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November 24, 2020, Vol 324, No. 20, Pages 2013-2114

In This Issue of JAMA

Audio Highlights

Abstract Full Text
free access online only has multimedia has audio
JAMA. 2020;324(20):e200046. doi:10.1001/jama.2020.0046
Original Investigation

Effect of Nebulized Magnesium vs Placebo Added to Albuterol on Hospitalization Among Children With Refractory Acute Asthma Treated in the Emergency Department: A Randomized Clinical Trial

Suzanne Schuh, MD; Judy Sweeney, RN, BScN; Maggie Rumantir, MD; et al.
Abstract Full Text
has active quiz
JAMA. 2020;324(20):2038-2047. doi:10.1001/jama.2020.19839

This randomized trial compares the effect of nebulized magnesium vs placebo added to albuterol on hospitalization at 24 hours of children with acute asthma in respiratory distress after initial therapy in Canadian pediatric emergency departments (EDs).

Association of Hemochromatosis HFE p.C282Y Homozygosity With Hepatic Malignancy

Janice L. Atkins, PhD; Luke C. Pilling, PhD; Jane A. H. Masoli, MBChB; et al.
Abstract Full Text
JAMA. 2020;324(20):2048-2057. doi:10.1001/jama.2020.21566

This cohort study uses UK Biobank data to estimate the risk for primary hepatic carcinoma and cancer-related death by HFE variant status among community-dwelling individuals of European ancestry in England, Scotland, and Wales.

Association of State Certificate of Need Regulation With Procedural Volume, Market Share, and Outcomes Among Medicare Beneficiaries

Tarik K. Yuce, MD, MS; Jeanette W. Chung, PhD; Cynthia Barnard, PhD, MBA; et al.
Abstract Full Text
has active quiz has audio
JAMA. 2020;324(20):2058-2068. doi:10.1001/jama.2020.21115

This study investigates associations between US state certificate of need laws, which regulate health system spending and expansion, and markers of surgical quality, including procedural volume and postoperative outcomes for Medicare beneficiaries.

  • Audio Clinical Review: Health Care Facility Certificate of Need Regulations—Laws That Have Outlived Their Usefulness
Research Letter

COVID-19 and Excess All-Cause Mortality in the US and 18 Comparison Countries

Alyssa Bilinski, MSc; Ezekiel J. Emanuel, MD, PhD
Abstract Full Text
free access has active quiz
JAMA. 2020;324(20):2100-2102. doi:10.1001/jama.2020.20717

This Viewpoint compares the COVID-19 per capita overall and excess mortality rates in the US vs that of 18 OECD countries and the timing of any increases in excess mortality between February and September 2020.

Pediatric Magnet Ingestions After Federal Rule Changes, 2009-2019

Michael R. Flaherty, DO; Terry Buchmiller, MD; Mark Vangel, PhD; et al.
Abstract Full Text
JAMA. 2020;324(20):2102-2104. doi:10.1001/jama.2020.19153

This study describes trends in emergency department visits for ingestions by children of small neodymium magnets between 2009 and 2019, before, during, and after a 2014 Consumer Product Safety Commission rule restricting their sales.

US Preventive Services Task Force

Recommendation Statement

Behavioral Counseling Interventions to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: US Preventive Services Task Force Recommendation Statement

US Preventive Services Task Force
Abstract Full Text
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JAMA. 2020;324(20):2069-2075. doi:10.1001/jama.2020.21749

This 2020 US Preventive Services Task Force Recommendation Statement recommends offering or referring adults with CVD risk factors to behavioral counseling interventions to promote a healthy diet and physical activity (B recommendation).

Evidence Report

Behavioral Counseling to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Elizabeth A. O’Connor, PhD; Corinne V. Evans, MPP; Megan C. Rushkin, MPH; et al.
Abstract Full Text
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JAMA. 2020;324(20):2076-2094. doi:10.1001/jama.2020.17108

This systematic review to support the 2020 US Preventive Services Task Force Recommendation Statement on behavioral counseling to promote healthy diet and physical activity for cardiovascular disease (CVD) prevention summarizes published evidence on the benefits and harms of behavioral counseling to promote healthy diet and physical activity for CVD prevention in adults with cardiovascular risk factors.

Viewpoint

Is It Lawful and Ethical to Prioritize Racial Minorities for COVID-19 Vaccines?

Harald Schmidt, PhD; Lawrence O. Gostin, JD; Michelle A. Williams, ScD
Abstract Full Text
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JAMA. 2020;324(20):2023-2024. doi:10.1001/jama.2020.20571

This Viewpoint considers how COVID-19 vaccines can be distributed strategically, ethically, and legally given conflicts between consensus public health recommendations to prioritize allocation to disadvantaged racial and ethnic minorities and laws discouraging explicit consideration of race in policy decisions.

