tbuckley/cabot-search huggingface dataset:
More dynamical and more symbiotic: Cortico-striatal models of resolve, suppression, and routine habit
Authors: Linus Ta-Lun Huang
Journal: Behavioral and Brain Sciences (2021)

Abstract I extend Ainslie's core claims with three cortico-striatal models that respectively subserve the key constructs of resolve, suppression, and routine habit. I show that these models suggest a more dynamical and symbiotic relation among the constructs: there are more ways they interact to reinforce willpower, and the temporal dimension of the interactions can often determine the effectiveness of the reinforcement.
EFFICACY AND OUTCOMES OF COLCHICINE FOR REDUCTION OF ADVERSE OUTCOMES IN PATIENTS UNDERGOING PCI WITH BMS. THE ORCA REGISTRY
Authors: Alfredo Matias Rodriguez-Granillo, Sandra Swieszkowski, Camila Correa-Sadouet, Maria Valeria Curotto, Camila Gallardo, Carlos Fernandez-Pereira, Juan Mieres, Ricardo Perez de la Hoz, Alfredo E. Rodriguez
Journal: Journal of the American College of Cardiology (2021)
TENASCIN C PROMOTES ENDOTHELIAL DYSFUNCTION ACCOMPANIED WITH CARDIAC FIBROSIS IN A MOUSE MODEL OF DUCHENNE MUSCULAR DYSTROPHY
Authors: Petra Lujza Szabo, Ouafa Hamza, Milat Inci, Janine Ebner, Karlheinz Hilber, Abraham Dietmar, Sandra Trojanek, Bruno K. Podesser, Attila Kiss
Journal: Journal of the American College of Cardiology (2021)
ONE YEAR PREDICTION OF MODERATE OR SEVERE AORTIC STENOSIS USING ECG- AND EHR-BASED MACHINE LEARNING MODELS
Authors: Ruijun Chen, Alvaro E Ulloa Cerna, Christopher Good, Sushravya Raghunath, Leyla Warsame, Raghuveer Puttagunta, Spencer Tavares, Brandon Fornwalt, Christopher Haggerty
Journal: Journal of the American College of Cardiology (2021)
THE SPECTRUM AND OUTCOMES OF ARRHYTHMIA IN SICKLE CELL HOSPITALIZATIONS
Authors: Harsh Patel, Nikhil Agrawal, Samarthkumar Thakkar, Lucas Battel, Ankita Kapoor, Smit Patel, Mehul Thakkar, Kirtenkumar Patel, Aakash Sheth, Toralben Patel, Tanushri Bhushan, Marmik Patel, Bipul Baibhav, Mohan Rao
Journal: Journal of the American College of Cardiology (2021)
Head circumference from birth to five years in France: New national reference charts and comparison to WHO standards
Authors: Manon Bergerat, Barbara Heude, Marion Taine, Sylvie Nguyen The Tich, Andreas Werner, Bruno Frandji, Thomas Blauwblomme, Dorin Sumanaru, Marie-Aline Charles, Martin Chalumeau, Pauline Scherdel
Journal: The Lancet Regional Health - Europe (2021)

The monitoring of head circumference (HC) is essential to early detect any conditions affecting its growth in early childhood. A positive secular trend and regional specificities in HC suggested the need to provide updated national HC reference growth charts.We extracted all growth data collected from 42 primary-care physicians from across the French metropolitan territory who used the same electronic medical-records software. We selected HC measurements up to age five years for all children who were born after 1990 with birth weight > 2500 g. We derived new HC growth charts by using Generalized Additive Models for Location, Scale and Shape, then externally validated them until 30 months of age by comparison with the national population-based Étude Longitudinale Française depuis l'Enfance (ELFE) birth cohort and compared them to previous French and WHO growth charts.With 973,869 HC measurements from 157,762 children, new calibrated HC growth charts from birth to age five years were generated. The new HC growth charts showed good external fit by comparison with the ELFE birth cohort. As compared with the new HC growth charts, the previous French and WHO growth charts mean HC z-scores were, respectively, -0.4 and -0.6 SD for girls and -0.2 and -0.6 SD for boys.We produced and validated national calibrated HC growth charts by using a novel big-data approach applied to data routinely collected in clinical practice. Comparison with previous French and WHO growth charts confirmed a positive secular trend since the 1960s and regional specificities.The French Ministry of Health; Laboratoires Guigoz-General Pediatrics section of the French Society of Pediatrics-Paediatric Epidemiological Research Group; the French Association of Ambulatory Pediatrics; and educational grant from the Regional Health Agency of Ile-de-France.
Abstract 15106: Prevalence and Impact of Cardiovascular Disease in Patients With HIV: A Nationwide Prospective
Authors: Mohit Pahuja, Omar Chehab, Ahmed Yassin, Venkat Ramesh, Hossam Abubakar, Sagar Ranka, Aman Handa, Tanvir Khosla, Luis Afonso, Ileana L Pina
Journal: Circulation (2019)

