JAMA

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    Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation—ie, when the reasons for intubation are substantially improved and a number of clinical stability criteria are met. Second, patients who meet these “readiness to wean” criteria are then assessed for their […]
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    In 1950, at lunch with 3 colleagues, the great physicist Enrico Fermi is alleged to have blurted out a question that became known as “the Fermi paradox.” He asked, “Where is everybody?” referring to calculations suggesting that extraterrestrial life forms are abundant in the universe, certainly abundant enough that many of them should have by […]
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    This randomized clinical trial compares the effect of high-flow nasal oxygen with prophylactic noninvasive ventilation applied immediately after extubation vs high-flow nasal oxygen alone on the rate of reintubation in patients at high risk of extubation failure in the intensive care unit (ICU).
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    An implantable neuromodulation device was approved for symptom improvement in patients with advanced heart failure who aren’t eligible for cardiac resynchronization therapy. Heart failure is the fourth leading cause of death attributable to cardiovascular disease, affecting 5.7 million people in the United States.
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    This Special Communication uses a systematic literature review to update previous dollar estimates of waste in the US health care system attributable to failure of care delivery and coordination, low-value care, price inflation, fraud, and administrative complexity.
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    This Viewpoint proposes conditions under which physicians might sign on to deliver humane and ethical medical treatment of immigrants in US detention facilities while managing dual loyalty conflicts with immigration enforcement agencies, including exemption from nondisclosure agreements, use of 3rd-party hiring agencies, and establishment of independent health oversight committees.
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    The FDA recently approved the first spinal tether device for children and adolescents with idiopathic scoliosis—the most common form of this spinal deformity.
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    This JAMA Patient Page describes causes, control, and prevention of infection with the yeast Candida auris.
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    This preliminary exploratory analysis of the ongoing PREDIMED-Plus randomized trial reports dietary adherence among Spanish community-dwelling participants with metabolic syndrome randomized to an energy-reduced Mediterranean diet, physical activity, and behavioral support vs an energy-unrestricted Mediterranean diet alone.
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    In this narrative medicine essay, a married pair of pediatricians share the story of the loss of their first pregnancy, the compassionate care they received, the challenges those around them faced in offering consolation, and, ultimately, the successful pregnancies that brought children to their family.

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