April 6, 2021, Vol 325, No. 13, Pages 1239-1356

In This Issue of JAMA

Audio Highlights

Abstract Full Text

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JAMA. 2021;325(13):e2017869. doi:10.1001/jama.2020.17869

Audio Editors' Summary: Low- vs High-Intensity Walking for PAD, Celecoxib for Stage III CRC, N95 Reprocessing Review, and more

Original Investigation

Effect of Low-Intensity vs High-Intensity Home-Based Walking Exercise on Walk Distance in Patients With Peripheral Artery Disease: The LITE Randomized Clinical Trial

Mary M. McDermott, MD; Bonnie Spring, PhD; Lu Tian, ScD; et al.

Abstract Full Text

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JAMA. 2021;325(13):1266-1276. doi:10.1001/jama.2021.2536

This randomized trial compares the effects of comfortable low-intensity home-based walking exercise vs high-intensity exercise sufficient to elicit ischemic symptoms vs nonexercise control on 6-minute walk distance among patients with peripheral arterial disease (PAD).

Effect of Celecoxib vs Placebo Added to Standard Adjuvant Therapy on Disease-Free Survival Among Patients With Stage III Colon Cancer: The CALGB/SWOG 80702 (Alliance) Randomized Clinical Trial

Jeffrey A. Meyerhardt, MD, MPH; Qian Shi, PhD; Charles S. Fuchs, MD, MPH; et al.

Abstract Full Text

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JAMA. 2021;325(13):1277-1286. doi:10.1001/jama.2021.2454

This randomized trial compares the effect of adding celecoxib to standard adjuvant chemotherapy in improving disease-free survival among patients treated for stage III colon cancer.

Editorial
Celecoxib for Stage III Colon Cancer
David J. Kerr, MD, DSc; Sarah Chamberlain, BMedSci, MBChB; Rachel S. Kerr, MBChB, PhD

Antimicrobial Use in a Cohort of US Nursing Homes, 2017

Nicola D. Thompson, MS, PhD; Nimalie D. Stone, MD; Cedric J. Brown, MS; et al.

Abstract Full Text

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JAMA. 2021;325(13):1286-1295. doi:10.1001/jama.2021.2900

This cross-sectional survey assessed the risks of antimicrobial use among 15 276 nursing home residents across 161 facilities.

Editorial
Opportunities to Improve Antimicrobial Use in US Nursing Homes
Christopher J. Crnich, MD, PhD; Preeti Malani, MD, MSJ

Research Letter

Emergence of a Novel SARS-CoV-2 Variant in Southern California

Wenjuan Zhang, PhD; Brian D. Davis, BSc; Stephanie S. Chen, BSc; et al.

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JAMA. 2021;325(13):1324-1326. doi:10.1001/jama.2021.1612

This research describes findings of sequencing and phylogenetic analyses of SARS-CoV-2 isolates from symptomatic patients cared for at Cedar-Sinai Medical Center in November-December 2020 during a regional surge in cases and hospitalizations.

Conversations with Dr Bauchner: Coronavirus Vaccine Update From the CDC With Nancy E. Messonnier, MD

Editorial
SARS-CoV-2 Viral Variants—Tackling a Moving Target
John R. Mascola, MD; Barney S. Graham, MD, PhD; Anthony S. Fauci, MD
- Conversations with Dr Bauchner: Coronavirus Update With CDC Director Rochelle Walensky - February 17, 2021
- Conversations with Dr Bauchner: Coronavirus Vaccine Update From the CDC With Nancy E. Messonnier, MD

Changes in Shooting Incidence in Philadelphia, Pennsylvania, Between March and November 2020

Jessica H. Beard, MD, MPH; Sara F. Jacoby, PhD, MPH; Zoë Maher, MD; et al.

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JAMA. 2021;325(13):1327-1328. doi:10.1001/jama.2021.1534

This study uses police department registry data to describe trends in incidence of firearm shootings and deaths in January-November 2020, before and after the closure of nonessential businesses in March, the killing of George Floyd in May, and the partial lifting of containment policies in June.

Trends in Age at Natural Menopause and Reproductive Life Span Among US Women, 1959-2018

Duke Appiah, PhD, MPH; Chike C. Nwabuo, MD, MPH; Imo A. Ebong, MD, MS; et al.

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JAMA. 2021;325(13):1328-1330. doi:10.1001/jama.2021.0278

This national survey study uses the National Health and Nutrition Examination Survey (NHANES) to describe trends in age at natural menopause, age at menarche, and reproductive life span, and variables associated with shorter and longer spans, among US women between 1959-1962 and 2015-2018.

