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Transcriptomic based prognostic model versus TNM 9th edition in HPV-positive oropharyngeal cancer
No full textBeyond Randomization:Design and Analysis of Discrete Choice Experiments in the Presence of Profile Order Effects Within Choice Sets
No full textDiscrete Choice Experiments (DCEs) investigate the attributes that affect individual choices among different options and are widely applied across numerous fields. Past DCEs provide clear evidence that the presentation order of the profiles within a choice set can impact the respondents' choices. Ignoring such order effects can produce severely biased estimates, as we illustrate using a product packaging DCE performed for Procter & Gamble in Mexico. Currently, the most common approach to address profile order effects is to randomize the profile order. While this method is relatively easy to implement in online surveys, it can be considerably cumbersome in offline experimental settings. To address this, we suggest incorporating an order covariate in the model to measure the effect of profile order, and propose a Bayesian optimal Balanced Profile Order Design (BPOD) that accounts for this order effect. Our simulation experiments reveal that our Bayesian optimal BPOD achieves accurate parameter estimates comparable to those obtained through randomization in both the multinomial logit model and the panel mixed logit model. Beyond DCEs, this design strategy contributes to broader efforts in experimental design by providing a generalizable framework for addressing structural sources of bias in applied statistical research
Individual-Level Effects of a Digital Behavioural Treatment for Chronic Pain:Proof-of-Concept of a Single-Case Experimental Design Study
No full textBackground: Chronic pain affects 20%–30% of the population worldwide, leading to significant distress, disability and financial burden. Pain management strategies focusing on pain reduction have shown limited effects on functioning; however, behavioural treatments aimed at enhancing resilience have demonstrated strong empirical support. Digital solutions offer new opportunities for delivering evidence-based treatments, but evaluation at the individual level is needed. The aim of this study is to examine individual-level treatment effects of a digital behavioural treatment for chronic pain in a heterogeneous sample. Methods: A study with a single-case experimental design (SCED) was conducted with participants (N = 11) experiencing chronic pain (> 3 months) recruited through healthcare. Participants were randomised at baseline (5–10-day A-phase) and completed a 6-module digital treatment based on learning theory and well-established theories applied to chronic pain (6–8-week B-phase), with weekly therapist contact. Digital diaries, prompted twice daily, tracked psychological flexibility and acceptance, pain-related functioning, pain intensity and well-being. Data were analysed using visual analysis and effect size calculations. Results: N = 11 enrolled and data from n = 10 were analysed (n = 1 refused digital diary, n = 2 partial completers, n = 8 full completers). Pain profiles varied (e.g., chronic migraine, fibromyalgia, lower back pain, etc.). Several participants benefited from the treatment, though results varied across individuals and across outcomes. Conclusion: The digital behavioural treatment showed promise in addressing diverse pain profiles and associated functioning. The variability in responses highlights the benefit of using SCED to explore individual-level effects, thus offering a methodological proof-of-concept. Findings support further development, including tailoring to match individual needs. Significance Statement: This proof-of-concept study provides support for the utility of digital behavioural interventions and individual-level evaluation of treatment effects, highlighting the potential of personalised pain treatments. The findings contribute to the growing body of support for digital solutions as effective and accessible approaches to improve functioning and resilience for people with diverse pain experiences
Antenatal Sildenafil for Congenital Diaphragmatic Hernia:A Systematic Review and Bayesian Meta-Analysis of Preclinical Studies
No full textBackground: In congenital diaphragmatic hernia (CDH), pulmonary hypoplasia and pulmonary hypertension are major causes of morbidity and mortality. Antenatal treatment with sildenafil has shown some promising protective effects in experimental CDH, but no systematic review has yet evaluated the preclinical evidence on this topic. Methods: PubMed and EMBASE databases were searched for studies using antenatal sildenafil in animal models of CDH. Bayesian model-averaged (BMA) meta-analysis was used to calculate Bayes factors (BFs). The BF 10 is the ratio of the probability of the data under the alternative hypothesis (presence of effect) over the probability of the data under the null hypothesis (absence of effect). Risk of bias was assessed by the SYRCLE tool. Results: We included 18 studies (14 nitrofen and 4 surgical CDH). The BMA analysis showed inconclusive evidence (BF 10 between 0.33 and 3) for the presence of an effect of sildenafil in fetal survival (7 studies, BF 