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Full-Text Articles in Medicine and Health Sciences

Predictors Of Biologic Use And Satisfaction Among Patients With Psoriasis: An Analysis And Geographic Visualization Of The 2016 And 2017 National Psoriasis Foundation Annual Surveys, Clinton W. Enos, Hadiza I. Galadima, Arjun Saini, Stacie Bell, Michael Siegel, Abby S. Van Voorhees Jul 2020

Predictors Of Biologic Use And Satisfaction Among Patients With Psoriasis: An Analysis And Geographic Visualization Of The 2016 And 2017 National Psoriasis Foundation Annual Surveys, Clinton W. Enos, Hadiza I. Galadima, Arjun Saini, Stacie Bell, Michael Siegel, Abby S. Van Voorhees

Community & Environmental Health Faculty Publications

Background: There are an increasing number of biologic therapies approved for the treatment of psoriasis. Previous reports have identified undertreatment as a concern in the United States. Undertreatment has been associated with decreased patient satisfaction and increased morbidity.

Objectives: Assess biologic use and satisfaction among respondents to the 2016 and 2017 National Psoriasis Foundation (NPF) Annual Surveys.

Methods: Retrospective data analysis of the 2016 and 2017 NPF Annual Survey responses from individuals with psoriasis. ArcGIS Pro software was utilized to generate maps and perform an optimized hot spot analysis of moderate-to-severe psoriasis and biologic use.

Results: …


Workshop #1: Vulnerable Populations & Planning Considerations For The 2020 Hurricane Season: After Action Report (Aar), Converge Nsf Working Group, Joshua G. Behr, Wie Yusuf, Jennifer Marshall, Elizabeth Dunn Jun 2020

Workshop #1: Vulnerable Populations & Planning Considerations For The 2020 Hurricane Season: After Action Report (Aar), Converge Nsf Working Group, Joshua G. Behr, Wie Yusuf, Jennifer Marshall, Elizabeth Dunn

Presentations, Lectures, Posters, Reports

This workshop shed light on the challenges and importance of adapting current hurricane season planning. Coexisting with COVID-19 will pose even more challenges for hurricane season responses. Suggested adaptations include identifying further shelter spaces to reduce the numbers of evacuees per building (for required social distancing), create isolation spaces to protect populations vulnerable to COVID-19, and quarantine those who are symptomatic. Some strategies being considered include modifying existing shelters (e.g. schools, by using classrooms) and using hotels, dormitories, and other large vacant spaces (e.g., stores and convention centers).

Along with identifying new shelter options comes modifying procedures for screening, triage, …


Quercetin And Vitamin C: An Experimental, Synergistic Therapy For The Prevention And Treatment Of Sars-Cov-2 Related Disease (Covid-19), Ruben Manuel Luciano Colunga Biancatelli, Max Berrill, John D. Catravas, Paul Ellis Marik Jun 2020

Quercetin And Vitamin C: An Experimental, Synergistic Therapy For The Prevention And Treatment Of Sars-Cov-2 Related Disease (Covid-19), Ruben Manuel Luciano Colunga Biancatelli, Max Berrill, John D. Catravas, Paul Ellis Marik

Bioelectrics Publications

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) represents an emergent global threat which is straining worldwide healthcare capacity. As of May 27th, the disease caused by SARS-CoV-2 (COVID-19) has resulted in more than 340,000 deaths worldwide, with 100,000 deaths in the US alone. It is imperative to study and develop pharmacological treatments suitable for the prevention and treatment of COVID-19. Ascorbic acid is a crucial vitamin necessary for the correct functioning of the immune system. It plays a role in stress response and has shown promising results when administered to the critically ill. Quercetin is a well-known flavonoid whose antiviral properties …


Tactics Against Scheming Diseases, Brian Martin May 2020

Tactics Against Scheming Diseases, Brian Martin

The Journal of Sociotechnical Critique

Achieving good health can be thought of as a struggle against opponents—disease and unhealthy practices—that are imagined to be active agents, in a type of thought experiment. These opponents of health, to reduce outrage about their activities, draw on a standard set of tactics: cover-up of the threat, devaluation of victims, reinterpretation of what is happening, use of official processes to give an illusion of safety, and intimidation. To promote good health, each of these tactics can be countered, by exposure of the problem, validation of victims, reframing of what is happening, mobilisation of support, and resistance. Three case studies …


