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

Carfilzomib, lenalidomide, dexamethasone, and cyclophosphamide (KRdc) as induction therapy for transplant-eligible, newly diagnosed multiple myeloma patients (Myeloma XI+): Interim analysis of an open-label randomised controlled trial
by Graham H. Jackson, Charlotte Pawlyn, David A. Cairns, Ruth M. de Tute, Anna Hockaday, Corinne Collett, John R. Jones, Bhuvan Kishore, Mamta Garg, Cathy D. Williams, Kamaraj Karunanithi, Jindriska Lindsay, Alberto Rocci, John A. Snowden, Matthew W. Jenner, Gordon Cook, Nigel H. Russell, Mark T. Drayson, Walter M. Gregory, Martin F. Kaiser, Roger G. Owen, Faith E. Davies, Gareth J. Morgan, the UK NCRI Haemato-oncology Clinical Studies Group BackgroundCarfilzomib is a second-generation irreversible proteasome inhibitor that is efficacious in the treatment of myeloma and carries less risk of peripheral neuropathy than first...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Graham H. Jackson Source Type: research

Associations of parental depression during adolescence with cognitive development in later life in China: A population-based cohort study
This study used longitudinal data from the nationally representative China Family Panel Studies (CFPS). The sample included 2,281 adolescents aged 10 –15 years (the median age was 13 years with an interquartile range between 11 and 14 years) in 2012 when their parents were surveyed for depression symptoms with the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). The sample was approximately balanced by sex, with 1,088 females (47.7%). We examined the associations of parental depression in 2012 with offspring cognitive performance (measured by mathematics, vocabulary, immediate word recall, delayed w...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Zhihui Li Source Type: research

Postpartum depressive symptoms following implementation of the 10 steps to successful breastfeeding program in Kinshasa, Democratic Republic of Congo: A cohort study
by Robert A. Agler, Paul N. Zivich, Bienvenu Kawende, Frieda Behets, Marcel Yotebieng BackgroundSocial support and relevant skills training can reduce the risk of postpartum depression (PPD) by reducing the impact of stressors. The 10-step program to encourage exclusive breastfeeding that forms the basis of the Baby-Friendly Hospital Initiative (BFHI) provides both, suggesting it may lessen depressive symptoms directly or by reducing difficulties associated with infant feeding. Our objective was to quantify the association of implementing Steps 1 –9 or Steps 1–10 on postpartum depressive symptoms and test wheth...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Robert A. Agler Source Type: research

Interpersonal psychotherapy delivered by nonspecialists for depression and posttraumatic stress disorder among Kenyan HIV –positive women affected by gender-based violence: Randomized controlled trial
ConclusionsIPT for MDD and PTSD delivered by nonspecialists in the context of HIV care yielded significant improvements in HIV –positive women’s mental health, functioning, and GBV (IPV) exposure, compared to controls. Trial registrationClinical Trials Identifier NCT02320799. (Source: PLoS Medicine)
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Susan M. Meffert Source Type: research

Mindfulness-based programmes for mental health promotion in adults in nonclinical settings: A systematic review and meta-analysis of randomised controlled trials
by Julieta Galante, Claire Friedrich, Anna F Dawson, Marta Modrego-Alarc ón, Pia Gebbing, Irene Delgado-Suárez, Radhika Gupta, Lydia Dean, Tim Dalgleish, Ian R White, Peter B Jones BackgroundThere is an urgent need for mental health promotion in nonclinical settings. Mindfulness –based programmes (MBPs) are being widely implemented to reduce stress, but a comprehensive evidence synthesis is lacking. We reviewed trials to assess whether MBPs promote mental health relative to no intervention or comparator interventions. Methods and findingsFollowing a detailed preregistered protocol (PROSPERO CRD420181052...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Julieta Galante Source Type: research

