51886 research outputs found
Sort by
Data Mining Trauma: AI-Assisted Qualitative Study of Cyber Victimization on Reddit
No full textBackground: Cyber victimization exposes individuals to numerous risks. Developmental and psychological factors may leave some users unaware of the potential dangers, increasing their susceptibility to psychological distress. Despite this vulnerability, methods for identifying those at risk of cyber victimization within health care settings are limited, as is research that explores their experiences of cyber victimization. The purpose of this study was to analyze how users describe experiences of cyber victimization on the social media platform Reddit (Reddit, Inc) using data mining.
Objective: This study aimed to analyze and describe how users on Reddit describe and discuss their experience of cyber victimization using data mining and computational analysis of unsolicited data.
Methods: This computational qualitative study used data mining, Word Adjacency Graph (WAG) modeling, and thematic analysis to analyze discussions of Reddit users surrounding cyber victimization. Inclusion criteria included posts from 2012 to 2023 from subreddits r/cyberbullying and r/bullying. GPT-4 (OpenAI), an advanced artificial intelligence language model, summarized posts and assisted in cluster labeling. Posts were reviewed to remove irrelevant content and duplicates. User anonymity was maintained throughout the study.
Results: A total of 13,381 posts from 3283 Reddit were analyzed, with approximately 5.1% (n=678) originating between 2012 and 2018 and 94.9% (n=12,703) from 2019 to 2023. The WAG modeling approach identified 38 clusters, with 35 deemed to be relevant to cyber victimization experiences. Two clusters containing irrelevant material were excluded. Six overarching themes emerged: (1) psychological impact, (2) coping and healing, (3) protecting yourself online, (4) protecting yourself offline, (5) victimization across various settings, and (6) seeking meaning and understanding.
Conclusions: The study highlights the effectiveness of data mining and AI in analyzing large public datasets for qualitative research. These methods can inform future studies on risky internet behavior, victimization, and assessment strategies in health care settings
Immediate Breast Reconstruction for Inflammatory Breast Carcinoma: A Scoping Review
No full textInflammatory breast carcinoma (IBC) is an aggressive form of breast cancer involving skin lymphatics. Breast reconstruction traditionally has been delayed in IBC. Immediate reconstruction has been described in select patients. Studies evaluating the reconstructive and oncologic safety of immediate breast reconstruction in this patient population are limited and retrospective. The purpose of this study is to assess the current body of literature on immediate breast reconstruction in IBC patients to identify knowledge gaps. A scoping review was conducted using PubMed, Scopus, Embase, and Cochrane databases. Original articles that evaluated patients diagnosed with IBC who underwent immediate breast reconstruction were included. The search yielded 821 articles, of which 9 articles containing 1429 IBC patients were included for analysis. Immediate implant-based reconstruction occurred in 12.2% (174/1429) of patients. Immediate autologous reconstruction occurred in 19.0% (272/1429). Immediate reconstruction with both autologous and implant-based techniques was 4.5% (64/1429). Reconstruction type was not reported for 63.0% (899/1429) of patients. Postoperative complications occurred in 1.8% (26/1429) of patients. Local cancer recurrence was 14.3% (3/21) at 18.9 months. The mortality rate was 32.4% (131/404) at 22 months. Performance of immediate breast reconstruction can be safely performed from a reconstructive standpoint in select patients
Growth after pediatric and neonatal acute kidney injury: a meta-analysis
No full textBackground: Acute kidney injury (AKI) occurs commonly in critically ill children. The impact of AKI on pediatric growth outcomes has been sparsely described.
Objective: To compare growth in children with a history of AKI compared to those without AKI. We hypothesized that children with AKI would have worse growth compared to those without AKI.
Data sources: A convenience sample of existing prospective and retrospective cohorts of children with AKI who had already collected or were able to collect data on growth parameters before and after an episode of AKI.
Study eligibility criteria: There are < 5 studies in the published literature on growth in children with AKI. These investigators were contacted, and additional studies were added by contacting primary investigators of studies of childhood AKI in which data on growth parameters was able to be collected.
Participants and interventions: Children from existing cohorts evaluating AKI (exposure) during childhood. Each included cohort had previously received local IRB approval per institutional guidelines. As our study was a meta-analysis and only used cohort-level data, no IRB approval was required for this report.
