JAMA Network Open
@JAMANetworkOpen
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JAMA Network Open is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications.
Chicago, IL
Joined April 2017
1 in 3 academic physicians report they are considering leaving their institution within 2 years. Burnout and lack of professional fulfillment were associated with intention to leave; a comprehensive approach will be needed to reduce physician turnover.
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First-generation medical students experience disproportionate adversity and inadequate institutional support within medical education, forcing over-reliance on grit and resilience as survival strategies. @catiehavemann.
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Most viewed in the last 7 days from @JAMANetworkOpen: . This consensus statement creates a clinical guideline for the diagnosis and management of urinary tract infections (UTIs).
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This consensus statement creates a clinical guideline for the diagnosis and management of UTIs that addresses the gap between the evidence and recommendation strength. @bradspellberg.
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Most viewed in the last 7 days from @JAMANetworkOpen: . This consensus statement creates a clinical guideline for the diagnosis and management of UTIs that addresses the gap between the evidence and recommendation strength.
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In this meta-analysis of #COVID19 vaccine trials, adverse events in placebo arms ("nocebo responses") accounted for 76% of systemic adverse events after the first COVID-19 vaccine dose, and for 52% after the second dose.
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Stopping universal masking and SARS-CoV-2 testing at 10 US hospitals was associated with a substantial increase in hospital-onset COVID-19, influenza, and RSV.
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A @Wiki_Guidelines Consensus Statement: For adults with infective endocarditis, oral transitional therapy was at least as effective as IV-only therapy. @DrEmilyMcD @DrToddLee.
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In this cross-sectional study, oncology drugs were 40-times more likely to be deemed cost effective when the study was funded by pharmaceutical companies compared with no funding.
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Cross-sectional study comparing Medicaid & #ACA Marketplace finds fewer ED visits & more office visits in Marketplace, no clear quality advantage. Marketplace costs 80% more overall, with 10x higher out-of-pocket spending. @Prof_HeidiAllen @HarvardHPM
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RCT: Eating 10 min longer during family mealtimes increased fruit and vegetable intake but not dessert or bread consumption. Longer family meals are a simple tool that may improve children’s health.
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This study found that written exposure therapy (#WET) is non-inferior to cognitive processing therapy (#CPT) for #PTSD. WET was also associated with fewer treatment dropouts than CPT. @VA_PTSD_Info @strongstar_ptsd
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In qualitative interviews, Black patients with serious illness reported experiencing racism in clinical settings, often through epistemic injustice, that was associated with medical mistrust and poor patient-clinician communication.
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Case analysis of >3.9 mil COVID cases in California found that pediatric vaccination averted >375,000 cases of COVID-19 and 270 hospitalizations in children 6mo-15yrs in the 4 to 7 months following vaccine availability. @JenniferR_Head @Justin_Remais
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This cohort study in New Delhi found 2.5% reinfection in health care workers (HCWs). The BBV152 (Covaxin) 2-dose effectiveness against reinfection was 86%. Findings suggest infected HCWs should receive complete vaccine doses to prevent future infections.
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Only 8% of oncology clinical trials involve surgical interventions. Surgery can be critical to cancer care. There is a need for more surgeons in cooperative research groups and increased NCI funding to study surgical interventions.
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In a large nationwide cohort of 996,300 Danish-born females, there was no association between HPV vaccination and primary ovarian insufficiency. @anders_hviid
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Fathers of preterm infants reported less stress in Family Integrated Neonatal Care compared to standard care. Supporting fathers' participation in neonatal care is associated with improvements in fathers' mental health.
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Among vaccinated recipients of allogenic stem cell transplants, the incidence of #COVID19 infection was higher during Omicron vs Delta waves; most infections were mild, with 3 hospitalizations and 1 death out of 211 patients at one center in France.
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Women and parents report greater burden from early AM/late PM multi-disciplinary tumor boards. Radiologists, pathologists, those with ≥2 kids, or attending ≥3 hrs/wk of tumor boards report greater overall burden. @_katelynatkins @CedarsSinai.
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Rates of alcohol-associated hepatitis have increased significantly in adolescents and young adults with the risk of developing cirrhosis almost 50% higher for females compared to males. @Jenn_Flemming .
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Eli Perencevich MD, MS, has been named Editor in Chief of @JAMANetworkOpen. Dr Perencevich is a professor of internal medicine and epidemiology at @IowaMed and is a founding Associate Editor of JAMA Network Open. He will assume the position July 1.
