JAMA Network Open最新文献

{"title":"Alcohol Consumption Per Capita and Suicide: A Meta-Analysis.","authors":"Katherine Guo, Huan Jiang, Kevin D Shield, Sheryl Spithoff, Shannon Lange","doi":"10.1001/jamanetworkopen.2025.33129","DOIUrl":"10.1001/jamanetworkopen.2025.33129","url":null,"abstract":"<p><strong>Importance: </strong>At the individual level, alcohol use is an established risk factor for suicide; however, it is unclear whether this is reflected at the population level. If alcohol consumption per capita (APC), a population-level metric of total alcohol consumption used in international frameworks to measure progress in reducing the harmful use of alcohol, is associated with suicide, it could prove to be a useful target for suicide prevention initiatives.</p><p><strong>Objective: </strong>To examine whether there is an association between APC and suicide mortality, and if there is, to evaluate whether it differs by sex.</p><p><strong>Data sources: </strong>Embase, Medline, PsycINFO, and Web of Science were searched from database inception to February 24, 2025, for original quantitative studies that measured the association between APC and suicide.</p><p><strong>Study selection: </strong>Included studies consisted of (1) original quantitative studies with a longitudinal observational or cross-sectional ecological design, including pre-post designs; and (2) studies that provided a measure of association. A total of 304 records were initially identified.</p><p><strong>Data extraction and synthesis: </strong>Data extraction was completed by 1 reviewer and cross-checked by a second review. Risk of bias was assessed using the Risk of Bias in Nonrandomized Studies of Exposure tool, and evidence quality was assessed using Grading of Recommendations, Assessment, Development, and Evaluations. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline was followed. A random-effects meta-analysis was conducted to obtain a pooled estimate of the association between APC and suicide mortality. The presence of a sex difference was assessed using a random-effects meta-regression.</p><p><strong>Main outcomes and measures: </strong>The association between APC, measured as alcohol consumed in liters per person, and the suicide mortality rate.</p><p><strong>Results: </strong>A total of 13 studies were included in the main analysis. It was found that, on the population level, every 1-L increase in APC was associated with an increase of 3.59% (95% CI, 2.38%-4.79%) in the suicide mortality rate. There was no evidence of a sex difference in the association of interest.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, an increase in APC was associated with an increase in the suicide mortality rate at the population level and that the association was similar across sexes. As such, APC may be a useful target to consider within comprehensive national suicide prevention strategies.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2533129"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113139","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":"Age, Sex, BMI, Meal Timing, and Glycemic Response to Meal Glycemic Load.","authors":"Mar Calvo-Malvar, Óscar Lado-Baleato, Ana Cao Ríos, Cristina Porca Fernández, Alfonso Benítez-Calvo, Carmen Fernandez-Merino, Juan Sánchez-Castro, Robert Wagner, Marcos Matabuena, Francisco Gude","doi":"10.1001/jamanetworkopen.2025.33193","DOIUrl":"10.1001/jamanetworkopen.2025.33193","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Postprandial glycemic responses contribute to comorbidities and mortality risk, but the association between food and postprandial glucose responses in general population settings remains uncertain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the association of dietary glycemic load (GL), meal timing, age, sex, body mass index (BMI), and glycated hemoglobin (HbA1c) concentration with postprandial glycemic response to mixed meals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This cross-sectional study was conducted from August 21, 2012, to March 26, 2015, at a primary health care center in A Estrada, northwestern Spain. A population-based sample of adults aged 18 to 85 years without diabetes who were randomly selected from National Health System records agreed to participate. Data analysis was performed between April 20, 2023, and March 26, 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;The main exposure was dietary GL. Additional exposures included age, sex, BMI, meal timing, and HbA1c concentration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome and measures: &lt;/strong&gt;Postprandial glucose response over 3 hours after breakfast, lunch, and dinner was assessed using continuous glucose monitoring (CGM) for 7 days, with dietary assessments. Multilevel regression models evaluated the association between GL and glucose dynamics, accounting for age, sex, BMI, meal timing, and HbA1c concentration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 622 participants fitted with the CGM device, 514 (median age, 46 years [IQR, 36-58 years]; 64% females) met eligibility criteria and provided analyzable data. More than 1.3 million glucose measurements were analyzed across 2451 days. Dietary GL was associated with higher postprandial blood glucose levels, with maximum rises of up to 1.3 (95% CI, 0.8-1.8) mg/dL per 10 units of GL. Glucose responses were greater and more prolonged after lunches and dinners than after breakfasts, with peak values observed at 70 minutes after lunches and dinners and 50 minutes after breakfasts. Each 10-year increase in age was associated with an increase in postprandial glucose levels of 1.9 (95% CI, 0.6-3.3) mg/dL to 3.5 (95% CI, 2.2-4.8) mg/dL, while BMI was associated with glucose response after breakfast, with increases of up to 0.7 (95% CI, 0.4-1.1) mg/dL per BMI unit increase. Men had lower glucose levels than women during the late postprandial period after lunch and dinner, with differences of up to 4.6 (95% CI, 1.6-7.6) mg/dL. HbA1c concentrations and meal timing were also associated with postprandial glucose levels (eg, glucose levels increased up to 12.0 [95% CI, 6.5-17.5] mg/dL per 1% increase in HbA1c).