An evaluation framework for clinical use of large language models in patient interaction tasks.

The integration of large language models (LLMs) into clinical diagnostics has the potential to transform doctor-patient interactions. However, the readiness of these models for real-world clinical application remains inadequately tested. This paper introduces the Conversational Reasoning Assessment Framework for Testing in Medicine (CRAFT-MD) approach for evaluating clinical LLMs.

Association of binge alcohol use with functional outcomes among individuals with COVID-19 infection.

Aims: Alcohol consumption along with negative sequelae from excess alcohol intake increased during the COVID-19 pandemic. We evaluated the association between binge alcohol use and long-term functional outcomes among COVID-19-positive individuals.

Methods: Using a prospective, longitudinal, multisite cohort study design, we evaluated the association between binge alcohol use and mental and physical functional outcomes using Patient-Reported Outcomes Measurement Information System (PROMIS)-29 scores three and six months postinfection.

Subsequent pregnancies in the IMPAACT 2010/VESTED Trial: high rate of adverse outcomes in women living with HIV.

Introduction: Women with HIV (WHIV) have higher risks of adverse pregnancy outcomes, particularly in the absence of antiretroviral treatment(ART), and timing of ART may impact risk.

Methods: In IMPAACT 2010 (VESTED), 643 pregnant WHIV in 9 countries were randomized 1:1:1 to initiate ART: dolutegravir (DTG)+emtricitabine(FTC)/tenofovir alafenamide(TAF); DTG+FTC/tenofovir disoproxil fumarate (TDF) or efavirenz (EFV)/FTC/TDF. We describe adverse pregnancy outcomes in women with a subsequent pregnancy during 50 weeks of postpartum follow-up: spontaneous abortion (<20 weeks), stillbirth (≥20 weeks), preterm delivery (<37 weeks) and small-for-gestational-age (SGA).

Psychosocial correlates of alcohol and substance use in college youth with type 1 diabetes.

Objective: Adolescents and young adults with chronic diseases face unique challenges during the college years and may consume alcohol and other substances to cope with stressors. This study aimed to assess the patterns of substance use and to determine psychosocial correlates of these behaviors among college youth with type 1 diabetes (T1D).

Methods: College youth with T1D were recruited via social media and direct outreach into a web-based study.

The "FitBrain" program: implementing exergaming & dual-task exercise programs in outpatient clinical settings.

Dual-task training and exergaming interventions are increasingly recognized for their potential to enhance cognitive, physical, and mood outcomes among older adults and individuals with neurological conditions. Despite this, clinical and community programs that use these interventions are limited in availability. This paper presents the "FitBrain" program, an outpatient clinical model that combines dual-task and exergaming interventions to promote cognitive and physical health.

Understanding human papillomavirus vaccine response and efficacy in people living with HIV: A systematic mixed studies review and meta-analysis.

Coinfection with human papillomavirus (HPV) and HIV compounds the risks of developing cervical, anal, and HPV-associated oral neoplasia. Safe prophylactic vaccines are available to prevent HPV infections in people with HIV(PWH). Yet, vaccine efficacy and duration of protection remain questionable.

Gut-microbiota-brain Axis and post-traumatic epilepsy.

There has been growing evidence that perturbations in gut-microbiota-brain axis (GMBA) are involved in mechanisms of chronic sequelae of traumatic brain injury (TBI). This review discusses the connection between GMBA and post-traumatic epilepsy (PTE), the latter being a common outcome of TBI. The focus is on two aspects of post-TBI GMBA dysfunction that are relevant to epilepsy.

Comprehensive evaluation and practical guideline of gating methods for high-dimensional cytometry data: manual gating, unsupervised clustering, and auto-gating.

Cytometry is an advanced technique for simultaneously identifying and quantifying many cell surface and intracellular proteins at a single-cell resolution. Analyzing high-dimensional cytometry data involves identifying and quantifying cell populations based on their marker expressions. This study provided a quantitative review and comparison of various ways to phenotype cellular populations within the cytometry data, including manual gating, unsupervised clustering, and supervised auto-gating.

Machine learning and deep learning algorithms in stroke medicine: a systematic review of hemorrhagic transformation prediction models.

Background: Acute ischemic stroke (AIS) is a major cause of morbidity and mortality, with hemorrhagic transformation (HT) further worsening outcomes. Traditional scoring systems have limited predictive accuracy for HT in AIS. Recent research has explored machine learning (ML) and deep learning (DL) algorithms for stroke management.