Novel Method Of Supplementing Current Depression Treatments: Using Autonomous Sensory Meridian Response-Centered Therapy To Improve Constipation-Associated Comorbidity Of Depression, Shivam Patel Apr 2020

Novel Method Of Supplementing Current Depression Treatments: Using Autonomous Sensory Meridian Response-Centered Therapy To Improve Constipation-Associated Comorbidity Of Depression, Shivam Patel

Virginias Collegiate Honors Council Conference

One-third of individuals struggling with constipation also suffer chronically from comorbid depression, but the evidently shared etiology has remained relatively ambiguous. This proposed study aims to analyze the role of Autonomous Sensory Meridian Response (ASMR), a newly recorded neural phenomenon that causes relaxing “tingles” from unique “triggers” in a subset of individuals, in altering serotonin (5-HT) levels within the ENS to aid with both depression and constipation. In depressed individuals, reduced 5-HT has been clinically accepted as a key symptom and is frequently treated with ineffective SSRIs. Prospective alternative methods of non-invasive treatment, such as ASMR, would not only aid …


Canine Cognitive Dysfunction (Ccd), Alzheimer’S Disease (Ad), And Β-Amyloid Accumulation: Using Ccd As A Reference For The Development Of Ad Treatments And Therapies, Isabel Gibbs Apr 2020

Canine Cognitive Dysfunction (Ccd), Alzheimer’S Disease (Ad), And Β-Amyloid Accumulation: Using Ccd As A Reference For The Development Of Ad Treatments And Therapies, Isabel Gibbs

Virginias Collegiate Honors Council Conference

I researched the similarities and differences between Canine Cognitive Dysfunction (CCD)—a disease with symptoms and progression pattern that parallels Alzheimer’s Disease (AD)—and AD. I studied how β-amyloid accumulates in various brain regions—such as the prefrontal, occipital, entorhinal and parietal cortices—in canines to determine how β-amyloid accumulation is associated with the development of behaviors signifying cognitive decline observed in CCD and AD—such as changes in the sleep-wake cycle, social interaction, housetraining, and general orientation—in order to understand how neuroscientists may be able to derive new understandings from a canine model with CCD, and apply them to humans with AD to develop …


Antidepressants Versus Music Therapy: Which Treatment Is Better For Treating Depression In Parkinson's Disease?, Emaan Dawood Apr 2020

Antidepressants Versus Music Therapy: Which Treatment Is Better For Treating Depression In Parkinson's Disease?, Emaan Dawood

Virginias Collegiate Honors Council Conference

Music and medicine are merging to treat depression in Parkinson’s disease (PD). Antidepressants, the current standard, demonstrate mixed effects in clinical trials, warranting other treatment options. Here, I compare music therapy to antidepressants in the treatment of depression in PD via literature review. Studies of depressed PD patients undergoing music therapy and/or antidepressants were reviewed with attention to variables including depression (on a patient-reported outcome) that were measured pre- and post- therapy. In the music studies, improvements were seen in depression. Methodological inconsistencies across these studies, a paucity of studies, and small sample sizes, however, necessitate more research to reach …


Synthesis, Characterization, Dna Binding, Topoisomerase Inhibition, And Apoptosis Induction Studies Of A Novel Cobalt(Iii) Complex With A Thiosemicarbazone Ligand, Stephen J. Beebe, Michael J. Celestine, Jimmie L. Bullock, Shayna Sandhaus, Jessa Faye Arca, Donald M. Cropek, Tekettay A. Ludvig, Sydney R. Foster, Jasmine S. Clark, Floyd A. Beckford, Criszcele M. Tano, Elizabeth A. Tonsel-White, Raj K. Gurung, Courtney E. Stankavich, Yuk-Ching Tse-Dinh, William L. Jarrett, Alvin A. Holder Jan 2020

Synthesis, Characterization, Dna Binding, Topoisomerase Inhibition, And Apoptosis Induction Studies Of A Novel Cobalt(Iii) Complex With A Thiosemicarbazone Ligand, Stephen J. Beebe, Michael J. Celestine, Jimmie L. Bullock, Shayna Sandhaus, Jessa Faye Arca, Donald M. Cropek, Tekettay A. Ludvig, Sydney R. Foster, Jasmine S. Clark, Floyd A. Beckford, Criszcele M. Tano, Elizabeth A. Tonsel-White, Raj K. Gurung, Courtney E. Stankavich, Yuk-Ching Tse-Dinh, William L. Jarrett, Alvin A. Holder

