Summary Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea in...
Summary Background Across low-income and middle-income countries (LMICs), one in ten deaths in children younger than 5 years is attributable to diarrhoea. The substantial between-country variation in both diarrhoea incidence and mortality is attributable to interventions that protect children, prevent infection, and treat disease. Identifying subnational regions with the highest burden and mapping associated risk factors can aid in reducing preventable childhood *** We used Bayesian model-based geostatistics and a geolocated dataset comprising 15 072 746 children younger than 5 years from 466 surveys in 94 LMICs, in combination with findings of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017, to estimate posterior distributions of diarrhoea prevalence, incidence, and mortality from 2000 to 2017. From these data, we estimated the burden of diarrhoea at varying subnational levels (termed units) by spatially aggregating draws, and we investigated the drivers of subnational patterns by creating aggregated risk factor *** The greatest declines in diarrhoeal mortality were seen in south and southeast Asia and South America, where 54·0% (95% uncertainty interval [UI] 38·1-65·8), 17·4% (7·7-28·4), and 59·5% (34·2-86·9) of units, respectively, recorded decreases in deaths from diarrhoea greater than 10%. Although children in much of Africa remain at high risk of death due to diarrhoea, regions with the most deaths were outside Africa, with the highest mortality units located in Pakistan. Indonesia showed the greatest within-country geographical inequality; some regions had mortality rates nearly four times the average country rate. Reductions in mortality were correlated to improvements in water, sanitation, and hygiene (WASH) or reductions in child growth failure (CGF). Similarly, most high-risk areas had poor WASH, high CGF, or low oral rehydration therapy *** By co-analysing geospatial trends in d
SARS-CoV-2 infections display tremendous interindividual variability, ranging from asymptomatic infections to life-threatening disease. Inborn errors of, and autoantibodies directed against, type I interferons (IFNs) ...
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SARS-CoV-2 infections display tremendous interindividual variability, ranging from asymptomatic infections to life-threatening disease. Inborn errors of, and autoantibodies directed against, type I interferons (IFNs) account for about 20% of critical COVID-19 cases among SARS-CoV-2-infected individuals. By contrast, the genetic and immunological determinants of resistance to infection per se remain unknown. Following the discovery that autosomal recessive deficiency in the DARC chemokine receptor confers resistance to Plasmodium vivax, autosomal recessive deficiencies of chemokine receptor 5 (CCR5) and the enzyme FUT2 were shown to underlie resistance to HIV-1 and noroviruses, respectively. Along the same lines, we propose a strategy for identifying, recruiting, and genetically analyzing individuals who are naturally resistant to SARS-CoV-2 infection.
Cell segmentation is a critical step for quantitative single-cell analysis in microscopy images. Existing cell segmentation methods are often tailored to specific modalities or require manual interventions to specify ...
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Cell culture-conditioned medium (CCM) is a valuable source of extracellular vesicles (EVs) for basic scientific, therapeutic and diagnostic applications. Cell culturing parameters affect the biochemical composition, r...
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Machine learning plays an important and growing role in molecular simulation. The newest version of the OpenMM molecular dynamics toolkit introduces new features to support the use of machine learning potentials. Arbi...
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Background Calls for healthcare systems to reduce disparities in cancer care access and outcomes draw on comparisons of existing measures across race and ethnicity subgroups. This approach may hide inequities driven b...
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Background Calls for healthcare systems to reduce disparities in cancer care access and outcomes draw on comparisons of existing measures across race and ethnicity subgroups. This approach may hide inequities driven by systematic bias in the timing of care delivery. The goals of this study were to: (1) identify differences in the timing of care delivery between racial groups, and (2) determine whether these differences could be identified from quality measures. Methods Retrospective decedent follow-back study of hospitals treating Medicare fee-for-service beneficiaries with advanced cancer aged 65–99 who died April–December 2016. Among hospitals serving at least 11 decedents of color (including Black or African-American, Asian/Pacific Islander, Hispanic, American Indian/Alaska Native, and Other) and 11 White decedents, we calculated hospital-level differences between White decedents and decedents of color for 1) any use of palliative care and hospice (Measures) and 2) daily counts of palliative care and hospice use for each day in the 6 months before death (Signatures). Findings The cohort included 30,319 decedents across 217 hospitals, of whom 7,852 (25.9%) were people of color (POC). The median of the hospital-specific aggregate measure difference was −5.35% (IQR = 12.83) for palliative care, indicating more POC received any palliative care, and 3.66% (IQR = 12.45) for hospice care, indicating more White people (WP) received any hospice care. We identified 5 high-level cluster-group descriptions of inequality from signatures. Inequality information from signatures matched those from measures in only 46.5% and 39.2% of hospitals for palliative and hospice care, respectively. Interpretation Signatures incorporating timing of care delivery using longitudinal data revealed patterns of racial-ethnic inequalities in end-of-life cancer care otherwise missed by traditional aggregate quality measures. Funding This work was supported by the American Cancer Society Award (RS
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