Estimating HIV pre-exposure prophylaxis need and impact in Malawi, Mozambique and Zambia: A geospatial and risk-based analysis
ConclusionsA large proportion of new HIV infections in these 3 African countries were estimated to occur among people who had either an STI or an NP in the past year, providing a straightforward means to set PrEP targets. Greater prioritisation of PrEP by district, sex, age, and behavioural risk factors resulted in lower NNPs thereby increasing PrEP cost-effectiveness, but also diminished the overall impact on reducing new infections (Source: PLoS Medicine)
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Dominik Stelzle Source Type: research

Social determinants of mortality from COVID-19: A simulation study using NHANES
by Benjamin Seligman, Maddalena Ferranna, David E. Bloom BackgroundThe COVID-19 epidemic in the United States is widespread, with more than 200,000 deaths reported as of September 23, 2020. While ecological studies show higher burdens of COVID-19 mortality in areas with higher rates of poverty, little is known about social determinants of COVID-19 mortality at the individual level. Methods and findingsWe estimated the proportions of COVID-19 deaths by age, sex, race/ethnicity, and comorbid conditions using their reported univariate proportions among COVID-19 deaths and correlations among these variables in the general popu...
Source: PLoS Medicine - January 11, 2021 Category: Internal Medicine Authors: Benjamin Seligman Source Type: research

Associations between breast cancer survivorship and adverse mental health outcomes: A matched population-based cohort study in the United Kingdom
The objective of this study was to quantify the risk of several adverse mental health –related outcomes in women with a history of breast cancer followed in primary care in the United Kingdom National Health Service, compared to similar women who never had cancer. Methods and findingsWe conducted a matched cohort study using data routinely collected in primary care across the UK to quantify associations between breast cancer history and depression, anxiety, and other mental health –related outcomes. All women with incident breast cancer in the Clinical Practice Research Datalink (CPRD) GOLD primary care databas...
Source: PLoS Medicine - January 7, 2021 Category: Internal Medicine Authors: Helena Carreira Source Type: research

Sugar-sweetened beverage taxes: Lessons to date and the future of taxation
by Barry M. Popkin, Shu Wen Ng (Source: PLoS Medicine)
Source: PLoS Medicine - January 7, 2021 Category: Internal Medicine Authors: Barry M. Popkin Source Type: research

Correction: The World Health Organization Fetal Growth Charts: A Multinational Longitudinal Study of Ultrasound Biometric Measurements and Estimated Fetal Weight
by Torvid Kiserud, Gilda Piaggio, Guillermo Carroli, Mariana Widmer, Jos é Carvalho, Lisa Neerup Jensen, Daniel Giordano, José Guilherme Cecatti, Hany Abdel Aleem, Sameera A. Talegawkar, Alexandra Benachi, Anke Diemert, Antoinette Tshefu Kitoto, Jadsada Thinkhamrop, Pisake Lumbiganon, Ann Tabor, Alka Kriplani, Rogelio Gonzalez Perez, Kurt Hecher, Mark A. Hanson, A. Met in Gülmezoglu, Lawrence D. Platt (Source: PLoS Medicine)
Source: PLoS Medicine - January 7, 2021 Category: Internal Medicine Authors: Torvid Kiserud Source Type: research

Novel community health worker strategy for HIV service engagement in a hyperendemic community in Rakai, Uganda: A pragmatic, cluster-randomized trial
by Larry W. Chang, Ismail Mbabali, Heidi Hutton, K. Rivet Amico, Xiangrong Kong, Jeremiah Mulamba, Aggrey Anok, Joseph Ssekasanvu, Amanda Long, Alvin G. Thomas, Kristin Thomas, Eva Bugos, Rose Pollard, Kimiko van Wickle, Caitlin E. Kennedy, Fred Nalugoda, David Serwadda, Robert C. Bollinger, Thomas C. Quinn, Steven J. Reynolds, Ronald H. Gray, Maria J. Wawer, Gertrude Nakigozi BackgroundEffective implementation strategies are needed to increase engagement in HIV services in hyperendemic settings. We conducted a pragmatic cluster-randomized trial in a high-risk, highly mobile fishing community (HIV prevalence: approximately...
Source: PLoS Medicine - January 6, 2021 Category: Internal Medicine Authors: Larry W. Chang Source Type: research