Bioelectrics Publications

In this study, 9-anthraldehyde-N(4)-methylthiosemicarbazone (MeATSC) 1 and [Co(phen)2(O2CO)]Cl·6H2O 2 (where phen = 1,10-phenanthroline) were synthesized. [Co(phen)2(O2CO)]Cl·6H2O 2 was used to produce anhydrous [Co(phen)2(H2O)2(NO3)3 3. Subsequently, anhydrous [Co(phen)2(H2O)2] (NO3)3 3 was reacted with MeATSC 1 to produce [Co(phen)2(MeATSC)](NO3)3·1.5H2O·C2 H5OH 4. The ligand, MeATSC 1 and all complexes were characterized by elemental analysis, FT IR, UV–visible, and multinuclear NMR …


Electrochemical Detection Of Neurotransmitters, Saikat Banerjee, Stephanie Mccracken, Md Faruk Hossain, Gymama Slaughter Jan 2020

Electrochemical Detection Of Neurotransmitters, Saikat Banerjee, Stephanie Mccracken, Md Faruk Hossain, Gymama Slaughter

Bioelectrics Publications

Neurotransmitters are important chemical messengers in the nervous system that play a crucial role in physiological and physical health. Abnormal levels of neurotransmitters have been correlated with physical, psychotic, and neurodegenerative diseases such as Alzheimer's, Parkinson's, dementia, addiction, depression, and schizophrenia. Although multiple neurotechnological approaches have been reported in the literature, the detection and monitoring of neurotransmitters in the brain remains a challenge and continues to garner significant attention. Neurotechnology that provides high-throughput, as well as fast and specific quantification of target analytes in the brain, without negatively impacting the implanted region is highly desired for the monitoring of the …


Comparative Survival Of Asian And White Metastatic Castration-Resistant Prostate Cancer Men Treated With Docetaxel, Susan Halabi, Sandipan Dutta, Catherine M. Tangen, Mark Rosenthal, Daniel P. Petrylak, Ian M. Thompson Jr., Kim N. Chi, Johann S. De Bono, John C. Araujo, Christopher Logothetis, Mario A. Eisenberger, David I. Quinn, Karim Fizazi, Michael J. Morris, Celestia S. Higano, Ian F. Tannock, Eric J. Small, William Kevin Kelly Jan 2020

Comparative Survival Of Asian And White Metastatic Castration-Resistant Prostate Cancer Men Treated With Docetaxel, Susan Halabi, Sandipan Dutta, Catherine M. Tangen, Mark Rosenthal, Daniel P. Petrylak, Ian M. Thompson Jr., Kim N. Chi, Johann S. De Bono, John C. Araujo, Christopher Logothetis, Mario A. Eisenberger, David I. Quinn, Karim Fizazi, Michael J. Morris, Celestia S. Higano, Ian F. Tannock, Eric J. Small, William Kevin Kelly

Mathematics & Statistics Faculty Publications

There are few data regarding disparities in overall survival (OS) between Asian and white men with metastatic castration-resistant prostate cancer (mCRPC). We compared OS of Asian and white mCRPC men treated in phase III clinical trials with docetaxel and prednisone (DP) or a DP-containing regimen. Individual participant data from 8820 men with mCRPC randomly assigned on nine phase III trials to receive DP or a DP-containing regimen were combined. Men enrolled in these trials had a diagnosis of prostate adenocarcinoma. The median overall survival was 18.8 months (95% confidence interval [CI] = 17.4 to 22.1 months) and 21.2 months (95% …


Classification Models Of Idiopathic Pulmonary Fibrosis Patients, Mohammed Alqawba, Luis R. Rodriguez, Norou Diawara, Rebecca T. Beuschel, Maryann Kaler, Amisha V. Barochia, Stewart J. Levine, Steven D. Nathan, Geraldine Grant Jan 2020

Classification Models Of Idiopathic Pulmonary Fibrosis Patients, Mohammed Alqawba, Luis R. Rodriguez, Norou Diawara, Rebecca T. Beuschel, Maryann Kaler, Amisha V. Barochia, Stewart J. Levine, Steven D. Nathan, Geraldine Grant

