JAMA Pediatrics最新文献

{"title":"Cardiovascular Disease Risk Among Childhood and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis.","authors":"Chi Shu, Qian Yang, Qiaosen Dong, Zhuan Zou, Ahmad Jayedi, Bin Huang, Evropi Theodoratou, Kostantinos K Tsilidis, Chuan Xu, Yazhou He","doi":"10.1001/jamapediatrics.2026.4478","DOIUrl":"10.1001/jamapediatrics.2026.4478","url":null,"abstract":"<p><strong>Importance: </strong>There is a growing population of childhood, adolescent, and young adult (CAYA) cancer survivors (younger than 40 years). Cardiovascular disease (CVD) becomes one of the primary sequelae during their survival, yet the relative risk and variations in each age group have not been comprehensively investigated.</p><p><strong>Objective: </strong>To quantify the relative risk of CVD among CAYA cancer survivors compared with noncancer CAYA individuals, and to examine differences across various subgroups.</p><p><strong>Data sources: </strong>MEDLINE, Embase, and Cochrane Library databases were systematically searched from inception to November 5, 2025.</p><p><strong>Study selection: </strong>Cohort studies reporting incident CVD after cancer diagnosis in CAYA populations with noncancer controls were eligible.</p><p><strong>Data extraction and synthesis: </strong>Two reviewers independently extracted data and assessed study quality. Risk ratios (RRs) with 95% CIs were pooled using random-effects models. Meta-regression and subgroup analyses were conducted to evaluate sources of heterogeneity and the affect of study characteristics on relative risks.</p><p><strong>Main outcomes and measures: </strong>Relative risk of incident CVD.</p><p><strong>Results: </strong>Thirty-nine cohort studies, including 536 399 CAYA cancer survivors and 1 810 572 cancer-free peers, were analyzed. Overall, CAYA cancer survivors had a higher CVD risk compared with noncancer CAYA individuals (RR, 1.99; 95% CI, 1.66-2.40), corresponding to an excess of 90 CVD events per 1000 survivors. Childhood cancer survivors demonstrated a higher relative risk (RR, 2.48; 95% CI, 1.87-3.27) than young adult cancer survivors (RR, 1.61; 95% CI, 1.37-1.88). Meta-regression indicated that longer follow-up duration was associated with a smaller relative effect estimate (P = .02), but the increased CVD risk remained significant after 20 years of cancer diagnosis. Findings were consistent across subgroups stratified by follow-up time, CVD, and cancer subtypes, and remained robust in sensitivity analyses restricted to prospective, high-quality studies, population-based studies, studies including 5-year survivors, nonsibling control studies, and studies that adjusted for competing mortality risk.</p><p><strong>Conclusions and relevance: </strong>In this study, CAYA cancer survivors experienced an increased risk of CVD, with the greatest vulnerability observed in those diagnosed during childhood. These results highlight the need for age-specific and time-sensitive CVD surveillance to improve well-being during the survival of this growing population.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074637","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":"Governance and Responsible Deployment of AI-Enabled Pediatric Care.","authors":"François Modave, Lindsay A Thompson, Eric S Kirkendall","doi":"10.1001/jamapediatrics.2026.4089","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4089","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074733","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":"Beneficence, Nonmaleficence, and the Case for a Savings Clause-Reply.","authors":"Kathleen McDeavitt, Moti Gorin","doi":"10.1001/jamapediatrics.2026.4214","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4214","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074643","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 AI as a New Kind of Listener.","authors":"François Modave, Mona Sayedul Huq, Lindsay A Thompson","doi":"10.1001/jamapediatrics.2026.4424","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4424","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074744","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":"Diagnostic Yield of Genetic Testing in Cerebral Palsy: A Systematic Review and Meta-Analysis.","authors":"Sun-Young Joo, Eun Jae Ko, Bo Ryun Kim, Jaewon Kim, Jiyong Kim, Hye Jung Park, Jin A Yoon, You Gyoung Yi, Hyun Jung Lee, Hoo Young Lee, Ah-Ra Cho, Ja Young Choi, Seungbeen Hong, Juntaek Hong, Dae-Hyun Jang","doi":"10.1001/jamapediatrics.2026.4471","DOIUrl":"10.1001/jamapediatrics.2026.4471","url":null,"abstract":"<p><strong>Importance: </strong>Genetic etiologies are increasingly recognized in cerebral palsy (CP), yet diagnostic yields across different clinical subgroups and phenotypes remain inconsistent, limiting evidence-based prioritization of genetic testing.</p><p><strong>Objective: </strong>To determine the pooled diagnostic yield of genetic testing in CP and identify clinical and phenotypic predictors that influence diagnostic yields.</p><p><strong>Data sources: </strong>A systematic search of PubMed, Embase, and the Cochrane Library was conducted for studies published between January 2010 and August 25, 2025.</p><p><strong>Study selection: </strong>Peer-reviewed observational studies reporting genetic testing results in cohorts of at least 10 patients with CP.</p><p><strong>Data extraction and synthesis: </strong>Data were extracted independently by 2 reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A random-effects model with logit transformation was used to calculate pooled diagnostic yields with 95% CIs. Heterogeneity was evaluated using the I2 statistic and Cochran Q test.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the pooled diagnostic yield of genetic testing stratified by CP etiology (cryptogenic, noncryptogenic, and mixed/unselected cohorts). Secondary outcomes included diagnostic yields across phenotype-based subgroups defined by brain magnetic resonance imaging (MRI) findings, motor types, comorbidities, facial dysmorphism, congenital anomalies, and clinical trajectory.