bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global HIV Incidence Analysis and Implications for Affordability Using Long-Acting Cabotegravir Versus Continuous and Event-Driven Oral Preexposure Prophylaxis
Authors: Sharma Ishani , Hill Andrew 
Published: September 2023

Abstract

Background
The HIV Prevention Trials Network (HPTN) 083/084 trials showed up to 88% increased efficacy of long-acting cabotegravir (CAB-LA) versus continuous oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC). However, CAB-LA's high price limits the number of people who can be treated within fixed prevention budgets. Global human immunodeficiency virus (HIV) prevention budgets are highly limited, with TDF/FTC widely available as a low-cost generic. In randomized clinical trials, event-driven TDF/FTC has shown similar preventive efficacy to continuous TDF/FTC.

Methods
A systematic review of global HIV incidence studies was conducted. Weighted incidence was calculated in each at-risk population. HIV infection rates were evaluated for 5 prevention strategies, with additional HIV testing, education, and service access costs assumed for each ($18 per person per year). Assumed efficacies were 90% (continuous CAB-LA), 60% (continuous TDF/FTC), and 60% (event-driven TDF/FTC). Using weighted incidence and an assumed 100 000 target population, annual HIV infection rates by population were calculated for each prevention strategy.

Results
Ninety-eight studies in 5 230 189 individuals were included. Incidence per 100 person-years ranged from 0.03 (blood donors) to 3.82 (people who inject drugs). Using the number needed to treat to benefit for each strategy, a mean incidence of 2.6 per 100 person-years in at-risk populations, and a 100 000 target population, current-price continuous CAB-LA cost $949 487 per HIV infection successfully prevented, followed by target-price CAB-LA ($11 453), continuous TDF/FTC ($4231), and event-driven TDF/FTC ($1923).

Conclusions
High prices of CAB-LA limit numbers treatable within fixed budgets. Low-cost event-driven TDF/FTC consistently prevents the most HIV infections within fixed budgets.
AI Chatbots in Clinical Laboratory Medicine: Foundations and Trends
Authors: Yang He S , Wang Fei , Greenblatt Matthew B , Huang Sharon X , Zhang Yi 
Published: September 2023

Abstract

Background
Artificial intelligence (AI) conversational agents, or chatbots, are computer programs designed to simulate human conversations using natural language processing. They offer diverse functions and applications across an expanding range of healthcare domains. However, their roles in laboratory medicine remain unclear, as their accuracy, repeatability, and ability to interpret complex laboratory data have yet to be rigorously evaluated.

Content
This review provides an overview of the history of chatbots, two major chatbot development approaches, and their respective advantages and limitations. We discuss the capabilities and potential applications of chatbots in healthcare, focusing on the laboratory medicine field. Recent evaluations of chatbot performance are presented, with a special emphasis on large language models such as the Chat Generative Pre-trained Transformer in response to laboratory medicine questions across different categories, such as medical knowledge, laboratory operations, regulations, and interpretation of laboratory results as related to clinical context. We analyze the causes of chatbots’ limitations and suggest research directions for developing more accurate, reliable, and manageable chatbots for applications in laboratory medicine.

Summary
Chatbots, which are rapidly evolving AI applications, hold tremendous potential to improve medical education, provide timely responses to clinical inquiries concerning laboratory tests, assist in interpreting laboratory results, and facilitate communication among patients, physicians, and laboratorians. Nevertheless, users should be vigilant of existing chatbots’ limitations, such as misinformation, inconsistencies, and lack of human-like reasoning abilities. To be effectively used in laboratory medicine, chatbots must undergo extensive training on rigorously validated medical knowledge and be thoroughly evaluated against standard clinical practice.
A qualitative study of mothers’ experiences adopting deaf or hard-of-hearing children
Authors: Rosenzweig Elizabeth A , Smolen Elaine R , Hartman Maria , Powell Brynne , Alruwaili Thekra 
Published: September 2023

