JAMA Internal Medicine最新文献

{"title":"Article Changed to Open Access.","authors":"","doi":"10.1001/jamainternmed.2025.5638","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5638","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280252","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":"Artificial Intelligence and Clinical Care: JAMA Internal Medicine Call for Papers.","authors":"Cary P Gross, Ilana B Richman, Nathan M Stall, Jerard Z Kneifati-Hayek, Heather G Allore, Eve Rittenberg, Mitchell H Katz, Deborah Grady, Raegan W Durant, Timothy S Anderson, Yorghos Tripodis, Tracy Y Wang, Giselle Corbie, Lona Mody, Roy H Perlis, Ishani Ganguli, Sharon K Inouye","doi":"10.1001/jamainternmed.2025.4911","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.4911","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280254","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":"Simple Solutions for Complex Problems.","authors":"Raegan W Durant","doi":"10.1001/jamainternmed.2025.5300","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5300","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280317","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":"Slow-Tempo Music and Delirium/Coma-Free Days Among Older Adults Undergoing Mechanical Ventilation: A Randomized Clinical Trial.","authors":"Babar A Khan, Sikandar H Khan, Anthony J Perkins, Annie Heiderscheit, Frederick W Unverzagt, Sophia Wang, J Hunter Downs, Sujuan Gao, Linda L Chlan","doi":"10.1001/jamainternmed.2025.5263","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5263","url":null,"abstract":"<p><strong>Importance: </strong>An estimated 70% to 80% of older adults develop delirium in the intensive care unit (ICU).</p><p><strong>Objective: </strong>To determine if a slow-tempo music (60-80 beats/min) listening intervention decreases delirium duration, delirium severity, pain, or anxiety in older adults undergoing mechanical ventilation.</p><p><strong>Design, setting, and participants: </strong>This multicenter randomized clinical trial with concealed outcomes assessments was conducted in older adults undergoing mechanical ventilation from February 2020 to December 2023. Patients were enrolled from the ICUs of 2 hospitals affiliated with the Indiana University School of Medicine and from the Mayo Clinic in Rochester, Minnesota.</p><p><strong>Intervention: </strong>A music intervention comprising classical and contemporary tracks, delivered twice daily through noise-canceling headphones and tablets for up to 7 days, was compared to active control listening to a silence track delivered under identical conditions.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was delirium/coma-free days during the 7-day intervention period assessed by the Confusion Assessment Method for the ICU (CAM-ICU) and the Richmond Agitation-Sedation Scale. The secondary outcomes were delirium severity assessed by the CAM-ICU-7, pain assessed by the Critical Care Pain Observation Tool, and anxiety assessed by the visual analog scale for anxiety (VAS-A).</p><p><strong>Results: </strong>A total of 158 patients were randomized (mean [SD] age, 68 (9.2) years; 72 [45.5%] female and 86 [54.4%] male). In an intention-to-treat analysis, no differences were found in the number of delirium/coma-free days in the music intervention group compared with control (median [IQR] days, 2.5 [0-5] vs 3 [0-5]; P = .66). There were also no statistically significant differences in the mean CAM-ICU-7 scores, mean pain scores, or mean VAS-A scores over the 7-day intervention period. By end of the 7-day period, both music intervention and control groups had similar mean (SD) CAM-ICU-7 scores (2.72 [2.80] vs 2.56 [2.72]), Critical Care Pain Observation Tool scores (0.20 [0.55] vs 0.61 [1.29]), and VAS-A scores (43.6 [24.7] vs 28.8 [38.4]).</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial among older adults undergoing mechanical ventilation, a slow-tempo music intervention did not demonstrate a statistically significant decrease in delirium duration, delirium severity, pain, or anxiety symptoms.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04182334.