JAMA Pediatrics最新文献

{"title":"Ethics of Lifestyle Counsel Alone in a GLP-1 Era.","authors":"Kathryn M Stephenson,Naomi R M Schwartz,Douglas S Diekema","doi":"10.1001/jamapediatrics.2025.3327","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3327","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"1 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103488","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":"Expanding the Evidence on Late Preterm Steroids to Twin Pregnancies.","authors":"Mark A Clapp,E Nicole Teal,Cynthia Gyamfi-Bannerman","doi":"10.1001/jamapediatrics.2025.3293","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3293","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"87 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103319","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":"Pediatric Firearm Deaths and State Laws-Unequal Burden.","authors":"Shiuan-Chih Chen,Chun-Chieh Chen","doi":"10.1001/jamapediatrics.2025.3317","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3317","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"15 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103517","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":"The Family Caregiver Act-Safeguarding the Human Care Chain.","authors":"Eli Y Adashi,I Glenn Cohen","doi":"10.1001/jamapediatrics.2025.3093","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3093","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"17 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059074","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":"Reflections on Exception From Informed Consent in Pediatric Trials-Reply.","authors":"Jay R Malone,Barbara A Gaines,Christine M Leeper","doi":"10.1001/jamapediatrics.2025.3076","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3076","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"123 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058997","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":"Digital Health Interventions in Pediatric Perioperative Care: A Network Meta-Analysis.","authors":"Ziyue Luo,Ruihao Zhou,Kailei Nong,Xiran Peng,Lu Chen,Peiyi Li,Sisi Deng,Mengchan Ou,Xuechao Hao,Ling Ye,Yaqiang Wang,Guo Chen,Sheyu Li,Tao Zhu","doi":"10.1001/jamapediatrics.2025.3099","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3099","url":null,"abstract":"ImportancePediatric surgical patients often face considerable perioperative challenges, including anxiety and pain. Digital health interventions offer promise, but their efficacy remains uncertain.ObjectiveTo compare the effects of digital health interventions in pediatric perioperative care.Data SourcesPubMed, Embase, Web of Science, CENTRAL, and CINAHL databases were searched up to March 1, 2025.Study SelectionRandomized clinical trials (RCTs) involving pediatric patients (aged ≤18 years) undergoing surgery with general anesthesia, where digital technology was used as a distraction intervention.Data Extraction and SynthesisA frequentist network meta-analysis with random-effects model was used to calculate standardized mean differences (SMDs) or mean differences (MDs) with 95% CIs. Interventions were ranked using P values, risk of bias assessed using the Cochrane risk of bias tool 2, and certainty of evidence rated using the Grading of Recommendations, Assessment, Development, and Evaluations framework.Main Outcomes and MeasuresCritical outcomes included pediatric preoperative anxiety, postoperative pain, emergence delirium, and induction compliance. Important but noncritical outcomes encompassed parental preoperative anxiety and postoperative satisfaction.ResultsOf 7734 RCTs screened, 49 were included involving 4535 youth (pooled mean age, 7.42 years; 95% CI, 6.85 to 7.99; 2989 [65.9%] male) with 7 interventions: virtual reality (VR), 2-dimensional (2D) games, 2D videos, interactive robots, midazolam, control (standard care), and enhanced control (eg, booklets). Compared to control, VR (SMD, -1.14; 95% CI, -1.54 to -0.74; moderate certainty), 2D videos (SMD, -1.08; 95% CI, -1.51 to -0.65; moderate certainty), 2D games (SMD, -1.02; 95% CI, -1.54 to -0.49; low certainty), and enhanced control (SMD, -0.83; 95% CI, -1.53 to -0.13; low certainty) reduced preoperative anxiety. VR (SMD, -1.09; 95% CI, -1.58 to -0.59; moderate certainty), 2D games (SMD, -0.87; 95% CI, -1.62 to -0.12; low certainty), and 2D videos (SMD, -0.56; 95% CI, -1.06 to -0.06; moderate certainty) reduced postoperative pain. VR showed the greatest effect on compliance (MD, -0.93; 95% CI, -1.62 to -0.24; moderate certainty). No significant differences compared to control.Conclusions and RelevanceThis network meta-analysis of RCTs found that VR, 2D videos, and 2D games significantly reduced pediatric perioperative anxiety and pain and improved induction compliance. These findings support the use of digital health interventions in pediatric perioperative care and their broader clinical adoption.","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"34 