Abstract
The current study presents the results of a qualitative investigation into the perspectives of mothers who have adopted children who are deaf or hard of hearing. Nine mothers, recruited via convenience and snowball sampling, participated in semi-structured interviews via videoconference technology. The interviews were transcribed and coded for thematic analysis. Parent perspectives on the following topics were analyzed: motivation, reaction to identification, communication and technology decisions, language, services pre- and post-adoption, others’ reactions, expectations, race and ethnicity, and attachment and adjustment. Based on thematic analysis of the participants’ responses, key themes and implications for professional practice are proposed.
Wild-type transthyretin amyloid cardiomyopathy: expect the unexpected—a case report
Authors: Skov Jens Kæstel , Ladefoged Bertil , Clemmensen Tor Skibsted , Poulsen Steen Hvitfeldt 
Published: September 2023

Abstract

Background
General interest and incidence are increasing in wild-type transthyretin amyloidosis (ATTRwt) in recent time. As patient population increases, further knowledge of the management of the frequently encountered interacting cardiac comorbidities is requested to improve treatment of ATTRwt patients.

Case summary
A 73-year-old male ATTRwt patient presented to the outpatient clinic (Day 0) with dyspnoea, leg swelling, and palpitations. At diagnosis, 3 years prior to presentation, he exhibited only minor signs of ATTRwt. At Day 0, clinical examination revealed atrial fibrillation and mild peripheral oedema. Anticoagulant and symptomatic treatment with beta-blocker and diuretics was initiated, and the patient was planned for sub-acute direct cardioversion, and the patient was discharged with a Holter monitor to outpatient care. At Day 7, analysis of the monitoring demonstrated spontaneous conversion to sinus rhythm and, unexpectedly, episodes of high-rate self-remittent sustained monomorphic ventricular tachycardia (VT) and frequent ventricular ectopic beats. At Day 8, a sub-acute coronary angiography was performed which revealed a significant proximal left anterior descending artery stenosis which was treated with percutaneous coronary intervention (PCI) and subsequently an internal defibrillator was implanted. Following visits at 1- and 3-month post-PCI at the outpatient clinic revealed no VT and suppression of ventricular ectopic beats.

Discussion
The case illustrates some of the frequently encountered cardiac comorbidities (e.g. atrial fibrillation, ventricular arrhythmia, and ischaemic heart disease) associated with ATTRwt. A high level of suspicion is warranted to identify treatable cardiac conditions [atrial fibrillation, atrioventricular (AV) block, and ischaemic heart disease] and to uncover potentially fatal cardiac conditions in patients with ATTRwt.
The political economy of financing traditional vaccines and vitamin A supplements in six African countries
Authors: Nonvignon Justice , Aryeetey Genevieve Cecilia , Adjagba Alex , Asman Jennifer , Sharkey Alyssa , Hasman Andreas , Pallas Sarah W , Griffiths Ulla Kou 
Published: September 2023

Abstract
Vaccines and vitamin A supplementation (VAS) are financed by donors in several countries, indicating that challenges remain with achieving sustainable government financing of these critical health commodities. This qualitative study aimed to explore political economy variables of actors’ interests, roles, power and commitment to ensure government financing of vaccines and VAS. A total of 77 interviews were conducted in Burundi, Comoros, Ethiopia, Madagascar, Malawi and Zimbabwe. Governments and development partners had similar interests. Donor commitment to vaccines and VAS was sometimes dependent on the priorities and political situation of the donor country. Governments’ commitment to financing vaccines was demonstrated through policy measures, such as enactment of immunization laws. Explicit government financial commitment to VAS was absent in all six countries. Some development partners were able to influence governments directly via allocation of health funding while others influenced indirectly through coordination, consolidation and networks. Government power was exercised through multiple systemic and individual processes, including hierarchy, bureaucracy in governance and budgetary process, proactiveness of Ministry of Health officials in engaging with Ministry of Finance, and control over resources. Enablers that were likely to increase government commitment to financing vaccines and VAS included emerging reforms, attention to the voice of citizens and improvements in the domestic economy that in turn increased government revenues. Barriers identified were political instability, health sector inefficiencies, overly complicated bureaucracy, frequent changes of health sector leadership and non-health competing needs. Country governments were aware of their role in financing vaccines, but only a few had made tangible efforts to increase government financing. Discussions on government financing of VAS were absent. Development partners continue to influence government health commodity financing decisions. The political economy environment and contextual factors work together to facilitate or impede domestic financing.
Deconstructing the Eviction Protections Under the Revised European Social Charter: A Systematic Content Analysis of the Interplay Between the Right to Housing and the Right to Property
Authors: Nic Shuibhne Emma N , Bruijn L Michelle , Vols Michel 
Published: September 2023

