Raltegravir-intensified initial antiretroviral therapy in advanced HIV disease in Africa: A randomised controlled trial
by Cissy Kityo, Alexander J. Szubert, Abraham Siika, Robert Heyderman, Mutsa Bwakura-Dangarembizi, Abbas Lugemwa, Shalton Mwaringa, Anna Griffiths, Immaculate Nkanya, Sheila Kabahenda, Simon Wachira, Godfrey Musoro, Chatu Rajapakse, Timothy Etyang, James Abach, Moira J. Spyer, Priscilla Wavamunno, Linda Nyondo-Mipando, Ennie Chidziva, Kusum Nathoo, Nigel Klein, James Hakim, Diana M. Gibb, A. Sarah Walker, Sarah L. Pett, on behalf of the REALITY trial team BackgroundIn sub-Saharan Africa, individuals infected with HIV who are severely immunocompromised have high mortality (about 10%) shortly after starting antiretroviral th...
Source: PLoS Medicine - December 4, 2018 Category: Internal Medicine Authors: Cissy Kityo Source Type: research

Metabolic syndrome in pregnancy and risk for adverse pregnancy outcomes: A prospective cohort of nulliparous women
by Jessica A. Grieger, Tina Bianco-Miotto, Luke E. Grzeskowiak, Shalem Y. Leemaqz, Lucilla Poston, Lesley M. McCowan, Louise C. Kenny, Jenny E. Myers, James J. Walker, Gus A. Dekker, Claire T. Roberts BackgroundObesity increases the risk for developing gestational diabetes mellitus (GDM) and preeclampsia (PE), which both associate with increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in women in later life. In the general population, metabolic syndrome (MetS) associates with T2DM and CVD. The impact of maternal MetS on pregnancy outcomes, in nulliparous pregnant women, has not been invest...
Source: PLoS Medicine - December 4, 2018 Category: Internal Medicine Authors: Jessica A. Grieger Source Type: research

Deep learning and artificial intelligence in radiology: Current applications and future directions
by Koichiro Yasaka, Osamu Abe (Source: PLoS Medicine)
Source: PLoS Medicine - November 30, 2018 Category: Internal Medicine Authors: Koichiro Yasaka Source Type: research

Advancing the beneficial use of machine learning in health care and medicine: Toward a community understanding
by Linda Nevin, on behalf of the PLOS Medicine Editors (Source: PLoS Medicine)
Source: PLoS Medicine - November 30, 2018 Category: Internal Medicine Authors: Linda Nevin Source Type: research

Characterising risk of in-hospital mortality following cardiac arrest using machine learning: A retrospective international registry study
by Shane Nanayakkara, Sam Fogarty, Michael Tremeer, Kelvin Ross, Brent Richards, Christoph Bergmeir, Sheng Xu, Dion Stub, Karen Smith, Mark Tacey, Danny Liew, David Pilcher, David M. Kaye BackgroundResuscitated cardiac arrest is associated with high mortality; however, the ability to estimate risk of adverse outcomes using existing illness severity scores is limited. Using in-hospital data available within the first 24 hours of admission, we aimed to develop more accurate models of risk prediction using both logistic regression (LR) and machine learning (ML) techniques, with a combination of demographic, physiologic, and b...
Source: PLoS Medicine - November 30, 2018 Category: Internal Medicine Authors: Shane Nanayakkara Source Type: research

Deep learning for lung cancer prognostication: A retrospective multi-cohort radiomics study
This study explores deep learning applications in medical imaging allowing for the automated quantification of radiographic characteristics and potentially improving patient stratification. Methods and findingsWe performed an integrative analysis on 7 independent datasets across 5 institutions totaling 1,194 NSCLC patients (age median = 68.3 years [range 32.5 –93.3], survival median = 1.7 years [range 0.0–11.7]). Using external validation in computed tomography (CT) data, we identified prognostic signatures using a 3D convolutional neural network (CNN) for patients treated with radiotherapy (n = 771, age median...
Source: PLoS Medicine - November 30, 2018 Category: Internal Medicine Authors: Ahmed Hosny Source Type: research