Mathematics & Statistics Faculty Publications

Idiopathic pulmonary fibrosis (IPF) is a chronic and fatal interstitial lung disease with no current cure. Progression of IPF is difficult to predict as the clinical course can be highly variable and range from a rapidly deteriorating state to a relatively stable state, or may be characterized by a slow progressive decline. Therefore, the need for an accurate diagnosis and improved tools for monitoring and managing IPF is of paramount importance, all for understanding the mitochondrial structure and the function played in the IPF. Mitochondrial DNA copy number (MtDCN) has been correlated with mortality in IPF patients and is a …


Structural Biology Of The Enterovirus Replication-Linked 5'-Cloverleaf Rna And Associated Virus Proteins, Steven M. Pascal, Ravindranath Garimella, Meghan S. Warden, Komala Ponniah Jan 2020

Structural Biology Of The Enterovirus Replication-Linked 5'-Cloverleaf Rna And Associated Virus Proteins, Steven M. Pascal, Ravindranath Garimella, Meghan S. Warden, Komala Ponniah

Chemistry & Biochemistry Faculty Publications

Although enteroviruses are associated with a wide variety of diseases and conditions, their mode of replication is well conserved. Their genome is carried as a single, positive-sense RNA strand. At the 5′ end of the strand is an approximately 90-nucleotide self-complementary region called the 5′ cloverleaf, or the oriL. This noncoding region serves as a platform upon which host and virus proteins, including the 3B, 3C, and 3D virus proteins, assemble in order to initiate replication of a negative-sense RNA strand. The negative strand in turn serves as a template for synthesis of multiple positive-sense RNA strands. Building on structural …


Hsp90 Inhibition And Modulation Of The Proteome: Therapeutical Implications For Idiopathic Pulmonary Fibrosis (Ipf), Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Betsy Gregory, John D. Catravas Jan 2020

Hsp90 Inhibition And Modulation Of The Proteome: Therapeutical Implications For Idiopathic Pulmonary Fibrosis (Ipf), Ruben Manuel Luciano Colunga Biancatelli, Pavel Solopov, Betsy Gregory, John D. Catravas

Bioelectrics Publications

Idiopathic Pulmonary fibrosis (IPF) is a catastrophic disease with poor outcomes and limited pharmacological approaches. Heat shock protein 90 (HSP90) has been recently involved in the wound-healing pathological response that leads to collagen deposition in patients with IPF and its inhibition represents an exciting drug target against the development of pulmonary fibrosis. Under physiological conditions, HSP90 guarantees proteostasis through the refolding of damaged proteins and the degradation of irreversibly damaged ones. Additionally, its inhibition, by specific HSP90 inhibitors (e.g., 17 AAG, 17 DAG, and AUY-922) has proven beneficial in different preclinical models of human disease. HSP90 inhibition modulates a complex …


Thermal Analysis Of Infrared Irradiation-Assisted Nanosecond-Pulsed Tumor Ablation, James Hornef, Chelsea M. Edelblute, Karl H. Schoenbach, Richard Heller, Siqi Guo, Chunqi Jiang Jan 2020

Thermal Analysis Of Infrared Irradiation-Assisted Nanosecond-Pulsed Tumor Ablation, James Hornef, Chelsea M. Edelblute, Karl H. Schoenbach, Richard Heller, Siqi Guo, Chunqi Jiang

Bioelectrics Publications

Nanosecond Pulsed Electric Fields (nsPEF) have the potential to treat a variety of cancer types including melanoma, pancreatic and lung squamous cancers. Recent studies show that nsPEF-based cancer therapy may be improved further with the assistance of moderate heating of the target. A feedbacklooped heating system, utilizing a 980-nm fiber optic laser, was integrated into nsPEF electrodes for tumor ablation. The laser beam profile was determined to be Gaussian using a knife-edge technique. Thermal properties of the biological target were evaluated based on the treatment area, penetration depth and thermal distribution due to laser irradiation with or without nsPEF. Synergistic …


Hsp90 Inhibitors For Ipf/Covid-19, Ruben Manuel Luciano Colunga Biancatelli, Pavel A. Solopov, John Catravas Jan 2020

Hsp90 Inhibitors For Ipf/Covid-19, Ruben Manuel Luciano Colunga Biancatelli, Pavel A. Solopov, John Catravas