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This first of its kind study shines a light on a troubling problem - women physicians are underrepresented among perspective-type journal articles in top pediatrics journals. Read more from @JulieSilverMD: #WomenInMedicine
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Every $1 invested in the New York City #COVID19 vaccination campaign yielded an estimated $10.19 in cost savings from lower infection and mortality rates, fewer productivity losses, and averted health care use. @suhas_gondi @davechokshi @Alison_Galvani
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Cohort study finds excess mortality during the early phase of the #COVID19 outbreak in New York City was comparable to that observed during the peak of the 1918 H1N1 pandemic. @jeremyfaust @CarlosdelRio7
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The findings suggest that emergency department boarding -- waiting for in inpatient bed in the ED -- duration is a direct risk factor for developing delirium or severe agitation during inpatient admission.
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When physicians attend to emotions and then stop to allow a family to respond, families are able to express their emotions and provide valuable information. Learn more in this #Pediatrics Original Investigation:
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Cohort study finds 33% of mildly ill individuals reported persistent #COVID19 symptoms at an average of 6 months after their acute infection. @HelenChuMD @UWMedicine
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Cross-sectional study finds few oncology clinical trials assess QoL until death which is important particularly when gains in OS are marginal. @VPrasadMDMPH
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40% of low income households with young children "churn" off SNAP benefits due to missed administrative deadlines at recertification, despite being eligible. Streamlining administrative processes needed. #OAResearch.
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21% of medical journal articles cited by GPT-4 were found to be fake; GPT-3.5 cited an estimated 98% fake articles. Narrower topics had more fake articles than broader topics. Despite its promise, ChatGPT is currently not a reliable source of medical data.
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Health care worker (HCW)-collected throat specimens may have higher sensitivity than HCW-collected nasal specimens for COVID-19 rapid antigen testing. Self-collected specimen sensitivity may improve by combining nasal & throat specimens.
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Tax policy is an important, modifiable social determinant of health. Increased state-level tax revenue and increased tax progressivity (ie, higher taxes for wealthier individuals) were both associated with decreased infant mortality in the US, 1996-2019.
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Only 13-14% of @usnews-ranked medical schools give faculty 12-wks parental leave at full pay; lower rates for adoption/foster leave. Inadequate parental leave contributes to physician workforce attrition & #BurnOut. @JessSlostadMD @nedalai @ShikhaJainMD
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Integrating buprenorphine and harm reduction kits into primary care could improve clinical outcomes, and be cost-effective to health systems.
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Oral doxycycline for the treatment of ocular syphilis may be safe and effective in a selected subset of patients who completed an extended oral antibiotic regimen. @bradspellberg
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Case series observing 9 emergency medicine residents shows that 50% of ROS and PE content of physician documentation is inaccurate, likely to fulfill @CMSGov charting requirements. @carlberdahl (on #JNOLive Tuesday at 3 pm cst)
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The introduction of #ChildTaxCredit advanced payments in July 2021 was associated with a 26% drop in #FoodInsufficiency among households with children, in a study using @uscensusbureau data. @shaferpr @katie_mo_ @stephanieedc @AllisonBovell @juliaraifman
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Yesterday we welcomed Eli N. Perencevich as the new EIC of JAMA Network Open. Dr Perencevich is committed to upholding the mission of the journal through increasing geographic reach, adapting to the evolution of AI, & expanding diversity of contributors.
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Employer-mandated switching of people with #diabetes to high-deductible health plans is linked to higher rates severe hypoglycemia and hyperglycemia, especially for low-income and non-White employees. @RozalinaMD @DavidHJiang @NIDDKgov @MayoClinic.
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E-cigarettes are both the most commonly used cessation aid in England (~40% of quit attempts) and one of the most effective; other aids associated with increased odds of smoking cessation are used in <5% of quit attempts. @DrSarahEJackson @VeraBuss
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Cohort study finds men interrupt more than women at internal medicine residency teaching conferences, more so with a male faculty discussant. @amrapalimaitra @MariaYialamas @HarvardMed @brighamwomens
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This cohort study found no association in positivity rates among health care workers who wore medical masks vs respirator masks in routine patient care suggesting that medical masks protected HCWs from acquiring #COVID19
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For infants born at 22-23 weeks, antenatal steroids at 21-22 weeks is associated with better survival in this @NICHD_NIH Neonatal Research Network study. #neoEBM #OAResearch
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This model-based analysis estimated "on-ramps" and "off-ramps" for unmasking elementary students, using readily available data (case counts and vaccination rates). Appropriate metrics for unmasking will depend on community goals. @SalomonJA
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Prostate safety is a concern of men considering testosterone treatment. In the TRAVERSE Trial, a large testosterone RCT in men with hypogonadism, rates of prostate cancer and other prostate events were low and did not differ vs placebo.