Introduction: With significant improvement in the treatment of HIV by early and effective antiretroviral therapy (ART), people with HIV are living longer. However, patients with HIV have an increas...
Mortality from drug-resistant tuberculosis in high-burden countries comparing routine drug susceptibility testing with whole-genome sequencing: a multicentre cohort study
Authors: Kathrin Zürcher, Martina L Reichmuth, Marie Ballif, Chloé Loiseau, Sonia Borrell, Miriam Reinhard, Veronika Skrivankova, Rico Hömke, Peter Sander, Anchalee Avihingsanon, Alash'le G Abimiku, Olivier Marcy, Jimena Collantes, E Jane Carter, Robert J Wilkinson, Helen Cox, Marcel Yotebieng, Robin Huebner, Lukas Fenner, Erik C Böttger, Sebastien Gagneux, Matthias Egger
Journal: The Lancet Microbe (2021)

Drug resistance threatens global tuberculosis control. We aimed to examine mortality in patients with tuberculosis from high-burden countries, according to concordance or discordance of results from drug susceptibility testing done locally and whole-genome sequencing (WGS). In this multicentre cohort study, we collected pulmonary Mycobacterium tuberculosis isolates and clinical data from individuals with tuberculosis from antiretroviral therapy programmes and tuberculosis clinics in Côte d'Ivoire, Democratic Republic of the Congo, Kenya, Nigeria, Peru, South Africa, and Thailand, stratified by HIV status and drug resistance. Sites tested drug susceptibility using routinely available methods. WGS was done on Illumina HiSeq 2500 in the USA and Switzerland, and TBprofiler was used to analyse the genomes. We included individuals aged 16 years or older with pulmonary tuberculosis (bacteriologically confirmed or clinically diagnosed). We analysed mortality in multivariable logistic regression models adjusted for sex, age, HIV status, history of tuberculosis, and sputum positivity. Between Sept 1, 2014, and July 4, 2016, of 634 patients included in our previous analysis, we included 582 patients with tuberculosis (median age 33 years [IQR 27-43], 225 [39%] women, and 247 [42%] HIV-positive). Based on WGS, 339 (58%) isolates were pan-susceptible, 35 (6%) monoresistant, 146 (25%) multidrug-resistant, and 24 (4%) pre-extensively drug-resistant (pre-XDR) or XDR. The analysis of mortality was based on 530 patients; 63 (12%) died and 77 (15%) patients received inappropriate treatment. Mortality ranged from 6% (18 of 310) in patients with pan-susceptible tuberculosis to 39% (nine of 23) in patients with pre-XDR or XDR tuberculosis. The adjusted odds ratio for mortality was 4·92 (95% CI 2·47-9·78) among undertreated patients, compared with appropriately treated patients. In seven countries with a high burden of tuberculosis, we observed discrepancies between drug resistance patterns obtained locally and WGS. The underdiagnosis of drug resistance resulted in inappropriate treatment and higher mortality. WGS can provide accurate and detailed drug resistance information required to improve the outcomes of drug-resistant tuberculosis in high-burden settings. Our results support WHO's call for point-of-care tests based on WGS. National Institutes of Allergy and Infectious Diseases, Swiss National Science Foundation, and Swiss National Center for Mycobacteria.
Control of PD-L1 expression in CLL-cells by stromal triggering of the Notch-c-Myc-EZH2 oncogenic signaling axis
Authors: Martin Böttcher, Heiko Bruns, Simon Völkl, Junyan Lu, Elisavet Chartomatsidou, Nikos Papakonstantinou, Kristin Mentz, Maike Büttner-Herold, Thorsten Zenz, Marco Herling, Wolfgang Huber, Paolo Ghia, Kostas Stamatopoulos, Andreas Mackensen, Dimitrios Mougiakakos
Journal: Journal for ImmunoTherapy of Cancer (2021)