Scientific and Ethical Principles Underlying Recommendations From the Advisory Committee on Immunization Practices for COVID-19 Vaccination Implementation

Beth P. Bell, MD, MPH; José R. Romero, MD; Grace M. Lee, MD, MPH
Abstract Full Text
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JAMA. 2020;324(20):2025-2026. doi:10.1001/jama.2020.20847

This Viewpoint summarizes the principles guiding coronavirus disease 2019 (COVID-19) vaccine recommendations made by the Advisory Committee on Immunization Practices (ACIP), a nongovernment advisory standing committee that counsels the Centers for Disease Control and Prevention on US population vaccine use, emphasizing that any final recommendations await phase 3 safety and efficacy data from ongoing trials.

Answering Key Questions About COVID-19 Vaccines

Jesse L. Goodman, MD, MPH; John D. Grabenstein, RPh, PhD; M. Miles Braun, MD, MPH
Abstract Full Text
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JAMA. 2020;324(20):2027-2028. doi:10.1001/jama.2020.20590

This Viewpoint offers provisional answers to common questions the public will have about approved COVID-19 vaccines, including what they can expect regarding its effectiveness and safety, trustworthiness of the approval process, and whether society can return to normal once sufficient numbers of people are immunized.

Expanding Use of Clinical Genome Sequencing and the Need for More Data on Implementation

Kathryn A. Phillips, PhD; Michael P. Douglas, MS; Deborah A. Marshall, PhD
Abstract Full Text
has audio
JAMA. 2020;324(20):2029-2030. doi:10.1001/jama.2020.19933

This Viewpoint discusses the importance of understanding how next-generation genomic sequencing is being implemented—for whom noninvasive prenatal testing, whole-exome and -genome sequencing for suspected genetic disorders, and tumor sequencing is being used and who is paying for it—as precondition for knowing how the technologies can best serve patients.

A Piece of My Mind

Reflections of a COVID-19 Long Hauler

Jeffrey N. Siegelman, MD
Abstract Full Text
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JAMA. 2020;324(20):2031-2032. doi:10.1001/jama.2020.22130

In this narrative medicine essay, an emergency medical physician describes the lasting physical symptoms of a mild case of COVID-19, the effects of the illness on his family and professional community, and the lessons he’s learned about caring for symptomatic patients with normal test results.

Editorial

Revisiting States’ Experience With Certificate of Need

Vivian Ho, PhD
Abstract Full Text
JAMA. 2020;324(20):2033-2035. doi:10.1001/jama.2020.20831

Comprehensive Cardiovascular Health Promotion for Successful Prevention of Cardiovascular Disease

Sadiya S. Khan, MD, MSc; Philip Greenland, MD
Abstract Full Text
has audio
JAMA. 2020;324(20):2036-2037. doi:10.1001/jama.2020.18731
JAMA Insights

Herd Immunity and Implications for SARS-CoV-2 Control

Saad B. Omer, MBBS, MPH, PhD; Inci Yildirim, MD, PhD, MSc; Howard P. Forman, MD, MBA
Abstract Full Text
free access has active quiz has multimedia has audio
JAMA. 2020;324(20):2095-2096. doi:10.1001/jama.2020.20892

This JAMA Insights Clinical Update discusses herd immunity in the context of the COVID-19 pandemic and explains the herd immunity threshold as a function of transmissibility (R0), the role of an effective vaccine and vaccination program in sustaining herd immunity, and the risks of an infection-based herd immunity approach.

JAMA Clinical Challenge

Headache, Confusion, and Somnolence in a 27-Year-Old Woman

Rahul Sastry, MD; Krisztina Moldovan, MD; Tianyi Niu, MD
Abstract Full Text
has active quiz
JAMA. 2020;324(20):2097-2098. doi:10.1001/jama.2020.10167

A woman who had immigrated from Guatemala 1 year prior developed headache, photophobia, vomiting, somnolence, and confusion but no focal neurologic deficits. Brain CT showed ventriculomegaly, hydrocephalus, and cerebral edema, while brain MRI showed a nonenhancing lesion obstructing the aqueduct of Sylvius that moved to the fourth ventricle with hydrocephalus resolution on repeat imaging 5 days later. What is the diagnosis and what would you do next?

Medical News & Perspectives

First It Was Masks; Now Some Refuse Testing for SARS-CoV-2

Rita Rubin, MA
Abstract Full Text
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JAMA. 2020;324(20):2015-2016. doi:10.1001/jama.2020.22003

This Medical News feature examines the problem of people refusing to be tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

New Guideline Calls for Cervical Cancer Screening to Begin at Age 25 Years

Anita Slomski, MA
Abstract Full Text
JAMA. 2020;324(20):2017-2018. doi:10.1001/jama.2020.21706

This Medical News article discusses updates in the American Cancer Society’s cervical cancer screening guideline.