Study appraisal and synthesis methods: Growth parameters (length and weight z-scores) before and after an episode of AKI were compared using a meta-means analysis. MOOSE guidelines were used. Data were pooled using a random-effects model. Hedges g was calculated, and Higgins I2 statistic was used to define variability due to between-cohort heterogeneity.
Results: We included 3,586 children from 17 existing cohorts of AKI in various populations, including infants, children with cardiac disease, solid organ transplant and critically ill children without cardiac disease with follow-up from 12 months to 11 years after AKI. At most distant follow-up, those with AKI had lower length z-score than those without AKI (mean difference -0.37 [95%CI -0.52, -0.22, p < 0.001]) and lower weight z-score (mean difference of -0.29 [95%CI -0.43, -0.15, p < 0.001]). This difference was most striking in infants, as those with AKI had impaired growth (both length z-score and weight z-score) after AKI compared to those without AKI.
Limitations: The analysis included only a convenience sample of observational cohorts of children, study selection could have been biased, and we did not evaluate the relationship between decreased kidney function (e.g., chronic kidney disease) after AKI in these cohorts and its relationship to poor growth.
Conclusions and implications of key findings: This meta-analysis found that children with AKI have impaired growth after AKI. These findings were most striking in infants. We suggest focusing on growth outcomes in both clinical care and research investigating the impacts of AKI
Genome‐wide interaction and stratified study reveals CR1‐Alzheimer's disease association is moderated by education level
No full textBackground:
Genetic and environmental factors contribute to Alzheimer's disease (AD) risk. Understanding gene‐environment interactions may provide insight into unexplained AD heritability. Higher educational attainment is associated with lower AD risk, but the mechanism remains unclear. We conducted a genome‐wide association study (GWAS) to explore genetic‐education‐related associations with AD through SNP‐education interaction and education‐stratified analyses.
Method:
Educational attainment data were available and analyzed among 23,642 non‐Hispanic white (NHW; 10,272 cases) and 3,461 African American (AFA; 1064 cases) participants from the AD Genetic Consortium and the Framingham Heart Study. Educational attainment was dichotomized by median years of education across cohorts, which equated to completing four years of college. Across 35 datasets, we conducted separate GWAS: 1) including a SNP‐by‐education interaction term and 2) stratifying by median education status. MAGEE was used to estimate SNP‐by‐education interaction effects and SAIGE was used to estimate SNP effects in stratified analysis. GWAS models adjusted for age, sex, and principal components for population structure. METAL was used for inverse‐variance weighted within‐ancestry fixed‐effects meta‐analysis and METASOFT was used to estimate cross‐ancestry effects. Top GWAS hits were further analyzed for association with longitudinal trajectories of harmonized memory, language, and executive function factor scores in education‐stratified linear mixed effects models.
Result:
Stratified GWAS identified a genome‐wide significant association among participants with lower educational attainment in CR1, a well‐known AD‐associated locus on chromosome 1 (top SNP: rs12037841; lower educational attainment: MAF=0.19, OR=1.33, p = 3.1x10‐10; higher educational attainment: MAF=0.19, OR=1.09, p = 0.03; interaction‐model: βsnpXedu=‐0.18, p = 0.0018). Effects among those with lower educational attainment were present in both ancestries (NHW: MAF=0.19, OR=1.30, p = 1.8x10‐9; AFA: MAF=0.03, OR=1.64, p = 0.02). In analysis with neuropsychological factor scores, rs12037841 was associated with faster decline in memory and language among participants with lower educational attainment (memory: βsnpXtime=‐0.010, 95% CI:[‐0.016,‐0.004], p = 0.0019; language: βsnpXtime=‐0.006, 95% CI:[‐0.011,‐0.002], p = 0.0083). Weaker, non‐significant effects were observed among participants with higher educational attainment.
