β-Lactam Inoculum Effect in Methicillin-Susceptible Staphylococcus aureus Infective Endocarditis.

Importance: Infective endocarditis (IE) caused by Staphylococcus aureus is associated with high mortality, approximately 20% to 30%, mostly in the first month, with no improvement in recent decades. Current opinion is that antistaphylococcal penicillin and cefazolin are equally effective in treating methicillin-susceptible S aureus (MSSA) IE, and both are recommended as possible first-line treatments. Most MSSA strains carry the β-lactamase blaZ gene, and some blaZ-positive strains exhibit an inoculum effect, meaning increased minimum inhibitory concentrations at high inoculum.

An efficient joint model for high dimensional longitudinal and survival data via generic association features.

This paper introduces a prognostic method called FLASH that addresses the problem of joint modeling of longitudinal data and censored durations when a large number of both longitudinal and time-independent features are available. In the literature, standard joint models are either of the shared random effect or joint latent class type. Combining ideas from both worlds and using appropriate regularization techniques, we define a new model with the ability to automatically identify significant prognostic longitudinal features in a high-dimensional context, which is of increasing importance in many areas such as personalized medicine or churn prediction.

Gastrointestinal Angiectasia in patients with chronic kidney disease: A matched case-control study.

Background And Study Aims: Chronic kidney disease (CKD) is a well-known risk factor of gastrointestinal angiectasia (GIA). The aim was to compare this population with CDK patients without GIA.

Methods: Patients followed in the Nephrology Department of Tenon Hospital for which an endoscopy was performed between 2012 and 2022 were identified.

Physician's perceptions regarding the pharmaceutical industry: a Brazilian national study.

Objective: The objective of this study was to investigate the newly graduated physicians' attitudes and perceptions regarding the medical relationship with the pharmaceutical industry and identify the sociodemographic patterns related to such thinking.

Methods: A structured questionnaire was administered to 4,601 participants selected from a pool of 16,323 physicians who were registered with one of the 27 Regional Medical Councils of Brazil in 2015. Answers were analyzed using two stratification variables: type of medical school (public vs.

Inflammatory/juvenile-like polyps in neurofibromatosis type 1 associated with epithelial dysplasia.

The term "juvenile-like (inflammatory/hyperplastic) mucosal polyps" (JLIHMP) has been recently introduced to describe a spectrum of polypoid lesions in patients with neurofibromatosis type 1 (NF-1). Due to the scarce number of reported cases and histopathological similarities with entities such as sporadic/syndromic juvenile polyps or inflammatory fibroid polyps, this entity remains a subject of debate. We describe herein a case of multiple JLIHMPs in a patient with NF-1, and we document the presence of low-grade dysplasia within one of these polyps.

MS-CPFI: A model-agnostic Counterfactual Perturbation Feature Importance algorithm for interpreting black-box Multi-State models.

Multi-state processes (Webster, 2019) are commonly used to model the complex clinical evolution of diseases where patients progress through different states. In recent years, machine learning and deep learning algorithms have been proposed to improve the accuracy of these models' predictions (Wang et al., 2019).

Perception of newly graduated physicians toward ethical education in medical schools: a Brazilian cross-sectional nationwide study.

Objective: The objective of this study was to evaluate fresh medical graduates' perceptions regarding the general aspects of ethics teaching in Brazilian medical schools.

Methods: A structured questionnaire was applied to 4,601 participants among the 16,323 physicians who registered in one of the 27 Regional Medical Councils of Brazil in 2015. Answers to four questions regarding general aspects of ethics education in medical school were analyzed.

Time for change? A systematic review with meta-analysis of leptospires infecting dogs to assess vaccine compatibility in Brazil.

Dogs are thought to be highly exposed to environmental pathogenic leptospires, possibly acting as potential sources of infection for zoonotic transmission. Vaccination stands as the cornerstone strategy to prevent disease and urinary shedding in dogs, yet the success of vaccination is highly dependent on the correspondence of leptospires circulating locally with those used in vaccine compositions. To provide evidence for vaccine compatibility, and to assess whether there are regional differences on serogroup distribution, we conducted a systematic review with meta-analysis on serological data, characterization of leptospiral isolates and risk factors for seropositivity in dogs from Brazil.

IDNetwork: A deep illness-death network based on multi-state event history process for disease prognostication.

Multi-state models can capture the different patterns of disease evolution. In particular, the illness-death model is used to follow disease progression from a healthy state to an intermediate state of the disease and to a death-related final state. We aim to use those models in order to adapt treatment decisions according to the evolution of the disease.

Binacox: automatic cut-point detection in high-dimensional Cox model with applications in genetics.

