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Coarctation of the aorta is a congenital cardiovascular disease with focal aortic luminal narrowing, and paediatric patients face a high postoperative restenosis risk. This study aimed to develop and validate an interpretable machine learning model for early predicting restenosis after paediatric coarctation of the aorta direct repair using preoperative and intraoperative data.
Methods:
A total of 117 patients (2016–2024) were retrospectively enrolled, divided into restenosis (21 cases, 17.9%) and non-restenosis (96 cases, 82.1%) groups (restenosis was defined as a peak systolic pressure gradient >20 mmHg measured by echocardiography). Recursive feature elimination with cross-validation screened key variables; six machine learning models were built with 5-fold randomised search cross-validation tuning, using the area under the curve as the primary metric. SHapley Additive exPlanation analysed feature contributions.
Results:
The multilayer perceptron model performed best (mean area under the curve = 0.8333, 95% CI: 0.7111–0.9555, accuracy = 0.8376) with balanced precision-recall. SHapley Additive exPlanation identified low body surface area as the top risk factor. Resection and extended end-to-end anastomosis/end-to-side anastomosis were preferred surgically, while resection with end-to-end anastomosis should be avoided; end-to-side anastomosis reduced restenosis risk in patients with aortic arch hypoplasia.
Conclusion:
Machine learning models enable personalised, high-accuracy restenosis prediction. SHapley Additive exPlanation-facilitated risk factor identification optimises treatment strategies. Future prospective studies are needed to validate the models and develop clinical tools.
Blackgrass is a highly competitive weed in wheat fields and has increasingly evolved resistance to acetolactate synthase (ALS)-inhibiting herbicides. Ten field populations were screened, resulting in the selection of one highly resistant population (R-06) and one susceptible population (S-19) for detailed study. Whole-plant bioassays, ALS gene sequencing, molecular docking, metabolic inhibitor assays, glutathione S-transferase (GST) and ALS activity assays, and cross-resistance profiling were conducted to dissect the mechanisms of resistance. ALS sequencing identified three amino acid substitutions in R-06: Pro232Thr (P232T), His363Lys (H363K), and Trp574Leu (W574L). While W574L is a well-characterized ALS resistance-conferring mutation, P232T and H363K are outside major resistance hotspots and may serve secondary or compensatory roles. Molecular docking analyses predicted altered binding of mesosulfuron-methyl in the mutant ALS model, consistent with structural changes in the binding pocket. Metabolic inhibitor assays using malathion, piperonyl butoxide (PBO), and NBD-Cl resulted in modest increases in herbicide sensitivity, with a maximum reduction factor of 2.95 for PBO. GST activity was higher in R-06 at a single sampling time point (3 DAT). In addition, R-06 showed reduced sensitivity to several ALS inhibitors and reduced efficacy against selected herbicides with alternative modes of action. High-level resistance to mesosulfuron-methyl in the R-06 population is primarily associated with the ALS target-site mutation Trp574Leu, while the roles of Pro232Thr, His363Lys, and metabolism appear secondary and remain unresolved. These findings highlight complex resistance patterns in blackgrass and emphasize the need for diversified and integrated weed management strategies.
We investigate Taylor–Couette flow with realistic no-slip boundary conditions at all surfaces through direct numerical simulation (DNS) and theoretical analysis. Imposing physically consistent end-wall conditions at the top and bottom lids significantly alters the flow dynamics compared with that for periodic boundary conditions. We extend the classical angular-momentum-flux framework to account for axial transport, thereby extending the Eckhardt–Grossmann–Lohse model (Eckhardt et al. J. Fluid Mech. vol. 581, 2007, pp. 221–250) to no-slip boundary conditions. A systematic exploration of the parameter space $(\textit{Re}, n)$ uncovers multiple long-lived states with different roll number $n$ configurations at identical Reynolds numbers $\textit{Re}$, giving rise to pronounced hysteresis loops occurring under realistic boundary conditions. Our DNS for no-slip axial endcaps reveals a sequence of structural transitions: as the inner-cylinder Reynolds number increases, the flow evolves from Taylor vortex flow through chaotic wavy vortex flow and turbulent wavy vortex flow to an axisymmetric turbulent Taylor vortex flow. Using modal energy budgets, we identify transition mechanisms and quantify how the accessible phase-space volume and associated roll-specific angular momentum flux depend on control parameters and the specific flow state. Our findings demonstrate the impact of realistic boundary conditions on the dynamics in Taylor–Couette flow and how they change the stability landscape of multiple states. The coexistence of distinct flow patterns and their stability analysis offers promising insights into transition dynamics between laminar and turbulent regimes in closed sheared flows.