News From the Centers for Disease Control and Prevention

Hand Hygiene Gaps Identified

Bridget M. Kuehn, MSJ
Abstract Full Text
free access has active quiz
JAMA. 2020;324(20):2021. doi:10.1001/jama.2020.22227

Active Surveillance Testing to Prevent Staph Spread in NICUs

Bridget M. Kuehn, MSJ
Abstract Full Text
free access
JAMA. 2020;324(20):2021. doi:10.1001/jama.2020.21775
Clinical Trials Update

Cantharidin Drug-Device Clears Molluscum Contagiosum Lesions

Anita Slomski, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2020. doi:10.1001/jama.2020.21436

Long-term Mortality Outcomes in Early Breast Cancer Screening Trial

Anita Slomski, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2020. doi:10.1001/jama.2020.22569

Fecal Transplant for Clostridioides difficile Effective in Practice

Anita Slomski, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2020. doi:10.1001/jama.2020.22572

Opportunistic Atrial Fibrillation Screening Doesn’t Catch More Cases

Anita Slomski, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2020. doi:10.1001/jama.2020.22574

Antibiotics on Par With Surgery for Appendicitis

Anita Slomski, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2020. doi:10.1001/jama.2020.22576
Health Agencies Update

Study Aims to Identify Drugs That Could Be Repurposed for COVID-19

Rita Rubin, MA
Abstract Full Text
free access has active quiz
JAMA. 2020;324(20):2019. doi:10.1001/jama.2020.21726

Importance of Patient Input in Designing CRISPR Trials

Rita Rubin, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2019. doi:10.1001/jama.2020.22597

Aid for American Indian, Alaska Native Individuals Who Want to Quit Smoking

Rita Rubin, MA
Abstract Full Text
free access
JAMA. 2020;324(20):2019. doi:10.1001/jama.2020.22599
Poetry and Medicine

Alzheimer Aubade

Marjorie Maddox
Abstract Full Text
free access
JAMA. 2020;324(20):2108. doi:10.1001/jama.2020.14490
JAMA Revisited

Ecology and Medicine

Abstract Full Text
free access
JAMA. 2020;324(20):2109. doi:10.1001/jama.2019.13719
JAMA Patient Page

What Is Herd Immunity?

Angel N. Desai, MD, MPH; Maimuna S. Majumder, PhD, MPH
Abstract Full Text
free access has active quiz has multimedia has audio
JAMA. 2020;324(20):2113. doi:10.1001/jama.2020.20895

This JAMA Patient Page describes what herd immunity is, how it limits disease spread, and how it is achieved in a population either by vaccination or by infection and recovery from a disease.

Counseling on Healthy Diet and Physical Activity to Prevent Cardiovascular Disease

Jill Jin, MD, MPH
Abstract Full Text
free access has audio
JAMA. 2020;324(20):2114. doi:10.1001/jama.2020.22344

This JAMA Patient Page reviews the 2020 US Preventive Services Task Force’s recommendation to offer behavioral counseling to promote healthy diet and physical activity to prevent cardiovascular disease in adults with CVD risk factors (B recommendation).

Comment & Response

Maternal Docosahexaenoic Acid Supplementation and Bronchopulmonary Dysplasia in Infants

Chris H. P. van den Akker, MD, PhD; Wes Onland, MD, PhD; Anton H. van Kaam, MD, PhD
Abstract Full Text
JAMA. 2020;324(20):2104-2105. doi:10.1001/jama.2020.19404

Maternal Docosahexaenoic Acid Supplementation and Bronchopulmonary Dysplasia in Infants—Reply

Isabelle Marc, MD, PhD; Pierre Julien, PhD; Pascal M. Lavoie, MD, PhD
Abstract Full Text
JAMA. 2020;324(20):2105. doi:10.1001/jama.2020.19410

Cardiovascular Risk Assessment for Noncardiac Surgery

Christian Grasshoff, MD, PhD; Harry Magunia, MD
Abstract Full Text
JAMA. 2020;324(20):2105-2106. doi:10.1001/jama.2020.19407

Cardiovascular Risk Assessment for Noncardiac Surgery—Reply

Nathaniel R. Smilowitz, MD, MS; Jeffrey S. Berger, MD, MS
Abstract Full Text
JAMA. 2020;324(20):2106-2107. doi:10.1001/jama.2020.19416
Correction

Incorrect Dosages in Table

Abstract Full Text
free access
JAMA. 2020;324(20):2107. doi:10.1001/jama.2020.21736
JAMA Masthead

JAMA

Abstract Full Text
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JAMA. 2020;324(20):2013-2014. doi:10.1001/jama.2019.13712

New Online

Psychological Distress and COVID-19–Related Stressors Reported in a Longitudinal Cohort of US Adults in April and July 2020
Research Letter | November 23, 2020
Diagnosis, Management, and Pathophysiology of Arterial and Venous Thrombosis in COVID-19
JAMA Insights | November 23, 2020
Older Adults and the Mental Health Effects of COVID-19
Viewpoint | November 20, 2020
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