bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of generative language models to orthopaedic practice
Authors: Caterson Jessica , Ambler Olivia , Cereceda-Monteoliva Nicholas , Horner Matthew , Jones Andrew , Poacher Arwel Tomos 
Published: March 2024

ObjectiveTo explore whether large language models (LLMs) Generated Pre-trained Transformer (GPT)-3 and ChatGPT can write clinical letters and predict management plans for common orthopaedic scenarios.DesignFifteen scenarios were generated and ChatGPT and GPT-3 prompted to write clinical letters and separately generate management plans for identical scenarios with plans removed.Main outcome measuresLetters were assessed for readability using the Readable Tool. Accuracy of letters and management plans were assessed by three independent orthopaedic surgery clinicians.ResultsBoth models generated complete letters for all scenarios after single prompting. Readability was compared using Flesch-Kincade Grade Level (ChatGPT: 8.77 (SD 0.918); GPT-3: 8.47 (SD 0.982)), Flesch Readability Ease (ChatGPT: 58.2 (SD 4.00); GPT-3: 59.3 (SD 6.98)), Simple Measure of Gobbledygook (SMOG) Index (ChatGPT: 11.6 (SD 0.755); GPT-3: 11.4 (SD 1.01)), and reach (ChatGPT: 81.2%; GPT-3: 80.3%). ChatGPT produced more accurate letters (8.7/10 (SD 0.60) vs 7.3/10 (SD 1.41), p=0.024) and management plans (7.9/10 (SD 0.63) vs 6.8/10 (SD 1.06), p<0.001) than GPT-3. However, both LLMs sometimes omitted key information or added additional guidance which was at worst inaccurate.ConclusionsThis study shows that LLMs are effective for generation of clinical letters. With little prompting, they are readable and mostly accurate. However, they are not consistent, and include inappropriate omissions or insertions. Furthermore, management plans produced by LLMs are generic but often accurate. In the future, a healthcare specific language model trained on accurate and secure data could provide an excellent tool for increasing the efficiency of clinicians through summarisation of large volumes of data into a single clinical letter.
Tax revenue lost due to illicit cigarettes in South Africa: 2002−2022
Authors: Vellios Nicole , van Walbeek Corné 
Published: March 2024

ObjectiveTo estimate lost excise and value-added tax (VAT) revenue as a result of illicit cigarette trade from 2002 to 2022.DesignUsing gap analysis, we estimated the number of illicit cigarettes by calculating the difference between the number of self-reported cigarettes (derived from nationally representative surveys) and the number of legal (tax-paid) cigarettes (derived from government sources) from 2002 to 2022. We then calculated the excise and VAT revenue that the government lost through illicit trade, taking into account that some people would have quit or reduced their consumption if cigarette prices had been higher (ie, tax paid).SettingSouth Africa.Outcome measuresIllicit trade estimates and lost revenue estimates.ResultsThe illicit cigarette market comprised 5% of the market in 2009, peaked at 60% in 2021, and decreased to 58% in 2022. Accounting for the fact that some people would have reduced their consumption if cigarette prices had been higher (had the illicit marke not existed), the government lost R15 billion in excise revenue and R3 billion in VAT revenue in 2022. From 2002 to 2022, the government lost R119 billion (2022 prices) in excise and VAT revenue. The majority of the lost revenue occurred in the period 2010 to 2022, where R110 billion (2022 prices) in excise and VAT revenue was lost. A comprehensive sensitivity analysis indicates that the estimated lost revenue of R119 billion from 2002 to 2022 falls within the range of R65 billion to R130 billion (all 2022 prices).ConclusionsThe South African government has been losing a significant amount of revenue by not receiving excise and VAT from all cigarettes consumed in South Africa. This trend is likely to continue if the government does not secure the supply chain from the point of production to the point of sale.
Prevalence and predictors of depression and anxiety in patients with chronic rhinosinusitis: a systematic review and meta-analysis
Authors: Fan Hongli , Han Zhoutong , Gong Xinru , Wu Yuqi , Fu Yijie , Zhu Tianmin , Li Hui 
Published: March 2024