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this cross-sectional study of adults without diabetes, higher-GL meals were associated with sustained postprandial glucose elevations, especially after lunch and dinner. Age, sex, BMI, meal timing, and HbA1c concentration were also associated with glucose resp","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2533193"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124748","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":"Error in Figure 2.","authors":"","doi":"10.1001/jamanetworkopen.2025.38286","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.38286","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2538286"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137565","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":"Error in Byline.","authors":"","doi":"10.1001/jamanetworkopen.2025.39062","DOIUrl":"10.1001/jamanetworkopen.2025.39062","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2539062"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149054","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":"Checklist-Guided Code Status Discussions in Patients for Whom Cardiopulmonary Resuscitation Is Considered Futile: An Analysis of a Randomized Clinical Trial.","authors":"Armon Arpagaus, Leta Arpagaus, Christoph Becker, Sebastian Gross, Flavio Gössi, Benjamin Bissmann, Samuel Kaspar Zumbrunn, Philipp Schuetz, Jörg D Leuppi, Drahomir Aujesky, Balthasar Hug, Thomas Peters, Stefano Bassetti, Sabina Hunziker","doi":"10.1001/jamanetworkopen.2025.33638","DOIUrl":"10.1001/jamanetworkopen.2025.33638","url":null,"abstract":"<p><strong>Importance: </strong>Code status discussions represent a fundamental aspect of advanced care planning and impose major challenges for clinicians in patients for whom cardiopulmonary resuscitation (CPR) is considered futile.</p><p><strong>Objective: </strong>To investigate the effect of a structured communication approach in code status discussions on decisions regarding code status and various quality-of-care measures for patients in whom resuscitation is considered futile.</p><p><strong>Design, setting, and participants: </strong>The GUIDE trial is a multicenter randomized clinical trial, which included patients deemed futile regarding CPR measures. The study was conducted between June 1, 2019, and April 30, 2023, in medical inpatients wards across 6 Swiss teaching hospitals. Medical inpatients for whom CPR measures were considered futile based on a prearrest Good Outcome Following Attempted Resuscitation score of 14 or higher or a Clinical Frailty Scale score of 7 or higher were eligible. Patients with cognitive or physical condition hindering meaningful conversation were excluded.</p><p><strong>Main outcomes and measures: </strong>Main outcomes included patients' code status decisions as well as preference for mechanical ventilatory assistance and intensive care unit admission. Additional outcomes assessed patients' psychological burden after the discussion measured by the State-Trait Anxiety Inventory and Hospital Anxiety and Depression scale and physicians' perception regarding the discussions.</p><p><strong>Results: </strong>A total of 177 patients (mean [SD] age, 76.3 [12.0] years; 90 [51%] female) were studied. Overall, the rate of do-not-resuscitate orders was 85%. No significant difference was observed between groups (checklist vs usual care group, 79 of 89 [89%] vs 72 of 88 [82%]; odds ratio, 1.76; 95% CI, 0.75-4.12; P = .20). However, patients in the checklist group were less likely to prefer intensive care unit admission compared with usual care (31 of 89 [36%] vs 44 of 88 [52%]; odds ratio, 0.53; 95% CI, 0.29-0.99; P = .046). Physicians perceived code status discussions using the checklist less challenging (mean [SD], 3.5 [2.8] vs 4.7 [2.8]; difference, -1.23; 95% CI, -2.1 to -0.35; P = .006). There was no significant difference in patients' psychological reaction to code status discussions measured by State-Trait Anxiety Inventory and Hospital Anxiety and Depression scale.</p><p><strong>Conclusions and relevance: </strong>This analysis of a randomized clinical trial found that checklist-guided code status discussions in patients for whom CPR was considered futile reduced their preference for intensive care unit admission while alleviating physicians' challenges during code status discussions without adversely affecting patients' psychosocial burden.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03872154.