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Duke Law J 2019 Apr;68(7):1433-68

Lost in the cacophony surrounding the debate about high drug prices is the fundamental principle that pharmaceutical innovation will not occur without the prospect of outsized returns enabled through market exclusivity. Biopharmaceutical patents are currently under siege, subject to challenge both in inter partes review ("IPR") proceedings and in Hatch-Waxman actions. These twin assaults threaten to eliminate the incentives necessary for biotechnological innovation--particularly for discoveries made upstream in the innovation pipeline--thus imperiling the development of new drug therapies. Read More

Z Geburtshilfe Neonatol 2019 Apr 17. Epub 2019 Apr 17.

Kompetenz-Centrum Qualitätssicherung / Qualitätsmanagement, MDK Baden-Württemberg, Stuttgart.

Objective: In Germany the care of newborn infants is regulated by directives of the Federal Joint Committee. Assignment to the four levels of care, with level 1 being the highest level, is based on maternal risk factors, maternal and fetal diseases, birth weight and gestational age. This article compares birth weight and gestational age limits used in Germany with international regulations. Read More

Am J Nephrol 2019 Apr 17;49(6):435-437. Epub 2019 Apr 17.

Distinguished Scientist-in-Residence, Department of Health Studies, College of Arts and Sciences, American University, Washington, District of Columbia, USA.

Folia Phoniatr Logop 2019 Apr 17:1-12. Epub 2019 Apr 17.

Department of Biomedical and Clinical Sciences "L. Sacco," Università degli Studi di Milano, Milan, Italy.

Aims: The Mealtime Assessment Scale (MAS) was developed to assess swallowing safety and efficacy during the meal. The study aims to perform a preliminary validation of MAS by investigating internal consistency, inter-rater agreement, concurrent and known-group validity, and responsiveness.

Methods: MAS was tested on 100 persons without dysphagia (group 1) and 100 persons with dysphagia (group 2). Read More

Cardiorenal Med 2019 Apr 17;9(4):212-221. Epub 2019 Apr 17.

Kidney Disease Branch, NIDDK, Bethesda, Maryland, USA,

Background: Observational studies show that African American (AA) dialysis patients have longer survival than European Americans. We hypothesized that apolipoprotein L1 (APOL1) genetic variation, associated with nephropathy in AAs, contributes to the survival advantage in AA dialysis patients.

Methods: We examined the association between race and mortality among 37,097 adult dialysis patients, including 54% AAs and 46% European Americans from a large dialysis organization (entry period from July 2001 to June 2006, follow-up through June 2007), within each cause of end-stage renal disease (ESRD) category associated with APOL1 renal risk variants using Cox proportional hazard models. Read More

N Engl J Med 2019 04;380(16):1546-1554

From the Center for Health Policy-Center for Primary Care and Outcomes Research, Stanford University School of Medicine (D.C.C., D.M.S.), and Stanford Law School (D.M.S.), Stanford, the Department of Medicine, Veterans Affairs Palo Alto Health Care System, Palo Alto (D.C.C.), and the Department of Economics, University of California Los Angeles, Los Angeles (J.H.) - all in California.

Background: The Relative Value Scale Update Committee (RUC) of the American Medical Association plays a central role in determining physician reimbursement. The RUC's role and performance have been criticized but subjected to little empirical evaluation.

Methods: We analyzed the accuracy of valuations of 293 common surgical procedures from 2005 through 2015. Read More

N Engl J Med 2019 04;380(16):1525-1534

From the Departments of Bone Marrow Transplantation and Cellular Therapy (E.M., B.T., W.J., S.G.), Hematology (S.Z., Z.M., J.C., J.D., X.T., B.Y.R., M.J.W., B.P.S.), Therapeutics Production and Quality (T.L., M.M.M.), Immunology (H.A., B.Y.), Pharmaceutical Sciences (S.J.C.), Biostatistics (G.K., C.L.), and Infectious Diseases (G.M.), St. Jude Children's Research Hospital, Memphis, TN; the Allergy and Clinical Immunology Division, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru (J.C.A.B.); the Department of Pediatrics, Allergy-Immunology Division, Children's Hospital Los Angeles, Los Angeles (J.A.C.), and the Department of Pediatrics, Division of Pediatric Allergy-Immunology-Bone Marrow Transplantation, University of California, San Francisco (UCSF) Benioff Children's Hospital, San Francisco (J.R.L.-B., J.M.P., M.J.C.) - both in California; the Department of Pediatrics, Pediatric Allergy and Immunology, University of New Mexico, Albuquerque (E.D.); University of Oklahoma Health Sciences Center, Tulsa (J.T.L.); Departamento de Pediatria da Universidade de Taubaté, Conselho Nacional de Medicina, São Paulo (A.C.M.A.); Copperfield Childcare, Claremont, South Africa (H.W.); and the Genetic Immunotherapy Section, Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD (S.S.D.R., H.L.M.).

