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PLoS Medicine

Raphael J Landovitz, Sue Li, Beatriz Grinsztejn, Halima Dawood, Albert Y Liu, Manya Magnus, Mina C Hosseinipour, Ravindre Panchia, Leslie Cottle, Gordon Chau, Paul Richardson, Mark A Marzinke, Craig W Hendrix, Susan H Eshleman, Yinfeng Zhang, Elizabeth Tolley, Jeremy Sugarman, Ryan Kofron, Adeola Adeyeye, David Burns, Alex R Rinehart, David Margolis, William R Spreen, Myron S Cohen, Marybeth McCauley, Joseph J Eron
BACKGROUND: Cabotegravir (CAB) is a novel strand-transfer integrase inhibitor being developed for HIV treatment and prevention. CAB is formulated both as an immediate-release oral tablet for daily administration and as a long-acting injectable suspension (long-acting CAB [CAB LA]) for intramuscular (IM) administration, which delivers prolonged plasma exposure to the drug after IM injection. HIV Prevention Trials Network study 077 (HPTN 077) evaluated the safety, tolerability, and pharmacokinetics of CAB LA in HIV-uninfected males and females at 8 sites in Brazil, Malawi, South Africa, and the United States...
November 2018: PLoS Medicine
Kathleen A Alexander, Alexandra K Heaney, Jeffrey Shaman
BACKGROUND: The impacts of climate change on surface water, waterborne disease, and human health remain a growing area of concern, particularly in Africa, where diarrheal disease is one of the most important health threats to children under 5 years of age. Little is known about the role of surface water and annual flood dynamics (flood pulse) on waterborne disease and human health nor about the expected impact of climate change on surface-water-dependent populations. METHODS AND FINDINGS: Using the Chobe River in northern Botswana, a flood pulse river-floodplain system, we applied multimodel inference approaches assessing the influence of river height, water quality (bimonthly counts of Escherichia coli and total suspended solids [TSS], 2011-2017), and meteorological variability on weekly diarrheal case reports among children under 5 presenting to health facilities (n = 10 health facilities, January 2007-June 2017)...
November 2018: PLoS Medicine
John R Zech, Marcus A Badgeley, Manway Liu, Anthony B Costa, Joseph J Titano, Eric Karl Oermann
BACKGROUND: There is interest in using convolutional neural networks (CNNs) to analyze medical imaging to provide computer-aided diagnosis (CAD). Recent work has suggested that image classification CNNs may not generalize to new data as well as previously believed. We assessed how well CNNs generalized across three hospital systems for a simulated pneumonia screening task. METHODS AND FINDINGS: A cross-sectional design with multiple model training cohorts was used to evaluate model generalizability to external sites using split-sample validation...
November 2018: PLoS Medicine
Haotian Lin, Erping Long, Xiaohu Ding, Hongxing Diao, Zicong Chen, Runzhong Liu, Jialing Huang, Jingheng Cai, Shuangjuan Xu, Xiayin Zhang, Dongni Wang, Kexin Chen, Tongyong Yu, Dongxuan Wu, Xutu Zhao, Zhenzhen Liu, Xiaohang Wu, Yuzhen Jiang, Xiao Yang, Dongmei Cui, Wenyan Liu, Yingfeng Zheng, Lixia Luo, Haibo Wang, Chi-Chao Chan, Ian G Morgan, Mingguang He, Yizhi Liu
BACKGROUND: Electronic medical records provide large-scale real-world clinical data for use in developing clinical decision systems. However, sophisticated methodology and analytical skills are required to handle the large-scale datasets necessary for the optimisation of prediction accuracy. Myopia is a common cause of vision loss. Current approaches to control myopia progression are effective but have significant side effects. Therefore, identifying those at greatest risk who should undergo targeted therapy is of great clinical importance...
November 2018: PLoS Medicine
Effy Vayena, Alessandro Blasimme, I Glenn Cohen
Effy Vayena and colleagues argue that machine learning in medicine must offer data protection, algorithmic transparency, and accountability to earn the trust of patients and clinicians.
November 2018: PLoS Medicine
Marie Warny, Jens Helby, Børge Grønne Nordestgaard, Henrik Birgens, Stig Egil Bojesen
BACKGROUND: Neutropenia increases the risk of infection, but it is unknown if this also applies to lymphopenia. We therefore tested the hypotheses that lymphopenia is associated with increased risk of infection and infection-related death in the general population. METHODS AND FINDINGS: Of the invited 220,424 individuals, 99,191 attended examination. We analyzed 98,344 individuals from the Copenhagen General Population Study (Denmark), examined from November 25, 2003, to July 9, 2013, and with available blood lymphocyte count at date of examination...
