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In this issue of JAMA, contributors to the World Brain Death Project present an international consensus report on criteria for the diagnosis of brain death, or determination of death by neurologic criteria (BD/DNC). The report addresses inconsistencies in clinical guidelines across different countries and focuses attention on the need for better education and certification of clinicians who are authorized to make this clinical diagnosis.
This Special Communication summarizes consensus recommendations from the World Brain Death project, an international collaborative created to establish minimum standards for diagnosing brain death/death by neurologic criteria (BD/DNC) in children and adults across a broad range of settings and clinical circumstances.
To mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (COVID-19), US states enacted a suite of nonpharmaceutical interventions. School closures were among the most consistently applied of these interventions. Over a 10-day period in March, all 50 US states closed kindergarten-grade 12 schools and childcare centers; nearly all colleges and universities followed suit. These closures were unprecedented in scope, affecting 21 million children in childcare, 57 million students in kindergarten-grade 12, and 20 million college and university students.
This Viewpoint summarizes recommendations made in a National Academies of Sciences, Engineering, and Medicine report about how to safely reopen and operate elementary and secondary schools for the 2020-2021 school year, which emphasizes the need for partnerships with public health officials and community leaders, and for transparent communication of risks and rewards that will result from every policy decision.
This population epidemiology study estimates associations of school closures in the US and the timing of those closures in March 2020 with change in daily coronavirus disease 2019 (COVID-19) incidence and mortality through the first week of May, accounting for other contemporaneous public health interventions.
This cross-sectional study compares the accuracy of plasma tau phosphorylated at threonine 217 (P-tau217) levels vs other plasma-, MRI-, CSF-, and PET-based markers for distinguishing Alzheimer from other neurodegenerative diseases in 3 cohorts in Arizona, Sweden, and Columbia with or at risk for dementia.
Are antibiotics as good as surgery for pediatric appendicitis? The answer depends on who is asking the question. In this issue of JAMA, Minneci et al report outcomes from a nonrandomized study of nonoperative treatment of 1068 pediatric patients with uncomplicated appendicitis. Because of how the minimal clinically important difference (MCID) was defined and who defined it, the study yielded a statistically negative result. Success was defined as not requiring appendectomy within 1 year of study enrollment. Surgeons defined the minimal acceptable success rate for antibiotic treatment of appendicitis as more than 70%. However, members of a multidisciplinary group (including patients, families, community pediatricians, emergency medicine phys.
This Viewpoint uses US News & World Report’s annual hospital rankings to discuss how such efforts typically disadvantage hospitals caring for patients of lower socioeconomic status (SES) in regions with poorer population health, and argues for transparent and accurate ratings methods that use patient-centric quality measures and account for population SES.
The molecular underpinnings of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the disease it causes, coronavirus disease 2019 (COVID-19), are poorly understood. Inherited genetic variation is an important tool to disentangle cause and consequence, which in turn can generate insights to guide therapeutic interventions to prevent or treat disease. To date, little is known about genetic susceptibility to SARS-CoV-2 infection and severe forms of COVID-19.
This Viewpoint discusses evidence supporting use of conversational agents in health care—artificial intelligence (AI) programs that interpret users’ questions or concerns and respond with answers—and proposes 12 domains (eg, safety, transparency, security) that clinicians and health care organizations should evaluate before using them for patient care.
This Viewpoint describes the unique challenges faced by Lebanon, a small densely populated country with a fragmented health care system, in its response to the emerging COVID-19 pandemic, and it summarizes organizational, testing, and communications policies the nation has implemented that might be useful to other resource-limited countries and settings.
In this Viewpoint the president of the Ford Foundation calls on philanthropic and other wealthy organizations to make creative and generous grants to less well-endowed counterpart institutions and communities to redress the racial and socioeconomic disparities exposed by the COVID-19 pandemic and continued killings of Black Americans.
A 68-year-old woman with history of uterine carcinoma (unknown histology) treated 30 years prior had 2 months of generalized abdominal pain and distention but no fever, nausea, vomiting, diarrhea, constipation, blood in the stool, or weight loss. CBC and serum chemistries were unremarkable; CT and MRI showed pelvic ascites and an enhancing lesion at the base of the cecum; CEA level was 18 ng/mL (normal <5 ng/mL). What is the diagnosis and what would you do next?

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