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2533638"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137555","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":"Chronic Conditions and Food Insecurity in US Children.","authors":"Nina E Hill, Deepak Palakshappa, Kao-Ping Chua","doi":"10.1001/jamanetworkopen.2025.33953","DOIUrl":"10.1001/jamanetworkopen.2025.33953","url":null,"abstract":"<p><strong>Importance: </strong>Food insecurity is associated with adverse health outcomes in children. There are few recent national studies comparing the prevalence of food insecurity among children with and without chronic conditions.</p><p><strong>Objective: </strong>To compare the prevalence of food insecurity in children with and without chronic conditions.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study included children ages 2 to 17 years in the 2019-2023 National Health Interview Survey (NHIS). Data were analyzed December 2024 through February 2025.</p><p><strong>Exposure: </strong>Reporting any of 7 chronic conditions included in the NHIS: asthma, attention-deficit/hyperactivity disorder, autism spectrum disorder, developmental delay, intellectual disability, learning disability, and prediabetes or diabetes.</p><p><strong>Main outcomes and measures: </strong>Food insecurity, defined as low or very low food security in the preceding 30 days. We calculated the prevalence of food insecurity among children with and without any of the 7 chronic conditions, both across the study period and by year. To evaluate whether any differences reflected confounding by demographic characteristics, logistic regression models were fitted that controlled for family characteristics (income, education, number of children and parents, number of employed adults, urbanicity, census region) and child characteristics (age, sex, self-reported race and ethnicity, disability, health insurance type).</p><p><strong>Results: </strong>Analyses included a weighted sample of 63 163 342 children, of whom 51.1% (95% CI, 50.5%-51.7%) were female with a mean (SD) age of 9.6 (4.6) years. The most common conditions were ADHD (8.6%; 95% CI, 8.2%-9.0%) and asthma (7.0%; 95% CI, 6.7%-7.3%). Across the study period, the weighted prevalence of food insecurity among children with and without chronic conditions was 14.8% (95% CI, 13.7%-16.0%) and 9.0% (95% CI, 8.5%-9.5%), respectively. This difference was attenuated but persisted after controlling for family and child characteristics (average marginal effect, 2.6 percentage points; 95% CI, 1.7 to 3.5 percentage points). In 2021, the prevalence of food insecurity among children with and without chronic conditions decreased to 9.7% (95% CI, 8.1%-11.7%) and 6.6% (95% CI, 5.8%-7.6%), respectively, but then increased to 15.9% (95% CI, 13.9%-18.2%) and 11.1% (95% CI, 10.1%-12.1%), respectively, by 2023.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional analysis, children were more likely to have food insecurity if they had chronic conditions than if they did not. This difference was only partially explained by several key demographic characteristics. Findings suggest children with chronic conditions should be prioritized in efforts to screen for food insecurity and efforts to enroll patients in programs designed to mitigate food insecurity.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2533953"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149131","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":"Text-to-Speech Screen Reader Accessibility of Phase 3 Consent Documents on ClinicalTrials.gov.","authors":"Alexa Lisenby, Nicholas A Giordano, Solomon Tagbor, Sydney A Axson","doi":"10.1001/jamanetworkopen.2025.30783","DOIUrl":"10.1001/jamanetworkopen.2025.30783","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2530783"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015360","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":"Opioid Administration and Reduction of Pediatric Ileocolic Intussusception.","authors":"Karina Burke, Itai Shavit, Daniel M Cohen, Doug MacDowell, Rakesh D Mistry, Santiago Mintegi, Simon Craig, Damian Roland, Michael R Miller, Samina Ali, Naveen Poonai","doi":"10.1001/jamanetworkopen.2025.33584","DOIUrl":"10.1001/jamanetworkopen.2025.33584","url":null,"abstract":"<p><strong>Importance: </strong>Ileocolic intussusception is an important and painful cause of bowel obstruction in children. Its reduction is also painful, but neither sedation nor analgesia is routinely provided, in part due to concerns surrounding gastrointestinal slowing and consequent failed reduction, and while fentanyl is a potent analgesic, little is known about its association with failed reduction.</p><p><strong>Objective: </strong>To investigate whether fentanyl is associated with failed reduction in children with intussusception.</p><p><strong>Design, setting, and participants: </strong>This was a secondary analysis of a cross-sectional study from 86 pediatric tertiary care centers in 14 countries conducted between January 1, 2017, and December 31, 2019, characterizing the association of opioid analgesia and sedation with intestinal perforation and failed reduction in children. A consecutive sample of patients 4 to 48 months of age with a discharge diagnosis of ileocolic intussusception who underwent an attempted reduction of intussusception was analyzed, excluding repeat presentations of intussusception and records lacking data for the primary outcome.</p><p><strong>Main outcome and measures: </strong>Age, sex, preexisting gastrointestinal anomalies, time to reduction, and use of prereduction opioid medication data were collected. The primary outcome was the percentage of patients with failed reduction of ileocolic intussusception. Bivariate and multivariable analyses were conducted to determine the association between fentanyl and failed reduction. Data were analyzed in February 2025.