bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world effectiveness of mpox (monkeypox) vaccines: a systematic review
Authors: Xu Mingda , Liu Caifen , Du Zhanwei , Bai Yuan , Wang Zhen , Gao Chao 
Published: March 2023

AbstractUnderstanding the effectiveness of smallpox vaccines against mpox in humans can inform public health preparedness for mpox prophylaxis during the 2022 outbreak. However, the efficacy of current vaccines against mpox has been inferred from animal and immunogenicity studies and has barely been demonstrated in human clinical trials. Thus, we conducted a systematic literature review to estimate the real-world effectiveness of mpox vaccines. The study showed a pooled estimate of 0.89 (95% CI: 0.86-0.91) for the third-generation smallpox vaccine (MVA-BN) effectiveness during the 2022 outbreak. The results showed that the incidence of mpox was significantly lower in the vaccinated group than in the unvaccinated group. Considering the potential mutations, side effects, and breakthrough infections, it is recommended to develop a next-generation vaccine that is more effective and safer for future mpox outbreaks.
ChatGPT Goes to Operating Room: Evaluating GPT-4 Performance and Its Potential in Surgical Education and Training in the Era of Large Language Models
Authors: Oh Namkee , Choi Gyu-Seong , Lee Woo Yong 
Published: March 2023

AbstractPurposeThis study aimed to assess the performance of ChatGPT, specifically the GPT-3.5 and GPT-4 models, in understanding complex surgical clinical information and its potential implications for surgical education and training.MethodsThe dataset comprised 280 questions from the Korean general surgery board exams conducted between 2020 and 2022. Both GPT-3.5 and GPT-4 models were evaluated, and their performances were compared using McNemar’s test.ResultsGPT-3.5 achieved an overall accuracy of 46.8%, while GPT-4 demonstrated a significant improvement with an overall accuracy of 76.4%, indicating a notable difference in performance between the models (P < 0.001). GPT-4 also exhibited consistent performance across all subspecialties, with accuracy rates ranging from 63.6% to 83.3%.ConclusionChatGPT, particularly GPT-4, demonstrates a remarkable ability to understand complex surgical clinical information, achieving an accuracy rate of 76.4% on the Korean general surgery board exam. However, it is important to recognize the limitations of LLMs and ensure that they are used in conjunction with human expertise and judgment.
Trade-offs between water use and greenhouse gas emissions related to food systems: an optimization study in French adults
Authors: Kesse-Guyot Emmanuelle , Pointereau Philippe , Brunin Joséphine , Perraud Elie , Toujgani Hafsa , Berthy Florine , Allès Benjamin , Touvier Mathilde , Lairon Denis , Mariotti François , Baudry Julia , Fouillet Hélène 
Published: March 2023

AbstractWater use (WU) and greenhouse gas emissions (GHGe) are two main issues facing food systems. Still, they have rarely been studied together even though they are potentially conflicting because their levers for improvement are not necessarily the same. Data on food-related environmental pressures suggest that GHGe and WU can be improved jointly, but their potential conflicts and trade-offs have not been explored. This is what we studied here by a compromise programming approach, using multi-criteria non-linear optimization under a set of nutritional and epidemiological constraints. We used food consumption data of adults aged 18-64 years (n=1,456) from the French representative study INCA 3 (2014-2015) coupled with food environmental impact data from the Agribalyse ® database. A full range of scenarios was identified by prioritizing the two objectives differently, giving weight from 0% to 100%, by 5-% steps, to GHGe improvement over WU improvement.Overall, we showed that it is possible to achieve significant joint reductions in WU and GHGe relative to their observed values: across the prioritization scenarios, WU reduction ranged from -36% to -14% as its prioritization decreased, while GHGe reduction varied less, from -44 to -52% as its prioritization increased. These joint important reductions in GHGe and WU required the removal of meat consumption (beef, pork, poultry and processed meat), while the consumptions of offal and dairy products remained moderate in order to meet nutrient reference values. However, the consumption of some foods varied according to the priority given to WU over GHGe reductions (namely, vegetables, fruit juice, dairy products, eggs, refined cereal, substitutes, offal and potatoes). Fish, whole grains, and fruit remained more constant due to the epidemiological constraints used. Whatever the scenario, the modeled diets were more plant-based than the observed diet from which they differed significantly (only 23-31% of common food consumptions), and were therefore healthier (63-76% reduction in distance to theoretical minimum risk of chronic disease).To conclude, while focusing solely on WU reduction induces a joint GHGe reduction that is near-maximal, the reverse is not true, showing that there is good alignment but also some divergence between these objectives. This suggests that food systems WU should be better considered in dietary guidelines for healthy and sustainable diet.
Use of pharmacy services in community-dwelling middle-aged and older adults; findings from The Irish Longitudinal Study on Ageing (TILDA)
Authors: Murry Logan T. , Flood Michelle , Holton Alice , Kenny Rose Anne , Moriarty Frank 
Published: March 2023