Background: Allogeneic hematopoietic stem-cell transplantation for X-linked severe combined immunodeficiency (SCID-X1) often fails to reconstitute immunity associated with T cells, B cells, and natural killer (NK) cells when matched sibling donors are unavailable unless high-dose chemotherapy is given. In previous studies, autologous gene therapy with γ-retroviral vectors failed to reconstitute B-cell and NK-cell immunity and was complicated by vector-related leukemia.

Methods: We performed a dual-center, phase 1-2 safety and efficacy study of a lentiviral vector to transfer complementary DNA to bone marrow stem cells after low-exposure, targeted busulfan conditioning in eight infants with newly diagnosed SCID-X1. Read More

J Clin Psychol 2019 Apr 17. Epub 2019 Apr 17.

Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.

There is convincing evidence that trauma-related psychological distress and aggressive behavior are highly related among adolescents. The evidence is less clear regarding the direction of this relation.

Objective: The purpose of this study was to examine reciprocal longitudinal relations between trauma-related distress and physical aggression. Read More

Agri 2019 Apr;31(2):101-103

Department of Anesthesia and Reanimation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.

This report was submitted to share an experience of the development of a local hematoma as a complication following ultrasound-guided popliteal block performance in a 92-year-old, American Society of Anaesthesiologists class III, male patient undergoing surgical excision of a malignant melanoma lesion in the base of the left foot performed by the plastic surgery department. Read More

Am J Epidemiol 2019 Apr 17. Epub 2019 Apr 17.

Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Women comprise about half of senior epidemiologists, but little is known about whether they are also viewed as leaders (i.e., authorities) in the field. Read More

PLoS One 2019 17;14(4):e0215575. Epub 2019 Apr 17.

Nephrology Training Program at Houston Methodist Hospital, Houston, Texas, United States of America.

Background And Objectives: HIV-infected patients are at risk for developing chronic kidney disease (CKD), defined by estimated glomerular filtration rate (eGFR) <60 ml/min/1.73m2. Our purpose was to understand the genesis of CKD in HIV patients from a large urban clinic in Houston, Texas, USA, and to characterize progression of CKD in the cohort. Read More

PLoS Negl Trop Dis 2019 Apr 17;13(4):e0007343. Epub 2019 Apr 17.

Department of Veterinary and Biomedical Sciences, University of Minnesota, Twin Cities; St. Paul, MN, United States of America.

Congenital Zika virus (ZIKV) infection was first linked to birth defects during the American outbreak in 2015/2016. It has been proposed that mutations unique to the Asian/American-genotype explain, at least in part, the ability of Asian/American ZIKV to cause congenital Zika syndrome (CZS). Recent studies identified mutations in ZIKV infecting humans that arose coincident with the outbreak in French Polynesia and were stably maintained during subsequent spread to the Americas. Read More

J Speech Lang Hear Res 2019 Apr 17:1-13. Epub 2019 Apr 17.

Department of Communication Sciences and Disorders, California State University, Northridge.

Purpose The goal of this study was to investigate vowel detection and identification in noise and provide baseline data regarding how vowel perception changed with signal-to-noise ratios. Psychometric functions of vowel detection and identification for 12 American English isolated vowels in long-term speech-shaped noise were examined for young listeners with normal hearing in this study. Method Vowel detection was measured at sensation levels from -10 to +5 dB (re: thresholds of vowel detection from the study of Liu and Eddins, 2008a ) with a 4-interval forced-choice procedure. Read More

Hist Psychiatry 2019 Apr 17:957154X19839912. Epub 2019 Apr 17.

Universidad Camilo José Cela, Madrid.

The so-called 'Kirkbride Plan' is a type of mental institution designed by the American psychiatrist Thomas Story Kirkbride. The Kirkbride-design asylums were built from 1848 to the end of the nineteenth century. Their structural characteristics were subordinated to a certain approach to moral management: exposure to natural light, beautiful views and good air circulation. Read More

Am J Speech Lang Pathol 2019 Apr 17:1-22. Epub 2019 Apr 17.

Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign.