November 2018: PLoS Medicine
Claudia P Cabrera, Joanna Manson, Joanna M Shepherd, Hew D Torrance, David Watson, M Paula Longhi, Mimoza Hoti, Minal B Patel, Michael O'Dwyer, Sussan Nourshargh, Daniel J Pennington, Michael R Barnes, Karim Brohi
[This corrects the article DOI: 10.1371/journal.pmed.1002352.].
October 2018: PLoS Medicine
Roy Burstein, Haidong Wang, Robert C Reiner, Simon I Hay
BACKGROUND: The addition of neonatal (NN) mortality targets in the Sustainable Development Goals highlights the increased need for age-specific quantification of mortality trends, detail that is not provided by summary birth histories (SBHs). Several methods exist to indirectly estimate trends in under-5 mortality from SBHs; however, efforts to monitor mortality trends in important age groups such as the first month and first year of life have yet to utilize the vast amount of SBH data available from household surveys and censuses...
October 2018: PLoS Medicine
Hannah H Leslie, Lisa R Hirschhorn, Tanya Marchant, Svetlana V Doubova, Oye Gureje, Margaret E Kruk
Hannah Leslie and colleagues of the High-Quality Health Commission discuss in an Editorial the findings from their report that detail the improvements needed to prevent declines in individuals' health as the scope and quality of health systems increase. Patient-centered care at the population level, improved utility of research products, and innovative reporting tools to help guide the development of new methods are key to improved global healthcare.
October 2018: PLoS Medicine
Delphina Gomes, Rüdiger von Kries, Maria Delius, Ulrich Mansmann, Martha Nast, Martina Stubert, Lena Langhammer, Nikolaus A Haas, Heinrich Netz, Viola Obermeier, Stefan Kuhle, Lesca M Holdt, Daniel Teupser, Uwe Hasbargen, Adelbert A Roscher, Regina Ensenauer
BACKGROUND: Maternal pre-conception obesity is a strong risk factor for childhood overweight. However, prenatal mechanisms and their effects in susceptible gestational periods that contribute to this risk are not well understood. We aimed to assess the impact of late-pregnancy dysglycemia in obese pregnancies with negative testing for gestational diabetes mellitus (GDM) on long-term mother-child outcomes. METHODS AND FINDINGS: The prospective cohort study Programming of Enhanced Adiposity Risk in Childhood-Early Screening (PEACHES) (n = 1,671) enrolled obese and normal weight mothers from August 2010 to December 2015 with trimester-specific data on glucose metabolism including GDM status at the end of the second trimester and maternal glycated hemoglobin (HbA1c) at delivery as a marker for late-pregnancy dysglycemia (HbA1c ≥ 5...
October 2018: PLoS Medicine
Carlos S Grijalva-Eternod, Mohamed Jelle, Hassan Haghparast-Bidgoli, Tim Colbourn, Kate Golden, Sarah King, Cassy L Cox, Joanna Morrison, Jolene Skordis-Worrall, Edward Fottrell, Andrew J Seal
BACKGROUND: Somalia has been affected by conflict since 1991, with children aged <5 years presenting a high acute malnutrition prevalence. Cash-based interventions (CBIs) have been used in this context since 2011, despite sparse evidence of their nutritional impact. We aimed to understand whether a CBI would reduce acute malnutrition and its risk factors. METHODS AND FINDINGS: We implemented a non-randomised cluster trial in internally displaced person (IDP) camps, located in peri-urban Mogadishu, Somalia...
October 2018: PLoS Medicine
Peter D Ghys, Brian G Williams, Mead Over, Timothy B Hallett, Peter Godfrey-Faussett
Peter Godfrey-Faussett and colleagues present six epidemiological metrics for tracking progress in reducing the public health threat of HIV.
October 2018: PLoS Medicine
Irva Hertz-Picciotto, Jennifer B Sass, Stephanie Engel, Deborah H Bennett, Asa Bradman, Brenda Eskenazi, Bruce Lanphear, Robin Whyatt
In a Policy Forum, Irva Hertz-Picciotto and colleagues review the scientific evidence linking organophosphate pesticides to cognitive, behavioral, and neurological deficits in children and recommend actions to reduce exposures.
October 2018: PLoS Medicine
Jennifer S Lord, John W Hargrove, Stephen J Torr, Glyn A Vale
BACKGROUND: Quantifying the effects of climate change on the entomological and epidemiological components of vector-borne diseases is an essential part of climate change research, but evidence for such effects remains scant, and predictions rely largely on extrapolation of statistical correlations. We aimed to develop a mechanistic model to test whether recent increases in temperature in the Mana Pools National Park of the Zambezi Valley of Zimbabwe could account for the simultaneous decline of tsetse flies, the vectors of human and animal trypanosomiasis...
