pp-nejm

New England Journal of Medicine — Printing Press CLI

Prerequisites: Install the CLI

This skill drives the nejm-pp-cli binary. You must verify the CLI is installed before invoking any command from this skill. If it is missing, install it first:

Install via the Printing Press installer. It defaults binaries to $HOME/.local/bin on macOS/Linux and %LOCALAPPDATA%\Programs\PrintingPress\bin on Windows:
```
npx -y @mvanhorn/printing-press-library install nejm --cli-only
```
Verify: nejm-pp-cli --version
Ensure the reported install directory is on $PATH for the agent/runtime that will invoke this skill.

If the npx install fails (no Node, offline, etc.), fall back to a direct Go install (requires Go 1.26.6 or newer). This installs into $GOPATH/bin (default $HOME/go/bin), so add that directory to $PATH instead:

go install github.com/mvanhorn/printing-press-library/library/health/nejm/cmd/nejm-pp-cli@latest

If --version reports "command not found" after install, the runtime cannot see the binary directory on $PATH. Do not proceed with skill commands until verification succeeds.

NEJM has no public API. This CLI builds an offline-queryable, agent-native corpus of NEJM articles sourced from OpenAlex's CC0 scholarly index (abstracts, authors, publication types, open-access flags), plus per-article metadata by DOI and full-text search over everything you have synced. Novel local-state commands like 'since', 'digest', 'reading-list', 'trends', and 'open-access' do things the website and PubMed wrappers cannot.

When to Use This CLI

Use this CLI when an agent or clinician needs current peer-reviewed NEJM literature metadata programmatically: the current issue, recently published articles, an article's abstract and bibliographic data by DOI, or an offline searchable corpus filtered by specialty, type, author, or free-access. It is the right choice when you want structured, composable output without driving a Cloudflare-gated browser.

Anti-triggers

Do not use this CLI for:

Do not use this CLI to read full article text behind the NEJM paywall; it surfaces abstracts and metadata only.
Do not use it for a broad multi-journal literature review; use a PubMed/Crossref tool for cross-journal search.
Do not use the corpus 'search' command before syncing; it searches only locally synced data. For live archive-wide queries without a sync, use 'openalex search'.

Unique Capabilities

These capabilities aren't available in any other tool for this API.

Local state that compounds

since — Show NEJM articles first seen in your local corpus within a time window.

Reach for this when an agent needs only what changed since the last check, not the whole issue.
```
nejm-pp-cli since 48h --agent
```
digest — Triage the current issue grouped by specialty or type with abstracts and free/paywalled flags.

Use to summarize the week's NEJM issue in one structured payload instead of fetching each article.
```
nejm-pp-cli digest --agent
```
reading-list — Queue NEJM articles by DOI locally and track read/unread state.

Use to persist a clinician's to-read queue across sessions without an account.
```
nejm-pp-cli reading-list add 10.1056/NEJMoa2506905
```

Second data source: OpenAlex (CC0)

openalex search — Search NEJM works live in the OpenAlex scholarly index: abstracts, author lists, citation counts, and open-access flags.

Use when you need abstracts or citation counts without syncing and without the Cloudflare-gated NEJM transport; data is CC0-licensed.
```
nejm-pp-cli openalex search --query "vitamin D" --from-year 2015 --to-year 2026 --per-page 10 --sort cited
```
Flags: --query (full-text search), --from-year/--to-year (publication-year range), --per-page (1-50, default 20), --sort (cited or date).

Set NEJM_OPENALEX_MAILTO to your email to enroll OpenAlex requests (live search and sync) in the polite pool — a dedicated, faster server pool. Unset, requests use the anonymous pool.

Corpus analytics

trends — Show how NEJM output distributes by specialty, article type, and issue across the synced corpus.

Use to quantify NEJM coverage patterns no single page exposes.
```
nejm-pp-cli trends --agent
```
open-access — Surface free full-text NEJM articles in the corpus, newest first.

Use for unsubscribed readers who can only act on freely-readable articles.
```
nejm-pp-cli open-access --agent --limit 20
```

HTTP Transport

This CLI uses Chrome-compatible HTTP transport for browser-facing endpoints. It does not require a resident browser process for normal API calls.

Command Reference

article — NEJM articles by DOI

nejm-pp-cli article <doi> — Fetch an NEJM article's metadata and abstract by DOI (e.g. 10.1056/NEJMoa2506905)

specialty — NEJM specialty sections

nejm-pp-cli specialty — List NEJM specialty sections

Finding the right command

When you know what you want to do but not which command does it, ask the CLI directly:

nejm-pp-cli which "<capability in your own words>"

which resolves a natural-language capability query to the best matching command from this CLI's curated feature index. Exit code 0 means at least one match; exit code 2 means no confident match — fall back to --help or use a narrower query.