Discrepancies in iodised salt coverage rate (ISCR) between household salt and that used in catering establishments may significantly compromise the accuracy of dietary iodine intake assessments. To evaluate this impact, we analysed data from the 2023 Shanghai Diet and Health Survey, a cross-sectional study involving 2920 adults. Dietary intake was assessed using three 24-h dietary recalls and an FFQ, while condiment intake was collected using the weighed inventory method. Additionally, salt samples from 960 canteens and restaurants were tested to determine the ISCR in dining establishments. Results showed that the ISCR was 85·9 % in dining establishments, markedly higher than the 53·3 % observed in households. Among employed participants in Shanghai, 51·7 %, 56·1 % and 18·7 % reported consuming breakfast, lunch and dinner outside the home at least once during the 3-d study period, respectively. The estimated daily iodine intake was 101 μg/d when dining-out salt was assumed to have the same ISCR as household salt, but it increased to 118 μg/d after accounting for the ISCR discrepancy. In conclusion, the rising prevalence of eating out has reshaped residents’ dietary habits, rendering traditional household-centric survey methods inadequate for iodine intake estimation in Shanghai. Incorporating ISCR differences between household and dining settings is essential for more accurate dietary iodine assessments.
We systematically investigate the multiplicity of flow states in centrifugal convection in water at about $40\,^\circ$C with Prandtl number $Pr = 4.3$ in a vertically aligned annulus in which the inner radius, the gap between the cylinders and the height all coincide (6 cm). This leaves two independent control parameters: the thermal driving, quantified by the Rayleigh number ${\textit{Ra}}$, and the rotation strength, expressed by the Froude number ${\textit{Fr}}$. We explore the range $2\times 10^{5} \le {{\textit{Ra}}} \le 10^{7}$ for ${{\textit{Fr}}} = 10$ and $100$ with direct numerical simulations (DNS). The states are characterised by the number of convection rolls in the mid-height cross-section. We show that the final state sensitively depends on the initial condition, leading to pronounced multistability and substantial variations in heat and momentum transport, while the range of attainable states is strongly restricted. We derive a theoretical estimate of the admissible roll numbers based on the Poincaré–Friedrichs inequality and demonstrate quantitative agreement with the DNS. We further show that, for larger ${\textit{Ra}}$, the range of possible states shrinks systematically due to an elliptical instability, providing a predictive framework for the selection and disappearance of coherent roll states in centrifugal convection.
Kaolinite, a widely distributed clay mineral, is extensively applied in construction, industry and agriculture due to its physical, chemical and mechanical properties. This study employed quantum mechanics-based first-principles calculations to investigate the crystal structure, electronic properties and mechanical properties of kaolinite at various temperatures from a microscopic perspective. The main conclusions are as follows: structurally, lattice parameters (a, b, c) and volume increased with temperature, with c showing the largest such increase. The interlayer spacing between silicate tetrahedral and alumina octahedral layers slightly decreased from 0.3733 to 0.3702 Å, indicating that temperature exerts a stronger influence on the interlayer hydrogen bonds than on the covalent bonds within the layers. Electronically, in the 0–750 K range, kaolinite’s band gap narrowed from 5.13 to 5.06 eV; s orbital electrons of Al atoms jumped from the valence to the conduction band, reducing insulation. Mechanically, the elastic constants C11, C22, C33, C44 and C66 decreased while C55 increased with temperature. The bulk modulus declined continuously, whereas the shear modulus and Young’s modulus first increased then decreased. The universal anisotropy index decreased markedly, reducing elastic anisotropy. Temperature (0–750 K) significantly affects kaolinite’s properties. This study provides a reliable theoretical basis for optimizing the physicochemical and mechanical properties of kaolinite-based materials.
