IMPORTANCE There are conflicting data on the association between blood donor characteristics and outcomes among patients receiving transfusions.OBJECTIVE To evaluate the association of blood donor sex and age with mortality or serious morbidity in very low-birth-weight (VLBW) infants receiving blood transfusions. DESIGN, SETTING, AND PARTICIPANTSThis is a cohort study using data collected from 3 hospitals in Atlanta, Georgia. VLBW infants (Յ1500 g) who received red blood cell (RBC) transfusion from exclusively male or female donors were enrolled from January 2010 to February 2014. Infants received follow-up until 90 days, hospital discharge, transfer to a non-study-affiliated hospital, or death. Data analysis was performed from July 2019 to December 2020.EXPOSURES Donor sex and mean donor age. MAIN OUTCOMES AND MEASURESThe primary outcome was a composite outcome of death, necrotizing enterocolitis (Bell stage II or higher), retinopathy of prematurity (stage III or higher), or moderate-to-severe bronchopulmonary dysplasia. Modified Poisson regression, with consideration of covariate interactions, was used to estimate the association between donor sex and age with the primary outcome, with adjustment for the total number of transfusions and birth weight. RESULTSIn total, 181 infants were evaluated, with a mean (SD) birth weight of 919 (253) g and mean (SD) gestational age of 27.0 (2.2) weeks; 56 infants (31%) received RBC transfusion from exclusively female donors. The mean (SD) donor age was 46.6 (13.7) years. The primary outcome incidence was 21% (12 of 56 infants) among infants receiving RBCs from exclusively female donors, compared with 45% (56 of 125 infants) among those receiving RBCs from exclusively male donors. Significant interactions were detected between female donor and donor age (P for interaction = .005) and between female donor and number of transfusions (P for interaction < .001). For the typical infant, who received a median (interquartile range) of 2 (1-3) transfusions, RBC transfusion from exclusively female donors, compared with male donors, was associated with a lower risk of the primary outcome (relative risk, 0.29; 95% CI, 0.16-0.54). The protective association between RBC transfusions from female donors, compared with male donors, and the primary outcome increased as the donor age increased, but decreased as the number of transfusions increased. CONCLUSIONS AND RELEVANCEThese findings suggest that RBC transfusion from female donors, particularly older female donors, is associated with a lower risk of death or serious morbidity in VLBW infants receiving transfusion. Larger studies confirming these findings and examining potential mechanisms are warranted.

Identifying optimal designs for generalized linear models with a binary response can be a challenging task, especially when there are both discrete and continuous independent factors in the model. Theoretical results rarely exist for such models, and for the handful that do, they usually come with restrictive assumptions. In this article, we propose the d-QPSO algorithm, a modified version of quantum-behaved particle swarm optimization, to find a variety of D-optimal approximate and exact designs for experiments with discrete and continuous factors and a binary response. We show that the d-QPSO algorithm can efficiently find locally D-optimal designs even for experiments with a large number of factors and robust pseudo-Bayesian designs when nominal values for the model parameters are not available. Additionally, we investigate robustness properties of the d-QPSO algorithm-generated designs to various model assumptions and provide real applications to design a bio-plastics odor removal experiment, an electronic static experiment, and a 10-factor car refueling experiment. Supplementary materials for the article are available online.

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Background Patients with cystic fibrosis (CF) have increased risk of vitamin D deficiency owing to fat malabsorption and other factors. Vitamin D deficiency has been associated with increased risk of pulmonary exacerbations of CF. Objectives The primary objective of this study was to examine the impact of a single high-dose bolus of vitamin D3 followed by maintenance treatment given to adults with CF during an acute pulmonary exacerbation on future recurrence of pulmonary exacerbations. Methods This was a multicenter, double-blind, placebo-controlled, intent-to-treat clinical trial. Subjects with CF were randomly assigned to oral vitamin D3 given as a single dose of 250,000 International Units (IU) or to placebo within 72 h of hospital admission for an acute pulmonary exacerbation, followed by 50,000 IU of vitamin D3 or an identically matched placebo pill taken orally every other week starting at 3 mo after random assignment. The primary outcome was the composite endpoint of the time to next pulmonary exacerbation or death within 1 y. The secondary outcomes included circulating concentrations of the antimicrobial peptide cathelicidin and recovery of lung function as assessed by the percentage of predicted forced expiratory volume in 1 s (FEV1%). Results A total of 91 subjects were enrolled in the study. There were no differences between the vitamin D3 and placebo groups in time to next pulmonary exacerbation or death at 1 y. In addition, there were no differences in serial recovery of lung function after pulmonary exacerbation by FEV1% or in serial concentrations of plasma cathelicidin. Conclusions Vitamin D3 initially given at the time of pulmonary exacerbation of CF did not alter the time to the next pulmonary exacerbation, 12-mo mortality, serial lung function, or serial plasma cathelicidin concentrations. This trial was registered at clinicaltrials.gov as NCT01426256.

Investigating the similarity and changes in brain networks under different mental conditions has become increasingly important in neuroscience research. A standard separate estimation strategy fails to pool information across networks and hence has reduced estimation accuracy and power to detect betweennetwork differences. Motivated by an fMRI Stroop task experiment that involves multiple related tasks, we develop an integrative Bayesian approach for jointly modeling multiple brain networks that provides a systematic inferential framework for network comparisons. The proposed approach explicitly models shared and differential patterns via flexible Dirichlet process-based priors on edge probabilities. Conditional on edges, the connection strengths are modeled via Bayesian spike-and-slab prior on the precision matrix off-diagonals. Numerical simulations illustrate that the proposed approach has increased power to detect true differential edges while providing adequate control on false positives and achieves greater network estimation accuracy compared to existing methods. The Stroop task data analysis reveals greater connectivity differences between task and fixation that are concentrated in brain regions previously identified as differentially activated in Stroop task, and more nuanced connectivity differences between exertion and relaxed task. In contrast, penalized modeling approaches involving computationally burdensome permutation tests reveal negligible network differences between conditions that seem biologically implausible. Supplementary materials for this article, including a standardized description of the materials available for reproducing the work, are available as an online supplement.