Abstract
This article analyses the eviction protections provided by the Revised European Social Charter by conducting a systematic content analysis of the European Committee on Social Rights’ (ECSR) Conclusions and Decisions on Articles 16 and 31. The findings reveal that the ECSR has established nine consistent eviction protections throughout its jurisprudence. Additionally, this article examines how the ECSR considers the right to property within the context of evictions, revealing additional eviction protections inconsistently applied by the ECSR that addresses the conflict between the right to housing and property. To provide insight into how the ECSR could address the conflict more directly, this paper compares the ECSR’s approach with that adopted by the United Nations Committee on Economic, Social and Cultural Rights (UN CESCR). Ultimately, this study concludes that the UN CESCR engages with the right to property in the context of evictions more directly than the ECSR.
Multicountry Review of Streptococcus pneumoniae Serotype Distribution Among Adults With Community-Acquired Pneumonia
Authors: Grant Lindsay R , Begier Elizabeth , Theilacker Christian , Barry Rachid , Hall-Murray Cassandra , Yan Qi , Pope Veneta , Pride Michael W , Jodar Luis , Gessner Bradford D 
Published: September 2023

Abstract

Background
Nonbacteremic community-acquired pneumonia (CAP) is a leading presentation of severe pneumococcal disease in adults. Serotype-specific urinary antigen detection (UAD) assay can detect serotypes causing pneumococcal CAP, including nonbacteremic cases, and guide recommendations for use of higher valency pneumococcal conjugate vaccines (PCVs).

Methods
Adult CAP serotype distribution studies that used both Pfizer UADs (UAD1, detects PCV13 serotypes; UAD2, detects PCV20 non-PCV13 serotypes plus 2, 9N, 17F, and 20) were identified by review of an internal study database and included if results were published. The percentages of all-cause radiologically confirmed CAP (RAD + CAP) due to individual or grouped (PCV13, PCV15, and PCV20) serotypes as detected from culture or UAD were reported.

Results
Six studies (n = 2, United States; n = 1 each, Germany, Sweden, Spain, and Greece) were included. The percentage of RAD + CAP among adults ≥18 years with PCV13 serotypes equaled 4.6% to 12.9%, with PCV15 serotypes 5.9% to 14.5%, and with PCV20 serotypes 7.8% to 23.8%. The percentage of RAD + CAP due to PCV15 and PCV20 serotypes was 1.1–1.3 and 1.3–1.8 times higher than PCV13 serotypes, respectively.

Conclusions
PCV13 serotypes remain a cause of RAD + CAP among adults even in settings with pediatric PCV use. Higher valency PCVs among adults could address an important proportion of RAD + CAP in this population.
Differential Induction of Interferon-Stimulated Genes by Cell-Based Versus Egg-Based Quadrivalent Influenza Vaccines in Children During the 2018–2019 Season
Authors: Martin Judith M , Moehling Geffel Krissy , Ortiz Marianna A , Rajasundaram Dhivyaa , Nowalk Mary Patricia , Zimmerman Richard K , Alcorn John F 
Published: September 2023

Abstract

Background
Cell-based quadrivalent-inactivated influenza vaccine has been shown to have higher vaccine effectiveness than traditional egg-based quadrivalent-inactivated influenza vaccine. This is observed despite similar levels of serum hemagglutinin antibodies induced by each vaccine.

Methods
In this study, we examine peripheral immune activation after egg-based or cell-based influenza vaccination in a clinical trial in children. Peripheral blood mononuclear cells were isolated, and ribonucleic acid was sequenced from 81 study participants (41 Fluzone, egg based and 40 Flucelvax, cell based) pre- and 7 days postvaccination. Seroconversion was assessed by hemagglutinin inhibition assay. Differential gene expression was determined and pathway analysis was conducted.