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The #COVID19 vaccine rollout in the US saved an estimated 240,000 lives and averted 1.13 million hospitalizations from the start of vaccination campaign to June 30, 2021. @Alison_Galvani @Pratha_Sah @MeaganCFitz @abhiganit
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Does repeated flu vaccination reduce protection in children? A 3-year study says no and protection against H3N2 was increased by repeated vaccination.
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Qualitative study describes female academic surgeons' perceptions of factors promoting and hindering their professional success. @UMichSurgery @JAMASurgery #JNOVA50 cc: @mdaware
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Ultra-Restrictive Opioid Prescription Protocol (#UROPP): radical decrease in postoperative opioid use with no changes in pain scores & opioid refills.
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Structural racism in the form of historical housing discrimination known as “redlining” is associated with higher stroke prevalence in NYC communities, even after controlling for classic stroke risk factors and other social determinants of health.
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Commentary: Although many believe observational, real-world data will someday fill the gaps, for the time being, randomization remains the reference standard in cancer research. @RahulBanerjeeMD @VPrasadMDMPH
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Comparative effectiveness study with 41k insured people w OUD finds only buprenorphine/methadone associated with reduced #overdose at 3 & 12 mos; longer treatment assoc w lowest OD risk #VisualAbstract @DrSarahWakeman @MDaware
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Open Access from the JAMA Network: . The Burden of Cardiovascular Diseases Among US States, 1990-2016 #cardiology
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Cohort study finds the #ACA was associated with 2 million fewer adults experiencing catastrophic health expenditures each year; 11 million, including 6 million privately insured, experience catastrophic spending annually. @chasliu @krchhabra @DrJohnScott
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RCT: Eating 10 min longer during family mealtimes increased fruit and vegetable intake but not dessert or bread consumption. Longer family meals are a simple tool that may improve children’s health.
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In this cohort study there was no evidence to support an association between a higher number of lumbar segments with radiographic changes and more severe back pain–related disability cross-sectionally or over time.
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Modeling study by @CCDD_HSPH supports frequent screening testing to control nursing home outbreaks of #COVID19 and finds staffing based on infection history can protect residents. @ingaholmdahl @rebeccajk13 @jameshay218 Caroline Buckee @michaelmina_lab
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This cohort study found that after the #MuslimBan, missed primary care appointments and emergency department visits increased among people from Muslim-majority countries living in Minneapolis-St. Paul.
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Meta-analysis: 94% of patients with atraumatic altered mental status received a noncontrast CT head, with an average yield of 11% which varied by setting: 18% in ED patients, 12% of ICU patients, and 3% of general inpatients had positive findings on CT.
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Amid a changing landscape of public charge rules, nearly 1 in 6 low-income immigrant adults avoided public programs out of fear it would negatively impact immigration status, leading to delayed medical care. @UCLACHPR @NinezPonce @UCLAFSPH @CalEndow
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Editorial: Current events surrounding racially motivated police brutality highlight that journals must focus on the effects of structural racism on the care of Black, Hispanic, indigenous, and other people of color, including interventions. @GbengaOgedegbe
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Prognostic study finds modeling real-time, dynamic changes in suicidal thoughts improves prediction of suicide attempts post-psychiatric hospitalization. @ShirleyBWang @mk_nock @NockLabHarvard
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Gender-affirming surgery increased substantially among US adults from 2016 to 2019 and declined slightly in 2020. Breast and chest surgeries were the most common procedures performed and genital reconstruction was more common on older individuals.
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This phase 3 randomized controlled trial demonstrated that a new macrophage-regulating drug significantly improved the incidence of complete wound closure in treating chronic diabetic foot ulcers.
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Subgroup analyses are common in oncology trials. However, a new study of 379 phase III trials suggests most claims for differential treatment effects in subgroup analyses have low credibility. @MDAndersonNews @AlexSherryMD @PavlosMsaouel @PavlosMsaouel.
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High doses of oral CBD can exacerbate THC’s effects through inhibition of THC metabolism, leading to stronger drug effects. Cannabis users, clinicians, and regulators stakeholders must understand the potential risk of drug interactions.
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SSRI antidepressant use may reduce mortality from #COVID19, @Cerner EHR study found those who had taken fluoxetine had a 28% ⬇️ in the relative risk of death @msirota84 @NimaAghaeepour @oskotsky @AliceTang_mstp @ivana_mmari @tomiko22 @SirotaLab @UCSF_BCHSI
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For patients with limited English proficiency undergoing surgery, interpreter use is low and only 12% of patients received language-concordant discharge forms, which provide critical opportunities to tangibly enhance care plans’ quality & understanding.
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Hepatocellular carcinoma screening is associated with reduced mortality even after accounting for lead-time & length-time biases, this study finds. @docamitgs @darinedaher @NDP1001 @drhuangdq @nicole_rich8 @kanwalfasiha @anandkulkarni2 @bluefaeryliver.
