JAMA最新文献

{"title":"Childhood Vaccination Rates Still Lag Behind Prepandemic Levels.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.4675","DOIUrl":"https://doi.org/10.1001/jama.2025.4675","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avoidable Deaths Rise in US Despite Increased Health Spending.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.4674","DOIUrl":"https://doi.org/10.1001/jama.2025.4674","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"219 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart Health Highlights From ACC—Marathon Runners and Mortality, Oral GLP-1 Drugs, and More","authors":"Jennifer Abbasi","doi":"10.1001/jama.2025.2731","DOIUrl":"https://doi.org/10.1001/jama.2025.2731","url":null,"abstract":"This Medical News article is an interview with Ajay Kirtane, MD, SM, about research highlights from this year’s American College of Cardiology Scientific Sessions.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a)","authors":"Samia Mora, Florian Kronenberg","doi":"10.1001/jama.2025.2373","DOIUrl":"https://doi.org/10.1001/jama.2025.2373","url":null,"abstract":"This JAMA Insights discusses lipoprotein(a), including factors associated with elevated lipoprotein(a) levels, how to manage them, and atherosclerotic cardiovascular disease risk.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modeling Reemergence of Vaccine-Eliminated Infectious Diseases Under Declining Vaccination in the US","authors":"Mathew V. Kiang, Kate M. Bubar, Yvonne Maldonado, Peter J. Hotez, Nathan C. Lo","doi":"10.1001/jama.2025.6495","DOIUrl":"https://doi.org/10.1001/jama.2025.6495","url":null,"abstract":"ImportanceWidespread childhood vaccination has eliminated many infectious diseases in the US. However, vaccination rates are declining, and there are ongoing policy debates to reduce the childhood vaccine schedule, which may risk reemergence of previously eliminated infectious diseases.ObjectiveTo estimate the number of cases and complications in the US under scenarios of declining childhood vaccination for measles, rubella, poliomyelitis, and diphtheria.Design, Setting, and ParticipantsA simulation model was used to assess the importation and dynamic spread of vaccine-preventable infectious diseases across 50 US states and the District of Columbia. The model was parameterized with data on area-specific estimates for demography, population immunity, and infectious disease importation risk. The model evaluated scenarios with different vaccination rates over a 25-year period. Inputs for current childhood vaccination rates were based on 2004-2023 data.Main Outcomes and MeasuresThe primary outcomes were estimated cases of measles, rubella, poliomyelitis, and diphtheria in the US. The secondary outcomes were estimated rates of infection-related complications (postmeasles neurological sequelae, congenital rubella syndrome, paralytic poliomyelitis, hospitalization, and death) and the probability and timing for an infection to reestablish endemicity.ResultsAt current state-level vaccination rates, the simulation model predicts measles may reestablish endemicity (83% of simulations; mean time of 20.9 years) with an estimated 851 300 cases (95% uncertainty interval [UI], 381 300 to 1.3 million cases) over 25 years. Under a scenario with a 10% decline in measles-mumps-rubella (MMR) vaccination, the model estimates 11.1 million (95% UI, 10.1-12.1 million) cases of measles over 25 years, whereas the model estimates only 5800 cases (95% UI, 3100-19 400 cases) with a 5% increase in MMR vaccination. Other vaccine-preventable diseases are unlikely to reestablish endemicity under current levels of vaccination. If routine childhood vaccination declined by 50%, the model predicts 51.2 million (95% UI, 49.7-52.5 million) cases of measles over a 25-year period, 9.9 million (95% UI, 6.4-13.0 million) cases of rubella, 4.3 million cases (95% UI, 4 cases to 21.5 million cases) of poliomyelitis, and 197 cases (95% UI, 1-1000 cases) of diphtheria. Under this scenario, the model predicts 51 200 cases (95% UI, 49 600-52 600 cases) with postmeasles neurological sequelae, 10 700 cases (95% UI, 6700-14 600 cases) of congenital rubella syndrome, 5400 cases (95% UI, 0-26 300 cases) of paralytic poliomyelitis, 10.3 million hospitalizations (95% UI, 9.9-10.5 million hospitalizations), and 159 200 deaths (95% UI, 151 200-164 700 deaths). In this scenario, measles became endemic at 4.9 years (95% UI, 4.3-5.6 years) and rubella became endemic at 18.1 years (95% UI, 17.0-19.6 years), whereas poliovirus