Bioelectrics Publications

Heat shock protein 90 (HSP90) is an important chaperone that assists the late stage folding of several proteins involved in cell survival in response to environmental stressors. The inhibition of HSP90 is followed by a complex modulation of the proteome and the kinome, that has proved beneficial in cancer and various neurodegenerative diseases. Additionally, accumulating literature suggests that HSP90 may be a key target during the development of pulmonary fibrosis and that its inhibition could serve as a new and exciting therapeutic approach. We have summarized the current evidence about HSP90’s role in Idiopathic Pulmonary Fibrosis (IPF), the results from …


Malignant Insulinoma With Multiple Liver Metastases And Hypercalcitoninemia In A Patient With Type 2 Diabetes Mellitus Presenting As Recurrent Episodes Of Diaphoresis Due To Severe Hypoglycemia, Marco Ciacciarelli, Gianluca Caruso, Marco Rengo, Piero Maceroni, Carmen Misurale, Eleonora D'Armiento, Cristina Napoli, Alberto Lombardini, Umberto Ceratti, Ruben Manuel Luciano Colunga Biancatelli, Leonardo Calvosa, Romina Milanese, Sonia Ferri, Teresa Massaro, Andrea Larusso, Veronica Sorrentino, Vincenzo Petrozza Jan 2020

Malignant Insulinoma With Multiple Liver Metastases And Hypercalcitoninemia In A Patient With Type 2 Diabetes Mellitus Presenting As Recurrent Episodes Of Diaphoresis Due To Severe Hypoglycemia, Marco Ciacciarelli, Gianluca Caruso, Marco Rengo, Piero Maceroni, Carmen Misurale, Eleonora D'Armiento, Cristina Napoli, Alberto Lombardini, Umberto Ceratti, Ruben Manuel Luciano Colunga Biancatelli, Leonardo Calvosa, Romina Milanese, Sonia Ferri, Teresa Massaro, Andrea Larusso, Veronica Sorrentino, Vincenzo Petrozza

Bioelectrics Publications

Insulinoma is an insulin-producing pancreatic neuroendocrine tumor that can be malignant in about 10% of cases. Locoregional invasion, lymph node metastases, or remote metastases are the main criteria of malignant insulinoma. Its incidence in patients with pre-existing diabetes mellitus (DM) is exceptionally rare. In this report, we describe a 66-year-old man with long-standing type 2 DM who presented with recurrent episodes of diaphoresis due to severe hypoglycemia despite the withdrawal of insulin therapy, hypercalcitoninemia, and biochemical and radiological findings suggestive of metastatic malignant insulinoma. Unfortunately, after few days of diazoxide treatment, edema, hypotension, oliguria, and water retention were observed, patient’s …


Three Cases Of Covid-19 Pneumonia That Responded To Icosapent Ethyl Supportive Treatment, Winston Suh, Ivan Urits, Omar Viswanath, Alan D. Kaye, Haresh Patel, Wade Hall, Jonathan P. Eskander Jan 2020

Three Cases Of Covid-19 Pneumonia That Responded To Icosapent Ethyl Supportive Treatment, Winston Suh, Ivan Urits, Omar Viswanath, Alan D. Kaye, Haresh Patel, Wade Hall, Jonathan P. Eskander

Nursing Faculty Publications

BACKGROUND Icosapent ethyl, a form of eicosapentaenoic acid with anti-inflammatory activity, has been approved as an adjunctive treatment with statins in patients with hypertriglyceridemia. Icosapent ethyl is currently undergoing clinical trials to determine its anti-inflammatory effects in patients with coronavirus disease 2019 (COVID-19). This report describes 3 intensive care unit (ICU) patients with moderate to severe COVID-19 pneumonia treated with icosapent ethyl as part of their supportive care who had favorable outcomes.

CASE REPORT Case 1 was a 75-year-old man with a past medical history of hyperlipidemia, hypertension, type 2 diabetes mellitus, obesity, and benign prostatic hyperplasia. Case 2 was …


Exposure To Household Secondhand Smoke Among Adolescents In Kuwait: Results From Two School-Based Cross-Sectional Studies, Ali H. Ziyab, Mohammad Almari, Abdullah Al-Taiar Jan 2020

Exposure To Household Secondhand Smoke Among Adolescents In Kuwait: Results From Two School-Based Cross-Sectional Studies, Ali H. Ziyab, Mohammad Almari, Abdullah Al-Taiar

Community & Environmental Health Faculty Publications

INTRODUCTION: Detrimental effects of secondhand smoke (SHS) exposure are well established; however, data on SHS exposure among adolescents in Kuwait are lacking. Hence, this study sought to estimate the prevalence of household SHS exposure among two samples of adolescents in Kuwait and assess its variation by socioeconomic status and parental education level.