10 = 1.25) or in lung hypoplasia as assessed by the lung-to-body weight ratio (16 studies, BF 10 = 2.04). In contrast, the BMA analysis showed conclusive evidence (BF 10 > 3) in favor of a positive effect of sildenafil on small pulmonary arteries medial wall thickness (12 studies, BF 10 = 1499), radial alveolar count (6 studies, BF 10 = 167.57), interalveolar septa thickness (4 studies, BF 10 = 56.86), distal airway complexity (3 studies, BF 10 = 7.95), mean saccular airspace diameter (2 studies, BF 10 = 7.61), total lung capacity (2 studies, BF 10 = 6.91), lung compliance (2 studies, BF 10 = 5.19), and VEGF expression (5 studies, BF 10 = 10.62). Conclusions: In preclinical models of CDH, antenatal sildenafil rescues pulmonary vascular remodeling and airway/airspace morphometric alterations.</p
Justice at Risk? The Influence of Recidivism Risk Information on Evaluation of Evidence and Determination of Guilt
No full textIn contrast to jurisdictions with bifurcated criminal justice proceedings, in Belgium and the Netherlands a defendant's assessed risk of recidivism is known to triers of fact prior to making decisions about guilt. In three experiments conducted in those two countries, we investigated whether information about recidivism risk would bias the fact finders' evaluations of evidence and the defendant's credibility, and their final decision on guilt. Specifically, student participants (Belgian sample: = 368; Dutch sample: = 236) and jury-eligible Belgian participants ( = 75) read a vignette about an aggravated assault with circumstantial evidence and a defendant who denied committing the alleged offense. Participants were randomly assigned to one of three vignettes: one without risk information, one describing a low risk of recidivism, and one describing a high risk of recidivism. We found no direct or indirect effect of risk on the proportion of guilty verdicts or on the evaluation of the evidence. We did find that participants who read that the defendant was low risk evaluated the innocence claim as being more credible, compared to those who were given high-risk information or no risk information. Moreover, higher credibility ratings were associated with a higher likelihood of a not-guilty verdict. While preliminary, these findings suggest recidivism risk information may influence fact finding, and merit replication, especially with judges
A transformation from vision to imagery in the human brain
No full textExtensive work has shown that the visual cortex is reactivated during mental imagery, and that models trained on visual data can predict imagery activity and decode imagined stimuli. These findings may explain why imagery can feel and function like vision, but give little insight into how the brain activity patterns that encode seen and mental images differ. While one popular theory ("weak vision") suggests that imagery differs from vision only in strength, recent work points to more complex differences. To clarify the relationship between visual and imagery activity in the human brain, we introduce the concept of an imagery transformation-a mapping from visual to imagery activity patterns evoked by the same stimulus. Importantly, this approach can describe a variety of possible scenarios, from simple rescaling to the selective removal or reorientation of activity dimensions. Using two 7T fMRI datasets, we estimated imagery transformations across different visual areas and found they accurately predict imagery activity. We show that imagery transformations are indeed more complex than simple weakening: in early visual cortex, they halve the number of active dimensions and reorient them, such that reconstructions of visual activity in terms of imagery dimensions explain only 25-50% of the variance. Nonetheless, these reoriented dimensions still coarsely encode the features encoded by the principal dimensions of visual activity. These findings help to explain the "same but different" relationship between mental imagery and vision: imagery activity patterns are transformations of visual activity patterns that approximate them, but encode fewer features and occupy a distinct subspace within the overall space of brain activations
Role of Field Epidemiology in Environmental and Climate Change-Related Health Incidents in Wales:A Qualitative Analysis Through Expert Interviews
No full textClimate change and environmental degradation pose significant challenges to public health globally, intensifying the frequency and severity of related health incidents. Field epidemiology, traditionally focused on infectious disease outbreaks, is now increasingly recognised as vital in addressing environmental and climate-related health threats. This study explores how organisations like Public Health Wales (PHW) can develop field epidemiology services responsive to these emerging challenges. Semi-structured interviews were conducted with 18 global and national experts in field epidemiology, environmental health, and related disciplines. An inductive content analysis approach was used to identify themes relating to best practices, challenges, competencies, and future directions in environmental field epidemiology. Key findings emphasise the necessity for integrated, multi-sectoral collaboration, capacity