Housing environment and early childhood development in sub-Saharan Africa: A cross-sectional analysis
by Yaqing Gao, Long Zhang, Ashish Kc, Yinping Wang, Siyu Zou, Chunyi Chen, Yue Huang, Xiaoyi Mi, Hong Zhou BackgroundThe influence of the safety and security of environments on early childhood development (ECD) has been under-explored. Although housing might be linked to ECD by affecting a child ’s health and a parent’s ability to provide adequate care, only a few studies have examined this factor. We hypothesized that housing environment is associated with ECD in sub-Saharan Africa (SSA). Methods and findingsFrom 92,433 children aged 36 to 59 months who participated in Multiple Indicator Cluster Survey (MICS) ...
Source: PLoS Medicine - April 19, 2021 Category: Internal Medicine Authors: Yaqing Gao Source Type: research

A call for diversity, equity, and inclusion: Highlights from the Consortium of Universities for Global Health 2021 conference
by Beryne Odeny Beryne Odeny reports from the CUGH 2021 virtual conference. (Source: PLoS Medicine)
Source: PLoS Medicine - April 15, 2021 Category: Internal Medicine Authors: Beryne Odeny Source Type: research

Health information technology interventions and engagement in HIV care and achievement of viral suppression in publicly funded settings in the US: A cost-effectiveness analysis
ConclusionsThese results provide additional support for the use of HIT as a tool to enhance rapid and effective treatment of HIV to achieve sustained viral suppression. HIT has the potential to increase utilization of services, improve health outcomes, and reduce subsequent transmission of HIV. (Source: PLoS Medicine)
Source: PLoS Medicine - April 7, 2021 Category: Internal Medicine Authors: Starley B. Shade Source Type: research

Maternal weight change from prepregnancy to 18 months postpartum and subsequent risk of hypertension and cardiovascular disease in Danish women: A cohort study
ConclusionsPostpartum weight retention/new gain in all mothers and postpartum weight loss in mothers with normal-/underweight may be associated with later adverse cardiovascular health. (Source: PLoS Medicine)
Source: PLoS Medicine - April 2, 2021 Category: Internal Medicine Authors: Helene Kirkegaard Source Type: research

Epidemiological, clinical, and public health response characteristics of a large outbreak of diphtheria among the Rohingya population in Cox ’s Bazar, Bangladesh, 2017 to 2019: A retrospective study
ConclusionsTo our knowledge, this is the largest reported diphtheria outbreak in refugee settings. We observed that high population density, poor living conditions, and fast growth rate were associated with explosive expansion of the outbreak during the initial exponential growth phase. Three rounds of mass vaccinations targeting those aged 6 weeks to 14 years were associated with only modestly reduced transmission, and additional public health measures were necessary to end the outbreak. This outbreak has a long-lasting tail, with Rt oscillating at around 1 for an extended period. An adequate global DAT stockpile needs to...
Source: PLoS Medicine - April 1, 2021 Category: Internal Medicine Authors: Jonathan A. Polonsky Source Type: research

Variation in HIV care and treatment outcomes by facility in South Africa, 2011 –2015: A cohort study
by Jacob Bor, Anna Gage, Dorina Onoya, Mhairi Maskew, Yorghos Tripodis, Matthew P. Fox, Adrian Puren, Sergio Carmona, Koleka Mlisana, William MacLeod BackgroundDespite widespread availability of HIV treatment, patient outcomes differ across facilities. We propose and evaluate an approach to measure quality of HIV care at health facilities in South Africa ’s national HIV program using routine laboratory data. Methods and findingsData were extracted from South Africa ’s National Health Laboratory Service (NHLS) Corporate Data Warehouse. All CD4 counts, viral loads (VLs), and other laboratory tests used in HIV mon...
Source: PLoS Medicine - March 31, 2021 Category: Internal Medicine Authors: Jacob Bor Source Type: research

Evaluation of the Arabin cervical pessary for prevention of preterm birth in women with a twin pregnancy and short cervix (STOPPIT-2): An open-label randomised trial and updated meta-analysis
ConclusionsThese results led us to reject our hypothesis that the Arabin pessary would reduce the risk of the primary outcome by 40%. Smaller treatment effects cannot be ruled out. Trial registrationClinicalTrials.gov ISRCTN 02235181.ClinicalTrials.gov NCT02235181. (Source: PLoS Medicine)
Source: PLoS Medicine - March 29, 2021 Category: Internal Medicine Authors: Jane E. Norman Source Type: research