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. Emerging data suggest that CLL-cells efficiently evade immunosurveillance. T-cell deficiencies in CLL include immuno(metabolic) exhaustion that is achieved by inhibitory molecules, with programmed cell death 1/programmed cell death ligand 1 (PD-L1) signaling emerging as a major underlying mechanism. Moreover, CLL-cells are characterized by a close and recurrent interaction with their stromal niches in the bone marrow and lymph nodes. Here, they receive nurturing signals within a well-protected environment. We could previously show that the interaction of CLL-cells with stroma leads to c-Myc activation that is followed by metabolic adaptations. Recent data indicate that c-Myc also controls expression of the immune checkpoint molecule PD-L1. Therefore, we sought out to determine the role of stromal contact for the CLL-cells’ PD-L1 expression and thus their immuno-evasive phenotype. To do so, we analyzed PD-L1 expression on CLL cell (subsets) in untreated patients and on healthy donor-derived B-cells. Impact of stromal contact on PD-L1 expression on CLL-cells and the underlying signaling pathways were assessed in well-established in vitro niche models. Ex vivo and in vitro findings were validated in the Eµ-TCL1 transgenic CLL mouse model. We found increased PD-L1 expression on CLL-cells as compared with B-cells that was further enhanced in a cell-to-cell contact-dependent manner by stromal cells. In fact, circulating recent stromal-niche emigrants displayed higher PD-L1 levels than long-time circulating CLL-cells. Using our in vitro niche model, we show that a novel Notch-c-Myc-enhancer of zeste homolog 2 (EZH2) signaling axis controls PD-L1 upregulation. Ultimately, elevated PD-L1 levels conferred increased resistance towards activated autologous T-cells. In summary, our findings support the notion that the CLL microenvironment contributes to immune escape variants. In addition, several targetable molecules (eg, Notch or EZH2) could be exploited in view of improving immune responses in patients with CLL, which warrants further in-depth investigation.
ADJUNCTIVE LOW-DOSE RIVAROXABAN IN PATIENTS WITH HEART FAILURE AND ATHEROSCLEROTIC CARDIOVASCULAR DISEASE: A META-ANALYSIS OF RANDOMIZED CONTROL TRIALS
Authors: Amit Rout, Abigail Chan, Aakash Garg, Sahib Singh, Udaya Tantry, Kevin Bliden, Paul Gurbel
Journal: Journal of the American College of Cardiology (2021)
Role of Regulatory Cells in Immune Tolerance Induction in Hemophilia A
Authors: Sarah J. Schep, Roger E. G. Schutgens, Kathelijn Fischer, Jan Voorberg, Marianne Boes
Journal: HemaSphere (2021)

