Exposomics-Based Analysis of Environmental Factors Associated with Forced Expiratory Volume in 1 Second at 6 Months Post Lung Transplantation
Bibliographic record
Abstract
Abstract Rationale Chronic lung allograft dysfunction is the biggest impediment to long-term survival after lung transplantation. Studies have shown an increased risk for chronic lung allograft dysfunction in patients exposed to traffic-related air pollution, using residential distance to roadways and outdoor pollution. Objectives Personal monitoring and the indoor environment post–lung transplantation have not been investigated. The exposome is a novel conceptual framework that allows for concurrent examination of multiple intrinsic and extrinsic factors, including environmental exposures, as well as changes in exposures over time, to elucidate the complex environmental factors that affect health outcomes. Methods We prospectively enrolled newly transplanted double-lung recipients for comprehensive indoor and personal environmental monitoring at 6 and 12 weeks after lung transplantation. In addition, home surveys were completed. To date, 43 patients have been enrolled; 37 patients have been followed for 6 months post–lung transplantation, a time point at which previous studies showed that most patients will have achieved maximal graft function (forced expiratory volume in 1 second). Results We conducted preliminary analysis using the exposome globe technique with Benjamini-Hochberg multiple testing correction. It revealed that chromium metal in the air was associated with home age, whereas vanadium was associated with residential proximity to a major road. Metals in the indoor air were also associated with one another and with ultrafine particles. Indoor black carbon was associated with attached garage, and personal monitoring black carbon was highly correlated to black carbon in the home. In a multivariate linear model optimized with Akaike information criterion, distance to major road and indoor particulate matter with aerodynamic diameter less than or equal to 2.5 μm were significantly associated with forced expiratory volume in 1 second at 6 months. In a subset of patients for whom indoor metal analysis was available, metal content of indoor particulate matter with aerodynamic diameter less than or equal to 2.5 μm was associated with lower forced expiratory volume in 1 second. Conclusions As people spend most of their time indoors, the home environment plays a role in post–lung transplantation outcomes. Future analysis with more patients and longer follow-up will allow us to identify potential environmental factors that contribute to chronic lung allograft dysfunction and to identify potential interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".