Persistent malnutrition is associated with poor clinical outcomes in cancer. However, assessing its reversibility can be challenging. The present study aimed to utilise machine learning (ML) to predict reversible malnutrition (RM) in patients with cancer. A multicentre cohort study including hospitalised oncology patients. Malnutrition was diagnosed using an international consensus. RM was defined as a positive diagnosis of malnutrition upon patient admission which turned negative one month later. Time-series data on body weight and skeletal muscle were modelled using a long short-term memory architecture to predict RM. The model was named as WAL-net, and its performance, explainability, clinical relevance and generalisability were evaluated. We investigated 4254 patients with cancer-associated malnutrition (discovery set = 2977, test set = 1277). There were 2783 men and 1471 women (median age = 61 years). RM was identified in 754 (17·7 %) patients. RM/non-RM groups showed distinct patterns of weight and muscle dynamics, and RM was negatively correlated to the progressive stages of cancer cachexia (r = –0·340, P < 0·001). WAL-net was the state-of-the-art model among all ML algorithms evaluated, demonstrating favourable performance to predict RM in the test set (AUC = 0·924, 95 % CI = 0·904, 0·944) and an external validation set (n 798, AUC = 0·909, 95 % CI = 0·876, 0·943). Model-predicted RM using baseline information was associated with lower future risks of underweight, sarcopenia, performance status decline and progression of malnutrition (all P < 0·05). This study presents an explainable deep learning model, the WAL-net, for early identification of RM in patients with cancer. These findings might help the management of cancer-associated malnutrition to optimise patient outcomes in multidisciplinary cancer care.
In this paper, an improved U-net welding engineering drawing segmentation model is proposed for the automatic segmentation and extraction of sheet metal engineering drawings in the process of mechanical manufacturing, to improve the cutting efficiency of sheet metal parts. To construct a high-precision segmentation model for sheet metal engineering drawings, this paper proposes a U-net jump structure with an attention mechanism based on the Convolutional Attention Module (CBAM) attention mechanism. At the same time, this paper also designs an encoder jump structure with vertical double pooling convolution, which fuses the features after maximum pooling+convolution of the high-dimensional encoder with the features after average pooling+convolution of the low-dimensional encoder. The method in this paper not only improves the global semantic feature extraction ability of the model but also reduces the dimensionality difference between the low-dimensional encoder and the high-dimensional decoder. Using Vgg16 as the backbone network, experiments verify that the IoU, mAP, and Accu indices of this paper’s method in the welding engineering drawing dataset segmentation task are 84.72%, 86.84%, and 99.42%, respectively, which are 22.10, 19.09 and 0.05 percentage points higher compared to the traditional U-net model, and it has a relatively excellent value in engineering applications.
The World Cancer Research Fund and the American Institute for Cancer Research recommend a plant-based diet to cancer survivors, which may reduce chronic inflammation and excess adiposity associated with worse survival. We investigated associations of plant-based dietary patterns with inflammation biomarkers and body composition in the Pathways Study, in which 3659 women with breast cancer provided validated food frequency questionnaires approximately 2 months after diagnosis. We derived three plant-based diet indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI). We assayed circulating inflammation biomarkers related to systemic inflammation (high-sensitivity C-reactive protein [hsCRP]), pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and anti-inflammatory cytokines (IL-4, IL-10, IL-13). We estimated areas (cm2) of muscle and visceral and subcutaneous adipose tissue (VAT and SAT) from computed tomography scans. Using multivariable linear regression, we calculated the differences in inflammation biomarkers and body composition for each index. Per 10-point increase for each index: hsCRP was significantly lower by 6·9 % (95 % CI 1·6%, 11·8%) for PDI and 9·0 % (95 % CI 4·9%, 12·8%) for hPDI but significantly higher by 5·4 % (95 % CI 0·5%, 10·5%) for uPDI, and VAT was significantly lower by 7·8 cm2 (95 % CI 2·0 cm2, 13·6 cm2) for PDI and 8·6 cm2 (95 % CI 4·1 cm2, 13·2 cm2) for hPDI but significantly higher by 6·2 cm2 (95 % CI 1·3 cm2, 11·1 cm2) for uPDI. No significant associations were observed for other inflammation biomarkers, muscle, or SAT. A plant-based diet, especially a healthful plant-based diet, may be associated with reduced inflammation and visceral adiposity among breast cancer survivors.