Purpose The goal of this study was to expand the field's understanding of autism through the analysis of 1st-person perspectives from autistic video webloggers (vloggers). Method This study analyzed the representation of autism in 39 YouTube videos authored by self-identified autistic individuals and published between 2007 and 2015. Consistent with the cross-disciplinary tradition of narrative inquiry, thematic analyses of the video transcripts were conducted. Read More

Am J Sports Med 2019 Apr 17:363546519833925. Epub 2019 Apr 17.

School of Medicine, Georgetown University, Washington, DC, USA.

Background: The use of artificial turf in American football continues to grow in popularity, and the effect of these playing surfaces on athletic injuries remains controversial. Knee injuries account for a significant portion of injuries in the National Collegiate Athletic Association (NCAA) football league; however, the effect of artificial surfaces on knee injuries remains ill-defined.

Hypothesis: There is no difference in the rate or mechanism of knee ligament and meniscal injuries during NCAA football events on natural grass and artificial turf playing surfaces. Read More

Arch Pharm (Weinheim) 2019 Apr 17:e1800281. Epub 2019 Apr 17.

Laboratorio de Ingeniería Genética, Instituto de Biomedicina, Facultad de Medicina, Universidad Central de Venezuela, Caracas, Venezuela.

Traditional antimalarial drugs based on 4-aminoquinolines have exhibited good antiproliferative activities against Leishmania parasites; however, their clinical use is currently limited. To identify new 4-aminoquinolines to combat American cutaneous leishmaniasis, we carried out a full in vitro evaluation of a series of dehydroxy isoquines and isotebuquines against two Leishmania parasites such as Leishmania braziliensis and Leishmania mexicana. First, the antiproliferative activity of the quinolines was studied against the promastigote forms of L. Read More

Am J Health Syst Pharm 2019 Apr 17. Epub 2019 Apr 17.

Drake University College of Pharmacy and Health Sciences, Des Moines, IA.

Purpose: We describe the use of liposomal amphotericin B and amphotericin B deoxycholate in a critically ill patient with pulmonary blastomycosis receiving both venovenous extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT).

Summary: A 50-year-old African American man presented for dyspnea and cough and was noted to have blastomycosis on bronchoscopy. He developed respiratory failure and acute kidney injury, requiring mechanical ventilation, ECMO, and CRRT. Read More

JAMA Cardiol 2019 Apr 17. Epub 2019 Apr 17.

Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Braz J Psychiatry 2019 Apr 15. Epub 2019 Apr 15.

Janssen-Cilag UK, Buckinghamshire, UK.

Objective: To analyze the efficacy and safety of paliperidone palmitate 3-monthly (PP3M) in Latin American patients with schizophrenia vs. rest-of-world (ROW).

Methods: We analyzed data from two multinational, double-blind (DB), randomized, controlled phase 3 studies including patients with schizophrenia (DSM-IV-TR) previously stabilized on PP1M/PP3M (open-label [OL] phase). Read More

Rev Assoc Med Bras (1992) 2019 Mar 11;65(3):370-374. Epub 2019 Apr 11.

Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, SP, Brasil.

Objective: The objective of this study is to report the results of arthroscopic debridement of the subtalar joint in eight patients with Sinus Tarsi Syndrome (STS) refractory to conservative treatment.

Methods: This is a retrospective study of eight patients with STS who underwent subtalar arthroscopy for debridement of the sinus tarsi between January 2015 and January 2017 after six months of conservative treatment. All patients answered an epidemiological questionnaire and underwent functional evaluation with the Visual Analogue Pain Scale (VAS) and the American Orthopedic Foot and Ankle Society Score (AOFAS) in the preoperative and in the last evaluation (average of 12 months - 6-24 months). Read More

Rev Assoc Med Bras (1992) 2019 Mar 11;65(3):316-318. Epub 2019 Apr 11.

Department of Atherosclerosis of the Heart Institute of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo, São Paulo, Brasil.

Coronary artery bypass graft (CABG) is a consolidated treatment in patients with coronary artery disease (CAD) for both symptom control and improvement of prognosis. The patency of venous grafts is still the most vulnerable point of the surgical treatment since it presents a high prevalence of occlusion both in the immediate postoperative period and in the long-term follow-up. Aspirin plays a well-established role in this setting, and for a long time, clopidogrel use has been restricted to patients allergic to aspirin. Read More

Rev Soc Bras Med Trop 2019 Apr 11;52:e20180172. Epub 2019 Apr 11.

Divisão de Dermatologia, Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

Introduction: American tegumentary leishmaniasis (ATL) and leprosy share common areas of prevalence, but reports of coinfection are scarce.

Methods: We report a series of 9 ATL-leprosy cases and discuss the association. An integrative diagram to analyze the clinico-immunological features of coinfection with both diseases. Read More

An Acad Bras Cienc 2019 8;91(1):e20180047. Epub 2019 Apr 8.