Results
Cell-based influenza vaccine induced greater interferon-stimulated and innate immune gene activation compared with egg-based influenza vaccine. Participants who seroconverted had increased interferon-signaling activation versus those who did not seroconvert.

Conclusions
These data suggest that cell-based influenza vaccine stimulates immune activation differently from egg-based influenza vaccine, shedding light on reported differences in vaccine effectiveness.
Measuring Human Immunodeficiency Virus Reservoirs: Do We Need to Choose Between Quantity and Quality?
Authors: Roux Hélène , Chomont Nicolas 
Published: September 2023

Abstract
The persistence of latent viral genomes in people receiving antiretroviral therapy (ART) is the main obstacle to a cure for human immunodeficiency virus (HIV) infection. Viral reservoirs can be defined as cells harboring HIV genomes that have the ability to produce infectious virions. Precise quantification of the cellular reservoirs of HIV is challenging because these cells are rare, heterogeneous, and outnumbered by a larger number of cells carrying defective genomes. In addition, measuring the inducibility of these proviruses requires functional assays and remains technically difficult. The recent development of single-cell and single-viral genome approaches revealed additional layers of complexity: the cell subsets that harbor proviruses are heterogeneous and their ability to be induced is variable. A substantial fraction of intact HIV genomes may be permanently silenced after years of ART, revealing the underappreciated importance of induction assays. As such, a simple approach that would assess simultaneously the genetic intactness and the inducibility of the reservoir is still lacking. In this study, we review recent advances in the development of methods to quantify and characterize persistently infected cells, and we discuss how these findings can inform the design of future assays aimed at measuring the size of the intact and inducible HIV reservoir.
Recent advances on research into high-speed railway noise
Authors: Sheng Xiaozhen , Zhang Shumin , Xiao Xinbiao , He Yuan 
Published: September 2023

Abstract
Around 42,000 km high-speed railways are in operation in China with a maximum speed of 350 km/h. Trains which can run at 400 km/h are also under development. To control both train pass-by and train interior noise, huge resources have been put into research on high-speed railway noise, and the authors of this paper and their teams have been involved in several key projects. This paper is to summarise some of the advances achieved in these projects by covering the following topics: measurement results and characteristics of high-speed railway pass-by noise; analyses on source contribution to pass-by noise based on microphone array measurement; modelling of high-speed rolling, aerodynamic, and viaduct bridge noise; prediction of the vibro-acoustic behaviour of car-body with poro-elastic media; analyses of vibration transmission in the suspension/bogie system; statistical energy analysis-based prediction of train interior noise. Open problems and potential technologies for controlling high-speed railway noise are also discussed.
Using a chat-based informed consent tool in large-scale genomic research
Authors: Savage Sarah K , LoTempio Jonathan , Smith Erica D , Andrew E Hallie , Mas Gloria , Kahn-Kirby Amanda H , Délot Emmanuèle , Cohen Andrea J , Pitsava Georgia , Nussbaum Robert , Fusaro Vincent A , Berger Seth , Vilain Eric 
Published: September 2023

Abstract

Objective
We implemented a chatbot consent tool to shift the time burden from study staff in support of a national genomics research study.

Materials and Methods
We created an Institutional Review Board-approved script for automated chat-based consent. We compared data from prospective participants who used the tool or had traditional consent conversations with study staff.

Results
Chat-based consent, completed on a user’s schedule, was shorter than the traditional conversation. This did not lead to a significant change in affirmative consents. Within affirmative consents and declines, more prospective participants completed the chat-based process. A quiz to assess chat-based consent user understanding had a high pass rate with no reported negative experiences.

