tbuckley/cabot-search huggingface dataset:
Compassionate Use of Remdesivir in Covid-19
Authors: Jiayuan Wu, Bin Wu, Tianwen Lai
Journal: New England Journal of Medicine (2020)

Compassionate Use of Remdesivir in Covid-19To the Editor: In their article, Grein et al.(published online on April 10 at NEJM.org) 1 report outcomes in a cohort of patients who were hospitalized for severe Covid-19 and who received remdesivir on a compassionate-use basis.Over a median follow-up of 18 days, the authors observed improvement in oxygen-support class in 36 of 53 patients (68%), and the condition of 8 patients (15%) worsened.Grein and colleagues reported that Kaplan-Meier analysis showed a cumulative incidence of clinical improvement of 84% (95% confidence interval [CI], 70 to 99).We have found that this result is not correct.A reanalysis of the patient-level data reported in Figure 2 of the article revealed a much lower estimate (approximately 70%).Apparently, the authors erroneously censored data on the deceased patients at the time of death.This is a serious methodologic error.A basic assumption in survival analysis is that censoring should be "noninformative" (i.e., patients for whom data have been censored have the same survival prospects as those who continue to be followed). 2Data on patients who died during the follow-up period should not have been censored; their status should have been considered "not improved" through day 28.We ask the authors to reanalyze and report the remdesivir data, taking into account the above methodologic aspects.
MALIGNANT POTENTIAL OF GASTRIC SUBEPITHELIAL HYPOECHOIC SOLID MASS IMAGED BY ENDOSCOPIC ULTRASONOGRAPHY: A LARGE PROSPECTIVE SINGLE CENTER OBSERVATIONAL STUDY
Authors: K Akahoshi, M Kubokawa, J Gibo, Y Shiratsuchi, K Yodoe, S Osada, K Inamura, T Osoegawa, Y Kuniki, K Akahoshi
Journal: Endoscopy (2020)

Aims The malignant potential of gastric subepithelial hypoechoic solid masses (GSHSM) imaged by endoscopic ultrasonography (EUS) is unclear. The aim of this study was to calculate the proportion of malignant tumors in GSHSM using endoscopic ultrasound guided fine needle aspiration (EUS-FNA) results from a large number of patients who have a GSHSM diagnosed by EUS.
Normal human enthesis harbours conventional CD4+ and CD8+ T cells with regulatory features and inducible IL-17A and TNF expression
Authors: Abdulla Watad, Hannah Rowe, Tobias Russell, Qiao Zhou, Lisa K Anderson, Almas Khan, Robert Dunsmuir, Peter Loughenbury, Vishal Borse, Abhay Rao, Peter A Millner, Nicola Luigi Bragazzi, Howard Amital, Richard Cuhtbert, Miriam Wittmann, Kassem Sharif, Tony Kenna, Matthew A Brown, Darren Newton, Charlie Bridgewood, Dennis G McGonagle
Journal: Annals of the Rheumatic Diseases (2020)

