{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:12:53Z","timestamp":1789053173154,"version":"build-2803163510"},"reference-count":89,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":51,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"National Key Research and Development Program of China","award":["2024YFB3909003"],"award-info":[{"award-number":["2024YFB3909003"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["42201448"],"award-info":[{"award-number":["42201448"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82473689"],"award-info":[{"award-number":["82473689"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mpox epidemiology has expanded from endemic zoonotic spillover to sustained human-to-human transmission. While behavioral risk factors have been well recognized, how macro-level correlates of mpox burden vary across epidemic phases remains insufficiently quantified, limiting targeted public health responses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using World Health Organization (WHO) global daily mpox surveillance data from January 1, 2022 to April 30, 2025, we calculated country-period reported mpox incidence and developed a phase-sensitive analytical framework integrating multi-domain macro-level variables across distinct epidemic phases. Five ensemble machine learning models (eXtreme Gradient Boosting, Gradient Boosting Decision Tree, Light Gradient Boosting Machine, Random Forest, Categorical Boosting) were optimized, and their outputs were interpreted using SHapley Additive exPlanations (SHAP) values to identify the changing correlates of mpox burden across phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Reported mpox incidence exhibited four temporal-epidemiological phases, comprising localized sporadic emergence, accelerated global spread, sustained dissemination, and region-specific resurgence. SHAP-based interpretation revealed a phase-dependent shift in model-associated correlates, from behavioral factors in earlier phases, such as close-contact networks and population mobility, to later structural vulnerability indicators related to socioeconomic disparities and health-system capacity. The LGBT+ (lesbian, gay, bisexual, transgender, and other sexual and gender minorities) Legal Index was the strongest overall predictor, accounting for 13.5% of the overall SHAP importance. Its association with reported mpox incidence was context-dependent, with positive contributions occurring in legally inclusive settings and negative contributions observed in restrictive settings, a pattern consistent with differential case ascertainment and reporting visibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our findings highlight a transition from behavioral to structural indicators in global mpox burden, uncovering phase-specific and geographic heterogeneity. These results support phase-tailored interventions that combine early targeted prevention with later health-system strengthening, equitable surveillance, community support, and stigma reduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12916-026-05068-4","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:15:21Z","timestamp":1784632521000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From behavioral to structural correlates: a multi-phase analysis of global reported mpox"],"prefix":"10.1186","volume":"24","author":[{"given":"Li","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengna","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenfan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuetong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqin","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengyan","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinzhan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junze","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijie","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqun","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"5068_CR1","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1016\/S1473-3099(19)30294-4","volume":"19","author":"A Yinka-Ogunleye","year":"2019","unstructured":"Yinka-Ogunleye A, Aruna O, Dalhat M, Ogoina D, McCollum A, Disu Y, et al. Outbreak of human monkeypox in Nigeria in 2017\u201318: a clinical and epidemiological report. Lancet Infect Dis. 2019;19:872\u20139.