3,520 results match your criteria PLoS Medicine [Journal]


Socioeconomic position and use of healthcare in the last year of life: A systematic review and meta-analysis.

PLoS Med 2019 Apr 23;16(4):e1002782. Epub 2019 Apr 23.

Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, United Kingdom.

Background: Low socioeconomic position (SEP) is recognized as a risk factor for worse health outcomes. How socioeconomic factors influence end-of-life care, and the magnitude of their effect, is not understood. This review aimed to synthesise and quantify the associations between measures of SEP and use of healthcare in the last year of life. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002782DOI Listing

Lay health supporters aided by mobile text messaging to improve adherence, symptoms, and functioning among people with schizophrenia in a resource-poor community in rural China (LEAN): A randomized controlled trial.

PLoS Med 2019 Apr 23;16(4):e1002785. Epub 2019 Apr 23.

Xiangya School of Public Health, Central South University, Changsha, Hunan, China.

Background: Schizophrenia is a leading cause of disability, and a shift from facility- to community-based care has been proposed to meet the resource challenges of mental healthcare in low- and middle-income countries. We hypothesized that the addition of mobile texting would improve schizophrenia care in a resource-poor community setting compared with a community-based free-medicine program alone.

Methods And Findings: In this 2-arm randomized controlled trial, 278 community-dwelling villagers (patient participants) were randomly selected from people with schizophrenia from 9 townships of Hunan, China, and were randomized 1:1 into 2 groups. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002785DOI Listing

Controlling latent TB tuberculosis infection in high-burden countries: A neglected strategy to end TB.

PLoS Med 2019 Apr 23;16(4):e1002787. Epub 2019 Apr 23.

University of Nebraska Medical Center, Omaha, Nebraska, United States of America.

In a Perspective, Gavin Churchyard and Sue Swindells discuss the importance of strategies to target latent tuberculosis infection in high risk populations and thus disrupt a reservoir for new infections in high burden countries. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002787DOI Listing

Host-response-based gene signatures for tuberculosis diagnosis: A systematic comparison of 16 signatures.

PLoS Med 2019 Apr 23;16(4):e1002786. Epub 2019 Apr 23.

Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, California, United States of America.

Background: The World Health Organization (WHO) and Foundation for Innovative New Diagnostics (FIND) have published target product profiles (TPPs) calling for non-sputum-based diagnostic tests for the diagnosis of active tuberculosis (ATB) disease and for predicting the progression from latent tuberculosis infection (LTBI) to ATB. A large number of host-derived blood-based gene-expression biomarkers for diagnosis of patients with ATB have been proposed to date, but none have been implemented in clinical settings. The focus of this study is to directly compare published gene signatures for diagnosis of patients with ATB across a large, diverse list of publicly available gene expression datasets, and evaluate their performance against the WHO/FIND TPPs. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002786DOI Listing

Tuberculosis vaccines: Rising opportunities.

PLoS Med 2019 Apr 23;16(4):e1002791. Epub 2019 Apr 23.

Wellcome, London, United Kingdom.

Johan Vekemans, Katherine O'Brien, and Jeremy Farrar discuss recent breakthroughs in the search for a highly effective tuberculosis vaccine. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002791DOI Listing

Discovery and validation of a prognostic proteomic signature for tuberculosis progression: A prospective cohort study.

PLoS Med 2019 Apr 16;16(4):e1002781. Epub 2019 Apr 16.

South African Tuberculosis Vaccine Initiative, Division of Immunology, Department of Pathology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.

Background: A nonsputum blood test capable of predicting progression of healthy individuals to active tuberculosis (TB) before clinical symptoms manifest would allow targeted treatment to curb transmission. We aimed to develop a proteomic biomarker of risk of TB progression for ultimate translation into a point-of-care diagnostic.

Methods And Findings: Proteomic TB risk signatures were discovered in a longitudinal cohort of 6,363 Mycobacterium tuberculosis-infected, HIV-negative South African adolescents aged 12-18 years (68% female) who participated in the Adolescent Cohort Study (ACS) between July 6, 2005 and April 23, 2007, through either active (every 6 months) or passive follow-up over 2 years. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002781DOI Listing

Screening for breech presentation using universal late-pregnancy ultrasonography: A prospective cohort study and cost effectiveness analysis.