Clean air actions in China, PM < sub > 2.5 < /sub > exposure, and household medical expenditures: A quasi-experimental study
ConclusionIn this study, we observed that compared with the PM2.5 reduction in 2013, the PM2.5 reduction in 2017 was associated with a saving of 552 (95% CI: 68, 1036) Yuan / (person × year), or approximately 736 billion Yuan (equivalent to 111 billion US dollar) per year nationally, which is equivalent to approximately 1% of the national gross domestic product of China. (Source: PLoS Medicine)
Source: PLoS Medicine - January 6, 2021 Category: Internal Medicine Authors: Tao Xue Source Type: research

Community Occupational Therapy for people with dementia and family carers (COTiD-UK) versus treatment as usual (Valuing Active Life in Dementia [VALID]) study: A single-blind, randomised controlled trial
ConclusionsProviding community occupational therapy as delivered in this study did not improve ADL performance, cognition, quality of life, or mood in people with dementia nor sense of competence or mood in family carers. Future research should consider measuring person-centred outcomes that are more meaningful and closely aligned to participants ’ priorities, such as goal achievement or the quantity and quality of activity engagement and participation. Trial RegistrationCurrent Controlled Trials ISRCTN10748953. (Source: PLoS Medicine)
Source: PLoS Medicine - January 4, 2021 Category: Internal Medicine Authors: Jennifer Wenborn Source Type: research

Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis
by Min Seo Kim, Min Ho An, Won Jun Kim, Tae-Ho Hwang BackgroundNumerous clinical trials and observational studies have investigated various pharmacological agents as potential treatment for Coronavirus Disease 2019 (COVID-19), but the results are heterogeneous and sometimes even contradictory to one another, making it difficult for clinicians to determine which treatments are truly effective. Methods and findingsWe carried out a systematic review and network meta-analysis (NMA) to systematically evaluate the comparative efficacy and safety of pharmacological interventions and the level of evidence behind each treatment reg...
Source: PLoS Medicine - December 30, 2020 Category: Internal Medicine Authors: Min Seo Kim Source Type: research

Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries
We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10 –19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal re presentation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported su...
Source: PLoS Medicine - December 29, 2020 Category: Internal Medicine Authors: Christelle Elia Source Type: research

Assessing the risk of ketoacidosis due to sodium-glucose cotransporter (SGLT)-2 inhibitors in patients with type 1 diabetes: A meta-analysis and meta-regression
by Giovanni Musso, Antonio Sircana, Francesca Saba, Maurizio Cassader, Roberto Gambino BackgroundSodium-glucose cotransporter-2 (SGLT2) inhibitors (SGLT2i) showed benefits in type 1 diabetes mellitus (T1DM), but the risk of diabetic ketoacidosis (DKA) limits their use. Ability to predict DKA risk and therapeutic responses would enable appropriate patient selection for SGLT2i. We conducted a meta-analysis and meta-regression of randomized controlled trials (RCTs) evaluating SGLT2i in T1DM to assess moderators of the relative risk (RR) of DKA, of glycemic (HbA1c, fasting plasma glucose, continuous glucose monitoring paramete...
Source: PLoS Medicine - December 29, 2020 Category: Internal Medicine Authors: Giovanni Musso Source Type: research

Associations between arterial stiffening and brain structure, perfusion, and cognition in the Whitehall II Imaging Sub-study: A retrospective cohort study
We examined whether aortic stiffening during a 4-year follow-up in mid-to-late life was associated with brain structure and cognition in the Whitehall II Imaging Sub-study. Methods and findingsThe Whitehall II Imaging cohort is a randomly selected subset of the ongoing Whitehall II Study, for which participants have received clinical follow-ups for 30 years, across 12 phases. Aortic pulse wave velocity (PWV) was measured in 2007 –2009 (Phase 9) and at a 4-year follow-up in 2012–2013 (Phase 11). Between 2012 and 2016 (Imaging Phase), participants received a multimodal 3T brain magnetic resonance imaging (MRI) sc...
Source: PLoS Medicine - December 29, 2020 Category: Internal Medicine Authors: Sana Suri Source Type: research

