Development of a US trust measure to assess and monitor parental confidence in the vaccine system

Objective

To develop a Vaccine Confidence Index (VCI) that is capable of detecting variations in parental confidence towards childhood immunizations centered on trust and concern issues that impact vaccine confidence.

Contemporary Outcomes and Factors Associated With Mortality After a Fetal or Postnatal Diagnosis of Common Arterial Trunk

Background

Common arterial trunk (CAT) is a rare anomaly with a spectrum of pathology. We sought to identify current trends and factors associated with postnatal outcomes.

An overview of translational prostate cancer cohorts for prognostic and predictive studies

The aim of this review is to describe the characteristics of patient cohorts commonly used for translational biomarker research in prostate cancer and to outline the most prominent contemporary cohorts which serve as a source of prognostic and predictive biomarkers. A non‐systematic review of the literature was performed to identify and summarise well‐characterized translational prostate cancer cohorts that provide state‐of‐the‐art characterization of (i) primary and (ii) metastatic and castration‐resistant prostate cancer. The main advantages and features of these cohorts are a substantial number of patients, unique patient groups, comprehensive genetic characterisation of tumours using multi‐omics/next‐generation sequencing approaches, high‐quality control standards and fully or partially open data for the research community. This overview includes the contemporary cohorts which serve as a rich source of new targets for prognostic and predictive biomarkers as well as a reference database for validation of known biomarkers, therefore representing the cohorts whose impact extends over the current state of biomarker research into the near future (5–10 years).     

Myocarditis in the pediatric population: A review

Myocarditis has a variable clinical presentation and there is still debate regarding accurate diagnostic criteria. Adding to the controversy surrounding this diagnosis, there is no clear consensus for the treatment or ongoing follow‐up of patients with myocarditis. All of this makes the diagnosis and management of myocarditis a particular challenge in the pediatric population. Furthermore, the literature with respect to this topic is dynamic and ever‐changing. In this review article, we aim to review and summarize the common clinical presentations of myocarditis, along with the latest recommendations for diagnostic criteria, treatment, and follow‐up of patients with myocarditis.     

PUBLIC AND ORAL HEALTH

The Affordable Care Act (ACA) expanded health insurance coverage and strengthened incentives for health care organizations to engage in community-wide health improvement initiatives. These incentives include enhanced community benefit requirements for tax-exempt hospitals, adjusted medical loss ratio requirements for health insurers, tax incentives for employers, and competitive federal funding through the Prevention and Public Health Fund. Reduced uncompensated care costs and cost-shifting may allow hospitals and other institutions to increase investments in community health, particularly when coupled with incentives to do so. Prior research is inconsistent regarding how health care organizations have responded to these reforms, due in part to data limitations. This study uses novel longitudinal data from a national cohort of U.S. communities to estimate whether changes in coverage and uncompensated care have led to changes in the implementation of community health activities by hospitals, physicians, insurers, and employers. The National Longitudinal Survey of Public Health Systems (NALSYS) follows a national cohort of approximately 600 communities between 2012 and 2018 to measure the implementation of guideline-recommended community health improvement activities in each community and the network of organizations contributing to each activity. Importantly, these data are reported by local public health officials rather than by hospitals and health care institutions who may inflate reported contributions. Survey data are linked with county-level coverage estimates, demographic and socioeconomic characteristics, health care market structure data, and CMS hospital cost report data on uncompensated care costs. Fixed-effects regression models with instrumental variables (IV) are used to estimate the causal effects of changes in coverage and uncompensated care on implementation of community health activities by hospitals, physicians, insurers, and employers while controlling for unmeasured confounding. Stratified random sample of 600 U.S. counties observed between 2012 and 2018. Coverage increased and uncompensated care costs declined after 2014 in 87% and 73% of communities, respectively, but by widely varying magnitudes. IV estimates indicate that a 10% reduction in uncompensated care costs resulted in a 14% increase in implementation of community health activities by hospitals (P < 0.01), along with an 8% increase in implementation by insurers (P < 0.05). Results for physicians and employers were not statistically significant. The estimated hospital and insurer effects were concentrated in states that expanded Medicaid eligibility under ACA (P < 0.01). Hospitals and insurers have expanded their involvement in community-wide health activities proportionate with the level of decline in demand for uncompensated care in their communities. Incentives for health care institutions to engage in community-wide health improvement initiatives appear effective in communities where gains in coverage lead to savings that can be redeployed for community benefit. This response may be an important but unrecognized pathway through which coverage gains improve population health, but recent erosion in coverage may dampen this effect. The Robert Wood Johnson Foundation.     

Fetal Size in a Rural Melanesian Population with Minimal Risk Factors for Growth Restriction: An Observational Ultrasound Study from Papua New Guinea

We conducted a prospective longitudinal study of fetal size in rural Papua New Guinea (PNG) involving 439 ultrasound-dated singleton pregnancies with no obvious risk factors for growth restriction. Sonographically estimated fetal weights (EFWs; N = 788) and birth weights (N = 376) were included in a second-order polynomial regression model (optimal fit) to generate fetal weight centiles. Means for specific fetal biometric measurements were also estimated. Fetal weight centiles from a healthy PNG cohort were consistently lower than those derived from Caucasian and Congolese populations, which overestimated the proportion of fetuses measuring small for gestational age (SGA; < 10th centile). Tanzanian and global reference centiles (Caucasian weight reference adapted to our PNG cohort) were more similar to those observed in our cohort, but the global reference underestimated SGA. Individual biometric measurements did not differ significantly from other cohorts. In rural PNG, a locally derived nomogram may be most appropriate for detection of SGA fetuses.     

A basal‐enriched microRNA is required for prostate tumorigenesis in a Pten knockout mouse model

MicroRNAs (miRNAs) play important roles in prostate cancer development. However, it remains unclear how individual miRNAs contribute to the initiation and progression of prostate cancer. Here we show that a basal layer‐enriched miRNA is required for prostate tumorigenesis. We identify miR‐205 as the most highly expressed miRNA and enriched in the basal cells of the prostate. Although miR‐205 is not required for normal prostate development and homeostasis, genetic deletion of miR‐205 in a Pten null tumor model significantly compromises tumor progression and does not promote metastasis. In Pten null basal cells, loss of miR‐205 attenuates pAkt levels and promotes cellular senescence. Furthermore, although overexpression of miR‐205 in prostate cancer cells with luminal phenotypes inhibits cell growth in both human and mouse, miR‐205 has a minimal effect on the growth of a normal human prostate cell line. Taken together, we have provided genetic evidence for a requirement of miR‐205 in the progression of Pten null‐induced prostate cancer.