AbstractIntroductionThe role of community pharmacists has evolved in recent years with expansion in pharmacy services offered. This study aims to assess pharmacy services use among adults aged ≥50 years in Ireland, and determine the demographic and clinical factors associated with pharmacy services use.MethodsThis cross-sectional study included community-dwelling participants in wave 4 of The Irish Longitudinal Study on Ageing (TILDA), aged ≥56 years who were self-respondents. TILDA is a nationally representative cohort study, with wave 4 data collected during 2016. TILDA collects participant demographics and health data, in addition to information on the use of several services when visiting the pharmacy in the last 12 months. Characteristics and pharmacy services use were summarised. Multivariate logistic regression was used to examine the association of demographic and health factors with reporting (i) any pharmacy service use and (ii) requesting medicines advice.ResultsAmong 5,782 participants (55.5% female, mean age 68 years), 96.6% (5,587) reported visiting a pharmacy in the previous 12 months, and almost one fifth of these (1,094) availed of at least one specified pharmacy service. The most common non-dispensing services reported were requesting advice about medications (786, 13.6%), blood pressure monitoring (184, 3.2%), and vaccination (166, 2.9%). Controlling for other factors, female sex (odds ratio (OR) 1.32, 95%CI 1.14-1.52), third-level education (OR 1.85, 95%CI 1.51-2.27), higher rates of GP visits, private health insurance (OR 1.29, 95%CI 1.07-1.56), higher number of medications, loneliness, and respiratory condition diagnosis (OR 1.42, 95%CI 1.14-1.74) were associated with higher likelihood of availing of pharmacy services. The relationship between these factors and requesting medicines advice were similar.ConclusionA high proportion of middle-aged and older adults visit community pharmacy and a fifth avail of specified pharmacy services. Despite advances in the services offered in pharmacies, medicines advice remains at the core of pharmacists’ practice.
What risk doBrucellavaccines pose to humans? A systematic review of the scientific literature on occupational exposure
Authors: Vives-Soto Manuel , Puerta-García Amparo , Pereira José-Luis , Rodríguez-Sánchez Esteban , Solera Javier 
Published: March 2023

ABSTRACTIntroductionVaccination of cattle, sheep and goats with attenuated strains ofBrucellais an effective measure for controlling brucellosis, although the vaccines pose risks to humans during the manufacturing process and throughout their distribution and administration to animals.ObjectiveThe aim of this study was to review the risk posed to humans by occupational exposure to vaccine strains and the measures that should be implemented to minimize this risk.Materials and methodsThis article reviewed the scientific literature indexed in PubMed up to January 31, 2023, following “the PRISMA guidelines”; special emphasis was placed on the vaccine strain used and the route of exposure.ResultsTwelve primary reports were found: six included the Rev-1 strain, three the S19, and four the RB-51 strain. Rev-1 seemed to be the most virulent. The most frequent type of exposure was needle injury during administration, while exposure accidents during vaccine manufacturing were exceptional. Prolonged contact with the pathogen, lack of information and a low adherence to personal protective equipment (PPE) use in the work environment were determining factors for becoming infected. Despite strict protection measures, a percentage of vaccine manufacturing workers developed a positive serology to the vaccine strain, which may have conferred immunity.ConclusionsBrucellavaccines pose risk of contagion to humans from their production to their administration to cattle; therefore, protection measures should be extreme, and active surveillance of exposed workers should be implemented.
Longitudinal population-level HIV epidemiologic and genomic surveillance highlights growing gender disparity of HIV transmission in Uganda
Authors: Monod Mélodie , Brizzi Andrea , Galiwango Ronald M , Ssekubugu Robert , Chen Yu , Xi Xiaoyue , Kankaka Edward Nelson , Ssempijja Victor , Dörner Lucie Abeler , Akullian Adam , Blenkinsop Alexandra , Bonsall David , Chang Larry W , Dan Shozen , Fraser Christophe , Golubchik Tanya , Gray Ronald H , Hall Matthew , Jackson Jade C , Kigozi Godfrey , Laeyendecker Oliver , Mills Lisa A. , Quinn Thomas C , Reynolds Steven J. , Santelli John , Sewankambo Nelson K. , Spencer Simon EF , Ssekasanvu Joseph , Thomson Laura , Wawer Maria J , Serwadda David , Godfrey-Faussett Peter , Kagaayi Joseph , Grabowski M Kate , Ratmann Oliver ,   Rakai Health Sciences Program,   PANGEA-HIV consortium
Published: March 2023