T-switch-ing TCR specificity.

Central tolerance restricts T cells that target self-antigens. In this issue of Immunity, Abdelfattah et al. describe a method to generate self-reactive T cell receptors (TCRs) by directed evolution of non-autoreactive TCRs to recognize self-antigen peptides and demonstrate potential for T cells engineered with such receptors in immunotherapy.

Outcome of Surgery for Hypothalamic Hamartoma-Related Epilepsy: A Systematic Review and Individual Participant Data Meta-Analysis.

Background And Objectives: There is a paucity of data directly comparing the outcome of surgical techniques available for the treatment of hypothalamic hamartomas (HHs). This study aims to evaluate the safety and efficacy of commonly used surgical approaches in the treatment of HH-related epilepsy.

Methods: A systematic review and individual participant data (IPD) meta-analysis was conducted.

Health System Expansion and Changes in Medicare Beneficiary Utilization of Safety Net Providers.

Background: Evidence is limited on insured patients' use of safety net providers as vertically integrated health systems spread throughout the United States.

Objectives: To examine whether market-level health system penetration is associated with: (1) switches in Medicare beneficiaries' usual source of primary care from federally qualified health centers (FQHCs) to health systems; and (2) FQHCs' overall Medicare patient and visit volume.

Research Design: Beneficiary-level discrete-time survival analysis and market-level linear regression analysis using Medicare fee-for-service claims data from 2013 to 2018.

Targeted protein evolution in the gut microbiome by diversity-generating retroelements.

Diversity-generating retroelements (DGRs) accelerate evolution by rapidly diversifying variable proteins. The human gastrointestinal microbiota harbors the greatest density of DGRs known in nature, suggesting they play adaptive roles in this environment. We identified >1,100 unique DGRs among human-associated species and discovered a subset that diversify adhesive components of Type V pili and related proteins.

The safety, acceptability, and success rates of amniocentesis in the context of preterm prelabor rupture of membranes and threatened preterm labor: a systematic review and meta-analysis.

Introduction: Preterm birth, defined as birth before 37 weeks of gestation, is the leading cause of death of children under the age of five years worldwide. Globally there has been no change in the preterm birth rate between 2010 and 2020, when rates were calculated to be 9.8% and 9.

Alterations and Imbalance of Dorsal and Ventral Mossy Cells in a Mouse Model of Epilepsy.

Mossy cells (MCs) in the hilus of the dentate gyrus (DG) are important for regulating activity of dentate granule cells and are particularly vulnerable to excitotoxic damage in epilepsy. Recent studies have demonstrated that MCs in the dorsal and ventral DG differ in the patterns of their axonal projections and neurochemical identities. Such differences raised questions about the vulnerability and plasticity of dorsal and ventral MCs in epilepsy and led to this study using a mouse pilocarpine model of epilepsy.

Participant acceptability and clinician satisfaction of cognitive behavioural therapy and medication management algorithm compared with enhanced standard care for treatment of depression among youth with HIV.

Primary results of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) 2002 trial showed that cognitive behavioural therapy (CBT) and medication management algorithm (MMA) (COMB-R) significantly improved depression in youth with HIV (YWH) compared with enhanced standard care (ESC). Acceptability and satisfaction were examined among study participants and clinicians. Between March 2017 and March 2019, 13 U.

A national perspective on palliative interventions for malignant gastric outlet obstruction.

Background: Of note, 15% to 20% of patients with duodenal or periampullary malignancies develop gastric outlet obstruction (GOO). Although small randomized trials have reported more rapid recovery and shorter hospital stay with endoscopic stenting (ES), limited studies have evaluated outcomes at a national level. The current study characterized short-term clinical and financial outcomes associated with gastrojejunostomy (GJ) vs ES in malignant GOO.

Progression to complete retinal pigment epithelium and outer retinal atrophy (cRORA): post hoc analysis of the GATHER1 trial.

Purpose: Determine rates of progression of incomplete retinal pigment epithelium and outer retinal atrophy (iRORA) to complete retinal pigment epithelium and outer retinal atrophy (cRORA) and rates of progression of drusen to iRORA/cRORA in eyes with geographic atrophy (GA) treated with avacincaptad pegol (ACP).

Methods: Post hoc analysis of the GATHER1 prospective, randomized, double-masked Phase II/III study that evaluated ACP 2 mg vs. sham.