Author Archives: PLoS Medicine

Improving tuberculosis diagnosis: Better tests or better healthcare?

by Sumona Datta, Matthew J. Saunders, Marco A. Tovar, Carlton A. Evans In a Perspective accompanying Sylvia and colleagues, Carlton Evans and colleagues discuss the challenge of squaring policies around tuberculosis diagnosis with the realities of clinical practice in small villages and low-resource settings.

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Tuberculosis detection and the challenges of integrated care in rural China: A cross-sectional…

by Sean Sylvia, Hao Xue, Chengchao Zhou, Yaojiang Shi, Hongmei Yi, Huan Zhou, Scott Rozelle, Madhukar Pai, Jishnu Das Background Despite recent reductions in prevalence, China still faces a substantial tuberculosis (TB) burden, with future progress dependent on the ability of rural providers to appropriately detect and refer TB patients for further care. This study (a) provides a baseline assessment of the ability of rural providers to correctly manage presumptive TB cases; (b) measures the gap between provider knowledge and practice and; (c) evaluates how ongoing reforms of China’s health system—characterized by a movement toward “integrated care” and promotion of initial contact with grassroots providers—will affect the care of TB patients. Methods/Findings Unannounced standardized patients (SPs) presenting with classic pulmonary TB symptoms were deployed in 3 provinces of China in July 2015. The SPs successfully completed 274 interactions across all 3 tiers of China’s rural health system, interacting with providers in 46 village clinics, 207 township health centers, and 21 county hospitals. Interactions between providers and standardized patients were assessed against international and national standards of TB care

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Elevated blood pressure and risk of mitral regurgitation: A longitudinal cohort study of 5.5…

by Kazem Rahimi, Hamid Mohseni, Catherine M. Otto, Nathalie Conrad, Jenny Tran, Milad Nazarzadeh, Mark Woodward, Terence Dwyer, Stephen MacMahon Background Mitral regurgitation in people without prior cardiac disease is considered a degenerative disease with no established risk factors for its prevention. We aimed to test the hypothesis that elevated systolic blood pressure (SBP) across its usual spectrum is associated with higher risk of mitral regurgitation. Methods and findings We used linked electronic health records from the United Kingdom Clinical Practice Research Datalink (CPRD) from 1 January 1990 to 31 December 2015.

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Benefit and harm of intensive blood pressure treatment: Derivation and validation of risk…

by Sanjay Basu, Jeremy B. Sussman, Joseph Rigdon, Lauren Steimle, Brian T. Denton, Rodney A. Hayward Background Intensive blood pressure (BP) treatment can avert cardiovascular disease (CVD) events but can cause some serious adverse events.

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The clinical utility and cost impact of cystatin C measurement in the diagnosis and management…

by Adam Shardlow, Natasha J. McIntyre, Simon D. S. Fraser, Paul Roderick, James Raftery, Richard J. Fluck, Christopher W

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Quantifying underreporting of law-enforcement-related deaths in United States vital statistics…

by Justin M. Feldman, Sofia Gruskin, Brent A. Coull, Nancy Krieger Background Prior research suggests that United States governmental sources documenting the number of law-enforcement-related deaths (i.e., fatalities due to injuries inflicted by law enforcement officers) undercount these incidents. The National Vital Statistics System (NVSS), administered by the federal government and based on state death certificate data, identifies such deaths by assigning them diagnostic codes corresponding to “legal intervention” in accordance with the International Classification of Diseases–10th Revision (ICD-10).

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Associations between an IgG3 polymorphism in the binding domain for FcRn, transplacental…

by Celia Dechavanne, Sebastien Dechavanne, Ibrahim Sadissou, Adjimon Gatien Lokossou, Fernanda Alvarado, Magalie Dambrun, Kabirou Moutairou, David Courtin, Gregory Nuel, Andre Garcia, Florence Migot-Nabias, Christopher L. King Background Transplacental transfer of maternal immunoglobulin G (IgG) to the fetus helps to protect against malaria and other infections in infancy. Recent studies have emphasized the important role of malaria-specific IgG3 in malaria immunity, and its transfer may reduce the risk of malaria in infancy. Human IgGs are actively transferred across the placenta by binding the neonatal Fc receptor (FcRn) expressed within the endosomes of the syncytiotrophoblastic membrane. Histidine at position 435 (H435) provides for optimal Fc–IgG binding

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Firearm-Related Injury and Death: A U.S. Health Care Crisis in Need of Health Care…

by Darren B. Taichman, Howard Bauchner, Jeffrey M. Drazen, Christine Laine, Larry Peiperl The U.S.-based Editors of ICMJE journals call for health-care professionals to act against the public health crisis of injury and death from guns.

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Safety and immunogenicity of rVSVΔG-ZEBOV-GP Ebola vaccine in adults and children in…

by Selidji T. Agnandji, José F. Fernandes, Emmanuel B. Bache, Régis M.

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Regional initiatives for malaria elimination: Building and maintaining partnerships

by Andrew A. Lover, Kelly E. Harvard, Alistair E. Lindawson, Cara Smith Gueye, Rima Shretta, Roly Gosling, Richard Feachem Andrew Lover and colleagues discuss regional malaria initiatives, the strengths and challenges.

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Assessing the neuroprotective benefits for babies of antenatal magnesium sulphate: An…

by Caroline A. Crowther, Philippa F. Middleton, Merryn Voysey, Lisa Askie, Lelia Duley, Peter G. Pryde, Stéphane Marret, Lex W. Doyle, for the AMICABLE Group Background Babies born preterm are at an increased risk of dying in the first weeks of life, and those who survive have a higher rate of cerebral palsy (CP) compared with babies born at term

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Gabapentin, opioids, and the risk of opioid-related death: A population-based nested…

by Tara Gomes, David N. Juurlink, Tony Antoniou, Muhammad M. Mamdani, J. Michael Paterson, Wim van den Brink Background Prescription opioid use is highly associated with risk of opioid-related death, with 1 of every 550 chronic opioid users dying within approximately 2.5 years of their first opioid prescription.

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When cost-effective interventions are unaffordable: Integrating cost-effectiveness and budget…

by Alyssa Bilinski, Peter Neumann, Joshua Cohen, Teja Thorat, Katherine McDaniel, Joshua A. Salomon Potential cost-effective barriers in cost-effectiveness studies mean that budgetary impact analyses should also be included in post-2015 Sustainable Development Goal projects says Joshua Salomon and colleagues.

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Chronic disease concordance within Indian households: A cross-sectional study

by Shivani A. Patel, Preet K. Dhillon, Dimple Kondal, Panniyammakal Jeemon, Kashvi Kahol, Sathya Prakash Manimunda, Anil J. Purty, Ajit Deshpande, P.

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