Viewpoint

Health Policy

Reinventing the Center for Medicare and Medicaid Innovation

Donald M. Berwick, MD; Rick Gilfillan, MD

Abstract Full Text

JAMA. 2021;325(13):1247-1248. doi:10.1001/jama.2021.3203

This Viewpoint makes 6 recommendations for how the Center for Medicare and Medicaid Innovation, as it enters its second decade, can better fulfill its mission of testing health care payment and service delivery models and scale them up to a national level to reduce health care expenditures and improve quality and safety.

Editorial
Health Care Is a Right, Not a Privilege: A New Series on US Health Care and Health Policy
Howard Bauchner, MD; Phil B. Fontanarosa, MD, MBA; Karen Joynt Maddox, MD, MPH
- Conversations with Dr Bauchner: Health Care Reform in the Biden Era

COVID-19: Beyond Tomorrow

The Potential Future of the COVID-19 Pandemic: Will SARS-CoV-2 Become a Recurrent Seasonal Infection?

Christopher J. L. Murray, MD; Peter Piot, MD

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JAMA. 2021;325(13):1249-1250. doi:10.1001/jama.2021.2828

This Viewpoint discusses the prospect that COVID-19 could become a recurrent seasonal disease like influenza and proposes strategies to mitigate the consequences for communities and health systems, including changes in surveillance, medical and public health response, and socioeconomic programs.

Conversations with Dr Bauchner: Will COVID-19 Become a Recurrent Seasonal Disease?

Approaches for Optimal Use of Different COVID-19 Vaccines: Issues of Viral Variants and Vaccine Efficacy

John P. Moore, PhD

Abstract Full Text

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JAMA. 2021;325(13):1251-1252. doi:10.1001/jama.2021.3465

This Viewpoint proposes ways to maximize vaccine efficacy and allocation given the rise of coronavirus variants and authorization of a Johnson & Johnson vaccine, including reserving the latter for younger healthier populations, boosting it with a single-dose messenger RNA (mRNA) vaccination, and single mRNA immunization of people with prior documented SARS-CoV-2 infection.

Conversations with Dr Bauchner: Coronavirus Variants With John P. Moore

Editorial
SARS-CoV-2 Viral Variants—Tackling a Moving Target
John R. Mascola, MD; Barney S. Graham, MD, PhD; Anthony S. Fauci, MD
- Conversations with Dr Bauchner: Coronavirus Update With CDC Director Rochelle Walensky - February 17, 2021
- Conversations with Dr Bauchner: Coronavirus Vaccine Update From the CDC With Nancy E. Messonnier, MD

The Future of Health Policy in a Partisan United States: Insights From Public Opinion Polls

Robert J. Blendon, ScD; John M. Benson, MA; Eric C. Schneider, MD

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JAMA. 2021;325(13):1253-1254. doi:10.1001/jama.2021.1147

This Viewpoint summarizes views measured in national opinion polls about COVID-19 response, national health insurance reform, reforming the US health care system in general, and race and race disparities in health, with a focus on differences between Democrat and Republican respondents and implications of those differences for enacting meaningful legislation.

A Piece of My Mind

Sitting in the River

Jessi Humphreys, MD

Abstract Full Text

JAMA. 2021;325(13):1255-1256. doi:10.1001/jama.2021.3857

In this narrative medicine essay, a palliative care physician finds the space between professional and patient distance thinning as the COVID pandemic drags on and wonders whether abiding with them is the lesson.

Editorial

Celecoxib for Stage III Colon Cancer

David J. Kerr, MD, DSc; Sarah Chamberlain, BMedSci, MBChB; Rachel S. Kerr, MBChB, PhD

Abstract Full Text

JAMA. 2021;325(13):1257-1258. doi:10.1001/jama.2021.2651

Opportunities to Improve Antimicrobial Use in US Nursing Homes

Christopher J. Crnich, MD, PhD; Preeti Malani, MD, MSJ

Abstract Full Text

JAMA. 2021;325(13):1259-1260. doi:10.1001/jama.2021.3258

SARS-CoV-2 Viral Variants—Tackling a Moving Target

John R. Mascola, MD; Barney S. Graham, MD, PhD; Anthony S. Fauci, MD

Abstract Full Text

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JAMA. 2021;325(13):1261-1262. doi:10.1001/jama.2021.2088

Conversations with Dr Bauchner: Coronavirus Update With CDC Director Rochelle Walensky - February 17, 2021
Conversations with Dr Bauchner: Coronavirus Vaccine Update From the CDC With Nancy E. Messonnier, MD

To JAMA Authors, Reviewers, and Especially Physician Readers—A Profound Thank You