The human enthesis conventional T cells are poorly characterised.To study the biology of the conventional T cells in human enthesis.CD4+ and CD8+ T cells were investigated in 25 enthesis samples using immunofluorescence, cytometrically, bulk RNAseq and quantitative real-time PCR following anti-CD3/CD28 bead stimulation to determine interleukin (IL)-17A and tumour necrosis factor (TNF) levels. T-cell receptor (TCR) repertoires were characterised and a search for putative T-cell reactivity was carried out using TCR3 database. The impact of pharmacological antagonism with retinoic acid receptor-related orphan nuclear receptor gamma t inhibitor (RORγti), methotrexate and phosphodiesterase type 4 inhibitor (PDE4i) was investigated.Immunofluorescence and cytometry suggested entheseal resident CD4+ and CD8+ T cells with a resident memory phenotype (CD69+/CD45RA-) and tissue residency gene transcripts (higher NR4A1/AhR and lower KLF2/T-bet transcripts). Both CD4+ and CD8+ T cells showed increased expression of immunomodulatory genes including IL-10 and TGF-β compared with peripheral blood T cells with entheseal CD8+ T cells having higher CD103, CD49a and lower SIPR1 transcript that matched CD4+ T cells. Following stimulation, CD4+ T cells produced more TNF than CD8+ T cells and IL-17A was produced exclusively by CD4+ T cells. RNAseq suggested both Cytomegalovirus and influenza A virus entheseal resident T-cell clonotype reactivity. TNF and IL-17A production from CD4+ T cells was effectively inhibited by PDE4i, while RORγti only reduced IL-17A secretion.Healthy human entheseal CD4+ and CD8+ T cells exhibit regulatory characteristics and are predicted to exhibit antiviral reactivity with CD8+ T cells expressing higher levels of transcripts suggestive of tissue residency. Inducible IL-17A and TNF production can be robustly inhibited in vitro.
DIAGNOSTIC YIELD OF CLEARING COLONOSCOPY ONE-YEAR AFTER BASELINE COLONOSCOPY IN PATIENTS WITH HIGH RISK ADENOMAS
Authors: L Medina-Prado, C Mangas-Sanjuan, S Zarraquiños, E Rodríguez-Camacho, AH Aginagalde, AC Álvarez-Urturi, J Cubiella, I Portillo, M Pellisé, MJ Valverde, D Salas, R Jover
Journal: Endoscopy (2020)

Aims Patients with ≥5 small adenomas or ≥1 adenoma ≥20mm are recommended to undergo one-year clearing colonoscopy according to the European guidelines. However, data from studies supporting this recommendation are not entirely consistent.
David Oliver: Covid-19 highlights the need for effective government communications
Authors: David Oliver
Journal: BMJ (2020)

I’m writing this nine weeks after the UK’s first reported death from coronavirus. For me, the effectiveness of our response and the narrative around it have been as much about the quality of professional communications from government as about innovations in science or service delivery.

Despite the multiplicity of healthcare providers in the English NHS we fundamentally still have a national system run from central organisations, such as NHS England and Public Health England, reporting to the health secretary and the Department of Health and Social Care.1 They, in turn, participate in collective cabinet decision making led by 10 Downing Street and supported by the Cabinet Office, which holds the Civil Contingencies Committee meetings (popularly known as COBRA).2

A strength of this apparatus has been the ability to generate official guidance and data at speed. It also enables a focus on proactive messaging, as well as attempts to make this clear …
PREMEDICATION WITH DIMETHICONE,N-ACETYLCYSTEINE AND PANCREATIN TO IMPROVE VISIBILITY DURING GASTROSCOPY: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL
Authors: MR Pineda-De Paz, TDJ Galicia-Gomez, JG Lopez-Fuentes, FJ Flores-Renteria, LA Waller-Gonzalez, MG Reyes-Aguilar, R Soto-Solis
Journal: Endoscopy (2020)

Aims Evaluate the efficacy and safety of premedication with Dimethicone, N-Acetylcysteine and Pancreatin during upper digestive endoscopy.
Excess Antibiotic Treatment Duration and Adverse Events in Patients Hospitalized With Pneumonia
Authors: Valerie M. Vaughn, Scott A. Flanders, Ashley Snyder, Anna Conlon, Mary A.M. Rogers, Anurag N. Malani, Elizabeth McLaughlin, Sarah Bloemers, Arjun Srinivasan, Jerod Nagel, Scott Kaatz, Danielle Osterholzer, Rama Thyagarajan, Lama Hsaiky, Vineet Chopra, Tejal N. Gandhi
Journal: Annals of Internal Medicine (2019)

Randomized trials have demonstrated the safety of shorter courses of antibiotic treatment for pneumonia, but how often excess treatment durations are prescribed is not known. This large multicenter...
Somatic Symptom Disorder and the Physician’s Role—Reply
Authors: Giuliana Morabito, Egidio Barbi, Giorgio Cozzi
Journal: JAMA Pediatrics (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Recombinant Human Growth Hormone in Patients with HIV-Associated Wasting
Authors: Morris Schambelan, Kathleen Mulligan, Carl Grunfeld, Eric S. Daar, Anthony LaMarca, Donald P. Kotler, Jack Wang, Samuel A. Bozzette, James B. Breitmeyer
Journal: Annals of Internal Medicine (1996)

