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Thank You to Authors, Reviewers, and Readers

Mar, 03/04/2018 - 02:00
The creation and communication of scientific and clinical content continue to undergo substantial change, and biomedical journals and other publications are evolving to develop new mechanisms and channels for efficient information dissemination. For example, open access journals and options for open access publication have become common. Many investigators are increasingly interested in speed to publication. Preprint servers that disseminate non–peer-reviewed content have proliferated. Team science, reflecting collaborative research involving multiple investigators and research groups, has become more prevalent with the growth of research networks and consortia and the continued emergence of big data and data sharing. Data sharing is evolving, with the International Committee of Medical Journal Editors (ICMJE) soon requiring greater transparency regarding sharing of data, with the expectation that every report of a randomized clinical trial will include a statement of whether data will be shared, and if so, how and with whom. More changes have come to the dissemination of scientific information in the last decade than in the previous 100 years.

Effect of a Loading Dose of Atorvastatin on MACE in Patients With ACS and Planned PCI

Mar, 03/04/2018 - 02:00
This randomized trial compares the effects of a periprocedural loading dose of atorvastatin vs placebo on major adverse cardiovascular events (MACE) at 30 days in patients with acute coronary syndrome (ACS) and planned percutaneous coronary intervention (PCI).

Negative Wealth Shock and All-Cause Mortality

Mar, 03/04/2018 - 02:00
This study investigated mortality of participants in the Heart and Retirement Study who experienced negative wealth shock from 1994 through 2014.

Solid Fuel Use and Mortality Risk in Rural China

Mar, 03/04/2018 - 02:00
This cohort study conducted in 5 rural areas across China examines associations between solid fuel use for cooking and heating and cardiovascular and all-cause mortality.

Neonatal Abstinence Syndrome: A Review

Mar, 03/04/2018 - 02:00
This narrative review summarizes advances in diagnosis and in pharmacologic and nonpharmacologic management of neonatal abstinence syndrome.

Evaluation and Treatment of Male Hypogonadism

Mar, 03/04/2018 - 02:00
This JAMA Clinical Guidelines Synopsis summarizes the 2018 Endocrine Society guideline on testosterone therapy in men with testosterone deficiency and hypogonadism..

Direct Antiglobulin Testing and Mycoplasma Pneumoniae Infection

Mar, 03/04/2018 - 02:00
A young adult with community-acquired Mycoplasma pneumonia was found to have new-onset anemia, thrombocytosis, positive direct antiglobulin testing for anti-C3, and red blood cell agglutination at 4°C and at room temperature. How would you interpret these results?

Mortality From Falls in Dutch Adults 80 Years and Older, 2000-2016

Mar, 03/04/2018 - 02:00
This study uses national statistics to characterize trends in mortality from falls in persons aged 80 years and older between 2000 and 2016 in the Netherlands.

Interventions to Prevent Falls in Older Adults

Mar, 03/04/2018 - 02:00
To the Editor Dr Tricco and colleagues compared interventions for preventing falls in older adults. The systematic review and network meta-analysis demonstrated that exercise alone and various combined interventions were associated with lower risk of injurious falls compared with usual care. Some methodological issues deserve comment.

Interventions to Prevent Falls in Older Adults—Reply

Mar, 03/04/2018 - 02:00
In Reply Drs Lee and Song make an important point about exercise being a broad category, which in our review could have ranged from tai chi to strength training. Given the number and complexity of interventions included in our review, it was not possible to analyze the types of exercise further, as there were too many nodes for network meta-analysis to be feasible. Therefore, all studies involving any form of exercise were combined. To further clarify what types and components of exercise are most effective, we are currently conducting a separate network meta-analysis of the exercise studies from our original review, using a coding scheme of approximately 25 different exercise codes that will allow us to break down each exercise into its components.

Continuous Glucose Monitors for Insulin Dosing

Mar, 03/04/2018 - 02:00
To the Editor Dr Shapiro raised concerns about using continuous glucose monitors (CGMs) to determine insulin dosing without a confirmatory blood glucose meter measurement, referred to as nonadjunctive CGM use. He suggested that the US Food and Drug Administration (FDA) was remiss in not considering device deficiency reports, which in his view are indicative of the lack of sufficient accuracy of CGMs for insulin-dosing decisions. Shapiro assumed that accuracy of blood glucose meters exceeds that of CGMs. Although this is true for some meters, current-generation CGMs have an accuracy level similar to or better than many blood glucose meters. The same concerns he raised for CGMs could be raised for many blood glucose meters.