PLoS Med 2019 Apr 16;16(4):e1002778. Epub 2019 Apr 16.

Department of Obstetrics and Gynaecology, University of Cambridge, NIHR Cambridge Comprehensive Biomedical Research Centre, Cambridge, United Kingdom.

Background: Despite the relative ease with which breech presentation can be identified through ultrasound screening, the assessment of foetal presentation at term is often based on clinical examination only. Due to limitations in this approach, many women present in labour with an undiagnosed breech presentation, with increased risk of foetal morbidity and mortality. This study sought to determine the cost effectiveness of universal ultrasound scanning for breech presentation near term (36 weeks of gestational age [wkGA]) in nulliparous women. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002778DOI Listing
April 2019
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Effects of repeat prenatal corticosteroids given to women at risk of preterm birth: An individual participant data meta-analysis.

PLoS Med 2019 Apr 12;16(4):e1002771. Epub 2019 Apr 12.

Department of Obstetrics and Gynaecology, The Royal Women's Hospital, University of Melbourne, Melbourne, Australia.

Background: Infants born preterm compared with infants born at term are at an increased risk of dying and of serious morbidities in early life, and those who survive have higher rates of neurological impairments. It remains unclear whether exposure to repeat courses of prenatal corticosteroids can reduce these risks. This individual participant data (IPD) meta-analysis (MA) assessed whether repeat prenatal corticosteroid treatment given to women at ongoing risk of preterm birth in order to benefit their infants is modified by participant or treatment factors. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002771DOI Listing
April 2019
3 Reads

Lipoarabinomannan in sputum to detect bacterial load and treatment response in patients with pulmonary tuberculosis: Analytic validation and evaluation in two cohorts.

PLoS Med 2019 Apr 12;16(4):e1002780. Epub 2019 Apr 12.

Otsuka Pharmaceutical Development & Commercialization, Rockville, Maryland, United States of America.

Background: Lipoarabinomannan (LAM) is a major antigen of Mycobacterium tuberculosis (MTB). In this report, we evaluated the ability of a novel immunoassay to measure concentrations of LAM in sputum as a biomarker of bacterial load prior to and during treatment in pulmonary tuberculosis (TB) patients.

Methods And Findings: Phage display technology was used to isolate monoclonal antibodies binding to epitopes unique in LAM from MTB and slow-growing nontuberculous mycobacteria (NTM). Read More

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http://dx.doi.org/10.1371/journal.pmed.1002780DOI Listing
April 2019
1 Read

The incidence of pregnancy hypertension in India, Pakistan, Mozambique, and Nigeria: A prospective population-level analysis.

PLoS Med 2019 Apr 12;16(4):e1002783. Epub 2019 Apr 12.

School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.

Background: Most pregnancy hypertension estimates in less-developed countries are from cross-sectional hospital surveys and are considered overestimates. We estimated population-based rates by standardised methods in 27 intervention clusters of the Community-Level Interventions for Pre-eclampsia (CLIP) cluster randomised trials.

Methods And Findings: CLIP-eligible pregnant women identified in their homes or local primary health centres (2013-2017). Read More

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http://dx.doi.org/10.1371/journal.pmed.1002783DOI Listing
April 2019
1 Read

Preferences for HIV testing services among men who have sex with men in the UK: A discrete choice experiment.

PLoS Med 2019 Apr 11;16(4):e1002779. Epub 2019 Apr 11.

Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom.

Background: In the UK, approximately 4,200 men who have sex with men (MSM) are living with HIV but remain undiagnosed. Maximising the number of high-risk people testing for HIV is key to ensuring prompt treatment and preventing onward infection. This study assessed how different HIV test characteristics affect the choice of testing option, including remote testing (HIV self-testing or HIV self-sampling), in the UK, a country with universal access to healthcare. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002779DOI Listing

Risk score for predicting mortality including urine lipoarabinomannan detection in hospital inpatients with HIV-associated tuberculosis in sub-Saharan Africa: Derivation and external validation cohort study.

PLoS Med 2019 Apr 5;16(4):e1002776. Epub 2019 Apr 5.

TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: The prevalence of and mortality from HIV-associated tuberculosis (HIV/TB) in hospital inpatients in Africa remains unacceptably high. Currently, there is a lack of tools to identify those at high risk of early mortality who may benefit from adjunctive interventions. We therefore aimed to develop and validate a simple clinical risk score to predict mortality in high-burden, low-resource settings. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002776
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http://dx.doi.org/10.1371/journal.pmed.1002776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450614PMC
April 2019
8 Reads

Octreotide-LAR in later-stage autosomal dominant polycystic kidney disease (ALADIN 2): A randomized, double-blind, placebo-controlled, multicenter trial.

PLoS Med 2019 Apr 5;16(4):e1002777. Epub 2019 Apr 5.

Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent genetically determined renal disease. In affected patients, renal function may progressively decline up to end-stage renal disease (ESRD), and approximately 10% of those with ESRD are affected by ADPKD. The somatostatin analog octreotide long-acting release (octreotide-LAR) slows renal function deterioration in patients in early stages of the disease. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6450618PMC
April 2019
1 Read

Tuberculosis drugs' distribution and emergence of resistance in patient's lung lesions: A mechanistic model and tool for regimen and dose optimization.

PLoS Med 2019 Apr 2;16(4):e1002773. Epub 2019 Apr 2.

Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California, United States of America.

Background: The sites of mycobacterial infection in the lungs of tuberculosis (TB) patients have complex structures and poor vascularization, which obstructs drug distribution to these hard-to-reach and hard-to-treat disease sites, further leading to suboptimal drug concentrations, resulting in compromised TB treatment response and resistance development. Quantifying lesion-specific drug uptake and pharmacokinetics (PKs) in TB patients is necessary to optimize treatment regimens at all infection sites, to identify patients at risk, to improve existing regimens, and to advance development of novel regimens. Using drug-level data in plasma and from 9 distinct pulmonary lesion types (vascular, avascular, and mixed) obtained from 15 hard-to-treat TB patients who failed TB treatments and therefore underwent lung resection surgery, we quantified the distribution and the penetration of 7 major TB drugs at these sites, and we provide novel tools for treatment optimization. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445413PMC

Community health workers to improve uptake of maternal healthcare services: A cluster-randomized pragmatic trial in Dar es Salaam, Tanzania.

PLoS Med 2019 Mar 29;16(3):e1002768. Epub 2019 Mar 29.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Background: Home delivery and late and infrequent attendance at antenatal care (ANC) are responsible for substantial avoidable maternal and pediatric morbidity and mortality in sub-Saharan Africa. This cluster-randomized trial aimed to determine the impact of a community health worker (CHW) intervention on the proportion of women who (i) visit ANC fewer than 4 times during their pregnancy and (ii) deliver at home.

Methods And Findings: As part of a 2-by-2 factorial design, we conducted a cluster-randomized trial of a home-based CHW intervention in 2 of 3 districts of Dar es Salaam from 18 June 2012 to 15 January 2014. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440613PMC
March 2019
1 Read

A whole-health-economy approach to antimicrobial stewardship: Analysis of current models and future direction.

PLoS Med 2019 Mar 29;16(3):e1002774. Epub 2019 Mar 29.

National Institute for Health Research Health Protection Research Unit, Healthcare Associated Infections and Antimicrobial Resistance, Imperial College, London in partnership with Public Health England, Hammersmith Hospital, London, United Kingdom.

In a Policy Forum, Alison Holmes and colleagues discuss coordinated approaches to antimicrobial stewardship. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440619PMC

Incidence of eclampsia and related complications across 10 low- and middle-resource geographical regions: Secondary analysis of a cluster randomised controlled trial.

PLoS Med 2019 Mar 29;16(3):e1002775. Epub 2019 Mar 29.

Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.

Background: In 2015, approximately 42,000 women died as a result of hypertensive disorders of pregnancy worldwide; over 99% of these deaths occurred in low- and middle-income countries. The aim of this paper is to describe the incidence and characteristics of eclampsia and related complications from hypertensive disorders of pregnancy across 10 low- and middle-income geographical regions in 8 countries, in relation to magnesium sulfate availability.