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Many firearm owners store firearms unlocked; those who lock their firearms most often use gun safes. Concerns about access speed often keep firearm owners from using locks, whereas concerns about child access may increase the odds they will use a lock.
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IV sodium thiosulphate (STS) treatment is not associated with improvements in skin lesions and survival in patients with calciphylaxis with chronic kidney disease in this meta-analysis of observational studies.
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Daily e-cigarette use and use of e-cigarettes in 2019 to 2021 were associated with greater cigarette discontinuation rates.
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In this cohort study of adult daily cigarette smokers with no plans to ever quit smoking, those who took up daily e-cigarette use experienced 8-fold greater odds of discontinuation versus those who did not use e-cigarettes.
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Racial, gender, and socioeconomic inequities are present in access to SGLT2i, which if unaddressed, may widen well-documented disparities in renal and cardiovascular outcomes in the US @eberly_lauren @sri_adu @pennmedicine @PennLDI @AmakaEMD
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Cross-sectional study finds #NIH funding not associated with more female faculty; increases in female faculty was modest vs increases in women’s matriculation in medical schools. @ebmalinzakMD @ZoinksScoob78 @mswami001 @DukeMedSchool
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What are the core competencies in evidence-based practice (#EBP) that health professionals should meet? Visit to view the findings.
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This consensus statement & systematic review uses a WikiGuidelines methodology for clinical guideline development (precluding recommendations based on low-quality data/opinion), addressing 7 questions regarding osteomyelitis management. @BradSpellberg
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Half of people who disenrolled from Minnesota Medicaid in 2018 or early 2019 had no observable coverage 6 months later, and a large share returned to Medicaid within a year, suggesting many were still eligible or had very short-term changes in eligibility.
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Older vs younger patients with cancer (≥70 vs <70) enroll in #NCI clinical trials at similar rates when screened and offered trial entry in the community setting, where 80% of older patients receive their #GeriOnc care. @minasedrakmd @WilliamDale_MD #OAR
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Quality improvement study from @MSFTResearch Project InnerEye team uses #DeepLearning to maintain clinical accuracy and reduce manual contouring time in radiotherapy treatment-CT scan mark up for radiotherapy in head & heck & prostate cancers. @ozanoktay_
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The impact of PRISM resilience coaching seems to last: Cancer survivors who received it reported sustained improvements in hope and quality of life 2 years later. @AbbyRosenbergMD @JohnMSalsmanPhD @seattlechildren @UWMedicine @UWPeds #hapc #pedpc #AYACSM
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Mortality associated with adverse effects of medical treatment decreased 21.4% from 1990-2016 #patientsafety
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Vitamin D supplementation may be less helpful at increasing circulating vitamin D concentration among individuals with higher BMI.
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Patients with cancer and their relatives in Turkey showed gaps in knowledge and concerns about clinical trial safety, which affected their willingness to participate.
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Only 0.2% of children 6-17-years-old with #COVID19 in Sweden were diagnosed with #LongCovid, more often in girls, those hospitalized for COVID or with comorbidities, and those whose parents had post-COVID conditions, suggesting a possible genetic link.
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Pooled results from @rheum_covid, @SecureIBD, and @PsoProtect, representing >6000 patients with immune-mediated inflammatory disease and #COVID19, support TNFi monotherapy use during the pandemic. @IzadiZara @EJBrenner_MD @JYazdanyMD @MichaelKappel12
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This study found no evidence of mortality benefit was for people who took multivitamins daily, compared to those who took no multivitamins. @NCIEpiTraining.
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Cross-sectional study finds states with legal recreational marijuana had fewer cases of e-cig/vaping associated lung injury #EVALI. @aaronecarroll @ajhollingsworth @AshleyCBradford @coady_wing #VisualAbstract
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Cohort study finds racial/ethnic, gender, age, language & SES differences in accessing telemedicine for primary care and specialty ambulatory care during #COVID19; differences may compound existing inequities in care. @eberly_lauren @sri_adu @PennMedicine
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This study finds that the first two overdose prevention centers to open in the US with government support were not associated with changes to neighborhood crime and disorder. Overdose prevention centers have a long track record of saving lives.
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This study suggests that a universal health checkup system is associated with a lower risk of incident diabetes and hypertension, but the system’s cost-effectiveness and its transportability to settings outside Japan remain to be elucidated.
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Liver metastases was associated with poorer survival (vs non-liver metastases) in patients with mismatch repair-deficient metastatic colorectal cancer treated with first-line pembrolizumab.
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Systematic review & meta-analysis finds steroid injections & physical therapy are associated with the best outcomes for frozen shoulder. @tendonglasgow
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