Centro de Estudios Parasitológicos y de Vectores/CEPAVE, Facultad de Ciencias Naturales y Museo/UNLP, Consejo Nacional de Investigaciones Científicas y Técnicas/CONICET, Boulevard 120, s/n, e/61 y 62 La Plata, Buenos Aires, Argentina.

The fourth instar larva and pupa of Dasyhelea flavifrons Guérin-Méneville are redescribed, illustrated, and photomicrographed using binocular, phase-contrast, and scanning electron microscopy. Comparisons with the American species of the grisea group were made. The immatures were collected by using a siphon bottle in tree-holes and from water collected in dead snail shells in Salta Province, Argentina, transported to the laboratory and there bred to the emergence of the adults. Read More

Med Care 2019 Apr 15. Epub 2019 Apr 15.

Methods and Results LLC, Austin, TX.

Curr Opin Anaesthesiol 2019 Apr 15. Epub 2019 Apr 15.

Division of Gastroenterology, Washington University School of Medicine, Saint Louis, Missouri, USA.

Purpose Of Review: The decision to undertake monitored anesthesia care (MAC) or general endotracheal anesthesia (GEA) for patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) is influenced by many factors. These include locoregional practice preferences, procedure complexity, patient position, and comorbidities. We aim to review the data regarding anesthesia-administered sedation for ERCP and identify the impact of airway management on procedure success, adverse event rates and endoscopy unit efficiency. Read More

Vector Borne Zoonotic Dis 2019 Apr 17. Epub 2019 Apr 17.

1 U.S. Geological Survey National Wildlife Health Center, Madison, Wisconsin.

Plague is a lethal zoonotic disease associated with rodents worldwide. In the western United States, plague outbreaks can decimate prairie dog ( spp.) colonies. Read More

Int J Offender Ther Comp Criminol 2019 Apr 17:306624X19843424. Epub 2019 Apr 17.

3 University of California, Irvine, USA.

Education and employment programs may be effective at reducing problem behaviors among at-risk young adults. This pilot study evaluated whether participants in a Conservation Corps program ( N = 100) showed changes in antisocial behavior, gang membership, and substance use during the program. Participants were young adults between 18 and 24 years who were predominantly male (60%) and ethnic minority (62% Latino; 31% African American). Read More

Foot Ankle Int 2019 Apr 17:1071100719842800. Epub 2019 Apr 17.

1 Saint Alphonsus Medical Group, Coughlin Foot & Ankle Clinic, Boise, ID, USA.

Background: The purpose of this study was to evaluate outcomes utilizing a low-profile titanium plate and screw construct for rigid fixation of first ray proximal crescentic osteotomies in the treatment of hallux valgus.

Methods: Forty-eight patients (53 feet) with mild to severe hallux valgus were prospectively enrolled and completed 12-month follow-up. All were treated with a proximal crescentic osteotomy, fixed with a low-profile titanium plate, distal soft tissue correction, with or without an Akin osteotomy. Read More

J Law Med Ethics 2019 Mar;47(1):152-160

Marielle S. Gross, M.D., M.B.E., is a Hecht-Levi postdoctoral research fellow in the Berman Institute of Bioethics at Johns Hopkins University where she recently completed residency training in Gynecology & Obstetrics. She attended medical school at the University of Florida, and previously completed degrees in Philosophy, Jewish Ethics and Bioethics at Columbia University, the Jewish Theological Seminary, and New York University, respectively. Holly A. Taylor, Ph.D., M.P.H., is a Core Faculty member of the Johns Hopkins Berman Institute of Bioethics and Associate Professor in the Department of Health Policy and Management (HPM), Bloomberg School of Public Health. Dr. Taylor received her B.A. from Stanford University, her M.P.H. from the School of Public Health at the University of Michigan and her Ph.D. in health policy with a concentration in bioethics from the Bloomberg School of Public Health, Johns Hopkins University. Cecilia Tomori, Ph.D., studied biology and education at Swarthmore College and obtained her Ph.D. in Anthropology from the University of Michigan in 2011. She completed a postdoctoral fellowship at Johns Hopkins School of Public Health and served as faculty there between 2013-2017. Jenell S. Coleman, M.D., M.P.H., is associate professor in the Johns Hopkins School of Medicine Department of Gynecology and Obstetrics with a joint appointment in the Department of Medicine and is the medical director of the John's Hopkins Women's Health Center. Dr. Coleman earned her M.D. from the University of Pennsylvania School of Medicine and completed Ob/Gyn residency at the University of California, Los Angeles. She completed a fellowship in reproductive infectious diseases at the University of California, San Francisco and received an M.P.H. from the University of California, Berkeley.