Correction: Interventions for treatment of COVID-19: A living systematic review with meta-analyses and trial sequential analyses (The LIVING Project)
by The PLOS Medicine Staff (Source: PLoS Medicine)
Source: PLoS Medicine - December 29, 2020 Category: Internal Medicine Authors: The PLOS Medicine Staff Source Type: research

Impact of food supplements on early child development in children with moderate acute malnutrition: A randomised 2 x 2 x 3 factorial trial in Burkina Faso
by Mette F. Olsen, Ann-Sophie Iuel-Brockdorff, Charles W. Yam éogo, Bernardette Cichon, Christian Fabiansen, Suzanne Filteau, Kevin Phelan, Albertine Ouédraogo, Kim F. Michaelsen, Melissa Gladstone, Per Ashorn, André Briend, Christian Ritz, Henrik Friis, Vibeke B. Christensen BackgroundLipid-based nutrient supplements (LNS) and corn –soy blends (CSBs) with varying soy and milk content are used in treatment of moderate acute malnutrition (MAM). We assessed the impact of these supplements on child development. Methods and findingsWe conducted a randomised 2 × 2 × 3 factorial trial to as...
Source: PLoS Medicine - December 23, 2020 Category: Internal Medicine Authors: Mette F. Olsen Source Type: research

Long-term health outcomes of people with reduced kidney function in the UK: A modelling study using population health data
We present a policy model that simulates individuals ’ long-term health outcomes and costs to inform strategies to reduce risks of kidney and CVDs in this population. Methods and findingsWe used a United Kingdom primary healthcare database, the Clinical Practice Research Datalink (CPRD), linked with secondary healthcare and mortality data, to derive an open 2005 –2013 cohort of adults (≥18 years of age) with reduced kidney function (≥2 measures of estimated glomerular filtration rate [eGFR] (Source: PLoS Medicine)
Source: PLoS Medicine - December 16, 2020 Category: Internal Medicine Authors: Iryna Schlackow Source Type: research

Cardiovascular health metrics from mid- to late-life and risk of dementia: A population-based cohort study in Finland
We examined the associations of composite CVH metrics from midlife to late life with risk of incident dementia. Methods and findingsThis cohort study included 1,449 participants from the Finnish Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, who were followed from midlife (baseline from1972 to 1987; mean age 50.4 years; 62.1% female) to late life (1998), and then 744 dementia-free survivors were followed further into late life (2005 to 2008). We defined and scored global CVH metrics based on 6 of the 7 components (i.e., smoking, physical activity, and body mass index [BMI] as behavioral CVH metrics; fastin...
Source: PLoS Medicine - December 15, 2020 Category: Internal Medicine Authors: Yajun Liang Source Type: research

Impact of scaling up dolutegravir on antiretroviral resistance in South Africa: A modeling study
ConclusionsOur model shows the potential benefit of scaling up DTG-based regimens for halting the rise of NNRTI resistance. Starting or switching all men and women to DTG would lead to a sustained decline in resistance levels, whereas using DTG-based ART in all men, or in men and women beyond childbearing age, would only slow down the increase in levels of NNRTI PDR. (Source: PLoS Medicine)
Source: PLoS Medicine - December 14, 2020 Category: Internal Medicine Authors: Anthony Hauser Source Type: research