October 2018: PLoS Medicine
Faraaz Mahomed, Michael Ashley Stein, Vikram Patel
Based on interviews with a variety of participants, Vikram Patel and colleagues advocate for philosophical and practical progress toward recognizing decision-making capacity in people with psychosocial disabilities.
October 2018: PLoS Medicine
Qian Long, Carol Kingdon, Fan Yang, Michael Dominic Renecle, Shayesteh Jahanfar, Meghan A Bohren, Ana Pilar Betran
BACKGROUND: China has witnessed a rapid increase of cesarean section (CS) rates in recent years. Several non-clinical factors have been cited as contributing to this trend including maternal request and perceived convenience. We aimed to assess preferences for mode of delivery and reasons for preferences for CS in China to inform the development of future interventions to mitigate unnecessary CSs, which are those performed in the absence of medical indications. METHODS AND FINDINGS: We conducted a mixed-methods systematic review and included longitudinal, cross-sectional, and qualitative studies in mainland China, Hong Kong, and Taiwan that investigated preferences for mode of delivery among women and family members and health professionals, and the reasons underlying such preferences...
October 2018: PLoS Medicine
Mairead Black, Sohinee Bhattacharya
Mairead Black and Sohinee Bhattacharya discuss research findings on preferences for cesarean delivery in Asian settings and share their Perspective on facilitating woman-centered birth choices in China following the end of the one-child policy.
October 2018: PLoS Medicine
Fumiaki Imamura, Amanda Fretts, Matti Marklund, Andres V Ardisson Korat, Wei-Sin Yang, Maria Lankinen, Waqas Qureshi, Catherine Helmer, Tzu-An Chen, Kerry Wong, Julie K Bassett, Rachel Murphy, Nathan Tintle, Chaoyu Ian Yu, Ingeborg A Brouwer, Kuo-Liong Chien, Alexis C Frazier-Wood, Liana C Del Gobbo, Luc Djoussé, Johanna M Geleijnse, Graham G Giles, Janette de Goede, Vilmundur Gudnason, William S Harris, Allison Hodge, Frank Hu, Albert Koulman, Markku Laakso, Lars Lind, Hung-Ju Lin, Barbara McKnight, Kalina Rajaobelina, Ulf Risérus, Jennifer G Robinson, Cécilia Samieri, David S Siscovick, Sabita S Soedamah-Muthu, Nona Sotoodehnia, Qi Sun, Michael Y Tsai, Matti Uusitupa, Lynne E Wagenknecht, Nick J Wareham, Jason Hy Wu, Renata Micha, Nita G Forouhi, Rozenn N Lemaitre, Dariush Mozaffarian
BACKGROUND: We aimed to investigate prospective associations of circulating or adipose tissue odd-chain fatty acids 15:0 and 17:0 and trans-palmitoleic acid, t16:1n-7, as potential biomarkers of dairy fat intake, with incident type 2 diabetes (T2D). METHODS AND FINDINGS: Sixteen prospective cohorts from 12 countries (7 from the United States, 7 from Europe, 1 from Australia, 1 from Taiwan) performed new harmonised individual-level analysis for the prospective associations according to a standardised plan...
October 2018: PLoS Medicine
Frederico Guanais, Svetlana V Doubova, Hannah H Leslie, Ricardo Perez-Cuevas, Ezequiel García-Elorrio, Margaret E Kruk
BACKGROUND: Despite the substantial attention to primary care (PC), few studies have addressed the relationship between patients' experience with PC and their health status in low-and middle-income countries. This study aimed to (1) test the association between overall patient-centered PC experience (OPCE) and self-rated health (SRH) and (2) identify specific features of patient-centered PC associated with better SRH (i.e., excellent or very good SRH) in 6 Latin American and Caribbean countries...
October 2018: PLoS Medicine
Kelsey B Loeliger, Jaimie P Meyer, Mayur M Desai, Maria M Ciarleglio, Colleen Gallagher, Frederick L Altice
BACKGROUND: Sustained retention in HIV care (RIC) and viral suppression (VS) are central to US national HIV prevention strategies, but have not been comprehensively assessed in criminal justice (CJ) populations with known health disparities. The purpose of this study is to identify predictors of RIC and VS following release from prison or jail. METHODS AND FINDINGS: This is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, to December 31, 2011, and observed through December 31, 2014 (n = 1,094)...
October 2018: PLoS Medicine
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