</p>","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280228","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 Potential of Music as a Nonpharmacologic Intervention for the ICU-Sound Medicine.","authors":"Farah Acher Kaiksow, Eduard Eric Vasilevskis","doi":"10.1001/jamainternmed.2025.5260","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5260","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280283","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":"Women's Health and Artificial Intelligence.","authors":"Eve Rittenberg, Cary P Gross, Melissa Wong, Sharon K Inouye","doi":"10.1001/jamainternmed.2025.4908","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.4908","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280266","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":"Food Insecurity Interventions to Improve Blood Pressure: The Healthy Food First Factorial Randomized Clinical Trial.","authors":"Seth A Berkowitz, Alice S Ammerman, Patricia Knoepp, Robert E Anderson, Lori H Taylor, Jenefer M Jedele, Jessica Archibald, Keyi Xue, Eleanor Wertman, Benjamin Dellva, Kevin Pignone, Bahjat Qaqish, Rowena J Dolor, Stephanie Turner, John R Lumpkin, Darren A DeWalt","doi":"10.1001/jamainternmed.2025.5287","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5287","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Food insecurity is associated with worse blood pressure control, but the optimal design for a food insecurity intervention to improve blood pressure is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To inform food insecurity intervention design by comparing different intervention elements: type of food resources provided, whether to offer lifestyle counseling, and intervention duration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;A 2 × 2 × 2 factorial comparative effectiveness randomized clinical trial was carried out including adults with hypertension and systolic blood pressure (SBP) of 130 mm Hg or higher, who spoke English or Spanish, and reported food insecurity in 2 clinical networks across 364 clinical sites in North Carolina.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Food resources included healthy food subsidy redeemable at grocery stores vs biweekly healthy food box home delivery. The lifestyle intervention included either no intervention or offering telephone-based lifestyle counseling. The intervention duration included 6 months vs 12 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was SBP. Secondary outcomes were diastolic blood pressure (DBP) and food security. The primary time point was 6 months from randomization. Twelve and 18 months were secondary time points.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, 458 individuals were randomized. The mean (SD) age was 49.7 (10.7) years and 345 (75.3%) were female individuals. Fewer than 11 participants identified as American Indian/Alaska Native; 11 (2.4%) identified as Asian, 237 (51.7%) identified as Black, 20 (4.4%) identified with multiple races, fewer than 11 participants identified as Native Hawaiian/Pacific Islander, 165 (36.0%) identified as White, and 22 (4.8%) did not report a racial identity. Twenty two participants (4.8%) identified as Hispanic ethnicity. Mean (SD) preintervention SBP and DBP were 138.2 (11.9) and 87.4 (9.1) mm Hg, respectively. The food subsidy, compared with the food box, led to moderately lower SBP at the 6-month primary time point (132.8 vs 135.3 mm Hg; difference -2.5 mm Hg; 95% CI -4.1 to -0.9; P = .003). DBP was also lower at 6 months (80.5 vs 82.1 mm Hg; difference -1.5 mm Hg; 95% CI, -2.5 to -0.6). The food subsidy group also had lower SBP and DBP at 18 months (SBP difference, -2.1 mm Hg; 95% CI, -4.2 to -0.05; DBP difference, -1.6 mm Hg; 95% CI -2.8 to -0.3). SBP and DBP differences at 12 months were in favor of the food subsidy, but not significantly different. Offering lifestyle counseling did not produce significantly lower SBP or DBP than not offering counseling at any time point. The 12-month duration did not produce significantly lower SBP or DBP than 6-month duration at any time point. 6-, 12-, and 18-month food security scores decreased from baseline in all groups, and did not differ significantly between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this randomiz","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280277","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":"Pharmacologic Confounders in Steatotic Liver Disease Outcomes Research-Reply.","authors":"Pedro Ochoa-Allemant, Rebecca A Hubbard, Marina Serper","doi":"10.1001/jamainternmed.2025.5043","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5043","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280280","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":"How Physicians Can Prepare for Generative AI.","authors":"Daniel J Morgan, Adam Rodman, Katherine E Goodman","doi":"10.1001/jamainternmed.2025.4914","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.4914","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280243","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":"A Distinctive Pattern With Coexisting Malignant Arrhythmias.","authors":"Guangqiang Wang, Na Zhao, Dongxia Zhang","doi":"10.1001/jamainternmed.2025.5201","DOIUrl":"https://doi.org/10.1001/jamainternmed.2025.5201","url":null,"abstract":"","PeriodicalId":14714,"journal":{"name":"JAMA Internal Medicine","volume":" ","pages":""},"PeriodicalIF":23.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280265","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}