Deep-learning-assisted diagnosis for knee magnetic resonance imaging: Development and retrospective validation of MRNet
In this study we developed a deep learning model for detecting general abnormalities and specific diagnoses (anterior cruciate ligament [ACL] tears and meniscal tears) on knee MRI exams. We then measured the effect of providing the model ’s predictions to clinical experts during interpretation. Methods and findingsOur dataset consisted of 1,370 knee MRI exams performed at Stanford University Medical Center between January 1, 2001, and December 31, 2012 (mean age 38.0 years; 569 [41.5%] female patients). The majority vote of 3 musculoskeletal radiologists established reference standard labels on an internal validation...
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Nicholas Bien Source Type: research

Development and validation of machine learning models to identify high-risk surgical patients using automatically curated electronic health record data (Pythia): A retrospective, single-site study
ConclusionsExtracting and curating a large, local institution ’s EHR data for machine learning purposes resulted in models with strong predictive performance. These models can be used in clinical settings as decision support tools for identification of high-risk patients as well as patient evaluation and care management. Further work is necessary to evaluate the impact of the Pythia risk calculator within the clinical workflow on postoperative outcomes and to optimize this data flow for future machine learning efforts. (Source: PLoS Medicine)
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Kristin M. Corey Source Type: research

Machine learning in population health: Opportunities and threats
by Abraham D. Flaxman, Theo Vos Abraham D. Flaxman and Theo Vos of the Institute for Health Metrics and Evaluation, University of Washington, discuss near-term applications for ML in population health and name their priorities for ongoing ML development. (Source: PLoS Medicine)
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Abraham D. Flaxman Source Type: research

Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study
This study aimed to evaluate whether models using machine learning techniques could significantly improve AKI risk prediction after PCI. Methods and findingsWe used the same cohort and candidate variables used to develop the current NCDR CathPCI Registry AKI model, including 947,091 patients who underwent PCI procedures between June 1, 2009, and June 30, 2011. The mean age of these patients was 64.8 years, and 32.8% were women, with a total of 69,826 (7.4%) AKI events. We replicated the current AKI model as the baseline model and compared it with a series of new models. Temporal validation was performed using data from 970...
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Chenxi Huang Source Type: research

Relationships between intensity, duration, cumulative dose, and timing of smoking with age at menopause: A pooled analysis of individual data from 17 observational studies
by Dongshan Zhu, Hsin-Fang Chung, Nirmala Pandeya, Annette J. Dobson, Janet E. Cade, Darren C. Greenwood, Sybil L. Crawford, Nancy E. Avis, Ellen B. Gold, Ellen S. Mitchell, Nancy F. Woods, Debra Anderson, Daniel E. Brown, Lynnette L. Sievert, Eric J. Brunner, Diana Kuh, Rebecca Hardy, Kunihiko Hayashi, Jung Su Lee, Hideki Mizunuma, Graham G. Giles, Fiona Bruinsma, Therese Tillin, Mette Kildev æld Simonsen, Hans-Olov Adami, Elisabete Weiderpass, Marianne Canonico, Marie-Laure Ancelin, Panayotes Demakakos, Gita D. Mishra BackgroundCigarette smoking is associated with earlier menopause, but the impact of being a former...
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Dongshan Zhu Source Type: research

Mobile detection of autism through machine learning on home video: A development and prospective validation study
ConclusionsThese results support the hypothesis that feature tagging of home videos for machine learning classification of autism can yield accurate outcomes in short time frames, using mobile devices. Further work will be needed to confirm that this approach can accelerate autism diagnosis at scale. (Source: PLoS Medicine)
Source: PLoS Medicine - November 27, 2018 Category: Internal Medicine Authors: Qandeel Tariq Source Type: research

Deep learning for chest radiograph diagnosis: A retrospective comparison of the CheXNeXt algorithm to practicing radiologists
ConclusionsIn this study, we developed and validated a deep learning algorithm that classified clinically important abnormalities in chest radiographs at a performance level comparable to practicing radiologists. Once tested prospectively in clinical settings, the algorithm could have the potential to expand patient access to chest radiograph diagnostics. (Source: PLoS Medicine)
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Pranav Rajpurkar Source Type: research