Recipes

Current issue, agent-native, narrowed fields

nejm-pp-cli current --agent --select articles.doi,articles.title,articles.authors

Return only the fields an agent needs from the current issue, as compact JSON.

What's new in the last two days

nejm-pp-cli since 48h --agent

List articles first seen in the local corpus within the window.

Triage the week by specialty

nejm-pp-cli digest --group specialty --agent

Group the current issue by specialty with one-line abstracts.

Free full-text only

nejm-pp-cli open-access --limit 20 --agent

Surface freely-readable NEJM articles, newest first.

Cite an article

nejm-pp-cli article cite 10.1056/NEJMoa2506905 --format bibtex

Emit a BibTeX entry from the local article record.

Auth Setup

No authentication required.

Run nejm-pp-cli doctor to verify setup.

Agent Mode

Add --agent to any command. Expands to: --json --compact --no-input --no-color --yes.

Pipeable — JSON on stdout, errors on stderr
Filterable — --select keeps a subset of fields. Dotted paths descend into nested structures; arrays traverse element-wise. Critical for keeping context small on verbose APIs:
```
nejm-pp-cli article mock-value --agent --select id,name,status
```
Previewable — --dry-run shows the request without sending
Offline-friendly — sync/search commands can use the local SQLite store when available
Non-interactive — never prompts, every input is a flag
Read-only — do not use this CLI for create, update, delete, publish, comment, upvote, invite, order, send, or other mutating requests

Response envelope

Commands that read from the local store or the API wrap output in a provenance envelope:

{
  "meta": {"source": "live" | "local", "synced_at": "...", "reason": "..."},
  "results": <data>
}

Parse .results for data and .meta.source to know whether it's live or local. A human-readable N results (live) summary is printed to stderr only when stdout is a terminal AND no machine-format flag (--json, --csv, --compact, --quiet, --plain, --select) is set — piped/agent consumers and explicit-format runs get pure JSON on stdout.

Agent Feedback

When you (or the agent) notice something off about this CLI, record it:

nejm-pp-cli feedback "the --since flag is inclusive but docs say exclusive"
nejm-pp-cli feedback --stdin < notes.txt
nejm-pp-cli feedback list --json --limit 10

Entries are stored locally at ~/.local/share/nejm-pp-cli/feedback.jsonl. They are never POSTed unless NEJM_FEEDBACK_ENDPOINT is set AND either --send is passed or NEJM_FEEDBACK_AUTO_SEND=true. Default behavior is local-only.

Write what surprised you, not a bug report. Short, specific, one line: that is the part that compounds.

Output Delivery

Every command accepts --deliver <sink>. The output goes to the named sink in addition to (or instead of) stdout, so agents can route command results without hand-piping. Three sinks are supported:

Sink	Effect
`stdout`	Default; write to stdout only
`file:<path>`	Atomically write output to `<path>` (tmp + rename)
`webhook:<url>`	POST the output body to the URL (`application/json` or `application/x-ndjson` when `--compact`)

Unknown schemes are refused with a structured error naming the supported set. Webhook failures return non-zero and log the URL + HTTP status on stderr.

Named Profiles

A profile is a saved set of flag values, reused across invocations. Use it when a scheduled agent calls the same command every run with the same configuration - HeyGen's "Beacon" pattern.

nejm-pp-cli profile save briefing --json
nejm-pp-cli --profile briefing article mock-value
nejm-pp-cli profile list --json
nejm-pp-cli profile show briefing
nejm-pp-cli profile delete briefing --yes

Explicit flags always win over profile values; profile values win over defaults. agent-context lists all available profiles under available_profiles so introspecting agents discover them at runtime.

Exit Codes

Code	Meaning
0	Success
2	Usage error (wrong arguments)
3	Resource not found
5	API error (upstream issue)
7	Rate limited (wait and retry)
10	Config error

Argument Parsing

Parse $ARGUMENTS:

Empty, help, or --help → show nejm-pp-cli --help output
Starts with install → ends with mcp → MCP installation; otherwise → see Prerequisites above
Anything else → Direct Use (execute as CLI command with --agent)

MCP Server Installation

Install the MCP server:

go install github.com/mvanhorn/printing-press-library/library/health/nejm/cmd/nejm-pp-mcp@latest

claude mcp add nejm-pp-mcp -- nejm-pp-mcp

Verify: claude mcp list

Direct Use

Check if installed: which nejm-pp-cli If not found, offer to install (see Prerequisites at the top of this skill).
Match the user query to the best command from the Unique Capabilities and Command Reference above.

Execute with the --agent flag:

nejm-pp-cli <command> [subcommand] [args] --agent

If ambiguous, drill into subcommand help: nejm-pp-cli <command> --help.