building in One Health competencies, and innovative surveillance systems that incorporate environmental and climate data and exposure measures. Participants highlighted barriers such as fragmented governance, data quality issues, and resource constraints. The evolving role of field epidemiology includes applications of environmental and climate-related health phenomena to encompass prevention, preparedness, and recovery phases, supported by technological advancements and holistic health security frameworks. To effectively address environmental and climate-related health incidents, field epidemiology services must evolve towards integrated, multidisciplinary, and adaptive frameworks. Organisations like PHW may consider strengthening international collaboration, investing in workforce development, and implementing integrated surveillance systems that incorporate environmental drivers of health. These strategic priorities align with global public health functions and support resilient health systems capable of mitigating climate-related health risks
Personalized treatment in HPV+ oropharynx cancer using genomic adjusted radiation dose
No full textBACKGROUNDA key objective in managing HPV+ oropharyngeal squamous cell carcinoma (OPSCC) is reducing radiation therapy (RT) doses without compromising cure rates. A recent phase II/III HN005 trial revealed that clinical factors alone are insufficient to guide safe RT dose de-escalation. Our prior research demonstrated that the genomic adjusted radiation dose (GARD) predicts RT benefit and may inform dose selection. We hypothesize that GARD can guide personalized RT de-escalation in HPV+ OPSCC patients.METHODSGene expression profiles were analyzed in 191 HPV+ OPSCC patients enrolled in an international, multi-institutional observational study (AJCC Eighth Edition, stages I-III). Most patients received 70 Gy in 35 fractions or 69.96 Gy in 33 fractions (median dose: 70 Gy; range: 51.0-74.0 Gy). Overall survival (OS) was 94.1% at 36 months and 87.3% at 60 months. A Cox proportional hazards model assessed association between GARD and OS, and time-dependent receiver operating characteristic analyses compared GARD with traditional clinical predictors.RESULTSDespite uniform RT dosing, GARD showed wide heterogeneity, ranging from 15.4 to 71.7. Higher GARD values were significantly associated with improved OS in univariate (HR = 0.941, P = 0.041) and multivariable analyses (HR = 0.943, P = 0.046), while T and N stages were not. GARD demonstrated superior predictive performance at 36 months (AUC = 78.26) versus clinical variables (AUC = 71.20). Two GARD-based RT de-escalation strategies were identified, offering potential survival benefits while reducing radiation exposure.CONCLUSIONGARD predicts OS and outperforms clinical variables, supporting its integration into the diagnostic workflow for personalized RT in HPV+ OPSCC.FUNDINGThis work was supported by the National Cancer Institute through the Cleveland Clinic/Emory ROBIN center (U54-CA274513, project 2), the European Union Horizon 2020 Framework Programme (grant/award 689715), the Italian Association for Cancer Research (AIRC project ID 23573), and the European Research Area Network ERA PerMed JTC2019/Fondazione Regionale per la Ricerca Biomedica project SuPerTreat (Supporting Personalized Treatment Decisions in Head and Neck Cancer through Big Data)
RecSys Challenge 2025: Universal Behavioral Profiles for Recommender Systems
No full textThe RecSys Challenge 2025 promotes a unified approach to behavior modeling by introducing Universal Behavioral Profiles. These user representations encode essential aspects of past interactions and are designed for universal applicability across different downstream tasks, thereby promoting generalization across applications and addressing the need for portable and efficient recommender systems.The participants task was to create universal user embeddings from detailed e-commerce activity logs. These embeddings were then fed into a small neural network to predict customer behavior in subsequent timeframes. The provided challenge dataset was large and sparse, requiring innovative methods to leverage the available interaction data in an effective way. Overall, the challenge was highly attractive with 400 teams participating in the competition
'It's the noise of the snacks!':School meals on the fringes and frail food pedagogies
No full textBased on ethnographic fieldwork conducted during recess and lunch in a primary school sited in a deprived Palermitan neighbourhood, this paper sheds light on the (dis)functioning of food pedagogies in a school on the fringes of society. During recess, teachers use food rules to highlight transgressions, but not to improve food literacy. Likewise, their efforts during lunchtime are devoted solely to keeping children under control, while trying to get to the end of lunch as soon as possible. Ultimately, both eating occasions are seldom opportunities for food education, as teachers’ primary focus is on preventing or halting children’s restlessness and skirmishes. I conclude by outlining some limitations and strengths of the ethnography while reflecting on the findings vis-à-vis previous fieldwork I conducted in less challenging contexts.</p