returned to endemic levels in about half of simulations (56%) at an estimated 19.6 y","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Mental Health Diagnoses Among Publicly Insured Children","authors":"Janet R. Cummings, Xin Hu, Jordan Marchak, Cristian Ramos, Ilana Graetz, Xu Ji","doi":"10.1001/jama.2025.4605","DOIUrl":"https://doi.org/10.1001/jama.2025.4605","url":null,"abstract":"ImportanceChildren living in poverty are at increased risk of mental health and neurodevelopmental disorders. Little is known about the trends in diagnoses of these disorders among children enrolled in public insurance programs, such as Medicaid, which insure more than 1 in 3 US children.ObjectiveTo provide comprehensive, multistate estimates of changes in the percentage of publicly insured children with mental health and/or neurodevelopmental disorder diagnoses.Design, Setting, and ParticipantsThis serial, cross-sectional study used administrative claims data from 22 states to test trends from 2010 to 2019 in the percentage of publicly insured children aged 3 to 17 years with mental health or neurodevelopmental disorder diagnoses. Regression models included a dummy variable for each year, controlled for child demographics, county-level metropolitan status, median household income, and US Census region. Adjusted risk differences were estimated, with standard errors clustered at the state level.ExposureCalendar year.Main OutcomesAny mental health or neurodevelopmental disorder diagnosis in the calendar year, and any diagnosis in 1 of 13 specific diagnostic categories.ResultsA total of 129 306 637 child-year observations (29 925 633 unique publicly insured children) were included. The percentage of publicly insured children with any diagnosed mental health or neurodevelopmental disorder increased from 10.7% in 2010 to 16.5% in 2019; this change remained significant after adjustment for covariates (adjusted risk difference [aRD], 6.7 percentage points [95% CI, 5.0-8.4]). Statistically significant increases were also observed in 9 of the 13 diagnostic categories examined. The largest absolute increases were observed for attention-deficit/hyperactivity disorder (aRD, 2.3 percentage points [95% CI, 1.4-3.3]), trauma- and stressor-related disorders (aRD, 1.7 percentage points [95% CI, 0.9-2.5]), anxiety disorders (aRD, 1.6 percentage points [95% CI, 1.2-2.1]), autism spectrum disorders (aRD, 1.1 percentage points [95% CI, 0.9-1.4]), depressive disorders (aRD, 0.9 percentage points [95% CI, 0.6-1.3]), and other neurodevelopmental disorders (aRD, 2.6 percentage points [95% CI, 1.8-3.5]).Conclusions and RelevanceThe percentage of publicly insured children receiving any mental health or neurodevelopmental disorder diagnosis significantly increased between 2010 and 2019, with increases observed for most diagnostic categories examined. These findings highlight the need for access to appropriate services in safety net systems and other settings that serve this population.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contributions of Pure Science to Progressive Medicine.","authors":"","doi":"10.1001/jama.2024.18823","DOIUrl":"https://doi.org/10.1001/jama.2024.18823","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Year of the Cicadas","authors":"Kimberly Hieftje","doi":"10.1001/jama.2025.2814","DOIUrl":"https://doi.org/10.1001/jama.2025.2814","url":null,"abstract":"The loud chorus of the Great Eastern cicadas interrupted the promise of spring for a mother mourning at the graveside of her 6-year-old son, but 17 years later when they returned, a now faculty member and pediatrics researcher, in this narrative medicine essay, she ponders her journey of grief.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Health Survey Infrastructure for Chronic Disease","authors":"Audrey D. Zhang, Sara D. Turbow, Himali M. Weerahandi, Timothy S. Anderson","doi":"10.1001/jama.2025.5395","DOIUrl":"https://doi.org/10.1001/jama.2025.5395","url":null,"abstract":"This Viewpoint discusses an opportunity to promote safeguarding, expanding, and modernizing the national health survey infrastructure as a crucial part of a comprehensive approach to address chronic disease.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143867183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Diagnoses Among Publicly Insured Children.","authors":"Vikki Wachino,Richard G Frank","doi":"10.1001/jama.2025.6359","DOIUrl":"https://doi.org/10.1001/jama.2025.6359","url":null,"abstract":"","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}