The main complication of hemophilia A treatment is the development of neutralizing antibodies (inhibitors) against factor VIII (FVIII). Immune tolerance induction (ITI) is the prescribed treatment for inhibitor eradication, although its working mechanism remains unresolved. To clarify this mechanism, we compared blood samples of hemophilia A patients with and without inhibitors for presence of immunoregulatory cells and markers, including regulatory B-cells (Bregs), regulatory T-cells (Tregs), myeloid-derived suppressor cells (MDSCs), and expression of regulatory markers on T-cells (programmed cell death protein 1 [PD1], inducable T-cell costimulator, cytotoxic T-lymphocyte-associated protein 4 [CTLA4]), by use of flow cytometry. By cross-sectional analysis inhibitor patients (N = 20) were compared with inhibitor-negative (N = 28) and ex-inhibitor (N = 17) patients. In another longitudinal study, changes in immunoregulatory parameters were evaluated during ITI (N = 12) and compared with inhibitor-negative hemophilia A patients (N = 36). The frequency of Bregs, but not of Tregs nor MDSCs, was significantly reduced in inhibitor patients (3.2%) compared with inhibitor-negative (5.9%) and ex-inhibitor patients (8.9%; P &lt; 0.01). CTLA4 expression on T-cells was also reduced (mean fluorescence intensity 133 in inhibitor versus 537 in inhibitor-negative patients; P &lt; 0.01). Fittingly, in patients followed during ITI, inhibitor eradication associated with increased Bregs, increased Tregs, and increased expression of CTLA4 and PD1 on CD4+ T-cells. In conclusion, inhibitor patients express significantly lower frequency of Bregs and Tregs marker expression, which are restored by successful ITI. Our findings suggest that an existing anti-FVIII immune response is associated with deficits in peripheral tolerance mechanisms and that Bregs and changes in immunoregulatory properties of CD4+ T-cells likely contribute to ITI in hemophilia A patients with inhibitors.
A SIMPLE SCORE TO PREDICT TRANSTHYRETIN CARDIAC AMYLOIDOSIS IN HEART FAILURE WITH PRESERVED EJECTION FRACTION
Authors: Daniel Davies, Masatoshi Minamisawa, Christopher Scott, Martha Grogan, Angela Dispenzieri, Panithaya Chareonthaitawee, Amil Shah, Sanjiv Shah, Scott Solomon, Margaret Redfield, Omar AbouEzzeddine
Journal: Journal of the American College of Cardiology (2021)
NATIONWIDE TRENDS IN AORTIC DISSECTION: A 10-YEAR ANALYSIS
Authors: James Brown, Bushra Usmani, George Arnaoutakis, Derek Serna-Gallegos, Konstadinos Plestis, Syed Mahmood Shah, Forozan Navid, Courtenay Dunn-Lewis, Ibrahim Sultan
Journal: Journal of the American College of Cardiology (2021)
ECHOCARDIOGRAPHY DERIVED PREDICTORS OF WORSE OUTCOMES IN THE ACUTE PHASE OF COVID-19 PATIENTS COMPARED TO MATCHED CONTROLS
Authors: Alaa Omar, Angel De La Cruz Tejada, Diana Ronderos, Nolberto Hernandez, Jeirym Miranda, Arsalan Rehmani, Marin Nicu, Sridhar Chilimuri, Jonathan N. Bella
Journal: Journal of the American College of Cardiology (2021)
EFFECTIVENESS AND SAFETY OF DIRECT ORAL ANTICOAGULANTS AMONG NONVALVULAR ATRIAL FIBRILLATION PATIENTS WITH MULTIMORBIDITY
Authors: Amol Dhamane, Mauricio Ferri, Allison Keshishian, Cristina Russ, Ruth Thomas, Gary Leung, Birol Emir, Huseyin Yuce, Manuela Di Fusco
Journal: Journal of the American College of Cardiology (2021)
ECHOCARDIOGRAPHIC BIVENTRICULAR COUPLING INDEX TO PREDICT PRE-CAPILLARY PULMONARY HYPERTENSION
Authors: Stefano Albani, Davide Stolfo, Ashwin Venkateshvaran, Vlad Chubuchny, Federico Biondi, Antonio De Luca, Marco De Scordilli, Bruno Pinamonti, Francesco Lo Giudice, Emilio Pasanisi, Christina Petersen, Edoardo Airo’, Carolina Bauleo, Lars H. Lund, Michele Emdin, Aristomenis Manouras, Gianfranco Sinagra, Alberto Giannoni
Journal: Journal of the American College of Cardiology (2021)
A dose substitution of anthracycline intensity with dose-dense rituximab in children and adolescents with good-risk mature B-cell lymphoma
Authors: Stan Goldman, Matthew Barth, Bruce Shiramizu, Qiuhu Shi, Jessica Hochberg, Liana Klejmont, Lauren Harrison, Jackie Basso, Yaya Chu, Humayun Islam, Perry Gerard, Melissa Agsalda-Garcia, Tiffany Shieh, Javier Oesterheld, Kenneth Heym, Ivan Kirov, Richard Drachtman, Paul Harker-Murray, Sherrie Perkins, Rodney R. Miles, Mitchell Cairo
Journal: Leukemia (2021)
CARDIOVASCULAR EFFECTIVENESS OF EMPAGLIFLOZIN COMPARED TO DPP4I IN ROUTINE CARE IN EAST ASIA: RESULTS FROM THE EMPRISE STUDY
Authors: Dae Jung Kim, Wayne H.-H. Sheu, Wook-Jin Chung, Daisuke Yabe, Kyoung Hwa Ha, Elise Chia-Hui Tan, Yusuke Taneda, Vanessa Lei, Laura Saarelainen, Anouk Deruaz-Luyet, Moe H. Kyaw, Yutaka Seino
Journal: Journal of the American College of Cardiology (2021)
Age at Smoking Initiation and Prevalence of Cigarette Use Among Youths in Sub-Saharan Africa, 2014-2017
Authors: Onyema Greg Chido-Amajuoyi, Patrick Fueta, Dale Mantey
Journal: JAMA Network Open (2021)