Predicting the risk of emergency admission with machine learning: Development and validation using linked electronic health records
ConclusionsThe use of machine learning and addition of temporal information led to substantially improved discrimination and calibration for predicting the risk of emergency admission. Model performance remained stable across a range of prediction time windows and when externally validated. These findings support the potential of incorporating machine learning models into electronic health records to inform care and service planning. (Source: PLoS Medicine)
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Fatemeh Rahimian Source Type: research

The use of machine learning to understand the relationship between IgE to specific allergens and asthma
by Thomas A. E. Platts-Mills, Matthew Perzanowski Thomas Platts-Mills and Matthew Perzanowski provide their expert Perspective on a translational study from Custovic and colleagues that identifies pairings of IgE that show value in estimating risk of concurrent asthma. (Source: PLoS Medicine)
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Thomas A. E. Platts-Mills Source Type: research

Automated detection of moderate and large pneumothorax on frontal chest X-rays using deep convolutional neural networks: A retrospective study
ConclusionsWe trained automated classifiers to detect moderate and large pneumothorax in frontal chest X-rays at high levels of performance on held-out test data. These models may provide a high specificity screening solution to detect moderate or large pneumothorax on images collected when human review might be delayed, such as overnight. They are not intended for unsupervised diagnosis of all pneumothoraces, as many small pneumothoraces (and some larger ones) are not detected by the algorithm. Implementation studies are warranted to develop appropriate, effective clinician alerts for the potentially critical finding of p...
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Andrew G. Taylor Source Type: research

Healthy volunteers' perceptions of risk in US Phase I clinical trials: A mixed-methods study
ConclusionsOur study demonstrates that healthy volunteers are generally aware of and reflective about Phase I trial risks. The discrepancy in healthy volunteers ’ views of overall and personal risk sheds light on why healthy volunteers might continue to enroll in clinical trials, even when they view trials on the whole as risky. (Source: PLoS Medicine)
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Jill A. Fisher Source Type: research

Reducing chronic disease through changes in food aid: A microsimulation of nutrition and cardiometabolic disease among Palestinian refugees in the Middle East
ConclusionsContrary to the supposition in the literature, our findings do not robustly support the theory that transitioning from traditional food aid to either debit card or cash delivery alone would necessarily reduce chronic disease outcomes. Rather, an alternative food parcel would be more effective, even after matching current budget ceilings. But compensatory increases in consumption of less healthy foods may neutralize the improvements from an alternative food parcel unless total aid funding were increased substantially. Our analysis is limited by uncertainty in estimates of modeling long-term outcomes from shorter-...
Source: PLoS Medicine - November 20, 2018 Category: Internal Medicine Authors: Sanjay Basu Source Type: research

Machine learning to identify pairwise interactions between specific IgE antibodies and their association with asthma: A cross-sectional analysis within a population-based birth cohort
ConclusionsInteractions between pairs of sIgE components are associated with increased risk of asthma and may provide the basis for designing diagnostic tools for asthma. (Source: PLoS Medicine)
Source: PLoS Medicine - November 13, 2018 Category: Internal Medicine Authors: Sara Fontanella Source Type: research

Transforming health policy through machine learning
by Hutan Ashrafian, Ara Darzi In their Perspective, Ara Darzi and Hutan Ashrafian give us a tour of the future policymaker's machine learning toolkit. (Source: PLoS Medicine)
Source: PLoS Medicine - November 13, 2018 Category: Internal Medicine Authors: Hutan Ashrafian Source Type: research

Machine learning assessment of myocardial ischemia using angiography: Development and retrospective validation
by Hyeonyong Hae, Soo-Jin Kang, Won-Jang Kim, So-Yeon Choi, June-Goo Lee, Youngoh Bae, Hyungjoo Cho, Dong Hyun Yang, Joon-Won Kang, Tae-Hwan Lim, Cheol Hyun Lee, Do-Yoon Kang, Pil Hyung Lee, Jung-Min Ahn, Duk-Woo Park, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park BackgroundInvasive fractional flow reserve (FFR) is a standard tool for identifying ischemia-producing coronary stenosis. However, in clinical practice, over 70% of treatment decisions still rely on visual estimation of angiographic stenosis, which has limited accuracy (about 60% –65%) for the prediction of FFR (Source: PLoS Medicine)
Source: PLoS Medicine - November 13, 2018 Category: Internal Medicine Authors: Hyeonyong Hae Source Type: research