Methods And Findings: This is a secondary analysis of a stepped-wedge cluster randomised controlled trial undertaken in sub-Saharan Africa, India, and Haiti. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440614PMC
March 2019
1 Read

Measles vaccination: A matter of confidence and commitment.

Authors:
Richard Turner

PLoS Med 2019 Mar 26;16(3):e1002770. Epub 2019 Mar 26.

Public Library of Science, San Francisco, California, United States of America, and Cambridge, United Kingdom.

The PLOS Medicine Editors discuss issues of vaccination uptake in the context of recent and ongoing measles outbreaks. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002770DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435109PMC

Keeping phase III tuberculosis trials relevant: Adapting to a rapidly changing landscape.

PLoS Med 2019 Mar 22;16(3):e1002767. Epub 2019 Mar 22.

Medical Research Council Clinical Trials Unit at University College London, London, United Kingdom.

In a Collection Review, Patrick Phillips and colleagues discuss developments in clinical trial design for the evaluation of TB therapeutics. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002767DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430373PMC

Advances in clinical trial design for development of new TB treatments: A call for innovation.

PLoS Med 2019 Mar 22;16(3):e1002769. Epub 2019 Mar 22.

Division of Pulmonary and Critical Care Medicine, University of California San Francisco, San Francisco, California, United States of America.

Christian Lienhardt and Payam Nahid launch the Collection on Advances in Clinical Trial Design for Development of New Tuberculosis Treatments. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002769
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http://dx.doi.org/10.1371/journal.pmed.1002769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430361PMC
March 2019
3 Reads

Independent and combined effects of improved water, sanitation, and hygiene (WASH) and improved complementary feeding on early neurodevelopment among children born to HIV-negative mothers in rural Zimbabwe: Substudy of a cluster-randomized trial.

PLoS Med 2019 Mar 21;16(3):e1002766. Epub 2019 Mar 21.

Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe.

Background: Globally, nearly 250 million children (43% of all children under 5 years of age) are at risk of compromised neurodevelopment due to poverty, stunting, and lack of stimulation. We tested the independent and combined effects of improved water, sanitation, and hygiene (WASH) and improved infant and young child feeding (IYCF) on early child development (ECD) among children enrolled in the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe.

Methods And Findings: SHINE was a cluster-randomized community-based 2×2 factorial trial. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6428259PMC

Cost-effectiveness of financial incentives for improving diet and health through Medicare and Medicaid: A microsimulation study.

PLoS Med 2019 Mar 19;16(3):e1002761. Epub 2019 Mar 19.

Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America.

Background: Economic incentives through health insurance may promote healthier behaviors. Little is known about health and economic impacts of incentivizing diet, a leading risk factor for diabetes and cardiovascular disease (CVD), through Medicare and Medicaid.

Methods And Findings: A validated microsimulation model (CVD-PREDICT) estimated CVD and diabetes cases prevented, quality-adjusted life years (QALYs), health-related costs (formal healthcare, informal healthcare, and lost-productivity costs), and incremental cost-effectiveness ratios (ICERs) of two policy scenarios for adults within Medicare and Medicaid, compared to a base case of no new intervention: (1) 30% subsidy on fruits and vegetables ("F&V incentive") and (2) 30% subsidy on broader healthful foods including F&V, whole grains, nuts/seeds, seafood, and plant oils ("healthy food incentive"). Read More

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http://dx.plos.org/10.1371/journal.pmed.1002761
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http://dx.doi.org/10.1371/journal.pmed.1002761DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6424388PMC
March 2019
7 Reads

Seasonal malaria chemoprevention combined with community case management of malaria in children under 10 years of age, over 5 months, in south-east Senegal: A cluster-randomised trial.

PLoS Med 2019 Mar 13;16(3):e1002762. Epub 2019 Mar 13.

London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: Seasonal malaria chemoprevention (SMC) is recommended in the Sahel region of Africa for children under 5 years of age, for up to 4 months of the year. It may be appropriate to include older children, and to provide protection for more than 4 months. We evaluated the effectiveness of SMC using sulfadoxine-pyrimethamine plus amodiaquine given over 5 months to children under 10 years of age in Saraya district in south-east Senegal in 2011. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002762
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http://dx.doi.org/10.1371/journal.pmed.1002762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415816PMC
March 2019
6 Reads

Comparative effectiveness of generic and brand-name medication use: A database study of US health insurance claims.