Genetic associations with temporal shifts in obesity and severe obesity during the obesity epidemic in Norway: A longitudinal population-based cohort (the HUNT Study)
by Maria Brandkvist, Johan H åkon Bjørngaard, Rønnaug Astri Ødegård, Ben Brumpton, George Davey Smith, Bjørn Olav Åsvold, Erik R. Sund, Kirsti Kvaløy, Cristen J. Willer, Gunnhild Åberge Vie BackgroundObesity has tripled worldwide since 1975 as environments are becoming more obesogenic. Our study investigates how changes in population weight and obesity over time are associated with genetic predisposition in the context of an obesogenic environment over 6 decades and examines the robustness of the findings using sibling design. Methods and findingsA total of 67,110 ...
Source: PLoS Medicine - December 14, 2020 Category: Internal Medicine Authors: Maria Brandkvist Source Type: research

The potential impact of urine-LAM diagnostics on tuberculosis incidence and mortality: A modelling analysis
by Saskia Ricks, Claudia M. Denkinger, Samuel G. Schumacher, Timothy B. Hallett, Nimalan Arinaminpathy BackgroundLateral flow urine lipoarabinomannan (LAM) tests could offer important new opportunities for the early detection of tuberculosis (TB). The currently licensed LAM test, Alere Determine TB LAM Ag ( ‘LF-LAM’), performs best in the sickest people living with HIV (PLHIV). However, the technology continues to improve, with newer LAM tests, such as Fujifilm SILVAMP TB LAM (‘SILVAMP-LAM’) showing improved sensitivity, including amongst HIV-negative patients. It is important to anticipate the epid...
Source: PLoS Medicine - December 11, 2020 Category: Internal Medicine Authors: Saskia Ricks Source Type: research

Hospitalizations among adults with chronic kidney disease in the United States: A cohort study
by Sarah J. Schrauben, Hsiang-Yu Chen, Eugene Lin, Christopher Jepson, Wei Yang, Julia J. Scialla, Michael J. Fischer, James P. Lash, Jeffrey C. Fink, L. Lee Hamm, Radhika Kanthety, Mahboob Rahman, Harold I. Feldman, Amanda H. Anderson, the CRIC Study Investigators BackgroundAdults with chronic kidney disease (CKD) are hospitalized more frequently than those without CKD, but the magnitude of this excess morbidity and the factors associated with hospitalizations are not well known. Methods and findingsData from 3,939 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study between 2003 and 2008 at 7 clin...
Source: PLoS Medicine - December 11, 2020 Category: Internal Medicine Authors: Sarah J. Schrauben Source Type: research

Thresholds of glycemia, insulin therapy, and risk for severe retinopathy in premature infants: A cohort study
The objective of our study was to examine the association between hyperglycemia and severe ROP in premature infants. Methods and findingsIn 2 independent, monocentric cohorts of preterm infants born at (Source: PLoS Medicine)
Source: PLoS Medicine - December 11, 2020 Category: Internal Medicine Authors: Elsa Kermorvant-Duchemin Source Type: research

A combination of urinary biomarker panel and PancRISK score for earlier detection of pancreatic cancer: A case –control study
ConclusionsWe have successfully validated our urinary biomarker panel, which was improved by substituting REG1A with REG1B. At a pre-selected cutoff of>80% SN and SP for the affiliated PancRISK score, we demonstrate a clinically applicable risk stratification tool with a binary output for risk of developing PDAC ( ‘elevated’ or ‘normal’). PancRISK provides a step towards precision surveillance for PDAC patients, which we will test in a prospective clinical study, UroPanc. (Source: PLoS Medicine)
Source: PLoS Medicine - December 10, 2020 Category: Internal Medicine Authors: Silvana Debernardi Source Type: research

Associations among circulating sphingolipids, β-cell function, and risk of developing type 2 diabetes: A population-based cohort study in China
by Huan Yun, Liang Sun, Qingqing Wu, Geng Zong, Qibin Qi, Huaixing Li, He Zheng, Rong Zeng, Liming Liang, Xu Lin BackgroundAnimal studies suggest vital roles of sphingolipids, especially ceramides, in the pathogenesis of type 2 diabetes (T2D) via pathways involved in insulin resistance, β-cell dysfunction, and inflammation, but human studies are limited. We aimed to evaluate the associations of circulating sphingolipids with incident T2D and to explore underlying mechanisms. Methods and findingsThe current study included 826 men and 1,148 women who were aged 50 –70 years, from Beijing and Shanghai, and without T...
Source: PLoS Medicine - December 9, 2020 Category: Internal Medicine Authors: Huan Yun Source Type: research

