Featured
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Article
| Open AccessCost-effectiveness uncertainty may bias the decision of coal power transitions in China
China’s use of coal is complex to establish a clean and low-carbon transition for the country. With an uncertainty assessment framework, this study displays the risks of missing opportunities in obtaining cumulative positive net benefits and identifying an optimal transition strategy.
- Xizhe Yan
- , Dan Tong
- & Yu Lei
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Article
| Open AccessSystematic review and meta-analysis for a Global Patient co-Owned Cloud (GPOC)
Use of cloud-based personal health records are increasing globally. Here, authors introduce the Global Patient co-Owned Cloud (GPOC) concept. The systematic review and meta-analysis examine factors like data security, efficiency, privacy, and cost. It aims to establish a scientific basis for a GPOC, which may disseminate global artificial intelligence for healthcare.
- Niklas Lidströmer
- , Joe Davids
- & Eric Herlenius
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Article
| Open AccessEnhancing the fairness of AI prediction models by Quasi-Pareto improvement among heterogeneous thyroid nodule population
Artificial Intelligence (AI) models for medical diagnosis often face challenges of generalizability and fairness. Here, the authors show that the Quasi-Pareto Improvement approach is widely applicable to improving AI models among less-prevalent subgroups, promoting equitable healthcare outcomes.
- Siqiong Yao
- , Fang Dai
- & Hui Lu
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Article
| Open AccessInequalities in healthcare use during the COVID-19 pandemic
An indirect impact of the COVID-19 pandemic was a decline in healthcare utilisation for other conditions. Here, the authors quantify this decline in the Netherlands and show that impacts were greater for individuals with lower household income, females, older people, and those with a migrant background.
- Arun Frey
- , Andrea M. Tilstra
- & Mark D. Verhagen
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Article
| Open AccessConcordance of randomised controlled trials for artificial intelligence interventions with the CONSORT-AI reporting guidelines
The CONSORT-AI extension was developed to provide specific guidance for randomised controlled trials involving Artificial Intelligence (AI) interventions. Here, the authors show that since publication of CONSORT-AI, several AI-specific considerations remain systematically underreported.
- Alexander P. L. Martindale
- , Benjamin Ng
- & Xiaoxuan Liu
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Article
| Open AccessGlobal surveillance of antimicrobial resistance in food animals using priority drugs maps
Monitoring antimicrobial resistance in food animals is challenging due to limited surveillance systems. Here, the authors combine data from point prevalence surveys in lower- and middle-income settings to map resistance to seven antimicrobials and predict which are likely to exceed key resistance thresholds.
- Cheng Zhao
- , Yu Wang
- & Thomas P. Van Boeckel
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Article
| Open AccessA randomized trial looking at planning prompts to reduce opioid prescribing
A personalized letter from the Medical Examiner-Coroner in Los Angeles County has proven effective at reducing opioid and benzodiazepine prescribing. Here the authors show that the introduction of if/when-then planning prompts in to the letter further reduced opioid prescribing by 12.85% and benzodiazepine prescribing by 8.32%; they were most effective for clinicians with multiple patient deaths due to accidental opioid-related overdose.
- Jason N. Doctor
- , Marcella A. Kelley
- & Emily P. Stewart
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Article
| Open AccessQuantitatively assessing early detection strategies for mitigating COVID-19 and future pandemics
Monitoring samples from hospital patients, wastewater, or air travel may enable early detection of pathogens. Here, the authors assess how these surveillance systems could have impacted detection of COVID-19 and their potential benefits for detection of other emerging pathogens.
- Andrew Bo Liu
- , Daniel Lee
- & Michael Springer
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Review Article
| Open AccessThe promise of data science for health research in Africa
In this Review article, the authors discuss emerging efforts to build ethical governance frameworks for data science health research in Africa and the opportunities to advance these through investments by African governments and institutions, international funding organizations and collaborations for research and capacity development.