Background: Body wasting, particularly loss of body cell mass, is an increasingly prevalent acquired immunodeficiency syndrome (AIDS)-defining condition and is an independent risk factor for death ...
Extensive Intraspinal Hypermetabolism Caused by Neurobrucellosis Shown on 18F-FDG PET/CT
Authors: Meiqi Wu, Ruixue Cui, Fang Li, Li Huo, Yaping Luo
Journal: Clinical Nuclear Medicine (2020)

Abstract A 55-year-old man and a 52-year-old man presenting with neurological symptoms were referred for 18 F-FDG PET/CT for the underlying malignancy. In both cases, extensive intraspinal hypermetabolism was observed in 18 F-FDG PET/CT. The cerebrospinal fluid culture finally confirmed infection of Brucella . This report illustrates that neurobrucellosis may present as intraspinal hypermetabolism on 18 F-FDG PET/CT, and thus it should be added to the differential diagnosis.
Early precursors and molecular determinants of tissue-resident memory CD8 <sup>+</sup> T lymphocytes revealed by single-cell RNA sequencing
Authors: Nadia S. Kurd, Zhaoren He, Tiani L. Louis, J. Justin Milner, Kyla D. Omilusik, Wenhao Jin, Matthew S. Tsai, Christella E. Widjaja, Jad N. Kanbar, Jocelyn G. Olvera, Tiffani Tysl, Lauren K. Quezada, Brigid S. Boland, Wendy J. Huang, Cornelis Murre, Ananda W. Goldrath, Gene W. Yeo, John T. Chang
Journal: Science Immunology (2020)

Heterogeneity of small intestine intraepithelial CD8 + T cells suggests functionally distinct subsets of T RM cells and their precursors.
Creating Entrustable Professional Activities to Assess Internal Medicine Residents in Training
Authors: David R. Taylor, Yoon Soo Park, Christopher A. Smith, Jolanta Karpinski, William Coke, Ara Tekian
Journal: Annals of Internal Medicine (2018)

Competency-based medical education has not advanced residency training as much as expected, and some medical educators now advocate reorienting competency-based approaches to focus on a resident's ...
LONG-TERM OUTCOMES OF ENDOSCOPIC PAPILLECTOMY FOR EARLY-STAGE CANCER IN DUODENAL AMPULLARY ADENOMA: COMPARISON WITH SURGICAL TREATMENT
Authors: SS Lee, JS Hwang, SW Ko, H So, DW Oh, TJ Song, SK Lee, MH Kim
Journal: Endoscopy (2020)

Aims Recently, the evidence has been accumulating that the endoscopic resection may be curative in treating ampullary tumor with high grade intraepithelial neoplasia. However, there are only small cases series of endoscopic management of early ampullary cancer, and radical surgery is still considered the only accepted treatment modality. The aim of this study is to evaluate the long-term outcomes of patients diagnosed with early ampullary adenocarcinoma treated with endoscopic management.
Irinotecan Enhances IL-12 Production by OK-432-Activated Murine Macrophages
Authors: B. Zhang, T. Fujimoto, M. Mai
Journal: Cancer Research (2005)