To help eliminate perinatal HIV transmission, the US Department of Health and Human Services recommends against breastfeeding for women living with HIV, regardless of viral load or combined antiretroviral therapy (cART) status. However, cART radically improves HIV prognosis and virtually eliminates perinatal transmission, and breastfeeding's health benefits are well-established. In this setting, pregnancy is increasing among American women with HIV, and a harm reduction approach to those who breastfeed despite extensive counseling is suggested. Read More

J Law Med Ethics 2019 Mar;47(1):70-87

Patricia A. Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses on demonstrating the value of genomic sequencing for health systems and policymakers. Dierdre Gilmore, M.A., is a Senior Researcher at the American Institutes for Research. Gilmore earned a MA in Medical Anthropology at the University of London. Jennifer Richmond, M.S.P.H., is a Research Associate at the American Institutes for Research and a doctoral student in the Department of Health Behavior at the University of North Carolina at Chapel Hill (UNC-CH) Gillings School of Global Public Health. Zachary Smith is a Research Assistant at the American Institutes for Research. Rikki Mangrum, M.L.S., is a Senior Research Scientist at the American Institutes for Research. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She serves as Director of the UCSF Program in Bioethics. Robert Cook-Deegan, M.D., is a Professor in the School for the Future of Innovation in Society at Arizona State University. He is a physician and molecular biologist who turned to policy and then entered academe through Georgetown, Stanford, and Duke Universities before joining ASU. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Amy L. McGuire, J.D., Ph.D., is the Leon Jaworski Professor of Biomedical Ethics and Director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Dr. McGuire serves on the program committee for the Greenwall Foundation Faculty Scholars Program in Bioethics and is immediate past president of the Association of Bioethics Program Directors.

A medical information commons (MIC) is a networked data environment utilized for research and clinical applications. At three deliberations across the U.S. Read More