- Clement A. Adebamowo
- , Shawneequa Callier
- & Sally N. Adebamowo
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Article
| Open AccessGabapentinoid consumption in 65 countries and regions from 2008 to 2018: a longitudinal trend study
With their misuse potential, there is a need to understand the global consumption of gabapentinoids. Here, authors show a + 17.20% worldwide average annual increase in consumption of gabapentinoids from 2008 to 2018.
- Adrienne Y. L. Chan
- , Andrew S. C. Yuen
- & Kenneth K. C. Man
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Article
| Open AccessUsing mortuary and burial data to place COVID-19 in Lusaka, Zambia within a global context
Estimates of COVID-19 impacts in many low- and middle-income countries remain very uncertain, with lack of high-quality data. Here, the authors reconstruct epidemic dynamics in Lusaka, Zambia and estimate that, when accounting for demographic patterns, the epidemic severity is comparable with global norms.
- Richard J. Sheppard
- , Oliver J. Watson
- & Christopher J. Gill
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Article
| Open AccessModelling the economic burden of SARS-CoV-2 infection in health care workers in four countries
Health care workers were at high risk of SARS-CoV-2 infection in the early stage of the pandemic, and this had knock-on effects including secondary infections and disruptions in health service delivery. Here, the authors estimate the economic impacts of SARS-CoV-2 infections in health care workers at the society level in five low- and middle-income country settings.
- Huihui Wang
- , Wu Zeng
- & Mickey Chopra
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Article
| Open AccessEffectiveness of BNT162b2 after extending the primary series dosing interval in children and adolescents aged 5–17
Extending the interval between doses of mRNA Covid-19 vaccines has been linked with a reduced risk of myocarditis in children and adolescents, but impacts on vaccine effectiveness are not known. Here, the authors perform a nested case-control study using data from Hong Kong and find evidence of reduced risk of infection following a longer dosing interval.
- Francisco Tsz Tsun Lai
- , Min Fan
- & Esther Wai Yin Chan
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Article
| Open AccessA scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups
Physical distancing measures introduced to control the spread of COVID-19 had socio-economic trade-offs that may have particularly impacted vulnerable population groups. Here, the authors perform a scoping review and summarise the impacts on different vulnerable groups described in 265 studies.
- Lili Li
- , Araz Taeihagh
- & Si Ying Tan
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Article
| Open AccessEstimation of stillbirths attributable to ambient fine particles in 137 countries
Gestational exposure to ambient fine particles increases the risk of stillbirth, but the related disease burden is unknown, particularly in low- and middle-income countries (LMICs). Here, the authors combine state-of-the-art estimates on stillbirths, and multiple exposure–response functions to evaluate the burden in 137 countries.
- Tao Xue
- , Mingkun Tong
- & Tong Zhu
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Article
| Open AccessGlobal mortality of snakebite envenoming between 1990 and 2019
Snakebite envenoming is a leading cause of mortality among neglected tropical diseases. Here, the authors analyze a global data repository and estimate that snakebite envenoming caused over 63,000 deaths in 2019, primarily concentrated in South Asia and Sub-Saharan Africa.
- Nicholas L. S. Roberts
- , Emily K. Johnson
- & Kanyin Liane Ong
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Article
| Open AccessThe effect of COVID certificates on vaccine uptake, health outcomes, and the economy
Many countries introduced COVID certificates that were required to access public venues. Here, the authors analyse data from France, Germany, and Italy, and estimate that these policies led to increased vaccine uptake of 6-13 percentage points with subsequent beneficial impacts on health and economic outcomes.
- Miquel Oliu-Barton
- , Bary S. R. Pradelski
- & Guntram B. Wolff
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Article
| Open AccessComparative effectiveness and safety of homologous two-dose ChAdOx1 versus heterologous vaccination with ChAdOx1 and BNT162b2
Different homologous and heterologous vaccination regimens have been used for COVID-19. Here the authors show in a cohort analysis from Catalonia that heterologous vaccination with ChAdOx1 followed by BNT162b2 has better vaccine effectiveness than two doses of ChAdOx1.