PLoS Med 2019 Mar 13;16(3):e1002763. Epub 2019 Mar 13.

Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.

Background: To the extent that outcomes are mediated through negative perceptions of generics (the nocebo effect), observational studies comparing brand-name and generic drugs are susceptible to bias favoring the brand-name drugs. We used authorized generic (AG) products, which are identical in composition and appearance to brand-name products but are marketed as generics, as a control group to address this bias in an evaluation aiming to compare the effectiveness of generic versus brand medications.

Methods And Findings: For commercial health insurance enrollees from the US, administrative claims data were derived from 2 databases: (1) Optum Clinformatics Data Mart (years: 2004-2013) and (2) Truven MarketScan (years: 2003-2015). Read More

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http://dx.plos.org/10.1371/journal.pmed.1002763
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http://dx.doi.org/10.1371/journal.pmed.1002763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415809PMC
March 2019
6 Reads

Age distribution, trends, and forecasts of under-5 mortality in 31 sub-Saharan African countries: A modeling study.

PLoS Med 2019 Mar 12;16(3):e1002757. Epub 2019 Mar 12.

Department of Biology, Stanford University, Stanford, California, United States of America.

Background: Despite the sharp decline in global under-5 deaths since 1990, uneven progress has been achieved across and within countries. In sub-Saharan Africa (SSA), the Millennium Development Goals (MDGs) for child mortality were met only by a few countries. Valid concerns exist as to whether the region would meet new Sustainable Development Goals (SDGs) for under-5 mortality. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413894PMC

Individual prognosis at diagnosis in nonmetastatic prostate cancer: Development and external validation of the PREDICT Prostate multivariable model.

PLoS Med 2019 Mar 12;16(3):e1002758. Epub 2019 Mar 12.

Academic Urology Group, Department of Surgery, University of Cambridge, Cambridge, United Kingdom.

Background: Prognostic stratification is the cornerstone of management in nonmetastatic prostate cancer (PCa). However, existing prognostic models are inadequate-often using treatment outcomes rather than survival, stratifying by broad heterogeneous groups and using heavily treated cohorts. To address this unmet need, we developed an individualised prognostic model that contextualises PCa-specific mortality (PCSM) against other cause mortality, and estimates the impact of treatment on survival. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002758
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http://dx.doi.org/10.1371/journal.pmed.1002758DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413892PMC
March 2019
8 Reads

The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana and the path to universal health coverage in India: Overcoming the challenges of stewardship and governance.

PLoS Med 2019 Mar 7;16(3):e1002759. Epub 2019 Mar 7.

The George Institute for Global Health, University of New South Wales, Sydney, Australia.

In an Essay, Blake Angell and colleagues discuss ambitious reforms planned to expand coverage of the health system in India. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405049PMC

The association between Zika virus infection and microcephaly in Brazil 2015-2017: An observational analysis of over 4 million births.

PLoS Med 2019 Mar 5;16(3):e1002755. Epub 2019 Mar 5.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.

Background: In 2015, high rates of microcephaly were reported in Northeast Brazil following the first South American Zika virus (ZIKV) outbreak. Reported microcephaly rates in other Zika-affected areas were significantly lower, suggesting alternate causes or the involvement of arboviral cofactors in exacerbating microcephaly rates.

Methods And Findings: We merged data from multiple national reporting databases in Brazil to estimate exposure to 9 known or hypothesized causes of microcephaly for every pregnancy nationwide since the beginning of the ZIKV outbreak; this generated between 3. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400331PMC
March 2019
5 Reads

Potential effectiveness of prophylactic HPV immunization for men who have sex with men in the Netherlands: A multi-model approach.

PLoS Med 2019 Mar 4;16(3):e1002756. Epub 2019 Mar 4.

Cluster of Infectious Diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.