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058999","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":"Disparities in Sexual Violence Among Native Hawaiian and Other Pacific Islander Adolescents in Hawai'i.","authors":"Meripa T Godinet,Damaris Lopez Mercado,Jonathan Purtle,Jim P Stimpson,Alexander N Ortega","doi":"10.1001/jamapediatrics.2025.3165","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3165","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"45 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058944","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":"Efficacy and Safety of GLP-1 RAs in Children and Adolescents With Obesity or Type 2 Diabetes: A Systematic Review and Meta-Analysis.","authors":"Pareeta Kotecha,Wenxi Huang,Ya-Yun Yeh,Valerie Martino Narvaez,Darlene Adirika,Huilin Tang,Angelina V Bernier,Sarah C Westen,Steven M Smith,Jiang Bian,Jingchuan Guo","doi":"10.1001/jamapediatrics.2025.3243","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3243","url":null,"abstract":"ImportanceObesity affects 1 in 5 children and adolescents, increasing the risk of type 2 diabetes (T2D). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are among the few pharmacotherapy options available for this population, necessitating a comprehensive evaluation of efficacy and safety.ObjectiveTo assess the efficacy and safety of GLP-1 RAs in children and adolescents (<18 years) with obesity, prediabetes, or T2D.Data SourcesA systematic search was conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for randomized clinical trials (RCTs) published from inception until February 28, 2025. Data analysis was completed from January 2025 to April 2025.Study SelectionRCTs comparing GLP-1 RAs to placebo in children and adolescents with obesity, overweight, prediabetes, or T2D with reported safety and efficacy data were included.Data Extraction and SynthesisTwo reviewers independently extracted data on sample size, population, interventions, follow-up, and outcomes. Risk of bias was assessed using version 2 of the Cochrane risk of bias tool (RoB2). Efficacy outcomes (except lipids) were analyzed as estimated treatment differences, lipids as estimated treatment ratios, and safety via rate ratios. A random-effects inverse variance model was used for all outcomes.Main Outcomes and MeasuresThe primary efficacy outcomes were change in hemoglobin A1c (HbA1c) (in percentage points), fasting glucose (in milligrams per deciliter), body weight (in kilograms), body mass index (BMI, calculated as weight in kilograms divided by height in meters squared), BMI z scores or percentiles, BMI standard deviation score (SDS), lipid outcomes, and blood pressure. Exploratory efficacy outcomes included obstructive sleep apnea and metabolic dysfunction-associated steatohepatitis or metabolic dysfunction-associated steatotic liver disease. Safety outcomes included gastrointestinal adverse effects (GI AEs), infections, hepatobiliary disorders, suicidal ideation or behaviors, depression, hypoglycemia, and adverse event discontinuations.ResultsA total of 18 RCTs (11 in obesity, 6 in T2D, and 1 in prediabetes) with 1402 participants (838 GLP-1 RA users and 564 placebo) were included (mean [range] age, 13.7 [6-17] years; 831 female participants (59.3%); median [IQR] treatment duration, 0.51 [0.25-1.00] years). GLP-1 RAs significantly reduced HbA1c (-0.44%; 95% CI, -0.68% to -0.21%), fasting glucose (-9.92 mg/dL; 95% CI, -16.20 to -3.64), body weight (-3.02 kg; 95% CI, -4.98 to -1.06), BMI (-1.45; 95% CI, -2.40 to -0.49), BMI SDS (-0.20; 95% CI, -0.36 to -0.05), BMI percentile (-7.24%; 95% CI, -12.97% to -1.51%), and systolic blood pressure (-2.73 mm Hg; 95% CI, -4.04 to -1.43) and increased GI AE (log[rate ratio] [RR], 0.75). Other AEs, including suicidal ideation or behaviors, showed no significant differences.Conclusions and RelevanceIn this systematic review and meta-analysis of 18 trials, GLP-1 RAs significantly improved glycemic, w","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"36 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058946","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":"Trends in Circumcision Among Newborn Males in the US.","authors":"Ping Yang,Xianming Zhu,Eshan U Patel,Thomas C Quinn,Mary K Grabowski,Aaron A R Tobian","doi":"10.1001/jamapediatrics.2025.2464","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.2464","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"34 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058948","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":"Reflections on Exception From Informed Consent in Pediatric Trials.","authors":"Mar Romero-Lopez,Susan Wootton,Jon Tyson","doi":"10.1001/jamapediatrics.2025.3079","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2025.3079","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":"69 1","pages":""},"PeriodicalIF":26.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145059160","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}