- Eduardo Hermosilla
- , Ermengol Coma
- & Daniel Prieto-Alhambra
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Article
| Open AccessThe effect of COVID-19 vaccination in Italy and perspectives for living with the virus
Vaccination campaigns against COVID-19 are allowing the progressive release of physical distancing restrictions in many countries. Here, the authors assess the impact of the vaccination program in Italy and evaluate possible prospects for reopening the society while at the same time keeping COVID-19 under control.
- Valentina Marziano
- , Giorgio Guzzetta
- & Stefano Merler
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Article
| Open AccessSerological responses and vaccine effectiveness for extended COVID-19 vaccine schedules in England
The UK extended the interval until the second COVID-19 vaccine dose up to 12 weeks. Here, the authors show in a cohort of 750 participants aged 50–89 years that the extended schedule results in higher antibody titers and estimate a higher vaccine effectiveness for the extended schedule.
- Gayatri Amirthalingam
- , Jamie Lopez Bernal
- & Mary E. Ramsay
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Article
| Open AccessCOVID-19 spread, detection, and dynamics in Bogota, Colombia
Detailed information on SARS-CoV-2 infection rates in Latin America by occupation, socioeconomic group and geographic area are rarely available. Here, the authors provide these estimates for in Bogota, Colombia using data from a sentinel surveillance scheme, and find that over half the population had been infected by March 2021.
- Rachid Laajaj
- , Camilo De Los Rios
- & Duncan Webb
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Article
| Open AccessTime-varying optimization of COVID-19 vaccine prioritization in the context of limited vaccination capacity
In the context of limited supply, strategies for optimising allocation of COVID-19 vaccines are needed. Here, the authors explore time-varying strategies that adapt to the epidemiological situation and simultaneously optimise for multiple objectives including reducing numbers of infections, hospitalisations, and deaths.
- Shasha Han
- , Jun Cai
- & Hongjie Yu
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Article
| Open AccessLack of consideration of sex and gender in COVID-19 clinical studies
Sex and gender have been associated with differences in SARS-CoV-2 incidence and clinical outcomes and therefore warrant consideration in study designs. Here, the authors assess registered and published clinical COVID-19 studies and find that sex-disaggregated analyses are infrequently presented or planned.
- Emer Brady
- , Mathias Wullum Nielsen
- & Sabine Oertelt-Prigione
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Article
| Open AccessDesign of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures
Selection of COVID-19 mitigation measures requires balancing health outcomes with economic impacts. Here, the authors derive a system to set triggers for increasing mitigation measures to preserve healthcare capacity, and describe how it has been used to support public health decision making in Austin, Texas.
- Haoxiang Yang
- , Özge Sürer
- & Lauren Ancel Meyers
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Article
| Open AccessMolecular benchmarks of a SARS-CoV-2 epidemic
The concentration of SARS-CoV-2 changes during an individual’s infection, and mutations accumulate as viruses are transmitted between people. Here, the authors use data from Iceland to demonstrate how this information can be exploited at the population-level to determine the phase of the epidemic.
- Hakon Jonsson
- , Olafur T. Magnusson
- & Kari Stefansson
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Article
| Open AccessImpacts of social distancing policies on mobility and COVID-19 case growth in the US
In response to COVID-19, many states have implemented social distancing orders, but the effect of these orders on population mobility has not been fully quantified. Here, the authors use data from the US to show that state-level social distancing orders substantially reduced mobility and limited the spread of disease.
- Gregory A. Wellenius
- , Swapnil Vispute
- & Evgeniy Gabrilovich
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Article
| Open AccessThe effect of generic market entry on antibiotic prescriptions in the United States
Generics contribute to increased availability of antibiotics, benefiting healthcare systems but potentially leading to increased consumption with implications for antibiotic stewardship and resistance. Here, the authors found no consistent changes in prescribing patterns of the 13 antibiotics that entered the US market as generics from 2000–2012.