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR2","first-page":"593","volume":"46","author":"P Ziegler","year":"1972","unstructured":"Ziegler P, Kima E. A human infection caused by monkeypox virus in Basankusu Territory, Democratic Republic of the Congo. Bull World Health Organ. 1972;46:593\u20137.","journal-title":"Bull World Health Organ"},{"key":"5068_CR3","doi-asserted-by":"publisher","first-page":"241","DOI":"10.3389\/fpubh.2018.00241","volume":"6","author":"N Sklenovsk\u00e1","year":"2018","unstructured":"Sklenovsk\u00e1 N, Van Ranst M. Emergence of monkeypox as the most important Orthopoxvirus infection in humans. Front Public Health. 2018;6:241.","journal-title":"Front Public Health"},{"key":"5068_CR4","doi-asserted-by":"publisher","first-page":"e0009222","DOI":"10.1128\/cmr.00092-22","volume":"35","author":"S Elsayed","year":"2022","unstructured":"Elsayed S, Bondy L, Hanage WP. Monkeypox virus infections in humans. Clin Microbiol Rev. 2022;35:e0009222.","journal-title":"Clin Microbiol Rev"},{"key":"5068_CR5","doi-asserted-by":"publisher","first-page":"2457","DOI":"10.1186\/s12889-024-19058-9","volume":"24","author":"A Izzoddeen","year":"2024","unstructured":"Izzoddeen A, Elbadri O, Nageeb Abdalla M, Magbol M, Osman M. Monkeypox pandemic in sudan, surveillance epidemiologic report, 2022. BMC Public Health. 2024;24:2457.","journal-title":"BMC Public Health"},{"key":"5068_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.cytogfr.2022.10.002","volume":"68","author":"H Li","year":"2022","unstructured":"Li H, Zhang H, Ding K, Wang X-H, Sun G-Y, Liu Z-X, et al. The evolving epidemiology of monkeypox virus. Cytokine Growth Factor Rev. 2022;68:1\u201312.","journal-title":"Cytokine Growth Factor Rev"},{"key":"5068_CR7","unstructured":"Monkeypox - United Kingdom of Great Britain and Northern Ireland. World Health Organization. 2022. https:\/\/www.who.int\/emergencies\/disease-outbreak-news\/item\/2022-DON381. Accessed 23 Dec 2024."},{"key":"5068_CR8","unstructured":"WHO Director-General declares the ongoing monkeypox outbreak a Public Health Emergency of International Concern. WHO. 2022. https:\/\/www.who.int\/europe\/news\/item\/23-07-2022-who-director-general-declares-the-ongoing-monkeypox-outbreak-a-public-health-event-of-international-concern. Accessed 22 May 2025."},{"key":"5068_CR9","unstructured":"WHO Director-General declares mpox outbreak a public health emergency of international concern. WHO. 2024. https:\/\/www.who.int\/news\/item\/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern. Accessed 22 May 2025."},{"key":"5068_CR10","doi-asserted-by":"publisher","first-page":"e1012","DOI":"10.1016\/S2214-109X(23)00198-5","volume":"11","author":"H Laurenson-Schafer","year":"2023","unstructured":"Laurenson-Schafer H, Sklenovsk\u00e1 N, Hoxha A, Kerr SM, Ndumbi P, Fitzner J, et al. Description of the first global outbreak of mpox: an analysis of global surveillance data. Lancet Glob Health. 2023;11:e1012\u201323.","journal-title":"Lancet Glob Health"},{"key":"5068_CR11","doi-asserted-by":"publisher","first-page":"1408","DOI":"10.1038\/s41564-024-01690-1","volume":"9","author":"B Moss","year":"2024","unstructured":"Moss B. Understanding the biology of monkeypox virus to prevent future outbreaks. Nat Microbiol. 2024;9:1408\u201316.","journal-title":"Nat Microbiol"},{"key":"5068_CR12","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1016\/S1473-3099(22)00651-X","volume":"23","author":"KM Angelo","year":"2023","unstructured":"Angelo KM, Smith T, Camprub\u00ed-Ferrer D, Balerdi-Sarasola L, D\u00edaz Men\u00e9ndez M, Servera-Negre G, et al. Epidemiological and clinical characteristics of patients with monkeypox in the GeoSentinel Network: a cross-sectional study. Lancet Infect Dis. 2023;23:196\u2013206.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR13","doi-asserted-by":"publisher","first-page":"e28701","DOI":"10.1002\/jmv.28701","volume":"95","author":"D Aden","year":"2023","unstructured":"Aden D, Zaheer S, Kumar R, Ranga S. Monkeypox (Mpox) outbreak during COVID-19 pandemic-Past and the future. J Med Virol. 