Safety and tolerability of natural and synthetic cannabinoids in adults aged over 50 years: A systematic review and meta-analysis
by Latha Velayudhan, Katie McGoohan, Sagnik Bhattacharyya BackgroundCannabinoid-based medicines (CBMs) are being used widely in the elderly. However, their safety and tolerability in older adults remains unclear. We aimed to conduct a systematic review and meta-analysis of safety and tolerability of CBMs in adults of age ≥50 years. Methods and findingsA systematic search was performed using MEDLINE, PubMed, EMBASE, CINAHL PsychInfo, Cochrane Library, and ClinicalTrials.gov (1 January 1990 to 3 October 2020). Randomised clinical trials (RCTs) of CBMs in those with mean age of ≥50 years for all indications, evaluating ...
Source: PLoS Medicine - March 29, 2021 Category: Internal Medicine Authors: Latha Velayudhan Source Type: research

The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
by Matthew J. Page, Joanne E. McKenzie, Patrick M. Bossuyt, Isabelle Boutron, Tammy C. Hoffmann, Cynthia D. Mulrow, Larissa Shamseer, Jennifer M. Tetzlaff, Elie A. Akl, Sue E. Brennan, Roger Chou, Julie Glanville, Jeremy M. Grimshaw, Asbj ørn Hróbjartsson, Manoj M. Lalu, Tianjing Li, Elizabeth W. Loder, Evan Mayo-Wilson, Steve McDonald, Luke A. McGuinness, Lesley A. Stewart, James Thomas, Andrea C. Tricco, Vivian A. Welch, Penny Whiting, David Moher Matthew Page and co-authors describe PRISMA 2020, an updated reporting guideline for systematic reviews and meta-analyses. (Source: PLoS Medicine)
Source: PLoS Medicine - March 29, 2021 Category: Internal Medicine Authors: Matthew J. Page Source Type: research

Healthcare without borders: A cross-sectional study of immigrant and nonimmigrant children admitted to a large public sector hospital in the Gauteng Province of South Africa
The objective of the study was to describe the characteristics and differences between the immigrant and SA children admitted to Kalafong Provincial Tertiary Hospital (KPTH), a large public sector hospital in the urban Gauteng Province of SA. Methods and findingsA cross-sectional study was conducted over a 4-month period during 2016 to 2017. Information was obtained through a structured questionnaire and health record review. The enrolled study participants included 508 children divided into 2 groups, namely 271 general paediatric patients and 237 neonates. Twenty-five percent of children in the neonatal group and 22.5% in...
Source: PLoS Medicine - March 23, 2021 Category: Internal Medicine Authors: Gerhard H. Janse van Rensburg Source Type: research

The “gateway” effect of e-cigarettes may be explained by a genetic liability to risk-taking
by Wayne Hall, Gary Chan Wayne Hall and Gary Chan discuss Jasmine Khouja and co-workers’ accompanying study on genetic susceptibility to tobacco smoking initiation and e-cigarette use. (Source: PLoS Medicine)
Source: PLoS Medicine - March 18, 2021 Category: Internal Medicine Authors: Wayne Hall Source Type: research

Association of genetic liability to smoking initiation with e-cigarette use in young adults: A cohort study
by Jasmine N. Khouja, Robyn E. Wootton, Amy E. Taylor, George Davey Smith, Marcus R. Munaf ò BackgroundTobacco smoking and e-cigarette use are strongly associated, but it is currently unclear whether this association is causal, or due to shared factors that influence both behaviours such as a shared genetic liability. The aim of this study was to investigate whether polygenic risk scores (PRS) for smoking initiation are associated with ever use of e-cigarettes. Methods and findingsSmoking initiation PRS were calculated for young adults (N = 7,859, mean age = 24 years, 51% male) of European ancestry in the Avon Longi...
Source: PLoS Medicine - March 18, 2021 Category: Internal Medicine Authors: Jasmine N. Khouja Source Type: research

The potential shared role of inflammation in insulin resistance and schizophrenia: A bidirectional two-sample mendelian randomization study
ConclusionsOur findings support a role for inflammation as a common cause for insulin resistance and schizophrenia, which may at least partly explain why the traits commonly co-occur in clinical practice. Inflammation and immune pathways may represent novel therapeutic targets for the prevention or treatment of schizophrenia and comorbid insulin resistance. Future work is needed to understand how inflammation may contribute to the risk of schizophrenia and insulin resistance. (Source: PLoS Medicine)
Source: PLoS Medicine - March 12, 2021 Category: Internal Medicine Authors: Benjamin I. Perry Source Type: research

Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis
ConclusionsOur results from 2 independent models suggest that HPV vaccination for adult women and men aged 30 to 45 years is unlikely to represent good value for money in the US. (Source: PLoS Medicine)
Source: PLoS Medicine - March 11, 2021 Category: Internal Medicine Authors: Jane J. Kim Source Type: research

Factors associated with suicide risk among Chinese adults: A prospective cohort study of 0.5 million individuals
The objective of this study was to examine the recent distribution of suicide and risk factors for death by suicide. Identifying underlying risk factors could benefit development of evidence-based prevention and intervention programs. Methods and findingsWe conducted a prospective study, the China Kadoorie Biobank, of 512,715 individuals (41% men, mean age 52 years) from 10 (5 urban, 5 rural) areas which are diverse across China in geographic locations, social economic developmental stages, and prevalence of disease patterns. After the baseline measurements of risk factors during 2004 to 2008, participants were followed up...
Source: PLoS Medicine - March 11, 2021 Category: Internal Medicine Authors: Rongqin Yu Source Type: research

Parental death in childhood and pathways to increased mortality across the life course in Stockholm, Sweden: A cohort study
ConclusionsOur findings from this cohort study suggest that childhood parental death is associated with increased mortality and that the association was mediated through a chain of disadvantages over the life course including delinquency in adolescence and lower income during early adulthood. Professionals working with bereaved children should take the higher mortality risk in bereaved offspring into account and consider its lifelong consequences. When planning and providing support to bereaved children, it may be particularly important to be aware of their increased susceptibility to delinquency and socioeconomic vulnerab...
Source: PLoS Medicine - March 11, 2021 Category: Internal Medicine Authors: Ayako Hiyoshi Source Type: research

How will COVID-19 transform global health post-pandemic? Defining research and investment opportunities and priorities
by Michael Reid, Quarraisha Abdool-Karim, Elvin Geng, Eric Goosby Michael Reid and co-authors introduce a Collection on the global health in the post-COVID-19 era. (Source: PLoS Medicine)
Source: PLoS Medicine - March 11, 2021 Category: Internal Medicine Authors: Michael Reid Source Type: research

Correction: Diagnostic performance of congestion score index evaluated from chest radiography for acute heart failure in the emergency department: A retrospective analysis from the PARADISE cohort
by Masatake Kobayashi, Amine Douair, Kevin Duarte, D éborah Jaeger, Gaetan Giacomin, Adrien Bassand, Victor Jeangeorges, Laure Abensur Vuillaume, Gregoire Preud’homme, Olivier Huttin, Faiez Zannad, Patrick Rossignol, Tahar Chouihed, Nicolas Girerd (Source: PLoS Medicine)
Source: PLoS Medicine - March 5, 2021 Category: Internal Medicine Authors: Masatake Kobayashi Source Type: research

Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data
ConclusionsThis study found underuse of guideline-indicated BP medication in people with elevated CVD risk and overuse by people with lower CVD risk. Country-specific targeted policies are needed to help improve the identification and management of those at highest CVD risk. (Source: PLoS Medicine)
Source: PLoS Medicine - March 4, 2021 Category: Internal Medicine Authors: David Peiris Source Type: research

Applicability and cost-effectiveness of the Systolic Blood Pressure Intervention Trial (SPRINT) in the Chinese population: A cost-effectiveness modeling study
by Chao Li, Kangyu Chen, Victoria Cornelius, Ewan Tomeny, Yang Wang, Xiaowei Yang, Xiaodan Yuan, Rui Qin, Dahai Yu, Zhenqiang Wu, Duolao Wang, Tao Chen BackgroundThe Systolic Blood Pressure Intervention Trial (SPRINT) showed significant reductions in death and cardiovascular disease (CVD) risk with a systolic blood pressure (SBP) goal of (Source: PLoS Medicine)
Source: PLoS Medicine - March 4, 2021 Category: Internal Medicine Authors: Chao Li Source Type: research

Diagnostic accuracy of cervical cancer screening and screening –triage strategies among women living with HIV-1 in Burkina Faso and South Africa: A cohort study
This study evaluated the sensitivity, specificity, and positive predictive value of different cervical cancer strategies in WLHIV in Africa. Methods and findingsWLHIV aged 25 –50 years attending HIV treatment centres in Burkina Faso (BF) and South Africa (SA) from 5 December 2011 to 30 October 2012 were enrolled in a prospective evaluation study of visual inspection using acetic acid (VIA) or visual inspection using Lugol’s iodine (VILI), high-risk human papillomavir us DNA test (Hybrid Capture 2 [HC2] or careHPV), and cytology for histology-verified high-grade cervical intraepithelial neoplasia (CIN2+/CIN3+) a...
Source: PLoS Medicine - March 4, 2021 Category: Internal Medicine Authors: Helen A. Kelly Source Type: research