Duration of obesity exposure between ages 10 and 40 years and its relationship with cardiometabolic disease risk factors: A cohort study
by Tom Norris, Tim J. Cole, David Bann, Mark Hamer, Rebecca Hardy, Leah Li, Ken K. Ong, George B. Ploubidis, Russell Viner, William Johnson BackgroundIndividuals with obesity do not represent a homogeneous group in terms of cardiometabolic risk. Using 3 nationally representative British birth cohorts, we investigated whether the duration of obesity was related to heterogeneity in cardiometabolic risk. Methods and findingsWe used harmonised body mass index (BMI) and cardiometabolic disease risk factor data from 20,746 participants (49.1% male and 97.2% white British) enrolled in 3 British birth cohort studies: the 1946 Nati...
Source: PLoS Medicine - December 8, 2020 Category: Internal Medicine Authors: Tom Norris Source Type: research

Induction of labour at 41 weeks or expectant management until 42 weeks: A systematic review and an individual participant data meta-analysis of randomised trials
by M årten Alkmark, Judit K. J. Keulen, Joep C. Kortekaas, Christina Bergh, Jeroen van Dillen, Ruben G. Duijnhoven, Henrik Hagberg, Ben Willem Mol, Mattias Molin, Joris A. M. van der Post, Sissel Saltvedt, Anna-Karin Wikström, Ulla-Britt Wennerholm, Esteriek de Miranda BackgroundThe risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. Several randomised controlled trials (RCTs) have assessed if induction of labour (IOL) in uncomplicated pregnancies at 41 weeks will improve perinatal outcomes. We performed an individual participant data meta-analysis (IPD-MA) on t...
Source: PLoS Medicine - December 8, 2020 Category: Internal Medicine Authors: M årten Alkmark Source Type: research

Sweetened beverages and risk of frailty among older women in the Nurses ’ Health Study: A cohort study
by Ellen A. Struijk, Fernando Rodr íguez-Artalejo, Teresa T. Fung, Walter C. Willett, Frank B. Hu, Esther Lopez-Garcia BackgroundConsumption of sugar-sweetened beverages (SSBs) has been consistently associated with a higher risk of obesity, type 2 diabetes, cardiovascular disease, and premature mortality, whereas evidence for artificially sweetened beverages (ASBs) and fruit juices on health is less solid. The aim of this study was to evaluate the consumption of SSBs, ASBs, and fruit juices in association with frailty risk among older women. Methods and findingsWe analyzed data from 71,935 women aged ≥60 (average...
Source: PLoS Medicine - December 8, 2020 Category: Internal Medicine Authors: Ellen A. Struijk Source Type: research

Bariatric surgery for patients with type 2 diabetes mellitus requiring insulin: Clinical outcome and cost-effectiveness analyses
by Emma Rose McGlone, Iain Carey, Vladica Veli čković, Prem Chana, Kamal Mahawar, Rachel L. Batterham, James Hopkins, Peter Walton, Robin Kinsman, James Byrne, Shaw Somers, David Kerrigan, Vinod Menon, Cynthia Borg, Ahmed Ahmed, Bruno Sgromo, Chandra Cheruvu, Gul Bano, Catherine Leonard, Howard Thom, Carel W le Roux, Marcus Reddy, Richard Welb ourn, Peter Small, Omar A. Khan BackgroundAlthough bariatric surgery is well established as an effective treatment for patients with obesity and type 2 diabetes mellitus (T2DM), there exists reluctance to increase its availability for patients with severe T2DM. The aims of this stu...
Source: PLoS Medicine - December 7, 2020 Category: Internal Medicine Authors: Emma Rose McGlone Source Type: research