2023;95:e28701.","journal-title":"J Med Virol"},{"key":"5068_CR14","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/OLQ.0000000000002078","volume":"52","author":"GA Orta Portillo","year":"2025","unstructured":"Orta Portillo GA, Stafylis C, Tapia Y, Klausner JD. Group sex and behavior change associated with the 2022 mpox outbreak among men who have sex with men in Southern California. Sex Transm Dis. 2025;52:55\u20138.","journal-title":"Sex Transm Dis"},{"key":"5068_CR15","doi-asserted-by":"publisher","first-page":"1029215","DOI":"10.3389\/fpubh.2023.1029215","volume":"11","author":"SA Meo","year":"2023","unstructured":"Meo SA, Al-Khlaiwi T, Al Jassir FF, Meo AS. Impact of traveling on transmission trends of human monkeypox disease: worldwide data based observational analysis. Front Public Health. 2023;11:1029215.","journal-title":"Front Public Health"},{"key":"5068_CR16","doi-asserted-by":"crossref","unstructured":"Costello V, Sowash M, Gaur A, Cardis M, Pasieka H, Wortmann G et al. Imported monkeypox from international traveler, Maryland, USA, 2021. Emerg Infect Dis. 2022;28:1002\u20135.","DOI":"10.3201\/eid2805.220292"},{"key":"5068_CR17","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.jiph.2023.02.006","volume":"16","author":"Q Huang","year":"2023","unstructured":"Huang Q, Sun Y, Jia M, Jiang M, Zhang T, Xu Y, et al. Risk assessment for cross-border transmission of multi-country Mpox outbreaks in 2022. J Infect Public Health. 2023;16:618\u201325.","journal-title":"J Infect Public Health"},{"key":"5068_CR18","doi-asserted-by":"publisher","first-page":"e619","DOI":"10.1016\/S1473-3099(24)00592-9","volume":"24","author":"E Nakkazi","year":"2024","unstructured":"Nakkazi E. Mpox emergency in Africa. Lancet Infect Dis. 2024;24:e619.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR19","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s11908-023-00812-w","volume":"25","author":"S Barkati","year":"2023","unstructured":"Barkati S, Harrison LB, Klein MB, Norman FF. Mpox in 2023: current epidemiology and management. Curr Infect Dis Rep. 2023;25:199\u2013209.","journal-title":"Curr Infect Dis Rep"},{"key":"5068_CR20","first-page":"805","volume":"9","author":"Q Huang","year":"2024","unstructured":"Huang Q, Sun Y, Jia M, Jiang M, Xu Y, Feng L, et al. An effectiveness study of vaccination and quarantine combination strategies for containing mpox transmission on simulated college campuses. Infect Dis Model. 2024;9:805\u201315.","journal-title":"Infect Dis Model"},{"key":"5068_CR21","doi-asserted-by":"publisher","first-page":"7112","DOI":"10.1038\/s41467-024-51143-w","volume":"15","author":"YD Jeong","year":"2024","unstructured":"Jeong YD, Hart WS, Thompson RN, Ishikane M, Nishiyama T, Park H, et al. Modelling the effectiveness of an isolation strategy for managing mpox outbreaks with variable infectiousness profiles. Nat Commun. 2024;15:7112.","journal-title":"Nat Commun"},{"key":"5068_CR22","doi-asserted-by":"publisher","first-page":"4100","DOI":"10.1038\/s41467-023-38816-8","volume":"14","author":"SPC Brand","year":"2023","unstructured":"Brand SPC, Cavallaro M, Cumming F, Turner C, Florence I, Blomquist P, et al. The role of vaccination and public awareness in forecasts of Mpox incidence in the United Kingdom. Nat Commun. 2023;14:4100.","journal-title":"Nat Commun"},{"key":"5068_CR23","doi-asserted-by":"publisher","first-page":"2179","DOI":"10.1016\/S0140-6736(25)01284-X","volume":"405","author":"The Lancet","year":"2025","unstructured":"The Lancet. The mpox response: African leadership, global responsibility. Lancet. 2025;405:2179.","journal-title":"Lancet"},{"key":"5068_CR24","unstructured":"Global Mpox Trends. World Health Organization. 2025. https:\/\/worldhealthorg.shinyapps.io\/mpx_global\/. Accessed 22 May 2025."},{"key":"5068_CR25","doi-asserted-by":"publisher","first-page":"04037","DOI":"10.7189\/jogh.14.04037","volume":"14","author":"M Lin","year":"2024","unstructured":"Lin M, Xin Y, Wang J, Nie P, Yan Q, Wang L, et al. Analysing monkeypox epidemic drivers: Policy simulation and multi-index modelling across 39 nations. J Glob Health. 2024;14:04037.","journal-title":"J Glob Health"},{"key":"5068_CR26","unstructured":"World Population Prospects. 2024. United Nations, Department of Economic and Social Affairs, Population Division. 2024. https:\/\/population.un.org\/wpp\/. Accessed 28 Nov 2024."},{"key":"5068_CR27","unstructured":"UNAIDS Key Populations Atlas. Joint United Nations Programme on HIV\/AIDS. 2025. https:\/\/aidsinfo.unaids.org\/kpatlas. Accessed 28 Feb 2025."},{"key":"5068_CR28","unstructured":"World Development Indicators. The World Bank. 2024. https:\/\/datacatalog.worldbank.org\/search\/dataset\/0037712\/world-development-indicators. Accessed 28 Nov 2024."},{"key":"5068_CR29","unstructured":"LGBT Equality Index. Equaldex. 