AbstractHIV incidence in eastern and southern Africa has historically been concentrated among girls and women aged 15-24 years. As new cases decline with HIV interventions, population-level infection dynamics may shift by age and gender. Here, we integrated population-based surveillance of 38,749 participants in the Rakai Community Cohort Study and longitudinal deep sequence viral phylogenetics to assess how HIV incidence and population groups driving transmission have changed from 2003 to 2018 in Uganda. We observed 1,117 individuals in the incidence cohort and 1,978 individuals in the transmission cohort. HIV viral suppression increased more rapidly in women than men, however incidence declined more slowly in women than men. We found that age-specific transmission flows shifted, while HIV transmission to girls and women (aged 15-24 years) from older men declined by about one third, transmission to women (aged 25-34 years) from men that were 0-6 years older increased by half in 2003 to 2018. Based on changes in transmission flows, we estimated that closing the gender gap in viral suppression could have reduced HIV incidence in women by half in 2018. This study suggests that HIV programs to increase HIV suppression in men are critical to reduce incidence in women, close gender gaps in infection burden and improve men’s health in Africa.
Relative vaccine effectiveness (rVE) of mRNA COVID-19 boosters in people aged at least 75 years in the UK vaccination programme, during the Spring-Summer (monovalent vaccine) and Autumn-Winter 2022 (bivalent vaccine) booster campaigns: a prospective test negative case-control study
Authors: Chatzilena Anastasia , Hyams Catherine , Challen Rob , Marlow Robin , King Jade , Adegbite David , Kinney Jane , Clout Madeleine , Maskell Nick , Oliver Jennifer , Finn Adam , Danon Leon ,   The Avon CAP Research Group
Published: March 2023

ABSTRACTBackgroundUnderstanding the relative vaccine effectiveness (rVE) of new COVID-19 vaccine formulations against SARS-CoV-2 infection is an urgent public health priority. A precise analysis of the rVE of monovalent and bivalent boosters given during the 2022 Spring-Summer and Autumn-Winter campaigns, respectively, in a defined population has not been reported.AimWe therefore assessed rVE against hospitalisation for the Spring-Summer (fourth vs third monovalent mRNA vaccine doses) and Autumn-Winter (fifth BA.1/ancestral bivalent vs fourth monovalent mRNA vaccine dose) boosters.MethodsA prospective single-centre test-negative design case-control study of ≥75 year-olds hospitalised with COVID-19 or other acute respiratory disease. We conducted regression analyses controlling for age, sex, socioeconomic status, patient comorbidities, community SARS-CoV-2 prevalence, vaccine brand and time between baseline dose and hospitalisation.Results682 controls and 182 cases were included in the Spring-Summer booster analysis; 572 controls and 152 cases for the Autumn-Winter booster analysis. A monovalent mRNA COVID-19 vaccine as fourth dose showed rVE 46·6% (95% confidence interval [CI] 13·9-67·1) versus those not fully boosted. A bivalent mRNA COVID-19 vaccine as fifth dose had rVE 46·7% (95%CI 18-65·1), compared to a fourth monovalent mRNA COVID-19 vaccine dose.ConclusionsBoth fourth monovalent and fifth BA.1/ancestral mRNA bivalent COVID-19 vaccine doses demonstrated benefit as a booster in older adults. Bivalent mRNA boosters offer similar protection against hospitalisation with Omicron infection to monovalent mRNA boosters given earlier in the year. These findings support immunisation programmes in several European countries that advised the use of BA.1/ancestral bivalent booster doses.
Altered Amygdala Volumes and Microstructure in Focal Epilepsy Patients with Tonic-Clonic Seizures, Ictal and Post-Ictal Central Apnea
Authors: Zeicu Claudia , Legouhy Antoine , Scott Catherine A. , Oliveira Joana F. A. , Winston Gavin , Duncan John S , Vos Sjoerd B. , Thom Maria , Lhatoo Samden , Zhang Hui , Harper Ronald M. , Diehl Beate 
Published: March 2023