METHODS: Data from two large school-based cross-sectional studies were analyzed. Adolescents attending public middle (n=3864; aged 11-14 years) and high (n=1959; aged 14-19 years) schools throughout Kuwait were enrolled in 2016-2017, and parental self-reported household SHS exposure was ascertained. Associations were assessed using Poisson regression with robust variance …


Strategies For Safe And Effective Treatment Of Patients With Alzheimer Disease, Jafar Alabdullah, Ahmed Almuntashiri Jan 2020

Strategies For Safe And Effective Treatment Of Patients With Alzheimer Disease, Jafar Alabdullah, Ahmed Almuntashiri

Community & Environmental Health Faculty Publications

Alzheimer disease is a progressive neurodegenerative disorder that causes cognition impairment and memory loss, affecting activities in daily living. In the United States, an estimated 4.5 million people have AD and this figure is expected to reach 14 million by 2050. Because patients with AD experience a deterioration of their mental functions, patients need more help with their activities of daily living, including oral hygiene, as their AD progresses. Studies have found that individuals with AD often experience poor oral health. As advanced age is a risk factor for AD and the number of older adults in the US continues …


The Impact Of Delayed Treatment Of Uncomplicated P. Falciparum Malaria On Progression To Severe Malaria: A Systematic Review And A Pooled Multicentre Individual-Patient Meta-Analysis, Andria Mousa, Abdullah Al-Taiar, Nicholas M. Anstey, Cyril Badaut, Bridget E. Barber, Quique Bassat, Joseph D. Challenger, Aubrey J. Cunnington, Dibyadyuti Datta, Chris Drakeley, Azra C. Ghani, Victor R. Gordeuk, Matthew J. Grigg, Pierre Hugo, Chandy C. John, Alfredo Mayor, Florence Migot-Nabias, Robert O. Opoka, Geoffrey Pasvoi, Claire Rees, Hugh Reyburn, Eleanor M. Riley, Binal N. Shah, Antonio Sitoe, Colin J. Sutherland, Philip E. Thuma, Stefan A. Unger, Firmine Viwami, Michael Walther, Christopher J.M. Whitty, Timothy William, Lucy C. Okell Jan 2020

The Impact Of Delayed Treatment Of Uncomplicated P. Falciparum Malaria On Progression To Severe Malaria: A Systematic Review And A Pooled Multicentre Individual-Patient Meta-Analysis, Andria Mousa, Abdullah Al-Taiar, Nicholas M. Anstey, Cyril Badaut, Bridget E. Barber, Quique Bassat, Joseph D. Challenger, Aubrey J. Cunnington, Dibyadyuti Datta, Chris Drakeley, Azra C. Ghani, Victor R. Gordeuk, Matthew J. Grigg, Pierre Hugo, Chandy C. John, Alfredo Mayor, Florence Migot-Nabias, Robert O. Opoka, Geoffrey Pasvoi, Claire Rees, Hugh Reyburn, Eleanor M. Riley, Binal N. Shah, Antonio Sitoe, Colin J. Sutherland, Philip E. Thuma, Stefan A. Unger, Firmine Viwami, Michael Walther, Christopher J.M. Whitty, Timothy William, Lucy C. Okell

Community & Environmental Health Faculty Publications

BACKGROUND: Delay in receiving treatment for uncomplicated malaria (UM) is often reported to increase the risk of developing severe malaria (SM), but access to treatment remains low in most high-burden areas. Understanding the contribution of treatment delay on progression to severe disease is critical to determine how quickly patients need to receive treatment and to quantify the impact of widely implemented treatment interventions, such as 'test-and-treat' policies administered by community health workers (CHWs). We conducted a pooled individual-participant meta-analysis to estimate the association between treatment delay and presenting with SM.

METHODS AND FINDINGS: A search using Ovid MEDLINE and Embase …