Background: Men who have sex with men (MSM) are at high risk for anal cancer, primarily related to human papillomavirus genotype 16 (HPV16) infections. At 8.5 per 100,000 per year, the incidence rate of anal cancer among MSM is similar to that of cervical cancer among adult women in the Netherlands. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002756
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http://dx.doi.org/10.1371/journal.pmed.1002756DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398832PMC
March 2019
7 Reads

Health system performance for people with diabetes in 28 low- and middle-income countries: A cross-sectional study of nationally representative surveys.

PLoS Med 2019 Mar 1;16(3):e1002751. Epub 2019 Mar 1.

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.

Background: The prevalence of diabetes is increasing rapidly in low- and middle-income countries (LMICs), urgently requiring detailed evidence to guide the response of health systems to this epidemic. In an effort to understand at what step in the diabetes care continuum individuals are lost to care, and how this varies between countries and population groups, this study examined health system performance for diabetes among adults in 28 LMICs using a cascade of care approach.

Methods And Findings: We pooled individual participant data from nationally representative surveys done between 2008 and 2016 in 28 LMICs. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002751DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396901PMC
March 2019
9 Reads

Constructing care cascades for active tuberculosis: A strategy for program monitoring and identifying gaps in quality of care.

PLoS Med 2019 Feb 27;16(2):e1002754. Epub 2019 Feb 27.

Department of Epidemiology, Biostatistics and Occupational Health and McGill International TB Centre, McGill University, Montreal, Canada.

The cascade of care is a model for evaluating patient retention across sequential stages of care required to achieve a successful treatment outcome. This approach was first used to evaluate HIV care and has since been applied to other diseases. The tuberculosis (TB) community has only recently started using care cascade analyses to quantify gaps in quality of care. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6392267PMC
February 2019
6 Reads

A reduced-carbohydrate and lactose-free formulation for stabilization among hospitalized children with severe acute malnutrition: A double-blind, randomized controlled trial.

PLoS Med 2019 Feb 26;16(2):e1002747. Epub 2019 Feb 26.

The Childhood Acute Illness and Nutrition Network (CHAIN), Nairobi, Kenya.

Background: Children with medically complicated severe acute malnutrition (SAM) have high risk of inpatient mortality. Diarrhea, carbohydrate malabsorption, and refeeding syndrome may contribute to early mortality and delayed recovery. We tested the hypothesis that a lactose-free, low-carbohydrate F75 milk would serve to limit these risks, thereby reducing the number of days in the stabilization phase. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390989PMC
February 2019
7 Reads

Patterns of joint involvement in juvenile idiopathic arthritis and prediction of disease course: A prospective study with multilayer non-negative matrix factorization.

PLoS Med 2019 Feb 26;16(2):e1002750. Epub 2019 Feb 26.

Division of Rheumatology, Department of Paediatrics, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada.

Background: Joint inflammation is the common feature underlying juvenile idiopathic arthritis (JIA). Clinicians recognize patterns of joint involvement currently not part of the International League of Associations for Rheumatology (ILAR) classification. Using unsupervised machine learning, we sought to uncover data-driven joint patterns that predict clinical phenotype and disease trajectories. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002750
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http://dx.doi.org/10.1371/journal.pmed.1002750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390994PMC
February 2019
4 Reads

The US Affordable Care Act: Reflections and directions at the close of a decade.

PLoS Med 2019 Feb 26;16(2):e1002752. Epub 2019 Feb 26.

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, United States of America.

In this month's Editorial, PLOS Medicine Academic Editor Zirui Song and his colleague Adrianna McIntyre discuss outcomes and possible futures for the United States Affordable Care Act as it nears the ten year mark. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002752DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390990PMC
February 2019

Antenatal corticosteroid therapy (ACT) and size at birth: A population-based analysis using the Finnish Medical Birth Register.

PLoS Med 2019 Feb 26;16(2):e1002746. Epub 2019 Feb 26.

Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.

Background: Antenatal corticosteroid therapy (ACT) is used clinically to prepare the fetal lung for impending preterm birth, but animal and human studies link corticosteroids to smaller birth size. Whether ACT is associated with birth size is debated; therefore, we assessed differences in birth size in treated versus untreated pregnancies.

Methods And Findings: This observational register-based study used data from the Finnish Medical Birth Register (FMBR) covering all births in Finland (January 1, 2006-December 31, 2010). Read More

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http://dx.doi.org/10.1371/journal.pmed.1002746DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390995PMC
February 2019
1 Read

The association between heatwaves and risk of hospitalization in Brazil: A nationwide time series study between 2000 and 2015.

