Lise Barnéoud's Hidden Guests shows how this fascinating new field brings with it profound implications for medicine, and even what it means to be human, finds Helen Thomson "We are composed not only of human cells and microbes but also fragments of others " My children were conceived using donated eggs, so you would be forgiven for assuming we share no genetic material. Yet science has proved this isn't entirely true. We now know that during pregnancy, fetal cells cross the placenta into the mother, embedding themselves in every organ yet studied. Likewise, maternal cells, and even those that crossed from my mum to me, can make their way into my kids. And things might get even more chimeric - I have older sisters, so their cells, having passed into my mum during their own gestation, might have then found their way into me and, in turn, into my kids.

Widespread stigma, both in the offline and online spaces, acts as a barrier to harm reduction efforts in the context of opioid use disorder (OUD). This stigma is prominently directed towards clinically approved medications for addiction treatment (MAT), people with the condition, and the condition itself. Given the potential of artificial intelligence based technologies in promoting health equity, and facilitating empathic conversations, this work examines whether large language models (LLMs) can help abate OUD-related stigma in online communities. To answer this, we conducted a series of pre-registered randomized controlled experiments, where participants read LLM-generated, human-written, or no responses to help seeking OUD-related content in online communities. The experiment was conducted under two setups, i.e., participants read the responses either once (N = 2,141), or repeatedly for 14 days (N = 107). We found that participants reported the least stigmatized attitudes toward MAT after consuming LLM-generated responses under both the setups. This study offers insights into strategies that can foster inclusive online discourse on OUD, e.g., based on our findings LLMs can be used as an education-based intervention to promote positive attitudes and increase people's propensity toward MAT.

Opioid use disorder (OUD) is a leading health problem that affects individual well-being as well as general public health. Due to a variety of reasons, including the stigma faced by people using opioids, online communities for recovery and support were formed on different social media platforms. In these communities, people share their experiences and solicit information by asking questions to learn about opioid use and recovery. However, these communities do not always contain clinically verified information. In this paper, we study natural language questions asked in the context of OUD-related discourse on Reddit. We adopt transformer-based question detection along with hierarchical clustering across 19 subreddits to identify six coarse-grained categories and 69 fine-grained categories of OUD-related questions. Our analysis uncovers ten areas of information seeking from Reddit users in the context of OUD: drug sales, specific drug-related questions, OUD treatment, drug uses, side effects, withdrawal, lifestyle, drug testing, pain management and others, during the study period of 2018-2021. Our work provides a major step in improving the understanding of OUD-related questions people ask unobtrusively on Reddit. We finally discuss technological interventions and public health harm reduction techniques based on the topics of these questions.

Understanding the neurobiology of opioid use disorder (OUD) using resting-state functional magnetic resonance imaging (rs-fMRI) may help inform treatment strategies to improve patient outcomes. Recent literature suggests temporal characteristics of rs-fMRI blood oxygenation level-dependent (BOLD) signals may offer complementary information to functional connectivity analysis. However, existing studies of OUD analyze BOLD signals using measures computed across all time points. This study, for the first time in the literature, employs data-driven machine learning (ML) modeling of rs-fMRI BOLD features representing multiple time points to identify region(s) of interest that differentiate OUD subjects from healthy controls (HC). Following the triple network model, we obtain rs-fMRI BOLD features from the default mode network (DMN), salience network (SN), and executive control network (ECN) for 31 OUD and 45 HC subjects. Then, we use the Boruta ML algorithm to identify statistically significant BOLD features that differentiate OUD from HC, identifying the DMN as the most salient functional network for OUD. Furthermore, we conduct brain activity mapping, showing heightened neural activity within the DMN for OUD. We perform 5-fold cross-validation classification (OUD vs. HC) experiments to study the discriminative power of functional network features with and without fusing demographic features. The DMN shows the most discriminative power, achieving mean AUC and F1 scores of 80.91% and 73.97%, respectively, when fusing BOLD and demographic features. Follow-up Boruta analysis using BOLD features extracted from the medial prefrontal cortex, posterior cingulate cortex, and left and right temporoparietal junctions reveals significant features for all four functional hubs within the DMN.

The United States is experiencing an opioid epidemic, and there were more than 10 million opioid misusers aged 12 or older each year. Identifying patients at high risk of Opioid Use Disorder (OUD) can help to make early clinical interventions to reduce the risk of OUD. Our goal is to predict OUD patients among opioid prescription users through analyzing electronic health records with machine learning and deep learning methods. This will help us to better understand the diagnoses of OUD, providing new insights on opioid epidemic. Electronic health records of patients who have been prescribed with medications containing active opioid ingredients were extracted from Cerner Health Facts database between January 1, 2008 and December 31, 2017. Long Short-Term Memory (LSTM) models were applied to predict opioid use disorder risk in the future based on recent five encounters, and compared to Logistic Regression, Random Forest, Decision Tree and Dense Neural Network. Prediction performance was assessed using F-1 score, precision, recall, and AUROC. Our temporal deep learning model provided promising prediction results which outperformed other methods, with a F1 score of 0.8023 and AUCROC of 0.9369. The model can identify OUD related medications and vital signs as important features for the prediction. LSTM based temporal deep learning model is effective on predicting opioid use disorder using a patient past history of electronic health records, with minimal domain knowledge. It has potential to improve clinical decision support for early intervention and prevention to combat the opioid epidemic.

The opioid epidemic in the United States claims over 40,000 lives per year, and it is estimated that well over two million Americans have an opioid use disorder. Over-prescription and misuse of prescription opioids play an important role in the epidemic. Individuals who are prescribed opioids, and who are diagnosed with opioid use disorder, have diverse underlying health states. Policy interventions targeting prescription opioid use, opioid use disorder, and overdose often fail to account for this variation. To identify latent health states, or phenotypes, pertinent to opioid use and opioid use disorders, we use probabilistic topic modeling with medical diagnosis histories from a statewide population of individuals who were prescribed opioids. We demonstrate that our learned phenotypes are predictive of future opioid use-related outcomes. In addition, we show how the learned phenotypes can provide important context for variability in opioid prescriptions. Understanding the heterogeneity in individual health states and in prescription opioid use can help identify policy interventions to address this public health crisis.