Neighborhood-level indices, such as the Social Vulnerability Index and Area Deprivation Index, showed weak associations with patient-level socioecological assessments (SEDOH-88) before major surgery, with poor correlation to SEDOH-88 scores. ja.ma/48oG9Es

From 2017 to 2023, #Medicare clinician participation in the Merit-Based Incentive Payment System fell from 65% to 36%, with about 23% remaining, nearly half switching tracks, and a shift towards more group-based reporting. ja.ma/3VpWX6o

Out of over 800,000 Medicaid-insured children with autism spectrum disorder or intellectual disability, more than 90% did not receive genetic testing, with disparities in rates based on race, location, and gender. ja.ma/42nCOSz

Recent gains in insurance coverage among same-sex couples have been concentrated among those who are male, married, insured by employer plans, living in states that have expanded Medicaid, and those at the top of the income distribution. ja.ma/3IsMcxj

Poverty and social disadvantage, characterized by low educational level and household income in women and men, were associated with lower fecundability and higher subfertility risks, but not miscarriage risk. ja.ma/4n4pHOe

RCT: In patients with postoperative #cervicalcancer and full-thickness stromal invasion, simultaneous integrated boost radiotherapy improved 3-year progression-free survival by 7.8% compared to conventional chemoradiotherapy, without added toxic effects. ja.ma/3KtTIsg

Digital measures collected using personal #smartphones, such as step count and cadence, were longitudinally associated with performance status, quality of life, and physical functioning in patients with advanced #cancer. ja.ma/42ER3lM

This decision analytic model, based on plausible assumptions of immune escape and vaccine recommendations, suggests that maintaining universal #COVID19 vaccine recommendations could save more lives than targeting high-risk groups alone. ja.ma/47QhWqp

Among transgender, nonbinary, and gender-diverse adults, 44% reported having gender-affirming surgery, with 82% expressing high satisfaction, and 94.4% faced barriers to accessing surgery. ja.ma/48lgc8L

In adult amateur soccer players, more repetitive head impacts were associated with reduced fractional anisotropy slope sharpness at the orbitofrontal gray-white interface, mediating the association between head impacts and task performance. ja.ma/4mrJlm1

Among adults with severe encephalitis requiring intensive care, 51.9% had an unfavorable outcome at 3 months, including a 27.1% mortality rate, with improved recovery at 1 year for autoimmune encephalitis compared to other causes. ja.ma/4mrHMVb

In a survey of general practitioners, 84% reported prescribing essentially placebo treatments at least once, with a median rate of 0.5 per week or 0.67% of consultations, more commonly among male GPs and those with more experience. ja.ma/46cp27y

Black and Hispanic patients with STEMI were less likely than White patients to present to hospitals capable of performing percutaneous coronary intervention (PCI), be transferred from non-PCI-capable hospitals, or receive PCI if eligible. ja.ma/46Bigr0

"Moving forward, refining guidelines based on rigorous, adequately powered trials remains imperative for optimizing acute SCI management." Learn more in the Invited Commentary: ja.ma/3KtcHDi

RCT: For patients with spinal cord injury, augmenting mean arterial pressure >85 vs 65 mmHg did not improve 6‐month neurological outcomes, and the MAP >85 group had more respiratory complications, longer mechanical ventilation, and worse organ dysfunction. #NCS2025 ja.ma/4naOW1t

Although #obesity increases #cancer risk, greater obesity severity was associated with reduced rates of screenings like mammography and colonoscopy, while screenings like FOBT increased with higher BMI levels. ja.ma/42C0Skq

In a survey US adults, 72.64% supported expanding community-based #mentalhealth services, while fewer favored involuntary interventions. ja.ma/46wjNOX

Despite the risks, most US allopathic medical schools do not clearly ban faculty from industry-sponsored speakers' bureaus, with only 38% explicitly prohibiting them and others allowing or not addressing the issue. ja.ma/42BLmFb

In out-of-hospital cardiac arrest cases, EMS agencies that shifted from endotracheal intubation to supraglottic airway use saw improved outcomes, especially where baseline survival was low, despite overall declining return of spontaneous circulation. ja.ma/4mrbbz5

Among patients with hepatocellular carcinoma, a machine learning-based decision-support model estimated accurate risk stratification and identified the potential for improved survival and identification of liver transplant candidates. ja.ma/46GUQl4

The RELATE rating scale, used to assess clinician communication skills in managing implicit bias, demonstrated strong construct validity, good interrater reliability, and internal consistency. ja.ma/46oVYIz

#AI translation of pediatric inpatient discharge instructions was comparable to professional translation for Spanish, but performed worse for Chinese, Vietnamese, and Somali. ja.ma/46pdOLL

In patients aged 50 to 69 with early-stage #breastcancer and a low Oncotype DX score, receiving adjuvant radiotherapy reduced locoregional recurrence compared to those omitting radiotherapy or both radiotherapy and endocrine therapy. ja.ma/4niBlFl

Among patients with uterine fibroids, uterine fibroid embolization (UFE) is underutilized compared to surgery, with differences in use based on race, insurance status, and income level. ja.ma/46qSVzV

In Mali, preterm birth was associated with an increased risk of #malaria infection in children, particularly those born to multigravid and secundigravid women who were not infected during pregnancy. ja.ma/46pqvGa

