Author Archives: PLoS Medicine

Health Research and the World Humanitarian Summit—Not a Thousand Miles Apart

by The PLOS Medicine Editors As the World Humanitarian Summit and the World Health Assembly convene on the same day in different cities, The PLOS Medicine Editors support a role for health in the UN Agenda for Humanity.

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Toward a Common Secure Future: Four Global Commissions in the Wake of Ebola

by Lawrence O. Gostin, Oyewale Tomori, Suwit Wibulpolprasert, Ashish K. Jha, Julio Frenk, Suerie Moon, Joy Phumaphi, Peter Piot, Barbara Stocking, Victor J. Dzau, Gabriel M. Leung Lawrence Gostin and colleagues offer a set of priorities for global health preparedness and response for future infectious disease threats.

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Estimating the Risk of Chronic Pain: Development and Validation of a Prognostic Model (PICKUP)…

by Adrian C. Traeger, Nicholas Henschke, Markus Hübscher, Christopher M. Williams, Steven J. Kamper, Christopher G.

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Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New…

by Anna J. Dare, Katherine C. Lee, Josh Bleicher, Alex E. Elobu, Thaim B.

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The Clinical Challenge of Sepsis Identification and Monitoring

by Jean-Louis Vincent Jean-Louis Vincent outlines why combinations of biomarkers will be central to the future of sepsis diagnosis.

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Initiating Antiretroviral Therapy for HIV at a Patient’s First Clinic Visit: The RapIT…

by Sydney Rosen, Mhairi Maskew, Matthew P. Fox, Cynthia Nyoni, Constance Mongwenyana, Given Malete, Ian Sanne, Dorah Bokaba, Celeste Sauls, Julia Rohr, Lawrence Long Background High rates of patient attrition from care between HIV testing and antiretroviral therapy (ART) initiation have been documented in sub-Saharan Africa, contributing to persistently low CD4 cell counts at treatment initiation. One reason for this is that starting ART in many countries is a lengthy and burdensome process, imposing long waits and multiple clinic visits on patients. We estimated the effect on uptake of ART and viral suppression of an accelerated initiation algorithm that allowed treatment-eligible patients to be dispensed their first supply of antiretroviral medications on the day of their first HIV-related clinic visit. Methods and Findings RapIT (Rapid Initiation of Treatment) was an unblinded randomized controlled trial of single-visit ART initiation in two public sector clinics in South Africa, a primary health clinic (PHC) and a hospital-based HIV clinic

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All-Cause Mortality of Low Birthweight Infants in Infancy, Childhood, and Adolescence:…

by W. John Watkins, Sarah J. Kotecha, Sailesh Kotecha Background Low birthweight (LBW) is associated with increased mortality in infancy, but its association with mortality in later childhood and adolescence is less clear. We investigated the association between birthweight and all-cause mortality and identified major causes of mortality for different birthweight groups.

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Smoking Behavior and Healthcare Expenditure in the United States, 1992–2009: Panel Data…

by James Lightwood, Stanton A. Glantz Background Reductions in smoking in Arizona and California have been shown to be associated with reduced per capita healthcare expenditures in these states compared to control populations in the rest of the US. This paper extends that analysis to all states and estimates changes in healthcare expenditure attributable to changes in aggregate measures of smoking behavior in all states. Methods and Findings State per capita healthcare expenditure is modeled as a function of current smoking prevalence, mean cigarette consumption per smoker, other demographic and economic factors, and cross-sectional time trends using a fixed effects panel data regression on annual time series data for each the 50 states and the District of Columbia for the years 1992 through 2009.

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How Much Can the USA Reduce Health Care Costs by Reducing Smoking?

by Wayne Hall, Chris Doran In this Perspective, Wayne Hall and Chris Doran discuss Lightwood and Glantz’s findings and the implications for tobacco control programs in the US, which are currently poorly funded.

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A Public Health Paradox: The Women Most Vulnerable to Malaria Are the Least Protected

by Raquel González, Esperança Sevene, George Jagoe, Laurence Slutsker, Clara Menéndez Raquel Gonzalez and colleagues highlight an urgent need to evaluate antimalarials that can be safely administered to HIV-infected pregnant women on antiretroviral treatment and cotrimoxazole prophylaxis.

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Effectiveness of and Financial Returns to Voluntary Medical Male Circumcision for HIV…

by Markus Haacker, Nicole Fraser-Hurt, Marelize Gorgens Background Empirical studies and population-level policy simulations show the importance of voluntary medical male circumcision (VMMC) in generalized epidemics. This paper complements available scenario-based studies (projecting costs and outcomes over some policy period, typically spanning decades) by adopting an incremental approach—analyzing the expected consequences of circumcising one male individual with specific characteristics in a specific year. This approach yields more precise estimates of VMMC’s cost-effectiveness and identifies the outcomes of current investments in VMMC (e.g., within a fiscal budget period) rather than of investments spread over the entire policy period. Methods/Findings The model has three components.

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Interpreting the Global Enteric Multicenter Study (GEMS) Findings on Sanitation, Hygiene, and…

by Jonny Crocker, Jamie Bartram In this Perspective on the GEMS study by Kelly Baker and colleagues, Jonny Crocker and Jamie Bartram consider the implications of associations found and not found between diarrheal disease and sanitation and hygiene.

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Sanitation and Hygiene-Specific Risk Factors for Moderate-to-Severe Diarrhea in Young Children…

by Kelly K. Baker, Ciara E. O’Reilly, Myron M. Levine, Karen L. Kotloff, James P

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Risk of Advanced Neoplasia in First-Degree Relatives with Colorectal Cancer: A Large…

by Enrique Quintero, Marta Carrillo, Maria-Liz Leoz, Joaquin Cubiella, Carla Gargallo, Angel Lanas, Luis Bujanda, Antonio Z. Gimeno-García, Manuel Hernández-Guerra, David Nicolás-Pérez, Inmaculada Alonso-Abreu, Juan Diego Morillas, Francesc Balaguer, Alfonso Muriel, on behalf of the Oncology Group of the Asociación Española de Gastroenterología (AEG) Background First-degree relatives (FDR) of patients with colorectal cancer have a higher risk of developing colorectal cancer than the general population. For this reason, screening guidelines recommend colonoscopy every 5 or 10 y, starting at the age of 40, depending on whether colorectal cancer in the index-case is diagnosed at <60 or ≥60 y, respectively. However, studies on the risk of neoplastic lesions are inconclusive. The aim of this study was to determine the risk of advanced neoplasia (three or more non-advanced adenomas, advanced adenoma, or invasive cancer) in FDR of patients with colorectal cancer compared to average-risk individuals (i.e., asymptomatic adults 50 to 69 y of age with no family history of colorectal cancer).</p> Methods and Findings This cross-sectional analysis includes data from 8,498 individuals undergoing their first lifetime screening colonoscopy between 2006 and 2012 at six Spanish tertiary hospitals

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