J Law Med Ethics 2019 Mar;47(1):12-20

Amy L. McGuire, J.D., Ph.D., is the Leon Jaworski Professor of Biomedical Ethics and Director of the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Dr. McGuire serves on the program committee for the Greenwall Foundation Faculty Scholars Program in Bioethics and is immediate past president of the Association of Bioethics Program Directors. Mary A. Majumder, J.D., Ph.D., is an Associate Professor of Medicine at the Center for Medical Ethics and Health Policy, Baylor College of Medicine. Angela G. Villanueva, M.P.H., is a Research Associate at the Center for Medical Ethics and Health Policy at Baylor College of Medicine. Jessica Bardill, Ph.D., is an Assistant Professor of Indigenous Canadian Literatures and Cultures at Concordia University in Montreal, Quebec. Juli M. Bollinger, M.S., is a Research Associate in the Center for Medical Ethics and Health Policy at the Baylor College of Medicine and a Research Associate and Associate Faculty at the Berman Institute of Bioethics at Johns Hopkins University. Eric Boerwinkle, Ph.D., is the Dean of the University of Texas Health Science Center at Houston, School of Public Health and the Associate Director, Human Genome Sequencing Center at Baylor College of Medicine. Tania Bubela, Ph.D., J.D., is the Dean of the Faculty of Health Sciences at Simon Fraser University and a Fellow of the Canadian Academy of Health Sciences. Patricia Deverka, M.D., M.S., M.B.E., is Director, Value Evidence and Outcomes at Geisinger National Precision Health, where she focuses Outcomes at Geisinger National Precision Health, where she focuses systems and policymakers. Barbara Evans, MS, Ph.D., J.D., LL.M., is the Mary Ann and Lawrence E. Faust Professor of Law and Director of the Center for Biotechnology & Law at the University of Houston Law Center and holds a joint appointment as Professor of Electrical and Computer Engineering at the UH Cullen College of Engineering. Nanibaa' A. Garrison, Ph.D. (Navajo), is an Assistant Professor at the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Hospital and Research Institute and at the Department of Pediatrics at the University of Washington School of Medicine. David Glazer is an engineering director at Verily Life Sciences, where he helps life science organizations use cloud computing to accelerate and scale their work with big data. Melissa M. Goldstein, J.D., is an Associate Professor in the Department of Health Policy and Management at the Milken Institute School of Public Health at the George Washington University. Henry T. Greely, J.D., is the Deane F. and Kate Edelman Johnson Professor of Law and a professor (by courtesy) of Genetics at Stanford University, where he directs the Center for Law and the Biosciences. He is President of the International Neuroethics Society, co-chair of the Neuroethics Work Group of the NIH BRAIN Initiative, and a member of the National Academies' Committee on Science, Technology, and Law. Scott D. Kahn, Ph.D., is the Chief Information Officer at LunaDNA where he is responsible for all informatics and data science strategy. Bartha M. Knoppers, Ph.D., (Comparative Medical Law), is a Full Professor, Canada Research Chair in Law and Medicine and Director of the Centre of Genomics and Policy of the Faculty of Medicine at McGill University. Barbara A. Koenig, Ph.D., is Professor of Bioethics and Medical Anthropology, based at the Institute for Health & Aging, University of California, San Francisco. She also serve as Director of the UCSF Program in Bioethics. J. Mark Lambright, M.B.A., is the Chairman, Trident Advisors, LLC - CEO (Interim), Private Access, Inc. Mark Lambright has been a senior executive of a number of healthcare and technology companies ranging in size from startup to multi-billion in revenue. John Mattison, M.D., is Assistant Medical Director, KP, SCAL, Chief Health Information Officer. Founder of CDA/CCD (XML standard for healthcare interoperability). Co-Editor of Healthcare Information Technology (2017 McGraw Hill). Christopher J. O'Donnell, M.D., M.P.H., is Chief, Cardiology Section and Director, Center for Population Genomics, of the Boston VA Healthcare System and co-Principal Investigator (Chief Scientist) of the national VA Million Veteran Program; and is VA Contact Principal Investigator of the NIH All of Us Research Program. He is also a faculty member of the Department of Medicine, Brigham and Women's Hospital and Associate Professor of Medicine, Harvard Medical School. Arti K. Rai, J.D., is the Elvin R. Latty Professor of Law and co-Director of the Center for Innovation Policy at Duke Law. Laura L. Rodriguez, Ph.D., is the Director of the Division of Policy, Communications, and Education at the National Human Genome Research Institute. Tania Simoncelli, M.S., is the Director of Science Policy at the Chan Zuckerberg Initiative. Formerly Executive Director, Count Me In at the Broad Institute, Assistant Director of Forensic Science and Biomedical Innovation, White House Office of Science & Technology Policy, and Science Advisor to the American Civil Liberties Union. Sharon F. Terry, M.A., is the president and CEO of Genetic Alliance. Adrian Thorogood, B.C.L./LL.B., is a lawyer and Academic Associate at the Centre of Genomics and Policy at McGill University in Montreal, Canada. He manages the Regulatory and Ethics Work Stream of the Global Alliance for Genomics and Health. Michael S. Watson, M.S., Ph.D., is the Executive Director, American College of Medical Genetics and Genomics and ACMG Foundation for Genetic and Genomic Medicine and an Adjunct Professor of Pediatrics at Washington University School of Medicine. John T. Wilbanks is the Chief Commons Officer at Sage Bionetworks, and co-PI on awards for AllofUs Research Program, ELSI Issues in Unregulated Mobile Research, CTSA Center for Data To Health. Robert Cook-Deegan, M.D., is a Professor in the School for the Future of Innovation in Society at Arizona State University.

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). Read More

Ann Glob Health 2019 Apr 15;85(1). Epub 2019 Apr 15.

Colegio de Ciencias de la Salud, Universidad San Francisco de Quito, Quito, EC.

Background: There is a lack of sexual health knowledge and resource access among youth in Latin America, along with rising rates of teenage pregnancy and STD transmission.

Objective: To determine baseline sexual health knowledge and the acceptance of a technology based sexual health risk-reduction program among Ecuadorean adolescents.

Methods: We used mixed methods to determine the sexual health knowledge and practices, and technology use among 204 adolescents from two schools in Cumbayá and Lumbisí, Ecuador. Read More

Cancer Med 2019 Apr 16. Epub 2019 Apr 16.

Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio (UTHSCSA), San Antonio, Texas.

Background: We assessed racial/ethnic disparity in hepatocellular carcinoma (HCC) incidence among men with type 2 diabetes (T2D) but without chronic liver diseases (CLD), and whether metformin use modified the disparity.

Methods: Study cohort: the nationwide Veterans Administration Health Care System electronic medical records among 40-89 years old men with T2D; without CLD, cancer, cardiovascular or renal diseases previously; insulin and thiazolidinedione naive. Logistic regression analyses compared HCC incidence between race/ethnicity groups under no metformin use adjusted for covariates and inverse propensity score weights (IPSW) for race/ethnicity. Read More

Thorac Cancer 2019 Apr 16. Epub 2019 Apr 16.

Stem Cell Translational Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.