Probabilistic seasonal dengue forecasting in Vietnam: A modelling study using superensembles
ConclusionsThis study shows that by combining detailed Earth observation data, seasonal climate forecasts, and state-of-the-art models, dengue outbreaks can be predicted across a broad range of settings, with enough lead time to meaningfully inform dengue control. While our system omits some important variables not currently available at a subnational scale, the majority of past outbreaks could be predicted up to 3 months ahead. Over the next 2 years, the system will be prospectively evaluated and, if successful, potentially extended to other areas and other climate-sensitive disease systems. (Source: PLoS Medicine)
Source: PLoS Medicine - March 4, 2021 Category: Internal Medicine Authors: Felipe J. Col ón-González Source Type: research

Cardiometabolic risk factors for COVID-19 susceptibility and severity: A Mendelian randomization analysis
by Aaron Leong, Joanne B. Cole, Laura N. Brenner, James B. Meigs, Jose C. Florez, Josep M. Mercader BackgroundEpidemiological studies report associations of diverse cardiometabolic conditions including obesity with COVID-19 illness, but causality has not been established. We sought to evaluate the associations of 17 cardiometabolic traits with COVID-19 susceptibility and severity using 2-sample Mendelian randomization (MR) analyses. Methods and findingsWe selected genetic variants associated with each exposure, including body mass index (BMI), atp (Source: PLoS Medicine)
Source: PLoS Medicine - March 4, 2021 Category: Internal Medicine Authors: Aaron Leong Source Type: research

Early versus deferred anti-SARS-CoV-2 convalescent plasma in patients admitted for COVID-19: A randomized phase II clinical trial
ConclusionsIn the present study, we failed to find evidence of benefit in mortality, length of hospitalization, or mechanical ventilation requirement by immediate addition of CP therapy in the early stages of COVID-19 compared to its use only in case of patient deterioration. Trial registrationNCT04375098. (Source: PLoS Medicine)
Source: PLoS Medicine - March 3, 2021 Category: Internal Medicine Authors: Mar ía Elvira Balcells Source Type: research

Global burden of influenza-associated lower respiratory tract infections and hospitalizations among adults: A systematic review and meta-analysis
by Kathryn E. Lafond, Rachael M. Porter, Melissa J. Whaley, Zhou Suizan, Zhang Ran, Mohammad Abdul Aleem, Binay Thapa, Borann Sar, Viviana Sotomayor Proschle, Zhibin Peng, Luzhao Feng, Daouda Coulibaly, Edith Nkwembe, Alfredo Olmedo, William Ampofo, Siddhartha Saha, Mandeep Chadha, Amalya Mangiri, Vivi Setiawaty, Sami Sheikh Ali, Sandra S. Chaves, Dinagul Otorbaeva, Onechanh Keosavanh, Majd Saleh, Antonia Ho, Burmaa Alexander, Hicham Oumzil, Kedar Prasad Baral, Q. Sue Huang, Adedeji A. Adebayo, Idris Al-Abaidani, Marta von Horoch, Cheryl Cohen, Stefano Tempia, Vida Mmbaga, Malinee Chittaganpitch, Mariana Casal, Duc Anh Dan...
Source: PLoS Medicine - March 1, 2021 Category: Internal Medicine Authors: Kathryn E. Lafond Source Type: research

Vitamin D levels and risk of type 1 diabetes: A Mendelian randomization study
ConclusionsOur findings suggest that 25OHD levels are unlikely to have a large effect on risk of type 1 diabetes, but larger MR studies or RCTs are needed to investigate small effects. (Source: PLoS Medicine)
Source: PLoS Medicine - February 25, 2021 Category: Internal Medicine Authors: Despoina Manousaki Source Type: research

Recovery of kidney function after dialysis initiation in children and adults in the US: A retrospective study of United States Renal Data System data
by Elaine Ku, Raymond K. Hsu, Kirsten L. Johansen, Charles E. McCulloch, Mark Mitsnefes, Barbara A. Grimes, Kathleen D. Liu BackgroundLittle is known about factors associated with recovery of kidney function —and return to dialysis independence—or temporal trends in recovery after starting outpatient dialysis in the United States. Understanding the characteristics of individuals who may have the potential to recover kidney function may promote better recognition of such events. The goal of this stud y was to determine factors associated with recovery of kidney function in children compared with adults starting ...
Source: PLoS Medicine - February 19, 2021 Category: Internal Medicine Authors: Elaine Ku Source Type: research