</p><p><strong>Results: </strong>A total of 31 studies met inclusion criteria, of which 20 were included in the quantitative meta-analysis. The overall pooled diagnostic yield in unselected CP cohorts was 0.19 (95% CI, 0.11-0.32; I2 = 95.1%). In patients with cryptogenic CP, the yield was 0.44 (95% CI, 0.37-0.50; I2 = 72.2%), compared with 0.13 (95% CI, 0.07-0.21; I2 = 85.1%) in noncryptogenic cases. Higher yields were observed in patients with normal brain MRI findings (25%-80%), facial dysmorphism (66%-71%), congenital anomalies (85%), and neurological atypical features (50%). Combined next-generation sequencing and chromosomal microarray analysis provided the highest pooled yield of 0.53 (95% CI, 0.43-0.62) in the cryptogenic subgroup.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, genetic testing demonstrated a high diagnostic yield in CP, particularly in cryptogenic cases and in patients with specific clinical phenotypes. These findings suggest the integration of genomic evaluation into the standard diagnostic workup for CP, guided by clinical indicators, to facilitate timely diagnosis and personalized management.</p>","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074579","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":"Cerebral Palsy-a Symptom Rather Than a Diagnosis.","authors":"Harry Ostrer, Dimitri A Christakis","doi":"10.1001/jamapediatrics.2026.4581","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.4581","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074629","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 of Technology-Augmented Behavioral Counseling for Risky Firearm Behaviors: A Randomized Clinical Trial.","authors":"Patrick M Carter, Ken Resnicow, Philip Stallworth, Jason Goldstick, Alejandro Carrillo, Laura Seewald, Rebecca M Cunningham, Lynn Massey, Katherine Battisti, Benjamin Schoener, Maureen A Walton","doi":"10.1001/jamapediatrics.2026.3893","DOIUrl":"10.1001/jamapediatrics.2026.3893","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Firearm violence is a leading cause of morbidity and mortality for US adolescents and emerging adults (A/EAs). Health care visits are an important opportunity to provide preventive counseling addressing risky firearm behaviors (RFBs), which increase fatal and nonfatal firearm injury risk, as well as associated negative health and social outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine the efficacy of a technology-augmented behavioral counseling intervention addressing RFBs among A/EAs seeking emergency department (ED) treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This prospective, 2-arm randomized clinical trial was conducted at 2 US trauma center EDs in Michigan. A/EAs aged 16 to 30 years reporting past 3-month firearm carriage and smartphone ownership were enrolled from January 24, 2022, through October 25, 2024, and randomized to either IntERact or enhanced usual care (EUC). Follow-up surveys were conducted through April 2025, with data analysis conducted from May 2025 to November 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;IntERact included (1) 3 sessions of trauma-informed behavioral counseling delivered by a telehealth health coach and integrating motivational interviewing and strengths-based care management; and (2) a smartphone application delivering additional tailored therapeutic content between counseling sessions. Both were delivered during the 30 days after an ED visit. EUC participants received an assessment-only application for 30 days. Participants in both groups received a resource brochure and gunlock(s).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was self-reported RFBs evaluated at 3 and 6 months. Secondary outcomes included experiencing physical violence and nonfirearm physical aggression. Exploratory outcomes included violent injuries, violence consequences, criminal justice outcomes, substance use and consequences, mental health symptoms, and any firearm violence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 373 patients were randomized to IntERact (n = 186) or EUC (n = 187). Mean (SD) age was 25.0 (3.7) years, 195 patients (52.3%) were female, and 278 of 371 patients (74.9%) reported past 3-month RFBs at baseline. Compared to EUC, IntERact participants demonstrated significantly greater reductions in RFBs at 6 months (IntERact: -57.4%; EUC: -25.4%; rate ratio [RR] = 0.51; 95% CI, 0.33-0.79). IntERact participants also demonstrated significantly greater reductions in experiencing physical violence at 3 months (RR = 0.46; 95% CI, 0.26-0.81) compared to EUC. Among exploratory outcomes, between-group comparisons demonstrated that compared to EUC, patients in the IntERact group showed greater reductions in violent injuries at 3 and 6 months, as well as violence consequences, substance use, anxiety, and depression outcomes at 6 months. Patients in the IntERact group also showed greater reductions in delinquency, violent offending, and any fire","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074574","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":"TORCH Infections in Pregnancy and Autism Spectrum Disorders.","authors":"Mark R Schleiss","doi":"10.1001/jamapediatrics.2026.4468","DOIUrl":"10.1001/jamapediatrics.2026.4468","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016812","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 Need for Vitamin K Among US Newborns.","authors":"Richa Lakhotia, Talkad S Raghuveer","doi":"10.1001/jamapediatrics.2026.3581","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3581","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016792","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 Need for Vitamin K Among US Newborns-Reply.","authors":"Laura R Kair, Jaspreet Loyal, Carrie A Phillipi","doi":"10.1001/jamapediatrics.2026.3584","DOIUrl":"https://doi.org/10.1001/jamapediatrics.2026.3584","url":null,"abstract":"","PeriodicalId":14683,"journal":{"name":"JAMA Pediatrics","volume":" ","pages":""},"PeriodicalIF":17.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016731","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}