In patients aged 65 and older with early-stage #cervicalcancer, receiving recommended surgery or radiotherapy improved 5-year survival rates and decreased cervical cancer–specific mortality. ja.ma/3K4ZLU9

#Insomnia and obstructive #sleepapnea during pregnancy were associated with a higher risk of ischemic placental disease, severe morbidity, and preterm birth compared to those without these sleep disorders. ja.ma/4gvCbMo

The PREVENT model underestimated ASCVD risk among patients not treated with statins, while the PCE estimates more accurately reflected observed risk without statin therapy. ja.ma/3K6LtSP

In women with BRCA mutations, the effectiveness of risk-reducing early-salpingectomy with delayed oophorectomy was assessed by the proportion of ovarian cancers prevented compared to no surgery, providing a feasible recruitment target for the PROTECTOR study. ja.ma/46l1ZpO

Integrated pediatric behavioral health services and psychotropic prescriptions were associated with improved psychosocial symptoms in children who receive care at federally qualified health centers. ja.ma/42u5mJN

RCT: For women with urinary incontinence, treatment via a mobile app led to faster symptom reduction than video visits, but there were no meaningful differences at 12 weeks, and booster video visits did not improve outcomes. ja.ma/47NGGzM

Amazing work by my PhD student Dr Jessica Shipley is out exploring the impacts of pregnancy on relapse and disability outcomes in women woth moderate to severe disability. We found that like in women with mild disease, relapse rates fell by up to 75% in this population.

EHR-based recruitment via portal messaging efficiently identified potential trial participants, but yielded low engagement, with only 7% expressing interest and demographic factors influencing message view and enrollment rates. ja.ma/46iLtXh

Frailty in women aged 70 and older undergoing surgery for nonmetastatic #breastcancer was associated with higher rates of local complications like surgical site infections and systemic complications such as sepsis, regardless of age. ja.ma/3Vj4owg

Global social isolation increased by 13.4% from 2009 to 2024, mainly after 2019, with initial rises in lower-income groups and ongoing increases across all income levels, peaking in 2020 with disparities between income groups. ja.ma/4mlVBVt

Non–US-born pregnant individuals had a lower risk of prenatal #depression diagnosis but a higher risk of moderate to severe depression symptoms, varying by race and ethnicity. ja.ma/46h0Gs0

In children hospitalized with acute respiratory illness, #influenza and RSV testing significantly increased from 2016-20 to 2023-24, while SARS-CoV-2 testing decreased from 2020-21 to 2023-24. ja.ma/3I9yAHb

Pregnancy in women with moderate to severe MS reduced relapse rates by 59% to 75% during pregnancy, increased them by 36% postpartum, but did not influence long-term disability progression compared to nonpregnant women. ja.ma/4n7jO2V

Among women with #breast cancer, the prevalence of pathogenic or likely pathogenic BRCA1 and BRCA2 variants varied by race, with Hispanic women being 2.58 times more likely than non-Hispanic women to carry BRCA1 variants. ja.ma/3JXdVXt

EtCO2 values during out-of-hospital cardiac arrest resuscitation did not differ between laryngeal tube and endotracheal intubation, with both devices similarly estimating return of spontaneous circulation. ja.ma/4pokgvd

Cluster RCT: Reducing the frequency of short daily rest periods between shifts for health care workers resulted in fewer sickness-related absences and a positive economic return. ja.ma/468H8Hq

📄 New from Dr. Reeves, CHEAR faculty & staff. These findings highlight the need to train dentists to care for youths with SCD and for clinicians to stress the importance of dental care. #SickleCellAwarenessMonth 🔗 bit.ly/Reeves_JAMA @um-ihpi.bsky.social @jamanetworkopen.com

Between 2015 and 2020, nearly one in six deaths among incarcerated individuals were due to trauma or acute care surgical (ACS) conditions, with suicides accounting for 74.8% of traumatic deaths and cirrhosis for 68.7% of ACS-related deaths. ja.ma/465ytWo

Solid-organ transplant recipients had a higher risk of developing nontuberculous mycobacterial disease compared to the general population, with lung and other organ recipients showing increased mortality associated with the disease. ja.ma/4gpOU3a

Childhood loneliness was associated with faster cognitive decline and increased dementia risk in adulthood, with adult loneliness mediating part of these associations but not significantly modifying them. ja.ma/4mdNyJY

Maturational imbalance may be a risk factor for heavy drinking onset, which in turn may pose risks for developing alcohol-induced damage of both brain-behavior systems. ja.ma/4n4Dgxh

Parental diseases of despair, including substance use disorder, alcohol-related disease, and suicidal behavior, were associated with a higher risk of suicidal events in their children. ja.ma/4ntGERR

In patients with pancreatic ductal adenocarcinoma and cholangiocarcinoma, circulating tumor DNA testing showed mutation concordance with tissue next-generation sequencing and indicated markers associated with higher odds of progressive disease. ja.ma/3Ialp8U

RCT: For older adults with chronic low back pain, 12 weeks of #acupuncture needling was associated with improved pain-related disability at 6 months and 12 months compared to usual care alone. ja.ma/464NSGp

Among over 80,000 women with a history of cervical #cancer, anal cancer incidence was highest in those aged 65 to 74, reaching 17.6 cases per 100,000 person-years, and increased with time since cervical cancer diagnosis. ja.ma/3VHthBQ