Assessing the impact of preventive mass vaccination campaigns on yellow fever outbreaks in Africa: A population-level self-controlled case series study
by K évin Jean, Hanaya Raad, Katy A. M. Gaythorpe, Arran Hamlet, Judith E. Mueller, Dan Hogan, Tewodaj Mengistu, Heather J. Whitaker, Tini Garske, Mounia N. Hocine BackgroundThe Eliminate Yellow fever Epidemics (EYE) strategy was launched in 2017 in response to the resurgence of yellow fever in Africa and the Americas. The strategy relies on several vaccination activities, including preventive mass vaccination campaigns (PMVCs). However, to what extent PMVCs are associated with a decreased risk of outbreak has not yet been quantified. Methods and findingsWe used the self-controlled case series (SCCS) method to asses...
Source: PLoS Medicine - February 18, 2021 Category: Internal Medicine Authors: K évin Jean Source Type: research

Estimated impact of the pneumococcal conjugate vaccine on pneumonia mortality in South Africa, 1999 through 2016: An ecological modelling study
by Jackie Kleynhans, Stefano Tempia, Kayoko Shioda, Anne von Gottberg, Daniel M. Weinberger, Cheryl Cohen BackgroundData on the national-level impact of pneumococcal conjugate vaccine (PCV) introduction on mortality are lacking from Africa. PCV was introduced in South Africa in 2009. We estimated the impact of PCV introduction on all-cause pneumonia mortality in South Africa, while controlling for changes in mortality due to other interventions. Methods and findingsWe used national death registration data in South Africa from 1999 to 2016 to assess the impact of PCV introduction on all-cause pneumonia mortality in all ages...
Source: PLoS Medicine - February 16, 2021 Category: Internal Medicine Authors: Jackie Kleynhans Source Type: research

Comparative effect of physical exercise versus statins on improving arterial stiffness in patients with high cardiometabolic risk: A network meta-analysis
ConclusionsIn this NMA, we found that although many patients could benefit from statins for reducing CVD risk, our results support that, considering the beneficial effects of high-intensity exercise on arterial stiffness, it would be worthwhile to refocus our attention on this type of exercise as an effective tool for the prevention of CVD. Systematic review registrationPROSPERO CRD42019123120. (Source: PLoS Medicine)
Source: PLoS Medicine - February 16, 2021 Category: Internal Medicine Authors: Iv án Cavero-Redondo Source Type: research

Association of socioeconomic deprivation with asthma care, outcomes, and deaths in Wales: A 5-year national linked primary and secondary care cohort study
by Mohammad A. Alsallakh, Sarah E. Rodgers, Ronan A. Lyons, Aziz Sheikh, Gwyneth A. Davies BackgroundSocioeconomic deprivation is known to be associated with worse outcomes in asthma, but there is a lack of population-based evidence of its impact across all stages of patient care. We investigated the association of socioeconomic deprivation with asthma-related care and outcomes across primary and secondary care and with asthma-related death in Wales. Methods and findingsWe constructed a national cohort, identified from 76% (2.4 million) of the Welsh population, of continuously treated asthma patients between 2013 and 2017 ...
Source: PLoS Medicine - February 12, 2021 Category: Internal Medicine Authors: Mohammad A. Alsallakh Source Type: research

Cervical ripening in prolonged pregnancies by silicone double balloon catheter < i > versus < /i > vaginal dinoprostone slow release system: The MAGPOP randomised controlled trial
by Caroline Diguisto, Am élie Le Gouge, Chloé Arthuis, Norbert Winer, Olivier Parant, Christophe Poncelet, Celine Chauleur, Jacob Hannigsberg, Guillaume Ducarme, Denis Gallot, Rene Gabriel, Raoul Desbriere, Gael Beucher, Cyrille Faraguet, Helene Isly, Patrick Rozenberg, Bruno Giraudeau, Franck Perrotin, for the Groupe de Recherche en Obstétrique et Gynécologie (GROG) BackgroundProlonged pregnancies are a frequent indication for induction of labour. When the cervix is unfavourable, cervical ripening before oxytocin administration is recommended to increase the likelihood of vaginal delivery, but ...
Source: PLoS Medicine - February 11, 2021 Category: Internal Medicine Authors: Caroline Diguisto Source Type: research

Persistence of Ebola virus in semen among Ebola virus disease survivors in Sierra Leone: A cohort study of frequency, duration, and risk factors
ConclusionsIn this study we observed that EBOV RNA persistence in semen was a frequent phenomenon, with high population rates over time. This finding will inform forthcoming updated recommendations on risk reduction strategies relating to sexual transmission of EBOV. Our findings support implementation of a semen testing program as part of epidemic preparedness and response. Further, the results will enable planning of the magnitude of testing and targeted counseling needs over time. (Source: PLoS Medicine)
Source: PLoS Medicine - February 10, 2021 Category: Internal Medicine Authors: A. E. Thorson Source Type: research

HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda
by Catherine A. Koss, Diane V. Havlir, James Ayieko, Dalsone Kwarisiima, Jane Kabami, Gabriel Chamie, Mucunguzi Atukunda, Yusuf Mwinike, Florence Mwangwa, Asiphas Owaraganise, James Peng, Winter Olilo, Katherine Snyman, Benard Awuonda, Tamara D. Clark, Douglas Black, Joshua Nugent, Lillian B. Brown, Carina Marquez, Hideaki Okochi, Kevin Zhang, Carol S. Camlin, Vivek Jain, Monica Gandhi, Craig R. Cohen, Elizabeth A. Bukusi, Edwin D. Charlebois, Maya L. Petersen, Moses R. Kamya, Laura B. Balzer BackgroundOral pre-exposure prophylaxis (PrEP) is highly effective for HIV prevention, but data are limited on HIV incidence among P...
Source: PLoS Medicine - February 9, 2021 Category: Internal Medicine Authors: Catherine A. Koss Source Type: research

Egg and cholesterol consumption and mortality from cardiovascular and different causes in the United States: A population-based cohort study
ConclusionsIn this study, intakes of eggs and cholesterol were associated with higher all-cause, CVD, and cancer mortality. The increased mortality associated with egg consumption was largely influenced by cholesterol intake. Our findings suggest limiting cholesterol intake and replacing whole eggs with egg whites/substitutes or other alternative protein sources for facilitating cardiovascular health and long-term survival. Trial registrationClinicalTrials.gov NCT00340015. (Source: PLoS Medicine)
Source: PLoS Medicine - February 9, 2021 Category: Internal Medicine Authors: Pan Zhuang Source Type: research

Correction: Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: A cross-sectional study
by Mary T. Bassett, Jarvis T. Chen, Nancy Krieger (Source: PLoS Medicine)
Source: PLoS Medicine - February 4, 2021 Category: Internal Medicine Authors: Mary T. Bassett Source Type: research

Quantification of fibroblast growth factor 23 and N-terminal pro-B-type natriuretic peptide to identify patients with atrial fibrillation using a high-throughput platform: A validation study
In this study, we validated the AF model using standardised, high-throughput, high-sensitivity biomarker assays. Methods and findingsFor this study, 1,625 consecutive patients with either (1) diagnosed AF or (2) sinus rhythm with CHA2DS2-VASc score of 2 or more were recruited from a large teaching hospital in Birmingham, West Midlands, UK, between September 2014 and February 2018. Seven-day ambulatory ECG monitoring excluded silent AF. Patients with tachyarrhythmias apart from AF and incomplete cases were excluded. AF was diagnosed according to current clinical guidelines and confirmed by ECG. We developed a high-throughpu...
Source: PLoS Medicine - February 3, 2021 Category: Internal Medicine Authors: Winnie Chua Source Type: research

Safety, acceptability, and pharmacokinetics of a monoclonal antibody-based vaginal multipurpose prevention film (MB66): A Phase I randomized trial
ConclusionsSingle and repeated intravaginal applications of MB66 film were safe, well tolerated, and acceptable. Concentrations and ex vivo bioactivity of both mAbs in vaginal secretions were significantly elevated and thus could provide protection for at least 24 hours postdose. However, further research is needed to evaluate the efficacy of MB66 film in women at risk for HIV and HSV infection. Additional antibodies could be added to this platform to provide protection against other sexually transmitted infections (STIs) and contraception. Trial registrationClinicalTrials.gov NCT02579083. (Source: PLoS Medicine)
Source: PLoS Medicine - February 3, 2021 Category: Internal Medicine Authors: Joseph A. Politch Source Type: research

Healthy lifestyle, endoscopic screening, and colorectal cancer incidence and mortality in the United States: A nationwide cohort study
ConclusionsOur study suggests that healthy lifestyle is associated with lower CRC incidence and mortality independent of endoscopic screening. An integration of healthy lifestyle with endoscopic screening may substantially enhance prevention for CRC, particularly for proximal colon cancer, compared to endoscopic screening alone. (Source: PLoS Medicine)
Source: PLoS Medicine - February 1, 2021 Category: Internal Medicine Authors: Kai Wang Source Type: research

