UCSF Open Access Publishing Fund

A third year medical student shares his approach for translating personal experiences with racial bias into teaching moments that enrich the learning environment.

Do private providers give patients what they demand, even if it is inappropriate? A randomised study using unannounced standardised patients in Kenya

(2022)

A Domain-General Developmental "Do-GooD" Network Model of Prosocial Cognition in Adolescence: A Systematic Review

(2022)

Abortion Stigma and Its Relationship with Grief, Post-traumatic Stress, and Mental Health-Related Quality of Life After Abortion for Fetal Anomalies

(2022)

Transepidermal water loss (TEWL): Environment and pollution-- A systematic review

(2022)

Risk factor targeting for vaccine prioritization during the COVID-19 pandemic

(2022)

Superior Long-term Appearance of Strip Craniectomy Compared with Cranial Vault Reconstruction in Metopic Craniosynostosis

(2022)

Responding to the Needs of Persons Living With Dementia and Their Caregivers During the COVID-19 Pandemic: Lessons From the Care Ecosystem

(2022)

Risk Factors Associated With Early-Onset Esophageal Cancer in Tanzania

(2022)

Fertility preservation in transgender men without discontinuation of testosterone

(2022)

Addressing health disparities through implementation science - a need to integrate an equity lens from the outset

(2022)

Transient Hyperkalemia Following Treatment of Chronic Hypokalemia: A Case Report and Review of Distal Tubule Physiology

(2022)

Rates of readmission and reoperation following pelvic osteotomy in adolescent patients: a database study evaluating the pediatric health information system

(2022)

Optimizing quality of care in patients admitted with chronic obstructive pulmonary disease exacerbation

(2022)

Functional Outcomes and Morbidity in Pediatric Sepsis Survivors: A Tanzanian Experience

(2022)

Burst Suppression During General Anesthesia and Postoperative Outcomes: Mini Review

(2022)

Compression Therapy for HIV-Associated Kaposi Sarcoma Leg Lymphedema: Results of the Kenyan Improvised Compression for Kaposi Sarcoma Randomized Controlled Trial

(2022)

Odds of return: a prospective study using provider assessment to predict short-term patient return visits to the emergency department

(2021)

Barriers and Facilitators to Integrating Clinical Breast Examinations With Cervical Cancer Screening Programs in Outpatient Clinics in Western Kenya

(2021)

Self-reported provision of person-centred maternity care among providers in Kenya and Ghana: scale validation and examination of associated factors

(2021)

Cover page of Diagnostic accuracy of a liquid chromatography-tandem mass spectrometry assay in small hair samples for rifampin-resistant tuberculosis drug concentrations in a routine care setting

Diagnostic accuracy of a liquid chromatography-tandem mass spectrometry assay in small hair samples for rifampin-resistant tuberculosis drug concentrations in a routine care setting

(2021)

Background

Treatment monitoring of drug-resistant tuberculosis (DR-TB) in resource-limited settings is challenging. We developed a multi-analyte assay for eleven anti-TB drugs in small hair samples as an objective metric of drug exposure.

Methods

Small hair samples were collected from participants at various timepoints during directly observed RR-TB treatment at an inpatient tertiary referral facility in South Africa (DR-TB cohort). We assessed qualitative determination (i.e., detection above limit of detection) of bedaquiline, linezolid, clofazimine, pretomanid, levofloxacin, moxifloxacin, pyrazinamide, isoniazid, ethambutol, ethionamide, and prothionamide in an LC-MS/MS index panel assay against a reference standard of inpatient treatment records. Because treatment regimens prior to hospitalization were not available, we also analyzed specificity (for all drugs except isoniazid) using an external cohort of HIV-positive patients treated for latent TB infection with daily isoniazid (HIV/LTBI cohort) in Uganda.

