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Objective: Human Papillomavirus (HPV) vaccine is an effective measure to prevent and control the diseases caused by HPV. However, widespread misinformation and vaccine hesitancy remain significant barriers to its uptake. This study focuses on the development of VaxBot-HPV, a chatbot aimed at improving health literacy and promoting vaccination uptake by providing information and answering questions about the HPV vaccine.
Methods: We constructed the knowledge base (KB) for VaxBot-HPV, which consists of 451 documents from biomedical literature and web sources on the HPV vaccine. We extracted 202 question-answer pairs from the KB and 39 questions generated by GPT-4 for training and testing purposes. To comprehensively understand the capabilities and potential of GPT-based chatbots, 3 models were involved in this study: GPT-3.5, VaxBot-HPV, and GPT-4. The evaluation criteria included answer relevancy and faithfulness.
Results: VaxBot-HPV demonstrated superior performance in answer relevancy and faithfulness compared to baselines. For test questions in KB, it achieved an answer relevancy score of 0.85 and a faithfulness score of 0.97. Similarly, it attained scores of 0.85 for answer relevancy and 0.96 for faithfulness on GPT-generated questions.
Discussion: VaxBot-HPV demonstrates the effectiveness of fine-tuned large language models in healthcare, outperforming generic GPT models in accuracy and relevance. Fine-tuning mitigates hallucinations and misinformation, ensuring reliable information on HPV vaccination while allowing dynamic and tailored responses. The specific fine-tuning, which includes context in addition to question-answer pairs, enables VaxBot-HPV to provide explanations and reasoning behind its answers, enhancing transparency and user trust.
Conclusions: This study underscores the importance of leveraging large language models and fine-tuning techniques in the development of chatbots for healthcare applications, with implications for improving medical education and public health communication.
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http://dx.doi.org/10.1093/jamiaopen/ooaf005 | DOI Listing |
Clin Orthop Relat Res
August 2025
Complex Joint Reconstruction Center, Hospital for Special Surgery, New York, NY, USA.
Background: Choosing the appropriate implants for reconstruction in revision TKA is essential for long-term fixation. While cones and augments are routinely utilized to address tibial defects, the effect of augment location and size on the biomechanical stability of revision TKA constructs and the indications for the use of metaphyseal cones are not known.
Questions/purposes: Is the risk of cement-implant debonding of revision TKA constructs impacted by the thickness and location (medial versus bicompartmental) of tibial augments and the presence of metaphyseal cones during (1) a demanding daily activity like stair ascent and (2) torsional loads?
Methods: Under institutional review board approval, we developed patient-specific finite-element models of revision TKA from four patients (three males and one female, ages 50 to 80 years, BMI 27 to 37 kg/m2) who underwent two-stage revision and had a CT scan with no metal artifact after first-stage implant removal.
PLoS Comput Biol
September 2025
Department of Genome Sciences, University of Washington, Seattle, Washington, United States of America.
Fanconi Anemia (FA) is a heritable syndrome characterized by DNA damage repair deficits, frequent malformations and a significantly elevated risk of bone marrow failure, leukemia, and mucosal head and neck squamous cell carcinomas (HNSCC). Hematopoietic stem cell gene therapy can prevent marrow failure and lower leukemia risk, but mucosal gene therapy to lower HNSCC risk remains untested. Major knowledge gaps include an incomplete understanding of how rapidly gene-corrected cellular lineages could spread through the oral epithelium, and which delivery parameters are critical for ensuring efficient gene correction.
View Article and Find Full Text PDFClin Orthop Relat Res
September 2025
Leni & Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Background: Peripheral nerve injury commonly results in pain and long-term disability for patients. Recovery after in-continuity stretch or crush injury remains inherently unpredictable. However, surgical intervention yields the most favorable outcomes when performed shortly after injury.
View Article and Find Full Text PDFHum Reprod Open
August 2025
Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Study Question: Do social determinants of health (SDoH) influence the age at menopause among women?
Summary Answer: In our study, adverse SDoH, particularly family low income-to-poverty ratio (PIR), low education level, and the marital status of being widowed, are associated with earlier age at menopause.
What Is Known Already: Some prior studies have considered certain SDoH variables (such as educational attainment and marital status) as potential factors influencing age at menopause, but systematic evidence clearly defining the relationship between multidimensional SDoH and menopausal age remains lacking.
Study Design Size Duration: This cross-sectional analysis included 6083 naturally menopausal women from 10 cycles (1999-2018) of the United States National Health and Nutrition Examination Survey (NHANES) and excluded cases of surgical menopause.
J Reprod Infant Psychol
September 2025
Center for Research in Neuropsychology & Cognitive & Behavioral Intervention, Universidade de Coimbra, Coimbra, Portugal.
Aims/background: Parents of multiples (twins, triplets+) have elevated postpartum mental health risks. About half of such parents desire postpartum mental health treatment, but only a minority receive care. We examined the feasibility and acceptability of - a self-guided web-based postpartum mental health intervention - in mothers of multiples (MoMs).
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