BackgroundChronic rhinosinusitis (CRS) is a persistent inflammation of the sinuses. As a result of long-term discomfort, patients may experience symptoms of common mental disorders such as anxiety and depression. This may affect the quality of life and disease progression. However, there is still uncertainty about the extent of the problem.ObjectiveThis meta-analysis aimed to determine the prevalence of depression and anxiety symptoms in patients with CRS.Search strategyWe searched PubMed, Embase, Web of Science, Cochrane Library, and CBM databases for relevant studies published before 15 July 2022 in patients with CRS with concomitant depression and anxiety symptoms.Data collection and analysisTwo authors independently performed screening and quality assessment using validated tools. Extraction of data using predefined standardised data collection spreadsheets. Heterogeneity and inconsistency were checked using theI² statistic.ResultsThe meta-analysis included 32 articles involving 56 933 patients. The prevalence of depression and anxiety symptoms was estimated at 24.7% (95% CI, 21.3% to 28. 1%) and 29.7% (95% CI, 19.3% to 40.2%). Subgroup analysis revealed the following: (1) CRS without nasal polyps (CRSsNP): 26.2% (95% CI, 21.9% to 30.5%), CRS with nasal polyps(CRSwNP): 20% (95% CI, 15.9% to 24%); (2) Female patients: 36. 1% (95% CI, 25.3% to 46.9%), male patients: 24.3% (95% CI, 12. 1% to 36.6%); and (3) The average age≤50 years patients: 29.8% (95% CI, 21.3% to 38.2%), the average age>50 years patients: 22. 1% (95% CI, 17.1% to 27%).ConclusionA significant proportion of people with CRS have symptoms of depression and anxiety, and early screening for depression and anxiety in people with CRS is critical. And, more attention needs to be given to females and patients with CRSsNP during screening.PROSPERO registration numberCRD42022345959).
High-flow nasal oxygenation versus face mask oxygenation for preoxygenation in patients undergoing double-lumen endobronchial intubation: protocol of a randomised controlled trial
Authors: He Ren , Fang Yuxiang , Jiang Yonghan , Yao Da , Li Zhi , Zheng Weijun , Liu Zhiheng , Luo Nanbo 
Published: March 2024

IntroductionWith the growing emphasis on swift recovery, minimally invasive thoracic surgery has advanced significantly. Video-assisted thoracoscopic surgery (VATS) has seen rapid development, and the double-lumen tube (DLT) remains the most dependable method for tracheal intubation in VATS. However, hypoxaemia during DLT intubation poses a threat to the perioperative safety of thoracic surgery patients. Recently, transnasal high-flow nasal oxygen (HFNO) has shown promise in anaesthesia, particularly in handling short-duration hypoxic airway emergencies. Yet, its application in the perioperative period for patients undergoing pulmonary surgery with compromised cardiopulmonary function lacks evidence, and there are limited reliable clinical data.Methods and analysisA prospective, randomised, controlled, single-blind design will be employed in this study. 112 patients aged 18–60 years undergoing elective VATS-assisted pulmonary surgery will be enrolled and randomly divided into two groups: the nasal high-flow oxygen group (H group) and the traditional mask transnasal oxygen group (M group) in a 1:1 ratio. HFNO will be used during DLT intubation for the prevention of asphyxia in group H, while conventional intubation procedures will be followed by group M. Comparison will be made between the two groups in terms of minimum oxygen saturation during intubation, hypoxaemia incidence during intubation, perioperative complications and postoperative hospital days.Ethics and disseminationApproval for this study has been granted by the local ethics committee at Shenzhen Second People’s Hospital. The trial results will be disseminated through peer-reviewed journals and scientific conferences.Trial registration numberNCT05666908.
Identifying the top 10 research priorities for the school food system in the UK: a priority setting exercise
Authors: Schliemann Désirée , Spence Suzanne , O’Kane Niamh , Chiang Cheng Choo , Olgacher Dilara , McKinley Michelle C , Woodside Jayne V 
Published: March 2024