Conclusion:
In educational attainment‐stratified GWAS of AD, we identified stronger association of known AD‐related gene CR1, among those with lower educational attainment. The finding implicating CR1, a complement pathway gene, suggests that the risk education confers on AD may be moderated by immune‐related mechanisms
Leveraging comparative phylogenetics for evolutionary medicine: applications to comparative oncology
No full textComparative phylogenetics provides a wealth of computational tools to understand evolutionary processes and their outcomes. Advances in these methodologies have occurred in parallel with a surge in cross-species genomic and phenotypic data. To date, however, the majority of published studies have focused on classical questions in evolutionary biology, such as speciation and the ecological drivers of trait evolution. Here, we argue that evolutionary medicine in general, and our understanding of the origin and diversification of disease traits in particular, would be greatly expanded by a wider integration of phylogenetic comparative methods (PCMs). We use comparative oncology-the study of cancer across the tree of life-as an example to demonstrate the power of the approach and show that implementing PCMs can highlight the mode and tempo of the evolutionary changes in intrinsic, species-level disease vulnerabilities
Current Practices in Monitoring Children and Adults With X-linked Hypophosphatemia: A Global Survey of Expert Experience
No full textThis report provides recommendations for X-linked hypophosphatemia (XLH) monitoring based on current monitoring practices of experts in the management of XLH in children (<18 years) and adults. We surveyed 43 international experts in XLH to determine their monitoring practices for children and adults with XLH, including pregnant and lactating women. In the initial evaluation of children and adults with XLH, experts consistently obtain a family history of XLH or hypophosphatemia, a history of fractures and dental infections, and assess pain through age-appropriate clinical interviews or caregiver reports. They measure height, weight, and blood pressure and conduct DNA analysis of multiple genes associated with hypophosphatemia including the PHEX gene. For children follow-up, experts arrange follow-up every 3 to 6 months assessing height, weight, and blood pressure and examining for skeletal deformities. Laboratory tests in children include serum phosphorus, corrected total/ionized calcium, alkaline phosphatase, renal function, and PTH and spot morning urine for calcium, creatinine, and phosphorus. During adult follow-up, experts assess patients every 6 to 12 months, with a clinical examination focused on skeletal deformities and joint involvement. The laboratory profile is completed at least once a year. In the presence of bone pain, experts conduct X-rays both in children and adults to evaluate for fractures or joint damage. With respect to nephrocalcinosis, renal ultrasound is suggested on an annual basis or less frequently when monitoring children and adults with XLH. Experts conduct a dental assessment at baseline and then every 6 to 12 months for all patients with XLH. The findings of the survey inform practice for assessing new patients with XLH, monitoring existing patients, and identifying areas for future research. All recommendations based on these practices are weak with very low-quality evidence
Using Electronic Health Records to Classify Cancer Site and Metastasis
No full textThe Enhanced EHR-facilitated Cancer Symptom Control (E2C2) Trial is a pragmatic trial testing a collaborative care approach for managing common cancer symptoms. There were challenges in identifying cancer site and metastatic status. This study compares three different approaches to determine cancer site and six strategies for identifying the presence of metastasis using EHR and cancer registry data. The E2C2 cohort included 50,559 patients seen in the medical oncology clinics of a large health system. SPPADE symptoms were assessed with 0 to 10 numeric rating scales (NRS). A multistep process was used to develop three approaches for representing cancer site: the single most prevalent International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) code, the two most prevalent codes, and any diagnostic code. Six approaches for identifying metastatic disease were compared: ICD-10 codes, natural language processing (NLP), cancer registry, medications typically prescribed for incurable disease, treatment plan, and evaluation for phase 1 trials. The approach counting the two most prevalent ICD-10 cancer site diagnoses per patient detected a median of 92% of the cases identified by counting all cancer site diagnoses, whereas the approach counting only the single most prevalent cancer site diagnosis identified a median of 65%. However, agreement among the three approaches was very good (kappa > 0.80) for most cancer sites. ICD and NLP methods could be applied to the entire cohort and had the highest agreement (kappa = 0.53) for identifying metastasis. Cancer registry data was available for less than half of the patients. Identification of cancer site and metastatic disease using EHR data was feasible in this large and diverse cohort of patients with common cancer symptoms. The methods were pragmatic and may be acceptable for covariates, but likely require refinement for key dependent and independent variables
Seeding biosensor cell line that reproduces the Alzheimer tau fold