Phil B. Fontanarosa, MD, MBA; Howard Bauchner, MD; Robert Golub, MD

Abstract Full Text

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JAMA. 2021;325(13):1263-1265. doi:10.1001/jama.2021.3860

Editorial
Health Care Heroes of the COVID-19 Pandemic
Howard Bauchner, MD; Thomas J. Easley; on behalf of the entire editorial and publishing staff of JAMA and the JAMA Network
The Reporting of Race and Ethnicity in Medical and Science Journals: Comments Invited
Annette Flanagin, RN, MA; Tracy Frey, BA; Stacy L. Christiansen, MA; Howard Bauchner, MD

Review

Filtering Facepiece Respirator (N95 Respirator) Reprocessing: A Systematic Review

Max A. Schumm, MD; Joseph E. Hadaya, MD; Nisha Mody, MLIS, MA, CCC-SLP; et al.

Abstract Full Text

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JAMA. 2021;325(13):1296-1317. doi:10.1001/jama.2021.2531

In the context of widespread reuse and reprocessing of N95 respirators due to shortages caused by the COVID-19 pandemic, this systematic review summarizes evidence on effectiveness and feasibility of 5 decontaminating processes: UV irradiation, vaporized hydrogen peroxide, moist-heat incubation, microwave-generated steam, and ethylene oxide.

Audio Clinical Review: Coronavirus (COVID-19) Update: Reusing Face Masks and N95 Respirators

JAMA Insights

SARS-CoV-2 Vaccines

C. Buddy Creech, MD, MPH; Shannon C. Walker, MD; Robert J. Samuels, MBChB

Abstract Full Text

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JAMA. 2021;325(13):1318-1320. doi:10.1001/jama.2021.3199

This JAMA Insights clinical review explains different approaches to SARS-CoV-2 vaccine development, including inactivated and protein subunit, viral vector, and mRNA immunization strategies, and summarizes safety and efficacy data for global products authorized for use or in later-stage clinical trials.

Audio Clinical Review: Coronavirus Vaccines—An Overview

From The Medical Letter on Drugs and Therapeutics

Drugs for Atopic Dermatitis

Abstract Full Text

JAMA. 2021;325(13):1321-1322. doi:10.1001/jama.2020.11192

This Medical Letter provides a Table summarizing key information about topical corticosteroids available for atopic dermatitis published as part of a comprehensive review on the topic.

Medical News & Perspectives

COVID-19 Vaccines vs Variants—Determining How Much Immunity Is Enough

Rita Rubin, MA

Abstract Full Text

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JAMA. 2021;325(13):1241-1243. doi:10.1001/jama.2021.3370

This Medical News feature examines what is known about the efficacy of COVID-19 vaccines against SARS-CoV-2 variants.

JAMA Medical News Audio: March 2021 Medical News Summary

JAMA Live Highlights

Experts Discuss COVID-19—Vaccine Questions, School Openings, and More

Abstract Full Text

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JAMA. 2021;325(13):1244-1245. doi:10.1001/jama.2021.4121

This Medical News article is a roundup of insights from recent livestream interviews with leading experts.

News From the Food and Drug Administration

A First in Surgical Devices for Transvaginal Hysterectomy

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2021;325(13):1246. doi:10.1001/jama.2021.4592

3D-Printed Implant Is Approved to Replace Ankle Joint Bone

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2021;325(13):1246. doi:10.1001/jama.2021.4029

Thermal Imaging Systems May Pose Public Health Risks

Rebecca Voelker, MSJ

Abstract Full Text

JAMA. 2021;325(13):1246. doi:10.1001/jama.2021.4594

Poetry and Medicine

Passing Out at the Hospital

Don Barkin, MA

Abstract Full Text

JAMA. 2021;325(13):1336. doi:10.1001/jama.2021.1001

JAMA Revisited

The Medical Profession and the Public

Abstract Full Text

JAMA. 2021;325(13):1337. doi:10.1001/jama.2020.17870

Peer Reviewers List

JAMA Peer Reviewers in 2020

Abstract Full Text

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JAMA. 2021;325(13):1338-1350. doi:10.1001/jama.2021.0638

Editorial
To JAMA Authors, Reviewers, and Especially Physician Readers—A Profound Thank You
Phil B. Fontanarosa, MD, MBA; Howard Bauchner, MD; Robert Golub, MD

JAMA Patient Page

Giardiasis

Angel N. Desai, MD, MPH

Abstract Full Text

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JAMA. 2021;325(13):1356. doi:10.1001/jama.2020.10289

This JAMA Patient Page summarizes risk factors, symptoms, diagnosis, and treatment of giardiasis, an intestinal parasite infection that can cause gastrointestinal symptoms including nausea, stomach cramps, and prolonged diarrhea.

Comment & Response