Objectives/Goals: Knowledge about predictive factors for immune-related endocrinopathies can help identify appropriate populations for specific screening approaches, provide recommendations for ICI therapy selection, guide clinical monitoring strategies to improve patient outcomes, and guide research efforts to provide equitable healthcare for all patients. Methods/Study Population: This is an analysis of the demographic and clinical data available of patients from DiRECT Cohort, a longitudinal study that prospectively follows adult cancer patients who self-identify as Black or White and undergo anti-PD-(L)1 ICI therapy. Endocrinopathies were graded using the CTCAE criteria. Kaplan–Meier method was used to calculate the incidence within the first year of treatment. Bivariate analysis (Chi-square and log-rank test) examined the associations between patient demographics, clinical characteristics, and endocrinopathies. Results/Anticipated Results: Among 955 patients, 13.20% developed endocrinopathies of any grade, most commonly hyper-/hypothyroidism and adrenal insufficiency, and 5.97% were at grade ≥2. Younger age (7.59% in age 30 vs. 4.72% in BMI ≤30, p = 0.022) showed significant associations. No significant difference was found in the incidence of grade ≥2 endocrinopathies by race (13.3 % in White and 10.79% in Black patients, p = 0.732). No association was found with cancer stage or comorbidities. Discussion/Significance of Impact: ICIs can lead to (irAEs). Endocrinopathies are a common type of irAEs, presenting a unique challenge. However, the current literature lacks real-time data and a comprehensive comparative analysis of variables like race. Identifying and understanding these variables ensures equatable access to safe and effective healthcare for all patients.
This study aimed to develop a predictive tool for identifying individuals with high antibody titers crucial for recruiting COVID-19 convalescent plasma (CCP) donors and to assess the quality and storage changes of CCP. A convenience sample of 110 plasma donors was recruited, of which 75 met the study criteria. Using univariate logistic regression and random forest, 6 significant factors were identified, leading to the development of a nomogram. Receiver operating characteristic curves, calibration plots, and decision curve analysis (DCA) evaluated the nomogram’s discrimination, calibration, and clinical utility. The nomogram indicated that females aged 18 to 26, blood type O, receiving 1 to 2 COVID-19 vaccine doses, experiencing 2 symptoms during infection, and donating plasma 41 to 150 days after symptom onset had higher likelihoods of high antibody titres. Nomogram’s AUC was 0.853 with good calibration. DCA showed clinical benefit within 9% ~ 90% thresholds. CCP quality was qualified, with stable antibody titres over 6 months (P > 0.05). These findings highlight developing predictive tools to identify suitable CCP donors and emphasize the stability of CCP quality over time, suggesting its potential for long-term storage.
Dietary restriction-influenced biological performance is found in many animal species. Pardosa pseudoannulata is a dominant spider species in agricultural fields and is important for controlling pests. In this study, three groups – a control group (CK group), a re-feeding group (RF group), and a dietary restriction group (RT group) – were used to explore development, mating, reproduction, and the expression levels of Vg (vitellogenin) and VgR (vitellogenin receptor) genes in the spider. The findings indicated that when subjected to dietary restriction, the carapace size, weight of the spiderlings, and weight of the adults exhibited a decrease. Furthermore, the preoviposition period and egg stage were observed to be prolonged, while the number of spiderlings decreased. It was also observed that re-feeding reduced cannibalism rates and extended the preoviposition period. Dietary restriction also affected the expression of the Vg-3 gene in the spider. These results will contribute to the understanding of the impact of dietary restriction in predators of pest control, as well as provide a theoretical foundation for the artificial rearing and utilisation of the dominant spider in the field.
