Infant Botulism and Carbohydrate Blood Group Antigens: Preliminary Results from a Discordant Twin Study
Bibliographic record
Abstract
Objective We investigated if specific carbohydrate blood group antigens were associated with infant botulism (IB) among discordant twins and triplets. Methods Infants in the United States and Canada from 2015 to 2022 who had laboratory-confirmed IB; were members of a multiple gestation birth; and had unaffected sibling(s) were eligible to participate. Blood specimens were tested for ABO, Lewis, H, and P1 carbohydrate blood antigens. FUT2 and FUT3 genes were sequenced to determine secretor and Lewis antigen status, respectively. In addition, characteristics of IB cases in the study were compared to singleton US-Canadian IB cases from 2015-2022. Results Parents of 14 of 26 IB cases who were twins/triplets with unaffected siblings consented to participate. No statistically significant associations between blood group antigens (ABO, Lewis, H, and P1) and IB were demonstrated. Twin cases in this study were significantly younger at onset of illness (median age 8.6 vs 17.3 weeks for singleton US-Canadian IB cases, t -test P <0.001); and less likely to be fed exclusively breastmilk (14% for twin vs. 63% for US-Canadian IB cases) and more likely to be mixed-fed breastmilk and formula (86% for twin vs. 23% for US-Canadian IB cases, Fisher’s exact test P <0.001). Conclusions In this first-of-its-kind small study of IB twin/triplet cases and their unaffected siblings, no carbohydrate blood group antigens were associated with IB. Future studies could compare the microbial composition of the gut microbiome of IB cases and uninfected twin siblings, or the prevalence of ABO blood groups in IB cases vs population norms.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".