2025. https:\/\/www.equaldex.com\/equality-index. Accessed 12 Feb 2025."},{"key":"5068_CR30","unstructured":"Human Development Reports, Gender Development Index. United Nations Development Programme (UNDP). 2024. https:\/\/hdr.undp.org\/data-center\/documentation-and-downloads. Accessed 28 Dec 2024."},{"key":"5068_CR31","unstructured":"Share of the population with tertiary education. Our World in Data. 2023. https:\/\/ourworldindata.org\/grapher\/share-of-the-population-with-completed-tertiary-education. Accessed 28 Nov 2024."},{"key":"5068_CR32","unstructured":"Average years of schooling. Our World in Data. 2023. https:\/\/ourworldindata.org\/grapher\/mean-years-of-schooling-long-run. Accessed 28 Nov 2024."},{"key":"5068_CR33","unstructured":"Current health expenditure (CHE) as percentage of gross domestic product (GDP) (%). World Health Organization, Global Health Observatory. 2023. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/current-health-expenditure-(che)-as-percentage-of-gross-domestic-product-(gdp)-(-). Accessed 28 Nov 2024."},{"key":"5068_CR34","unstructured":"Domestic general government health expenditure (GGHE-D) as percentage of general government expenditure (GGE) (%). World Health Organization, Global Health Observatory. 2023. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/domestic-general-government-health-expenditure-(gghe-d)-as-percentage-of-general-government-expenditure-(gge). Accessed 28 Nov 2024."},{"key":"5068_CR35","unstructured":"UHC Service Coverage Index (SDG 3.8.1). World Health Organization, Global Health Observatory. 2023. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/uhc-index-of-service-coverage. Accessed 28 Nov 2024."},{"key":"5068_CR36","unstructured":"International Health Regulations. (2005) SPAR second edition (IHR SPAR 2021-). World Health Organization, Global Health Observatory. 2023. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/sdgihr2021. Accessed 28 Nov 2024."},{"key":"5068_CR37","unstructured":"GBD Results. Institute for Health Metrics and Evaluation (IHME). 2021. https:\/\/vizhub.healthdata.org\/gbd-results. Accessed 28 Nov 2024."},{"key":"5068_CR38","unstructured":"COVID-19 Pandemic. Our World in Data. 2020. https:\/\/ourworldindata.org\/coronavirus. Accessed 28 Feb 2025."},{"key":"5068_CR39","unstructured":"Death rate in armed conflicts based on where they occurred. Our World in Data. 2022. https:\/\/ourworldindata.org\/grapher\/death-rate-in-armed-conflicts. Accessed 28 Nov 2024."},{"key":"5068_CR40","unstructured":"Tourism Statistics - Inbound Tourism. World Tourism Organization (UNWTO). 2022. https:\/\/www.untourism.int\/tourism-statistics\/tourism-data-inbound-tourism. Accessed 28 Nov 2024."},{"key":"5068_CR41","doi-asserted-by":"publisher","first-page":"064006","DOI":"10.1088\/1748-9326\/aabd42","volume":"13","author":"JR Meijer","year":"2018","unstructured":"Meijer JR, Huijbregts MAJ, Schotten KCGJ, Schipper AM. Global patterns of current and future road infrastructure. Environ Res Lett. 2018;13:064006.","journal-title":"Environ Res Lett"},{"key":"5068_CR42","doi-asserted-by":"publisher","DOI":"10.24381\/cds.f17050d7","author":"Copernicus Climate Change Service","year":"2023","unstructured":"Copernicus Climate Change Service. ERA5 monthly averaged data on single levels from 1940 to present. Copernicus Clim Change Service (C3S) Clim Data Store (CDS). 2023. https:\/\/doi.org\/10.24381\/cds.f17050d7. Accessed 28 Apr 2025.","journal-title":"Copernicus Clim Change Service (C3S) Clim Data Store (CDS)"},{"key":"5068_CR43","unstructured":"Global SDG, Indicators Database. United Nations Statistics Division, Department of Economic and Social Affairs. https:\/\/unstats.un.org\/sdgs\/dataportal. Accessed 28 Nov 2024."},{"key":"5068_CR44","unstructured":"WHO\/UNICEF JMP Global Database on Household Drinking Water. Sanitation and Hygiene, 2000\u20132022. World Health Organization and United Nations Children\u2019s Fund. https:\/\/washdata.org\/data\/household. Accessed 28 Nov 2024."},{"key":"5068_CR45","doi-asserted-by":"publisher","first-page":"101916","DOI":"10.1016\/j.uclim.2024.101916","volume":"55","author":"H Yang","year":"2024","unstructured":"Yang H, Wang W, Li G. Multi-factor PM2.5 concentration optimization prediction model based on decomposition and integration. Urban Clim. 2024;55:101916.","journal-title":"Urban Clim"},{"key":"5068_CR46","doi-asserted-by":"publisher","first-page":"108173","DOI":"10.1016\/j.ecolind.2021.108173","volume":"131","author":"B Fu","year":"2021","unstructured":"Fu B, Xie S, He H, Zuo P, Sun J, Liu L, et al. Synergy of multi-temporal polarimetric SAR and optical image satellite for mapping of marsh vegetation using object-based random forest algorithm. Ecol Indic. 