This study aimed to evaluate the methodological quality of existing meta-analyses (MA) and the quality of evidence for outcome indicators to provide an updated overview of the evidence concerning the therapeutic efficacy of the Mediterranean diet (MD) for various types of CVD.
Design:
We conducted comprehensive searches of PubMed, Cochrane Library, and Embase databases. The quality of the MA was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence evaluation system was employed to evaluate the quality of evidence for significant outcomes.
Setting:
The CVD remains a significant contributor to global mortality. Multiple MA have consistently demonstrated the efficacy of medical interventions in managing CVD. However, due to variations in the scope, quality and outcomes of these reviews, definitive conclusions are yet to be established.
Participants:
This study included five randomized trials and twelve non-randomized studies, with a combined participant population of 716 318.
Results:
The AMSTAR 2 checklist revealed that 54·55 % of the studies demonstrated high quality, while 9·09 % exhibited low quality, and 36·36 % were deemed critically low quality. Additionally, there was moderate evidence supporting a positive correlation between MD and CHD/acute myocardial infarction, stroke, heart failure, cardiovascular events, coronary events and major adverse cardiovascular events.
Conclusions:
This study indicates that although recognizing the potential efficacy of MD in managing CVD, the quality of the methodology and the evidence for the outcome indicators remain unsatisfactory.
In this paper, we study the Hausdorff dimension of sets defined by almost convergent binary expansion sequences. More precisely, the Hausdorff dimension of the following set
\begin{align*} \bigg\{x\in[0,1)\;:\;\frac{1}{n}\sum_{k=a}^{a+n-1}x_{k}\longrightarrow\alpha\textrm{ uniformly in }a\in\mathbb{N}\textrm{ as }n\rightarrow\infty\bigg\} \end{align*}
is determined for any $ \alpha\in[0,1] $. This completes a question considered by Usachev [Glasg. Math. J.64 (2022), 691–697] where only the dimension for rational $ \alpha $ is given.
In this work, an all-fiberized and narrow-linewidth fiber amplifier with record output power and near-diffraction-limited beam quality is presented. Up to 6.12 kW fiber laser with the conversion efficiency of approximately 78.8% is achieved through the fiber amplifier based on a conventional step-index active fiber. At the maximum output power, the 3 dB spectral linewidth is approximately 0.86 nm and the beam quality factor is Mx2 = 1.43, My2 = 1.36. We have also measured and compared the output properties of the fiber amplifier employing different pumping schemes. Notably, the practical power limit of the fiber amplifier could be estimated through the maximum output powers of the fiber amplifier employing unidirectional pumping schemes. Overall, this work could provide a good reference for the optimal design and potential exploration of high-power narrow-linewidth fiber laser systems.
High dietary fibre intake has been associated with a lower risk of diabetes, but the association of dietary fibre with prediabetes is only speculative, especially in China, where the supportive data from prospective studies are lacking. This study aimed to examine the association between dietary fibre intake and risk of incident prediabetes among Chinese adults. We performed a prospective analysis in 18 085 participants of the Tianjin Chronic Low-grade Systemic Inflammation and Health cohort study who were free of diabetes, prediabetes, cancer and CVD at baseline. Dietary data were collected using a validated 100-item FFQ. Prediabetes was defined based on the American Diabetes Association diagnostic criteria. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % CI. During 63 175 person-years of follow-up, 4139 cases of incident prediabetes occurred. The multivariable HR of prediabetes for the highest v. lowest quartiles were 0·85 (95 % CI 0·75, 0·98) (P for trend = 0·02) for total dietary fibre, 0·84 (95 % CI 0·74, 0·95) (P for trend < 0·01) for soluble fibre and 1·05 (95 % CI 0·93, 1·19) (P for trend = 0·38) for insoluble fibre. Fibre from fruits but not from cereals, beans and vegetables was inversely associated with prediabetes. Our results indicate that intakes of total dietary fibre, soluble fibre and fibre derived from fruit sources were associated with a lower risk of prediabetes.