Abstract and key wordsObjectivesSudden unexpected death in epilepsy (SUDEP) is a leading cause of death for patients with epilepsy; however, the pathophysiology remains unclear. Focal-to-bilateral tonic-clonic seizures (FBTCS) are a major risk factor, and centrally-mediated respiratory depression may increase the risk further. Here, we determined volume and microstructure of the amygdala, a key structure that can trigger apnea in people with focal epilepsy, stratified by presence or absence of FBTCS, ictal central apnea (ICA) and post-ictal central apnea (PICA).Methods73 patients with only-focal seizures and 30 with FBTCS recorded during video EEG (VEEG) with respiratory monitoring were recruited prospectively during presurgical investigations. We acquired high-resolution T1-weighted anatomical and multi-shell diffusion images, and computed neurite orientation dispersion and density imaging (NODDI) metrics in all epilepsy patients and 69 healthy controls. Amygdala volumetric and microstructure alterations were compared between healthy subjects, and patients with only-focal seizures or FBTCS The FBTCS group was further subdivided by presence of ICA and PICA, verified by VEEG.ResultsBilateral amygdala volumes were significantly increased in the FBTCS cohort compared to healthy controls and the focal cohort. Patients with recorded PICA had the highest increase in bilateral amygdala volume of the FBTCS cohort.Amygdala neurite density index (NDI) values were significantly decreased in both the focal and FBTCS groups relative to healthy controls, with values in the FBTCS group being the lowest of the two. The presence of PICA was associated with significantly lower NDI valuesvsthe non-apnea FBTCS group (p=0.004).SignificanceIndividuals with FBTCS and PICA show significantly increased amygdala volumes and disrupted architecture bilaterally, with greater changes on the left side. The structural alterations reflected by NODDI and volume differences may be associated with inappropriate cardiorespiratory patterns mediated by the amygdala, particularly after FBTCS. Determination of amygdala volumetric and architectural changes may assist identification of individuals at risk.
Individualized epidemic spreading models predict epilepsy surgery outcomes: a pseudo-prospective study
Authors: Millán Ana. P. , van Straaten Elisabeth C.W. , Stam Cornelis J. , Nissen Ida A. , Idema Sander , Van Mieghem Piet , Hillebrand Arjan 
Published: March 2023

AbstractEpilepsy surgery is the treatment of choice for drug-resistant epilepsy patients, but up to 50% of patients continue to have seizures one year after the resection. In order to aid presurgical planning and predict postsurgical outcome in a patient-by-patient basis, we developed a framework of individualized computational models that combine epidemic spreading with patient-specific connectivity and epileptogeneity maps: the Epidemic Spreading Seizure and Epilepsy Surgery framework (ESSES). The ESSES parameters were fitted in a retrospective study (N= 15) to reproduce invasive electroencephalography (iEEG)-recorded seizures. ESSES could not only reproduce the iEEG-recorded seizures, but significantly better so for patients with good (seizure-free, SF) than bad (non-seizure-free, NSF) outcome (area under the curveAUC= 0.73). Once the model parameters were set in the retrospective study, ESSES can be applied also to patients without iEEG data. We illustrate here the clinical applicability of ESSES with apseudo-prospective study(N= 34) with a blind setting (to the resection strategy and surgical outcome) that emulated the presurgical conditions. ESSES could predict the chances of good outcome afteranyresection by finding patient-specific optimal resection strategies, which we found to be smaller for SF than NSF patients, suggesting an intrinsic difference in the network organization or presurgical evaluation results of NSF patients. The actual surgical plan also overlapped more with the optimal resection, and had a larger effect in decreasing modeled seizure propagation, for SF patients than for NSF patients. Overall, ESSES could correctly predict 75% of NSF and 80.8% of SF cases pseudo-prospectively. Our results show that individualised computational models may inform surgical planning by suggesting optimal resections and providing information on the likelihood of a good outcome after a proposed resection. This is the first time that such a model is validated on a fully independent cohort without the need for iEEG recordings.
Psychometric development and validation of the Hospital Resilience Index
Authors: Lirk Philipp , Janjua Haroon , Rogers Michael , Flynn Stephen , Kuo Paul , Pietrobon Ricardo 
Published: March 2023