2021;131:108173.","journal-title":"Ecol Indic"},{"key":"5068_CR47","doi-asserted-by":"publisher","first-page":"106897","DOI":"10.1016\/j.catena.2022.106897","volume":"223","author":"H Xing","year":"2023","unstructured":"Xing H, Niu J, Feng Y, Hou D, Wang Y, Wang Z. A coastal wetlands mapping approach of yellow river delta with a hierarchical classification and optimal feature selection framework. CATENA. 2023;223:106897.","journal-title":"CATENA"},{"key":"5068_CR48","doi-asserted-by":"publisher","first-page":"105785","DOI":"10.1016\/j.scs.2024.105785","volume":"115","author":"J Boudreault","year":"2024","unstructured":"Boudreault J, Ruf A, Campagna C, Chebana F. Multi-region models built with machine and deep learning for predicting several heat-related health outcomes. Sustain Cities Soc. 2024;115:105785.","journal-title":"Sustain Cities Soc"},{"key":"5068_CR49","doi-asserted-by":"publisher","first-page":"105742","DOI":"10.1016\/j.scs.2024.105742","volume":"114","author":"X Zhang","year":"2024","unstructured":"Zhang X, Zhu Y, Gan W, Zou Y, Wu Z. Mapping heterogeneity: Spatially explicit machine learning approaches for urban value uplift characterisation and prediction. Sustain Cities Soc. 2024;114:105742.","journal-title":"Sustain Cities Soc"},{"key":"5068_CR50","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1007\/s10462-020-09896-5","volume":"54","author":"C Bent\u00e9jac","year":"2021","unstructured":"Bent\u00e9jac C, Cs\u00f6rg\u0151 A, Mart\u00ednez-Mu\u00f1oz G. A comparative analysis of gradient boosting algorithms. Artif Intell Rev. 2021;54:1937\u201367.","journal-title":"Artif Intell Rev"},{"key":"5068_CR51","doi-asserted-by":"crossref","unstructured":"Chen T, Guestrin C. XGBoost: a scalable tree boosting system. In: Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining. New York: Association for Computing Machinery; 2016. pp. 785\u201394.","DOI":"10.1145\/2939672.2939785"},{"key":"5068_CR52","unstructured":"Ke G, Meng Q, Finley T, Wang T, Chen W, Ma W et al. LightGBM: a highly efficient gradient boosting decision tree. In: Proceedings of the 31st International Conference on Neural Information Processing Systems. Red Hook: Curran Associates Inc.; 2017. pp. 3149\u201357."},{"key":"5068_CR53","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1023\/A:1010933404324","volume":"45","author":"L Breiman","year":"2001","unstructured":"Breiman L. Random forests. Mach Learn. 2001;45:5\u201332.","journal-title":"Mach Learn"},{"key":"5068_CR54","unstructured":"Prokhorenkova L, Gusev G, Vorobev A, Dorogush AV, Gulin A. CatBoost: unbiased boosting with categorical features. In: Proceedings of the 32nd International Conference on Neural Information Processing Systems. Red Hook: Curran Associates Inc.; 2018. pp. 6639\u201349."},{"key":"5068_CR55","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1038\/s42256-019-0138-9","volume":"2","author":"SM Lundberg","year":"2020","unstructured":"Lundberg SM, Erion G, Chen H, DeGrave A, Prutkin JM, Nair B, et al. From local explanations to global understanding with explainable AI for trees. Nat Mach Intell. 2020;2:56\u201367.","journal-title":"Nat Mach Intell"},{"key":"5068_CR56","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1007\/s10115-013-0679-x","volume":"41","author":"E \u0160trumbelj","year":"2014","unstructured":"\u0160trumbelj E, Kononenko I. Explaining prediction models and individual predictions with feature contributions. Knowl Inf Syst. 2014;41:647\u201365.","journal-title":"Knowl Inf Syst"},{"key":"5068_CR57","unstructured":"Lundberg SM, Lee S-I. A unified approach to interpreting model predictions. In: Proceedings of the 31st International Conference on Neural Information Processing Systems. Red Hook: Curran Associates Inc.; 2017. pp. 4768\u201377."