This cross-sectional study examines age at smoking initiation, prevalence of cigarette use, and prevalence of exposure to smoking-related risk factors among youths in sub-Saharan Africa.
EXAMINING THE EFFECTS OF AGING ON CLINICAL OUTCOMES IN PATIENTS RECEIVING GENOTYPE-GUIDED P2Y12 INHIBITOR SELECTION AFTER PERCUTANEOUS CORONARY INTERVENTION
Authors: Brian Wood, Ian R. Mulrenin, Megan N. Gower, Karen Weck, Joseph Rossi, Craig Lee, George Stouffer
Journal: Journal of the American College of Cardiology (2021)
Tumor mutational burden assessment in non-small-cell lung cancer samples: results from the TMB<sup>2</sup> harmonization project comparing three NGS panels
Authors: Javier Ramos-Paradas, Susana Hernández-Prieto, David Lora, Elena Sanchez, Aranzazu Rosado, Tamara Caniego-Casas, Nuria Carrizo, Ana Belén Enguita, María Teresa Muñoz-Jimenez, Borja Rodriguez, Urbicio Perez-Gonzalez, David Gómez-Sánchez, Irene Ferrer, Santiago Ponce Aix, Ángel Nuñez Buiza, Pilar Garrido, José Palacios, Fernando Lopez-Rios, Eva M Garrido-Martin, Luis Paz-Ares
Journal: Journal for ImmunoTherapy of Cancer (2021)

Tumor mutational burden (TMB) is a recently proposed predictive biomarker for immunotherapy in solid tumors, including non-small cell lung cancer (NSCLC). Available assays for TMB determination differ in horizontal coverage, gene content and algorithms, leading to discrepancies in results, impacting patient selection. A harmonization study of TMB assessment with available assays in a cohort of patients with NSCLC is urgently needed.We evaluated the TMB assessment obtained with two marketed next generation sequencing panels: TruSight Oncology 500 (TSO500) and Oncomine Tumor Mutation Load (OTML) versus a reference assay (Foundation One, FO) in 96 NSCLC samples. Additionally, we studied the level of agreement among the three methods with respect to PD-L1 expression in tumors, checked the level of different immune infiltrates versus TMB, and performed an inter-laboratory reproducibility study. Finally, adjusted cut-off values were determined.Both panels showed strong agreement with FO, with concordance correlation coefficients (CCC) of 0.933 (95% CI 0.908 to 0.959) for TSO500 and 0.881 (95% CI 0.840 to 0.922) for OTML. The corresponding CCCs were 0.951 (TSO500-FO) and 0.919 (OTML-FO) in tumors with <1% of cells expressing PD-L1 (PD-L1<1%; N=55), and 0.861 (TSO500-FO) and 0.722 (OTML-FO) in tumors with PD-L1≥1% (N=41). Inter-laboratory reproducibility analyses showed higher reproducibility with TSO500. No significant differences were found in terms of immune infiltration versus TMB. Adjusted cut-off values corresponding to 10 muts/Mb with FO needed to be lowered to 7.847 muts/Mb (TSO500) and 8.380 muts/Mb (OTML) to ensure a sensitivity >88%. With these cut-offs, the positive predictive value was 78.57% (95% CI 67.82 to 89.32) and the negative predictive value was 87.50% (95% CI 77.25 to 97.75) for TSO500, while for OTML they were 73.33% (95% CI 62.14 to 84.52) and 86.11% (95% CI 74.81 to 97.41), respectively.Both panels exhibited robust analytical performances for TMB assessment, with stronger concordances in patients with negative PD-L1 expression. TSO500 showed a higher inter-laboratory reproducibility. The cut-offs for each assay were lowered to optimal overlap with FO.
ACUTE ST ELEVATION MYOCARDIAL INFARCTION (STEMI) MANAGEMENT DURING COVID-19 ERA: AN INDIAN SURVEY REPORT BY 1083 CARDIOLOGISTS
Authors: Chandrashekar Ponde, Manjula Suresh, Sengottuvelu Gunasekaran, Sundeep Mishra, Thomas Alexander, Tiny Nair
Journal: Journal of the American College of Cardiology (2021)
METABOLIC PROFILING OF HYPERTENSION IN 36,985 FINNISH INDIVIDUALS
Authors: Joonatan Palmu, Emmi Tikkanen, Aki S. Havulinna, Erkki Vartiainen, Annamari Lundqvist, Markus Perola, Mika Ala-Korpela, Pekka Jousilahti, Peter Würtz, Veikko Salomaa, Leo Lahti, Teemu Niiranen
Journal: Journal of the American College of Cardiology (2021)
IMPACT OF OUT-OF-POCKET COST DISCUSSIONS ON SACUBITRIL/VALSARTAN CLINICAL DECISION DURING PHYSICIAN-PATIENT INTERACTIONS
Authors: Dennis Akrobetu, Neal Dickert, Thuy-Vi Nguyen, J. Kelly Davis, Ada Campagna, Andrea Mitchell, Anu Sharma, Birju Rao, Candace Speight, Samantha Farley, Sophia Gutterman, Taruni Santanam, Peter Ubel
Journal: Journal of the American College of Cardiology (2021)
IMPACT OF BASELINE LEFT VENTRICULAR EJECTION FRACTION ON OUTCOMES IN COVID-19 INFECTION
Authors: Daniel P. Morin, Marc Manzo, Peter Pantlin, Rashmi Verma, Robert Bober, Selim Krim, Carl Lavie, Salima Qamruddin, Jose Tafur Soto, Hector Ventura, Eboni G. Price-Haywood
Journal: Journal of the American College of Cardiology (2021)
Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28–180 Days After COVID-19 Diagnosis — Georgia, May 2020–March 2021
Authors: Alfonso C. Hernandez-Romieu, Serena Leung, Armand Mbanya, Brendan R. Jackson, Jennifer R. Cope, Dena Bushman, Meredith Dixon, Jessica Brown, Tim McLeod, Sharon Saydah, Deblina Datta, Kate Koplan, Felipe Lobelo
Journal: MMWR Morbidity and Mortality Weekly Report (2021)