Evaluation of oral dextrose gel for prevention of neonatal hypoglycemia (hPOD): A multicenter, double-blind randomized controlled trial
by Jane E. Harding, Joanne E. Hegarty, Caroline A. Crowther, Richard P. Edlin, Gregory D. Gamble, Jane M. Alsweiler, for the hPOD Study Group BackgroundNeonatal hypoglycemia is common and can cause brain injury. Buccal dextrose gel is effective for treatment of neonatal hypoglycemia, and when used for prevention may reduce the incidence of hypoglycemia in babies at risk, but its clinical utility remains uncertain. Methods and findingsWe conducted a multicenter, double-blinded, placebo-controlled randomized trial in 18 New Zealand and Australian maternity hospitals from January 2015 to May 2019. Babies at risk of neonatal h...
Source: PLoS Medicine - January 28, 2021 Category: Internal Medicine Authors: Jane E. Harding Source Type: research

Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium
by Ling-Wei Chen, Adrien M. Aubert, Nitin Shivappa, Jonathan Y. Bernard, Sara M. Mensink-Bout, Aisling A. Geraghty, John Mehegan, Matthew Suderman, Kinga Polanska, Wojciech Hanke, Elzbieta Trafalska, Caroline L. Relton, Sarah R. Crozier, Nicholas C. Harvey, Cyrus Cooper, Liesbeth Duijts, Barbara Heude, James R. H ébert, Fionnuala M. McAuliffe, Cecily C. Kelleher, Catherine M. Phillips BackgroundAdverse birth outcomes are major causes of morbidity and mortality during childhood and associate with a higher risk of noncommunicable diseases in adult life. Maternal periconception and antenatal nutrition, mostly focusing ...
Source: PLoS Medicine - January 21, 2021 Category: Internal Medicine Authors: Ling-Wei Chen Source Type: research

Risk of developing active tuberculosis following tuberculosis screening and preventive therapy for Tibetan refugee children and adolescents in India: An impact assessment
by Kunchok Dorjee, Sonam Topgyal, Tenzin Tsewang, Tenzin Tsundue, Tenzin Namdon, Elizabeth Bonomo, Caroline Kensler, Dekyi Lhadon, Tsering Choetso, Tenzin Nangsel, Tsering Dolkar, Thupten Tsekyi, Chungdak Dorjee, Dawa Phunkyi, Tsetan D. Sadutshang, Zorba Paster, Richard E. Chaisson BackgroundTuberculosis (TB) rates among Tibetan refugee children and adolescents attending boarding schools in India are extremely high. We undertook a comprehensive case finding and TB preventive treatment (TPT) program in 7 schools in the Zero TB Kids project. We aimed to measure the TB infection and disease burden and investigate the risk of ...
Source: PLoS Medicine - January 19, 2021 Category: Internal Medicine Authors: Kunchok Dorjee Source Type: research

The impact of a routine late third trimester growth scan on the incidence, diagnosis, and management of breech presentation in Oxfordshire, UK: A cohort study
by Ibtisam Salim, Eleonora Staines-Urias, Sam Mathewlynn, Lior Drukker, Manu Vatish, Lawrence Impey BackgroundBreech presentation at term contributes significantly to cesarean section (CS) rates worldwide. External cephalic version (ECV) is a safe procedure that reduces term breech presentation and associated CS. A principal barrier to ECV is failure to diagnose breech presentation. Failure to diagnose breech presentation also leads to emergency CS or unplanned vaginal breech birth. Recent evidence suggests that undiagnosed breech might be eliminated using a third trimester scan. Our aim was to evaluate the impact of intro...
Source: PLoS Medicine - January 15, 2021 Category: Internal Medicine Authors: Ibtisam Salim Source Type: research

Recognition and management of community-acquired acute kidney injury in low-resource settings in the ISN 0by25 trial: A multi-country feasibility study
by Etienne Macedo, Ulla Hemmila, Sanjib Kumar Sharma, Rolando Claure-Del Granado, Henry Mzinganjira, Emmanuel A. Burdmann, Jorge Cerd á, John Feehally, Fredric Finkelstein, Guillermo García-García, Vivekanand Jha, Norbert H. Lameire, Euyhyun Lee, Nathan W. Levin, Andrew Lewington, Raúl Lombardi, Michael V. Rocco, Eliah Aronoff-Spencer, Marcello Tonelli, Karen Yeates, Giuseppe Remuzzi, Ravindra L. Mehta, for the ISN 0by25 Trial Study Group BackgroundAcute kidney injury (AKI) is increasingly encountered in community settings and contributes to morbidity, mortality, and increased resource utilizati...
Source: PLoS Medicine - January 14, 2021 Category: Internal Medicine Authors: Etienne Macedo Source Type: research