},{"key":"5068_CR58","doi-asserted-by":"crossref","unstructured":"Ribeiro MT, Singh S, Guestrin C. Why should I trust you? explaining the predictions of any classifier. In: Proceedings of the 22nd ACM SIGKDD International Conference on Knowledge Discovery and Data Mining. New York: Association for Computing Machinery; 2016. pp. 1135\u201344.","DOI":"10.1145\/2939672.2939778"},{"key":"5068_CR59","doi-asserted-by":"publisher","first-page":"101845","DOI":"10.1016\/j.compenvurbsys.2022.101845","volume":"96","author":"Z Li","year":"2022","unstructured":"Li Z. Extracting spatial effects from machine learning model using local interpretation method: An example of SHAP and XGBoost. Comput Environ Urban. 2022;96:101845.","journal-title":"Comput Environ Urban"},{"key":"5068_CR60","doi-asserted-by":"publisher","first-page":"e1577","DOI":"10.1016\/S2214-109X(24)00363-2","volume":"12","author":"N Ndembi","year":"2024","unstructured":"Ndembi N, Folayan MO, Ngongo N, Ntoumi F, Ogoina D, Rabbat ME, et al. Mpox outbreaks in Africa constitute a public health emergency of continental security. Lancet Glob Health. 2024;12:e1577\u20139.","journal-title":"Lancet Glob Health"},{"key":"5068_CR61","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1016\/S1473-3099(24)00577-2","volume":"24","author":"K Kuppalli","year":"2024","unstructured":"Kuppalli K, Dunning J, Damon I, Mukadi-Bamuleka D, Mbala P, Ogoina D. The worsening mpox outbreak in Africa: a call to action. Lancet Infect Dis. 2024;24:1190\u20132.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR62","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1186\/s12916-024-03515-8","volume":"22","author":"M Chaturvedi","year":"2024","unstructured":"Chaturvedi M, Rodiah I, Kretzschmar M, Scholz S, Lange B, Karch A, et al. Estimating the relative importance of epidemiological and behavioural parameters for epidemic mpox transmission: a modelling study. BMC Med. 2024;22:297.","journal-title":"BMC Med"},{"key":"5068_CR63","doi-asserted-by":"publisher","first-page":"1516","DOI":"10.3201\/eid3108.241551","volume":"31","author":"PS Satheshkumar","year":"2025","unstructured":"Satheshkumar PS, Gigante CM, Mbala-Kingebeni P, Nakazawa Y, Anderson M, Balinandi S, et al. Emergence of clade Ib monkeypox virus: current state of evidence. Emerg Infect Dis. 2025;31:1516\u201325.","journal-title":"Emerg Infect Dis"},{"key":"5068_CR64","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1016\/S1473-3099(22)00379-6","volume":"22","author":"P Venkatesan","year":"2022","unstructured":"Venkatesan P. Global monkeypox outbreak. Lancet Infect Dis. 2022;22:950.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR65","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1016\/S0140-6736(23)00588-3","volume":"401","author":"I Adetifa","year":"2023","unstructured":"Adetifa I, Muyembe J-J, Bausch DG, Heymann DL. Mpox neglect and the smallpox niche: a problem for Africa, a problem for the world. Lancet. 2023;401:1822\u20134.","journal-title":"Lancet"},{"key":"5068_CR66","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1016\/S0140-6736(22)01101-1","volume":"399","author":"D Pan","year":"2022","unstructured":"Pan D, Sze S, Nazareth J, Martin CA, Al-Oraibi A, Baggaley RF, et al. Monkeypox in the UK: Arguments for a broader case definition. Lancet. 2022;399:2345\u20136.","journal-title":"Lancet"},{"key":"5068_CR67","doi-asserted-by":"publisher","first-page":"2200620","DOI":"10.2807\/1560-7917.ES.2022.27.36.2200620","volume":"27","author":"AM Vaughan","year":"2022","unstructured":"Vaughan AM, Cenciarelli O, Colombe S, de Sousa LA, Fischer N, Gossner CM, et al. A large multi-country outbreak of monkeypox across 41 countries in the WHO European Region, 7 March to 23 August 2022. Euro Surveill. 2022;27:2200620.","journal-title":"Euro Surveill"},{"key":"5068_CR68","doi-asserted-by":"publisher","first-page":"666","DOI":"10.1056\/NEJMoa2411368","volume":"392","author":"N Ndembi","year":"2025","unstructured":"Ndembi N, Folayan MO, Komakech A, Mercy K, Tessema S, Mbala-Kingebeni P, et al. Evolving epidemiology of mpox in Africa in 2024. N Engl J Med. 2025;392:666\u201376.","journal-title":"N Engl J Med"},{"key":"5068_CR69","doi-asserted-by":"publisher","first-page":"100085","DOI":"10.1016\/j.soh.2024.100085","volume":"3","author":"DB Olawade","year":"2024","unstructured":"Olawade DB, Wada OZ, Fidelis SC, Oluwole OS, Alisi CS, Orimabuyaku NF, et al. Strengthening Africa\u2019s response to Mpox (monkeypox): insights from historical outbreaks and the present global spread. Sci One Health. 