Among 3,171 nonhospitalized adult COVID-19 patients, 69% had one or more outpatient visits 28–180 days after the diagnosis. Two thirds had a visit for a new primary diagnosis, and approximately one third had a new specialist visit. Symptoms potentially related to COVID-19 were common new visit diagnoses. Visits for these symptoms decreased after 60 days but for some patients continued through 120–180 days.
CARDIOVASCULAR SYMPTOM BURDEN PRIOR TO DIAGNOSIS OF TRANSTHYRETIN AMYLOID CARDIOMYOPATHY AMONG MEDICARE BENEFICIARIES
Authors: Duncan Brown, Montserrat Vera-Llonch, Jose Tomas Ortiz Perez, Sheila R. Reddy, Eunice Chang, Marian H. Tarbox, Jose Nativi-Nicolau, Nowell Fine
Journal: Journal of the American College of Cardiology (2021)
Designing Evidence-Based Preventive Interventions That Reach More People, Faster, and with More Impact in Global Contexts
Authors: Mary Jane Rotheram-Borus
Journal: Annual Review of Clinical Psychology (2021)

This article demonstrates the substantial similarities globally among preventive, evidence-based interventions (EBIs) designed to address HIV by providing four examples: an HIV family-focused intervention, the Community Popular Opinion Leader intervention, a South African maternal/child health program, and an EBI for sex workers in India. Each identified the key problems in the target population, utilized well-established social cognitive theories, created processes for engaging the target population, set standards for staff accountability, and included routine data collection to facilitate iterative program improvements over time. Building EBIs based on these common, robust features is an alternative design strategy to replication with fidelity. These components provide a road map for researchers, especially those using new technologies, and for local providers seeking to deliver EBIs that match their clients’ and communities’ needs. Technology platforms and community organizations may serve as resources for designers of the next generation of EBIs, offering an alternative to repeatedly validating the same interventions and replicating them with fidelity.
RENÉ-THÉOPHILE-HYACINTHE LAËNNEC
Journal: JAMA (1961)

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