Saint Vincent College is a private Benedictine college in Latrobe, Pennsylvania. Founded in 1846 by Boniface Wimmer, a monk from Bavaria, it is operated by the Benedictine monks of Saint Vincent Archabbey, the first Benedictine monastery in the United States, which was also founded by Wimmer.
Survival analysis models have evolved significantly with deep learning approaches, yet often lack interpretability and meaningful risk stratification capabilities. We present Interpretable Risk Clustering Intelligence for Survival Analysis (IRIS), a novel framework that addresses the critical task of risk clustering while enhancing both input-level and model-body interpretability. Unlike traditional survival models that perform post-hoc risk clustering, IRIS learns to cluster patients into meaningful risk groups directly from data while providing transparent feature importance estimation through feature contribution functions. We validate IRIS on several benchmark datasets, a real-world Alzheimer's disease dataset, and an electronic health record dataset, showing superior performance in risk clustering and predictive reliability with only a modest decrease in time-toevent prediction accuracy compared to state-of-the-art methods. Our results show that IRIS successfully balances the trade-off between interpretability and prediction performance in riskbased survival analysis, offering clinicians actionable insights for treatment planning and resource allocation.
Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal morbidity and mortality in the U.S. Bacterial sexually transmitted infections (STIs), such as Chlamydia trachomatis and Neisseria gonorrhoeae, may contribute to HDP through infection-induced inflammation affecting placental development. Evidence for this association remains limited, particularly in urban U.S. populations with routine STI screening. We performed a retrospective cohort study using electronic medical records from two Penn Medicine hospitals in Philadelphia. We identified singleton deliveries from 2010–2022 with chlamydia/gonorrhea testing before 20 weeks gestation. The primary exposure was a positive initial test for chlamydia and/or gonorrhea. The primary outcome was HDP, defined as a composite of gestational hypertension, preeclampsia, eclampsia, or superimposed preeclampsia, based on ICD-9/10 codes. Multivariable logistic regression with generalized estimating equations adjusted for sociodemographic and clinical covariates. Among 25,387 pregnancies, 2.7% had a positive initial STI test. HDP occurred in 31.6% of the cohort. A positive initial STI test was associated with increased odds of HDP (adjusted odds ratio [aOR]: 1.23; 95% CI: 1.04–1.46). The association was driven largely by gestational hypertension (aOR: 1.21; 95% CI: 1.01–1.44). Chlamydia alone was significantly associated with HDP (aOR: 1.23; 95% CI: 1.03–1.47). Gonorrhea showed a similar but non-significant trend (aOR: 1.29; 95% CI: 0.84–1.99). No associations were observed for preterm birth or severe maternal morbidity. Findings were consistent in sensitivity analyses. Early pregnancy diagnosis of chlamydia and possibly gonorrhea is associated with increased risk of HDP. These findings support further research into the role of maternal infection in HDP pathogenesis and may inform STI screening policies in pregnancy. All Authors: No reported disclosures
The heuristic method posited by Bernard Lonergan, S. J., can convey knowing and doing as a continual dynamic process that, when placed in dialogue with Kimberlé W. Crenshaw’s notion of intersectionality, centers the relational character of self- knowing, appropriation, and self- identity in the context of communal conversion. Lonergan’s method, centering on the “good of order,” reveals the continual construction of subjects and the structures impacting— and being shaped by— those subjects. Wonder, noticing, insight, and conversion are all processes with communal implications. The lens of intersectional analysis can aid us in both understanding identity development and formulating action plans for the transformation of movements and structures, including religious, social, economic, and political systems.