Results

Among the 57 DR-TB patients (58% with pre-XDR/XDR-TB; 70% HIV-positive) contributing analyzable hair samples, the sensitivity of the investigational assay was 94% or higher for all drugs except ethionamide (58.5, 95% confidence interval [CI], 40.7-99.9). Assay specificity was low across all tested analytes within the DR-TB cohort; conversely, assay specificity was 100% for all drugs in the HIV/LTBI cohort.

Conclusions

Hair drug concentrations reflect long-term exposure, and multiple successive regimens commonly employed in DR-TB treatment may result in apparent false-positive qualitative and falsely elevated quantitative hair drug levels when prior treatment histories within the hair growth window are not known.

Turmeric-Induced Hepatotoxicity: Report of 2 Cases

(2021)

Mycobacterium Avium Complex Infection as a Rare Cause of Cerebral Mass Lesion and IRIS in a Patient with AIDS: Case Report and Review of the Literature

(2021)

Neurosarcoidosis: Pathophysiology, Diagnosis, and Treatment

(2021)

Understanding quality of contraceptive services from women’s perspectives in Gujarat, India: a focus group study

(2021)

Objectives

Understanding quality of contraceptive care from clients' perspectives is critical to ensuring acceptable and non-harmful services, yet little qualitative research has been dedicated to this topic. India's history of using incentives to promote contraceptive use, combined with reports of unsafe conditions in sterilisation camps, make a focus on quality important. The study objective was to understand women's experiences with and preferences for contraceptive counselling and care in the public sector in India.

Design

Qualitative study using eight focus group discussions (FGDs). FGDs were thematically analysed using a framework approach.

Setting

Rural and urban areas in one district in Gujarat.

Participants

31 sterilisation and 42 reversible contraceptive users who were married and represented different backgrounds. Inclusion criteria were: (1) female, (2) at least 18 years and (3) receipt of contraception services in the last 6 months from public health services.

Results

Providers motivate married women to use contraception and guide women to specific methods based on how many children they have. Participants found this common practice acceptable. Participants also discussed the lack of counselling about reversible and permanent options and expressed a need for more information on side effects of reversible methods. There were mixed opinions about whether compensation received for accepting long-term methods affects contraceptive decision making. While many women were satisfied with their experiences, we identified minor themes related to provider coercion towards provider-controlled methods and disrespectful and abusive treatment during sterilisation care, both of which require concerted efforts to address systemic factors enabling such experiences.

Conclusions

Findings illuminate opportunities for quality improvement as we identified several gaps between how women experience contraceptive care and their preferences, and with ideals of quality and rights frameworks. Findings informed adaptation of the Quality of Contraceptive Counselling Scale for India, and have implications for centring quality and rights in global efforts.

Racial and Gender Shoulder Arthroplasty Utilization Disparities of High- and Low-Volume Centers in New York State

(2021)

Cover page of Machine Learning Prediction of Liver Allograft Utilization From Deceased Organ Donors Using the National Donor Management Goals Registry.

Machine Learning Prediction of Liver Allograft Utilization From Deceased Organ Donors Using the National Donor Management Goals Registry.

(2021)

Early prediction of whether a liver allograft will be utilized for transplantation may allow better resource deployment during donor management and improve organ allocation. The national donor management goals (DMG) registry contains critical care data collected during donor management. We developed a machine learning model to predict transplantation of a liver graft based on data from the DMG registry.

Methods

Several machine learning classifiers were trained to predict transplantation of a liver graft. We utilized 127 variables available in the DMG dataset. We included data from potential deceased organ donors between April 2012 and January 2019. The outcome was defined as liver recovery for transplantation in the operating room. The prediction was made based on data available 12-18 h after the time of authorization for transplantation. The data were randomly separated into training (60%), validation (20%), and test sets (20%). We compared the performance of our models to the Liver Discard Risk Index.

Results

Of 13 629 donors in the dataset, 9255 (68%) livers were recovered and transplanted, 1519 recovered but used for research or discarded, 2855 were not recovered. The optimized gradient boosting machine classifier achieved an area under the curve of the receiver operator characteristic of 0.84 on the test set, outperforming all other classifiers.