Background: Lung adenocarcinoma (LUAD) is a set of heterogeneous diseases with distinct genetic and transcriptomic characteristics. Since the introduction of the 2011 International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society histologic classification, increasing evidence has provided insights into genomic mutations and rearrangements among individual histologic subtypes of LUAD. However, how genotypic and phenotypic features of LUAD are interconnected is not well understood. Read More

ESC Heart Fail 2019 Apr 16. Epub 2019 Apr 16.

Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.

Aims: Left atrial (LA) remodelling is an important predictor of cardiovascular events of heart failure (HF) and atrial fibrillation. Data regarding diagnostic value of LA remodelling on diastolic dysfunction (DD) and preclinical HF remain largely unexplored.

Methods And Results: We assessed LA dimension (LAD) in 8368 consecutive asymptomatic Asians (mean age: 49. Read More

Dev World Bioeth 2019 Apr 17. Epub 2019 Apr 17.

Research ethics regulation in parts of the Global North has sometimes been initiated in the face of biomedical scandal. More recently, developing and recently developed countries have had additional reasons to regulate, doing so to attract international clinical trials and American research funding, publish in international journals, or to respond to broader social changes. In Taiwan, biomedical research ethics policy based on 'principlism' and committee-based review were imported from the United States. Read More

Haemophilia 2019 Apr 17. Epub 2019 Apr 17.

St. Jude Children's Research Hospital, Memphis, Tennessee.

Background: Extended half-life (EHL) factor VIII (FVIII) and IX (FIX) products are intended to decrease the burden of prophylaxis for patients with haemophilia A or B. Whether these newer concentrates have led to meaningful clinical practice change remains vague.

Aim: To characterize the longitudinal use of standard (SHL) and EHL factor concentrates at haemophilia treatment centres (HTCs), using the ATHNdataset, a US database of 138 ATHN-affiliated HTCs. Read More

Am J Addict 2019 Apr 16. Epub 2019 Apr 16.

Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey.

Background And Objectives: Despite the overwhelming need for tobacco use disorder (TUD) treatment in behavioral health settings, few models have emerged for training psychiatry residents. One barrier may be a lack of curricula or faculty expertize in this area. The goal of this project was to develop and evaluate a 3 hour online webinar-based course for teaching psychiatry residents about TUD. Read More

Pediatr Dermatol 2019 Apr 16. Epub 2019 Apr 16.

Department of Dermatology, Stanford University Medical Center, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Lucile Packard Children's Hospital, Stanford, California.

Objectives: To characterize clinical differences among nonwhite/multiethnic vs white children, adolescents, and young adults with melanoma or atypical melanocytic neoplasms, including atypical Spitz tumors.

Patients And Methods: A cohort of 55 patients (< 25 years of age) prospectively followed from 1995 to 2018 in the Stanford Pigmented Lesion and Melanoma Program was analyzed for differences in clinical presentation, including skin phototype, race/ethnicity, age, sex, tumor/melanoma characteristics, and outcome.

Results: Seventeen patients (9 males and 8 females) were classified as nonwhite (predominantly skin phototype IV) and of Hispanic, Asian, or Black/African American ethnicity, and 38 patients (21 males and 17 females) were classified as white (predominantly phototypes I/II). Read More

J Public Health Dent 2019 Apr 17. Epub 2019 Apr 17.

Master of Library and Information Science, University of Florida Health Sciences Libraries, Gainesville, FL, USA.

Objectives: The information in this article is based on a presentation given at the American Institute of Dental Public Health's 2018 Colloquium on Precision Public Health (PPH). A brief introduction to precision medicine provides context for PPH. Precision medicine tailors treatment and prevention strategies for individual patients based on variability of genetic, lifestyle, and environmental factors. Read More

J Cancer Surviv 2019 Apr 16. Epub 2019 Apr 16.

School of Medicine and Public Health, University of Newcastle, Callaghan, Newcastle, NSW, 2308, Australia.

Purpose: Multiple health behaviours (not smoking, minimal alcohol consumption, and maintaining a healthy weight by having a healthy diet and regular physical activity) improve quality of life and longevity of cancer survivors. Despite international guidelines, there are no existing reviews that synthesise cancer survivors' adherence to healthy lifestyle recommendations.

Method: Five databases (Embase, MEDLINE, PsycINFO, Web of Science, and Google Scholar) were searched for relevant articles published from 2007 until January 2018. Read More

J Gen Intern Med 2019 Apr 16. Epub 2019 Apr 16.

American Board of Medical Specialties, Chicago, IL, USA.

