Author
David A. K. Watters
Other affiliations: University of Zambia, Western General Hospital, St. Vincent's Health System ...read more
Bio: David A. K. Watters is an academic researcher from Deakin University. The author has contributed to research in topics: Medicine & Population. The author has an hindex of 30, co-authored 202 publications receiving 5039 citations. Previous affiliations of David A. K. Watters include University of Zambia & Western General Hospital.
Topics: Medicine, Population, Mortality rate, Global health, Poison control
Papers published on a yearly basis
Papers
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Harvard University1, Boston Children's Hospital2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Partners In Health9, Brigham and Women's Hospital10, Royal North Shore Hospital11, Medical College of Wisconsin12, Monash University13, Nanyang Technological University14, University of Sierra Leone15, University of Oxford16, Mongolian National University17, University of Malawi18, Flinders University19, Beth Israel Deaconess Medical Center20, Bhabha Atomic Research Centre21, Royal Australasian College of Surgeons22, Stanford University23, University of California, San Francisco24
TL;DR: The need for surgical services in low- and middleincome countries will continue to rise substantially from now until 2030, with a large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs.
2,209 citations
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HealthPartners1, King's College London2, Obafemi Awolowo University3, Fred Hutchinson Cancer Research Center4, University of Washington5, University of Liverpool6, Guy's and St Thomas' NHS Foundation Trust7, University of London8, University of Texas Southwestern Medical Center9, Memorial Sloan Kettering Cancer Center10, University of Toronto11, Institut Gustave Roussy12, University of Oxford13, Lund University14, Pontifical Catholic University of Chile15, University of Texas at Austin16, Union for International Cancer Control17, Peking University18, Boston Children's Hospital19, Harvard University20, Indiana University21, Cairo University22, University of North Carolina at Chapel Hill23, University of Zambia24, Leiden University25, European Institute of Oncology26, Amrita Institute of Medical Sciences and Research Centre27, Barwon Health28, Deakin University29, Peking Union Medical College30, Guangdong General Hospital31
TL;DR: To deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning and wide equity and economic gaps are found.
Abstract: Surgery is essential for global cancer care in all resource settings. Of the 15.2 million new cases of cancer in 2015, over 80% of cases will need surgery, some several times. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. Yet, less than 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. This Commission on global cancer surgery, building on Global Surgery 2030, has examined the state of global cancer surgery through an analysis of the burden of surgical disease and breadth of cancer surgery, economics and financing, factors for strengthening surgical systems for cancer with multiple-country studies, the research agenda, and the political factors that frame policy making in this area. We found wide equity and economic gaps in global cancer surgery. Many patients throughout the world do not have access to cancer surgery, and the failure to train more cancer surgeons and strengthen systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Many of the key adjunct treatment modalities for cancer surgery--e.g., pathology and imaging--are also inadequate. Our analysis identified substantial issues, but also highlights solutions and innovations. Issues of access, a paucity of investment in public surgical systems, low investment in research, and training and education gaps are remarkably widespread. Solutions include better regulated public systems, international partnerships, super-centralisation of surgical services, novel surgical clinical trials, and new approaches to improve quality and scale up cancer surgical systems through education and training. Our key messages are directed at many global stakeholders, but the central message is that to deliver safe, affordable, and timely cancer surgery to all, surgery must be at the heart of global and national cancer control planning.
409 citations
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TL;DR: Vitamin B12 and calcium supplements may alleviate metformin-induced vitamin B12 deficiency and were associated with better cognitive outcomes in older people with diabetes who are taking met formin.
