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September 2020 - July 1883




August 11, 2020, Vol 324, No. 6, Pages 529-614

In This Issue of JAMA

Audio Highlights

Abstract Full Text
free access online only has audio
JAMA. 2020;324(6):e200032. doi:10.1001/jama.2020.0032
Original Investigation

Effects of Liberal vs Restrictive Transfusion Thresholds on Survival and Neurocognitive Outcomes in Extremely Low-Birth-Weight Infants: The ETTNO Randomized Clinical Trial

Abstract Full Text
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JAMA. 2020;324(6):560-570. doi:10.1001/jama.2020.10690

This randomized clinical trial assesses the effect of liberal vs restrictive red blood cell transfusion thresholds (based on postnatal age and current health state) on death or disability at 24 months of age among extremely low-birth-weight infants.

Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children: The BLINK Randomized Clinical Trial

Abstract Full Text
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JAMA. 2020;324(6):571-580. doi:10.1001/jama.2020.10834

This randomized trial compares the effects of higher add power (+2.50 D) vs lower add power (+1.50 D) soft multifocal contact lenses vs single-vision contact lenses on myopia progression at 3 years in children aged 7 to 11 years with myopia.

Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

Abstract Full Text
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JAMA. 2020;324(6):581-593. doi:10.1001/jama.2020.10888

This nonrandomized controlled trial allowed children with appendicitis and their families to choose antibiotic therapy vs laparoscopic appendectomy as initial management, and compares 1-year disability days and treatment success—no need for later surgery—between the groups.

Research Letter

COVID-19 Cases and Deaths in Federal and State Prisons

Abstract Full Text
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JAMA. 2020;324(6):602-603. doi:10.1001/jama.2020.12528

This study describes coronavirus disease 2019 (COVID-19) case rates and deaths among federal and state prisoners and compares them with corresponding rates for the US population.

Persistent Symptoms in Patients After Acute COVID-19

Abstract Full Text
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JAMA. 2020;324(6):603-605. doi:10.1001/jama.2020.12603

This case series describes COVID-19 symptoms persisting a mean of 60 days after onset among Italian patients previously discharged from COVID-19 hospitalization.

Trends in Daily Use of Biotin Supplements Among US Adults, 1999-2016

Abstract Full Text
JAMA. 2020;324(6):605-607. doi:10.1001/jama.2020.8144

This pharmacoepidemiology study uses NHANES data to characterize the prevalence and trends in use of high-dosage biotin supplementation among US adults between 1999 and 2016.


COVID-19: Beyond Tomorrow

The Work of Philanthropy in Responding to COVID-19 and Addressing Inequality: A New Foundation

Abstract Full Text
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JAMA. 2020;324(6):541-542. doi:10.1001/jama.2020.12904

In this Viewpoint the president of the Ford Foundation calls on philanthropic and other wealthy organizations to make creative and generous grants to less well-endowed counterpart institutions and communities to redress the racial and socioeconomic disparities exposed by the COVID-19 pandemic and continued killings of Black Americans.

Pooling Data From Individual Clinical Trials in the COVID-19 Era

Abstract Full Text
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JAMA. 2020;324(6):543-545. doi:10.1001/jama.2020.13042

This Viewpoint proposes principles and processes to allow pooling of individual patient data from clinical trials given decelerating participant recruitment at sites where the COVID-19 surge has been controlled and new cases are diminishing.

The Advisory Committee on Immunization Practices and Its Role in the Pandemic Vaccine Response

Abstract Full Text
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JAMA. 2020;324(6):546-547. doi:10.1001/jama.2020.13167

This Viewpoint discusses the role of the Advisory Committee on Immunization Practices, a federal advisory committee that makes vaccine-related recommendations to the CDC and DHHS, in guiding the development and deployment of COVID-19 vaccines.

COVID-19 Response in Lebanon: Current Experience and Challenges in a Low-Resource Setting

Abstract Full Text
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JAMA. 2020;324(6):548-549. doi:10.1001/jama.2020.12695

This Viewpoint describes the unique challenges faced by Lebanon, a small densely populated country with a fragmented health care system, in its response to the emerging COVID-19 pandemic, and it summarizes organizational, testing, and communications policies the nation has implemented that might be useful to other resource-limited countries and settings.

Prevention of Unintentional Medication Overdose Among Children: Time for the Promise of the Poison Prevention Packaging Act to Come to Fruition

Abstract Full Text
JAMA. 2020;324(6):550-551. doi:10.1001/jama.2020.2152

This Viewpoint discusses the success of US legislation to help prevent medication overdoses in children and suggests strategies to continue to reduce these overdoses, including changes to child-resistant packaging.

Clinical, Legal, and Ethical Aspects of Artificial Intelligence–Assisted Conversational Agents in Health Care

Abstract Full Text
JAMA. 2020;324(6):552-553. doi:10.1001/jama.2020.2724

This Viewpoint discusses evidence supporting use of conversational agents in health care—artificial intelligence (AI) programs that interpret users’ questions or concerns and respond with answers—and proposes 12 domains (eg, safety, transparency, security) that clinicians and health care organizations should evaluate before using them for patient care.

The Convergence of Neurology and Psychiatry: The Importance of Cross-Disciplinary Education

Abstract Full Text
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JAMA. 2020;324(6):554-555. doi:10.1001/jama.2020.0062

This Viewpoint reviews the historical convergence and then divergence of psychiatry and neurology as clinical disciplines and calls for a transformation of graduate and postgraduate education to integrate the two and span intersections of the humanities, philosophy, and science.