Conclusion
Our report shows that a structured script can convey important information while realizing the benefits of automation and burden shifting. Analysis suggests that it may be advantageous to use chatbots to scale this rate-limiting step in large research projects.
Time for a Gut Check: A Qualitative Study of Proposed Interventions to Address Gender Inequality in Gastroenterology
Authors: Sharma Sowmya , Mathias Holly , Jones Emma , Heisler Courtney , Rohatinsky Noelle , Novak Kerri , Leung Yvette , Fowler Sharyle , Kaczur Melaine , Targownik Laura , Jones Jennifer L 
Published: September 2023

Abstract

Background
Gender inequalities persist in medicine, particularly in some speciality fields where fewer women are employed. Although previous research has suggested potential interventions to broadly address gender inequality in medicine, no research has focused on interventions in the field of gastroenterology. The purpose of this research was to engage women in the field of gastroenterology in Canada, to identify interventions with potential to be effective in addressing gender inequality.

Methods
A World Café was hosted in 2019 to discuss gender inequality and interventions in gastroenterology. Twelve women employed in the field of gastroenterology (i.e. physicians, nurses, research staff, and trainees) were purposively recruited and participated in the event. The discussion rounds were audio-recorded, transcribed, and thematic analyses was conducted using Braun and Clarke’s principles.

Results
Three key themes identifying potential interventions to address gender inequality in gastroenterology were generated: (1) Education; (2) Addressing institutional structures and polices; and 3) Role modelling and mentorship. Participants indicated that interventions should target various stakeholders, including both women and men in gastroenterology, young girls, patients, and administrators.

Conclusion
Many of the interventions identified by participants correspond with existing research on interventions in general medicine, suggesting that institutional changes can be made for maximum effectiveness. Some novel interventions were also identified, including publicizing instances of gender parity and supporting interventions across the educational and professional lifecourse. Moving forward, institutions must assess their readiness for change and evaluate existing policies, programs, and practices for areas of improvement.
What a tangled web it weaves: auxin coordination of stem cell maintenance and flower production
Authors: Smith Elizabeth Sarkel , Nimchuk Zachary L 
Published: September 2023

Abstract
Robust agricultural yields require consistent flower production throughout fluctuating environmental conditions. Floral primordia are produced in the inflorescence meristem, which contains a pool of continuously dividing stem cells. Daughter cells of these divisions either retain stem cell identity or are pushed to the SAM periphery, where they become competent to develop into floral primordia after receiving the appropriate signal. Thus, flower production is inherently linked to regulation of the stem cell pool. The plant hormone auxin promotes flower development throughout its early phases and has been shown to interact with the molecular pathways regulating stem cell maintenance. Here, we will summarize how auxin signaling contributes to stem cell maintenance and promotes flower development through the early phases of initiation, outgrowth, and floral fate establishment. Recent advances in this area suggest that auxin may serve as a signal that integrates stem cell maintenance and new flower production.
The umbilical cord of finite model theory
Authors: Gurevich Yuri 
Published: September 2023

Abstract
Model theory was born and developed as a part of mathematical logic. It has various application domains but is not beholden to any of them. A priori, the research area known as finite model theory would be just a part of model theory but it didn’t turn out that way. There is one application domain, relational database management, that finite model theory had been beholden to during a substantial early period when databases provided the motivation and were the main application target for finite model theory. Arguably, finite model theory was motivated even more by complexity theory. But the subject of this paper is how relational database theory influenced finite model theory. This is NOT a scholarly history of the subject with proper credits to all participants. My original intent was to cover just the developments that I witnessed or participated in. The need to make the story coherent forced me to cover some additional developments.
Veterans Affairs’ Whole Health System of Care for Transitioning Service Members and Veterans
Authors: Gantt Cynthia J , Donovan Nancy , Khung Maureen 
Published: September 2023

ABSTRACT
The Department of Veterans Affairs (VA) has launched an organization-wide transformation to a Whole Health System of Care that will ideally begin at the time of transition from active duty through the end of a Veteran’s life. A brief history and overview of the Whole Health approach are provided along with selected evaluation results and planned initial actions as a result of the Total Force Fitness–Whole Health Summit held in March 2022. More work is required to strengthen the natural linkages between the Department of Defense’s Total Force Fitness and Veterans Affairs’ Whole Health approach to care. The Total Force Fitness–Whole Health collaboration is a model of whole-person care for the nation.