We introduce binacox, a prognostic method to deal with the problem of detecting multiple cut-points per feature in a multivariate setting where a large number of continuous features are available. The method is based on the Cox model and combines one-hot encoding with the binarsity penalty, which uses total-variation regularization together with an extra linear constraint, and enables feature selection. Original nonasymptotic oracle inequalities for prediction (in terms of Kullback-Leibler divergence) and estimation with a fast rate of convergence are established.

Assessment of diagnostics capacity in hospitals providing surgical care in two Latin American states.

Background: Diagnostic services are an essential component of high-quality surgical, anesthesia and obstetric (SAO) care. Efforts to scale up SAO care in Latin America have often overlooked diagnostics capacity. This study aims to analyze the capacity of diagnostic services, including radiology, pathology, and laboratory medicine, in hospitals providing SAO care in the states of Chiapas, Mexico and Amazonas, Brazil.

The role of private education in the selection of primary care careers in low and middle-income countries. Findings from a representative survey of medical residents in Brazil.

Background: Primary health care (PHC) doctors' numbers are dwindling in high- as well as low-income countries, which is feared to hamper the achievement of Universal Health Coverage goals. As a large proportion of doctors are privately educated and private medical schools are becoming increasingly common in middle-income settings, there is a debate on whether private education represents a suitable mean to increase the supply of PHC physicians. We analyse the intentions to practice of medical residents in Brazil to understand whether these differ for public and private schools.

Clonal tracking in gene therapy patients reveals a diversity of human hematopoietic differentiation programs.

In gene therapy with human hematopoietic stem and progenitor cells (HSPCs), each gene-corrected cell and its progeny are marked in a unique way by the integrating vector. This feature enables lineages to be tracked by sampling blood cells and using DNA sequencing to identify the vector integration sites. Here, we studied 5 cell lineages (granulocytes, monocytes, T cells, B cells, and natural killer cells) in patients having undergone HSPC gene therapy for Wiskott-Aldrich syndrome or β hemoglobinopathies.

Who and Where are the University of São Paulo Medical School Graduates?

Objective: To evaluate the impact of a complex-care-based medical school in the context of the Brazilian health care system on students' career choices.

Methods: This was a retrospective cross-sectional study based on medical regulatory organization records. It included records for 7,419 physicians who graduated from FMUSP.

Profiling recent medical graduates planning to pursue surgery, anesthesia and obstetrics in Brazil.

Background: Lack of providers in surgery, anesthesia, and obstetrics (SAO) is a primary driver of limited surgical capacity worldwide. We aimed to identify predictors of entry into Surgery, Anesthesia, and Obstetrics and Gynecology (SAO) fields and preference of working in the public sector in Brazil which may help in profiling medical students for recruitment into these needed areas.

Methods: A questionnaire was applied to all Brazilian medical graduates registered with a Board of Medicine from 2014 to 2015.

What explains wage differences between male and female Brazilian physicians? A cross-sectional nationwide study.

Objective: In many countries an increase in the number of women in medicine is accompanied by gender inequality in various aspects of professional practice. Women in medical workforce usually earn less than their male counterparts. The aim of this study was to describe the gender wage difference and analyse the associated factors in relation to Brazil's physicians.

ConvSCCS: convolutional self-controlled case series model for lagged adverse event detection.

With the increased availability of large electronic health records databases comes the chance of enhancing health risks screening. Most post-marketing detection of adverse drug reaction (ADR) relies on physicians' spontaneous reports, leading to under-reporting. To take up this challenge, we develop a scalable model to estimate the effect of multiple longitudinal features (drug exposures) on a rare longitudinal outcome.

Comparison of methods for early-readmission prediction in a high-dimensional heterogeneous covariates and time-to-event outcome framework.

Background: Choosing the most performing method in terms of outcome prediction or variables selection is a recurring problem in prognosis studies, leading to many publications on methods comparison. But some aspects have received little attention. First, most comparison studies treat prediction performance and variable selection aspects separately.

Association of Primary Resistance to Immune Checkpoint Inhibitors in Metastatic Colorectal Cancer With Misdiagnosis of Microsatellite Instability or Mismatch Repair Deficiency Status.

Importance: Primary resistance to immune checkpoint inhibitors is observed in 10% to 40% of patients with metastatic colorectal cancer (mCRC) displaying microsatellite instability (MSI) or defective mismatch repair (dMMR).

Objective: To investigate possible mechanisms underlying primary resistance to immune checkpoint inhibitors of mCRC displaying MSI or dMMR.

Design, Setting, And Participants: This post hoc analysis of a single-center, prospective cohort included 38 patients with mCRC diagnosed as MSI or dMMR by local laboratories and entered into trials of immune checkpoint inhibitors between January 1, 2015, and December 31, 2016.