</p><p><strong>Results: </strong>In total, 3184 patients (2038 [64.01%] male), with a median (IQR) age of 17 (9-27) months, were included. Fentanyl was administered within 120 minutes of attempted reduction for 116 of 3167 patients (3.66%). Failed reduction occurred in 484 of 3184 patients (15.20%). In the unadjusted analysis, fentanyl was not associated with failed reduction (odds ratio [OR], 0.66 [95% CI, 0.36-1.22]). In the adjusted analysis, preexisting gastrointestinal anomalies (OR, 4.38 [95% CI, 1.50-12.76]), longer triage to reduction time (OR, 1.04 [95% CI, 1.01-1.07]), and younger age (OR, 0.96 [95% CI, 0.95-0.97]) were associated with failed reduction.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study of pediatric ileocolic intussusception, fentanyl administration prior to attempted reduction was not associated with failed reduction. These results suggest that fentanyl may be considered a safe therapeutic option to manage children's intussusception and subsequent reduction-related pain.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2533584"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130867","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":"Mobile App-Based Intervention and Cardiovascular Risk Factors in Patients With Uncontrolled Type 2 Diabetes: A Randomized Clinical Trial.","authors":"Pei-Zhen Zhang, Dan Guo, Chang-Qin Liu, Ning Chen, Jian-Fang Liu, Xu-Zhen Lei, Lin-Jie Yang, Ya-Ting Liu, Xu Li, Jun-Feng Huang, Chun-Min Du, Kai Wang, Wei Mo, Jia-Yang Lin, Chen-Si-Han Huang, Bing-Yan Xu, Xue-Yun Wei, De-Ying Liu, Jun-Lin Huang, Yan Huang, Yao-Ming Xue, Yan-Mei Zeng, Shi-Qun Liu, Zhi-Min Ma, Hui-Jie Zhang","doi":"10.1001/jamanetworkopen.2025.29762","DOIUrl":"10.1001/jamanetworkopen.2025.29762","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Controlling modifiable cardiovascular risk factors is important but underused for patients with type 2 diabetes (T2D). Mobile message-based intervention strategies could address this gap but lack evidence of benefit on multiple risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the effectiveness of a mobile message-based intervention in controlling cardiovascular risk factors in patients with T2D.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;In this randomized clinical trial, adults with uncontrolled T2D comorbid with cardiovascular disease (CVD) risk factors were recruited from 5 clinical centers in China. Data were collected from November 2018 to March 2022 and analyzed from January to June 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Participants were randomized to receive either usual care or a mobile message-based intervention of 6 text messages per week from different modules designed to remind, encourage, and motivate them to participate in the behaviors needed for improving glycemic control and CVD risk factor management for 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome included mean changes in hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), and systolic blood pressure (SBP) levels across 12 months. The secondary outcomes included the percentage of participants with controlled HbA1c at 12 months. Data were analyzed using the intention-to-treat principle.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 819 participants (552 men [67.4%]; mean [SD] age, 50.1 [11.9] years; mean [SD] HbA1c level, 10.2% [2.1%]) were enrolled, of whom 410 were randomized to the intervention group and 409 to the control group. During the 12-month intervention, significant reductions in the mobile message-based intervention group were observed for HbA1c levels by -2.8% (95% CI, -2.9% to -2.6%), LDL-C by -11.1 mg/dL (95% CI, -14.7 to -7.4 mg/dL), and SBP by -2.5 mm Hg (95% CI, -3.9 to -1.2 mm Hg), and in the usual care group, by -2.5% (95% CI, -2.7% to -2.3%) for HbA1c, -11.9 mg/dL (95% CI, -15.8 to -8.0 mg/dL) for LDL-C, and -0.1 mm Hg (95% CI, -1.6 to 1.3 mm Hg) for SBP. The net group differences were -0.3% (95% CI, -0.5% to -0.0%) for HbA1c, 0.9 mg/dL (95% CI, -4.5 to 6.2 mg/dL) for LDL-C, and -2.4 mm Hg (95% CI, -4.3 to -0.4 mm Hg) for SBP (P = .001 for the combined overall effect). The percentage of participants with controlled HbA1c among all participants was significantly higher in the intervention group than in the control group at 12 months (195 participants [54.0%] vs 146 participants [46.1%]; P = .04).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this randomized clinical trial of adults with uncontrolled T2D in China, a mobile message-based intervention resulted in a modest improvement in HbA1c and SBP in patients with diabetes compared with usual care. These results suggest that mobile message-based strategies for improving glycemic control an","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2529762"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954772","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":"Disparities in Nephrology Care Among Hispanic Adults-A Barrier to Timely Dialysis Vascular Access.","authors":"Kana Amari, Ana C Ricardo, Milda R Saunders","doi":"10.1001/jamanetworkopen.2025.30977","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.30977","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 9","pages":"e2530977"},"PeriodicalIF":9.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000612","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}