2024;3:100085.","journal-title":"Sci One Health"},{"key":"5068_CR70","doi-asserted-by":"publisher","first-page":"e495","DOI":"10.1016\/S1473-3099(25)00413-X","volume":"25","author":"CH Coelho","year":"2025","unstructured":"Coelho CH, de Vries RD, Lucas C, Zucker J. A call to move beyond MSM-centric framing in mpox research. Lancet Infect Dis. 2025;25:e495\u20136.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR71","doi-asserted-by":"publisher","first-page":"1045","DOI":"10.1001\/jama.2024.17829","volume":"332","author":"C Rivers","year":"2024","unstructured":"Rivers C, Watson C, Phelan AL. The resurgence of mpox in Africa. JAMA. 2024;332:1045\u20136.","journal-title":"JAMA"},{"key":"5068_CR72","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1016\/S0140-6736(22)02187-0","volume":"400","author":"JP Thornhill","year":"2022","unstructured":"Thornhill JP, Palich R, Ghosn J, Walmsley S, Moschese D, Cortes CP, et al. Human monkeypox virus infection in women and non-binary individuals during the 2022 outbreaks: a global case series. Lancet. 2022;400:1953\u201365.","journal-title":"Lancet"},{"key":"5068_CR73","doi-asserted-by":"publisher","first-page":"100536","DOI":"10.1016\/j.lanepe.2022.100536","volume":"23","author":"JW M\u00e4rz","year":"2022","unstructured":"M\u00e4rz JW, Holm S, Biller-Andorno N. Monkeypox, stigma and public health. Lancet Reg Health Eur. 2022;23:100536.","journal-title":"Lancet Reg Health Eur"},{"key":"5068_CR74","first-page":"68","volume":"39","author":"AJ Rodriguez-Morales","year":"2024","unstructured":"Rodriguez-Morales AJ, Bonilla-Aldana DK, Cardona-Ospina JA. Impact of the LGBT+ rights on reporting cases and deaths of Mpox globally: Relationships with the LGBT+ rights index during 2022\u20132024 epidemics. J Glob Antimicrob Resist. 2024;39:68.","journal-title":"J Glob Antimicrob Resist"},{"key":"5068_CR75","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.annepidem.2025.06.016","volume":"109","author":"C Jimenez-Castro","year":"2025","unstructured":"Jimenez-Castro C, Kelvin EA. Association between state LGBTQ+ equality and mpox vaccination rates during the 2022\u20132023 epidemic in the United States. Ann Epidemiol. 2025;109:14\u201321.","journal-title":"Ann Epidemiol"},{"key":"5068_CR76","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1071\/SH23047","volume":"20","author":"J MacGibbon","year":"2023","unstructured":"MacGibbon J, Cornelisse VJ, Smith AKJ, Broady TR, Hammoud MA, Bavinton BR, et al. Mpox (monkeypox) knowledge, concern, willingness to change behaviour, and seek vaccination: results of a national cross-sectional survey. Sex Health. 2023;20:403\u201310.","journal-title":"Sex Health"},{"key":"5068_CR77","doi-asserted-by":"publisher","first-page":"e070882","DOI":"10.1136\/bmjopen-2022-070882","volume":"13","author":"LE Smith","year":"2023","unstructured":"Smith LE, Potts HW, Brainard J, May T, Oliver I, Aml\u00f4t R, et al. Did mpox knowledge, attitudes and beliefs affect intended behaviour in the general population and men who are gay, bisexual and who have sex with men? An online cross-sectional survey in the UK. BMJ Open. 2023;13:e070882.","journal-title":"BMJ Open"},{"key":"5068_CR78","doi-asserted-by":"publisher","first-page":"2200757","DOI":"10.2807\/1560-7917.ES.2022.27.42.2200757","volume":"27","author":"J Reyes-Urue\u00f1a","year":"2022","unstructured":"Reyes-Urue\u00f1a J, D\u2019Ambrosio A, Croci R, Bluemel B, Cenciarelli O, Pharris A, et al. High monkeypox vaccine acceptance among male users of smartphone-based online gay-dating apps in Europe, 30 July to 12 August 2022. Euro Surveill. 2022;27:2200757.","journal-title":"Euro Surveill"},{"key":"5068_CR79","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s10900-024-01383-0","volume":"50","author":"KD Krause","year":"2025","unstructured":"Krause KD, Lewis K, Scrofani S, Guo TY, Goulbourne D, Halkitis PN. Health behaviors and experiences of LGBTQ+ individuals during the 2022 mpox outbreak: findings from the QVax study. J Community Health. 2025;50:45\u201355.","journal-title":"J Community Health"},{"key":"5068_CR80","doi-asserted-by":"publisher","first-page":"1567","DOI":"10.2105\/AJPH.2022.307093","volume":"112","author":"CE Rodriguez-Diaz","year":"2022","unstructured":"Rodriguez-Diaz CE, Crowley JS, Santiago-Rivera Y, Millett GA. From COVID-19 to monkeypox: unlearned lessons for Black, Latino, and other men with HIV who have sex with men. Am J Public Health. 