IntroductionThe school food system varies widely between schools and across the UK. There is a need to understand evidence gaps in school food research to allow the development, implementation and evaluation of policies and interventions to support children’s healthy eating at school. This study aimed to conduct a priority setting exercise to co-produce research priorities in relation to the UK school food system.MethodsThe James Lind Alliance process informed this priority setting exercise; all key steps engaged a wide range of UK school food stakeholders (including teachers, parents, principals, school governors, policymakers, caterers). An initial online stakeholder survey identified perceived research priorities. In a second survey, stakeholders were asked to rank these priorities. Lastly, an online priority setting workshop with stakeholders elicited the most important research priorities.ResultsIn 2021, school food stakeholders (n=1280) completed the first survey, from which 136 research priorities were identified. In the second survey, participants (n=107) ranked these research priorities regarding their importance. Lastly, 30 workshop participants discussed and reached consensus on the research priorities. After final refinement by the research team, 18 priorities resulted, with the top 10 being related to the provision of free school meals (effectiveness of cost-effectiveness of different levels of eligibility, including universal provision), implementation of policy (including improving uptake) and food standards, issues around procurement, leadership, inequalities, social norms, the eating environment, food culture throughout the school setting and healthy eating.ConclusionThe top 10 research priorities were elicited through a rigorous approach, including a wide range of stakeholders across the UK. These should be considered by policymakers, researchers and others to inform research, evidence-based policy development and, ultimately, improve the UK school food system.
Physician characteristics associated with antiviral prescriptions for older adults with COVID-19 in Japan: an observational study
Authors: Miyawaki Atsushi , Kitajima Kei , Iwata Akihiro , Sato Daichi , Tsugawa Yusuke 
Published: March 2024

ObjectivesAlthough guidelines recommend antiviral therapy for outpatients with COVID-19 who are at high risk of progressing to severe conditions, such as older adults, many patients do not receive appropriate treatment. Little is known, however, about the physician factors associated with the prescription of guideline-recommended antiviral therapy for patients with COVID-19.DesignA cross-sectional study.SettingData including outpatient visits in primary care clinics in Japan from April to August 2023.ParticipantsWe analysed 30 953 outpatients aged ≥65 years treated with COVID-19 (mean (SD) age, 75.0 (7.6) years; 17 652 women (57.0%)) in 1394 primary care clinics.Outcome measuresThe primary outcome was the prescription of guideline-recommended antivirals (ie, nirmatrelvir–ritonavir or molnupiravir), adjusted for patient characteristics, months of visits and regions.ResultsAntiviral prescriptions were concentrated among a small proportion of physicians; for example, the top 10% of physicians that had the largest number of nirmatrelvir–ritonavir prescriptions accounted for 92.4% of all nirmatrelvir–ritonavir prescriptions. After adjusting for potential confounders, physicians with higher patient volumes were more likely to prescribe guideline-recommended antivirals to their patients (adjusted OR (aOR) for high vs low volume, 1.76; 95% CI 1.31 to 2.38; adjusted p<0.001). We found no evidence that the likelihood of guideline-recommended antiviral prescription differed based on physicians’ gender (aOR for women vs men, 1.24; 95% CI 0.88 to 1.74; adjusted p=0.48) or age (aOR for 45–59 vs <45 years, 1.16; 95% CI 0.87 to 1.54; adjusted p=0.48; aOR for ≥60 vs <45 years, 0.88; 95% CI 0.66 to 1.16; adjusted p=0.48). These patterns were similar when examining nirmatrelvir–ritonavir and molnupiravir separately.ConclusionsOur findings suggest that provider-level factors, such as the clinical experience of treating the patients with COVID-19, play an important role in the appropriate prescription of antiviral medications for COVID-19 in the primary care setting.
New robotic platform for transoral robotic surgery: an IDEAL stage 0 study
Authors: Arora Asit , Faulkner Jack , Paleri Vinidh , Kapoor Karan , Al-Lami Ali , Olaleye Oladejo , Winter Stuart , Oikonomou Geogios , Ofo Enyi , Ourselin Sebastien , Dasgupta Prokar , Slack Mark , Jeannon Jean-Pierre 
Published: March 2024