Abstract: OBJECTIVE To investigate the associations of metformin, serum vitamin B 12 , calcium supplements, and cognitive impairment in patients with diabetes. RESEARCH DESIGN AND METHODS Participants were recruited from the Primary Research in Memory (PRIME) clinics study, the Australian Imaging, Biomarkers and Lifestyle (AIBL) study of aging, and the Barwon region of southeastern Australia. Patients with Alzheimer disease (AD) ( n = 480) or mild cognitive impairment ( n = 187) and those who were cognitively intact ( n = 687) were included; patients with stroke or with neurodegenerative diseases other than AD were excluded. Subgroup analyses were performed for participants who had either type 2 diabetes ( n = 104) or impaired glucose tolerance ( n = 22). RESULTS Participants with diabetes ( n = 126) had worse cognitive performance than participants who did not have diabetes ( n = 1,228; adjusted odds ratio 1.51 [95% CI 1.03–2.21]). Among participants with diabetes, worse cognitive performance was associated with metformin use (2.23 [1.05–4.75]). After adjusting for age, sex, level of education, history of depression, serum vitamin B 12 , and metformin use, participants with diabetes who were taking calcium supplements had better cognitive performance (0.41 [0.19–0.92]). CONCLUSIONS Metformin use was associated with impaired cognitive performance. Vitamin B 12 and calcium supplements may alleviate metformin-induced vitamin B 12 deficiency and were associated with better cognitive outcomes. Prospective trials are warranted to assess the beneficial effects of vitamin B 12 and calcium use on cognition in older people with diabetes who are taking metformin.
292 citations
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Boston Children's Hospital1, Harvard University2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Brigham and Women's Hospital9, Royal North Shore Hospital10, Medical College of Wisconsin11, Nanyang Technological University12, University of Sierra Leone13, University of Oxford14, Mongolian National University15, University of Malawi16, Beth Israel Deaconess Medical Center17, Bhabha Atomic Research Centre18, Royal Australasian College of Surgeons19, Stanford University20, University of California, San Francisco21
TL;DR: The Lancet Commission on Global Surgery has five key messages, a set of indicators and recommendations to improve access to safe, affordable surgical and anaesthesia care in LMICs, and a template for a national surgical plan.
185 citations
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TL;DR: Low serum vitamin B12 levels are associated with neurodegenerative disease and cognitive impairment, and there is a need for large, well-resourced clinical trials to close the gaps in current understanding of the nature of the associations of vitamin B 12 insufficiency and neurodegnerative disease.
Abstract: Background: This review examines the associations between low vitamin B12 levels, neurodegenerative disease, and cognitive impairment. The potential impact of comorbidities and medications associated with vitamin B12 derangements were also investigated. In addition, we reviewed the evidence as to whether vitamin B12 therapy is efficacious for cognitive impairment and dementia.Methods: A systematic literature search identified 43 studies investigating the association of vitamin B12 and cognitive impairment or dementia. Seventeen studies reported on the efficacy of vitamin B12 therapy for these conditions.Results: Vitamin B12 levels in the subclinical low-normal range ( 19.9 μmol/L).Conclusion: Low serum vitamin B12 levels are associated with neurodegenerative disease and cognitive impairment. There is a small subset of dementias that are reversible with vitamin B12 therapy and this treatment is inexpensive and safe. Vitamin B12 therapy does not improve cognition in patients without pre-existing deficiency. There is a need for large, well-resourced clinical trials to close the gaps in our current understanding of the nature of the associations of vitamin B12 insufficiency and neurodegenerative disease.
177 citations
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TL;DR: Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
Abstract: With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
13,073 citations
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TL;DR: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden, while for many cancers, Denmark is closing the survival gap with the other Nordic countries.
2,756 citations
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Boston Children's Hospital1, Harvard University2, King's College London3, Lund University4, Massachusetts Eye and Ear Infirmary5, University of São Paulo6, University of California, San Diego7, Imperial College London8, Partners In Health9, Brigham and Women's Hospital10, Royal North Shore Hospital11, Medical College of Wisconsin12, Nanyang Technological University13, Monash University14, University of Sierra Leone15, University of Oxford16, Mongolian National University17, University of Malawi18, Flinders University19, Beth Israel Deaconess Medical Center20, Bhabha Atomic Research Centre21, Royal Australasian College of Surgeons22, Stanford University23, University of California, San Francisco24
TL;DR: The need for surgical services in low- and middleincome countries will continue to rise substantially from now until 2030, with a large projected increase in the incidence of cancer, road traffic injuries, and cardiovascular and metabolic diseases in LMICs.
2,209 citations
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TL;DR: In view of the high death and complication rates of major surgical procedures, surgical safety should now be a substantial global public-health concern.
1,963 citations