No full textThe assembly of tau protein into amyloid filaments through templated seeding is believed to underlie the propagation of pathology in neurodegenerative diseases, such as Alzheimer’s disease (AD) and other tauopathies. A commonly used model system for studying this process is through the induction of tau filament formation in cultured cells following the addition of tau seeds isolated from the human brain. However, little is known about the structures of seeded filaments; some biosensor cell lines are unable to reproduce the tau filament structures from AD, because they overexpress tau fragments that do not cover the whole of the ordered filament core. Here, we describe a novel tau seeding biosensor model in human embryonic kidney 293T cells that overexpress residues K297–E391 of human 4R tau. The construct contains an N-terminal hemagglutinin tag, which allows the specific detection of the amplified template. The biosensor cells detected filaments seeded by material from sporadic three-repeat (3R) + four-repeat (4R) tauopathies, with little activity by seeds from 3R-only or 4R-only tauopathies. The sensitivity of seed detection from 3R + 4R tauopathies in our system was similar to or higher than for previously reported biosensors. We also structurally characterized the AD-seeded tau filaments by cryo-EM. Most of the cell-derived filaments consisted of two protofilaments with the Alzheimer's fold but with a “head-to-head” interprotofilament packing. Our results establish a sensitive biosensor cell line with specificity toward seeds from 3R + 4R tauopathies
14 Staying connected: Community engagement for enhanced HIV care outcomes
No full textObjectives/Goals: Retention in care is vital for people living with HIV. We used human-centered design (HCD) to engage a community-based research panel over a 5-year period, allowing us to incorporate their insights on research guidance and interpretation of findings to investigate correlates of HIV care outcomes. Methods/Study Population: We recruited a diverse panel of individuals who were living with HIV, HIV clinicians, and/or providing non-clinical HIV services in Marion County, Indiana. We conducted biannual sessions using a variety of HCD tools and activities to engage participants. Each session took about three hours, and panelists were compensated for their participation. Due to the COVID-19 pandemic, sessions were initially held virtually. Sessions were designed for project discussion and to facilitate exploration of concerns and challenges facing receipt of HIV services. Our HCD approach put participants in the center of discussion and empowered them to externalize ideas and collaborate meaningfully with our team. Results/Anticipated Results: Since project inception, 48 individuals have joined the panel. Thirty-five are actively engaged, participating in one or more of six sessions conducted to date. We have learned much from the panel. One example is that a residential move might be a risk or protective factor for retention in care and the amount of time one had lived with HIV is a crucial factor. Panel insights have helped guide and prioritize analyses, aided in identification of data missing from our ecosystem, helped interpret results, provided feedback on future interventions, led to a quality improvement project with the local health department, and led to a presentation at a local health equity conference. Discussion/Significance of Impact: Community engagement is essential to impactful and sustainable research. HCD was a successful approach to engage our panel to inform interventions more relevant to the community. We anticipate these methods will be important for others conducting community-engaged research
The MR1/MAIT cell axis impacts the gut–brain axis through both cognition and microbial community structure in 5XFAD mice
No full textIntroduction: Mucosal-associated invariant T (MAIT) cells recognize microbial antigens presented by major histocompatibility complex class I-like molecule (MR1) and are elevated in Alzheimer's disease (AD) model mouse brains; MAIT cell-deficient AD mice have reduced brain pathology, supporting the importance of the gut-brain axis in AD. How the MR1/MAIT cell axis impacts cognition and the microbiome remains unknown.
Methods: Novel object recognition/placement, Y-maze, and Barnes maze were used to determine memory changes in wild-type (WT), MR1 KO, 5XFAD, and 5XFAD/MR1 KO mice. Fecal samples were analyzed using 16S rRNA gene amplicon sequencing.
Results: 5XFAD/MR1KO mice did not display the cognitive deficits observed in 5XFAD. There were relative abundance differences in the fecal microbiota between 5XFAD and 5XFAD/MR1 KO mice, and male 5XFAD/MR1 KO mice had increased microbiome alpha diversity compared to 5XFAD mice.
Discussion: Our data suggest that the MR1/MAIT cell axis negatively affects cognition and impacts gut microbiome diversity. These results further support a detrimental role for the MR1/MAIT cell axis in AD.
Highlights: 5XFAD mice lacking major histocompatibility complex, class I-related (MR1) and mucosal-associated invariant T (MAIT) cells had no deficits in recognition memory. Compared to 5XFAD, there was improved learning in the Barnes maze by female 5XFAD/MR1 knock-out (KO) mice. There was an increased abundance of Campylobacterota in male 5XFAD/MR1 KO versus 5XFAD mice. Six of nine linear discriminant analysis effect size-identified distinguishing features were higher in 5XFAD/MR1 KO mice