ObjectivesThis study aims to assess the feasibility to perform transoral robotic surgery (TORS) with a new robotic platform, the Versius Surgical System (CMR Surgical, UK) in a preclinical cadaveric setting in accordance to stage 0 of the IDEAL-D framework.DesignIDEAL stage 0 preclinical assessment of the Versius Robotic System in TORS in human cadavers.SettingAll procedures were performed in a simulated operating theatre environment at a UK surgical training centre.Participants11 consultant head and neck surgeons from the UK, mainland Europe and the USA took part in TORS procedures on six human cadavers.Interventions3 key index procedures were assessed that represent the core surgical workload of TORS: lateral oropharyngectomy, tongue base resection and partial supraglottic laryngectomy.Main outcome measuresThe primary outcome was the successful completion of each surgical procedure. Secondary outcomes included the optimisation of system setup, instrumentation and surgeon-reported outcomes for feasibility of each component procedural step.Results33 cadaveric procedures were performed and 32 were successfully completed. One supraglottic laryngectomy was not fully completed due to issues dividing the epiglottic cartilage with available instrumentation. Surgeon-reported outcomes met the minimal level of feasibility in all procedures and a consensus that it is feasible to perform TORS with Versius was reached. Available instrumentation was not representative of other robotic platforms used in TORS and further instrument optimisation is recommended before wider dissemination.ConclusionsIt is feasible to perform TORS with the Versius Surgical System (CMR Surgical) within a pre-clinical cadaveric setting. Clinical evaluation is needed and appropriate with the system. Further instrument development and optimisation is desirable.
Fast adiabatic transport of single laser-cooled 9Be+ ions in a cryogenic Penning trap stack
Authors: Meiners Teresa , Coenders Julia A. , Brombacher Johannes , Niemann Malte , Cornejo Juan M. , Ulmer Stefan , Ospelkaus Christian 
Published: March 2024

AbstractHigh precision mass and g-factor measurements in Penning traps have enabled groundbreaking tests of fundamental physics. The most advanced setups use multi-trap methods, which employ transport of particles between specialized trap zones. Present developments focused on the implementation of sympathetic laser cooling will enable significantly shorter duty cycles and better accuracies in many of these scenarios. To take full advantage of these increased capabilities, we implement fast adiabatic transport concepts developed in the context of trapped-ion quantum information processing in a cryogenic Penning trap system. We show adiabatic transport of a single $$^9\textrm{Be}^+$$

9

Be
+

ion initially cooled to 2 mK over a 2.2-cm distance within 15 ms and with less than 10 mK energy gain at a peak velocity of 3 m/s. These results represent an important step towards the implementation of quantum logic spectroscopy in the (anti-)proton system. Applying these developments to other multi-trap systems has the potential to considerably increase the data-sampling rate in these experiments.
Designing an IEEE-Compliant FPU that Supports Configurable Precision for Soft Processors
Authors: Keilbart Chris , Gao Yuhui , Chua Martin , Matthews Eric , Wilton Steven J.E. , Shannon Lesley 
Published: March 2024

Field Programmable Gate Arrays (FPGAs) are commonly used to accelerate floating-point (FP) applications. Although researchers have extensively studied FPGA FP implementations, existing work has largely focused on standalone operators and frequency-optimized designs. These works are not suitable for FPGA soft processors which are more sensitive to latency, impose a lower frequency ceiling, and require IEEE FP standard compliance. We present an open-source floating-point unit (FPU) for FPGA RISC-V soft processors that is fully IEEE compliant with configurable levels of FP precision. Our design emphasizes runtime performance with 25% lower latency in the most common instructions compared to previous works while maintaining efficient resource utilization.
Our FPU also allows users to explore various mantissa widths without having to rewrite or recompile their algorithms. We use this to investigate the scalability of our reduced-precision FPU across numerous microbenchmark functions as well as more complex case studies. Our experiments show that applications like the discrete cosine transformation and the Black-Scholes model can realize a speedup of more than 1.35x in conjunction with a 43% and 35% reduction in lookup table and flip-flop resources while experiencing less than a 0.025% average loss in numerical accuracy with a 16-bit mantissa width.
The Exonuclease TREX1 Constitutes an Innate Immune Checkpoint Limiting cGAS/STING-Mediated Antitumor Immunity
Authors: Lim Junghyun , Rodriguez Ryan , Williams Katherine , Silva John , Gutierrez Alan G. , Tyler Paul , Baharom Faezzah , Sun Tao , Lin Eva , Martin Scott , Kayser Brandon D. , Johnston Robert J. , Mellman Ira , Delamarre Lélia , West Nathaniel R. , Müller Sören , Qu Yan , Heger Klaus 
Published: March 2024