2022;112:1567\u201371.","journal-title":"Am J Public Health"},{"key":"5068_CR81","doi-asserted-by":"publisher","first-page":"1638","DOI":"10.1186\/s12889-024-19176-4","volume":"24","author":"CP Biesty","year":"2024","unstructured":"Biesty CP, Hemingway C, Woolgar J, Taylor K, Lawton MD, Waheed MW, et al. Community led health promotion to counter stigma and increase trust amongst priority populations: lessons from the 2022\u20132023 UK mpox outbreak. BMC Public Health. 2024;24:1638.","journal-title":"BMC Public Health"},{"key":"5068_CR82","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1186\/s41256-025-00418-w","volume":"10","author":"Y Liu","year":"2025","unstructured":"Liu Y, Zhang J, Cai Y. Mpox-related stigma and healthcare-seeking behavior among men who have sex with men. Glob Health Res Policy. 2025;10:16.","journal-title":"Glob Health Res Policy"},{"key":"5068_CR83","doi-asserted-by":"publisher","first-page":"3176","DOI":"10.1186\/s12889-025-24416-2","volume":"25","author":"AE Boutzoukas","year":"2025","unstructured":"Boutzoukas AE, Serrano PA, Cortez A, Abbott-Grimes P, Thibault D, D\u2019Agostino EM, et al. Mpox epidemiology, barriers to treatment and prevention, and perceived stigma: a cross-sectional study. BMC Public Health. 2025;25:3176.","journal-title":"BMC Public Health"},{"key":"5068_CR84","doi-asserted-by":"publisher","first-page":"3689","DOI":"10.2147\/JMDH.S442296","volume":"16","author":"AM Halboup","year":"2023","unstructured":"Halboup AM, Alzoubi KH, Abu-Farha RK, Harun SN, Al-Mohamadi A, Battah MM, et al. Perceptions and knowledge of public towards emerging human monkeypox in Yemen: a cross-sectional study. J Multidiscip Healthc. 2023;16:3689\u2013701.","journal-title":"J Multidiscip Healthc"},{"key":"5068_CR85","doi-asserted-by":"publisher","first-page":"e017090","DOI":"10.1136\/bmjgh-2024-017090","volume":"9","author":"NA Evaborhene","year":"2024","unstructured":"Evaborhene NA, Oga JO, Adebayo YA, Runyowa N, Okorie CE, Nakanwagi G, et al. Caught between violence: Mpox virus and the perils of neglect in Africa. BMJ Glob Health. 2024;9:e017090.","journal-title":"BMJ Glob Health"},{"key":"5068_CR86","doi-asserted-by":"publisher","first-page":"e44","DOI":"10.1016\/S1473-3099(24)00594-2","volume":"25","author":"E Jonas","year":"2025","unstructured":"Jonas E, Hamraz N, Marcadieu N, Salomon D, Niyizonkiza D, Furin J, et al. A pox on all our houses: a missing component in the global mpox response is equity. Lancet Infect Dis. 2025;25:e44\u20136.","journal-title":"Lancet Infect Dis"},{"key":"5068_CR87","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/s41256-025-00408-y","volume":"10","author":"EH Vakaniaki","year":"2025","unstructured":"Vakaniaki EH, Merritt S, Linsuke S, Malembi E, Muyembe F, Lunyanga L, et al. Establishment of a regional Mpox surveillance network in Central Africa: shared experiences in an endemic region. Glob Health Res Policy. 2025;10:14.","journal-title":"Glob Health Res Policy"},{"key":"5068_CR88","doi-asserted-by":"publisher","first-page":"101232","DOI":"10.1016\/j.onehlt.2025.101232","volume":"21","author":"B Akhavan","year":"2025","unstructured":"Akhavan B, Ahmed A-B, To W, Alkhouri S, Batra K. From forest to frontline: A comprehensive review of Mpox\u2019s global leap and viral evolution (2022\u20132024). One Health. 2025;21:101232.","journal-title":"One Health"},{"key":"5068_CR89","doi-asserted-by":"publisher","first-page":"20230637","DOI":"10.1098\/rsif.2023.0637","volume":"21","author":"NL Bragazzi","year":"2024","unstructured":"Bragazzi NL, Iyaniwura SA, Han Q, Woldegerima WA, Kong JD. Quantifying the basic reproduction number and underestimated fraction of Mpox cases worldwide at the onset of the outbreak. J R Soc Interface. 2024;21:20230637.","journal-title":"J R Soc Interface"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12916-026-05068-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05068-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05068-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:03:13Z","timestamp":1789052593000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12916-026-05068-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":89,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5068"],"URL":"https:\/\/doi.org\/10.1186\/s12916-026-05068-4","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]},"assertion":[{"value":"9 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"As the study data are open access, consent for publication is not required.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"484"}}