The aims of the study were to investigate the burden for health care workers (HCWs) who suffer from occupational-related adverse events (ORAEs) while working in contaminated areas in a specialized hospital for novel coronavirus pneumonia, to explore related risk factors, to evaluate the effectiveness of bundled interventions, as well as to provide scientific evidence regarding the reduction of risks concerning ORAEs and occupational exposure events.
Methods:
The study was completed using a special team of 138 HCWs assembled for a specialized hospital for novel coronavirus pneumonia in Wuhan, dated from February 16 to March 26, 2020. The incidence of occupational exposure was determined by data reported from the hospital, while the prevalence of ORAEs was derived from questionnaire results. The relation coefficients of ORAEs and the variable potential risk factors are analyzed by logistic regression. After the risk factors were identified, targeted organized intervention was implemented and chi-square tests were performed to compare the incidence of occupational exposure and the prevalence of ORAEs in contaminated areas before and after the interventions.
Results:
Ninety one out of 138 (65.94%) had reported ORAEs with 300 (27.96%) cases of ORAEs being recorded in a total of 1073 entries into contaminated areas. The prevalence of different ORAEs include 205 tenderness (24.73%), 182 headache/dizziness (21.95%), 138 dyspnea (16.65%), 130 blurred vision (15.68%), and 95 nausea/vomiting (11.46%). Personal protective equipment (PPE) is significantly associated with ORAEs in contaminated areas (P < 0.05). Among non-PPE-related factors, insomnia is associated with the majority of ORAEs in contaminated areas. Significant differences were achieved after organized interventions in the incidence of occupational exposure of HCWs (χ2 = 39.07, P < 0.001) and the prevalence of ORAEs in contaminated areas (χ2 = 22.95, P < 0.001).
Conclusion:
During the epidemic period of novel severe respiratory infectious disease, the burden of the ORAEs in contaminated areas and the risk of occupational exposure of HCWs were relatively high. In time, comprehensive and multi-level bundled interventions may help decrease the risk of both ORAEs and occupational exposure.
The objectives of this study were (1) to develop and validate a simulation model to estimate daily probabilities of healthcare-associated infections (HAIs), length of stay (LOS), and mortality using time varying patient- and unit-level factors including staffing adequacy and (2) to examine whether HAI incidence varies with staffing adequacy.
Setting:
The study was conducted at 2 tertiary- and quaternary-care hospitals, a pediatric acute care hospital, and a community hospital within a single New York City healthcare network.
Patients:
All patients discharged from 2012 through 2016 (N = 562,435).
Methods:
We developed a non-Markovian simulation to estimate daily conditional probabilities of bloodstream, urinary tract, surgical site, and Clostridioides difficile infection, pneumonia, length of stay, and mortality. Staffing adequacy was modeled based on total nurse staffing (care supply) and the Nursing Intensity of Care Index (care demand). We compared model performance with logistic regression, and we generated case studies to illustrate daily changes in infection risk. We also described infection incidence by unit-level staffing and patient care demand on the day of infection.
Results:
Most model estimates fell within 95% confidence intervals of actual outcomes. The predictive power of the simulation model exceeded that of logistic regression (area under the curve [AUC], 0.852 and 0.816, respectively). HAI incidence was greatest when staffing was lowest and nursing care intensity was highest.
Conclusions:
This model has potential clinical utility for identifying modifiable conditions in real time, such as low staffing coupled with high care demand.