PLoS Med 2019 Feb 22;16(2):e1002753. Epub 2019 Feb 22.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Background: To our knowledge, no study has assessed the association between heatwaves and risk of hospitalization and how it may change over time in Brazil. We quantified the heatwave-hospitalization association in Brazil during 2000-2015.

Methods And Findings: Daily data on hospitalization and temperature were collected from 1,814 cities (>78% of the national population) in the hottest five consecutive months during 2000-2015. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002753DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386221PMC
February 2019
1 Read

COSMOS-E: Guidance on conducting systematic reviews and meta-analyses of observational studies of etiology.

PLoS Med 2019 Feb 21;16(2):e1002742. Epub 2019 Feb 21.

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Background: To our knowledge, no publication providing overarching guidance on the conduct of systematic reviews of observational studies of etiology exists.

Methods And Findings: Conducting Systematic Reviews and Meta-Analyses of Observational Studies of Etiology (COSMOS-E) provides guidance on all steps in systematic reviews of observational studies of etiology, from shaping the research question, defining exposure and outcomes, to assessing the risk of bias and statistical analysis. The writing group included researchers experienced in meta-analyses and observational studies of etiology. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383865PMC
February 2019
1 Read

National policies and care provision in pregnancy and childbirth for twins in Eastern and Southern Africa: A mixed-methods multi-country study.

PLoS Med 2019 Feb 19;16(2):e1002749. Epub 2019 Feb 19.

Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Background: High-risk pregnancies, such as twin pregnancies, deserve particular attention as mortality is very high in this group. With a view to inform policy and national guidelines development for the Sustainable Development Goals, we reviewed national training materials, guidelines, and policies underpinning the provision of care in relation to twin pregnancies and assessed care provided to twins in 8 Eastern and Southern African countries: Kenya, Malawi, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe.

Methods And Findings: We located policies and guidelines by reviewing national repositories and by contacting experts to systematically map country-level maternal and newborn training materials, guidelines, and policies. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380547PMC
February 2019
5 Reads

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial.

PLoS Med 2019 Feb 15;16(2):e1002745. Epub 2019 Feb 15.

Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.

Background: The emergence and spread of multidrug-resistant Plasmodium falciparum in the Greater Mekong Subregion (GMS) threatens global malaria elimination efforts. Mass drug administration (MDA), the presumptive antimalarial treatment of an entire population to clear the subclinical parasite reservoir, is a strategy to accelerate malaria elimination. We report a cluster randomised trial to assess the effectiveness of dihydroartemisinin-piperaquine (DP) MDA in reducing falciparum malaria incidence and prevalence in 16 remote village populations in Myanmar, Vietnam, Cambodia, and the Lao People's Democratic Republic, where artemisinin resistance is prevalent. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002745DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377128PMC
February 2019
1 Read

Community-, facility-, and individual-level outcomes of a district mental healthcare plan in a low-resource setting in Nepal: A population-based evaluation.

PLoS Med 2019 Feb 14;16(2):e1002748. Epub 2019 Feb 14.

Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.

Background: In low-income countries, care for people with mental, neurological, and substance use (MNS) disorders is largely absent, especially in rural settings. To increase treatment coverage, integration of mental health services into community and primary healthcare settings is recommended. While this strategy is being rolled out globally, rigorous evaluation of outcomes at each stage of the service delivery pathway from detection to treatment initiation to individual outcomes of care has been missing. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375569PMC
February 2019

Maternal body mass index, gestational weight gain, and the risk of overweight and obesity across childhood: An individual participant data meta-analysis.

PLoS Med 2019 Feb 11;16(2):e1002744. Epub 2019 Feb 11.

The Generation R Study Group, Erasmus University Medical Center, Rotterdam, the Netherlands.