442  Microsatellite instability (MSI) analysis of colorectal tumors is clinically useful for identifying patients with hereditary non-polyposis colorectal cancer (due to germline mutations of mismatch repair genes). In addition, MSI status may be predictive of tumor response to certain chemotherapies. We have evaluated the MSI Analysis System (Promega Corp.) (5 mononucleotide repeats and 2 pentanucleotide repeats) and compared the results to an assay which interrogates the 5 microsatellite loci recommended as a reference panel by the 1997 National Cancer Institute sponsored MSI workshop (3 dinucleotide repeats and 2 mononucleotide repeats). These markers meet the new Bethesda guidelines for MSI testing (Umar et al, 2004). Parameters including input DNA concentration, number of PCR amplification cycles, and capillary electrophoresis injection conditions were evaluated to determine their effects on results. Initial results of 34 samples in an ongoing cross-validation study showed complete concordance of MSI Stable cases (18/18) and MSI-High cases (11/11). All of the MSI-High cases shifted all 5 of the mononucleotide repeats of the MSI Analysis System. Further, the percentage of alleles that were shifted generally exceeded 20% for each marker. Five samples shifted a single dinucleotide locus using the NCI-5 loci, and thus were interpreted as MSI-Low. All of these cases (5/5) tested MS Stable by the MSI Analysis System, as expected. Our results demonstrate a high concordance between MSI analysis using the MSI Analysis System and the NCI-recommended loci and suggest that the new markers may be useful to help resolve cases of MSI low into either MSI high or MSI negative (stable).
Abstract 15883: Stress, Resilience, and Cardiovascular Disease Risk Among Black Women
Authors: Ashley S Felix, Karen P Williams, Amy Lehman, Timiya S Nolan, Shawnita Sealy-Jefferson, Khadijah Breathett, Darryl B Hood, Daniel Addison, Cindy M Anderson, Crystal W Cené, Barbara J Warren, Rebecca D Jackson
Journal: Circulation (2019)

Introduction: Empirical data on the link between stress and cardiovascular (CVD) risk among Black women is limited. We examined associations of stressful life events and social strain with incident...
JEJUNAL POLYPECTOMY WITH NOVEL MOTORIZED SPIRAL ENTEROSCOPY (MSE) BY AN INEXPERIENCED OPERATOR AFTER FAILED CONVENTIONAL ENTEROSCOPY BY AN EXPERT: A TRUE “PROOF OF CONCEPT” EXPERIENCE
Authors: EF Valenzuela, AC López, RSO Hernández, PD Redondo, JT Tejada, CC Herbozo, MDB Sanz, JG Alonso, C De la Serna Higuera, MPM Castillo
Journal: Endoscopy (2020)

Introduction MSE with foot-pedal controlled spiral overtube facilitates progression by clockwise rotation. As MSE has only been tested diagnostically by experienced operators at referral centers, general applicability needs confirmation.
TECHNIQUE OF PERCUTANEOUS RESCUE PEG PLACEMENT AFTER ACCIDENTAL DISLOCATION
Authors: S Ohl, M Dietze, J Weigt
Journal: Endoscopy (2020)

Aims Accidental dislocation of PEG tubes frequently occurs in patients with balloon type PEG tubes. Dislocation may have crucial impact in case of supplementation of nutrition and medication. Unfortunately a simple reinsertion of a new PEG tube is frequently not achievable because of shrinking of the transabdominal orifice which can occur within hours. In addition placement of a new PEG may be altered in some individuals by changed anatomy or tumor progression.
POLYETHYLENE GLYCOL: DECREASING THE VOLUME DOES NOT COMPROMISE EFFECTIVENESS!
Authors: C Arieira, S Xavier, PB Carvalho, FD de Castro, J Magalhães, B Rosa, J Cotter
Journal: Endoscopy (2020)

Aims Success of colonoscopy is linked to the adequacy of bowel cleansing. Polyethylene glycol (PEG) solutions are widely used for colonic cleansing but with limitations concerning tolerability and acceptability. Plenvu is the first PEG-containing bowel preparation that requires only 1L of water for dissolution and ingestion.
The IgG/IgG4 mRNA ratio by quantitative PCR accurately diagnoses IgG4-related disease and predicts treatment response
Authors: L M Hubers, M E Doorenspleet, E L Culver, Wenniger Lmdb., P L Klarenbeek, R W Chapman, S F van de Graaf, J Verheij, T van Gulik, F Baas, E Barnes, N de Vries, U Beuers
Journal: Hepatology (2015)
Somatosensation in the Brain: A Theoretical Re-evaluation and a New Model
Authors: Edward H.F. de Haan, H. Chris Dijkerman
Journal: Trends in Cognitive Sciences (2020)