ABSTRACT IMPACT: Reversing tumor microenvironment (TME) immunosuppression will help to increase the overall efficacy of treatment of chemo-resistant triple negative breast cancer (TNBC) and mitigate racial disparities in treatment response. OBJECTIVES/GOALS: We have developed an ex-vivo whole tissue culture model to test the feasibility of reversing local immunosuppression in TME by chemokine modulatory (CKM) regimen. Our current objective is to analyze the molecular changes in CKM-treated chemoresistant TNBC from White and Black women and identify factors determining response to CKM. METHODS/STUDY POPULATION: Freshly resected residual TNBC from 20 White and 20 Black women ≥18 yrs old treated with neoadjuvant chemotherapy (NAC) will be procured. Tumor explants will be prepared & cultured in the absence and presence of CKM (Interferon-ð 〉1/4, TLR3 agonist rintatolimod and COX-2 inhibitor celecoxib). Chemokines implicated in cytotoxic T-lymphocyte (CTL)- & MDSC/ Treg attraction will be analyzed using Taqman & ELISA. We will have 80% power to detect a 0.7 standard deviation difference in chemokines between untreated & treated samples within and between cohorts using ANCOVA. Bulk RNA sequencing will be performed on both untreated & treated samples from CKM responding (highest aggregate increase in CTL- and highest decrease in Treg/MDSC-favoring chemokines in the top quartile) and non-responding (bottom quartile) tissues. RESULTS/ANTICIPATED RESULTS: Our preliminary data show that Black patients (pts) with breast cancer (BC) have an immunosuppressive TME associated with poor outcomes. This is similar to other existing literature showing that Black pts with BC have less favorable and more unfavorable chemokines in the TME. We anticipate the chemokine changes with CKM treatment will be larger in the Black cohort given their ability to elicit a robust inflammatory response. Therefore, we expect that CKM treatment will result in favorable TME in both groups and improve outcomes in TNBC, which has the worst prognosis of all subtypes, eliminating a key area of disparity in BC. The proposed transcriptome analysis will help identify key gene networks involved in response to CKM treatment and guide modulating the targets for non-responsiveness to improve efficacy of CKM. DISCUSSION/SIGNIFICANCE OF FINDINGS: Pts with residual disease (RD) after NAC have a 3-yr overall survival 68% vs. 94% for pts with complete response. Blacks have a higher incidence of TNBC with more likelihood of RD & mortality. We anticipate that the existing TME differences can be abrogated by our current CKM regimen or via developing an alternative CKM regimen optimized for Black pts.
The outbreak of COVID-19 generated severe emotional reactions, and restricted mobility was a crucial measure to reduce the spread of the virus. This study describes the changes in public emotional reactions and mobility patterns in the Chinese population during the COVID-19 outbreak.
Methods
We collected data on public emotional reactions in response to the outbreak through Weibo, the Chinese Twitter, between 1st January and 31st March 2020. Using anonymized location-tracking information, we analyzed the daily mobility patterns of approximately 90% of Sichuan residents.
Results
There were three distinct phases of the emotional and behavioral reactions to the COVID-19 outbreak. The alarm phase (19th–26th January) was a restriction-free period, characterized by few new daily cases, but a large amount public negative emotions [the number of negative comments per Weibo post increased by 246.9 per day, 95% confidence interval (CI) 122.5–371.3], and a substantial increase in self-limiting mobility (from 45.6% to 54.5%, changing by 1.5% per day, 95% CI 0.7%–2.3%). The epidemic phase (27th January–15th February) exhibited rapidly increasing numbers of new daily cases, decreasing expression of negative emotions (a decrease of 27.3 negative comments per post per day, 95% CI −40.4 to −14.2), and a stabilized level of self-limiting mobility. The relief phase (16th February–31st March) had a steady decline in new daily cases and decreasing levels of negative emotion and self-limiting mobility.
Conclusions
During the COVID-19 outbreak in China, the public's emotional reaction was strongest before the actual peak of the outbreak and declined thereafter. The change in human mobility patterns occurred before the implementation of restriction orders, suggesting a possible link between emotion and behavior.