JAMA Pediatrics最新文献

{"title":"Error in Table and Text.","authors":"","doi":"10.1001/jamapediatrics.2026.0188","DOIUrl":"10.1001/jamapediatrics.2026.0188","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":"587"},"PeriodicalIF":18.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12954593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Removing the Universal Hepatitis B Birth-Dose Vaccination in the US.","authors":"Margaret L Lind,Matt D T Hitchings,Roshni P Singh,Benjamin P Linas,Derek A T Cummings,Rachel L Epstein","doi":"10.1001/jamapediatrics.2026.1226","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1226","url":null,"abstract":"ImportanceIn December 2025, the Advisory Committee on Immunization Practices (ACIP) voted to replace the universal hepatitis B birth-dose recommendation with shared clinical decision-making for infants born to mothers who screen negative for hepatitis B surface antigen. Although the proposal would not alter recommendations for infants of unscreened mothers, historical data suggest that removing a universal birth-dose vaccine recommendation may reduce vaccination coverage in this group.ObjectiveTo estimate the impact of replacing universal hepatitis B virus (HBV) birth-dose vaccination with a targeted recommendation on neonatal and subsequent chronic HBV infections in the US.Design, Setting, and ParticipantsA compartmental model and simulated a US birth cohort (n = 3 659 289) under the 2 vaccine recommendations: universal birth-dose vaccination and targeted birth-dose vaccination vaccine recommendations, where the birth dose was recommended to infants of screened-positive or unscreened mothers and shared-decision making is recommended for infants of screened-negative mothers. Parameter values were literature derived and uncertainty was incorporated across 5000 iterations. These data were analyzed from September through November 2025.ExposuresBirth-dose vaccine recommendations and birth-dose vaccination coverage among infants of unscreened mothers.Main Outcomes and MeasuresNumbers of neonatal and subsequent chronic HBV infections.ResultsWith the current maternal HBV screening rate of 86%, the universal birth-dose vaccine recommendation resulted in a median of 1292 neonatal infections (95% percentile interval [PI], 670-2228). In comparison, the targeted birth-dose vaccine recommendation was associated with 628 additional neonatal infections (95% PI, 340-1034) when birth-dose vaccination coverage among infants of unscreened mothers was 10% (mirroring historic coverage declines under a targeted recommendation) and 69 additional infections (95% PI, -32 to 190) when coverage was 80% (mirroring levels under a universal recommendation.) To offset the excess infections under the targeted birth-dose vaccine recommendation, more than 100 000 additional pregnant individuals would need to be screened if the birth-dose vaccination coverage among infants of unscreened mothers was 80%, and more than 400 000 if coverage was 10%.Conclusions and RelevanceFindings from this study indicate that the targeted birth-dose vaccine recommendation will likely increase neonatal infections unless maternal screening rises substantially or vaccination coverage among infants of unscreened mothers exceeds current levels. As historic data show such improvements are unlikely, these findings underscore the continued importance of universal screening and vaccination as complementary safeguards.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"21 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promise and Equity Gaps in Online Care for Posttraumatic Stress in Children.","authors":"Shawn J Rangel","doi":"10.1001/jamapediatrics.2026.1135","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1135","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"23 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Stress After Trauma in Physically Injured Children: A Randomized Clinical Trial.","authors":"Linda Ewing-Cobbs,Shari L Wade,Devi Miron Murphy,Kelly McNally,Hilary Hickingbotham,Amy E Clark,Angela P Presson,Heather T Keenan","doi":"10.1001/jamapediatrics.2026.1143","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1143","url":null,"abstract":"ImportancePosttraumatic stress symptoms (PTSS) affect nearly 50% of children experiencing physical trauma. PTSS often persists after physical recovery and is associated with reduced health-related quality of life.ObjectiveTo evaluate efficacy of the online therapist-assisted, trauma-focused Reducing Stress After Trauma (ReSeT) program in reducing PTSS in children after hospitalization for physical injury.Design, Setting, and ParticipantsA 2-arm randomized clinical trial with 1:1 assignment to the ReSeT program or usual care (UC) was conducted between 2021 and 2024 at 4 sites with level 1 trauma centers. Injured children ages 8 to 17 years were recruited from inpatient and short-stay units. Exclusion criteria included moderate to severe traumatic brain injury, preexisting severe psychiatric problems, current psychotherapy, developmental disorders preventing participation, interpersonal violence, hospitalization for more than 30 days, and injury-related death of friend or family.InterventionThe ReSeT program has 8 online psychoeducational modules containing 3 to 4 short interactive videos that children completed independently. Modules are followed by an electronic health session with a therapist to practice cognitive behavioral skills and desensitization using trauma narrative techniques. Parents received optional psychoeducational resources.Main Outcomes and MeasuresGeneralized linear regression, controlling for baseline scores, was used to examine group differences on the Child Posttraumatic Stress Disorder Scale (CPSS) scores obtained 10 weeks (primary outcome) and 6 months (secondary outcome) after randomization.ResultsA total of 638 of 722 