being: “It’s gross,” “It hurts,” and “I’m ashamed/embarrassed.”
Of the five ESZs of the vagina, the superficial anterior (48.1%) and superficial posterior (32.9%) regions were the most selected. The cervix (6.8%), superficial posterior (5%), and deep posterior (3.4%) regions were the top ASZs due to “It hurts” and/or “It’s overly sensitive.”

Clinical Implications
Erogenous and aversive sensory maps could help identify sexual concerns, inform preoperative counseling, and track sensory changes.

Strengths and Limitations
This study captured detailed maps of internal and external ESZs and ASZs of the breasts, vulva, and vagina. Limitations include recall bias and inclusion of only cisgender women, rather than all people who share the same anatomy, irrespective of gender identity.

Conclusions
Erogenous sensation was most prominent in the vulvar structures, including the vaginal introitus and glans clitoris, followed by the superficial surface of the vaginal canal. Aversive sensation associated with the anus primarily came from feelings of judgment and shame, while other ASZs were reportedly due to pain and sensitivity.
Capturing and Categorizing the Burden of Musculoskeletal Injuries in U.S. Active Duty Service Members: A Comprehensive Methodology
Authors: Pav Veronika , Yuan Xiaoning , Isaacson Brad , Funk Wendy , Hando Ben 
Published: November 2024

ABSTRACT

Background
Musculoskeletal injuries (MSKIs) represent the most common, costly, and impactful medical conditions affecting active duty service members (ADSMs) of the United States Armed Forces. Inconsistent, variable MSKI surveillance methods and often incompletely described criteria for cohort selection, injuries, incidence, and prevalence have limited efforts to observe longitudinal trends, identify gaps in care, or highlight specific military branches or sites that could benefit from enhanced MSKI intervention protocols. The purpose of this manuscript is to present a comprehensive, well-documented, and reproducible framework for capturing and categorizing MSKI burden, healthcare utilization, and private sector costs for ADSMs across a 12-year period spanning the International Classification of Diseases, 10th Revision, Clinical Modification transition.

Methods
This was a retrospective, longitudinal population study, including ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Upper Extremity, Lower Extremity, Spine, and Head/Neck MSKIs, associated health care utilization, and private sector costs were obtained by querying electronic health records from military treatment facilities, private sector care (PC) claims, and theater medical data from October 1, 2010 to September 30, 2021 (Fiscal Years 10-21), using the Military Health System Data Repository. Utilization associated with MSKIs per body region in the direct care and PC settings was classified into mutually exclusive outpatient encounter categories and acute inpatient stays. PC MSKI-associated costs were captured per year and categorized by service, body region, and setting.

Conclusions
MSKI surveillance research in ADSMs has been impacted by variable, often incompletely described methods. While our approach is not without limitations, our aim was to present a well-documented, reproducible methodology for MSKI investigation in military personnel. By presenting a comprehensive blueprint for capturing and categorizing MSKI care in U.S. service members, our goal is for this methodology to enhance the efforts of researchers, public health officials, and Military Health System leaders to combat MSKIs, the primary medical threat to military readiness.
Burden of Musculoskeletal Injuries in U.S. Active Duty Service Members: A 12-Year Study Spanning Fiscal Years 2010–2021
Authors: Pav Veronika , Yuan Xiaoning , Isaacson Brad , Colahan Courtney , Hando Ben 
Published: November 2024

ABSTRACT

Background
Musculoskeletal injuries (MSKIs) represent the most substantial and enduring threat to U.S. military readiness. Previous studies have focused on narrow surveillance periods, single branches of service, and used variable approaches for MSKI identification and classification. Therefore, the goals of this retrospective population study were to report the incidence, prevalence, and types of MSKIs sustained by active duty service members (ADSMs) across four Services in direct care (DC) and private sector care (PC) settings over fiscal years (FYs) 2010–2021, and to quantify and describe associated health care utilization and PC costs over the same period.

Methods
This study included ADSMs from the Air Force, Army, Marine Corps, and Navy. Prevalence and incidence rates for Head/Neck, Upper Extremity (UE), Spine (upper back, middle back, lower back, pelvic), and Lower Extremity (LE) MSKIs in ADSMs, associated health care utilization, and PC costs were derived by querying electronic health records from DC, PC claims, and theater medical data from the Military Health System Data Repository. Patient episodes of care and associated PC costs related to MSKIs in DC and PC settings were classified into mutually exclusive outpatient encounter categories and acute inpatient stays, body regions, and Services.

Results
Over FY10–21, the most prevalent MSKIs were LE (24–29%) followed by Spine (17–20%), UE (14–16%), and Head/Neck (6–8%). Across FY10–21, soldiers were more likely to sustain LE MSKI than Airmen (risk ratio 1.12–1.30) and Marines demonstrated an increasing risk of LE MSKI prevalence and incidence (relative to Airmen) over the study period. The rise in prevalence of LE, Spine, UE, and Head/Neck MSKIs over FY10–21 was accompanied by increased health care utilization and reliance on PC care, especially same-day surgeries (SDS). PC reliance for SDS increased across body regions from FY10 to its peak in FY20 (Head/Neck: 22.7% to 49.7%, Spine: 37.1% to 57.0%, LE: 38.6% to 51.5%, UE: 40.4% to 53.5%). In FY21, the MHS incurred the highest PC costs for LE MSKIs ($132,242,289), followed by Spine ($98,738,863), UE ($92,118,071), and Head/Neck ($42,718,754).

Conclusions
To our knowledge, this is the first population study of MSKIs in ADSMs spanning the ICD-10 CM transition (FY15–16) that includes the four Services. Across Services, MSKIs in the U.S. military remain a prevalent and persistent problem. Consistent with prior research, the LE was the most common and costly body region affected by MSKIs. Service members with MSKIs demonstrated an increasing reliance on PC for MSKI care, particularly SDS, over the study period. Expanding future research efforts to include all Services to assess risk factors and patient outcomes for treatments across DC and PC settings is vital to mitigate the threat posed by MSKIs to the readiness of the U.S. Armed Forces.
High-Grade B-Cell Lymphoma: An Atypical Mass in the Colon
Authors: Corder Jessica , Paul Shira , Dehart Joshua , Jayne Lindsay , Bush Allison 
Published: November 2024

ABSTRACT
Masses in the colon can range from benign to malignant etiologies, with adenocarcinoma being the most common malignancy. Although the most frequently encountered hematologic malignancy in the military population, lymphoma is uncommonly identified during colonoscopy. We present a rare case of an active duty service member with abdominal pain and a large mesenteric mass with extension into the cecum that was a high-grade B-cell lymphoma diagnosed through endoscopy.