- Cecilia Kållberg
- , Jemma Hudson
- & Ramanan Laxminarayan
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Article
| Open AccessDigital proximity tracing on empirical contact networks for pandemic control
Digital contact tracing is increasingly considered as one of the tools to control infectious disease outbreaks, in particular the COVID-19 epidemic. Here, the authors present a modeling framework informed by empirical high-resolution contact data to analyze the impact of digital contact tracing apps.
- G. Cencetti
- , G. Santin
- & B. Lepri
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Article
| Open AccessThe impact of contact tracing and household bubbles on deconfinement strategies for COVID-19
The COVID-19 pandemic caused many governments to impose policies restricting social interactions. Here, the authors implement an age-specific, individual-based model with data on social contacts for the Belgian population and investigate the effect of non-pharmaceutical interventions.
- Lander Willem
- , Steven Abrams
- & Niel Hens
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Article
| Open AccessOrchestrating performance of healthcare networks subjected to the compound events of natural disasters and pandemic
COVID-19 might occur together with other natural disasters but frameworks to quantify collective effects is lacking. Here, the authors investigated the readiness of a healthcare system in the face of wildfire during an epidemic by assuming the COVID-19 pandemic occurred around the same time with the Camp Fire case in Butte Country California 2018/2019.
- Emad M. Hassan
- & Hussam N. Mahmoud
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Article
| Open AccessOptimal COVID-19 quarantine and testing strategies
Safely reducing the necessary duration of quarantine for COVID-19 could lessen the economic impacts of the pandemic. Here, the authors demonstrate that testing on exit from quarantine is more effective than testing on entry, and can enable quarantine to be reduced from fourteen to seven days.
- Chad R. Wells
- , Jeffrey P. Townsend
- & Alison P. Galvani
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Article
| Open AccessModelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa
Plasmodium falciparum infection in pregnancy is a major cause of adverse pregnancy outcomes. Here, the authors combine performance estimates of standard rapid diagnostic tests with modelling to assess whether screening at antenatal visits improves upon current intermittent preventative therapy.
- Patrick G. T. Walker
- , Matt Cairns
- & Feiko O. ter Kuile
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Article
| Open AccessThe economics of malaria control in an age of declining aid
Foreign aid is necessary to control tropical diseases in endemic countries. Here the authors outline the steps taken to control malaria in Africa since 2000 and present an economic model to propose that US$25−30 per capita will be needed to avoid a disease trap.
- Eric Maskin
- , Célestin Monga
- & Jean-Claude Berthélemy
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Article
| Open AccessThe utility of serology for elimination surveillance of trachoma
Robust surveillance methods are needed for trachoma control and recrudescence monitoring, but existing methods have limitations. Here, Pinsent et al. analyse data from nine trachoma-endemic populations and provide operational thresholds for interpretation of serological data in low transmission and post-elimination settings.
- Amy Pinsent
- , Anthony W. Solomon
- & Michael. T. White
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Article
| Open AccessNational and sub-national variation in patterns of febrile case management in sub-Saharan Africa
Treatment-seeking for fever is widely used to estimate treatment of childhood infections, but cross-country comparisons are problematic. Here, the authors estimate the probability of seeking treatment for fever at public facilities across 29 countries by quantifying person-level latent variables.
- Victor A. Alegana
- , Joseph Maina
- & Andrew J. Tatem
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Article |
Threat of invasive pests from within national borders
Invasive species are usually thought to originate from outside a country's borders. Here, using a self-organizing map, Paini and co-workers show that the species most likely to 'invade' the USA are already firmly established within the country, suggesting the need for biosecurity measures within national borders.
- Dean R. Paini
- , Susan P. Worner
- & Matthew B. Thomas