children screened positive at 1 week, and 271 children and caregivers completed the CPSS at 4 weeks. The highest value from each respondent on each item was summed, and 130 children (48%) had CPSS scores of 11 or greater, indicating potential eligibility for enrollment. A total of 93 children (72%; mean [SD] age, 11.7 [2.4] years; 56 male [60.2%]) were included in the study; 47 were randomized to the ReSeT cohort and 46 were randomized to the UC cohort. Intention-to-treat analyses indicated significant reduction in combined CPSS scores in the ReSeT vs UC cohorts, -4.2 points (95% CI, -7.6 to -0.8 points) at 10 weeks, which was maintained at the 6-month follow-up, -5.5 points (95% CI, -8.9 to -2.1 points).Conclusions and RelevanceFindings of this randomized clinical trial show that the ReSeT program was an effective, brief, trauma-focused intervention for reducing PTSS after physical injury. It offers a potentially cost-effective, scalable program to address American College of Surgeons standards for psychological screening and treatment for children sustaining PTSS.Trial RegistrationClinicalTrials.gov Identifier: NCT04838977.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"26 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision Fog in the Treatment of Pediatric Obstructive Sleep Apnea.","authors":"Lingkang Dong, Kaiming Su","doi":"10.1001/jamapediatrics.2026.1192","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1192","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":18.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Parents Need to Know About Screen Time and Language Development.","authors":"Lillian E Sutton,Lindsay A Thompson","doi":"10.1001/jamapediatrics.2026.0125","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.0125","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle-Free Prediction of Fetal Lung Maturity Using Vaginal Fluid Extracellular Vesicles.","authors":"Seungmin Kim,Hyeon Ji Kim,Hyo Jin Lee,Hyun Joon Im,Da Eun Jeong,Young Mi Jung,Eun Byul Lee,Hyunku Shin,Jee Yoon Park,Yeonho Choi","doi":"10.1001/jamapediatrics.2026.1081","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1081","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-Related School Absenteeism Among US Children.","authors":"Genevieve G Guyol,Kyle DeMeo Cook,Caitlin Lombardi","doi":"10.1001/jamapediatrics.2026.1274","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1274","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"25 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic Impact of Delaying the Infant Hepatitis B Vaccination Schedule","authors":"Eric W. Hall, Prabhu Gounder, Heather Bradley, Noele P. Nelson","doi":"10.1001/jamapediatrics.2026.1221","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1221","url":null,"abstract":"Importance Universal administration of hepatitis B (HepB) vaccine at birth is a cornerstone for hepatitis B virus (HBV) elimination efforts in the US. In 2025, the Advisory Committee on Immunization Practices (ACIP) recommended delaying HepB vaccine initiation among infants born to birth parents who tested negative for hepatitis B surface antigen (HBsAg). Objective To evaluate the health and economic impact of delaying HepB vaccination among US infants. Design, Setting, and Participants A Markov model of HBV infections was acquired among a cohort infants, born in 2025, up to age 18 years. The model incorporated HBsAg prevalence among birthing parents, HBsAg testing during pregnancy or delivery, vertical or perinatal and household or community HBV transmission among children, and sequalae from chronic infection. This study was conducted in the US. Exposures Eight scenarios in which the first HepB dose was delayed at intervals between 2 months and 12 years, applied either only to infants born to birth parents who tested negative for HBsAg or to parents who either tested negative for HBsAg or had unknown HBsAg status. All delayed vaccination scenarios were compared with administering first HepB dose at birth. Scenarios were modeled with perfect and imperfect adherence to recommendations. Main Outcomes and Measures Outcomes included acute and chronic HBV infections acquired until age 18 years, additional associated lifetime HBV-related morbidity and mortality, and health care costs (2025 US dollars). Results The health and economic outcomes of 3 628 934 infants were modeled in this analysis. All delayed vaccination scenarios resulted in more infections, worse health outcomes, and higher costs than administering first HepB dose at birth. Under perfect adherence, delaying HepB vaccination by 2 months for infants of parents negative for HBsAg led to an additional 90 acute infections (range, 16-107), 76 chronic infections (range, 14-97), 29 HBV-related deaths (range, 6-53), with $16.4 million in added costs for infants born during 1 year. Delaying to 12 years resulted in an additional 190 acute infections (range, 61-233), 50 deaths (range, 15-83), and nearly $30 million in added costs. Delaying HepB vaccination among infants of parents with unknown HBsAg status or imperfect adherence to the vaccination schedule amplified all negative outcomes. Conclusions and Relevance Results of this economic evaluation quantified the potential impact of changing ACIP recommendations. Even brief delays in HepB vaccine initiation were associated with a substantial increase in HBV infections, adverse health outcomes, and health care costs.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"133 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decision Fog in the Treatment of Pediatric Obstructive Sleep Apnea-Reply.","authors":"Gillian M Nixon,Kirsten P Perrett","doi":"10.1001/jamapediatrics.2026.1189","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.1189","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"6 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}