Conclusions

This model predicts successful liver recovery for transplantation in the operating room, using data available early during donor management. It performs favorably when compared to existing models. It may provide real-time decision support during organ donor management and transplant logistics.

Is positron emission tomography enough to rule out cardiac sarcoidosis? A case report.

(2021)

Cardiac sarcoidosis (CS) is associated with poor prognosis, yet the clinical diagnosis is often challenging. Advanced cardiac imaging including cardiac magnetic resonance (CMR) and positron emission tomographic (PET) have emerged as useful modalities to diagnose CS.

A 66-year-old woman presented with palpitations. A 24-h Holter monitor detected a high premature ventricular contraction burden of 25.6%. She underwent two transthoracic echocardiograms; both showed normal results. Stress perfusion CMR did not show any evidence of ischaemic aetiology; however, myocardial lesions detected by late gadolinium enhancement (LGE) imaging raised suspicion for CS. While there was no myocardial uptake of fluorodeoxyglucose (FDG) in subsequent cardiac PET, high FDG uptake was seen in hilar lymph nodes. Lymph node biopsy confirmed the diagnosis of sarcoidosis.

Cardiac magnetic resonance and PET imaging are designed to evaluate different aspects CS pathophysiology. The characteristic LGE in the absence of increased FDG uptake suggested inactive CS with residual myocardial scarring.

Relationship between food insecurity and smoking status among women living with and at risk for HIV in the USA: a cohort study

(2021)

Study protocol: a pilot randomised waitlist-controlled trial of a dyadic mobile health intervention for black sexual-minority male couples with HIV in the USA

(2021)

HIV care engagement is lower among black sexual-minority men relative to other racial/ethnic groups of sexual-minority men. Being in a primary relationship is generally associated with more successful HIV care engagement across various populations. However, among black sexual-minority men, the association between primary relationship status and HIV-related outcomes is inconsistent across the HIV care continuum. Given the ubiquity of mobile technology access and use among racial/ethnic minority communities, leveraging mobile technology for HIV care engagement appears a promising intervention strategy. This paper outlines the protocol of the LetSync study, a pilot randomised controlled trial of a mobile health app intervention developed using the Framework of Dyadic HIV Care Engagement to improve care-engagement outcomes among black sexual-minority male couples living with HIV.

Eighty black sexual-minority men in couples (n=160) will be enrolled to pilot test the LetSync app. At least one member of each dyad must be both HIV-positive and self-identify as black/African-American. Couples will be randomised to either a waitlist-control arm or an intervention that uses relationship-based approach to improve HIV care engagement. We will assess feasibility and acceptability of trial procedures and intervention protocols based on predefined metrics of feasibility and acceptability. Execution of the study will yield the opportunity to conduct analyses to test the measurement and analysis protocol on antiretroviral therapy adherence by comparing the intervention and waitlist-control arms on self-reported and biological (hair sample) measures of adherence.

Study staff will obtain electronic consent from all participants. This study has been approved by the University of California (UCSF) Institutional Review Board. Study staff will work with the Community Advisory Board at the UCSF Center for AIDS Prevention Studies Board to disseminate results to participants and the community via open discussions, presentations, journal publications and/or social media.

NCT04951544.

Fixation of intertrochanteric femur fractures using the SIGN intramedullary nail augmented by a lateral plate in a resource-limited setting without intraoperative fluoroscopy: assessment of functional outcomes at one-year follow-up at Juba Teaching Hospital

(2021)

Intramedullary nailing versus external fixation for open tibia fractures in Tanzania: a cost analysis

(2021)

Perspectives on Spain's legislative experience providing access to healthcare to irregular migrants: a qualitative interview study

(2021)

Evaluation of Dual-port versus Single-port Tissue Expanders in Postmastectomy Breast Reconstruction

(2021)

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