A Piece of My Mind

Good for Us All

Abstract Full Text
JAMA. 2020;324(6):556-557. doi:10.1001/jama.2020.12630

In this narrative medicine essay, a gastroenterologist recalls a microagression from a patient during fellowship training and realizes the fault lay with the medicine profession and calls for antiracist training as one measure in dismantling race-based health disparities.


Reducing the Progression of Myopia

Abstract Full Text
JAMA. 2020;324(6):558-559. doi:10.1001/jama.2020.10953
JAMA Insights

Clinical Update

Lipids and Lipoproteins in 2020

Abstract Full Text
JAMA. 2020;324(6):595-596. doi:10.1001/jama.2020.5685

This JAMA Insights Clinical Update reviews the central role of apolipoprotein B100 molecule (apoB)–containing lipoproteins in the development of atherosclerotic cardiovascular disease (ASCVD), with implications for patient risk assessment and choice of lipid-lowering therapy.

JAMA Clinical Guidelines Synopsis

Management of Acute Pulmonary Embolism

Abstract Full Text
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JAMA. 2020;324(6):597-598. doi:10.1001/jama.2020.3905

This JAMA Clinical Guidelines Synopsis summarizes the European Society of Cardiology’s 2019 guidelines for diagnosis and management of acute pulmonary embolism.

JAMA Clinical Challenge

Abdominal Pain and an Appendiceal Mass

Abstract Full Text
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JAMA. 2020;324(6):599-600. doi:10.1001/jama.2020.4707

A 68-year-old woman with history of uterine carcinoma (unknown histology) treated 30 years prior had 2 months of generalized abdominal pain and distention but no fever, nausea, vomiting, diarrhea, constipation, blood in the stool, or weight loss. CBC and serum chemistries were unremarkable; CT and MRI showed pelvic ascites and an enhancing lesion at the base of the cecum; CEA level was 18 ng/mL (normal <5 ng/mL). What is the diagnosis and what would you do next?

Editor's Note
Medical News & Perspectives

School Superintendents Confront COVID-19—“There Are No Good Options for Next Year”

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JAMA. 2020;324(6):534-536. doi:10.1001/jama.2020.12575

This Medical News story discusses the challenge of minimizing the risk of COVID-19 in kindergarten through 12th grades while maintaining prepandemic educational standards.

The JAMA Forum

Health Care Cost Growth Benchmarks in 5 States

Abstract Full Text
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JAMA. 2020;324(6):537-538. doi:10.1001/jama.2020.12437
News From the Centers for Disease Control and Prevention

Emerging Drug-Resistant Meningitis Detected in the US

Abstract Full Text
JAMA. 2020;324(6):540. doi:10.1001/jama.2020.13761

Severe Hypoglycemia Linked With Over-the-Counter Supplement

Abstract Full Text
JAMA. 2020;324(6):540. doi:10.1001/jama.2020.12914
Biotech Innovations

Promising Early Results for Potent, Long-Acting HIV Injection

Abstract Full Text
JAMA. 2020;324(6):539. doi:10.1001/jama.2020.14031

Regulatory T Cells Tested in Patients With COVID-19 ARDS

Abstract Full Text
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JAMA. 2020;324(6):539. doi:10.1001/jama.2020.13765

In Familial ALS, Antisense Agent Reduces Disease-Related Proteins

Abstract Full Text
JAMA. 2020;324(6):539. doi:10.1001/jama.2020.14032
The Arts and Medicine

Amabié—A Japanese Symbol of the COVID-19 Pandemic

Abstract Full Text
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JAMA. 2020;324(6):531-533. doi:10.1001/jama.2020.12660

This Arts and Medicine feature discusses Amabié, a 19th-century Japanese yōkai character said to protect against spread of infection, who has become the symbol of public health hygiene in Japan during the COVID-19 pandemic.

Poetry and Medicine


Abstract Full Text
JAMA. 2020;324(6):610. doi:10.1001/jama.2020.5659
JAMA Revisited

Internal and External Antisepsis

Abstract Full Text
JAMA. 2020;324(6):611. doi:10.1001/jama.2019.13565
JAMA Patient Page

Keeping Medicine Away From Children

Abstract Full Text
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JAMA. 2020;324(6):614. doi:10.1001/jama.2020.7206

This JAMA Patient Page describes practices for keeping household medicine safely stored away from children and what to do if an unintentional medicine exposure happens.

Comment & Response

Need for Additional Trials of Vitamin C for Sepsis

Abstract Full Text
JAMA. 2020;324(6):607-608. doi:10.1001/jama.2020.8633

Need for Additional Trials of Vitamin C for Sepsis—Reply

Abstract Full Text
JAMA. 2020;324(6):608. doi:10.1001/jama.2020.8636

Physician Orders for Life-Sustaining Treatment and ICU Admission Near the End of Life

Abstract Full Text
JAMA. 2020;324(6):608. doi:10.1001/jama.2020.8639

Physician Orders for Life-Sustaining Treatment and ICU Admission Near the End of Life—Reply

Abstract Full Text
JAMA. 2020;324(6):608-609. doi:10.1001/jama.2020.8654
JAMA Masthead


Abstract Full Text
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JAMA. 2020;324(6):529-530. doi:10.1001/jama.2019.13558