Continuous Glucose Monitors for Insulin Dosing—Reply

Mar, 03/04/2018 - 02:00
In Reply My Viewpoint called attention to a determination by the FDA that relabeled a class III device as accurate for use in dosing insulin, without the previously required need for a confirmatory blood glucose measurement. The decision was made despite more than 25?000 reports to the FDA of potentially harmful device inaccuracies. These reports were not mentioned to an advisory panel or directly addressed in the summary of safety and effectiveness data for the decision.

Glyphosate Levels in Older Adults

Mar, 03/04/2018 - 02:00
To the Editor The study on excretion of glyphosate in older adults was analyzed inappropriately. First, Table 1 reported levels above the limit of detection (LOD). To report quantifiable values, a limit of quantification (LOQ) is required. Only values greater than the LOQ are reliably quantifiable. Levels greater than the LOD and less than the LOQ can only be interpreted as “presence,” whereas levels less than the LOD can only be interpreted as “absence.”

Glyphosate Levels in Older Adults—Reply

Mar, 03/04/2018 - 02:00
In Reply We are keenly aware that the topic of glyphosate is highly controversial, often acrimonious, and stretches across diverse political and geographical boundaries.

Undisclosed Conflicts of Interest

Mar, 03/04/2018 - 02:00
To the Editor In the Research Letter entitled “Excretion of the Herbicide Glyphosate in Older Adults Between 1993 and 2016,” published in the October 24/31, 2017 issue of JAMA, the conflict of interest disclosure was incomplete. Dr Mills did not disclose that he established a citizen science crowdfunding site to raise funds for additional research that offers free glyphosate testing with a donation of $130, with tests being run by Health Research Institute (HRI) Laboratories and proceeds going to the University of California, San Diego. Dr Fagan only disclosed an affiliation with the nonprofit 501(c) (3) research organization HRI Laboratories, but not that he is founder, chairman of the board, and senior scientist of HRI Laboratories, which is conducting a citizen science research program in which individuals complete a lifestyle and diet survey, provide a urine sample, and partially cover the cost of testing of the urine sample for glyphosate ($99/sample). The Conflict of Interest Disclosure statement has been corrected online and a correction notice accompanies this letter. We apologize to readers.

Undisclosed Conflicts of Interest

Mar, 03/04/2018 - 02:00
In the Research Letter entitled “Excretion of the herbicide glyphosate in older adults between 1993 and 2016” published in the October 24/31, 2017 issue of JAMA, the conflict of interest statement was incomplete. It should have read: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Mills reported launching a citizen science crowdfunding site to raise funds for additional research that offers free glyphosate testing with a donation of $130, with tests being run by Health Research Institute (HRI) Laboratories, which processed the samples for the study, and proceeds going to the University of California, San Diego. Dr Fagan reported being founder, chairman of the board, and senior scientist at HRI Laboratories, a 501(c)(3) nonprofit research organization, which is conducting a citizen science research program in which individuals complete a lifestyle and diet survey, provide a urine sample, and partially cover the cost of testing the urine sample for glyphosate ($99/sample). Dr McEvoy reported receiving a grant from the National Institutes of Health. No other disclosures were reported.

Units of Measure Error

Mar, 03/04/2018 - 02:00
In the Original Investigation entitled “Effect of Low-Fat vs Low-Carbohydrate Diet on 12-Month Weight Loss in Overweight Adults and the Association With Genotype Pattern or Insulin Secretion: The DIETFITS Randomized Clinical Trial” published in the February 20, 2018, issue of JAMA, there were units of measure errors for 3 variables in Table 3. In Table 3, “lipid level” row, the units of measure should be “mg/dL” and the “SI conversion factors” footnote should read “To convert high-density and low-density lipoprotein cholesterol to mmol/L, multiply by 0.0259; triglycerides to mmol/L, multiply by 0.0113.” This article was corrected online.

Chronic Disease Approaches to Curb Gout

Mar, 03/04/2018 - 02:00
This Medical News story discusses clinical approaches in the treatment of gout.

A Novel Approach to Relieve Tinnitus Symptoms

Mar, 03/04/2018 - 02:00
In this Medical News story, researchers discuss an experimental device that uses a novel approach to relieve symptoms of somatic tinnitus.

Platelets May Contribute to Sepsis and Shock

Mar, 03/04/2018 - 02:00
Previous research has shown platelets are involved in the innate immune response to pathogens via toll-like receptor expression, and evidence is emerging that they may also be important for adaptive immunity. A new study published in the Proceedings of the National Academy of Sciences has uncovered an unappreciated role of platelets in antibody-mediated adaptive immune responses.

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