Hydrometeorology and flood pulse dynamics drive diarrheal disease outbreaks and increase vulnerability to climate change in surface-water-dependent populations: A retrospective analysis
ConclusionsIn flood pulse river —floodplain systems, hydrology and water quality dynamics can be highly variable, potentially impacting conventional water treatment facilities and the production of safe drinking water. In Southern Africa, climate change is predicted to intensify hydrological variability and the frequency of extr eme weather events, amplifying the public health threat of waterborne disease in surface-water-dependent populations. Water sector development should be prioritized with urgency, incorporating technologies that are robust to local environmental conditions and expected climate-driven impacts. ...
Source: PLoS Medicine - November 8, 2018 Category: Internal Medicine Authors: Kathleen A. Alexander Source Type: research

Safety, tolerability, and pharmacokinetics of long-acting injectable cabotegravir in low-risk HIV-uninfected individuals: HPTN 077, a phase 2a randomized controlled trial
ConclusionsIn this study, CAB LA was well tolerated at the doses and dosing intervals used. ISRs were common, but infrequently led to product discontinuation. CAB LA 600 mg every 8 weeks met pharmacokinetic targets for both male and female study participants. The safety and pharmacokinetic results observed support the further development of CAB LA, and efficacy studies of CAB LA for HIV treatment and prevention are in progress. Trial registrationClinicalTrials.gov Registry: ClinicalTrials.gov Trial number: NCT02178800. (Source: PLoS Medicine)
Source: PLoS Medicine - November 8, 2018 Category: Internal Medicine Authors: Raphael J. Landovitz Source Type: research

Prediction of myopia development among Chinese school-aged children using refraction data from electronic medical records: A retrospective, multicentre machine learning study
ConclusionsTo our knowledge, this study, for the first time, used large-scale data collected from electronic health records to demonstrate the contribution of big data and machine learning approaches to improved prediction of myopia prognosis in Chinese school-aged children. This work provides evidence for transforming clinical practice, health policy-making, and precise individualised interventions regarding the practical control of school-aged myopia. (Source: PLoS Medicine)
Source: PLoS Medicine - November 6, 2018 Category: Internal Medicine Authors: Haotian Lin Source Type: research

Variable generalization performance of a deep learning model to detect pneumonia in chest radiographs: A cross-sectional study
by John R. Zech, Marcus A. Badgeley, Manway Liu, Anthony B. Costa, Joseph J. Titano, Eric Karl Oermann BackgroundThere 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 findingsA cross-sectional design with multiple model training cohorts was used to evaluate model generalizability to external sites using spl...
Source: PLoS Medicine - November 6, 2018 Category: Internal Medicine Authors: John R. Zech Source Type: research

Machine learning in medicine: Addressing ethical challenges
by 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. (Source: PLoS Medicine)
Source: PLoS Medicine - November 6, 2018 Category: Internal Medicine Authors: Effy Vayena Source Type: research

Lymphopenia and risk of infection and infection-related death in 98,344 individuals from a prospective Danish population-based study
by Marie Warny, Jens Helby, B ørge Grønne Nordestgaard, Henrik Birgens, Stig Egil Bojesen BackgroundNeutropenia 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 findingsOf 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 coun...
Source: PLoS Medicine - November 1, 2018 Category: Internal Medicine Authors: Marie Warny Source Type: research

Development and validation of a new method for indirect estimation of neonatal, infant, and child mortality trends using summary birth histories
ConclusionsThis new method for estimating child mortality produces results that are comparable to current best methods for indirect estimation of under-5 mortality while additionally producing age-specific estimates. Use of such methods allows researchers to utilize a massive amount of SBH data for estimation of trends in NN and infant mortality. Systematic application of these methods could further improve the evidence base for monitoring of trends and inequalities in age-specific child mortality. (Source: PLoS Medicine)
Source: PLoS Medicine - October 31, 2018 Category: Internal Medicine Authors: Roy Burstein Source Type: research