AbstractImportanceThroughout the past decades, the United States healthcare system has seen increased efforts to promote resilience to external or internal stressors. However, measuring outcomes remains a challenge, mainly because most indices rely on markers that need to be gathered from different data sources. An alternative would be to use readily available large-scale data. The American Hospital Association (AHA) annual survey gathers over 1,000 data points from more than 6,000 hospitals. The RAND corporation provides information on the financial health and viability of hospitals and health care systems.ObjectiveOur study aimed to establish and psychometrically validate a new Hospital Resilience Index.DesignWe took the two databases as primary data sources, and defined hospital closure as the main negative outcome. We performed descriptive statistics, and regression analysis of the databases.Main outcomes and MeasuresLikelihood of hospital closure.ResultsOur findings show that a combination of eleven variables is strongly associated with the likelihood of hospital closure. These factors mirror smaller hospital size, lack of ancillary functions, staffing structure of the hospital, size of facilities, number of surgeries performed, Medicare discharges, operating expenses, and medical school affiliation as a teaching hospital. We further classified hospitals with a low HRI (<25) or high HRI (>25). In this setup, we found that both hospitals with a low HRI and hospitals that would subsequently close were characterized by smaller patient census, smaller numbers of surgeries, fewer beds, a smaller staff, and a lower operating margin.Conclusions and RelevanceTogether, these factors would point to a higher resilience to external stressors in larger, more expanded hospitals and healthcare systems, offering a broad range of services, and having a higher operating margin. The higher tiers of the healthcare system therefore seem to have more resilience, but the recent Covid-19 pandemic exhibited how much all tiers in the system are needed to respond to extraordinary crises such as pandemics or large natural disasters. Future research should seek to determine whether tracking the HRI over time may be a tool to identify hospitals at risk of closure.Key pointsQuestionCan existing databases (e.g., American Hospital Association) be used to quantify resilience of a hospital, and predict closure?FindingsIn this study, we combined data from the American Hospital Association Database, and the RAND corporation database to create a Hospital Resiliency Index, with the hard outcome of hospital closure. A combination of eleven variables characterized hospitals which would subsequently close, mostly pointing towards smaller, rural hospitals.MeaningOur study is the basis for potential monitoring of hospital resilience using data readily available for every U.S. hospital on an annual basis, to allow for identification of at-risk hospitals over time.
Pandemic telehealth flexibilities for buprenorphine treatment: A synthesis of evidence and policy implications for expanding opioid use disorder care in the U.S
Authors: Krawczyk Noa , Rivera Bianca D. , King Carla , Dooling Bridget C.E. 
Published: March 2023

AbstractBuprenorphine is a highly effective treatment for opioid use disorder and a critical tool for addressing the worsening U.S. overdose crisis. However, multiple barriers to treatment - including stringent federal regulations - have historically made this medication hard to reach for many who need it. In 2020, under the COVID-19 Public Health Emergency, federal regulators substantially changed access to buprenorphine by allowing prescribers to initiate patients on buprenorphine via telehealth without first evaluating them in person. As the Public Health Emergency is set to expire in May of 2023, Congress and federal agencies can leverage extensive evidence from studies conducted during the wake of the pandemic to make evidencebased decisions on the regulation of buprenorphine going forward. To aid policy makers, this review synthesizes and interprets peer-reviewed research on the effect of buprenorphine flexibilities on uptake and implementation of telehealth, and its impact on OUD patient and prescriber experiences, access to treatment and health outcomes. Overall, our review finds that many prescribers and patients took advantage of telehealth, including the audio-only option, with a wide range of benefits and few downsides. As a result, federal regulators—including agencies and Congress—should continue non-restricted use of telehealth for buprenorphine initiation.