Antenatal corticosteroid administration and early school age child development: A regression discontinuity study in British Columbia, Canada
by Jennifer A. Hutcheon, Sam Harper, Jessica Liauw, M. Amanda Skoll, Myriam Srour, Erin C. Strumpf BackgroundThere are growing concerns that antenatal corticosteroid administration may harm children ’s neurodevelopment. We investigated the safety of antenatal corticosteroid administration practices for children’s overall developmental health (skills and behaviors) at early school age. Methods and findingsWe linked population health and education databases from British Columbia (BC), Canada to identify a cohort of births admitted to hospital between 31 weeks, 0 days gestation (31+0 weeks), and 36+6 weeks, 2000 t...
Source: PLoS Medicine - December 7, 2020 Category: Internal Medicine Authors: Jennifer A. Hutcheon Source Type: research

Evaluating the relationship between alcohol consumption, tobacco use, and cardiovascular disease: A multivariable Mendelian randomization study
ConclusionsEvaluating the widest range of CVD risk factors and outcomes of any alcohol consumption or smoking MR study to date, we failed to find a cardioprotective impact of genetically predicted alcohol consumption on CVD outcomes. However, alcohol was associated with and increased HDL-C, decreased TRG, and increased BP, which may indicate pathways through impact CVD risk, warranting further study. We found smoking to be a risk factor for many CVDs even after adjusting for alcohol. While future studies incorporating alcohol consumption patterns are necessary, our data suggest causal inference between alcohol, smoking, an...
Source: PLoS Medicine - December 4, 2020 Category: Internal Medicine Authors: Daniel B. Rosoff Source Type: research

Correction:  Impact of self-imposed prevention measures and short-term government-imposed social distancing on mitigating and delaying a COVID-19 epidemic: A modelling study
by The PLOS Medicine Staff (Source: PLoS Medicine)
Source: PLoS Medicine - December 4, 2020 Category: Internal Medicine Authors: The PLOS Medicine Staff Source Type: research

Dose-dependent oral glucocorticoid cardiovascular risks in people with immune-mediated inflammatory diseases: A population-based cohort study
by Mar Pujades-Rodriguez, Ann W. Morgan, Richard M. Cubbon, Jianhua Wu BackgroundGlucocorticoids are widely used to reduce disease activity and inflammation in patients with a range of immune-mediated inflammatory diseases. It is uncertain whether or not low to moderate glucocorticoid dose increases cardiovascular risk. We aimed to quantify glucocorticoid dose-dependent cardiovascular risk in people with 6 immune-mediated inflammatory diseases. Methods and findingsWe conducted a population-based cohort analysis of medical records from 389 primary care practices contributing data to the United Kingdom Clinical Practice Rese...
Source: PLoS Medicine - December 3, 2020 Category: Internal Medicine Authors: Mar Pujades-Rodriguez Source Type: research

Intake of dietary fats and  fatty acids and the incidence of type 2 diabetes: A systematic review and dose-response meta-analysis of prospective observational studies
by Manuela Neuenschwander, Janett Barbaresko, Claudia R. Pischke, Nadine Iser, Julia Beckhaus, Lukas Schwingshackl, Sabrina Schlesinger BackgroundThe role of fat quantity and quality in type 2 diabetes (T2D) prevention is controversial. Thus, this systematic review and meta-analysis aimed to investigate the associations between intake of dietary fat and fatty acids and T2D, and to evaluate the certainty of evidence. Methods and findingsWe systematically searched PubMed and Web of Science through 28 October 2019 for prospective observational studies in adults on the associations between intake of dietary fat and fatty acids...
Source: PLoS Medicine - December 2, 2020 Category: Internal Medicine Authors: Manuela Neuenschwander Source Type: research