The somatosensory system is important for many functions, such as tactile recognition, the perception of our body, and motor actions. We present a comprehensive review of the human and animal literature on somatosensory processing over the past 10 years and evaluate how well existing models can accommodate the new observations. Based on these observations and a survey of the brain structures involved in somatosensation, we suggest that a new model is needed that describes multiple networks involved in separate subfunctions. These networks are highly interconnected and often multimodal in nature. The model includes basic somatosensory processing and five higher-order networks involved in haptic object recognition and memory, body perception, body ownership, affective processing, and action.
The Era of COVID-19 and the Rise of Science Collectivism in Cancer Research
Authors: Tobias Janowitz, David A. Tuveson
Journal: Cancer Discovery (2020)

Abstract Summary: The coronavirus SARS-CoV-2 has created a global pandemic that has killed more than a quarter million people since December 2019, halted commerce, and disrupted our ability to research cancer in the laboratory and clinic and care for our patients. A return to a functioning society can be facilitated by the active participation of cancer researchers to diagnose and treat SARS-CoV-2–infected patients, and the direct and indirect benefits of our involvement cannot be overstated.
Direct-Acting Antiviral Prophylaxis in Kidney Transplantation From Hepatitis C Virus–Infected Donors to Noninfected Recipients
Authors: Christine M. Durand, Mary G. Bowring, Diane M. Brown, Michael A. Chattergoon, Guido Massaccesi, Nichole Bair, Russell Wesson, Ashraf Reyad, Fizza F. Naqvi, Darin Ostrander, Jeremy Sugarman, Dorry L. Segev, Mark Sulkowski, Niraj M. Desai
Journal: Annals of Internal Medicine (2018)

The mortality rate of patients with end-stage kidney disease awaiting a transplant is high. In a small nonrandomized clinical trial, investigators studied the tolerability and feasibility of transp...
Publisher Correction: Comprehensive analysis of chromothripsis in 2,658 human cancers using whole-genome sequencing
Authors: Isidro Cortés-Ciriano, Jake June-Koo Lee, Ruibin Xi, Dhawal Jain, Youngsook L. Jung, Lixing Yang, Dmitry Gordenin, Leszek J. Klimczak, Cheng-Zhong Zhang, David S. Pellman, Kadir C. Akdemir, Eva G. Alvarez, Adrian Baez-Ortega, Rameen Beroukhim, Paul C. Boutros, David D. L. Bowtell, Benedikt Brors, Kathleen H. Burns, Peter J. Campbell, Kin Chan, Ken Chen, Isidro Cortés-Ciriano, Ana Dueso-Barroso, Andrew J. Dunford, Paul A. Edwards, Xavier Estivill, Dariush Etemadmoghadam, Lars Feuerbach, J. Lynn Fink, Milana Frenkel-Morgenstern, Dale W. Garsed, Mark Gerstein, Dmitry A. Gordenin, David Haan, James E. Haber, Julian M. Hess, Barbara Hutter, Marcin Imielinski, David T. W. Jones, Young Seok Ju, Marat D. Kazanov, Leszek J. Klimczak, Youngil Koh, Jan O. Korbel, Kiran Kumar, Eunjung Alice Lee, Jake June-Koo Lee, Yilong Li, Andy G. Lynch, Geoff Macintyre, Florian Markowetz, Iñigo Martincorena, Alexander Martinez-Fundichely, Satoru Miyano, Hidewaki Nakagawa, Fabio C. P. Navarro, Stephan Ossowski, Peter J. Park, John V. Pearson, Montserrat Puiggròs, Karsten Rippe, Nicola D. Roberts, Steven A. Roberts, Bernardo Rodriguez-Martin, Steven E. Schumacher, Ralph Scully, Mark Shackleton, Nikos Sidiropoulos, Lina Sieverling, Chip Stewart, David Torrents, Jose M. C. Tubio, Izar Villasante, Nicola Waddell, Jeremiah A. Wala, Joachim Weischenfeldt, Lixing Yang, Xiaotong Yao, Sung-Soo Yoon, Jorge Zamora, Cheng-Zhong Zhang, Peter J. Park
Journal: Nature Genetics (2020)
Oral Montelukast, Inhaled Beclomethasone, and Placebo for Chronic Asthma
Authors: Kerstin Malmstrom, Guillermo Rodriguez-Gomez, Jeremias Guerra, Cesar Villaran, Andres Piñeiro, Lynn X. Wei, Beth C. Seidenberg, Theodore F. Reiss
Journal: Annals of Internal Medicine (1999)