Correction: Signatures of inflammation and impending multiple organ dysfunction in the hyperacute phase of trauma: A prospective cohort study
by 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 (Source: PLoS Medicine)
Source: PLoS Medicine - October 31, 2018 Category: Internal Medicine Authors: Claudia P. Cabrera Source Type: research

Health systems thinking: A new generation of research to improve healthcare quality
by 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 le vel, improved utility of research products, and innovative reporting tools to help guide the development of new methods are key to improved global healthcare. (Source: PLoS Medicine)
Source: PLoS Medicine - October 30, 2018 Category: Internal Medicine Authors: Hannah H. Leslie Source Type: research

Late-pregnancy dysglycemia in obese pregnancies after negative testing for gestational diabetes and risk of future childhood overweight: An interim analysis from a longitudinal mother –child cohort study
ConclusionsFindings from this interim analysis suggest that offspring of obese mothers treated because of a diagnosis of GDM appeared to have a better BMI outcome in childhood than those of obese mothers who —following negative GDM testing—remained untreated in the last trimester and developed dysglycemia. Late-pregnancy dysglycemia related to uncontrolled weight gain may contribute to the development of child overweight and maternal diabetes. Our data suggest that negative GDM testing in obese preg nancies is not an “all-clear signal” and should not lead to reduced attention and risk awareness of p...
Source: PLoS Medicine - October 29, 2018 Category: Internal Medicine Authors: Delphina Gomes Source Type: research

A cash-based intervention and the risk of acute malnutrition in children aged 6 –59 months living in internally displaced persons camps in Mogadishu, Somalia: A non-randomised cluster trial
by 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 BackgroundSomalia has been affected by conflict since 1991, with children aged (Source: PLoS Medicine)
Source: PLoS Medicine - October 29, 2018 Category: Internal Medicine Authors: Carlos S. Grijalva-Eternod Source Type: research

Epidemiological metrics and benchmarks for a transition in the HIV epidemic
by 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. (Source: PLoS Medicine)
Source: PLoS Medicine - October 25, 2018 Category: Internal Medicine Authors: Peter D. Ghys Source Type: research

Organophosphate exposures during pregnancy and child neurodevelopment: Recommendations for essential policy reforms
by 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. (Source: PLoS Medicine)
Source: PLoS Medicine - October 24, 2018 Category: Internal Medicine Authors: Irva Hertz-Picciotto Source Type: research

Climate change and African trypanosomiasis vector populations in Zimbabwe's Zambezi Valley: A mathematical modelling study
ConclusionsThe model suggests that the increase in temperature may explain the observed collapse in tsetse abundance and provides a first step in linking temperature to trypanosomiasis risk. If the effect at Mana Pools extends across the whole of the Zambezi Valley, then transmission of trypanosomes is likely to have been greatly reduced in this warm low-lying region. Conversely, rising temperatures may have made some higher, cooler, parts of Zimbabwe more suitable for tsetse and led to the emergence of new disease foci. (Source: PLoS Medicine)
Source: PLoS Medicine - October 22, 2018 Category: Internal Medicine Authors: Jennifer S. Lord Source Type: research

Involuntary mental health treatment in the era of the United Nations Convention on the Rights of Persons with Disabilities
by 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. (Source: PLoS Medicine)
Source: PLoS Medicine - October 18, 2018 Category: Internal Medicine Authors: Faraaz Mahomed Source Type: research

Prevalence of and reasons for women ’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review
ConclusionsDespite a minority of women expressing a preference for CS, individual, health system, and socio-cultural factors converge, contributing to a high CS rate in mainland China, Hong Kong, and Taiwan. In order to reduce unnecessary CSs, interventions need to address all these non-clinical factors and concerns. Systematic review registryProspero CRD42016036596. (Source: PLoS Medicine)
Source: PLoS Medicine - October 16, 2018 Category: Internal Medicine Authors: Qian Long Source Type: research