Polygenic risk scores in cardiovascular risk prediction: A cohort study and modelling analyses
by Luanluan Sun, Lisa Pennells, Stephen Kaptoge, Christopher P. Nelson, Scott C. Ritchie, Gad Abraham, Matthew Arnold, Steven Bell, Thomas Bolton, Stephen Burgess, Frank Dudbridge, Qi Guo, Eleni Sofianopoulou, David Stevens, John R. Thompson, Adam S. Butterworth, Angela Wood, John Danesh, Nilesh J. Samani, Michael Inouye, Emanuele Di Angelantonio BackgroundPolygenic risk scores (PRSs) can stratify populations into cardiovascular disease (CVD) risk groups. We aimed to quantify the potential advantage of adding information on PRSs to conventional risk factors in the primary prevention of CVD. Methods and findingsUsing data f...
Source: PLoS Medicine - January 14, 2021 Category: Internal Medicine Authors: Luanluan Sun Source Type: research

Plasma proteins associated with cardiovascular death in patients with chronic coronary heart disease: A retrospective study
by Lars Wallentin, Niclas Eriksson, Maciej Olszowka, Tanja B. Grammer, Emil Hagstr öm, Claes Held, Marcus E. Kleber, Wolfgang Koenig, Winfried März, Ralph A. H. Stewart, Harvey D. White, Mikael Åberg, Agneta Siegbahn BackgroundCirculating biomarkers are associated with the development of coronary heart disease (CHD) and its complications by reflecting pathophysiological pathways and/or organ dysfunction. We explored the associations between 157 cardiovascular (CV) and inflammatory biomarkers and CV death using proximity extension assays (PEA) in patients with chronic CHD. Methods and findingsThe derivation ...
Source: PLoS Medicine - January 13, 2021 Category: Internal Medicine Authors: Lars Wallentin Source Type: research

Multimorbidity combinations, costs of hospital care and potentially preventable emergency admissions in England: A cohort study
ConclusionsOur findings indicate that there are no clear multimorbidity combinations for a cluster-targeted intervention approach to reduce secondary care costs. The role of risk-stratification and focus on individual high-cost patients with interventions is particularly questionable for this aim. However, if aetiology is favourable for preventing further disease, the cluster approach might be useful for targeting disease prevention efforts with potential for cost-savings in secondary care. (Source: PLoS Medicine)
Source: PLoS Medicine - January 13, 2021 Category: Internal Medicine Authors: Jonathan Stokes Source Type: research

Accelerometer measured physical activity and the incidence of cardiovascular disease: Evidence from the UK Biobank cohort study
ConclusionsIn this study, we found no evidence of a threshold for the inverse association between objectively measured moderate, vigorous, and total PA with CVD. Our findings suggest that PA is not only associated with lower risk for of CVD, but the greatest benefit is seen for those who are active at the highest level. (Source: PLoS Medicine)
Source: PLoS Medicine - January 12, 2021 Category: Internal Medicine Authors: Rema Ramakrishnan Source Type: research

Effects on childhood infections of promoting safe and hygienic complementary-food handling practices through a community-based programme: A cluster randomised controlled trial in a rural area of The Gambia
by Semira Manaseki-Holland, Buba Manjang, Karla Hemming, James T. Martin, Christopher Bradley, Louise Jackson, Makie Taal, Om Prasad Gautam, Francesca Crowe, Bakary Sanneh, Jeroen Ensink, Tim Stokes, Sandy Cairncross BackgroundThe Gambia has high rates of under-5 mortality from diarrhoea and pneumonia, peaking during complementary-feeding age. Community-based interventions may reduce complementary-food contamination and disease rates. Methods and findingsA public health intervention using critical control points and motivational drivers, delivered February –April 2015 in The Gambia, was evaluated in a cluster randomi...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Semira Manaseki-Holland Source Type: research

Clinical outcomes in a primary-level non-communicable disease programme for Syrian refugees and the host population in Jordan: A cohort analysis using routine data
ConclusionsGood treatment outcomes and reasonable rates of treatment interruption were achieved in a multidisciplinary, primary-level NCD programme in Jordan. Our approach to using continuous programmatic data may be a feasible way for humanitarian organisations to account for the complex and dynamic nature of interventions in unstable humanitarian settings when undertaking routine monitoring and evaluation. We suggest that frequency of patient contact could be reduced without negatively impacting patient outcomes and that season should be taken into account in analysing programme performance. (Source: PLoS Medicine)
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Éimhín Ansbro Source Type: research