Beclomethasone had a larger mean effect than montelukast, but both drugs provided clinical benefit to patients with chronic asthma. This finding is consistent with the use of these agents as contro...
Prioritizing Frontline Workers during the COVID-19 Pandemic
Authors: Nancy S. Jecker, Aaron G. Wightman, Douglas S. Diekema
Journal: The American Journal of Bioethics (2020)

COVID-19 has sickened more than one million people and outpaced the capacity of hospitals around the world to meet demand for vital medical resources, such as ventilators, intensive care unit (ICU)...
Immunogenicity of a Tetravalent Meningococcal Glycoconjugate Vaccine in Infants
Authors: Snape, K P Perrett, K J Ford, T M John, D Pace, Yu L-M., J M Langley, S McNeil, P M Dull, F Ceddia, A Anemona, S A Halperin, S Dobson, A J Pollard
Journal: JAMA (2008)
Vaping-associated lung injury
Authors: Orla O"Carroll, Keshav Sharma, Aurelie Fabre, David J Murphy, Michael P Keane, Cormac McCarthy
Journal: Thorax (2020)

An 18-year-old man presented to the emergency department of a community hospital with a cough, fever, night sweats and significant weight loss. He recently completed an antibiotic course for a lower respiratory-tract infection. Full blood count revealed a normal total white cell count with eosinophil count of 0.85×109/L. C-reactive protein (CRP) was normal but erythrocyte sedimentation rate (ESR) was 100 mm/hour. Chest radiograph demonstrated bilateral perihilar reticulonodular opacification with peripheral sparing (figure 1A). Immunoglobulin E was mildly elevated at 175UI/mL; other immunoglobulin levels, viral and autoantibody panels were normal. High-resolution CT thorax revealed diffuse centrilobular and peribronchovascular ground-glass opacification throughout both lungs with subpleural sparing (figure 1B/C). On further questioning, the patient disclosed a history of extensive vaping in the preceding 6 months including nicotine and tetrahydrocannabinol-containing products. He was referred to a specialist …
UPPER GASTROINTESTINAL BLEEDING IN PATIENTS WITH CIRRHOSIS: BEYOND VARICEAL BLEEDING
Authors: G Demetriou, A Veniamin, E Orfanudaki, V Valatas, M Koulendaki, D Samonakis, E Kalaitzakis
Journal: Endoscopy (2020)

Aims We aimed to investigate reasons for acute upper gastrointestinal bleeding(AUGIB) as well as to compare predictors and outcomes between portal(PH) and non-portal hypertension(NPH) related AUGIB in patients with cirrhosis.
ENDOSCOPIC SLEEVE GASTROPLASTY FOR OBESITY: FEATURES INVOLVING THE LEARNING CURVE
Authors: AJ del Pozo-Garcia, DR de la Cruz, T Valdés-Lacasa, R Polanco, S Nevado, FS Gómez
Journal: Endoscopy (2020)

Aims Endoscopic sleeve gastroplasty (ESG) has positioned as one of the most promising incisionless technique to induce gastric volume restriction, leading to weight loss, having showed good short-term results within a safe profile. Its main drawback is a slow and challenging learning curve which has not yet been standardised.
The lithium clinic: a new model for the delivery of psychiatric services
Authors: R R Fieve
Journal: American Journal of Psychiatry (1975)

Advances in the diagnosis of recurrent affective disorders and consistently high levels of lithium prophylaxis have made it possible to treat manic-depressive disorders on an outpatient basis. The author describes the experiences and organization of a lithium clinic that has operated for 15 years. Utilizing the services of trained paramedicals and a small medical staff, the clinic has efficiently served a large patient population. The author suggests that centers using this model could serve the community by increasing the availability of specialized psychiatric care.