Cesarean section in China, Taiwan, and Hong Kong —A safe choice for women and clinicians?
by 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. (Source: PLoS Medicine)
Source: PLoS Medicine - October 16, 2018 Category: Internal Medicine Authors: Mairead Black Source Type: research

Fatty acid biomarkers of dairy fat consumption and incidence of type 2 diabetes: A pooled analysis of prospective cohort studies
by 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 Djouss é, Johanna M. Geleijnse, Graham G. Giles, Janette de Goede, Vilmundur Gudnason, William S. Harris, Allison Hodge, Frank Hu, InterAct Consortium , Albert Koulman, Markku Laakso, Lars Lind, Hung-Ju Lin, Barbara McKnight, Kalina Rajaobelina, Ulf Risérus, Jennifer G. Robinson, Cécilia Samier...
Source: PLoS Medicine - October 10, 2018 Category: Internal Medicine Authors: Fumiaki Imamura Source Type: research

Retention in HIV care during the 3 years following release from incarceration: A cohort study
by Kelsey B. Loeliger, Jaimie P. Meyer, Mayur M. Desai, Maria M. Ciarleglio, Colleen Gallagher, Frederick L. Altice BackgroundSustained 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 findingsThis is a retrospective cohort study of all adult people living with HIV (PLWH) incarcerated in Connecticut, US, during the period January 1, 2007, t...
Source: PLoS Medicine - October 9, 2018 Category: Internal Medicine Authors: Kelsey B. Loeliger Source Type: research

Patient-centered primary care and self-rated health in 6 Latin American and Caribbean countries: Analysis of a public opinion cross-sectional survey
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. Methods and findingsWe conducted a secondary analysis of a 2013 public opinion cross-sectional survey on perceptions and experiences with healthcare systems in Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama; the data were nationally representative for urban populations. We analyzed 9 features of patient-centered PC. We calc...
Source: PLoS Medicine - October 9, 2018 Category: Internal Medicine Authors: Frederico Guanais Source Type: research

Expected changes in obesity after reformulation to reduce added sugars in beverages: A modeling study
ConclusionsReformulation to reduce added sugars in SSBs could produce large reductions in sugar consumption and obesity in the Mexican adult population. This study is limited by the use of a single dietary recall and by data collected in all seasons except summer; still, these limitations should lead to conservative estimates of the reformulation effect. Reformulation success could depend on government enforcement and industry and consumer response, for which further research and evidence are needed. (Source: PLoS Medicine)
Source: PLoS Medicine - October 5, 2018 Category: Internal Medicine Authors: Ana Basto-Abreu Source Type: research

Long-term trends in incidence and risk factors for ischaemic stroke subtypes: Prospective population study of the South London Stroke Register
by Hatem A. Wafa, Charles D. A. Wolfe, Anthony Rudd, Yanzhong Wang BackgroundAs the average life expectancy increases, more people are predicted to have strokes. Recent studies have shown an increasing incidence in certain types of cerebral infarction. We aimed to estimate time trends in incidence, prior risk factors, and use of preventive treatments for ischaemic stroke (IS) aetiological subtypes and to ascertain any demographic disparities. Methods and findingsPopulation-based data from the South London Stroke Register (SLSR) between 2000 and 2015 were studied. IS was classified, based on the underlying mechanism, into l...
Source: PLoS Medicine - October 5, 2018 Category: Internal Medicine Authors: Hatem A. Wafa Source Type: research

Association between ambient air pollution and daily hospital admissions for ischemic stroke: A nationwide time-series analysis
We examined the associations between air pollution and daily ischemic stroke admission using a two-stage method. Poisson time-series regression models were firs tly fitted to estimate the effects of air pollution in each city. Random-effects meta-analyses were then conducted to combine the estimates. Meta-regression models were applied to explore potential effect modifiers. More than 2 million hospital admissions for ischemic stroke were identified in 172 c ities in China. In single-pollutant models, increases of 10 μg/m3 in particulate matter with aerodynamic diameter (Source: PLoS Medicine)
Source: PLoS Medicine - October 4, 2018 Category: Internal Medicine Authors: Yaohua Tian Source Type: research