Trade-offs between cost and accuracy in active case finding for tuberculosis: A dynamic modelling analysis
ConclusionsOur results suggest that cheaper diagnostics do not necessarily translate to less costly ACF, as any savings from the test cost can be strongly outweighed by factors including false-positive TB treatment, reduced sensitivity, and foregone savings in second-line treatment. In resource-limited settings, it is therefore important to take all of these factors into account when designing cost-effective strategies for ACF. (Source: PLoS Medicine)
Source: PLoS Medicine - December 2, 2020 Category: Internal Medicine Authors: Lucia Cilloni Source Type: research

Mortality and major disease risk among migrants of the 1991 –2001 Balkan wars to Sweden: A register-based cohort study
by Edda Bjork Thordardottir, Li Yin, Arna Hauksdottir, Ellenor Mittendorfer-Rutz, Anna-Clara Hollander, Christina M. Hultman, Paul Lichtenstein, Weimin Ye, Filip K. Arnberg, Fang Fang, Emily A. Holmes, Unnur Anna Valdimarsdottir BackgroundIn recent decades, millions of refugees and migrants have fled wars and sought asylum in Europe. The aim of this study was to quantify the risk of mortality and major diseases among migrants during the 1991 –2001 Balkan wars to Sweden in comparison to other European migrants to Sweden during the same period. Methods and findingsWe conducted a register-based cohort study of 104,770 m...
Source: PLoS Medicine - December 1, 2020 Category: Internal Medicine Authors: Edda Bjork Thordardottir Source Type: research

Effects of vitamin B < sub > 12 < /sub > supplementation on neurodevelopment and growth in Nepalese Infants: A randomized controlled trial
In this study, we observed that there were no effects of the intervention on the Bayley-III scores, growth, or hemoglobin concentration. Children in both groups grew on an average 12.5 cm (SD: 1.8), and the mean difference was 0.20 cm (95% confidence interval (CI): −0.23 to 0.63,P = 0.354). Furthermore, at the end of the study, the mean difference in hemoglobin concentration was 0.02 g/dL (95% CI: −1.33 to 1.37,P = 0.978), and the difference in the cognitive scaled scores was 0.16 (95% CI: −0.54 to 0.87,P = 0.648). The tHcy and MMA concentrations were 23% (95% CI: 17 to 30,P (Source: PLoS Medicine)
Source: PLoS Medicine - December 1, 2020 Category: Internal Medicine Authors: Tor A. Strand Source Type: research

Estimated impact of RTS,S/AS01 malaria vaccine allocation strategies in sub-Saharan Africa: A modelling study
by Alexandra B. Hogan, Peter Winskill, Azra C. Ghani BackgroundThe RTS,S/AS01 vaccine againstPlasmodium falciparum malaria infection completed phase III trials in 2014 and demonstrated efficacy against clinical malaria of approximately 36% over 4 years for a 4-dose schedule in children aged 5 –17 months. Pilot vaccine implementation has recently begun in 3 African countries. If the pilots demonstrate both a positive health impact and resolve remaining safety concerns, wider roll-out could be recommended from 2021 onwards. Vaccine demand may, however, outstrip initial supply. We sought to identify where vaccine introd...
Source: PLoS Medicine - November 30, 2020 Category: Internal Medicine Authors: Alexandra B. Hogan Source Type: research

Assessment of deep neural networks for the diagnosis of benign and malignant skin neoplasms in comparison with dermatologists: A retrospective validation study
In this study, the performance of a neural network algorithm was compared with that of dermatologists in both real-world practice and experimental settings. Methods and findingsTo demonstrate generalizability, the skin cancer detection algorithm (https://rcnn.modelderm.com) developed in our previous study was used without modification. We conducted a retrospective study with all single lesion biopsied cases (43 disorders; 40,331 clinical images from 10,426 cases: 1,222 malignant cases and 9,204 benign cases); mean age (standard deviation [SD], 52.1 [18.3]; 4,701 men [45.1%]) were obtained from the Department of Dermatology...
Source: PLoS Medicine - November 25, 2020 Category: Internal Medicine Authors: Seung Seog Han Source Type: research