Background: Maternal obesity and excessive gestational weight gain may have persistent effects on offspring fat development. However, it remains unclear whether these effects differ by severity of obesity, and whether these effects are restricted to the extremes of maternal body mass index (BMI) and gestational weight gain. We aimed to assess the separate and combined associations of maternal BMI and gestational weight gain with the risk of overweight/obesity throughout childhood, and their population impact. Read More

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http://dx.plos.org/10.1371/journal.pmed.1002744
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http://dx.doi.org/10.1371/journal.pmed.1002744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370184PMC
February 2019
10 Reads

Long-term outcomes of an educational intervention to reduce antibiotic prescribing for childhood upper respiratory tract infections in rural China: Follow-up of a cluster-randomised controlled trial.

PLoS Med 2019 Feb 5;16(2):e1002733. Epub 2019 Feb 5.

School of Health Care Management, Shandong University, Jinan, China.

Background: Inappropriate antibiotic prescribing causes widespread serious health problems. To reduce prescribing of antibiotics in Chinese primary care to children with upper respiratory tract infections (URTIs), we developed an intervention comprising clinical guidelines, monthly prescribing review meetings, doctor-patient communication skills training, and education materials for caregivers. We previously evaluated our intervention using an unblinded cluster-randomised controlled trial (cRCT) in 25 primary care facilities across two rural counties. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363140PMC
February 2019
3 Reads

The effect of a programme to improve men's sedentary time and physical activity: The European Fans in Training (EuroFIT) randomised controlled trial.

PLoS Med 2019 Feb 5;16(2):e1002736. Epub 2019 Feb 5.

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Background: Reducing sitting time as well as increasing physical activity in inactive people is beneficial for their health. This paper investigates the effectiveness of the European Fans in Training (EuroFIT) programme to improve physical activity and sedentary time in male football fans, delivered through the professional football setting.

Methods And Findings: A total of 1,113 men aged 30-65 with self-reported body mass index (BMI) ≥27 kg/m2 took part in a randomised controlled trial in 15 professional football clubs in England, the Netherlands, Norway, and Portugal. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002736DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363143PMC
February 2019
2 Reads

Trazodone use and risk of dementia: A population-based cohort study.

PLoS Med 2019 Feb 5;16(2):e1002728. Epub 2019 Feb 5.

Research Department of Practice and Policy, UCL School of Pharmacy, London, United Kingdom.

Background: In vitro and animal studies have suggested that trazodone, a licensed antidepressant, may protect against dementia. However, no studies have been conducted to assess the effect of trazodone on dementia in humans. This electronic health records study assessed the association between trazodone use and the risk of developing dementia in clinical practice. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002728DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6363148PMC
February 2019
3 Reads

Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: A population-based cohort study.

PLoS Med 2019 Feb 4;16(2):e1002741. Epub 2019 Feb 4.

Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, the Netherlands.

Background: Non-communicable diseases (NCDs) are leading causes of premature disability and death worldwide. However, the lifetime risk of developing any NCD is unknown, as are the effects of shared common risk factors on this risk.

Methods And Findings: Between July 6, 1989, and January 1, 2012, we followed participants from the prospective Rotterdam Study aged 45 years and older who were free from NCDs at baseline for incident stroke, heart disease, diabetes, chronic respiratory disease, cancer, and neurodegenerative disease. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002741DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361416PMC
February 2019
4 Reads

Setting targets for HIV/AIDS-What lessons can be learned from other disease control programmes?

PLoS Med 2019 Feb 4;16(2):e1002735. Epub 2019 Feb 4.

Public Health England, London, United Kingdom.

In a Collection Review, Richard Hayes and colleagues discuss metrics for assessing progress in control of the HIV/AIDS epidemic in the context of prior disease control programmes. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002735DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361469PMC
February 2019

Evidence of a causal relationship between body mass index and psoriasis: A mendelian randomization study.

PLoS Med 2019 Jan 31;16(1):e1002739. Epub 2019 Jan 31.

Medical Research Council (MRC) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.

Background: Psoriasis is a common inflammatory skin disease that has been reported to be associated with obesity. We aimed to investigate a possible causal relationship between body mass index (BMI) and psoriasis.

Methods And Findings: Following a review of published epidemiological evidence of the association between obesity and psoriasis, mendelian randomization (MR) was used to test for a causal relationship with BMI. Read More

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http://dx.doi.org/10.1371/journal.pmed.1002739DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354959PMC
January 2019
3 Reads