Edward W. Campion

Aortic Dilatation in Patients with Bicuspid Aortic Valve

Bicuspid aortic valve is the most common congenital heart defect in adults. Dilatation of the proximal aorta, or bicuspid aortopathy, is present in approximately half these patients and can lead to complications, including aneurysm formation and aortic dissection.

Ebola and Quarantine

The governors of a number of states, including New York and New Jersey, recently imposed 21-day quarantines on health care workers returning to the United States from regions of the world where they may have cared for patients with Ebola virus disease. We understand their motivation for this policy — to protect the citizens of their states from contracting this often-fatal illness. This approach, however, is not scientifically based, is unfair and unwise, and will impede essential efforts to stop these awful outbreaks of Ebola disease at their source, which is the only satisfactory goal. The governors action is like .xa0.xa0.

A Glimpse of the Next 100 Years in Medicine

As the Journals 200th year comes to a close, we consider the changes and challenges medicine faces in the decades ahead.

H1N1 Influenza A Disease — Information for Health Professionals

In the first 2 weeks in April, cases of infection with an untypable influenza A virus began to be identified in Mexico and southern California.1 Although the exact sequence of events is uncertain, by the third week of April it was established that the illness resulted from a triple recombination of human, avian, and swine influenza viruses; the virus has been found to be H1N1. This virologic analysis allowed for the development of a polymerase-chain-reaction (PCR) test to determine whether, in any given person, illness with the protean manifestations of cough, fever, sore throat, diarrhea, and nausea could be confirmed .xa0.xa0.

Ebola — An Ongoing Crisis

In March 2014, an outbreak of a febrile illness associated with a high case fatality rate was identified in the Gueckedou region of Guinea–Conakry, a remote part of West Africa. An international field investigation was initiated. On April 16, the Journal published a preliminary report identifying the outbreak as due to Ebola virus.1 The initial sequence data showed that the outbreak strain was Zaire ebolavirus, but a strain distinct from those identified in prior outbreaks, such as those in the Democratic Republic of Congo (DRC) and Gabon. In Guinea there appeared to be ongoing human-to-human transmission. Over the next 4 .xa0.xa0.

A SPRINT to the Finish

When investigators enroll patients in a clinical study, they make an implicit contract with each participant. Through the data and safety monitoring board (DSMB) mechanism, they fulfill the first part of the contract — protecting the participant from avoidable harm that might result from participation in the trial. They fulfill the second part of the contract — the commitment to honor the time at risk that the participant spent in the trial — by deriving the clearest and most clinically directive information possible from the data gathered during the trial. This task takes tremendous time and energy. The SPRINT (Systolic .xa0.xa0.

Tracking the Peer-Review Process

Each week more than 60 manuscripts arrive at our editorial offices for consideration for publication in the Journal. Our job is to determine which of them are most likely to influence clinical practice or biomedical research. It is a challenging task. Here is how we do it. When a manuscript arrives, a staff member checks to make sure that all materials required for submission are included (see “Information for Authors,” which is posted on our Web site and appears in most issues of the Journal ). If everything is present, the article is logged into our computerized manuscript-tracking system. The .xa0.xa0.

Ebola in West Africa at One Year — From Ignorance to Fear to Roadblocks

It has been a year since the first case associated with the current Ebola virus outbreak in West Africa was identified and just over 8 months since we first started reporting on the outbreaks that stemmed from that patient in Guinea.1 Todays posts at NEJM.org include an anniversary update on the fight against Ebola virus disease (EVD).2 It is painfully clear that the worlds initial handling of this dangerous outbreak was far from optimal, but we now appear to be making progress in the battle. This headway is evidenced by the observations that the rate of appearance of new cases .xa0.xa0.

A New Web Site and a New Policy

The Journal has been on the World Wide Web for more than five years.1 During that time, rapid, global dissemination of new scientific information has come to be expected. Broad searches of the medical literature and of scientific data bases are now possible. Information on line is becoming highly interlinked and increasingly is available in multimedia formats. To serve the diverse needs of our readers, we are taking steps to use the technology of electronic publication to enhance and complement the print version of the Journal. However, the many new electronic possibilities must not obscure our fundamental goal: to .xa0.xa0.

The Importance — and the Complexities — of Data Sharing

We at the Journal are committed to making the sharing of clinical trial data an effective, efficient, and sustainable part of biomedical research. This issue of the Journal includes three Perspective articles on the topic of data sharing. Grossman et al. describe the Genomic Data Commons, which will initially house raw genomic data and diagnostic, histologic, and clinical outcome data from National Cancer Institute–funded projects.1 Lo and DeMets recommend steps for addressing clinical trialists’ primary reservations about sharing their data.2 And Rockhold et al. consider progress to date and a path forward that could avert the creation of a fragmented .xa0.xa0.