Background: As electronic health records (EHRs) became broadly available in medical practice, effective use of EHRs by medical students emerged as an essential aspect of medical education. While new federal clinical documentation guidelines have the potential to encourage greater medical student EHR use and enhance student learning experiences with respect to EHRs, little is known nationally about how students have engaged with EHRs in the past.

Objective: This study examines medical student accounts of EHR use during their internal medicine (IM) clerkships and sub-internships during a 5-year time period prior to the new clinical documentation guidelines. Read More

Mol Imaging Biol 2019 Apr 15. Epub 2019 Apr 15.

Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, 94143-0946, USA.

Purpose: There are several important positron emission tomography (PET) imaging scenarios that require imaging with very low photon statistics, for which both quantitative accuracy and visual quality should not be neglected. For example, PET imaging with the low photon statistics is closely related to active efforts to significantly reduce radiation exposure from radiopharmaceuticals. We investigated two examples of low-count PET imaging: (a) imaging [Y]microsphere radioembolization that suffers the very small positron emission fraction of Y-90's decay processes, and (b) cancer imaging with [Ga]citrate with uptake time of 3-4 half-lives, necessary for visualizing tumors. Read More

Can J Anaesth 2019 Apr 16. Epub 2019 Apr 16.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.

Purpose: We compared the effects of benzydamine hydrochloride (BH), 10% lidocaine, and normal saline spray on preventing postoperative sore throat (POST) in patients who underwent total thyroidectomy (TT).

Methods: In this prospective, randomized, parallel-group, double-blind study, the incidence of POST at six hours after tracheal extubation was compared among three groups as a primary outcome. American Society of Anesthesiologists physical status I-II patients undergoing elective TT under general anesthesia were enrolled. Read More

AAPS J 2019 Apr 16;21(4):55. Epub 2019 Apr 16.

Pharmaceutical Consultant, North Potomac, Maryland, 20878, USA.

In September 2018, the American Association of Pharmaceutical Scientists (AAPS) conducted an Annual Guidance Forum on the considerations related to immunogenicity testing for therapeutic protein products. In addition to a broad representation by the pharmaceutical industry, the event included strong representation by leading scientists from the US Food and Drug Administration (FDA). The agency and industry perspectives and updates to the guidance were presented. Read More

Child Psychiatry Hum Dev 2019 Apr 16. Epub 2019 Apr 16.

Psychology Department, Harvard University, Cambridge, USA.

Single-session interventions (SSIs) can help reduce youth psychopathology, but SSIs may benefit some youths more than others. Identifying predictors of SSIs' effectiveness may clarify youths' likelihoods of benefitting from an SSI alone, versus requiring further treatment. We tested whether pre-to-post-SSI shifts in hypothesized symptom change mechanisms predicted subsequent reductions in youth internalizing symptoms. Read More

AIDS Behav 2019 Apr 16. Epub 2019 Apr 16.

Craig A. Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

We aimed to discover barriers and facilitators of HIV pre-exposure prophylaxis (PrEP) adherence in young men and transgender women of color who have sex with men (YMSM/TW). Short-term and sustained adherence were measured by urine tenofovir concentration and pharmacy refills, respectively. Optimal adherence was defined as having both urine tenofovir concentration consistent with dose ingestion within 48 h and pharmacy refills consistent with ≥ 4 doses per week use. Read More

Environ Monit Assess 2019 Apr 16;191(5):282. Epub 2019 Apr 16.

Department of Natural Resources, University of Rhode Island, Kingston, RI, 02881, USA.

There is growing interest in generalizing the impact of hydrogeomorphology and weather variables on riparian functions. Here, we used RZ-TRADEOFF to estimate nitrogen, phosphorus, water table (WT) depth, and greenhouse gas (GHG: NO, CO, CH) functions for 80 riparian zones typical of the North American Midwest, Northeast (including Southern Ontario, Canada), and Mid-Atlantic. Sensitivity to weather perturbations was calculated for temperature and precipitation-dependent functions (CO, phosphate concentration, and water table), and multivariate statistical analysis on model outputs was conducted to determine trade-offs between riparian functions. Read More

Arch Virol 2019 Apr 16. Epub 2019 Apr 16.

Department of Microbiology and Immunology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA.

Genomic sequence analysis of zoo ranavirus (ZRV) suggests it is a strain of Bohle iridovirus (BIV), a virus that was first detected in, and thought to be confined to, Australia. Furthermore, marked sequence similarity and genomic co-linearity among ZRV, BIV, and German gecko ranavirus (GGRV) are consistent with the view that all three are strains  of Frog virus 3, the type species of the genus Ranavirus, family Iridoviridae. Read More