Correction: Comparison of artemether-lumefantrine and chloroquine with and without primaquine for the treatment of < i > Plasmodium vivax < /i > infection in Ethiopia: A randomized controlled trial
by Tesfay Abreha, Jimee Hwang, Kamala Thriemer, Yehualashet Tadesse, Samuel Girma, Zenebe Melaku, Ashenafi Assef, Moges Kassa, Mark D. Chatfield, Keren Z. Landman, Stella M. Chenet, Naomi W. Lucchi, Venkatachalam Udhayakumar, Zhiyong Zhou, Ya Ping Shi, S. Patrick Kachur, Daddi Jima, Amha Kebede, Hiwot Solomon, Addis Mekasha, Bereket Hailegiorgis Alemayehu, Joseph L. Malone, Gunewardena Dissanayake, Hiwot Teka, Sarah Auburn, Lorenz von Seidlein, Ric N. Price (Source: PLoS Medicine)
Source: PLoS Medicine - October 4, 2018 Category: Internal Medicine Authors: Tesfay Abreha Source Type: research

Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): A microsimulation study
ConclusionsLeveraging healthier eating through SNAP could generate substantial health benefits and be cost-effective or cost-saving. A combined food incentive/disincentive program appears most effective and may be most attractive to policy-makers. (Source: PLoS Medicine)
Source: PLoS Medicine - October 2, 2018 Category: Internal Medicine Authors: Dariush Mozaffarian Source Type: research

In an unhealthy food system, what role should SNAP play?
by Hilary Kessler Seligman, Sanjay Basu In a Perspective, Hilary Seligman and Sanjay Basu discuss future scenarios of food assistance programs to improve population health in a changing political environment. (Source: PLoS Medicine)
Source: PLoS Medicine - October 2, 2018 Category: Internal Medicine Authors: Hilary Kessler Seligman Source Type: research

High-risk human papillomavirus status and prognosis in invasive cervical cancer: A nationwide cohort study
by Jiayao Lei, Alexander Ploner, Camilla Lagheden, Carina Eklund, Sara Nordqvist Kleppe, Bengt Andrae, K. Miriam Elfstr öm, Joakim Dillner, Pär Sparén, Karin Sundström BackgroundHigh-risk human papillomavirus (hrHPV) infection is established as the major cause of invasive cervical cancer (ICC). However, whether hrHPV status in the tumor is associated with subsequent prognosis of ICC is controversial. We aim to evaluate the association between tumor hrHPV status and ICC prognosis using national registers and comprehensive human papillomavirus (HPV) genotyping. Methods and findingsIn this nationwide pop...
Source: PLoS Medicine - October 1, 2018 Category: Internal Medicine Authors: Jiayao Lei Source Type: research

Safety and pharmacokinetics of single, dual, and triple antiretroviral drug formulations delivered by pod-intravaginal rings designed for HIV-1 prevention: A Phase I trial
ConclusionsAn innovative pod-IVR delivery device with 3 different formulations delivering different regimens of ARV drugs vaginally appeared to be safe and acceptable and provided drug concentrations in CVFs and tissues exceeding concentrations achieved by highly protective oral dosing, suggesting that efficacy for vaginal HIV PrEP is achievable. These results show that an alternate, more adherence-independent, longer-acting prevention device based on the only FDA-approved PrEP combination regimen can be advanced to safety and efficacy testing. Trial registrationClinicalTrials.gov NCT02431273 (Source: PLoS Medicine)
Source: PLoS Medicine - September 28, 2018 Category: Internal Medicine Authors: Kathleen L. Vincent Source Type: research

Delivery outcomes in term births after bariatric surgery: Population-based matched cohort study
ConclusionsBariatric-surgery-induced weight loss was associated with lower risks for adverse delivery outcomes in term births. (Source: PLoS Medicine)
Source: PLoS Medicine - September 26, 2018 Category: Internal Medicine Authors: Olof Stephansson Source Type: research