Abstract
The DNA exonuclease three-prime repair exonuclease 1 (TREX1) is critical for preventing autoimmunity in mice and humans by degrading endogenous cytosolic DNA, which otherwise triggers activation of the innate cGAS/STING pathway leading to the production of type I IFNs. As tumor cells are prone to aberrant cytosolic DNA accumulation, we hypothesized that they are critically dependent on TREX1 activity to limit their immunogenicity. Here, we show that in tumor cells, TREX1 restricts spontaneous activation of the cGAS/STING pathway, and the subsequent induction of a type I IFN response. As a result, TREX1 deficiency compromised in vivo tumor growth in mice. This delay in tumor growth depended on a functional immune system, systemic type I IFN signaling, and tumor-intrinsic cGAS expression. Mechanistically, we show that tumor TREX1 loss drove activation of CD8+ T cells and NK cells, prevented CD8+ T-cell exhaustion, and remodeled an immunosuppressive myeloid compartment. Consequently, TREX1 deficiency combined with T-cell–directed immune checkpoint blockade. Collectively, we conclude that TREX1 is essential to limit tumor immunogenicity, and that targeting this innate immune checkpoint remodels the tumor microenvironment and enhances antitumor immunity by itself and in combination with T-cell–targeted therapies.
See related article by Toufektchan et al., p. 673
No-Reflow Prediction in Acute Coronary Syndrome During Percutaneous Coronary Intervention: The NORPACS Risk Score
Authors: Dawson Luke P. , Rashid Muhammad , Dinh Diem T. , Brennan Angela , Bloom Jason E. , Biswas Sinjini , Lefkovits Jeffrey , Shaw James A. , Chan William , Clark David J. , Oqueli Ernesto , Hiew Chin , Freeman Melanie , Taylor Andrew J. , Reid Christopher M. , Ajani Andrew E. , Kaye David M. , Mamas Mamas A. , Stub Dion ,   on behalf of the MIG and BCIS Investigators
Published: March 2024

BACKGROUND:
Suboptimal coronary reperfusion (no reflow) is common in acute coronary syndrome percutaneous coronary intervention (PCI) and is associated with poor outcomes. We aimed to develop and externally validate a clinical risk score for angiographic no reflow for use following angiography and before PCI.

METHODS:
We developed and externally validated a logistic regression model for prediction of no reflow among adult patients undergoing PCI for acute coronary syndrome using data from the Melbourne Interventional Group PCI registry (2005–2020; development cohort) and the British Cardiovascular Interventional Society PCI registry (2006–2020; external validation cohort).

RESULTS:
A total of 30 561 patients (mean age, 64.1 years; 24% women) were included in the Melbourne Interventional Group development cohort and 440 256 patients (mean age, 64.9 years; 27% women) in the British Cardiovascular Interventional Society external validation cohort. The primary outcome (no reflow) occurred in 4.1% (1249 patients) and 9.4% (41 222 patients) of the development and validation cohorts, respectively. From 33 candidate predictor variables, 6 final variables were selected by an adaptive least absolute shrinkage and selection operator regression model for inclusion (cardiogenic shock, ST-segment–elevation myocardial infarction with symptom onset >195 minutes pre-PCI, estimated stent length ≥20 mm, vessel diameter <2.5 mm, pre-PCI Thrombolysis in Myocardial Infarction flow <3, and lesion location). Model discrimination was very good (development C statistic, 0.808; validation C statistic, 0.741) with excellent calibration. Patients with a score of ≥8 points had a 22% and 27% risk of no reflow in the development and validation cohorts, respectively.

CONCLUSIONS:
The no-reflow prediction in acute coronary syndrome risk score is a simple count-based scoring system based on 6 parameters available before PCI to predict the risk of no reflow. This score could be useful in guiding preventative treatment and future trials.