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February 25, 2021
Viewpoint

Removing One Barrier to Opioid Use Disorder Treatment: Is It Enough?

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JAMA. Published online February 25, 2021. doi:10.1001/jama.2021.0958

This Viewpoint discusses policy reforms necessary to advance medical management of opioid use disorder in the wake of retraction by the Biden adminstration of proposed federal Practice Guidelines for the Administration of Buprenorphine for Treating Opioid Use Disorder.

Overcoming Barriers to Treatment of Opioid Use Disorder

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JAMA. Published online February 25, 2021. doi:10.1001/jama.2021.1741

This Viewpoint discusses federal guidance that would exempt physicians from a standing requirement to apply for a waiver to prescribe buprenorphine for opioid use disorder (OUD) and makes additional recommendations to expand access to medication treatment of OUD, including expanded prescriber training and office-based methadone treatment.

Medications in Single-Dose Vials and Implications of Discarded Injectable Drugs: A National Academies Report

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JAMA. Published online February 25, 2021. doi:10.1001/jama.2021.2414

This Viewpoint summarizes a 2021 NASEM report that makes policy recommendations to reduce systems inefficiencies that lead to discarded medications in the US, including development of standards to allow safe use of single-dose vials across multiple patients, and use of payment models to reimburse treatment episodes rather than drug vial volume or cost.

February 24, 2021
Original Investigation

Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial

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JAMA. Published online February 24, 2021. doi:10.1001/jama.2021.1831

This randomized clinical trial compares the effects of once-weekly subcutaneous semaglutide vs placebo for weight management as an adjunct to intensive behavioral therapy with initial low-calorie diet in adults with overweight or obesity.

Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19

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JAMA. Published online February 24, 2021. doi:10.1001/jama.2021.2091

This case series uses national coronavirus disease 2019 (COVID-19) registry data to describe the epidemiology, clinical characteristics, complications, and hospital and postdischarge outcomes of pediatric patients with multisystem inflammatory syndrome in children (MIS-C) and to compare each in patients with severe COVID-19.

JAMA Insights

First-Dose COVID-19 Vaccination Coverage Among Skilled Nursing Facility Residents and Staff

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JAMA. Published online February 24, 2021. doi:10.1001/jama.2021.2352

This JAMA Insights review from CDC COVID-19 Response team members presents data on the number of long-term care facilities and the numbers of residents and staff of those facilities who received first-dose vaccination through mid-January 2021 under the agency’s public-private partnership with CVS, Walgreens, and Managed Health Care Associates.

Medical News & Perspectives

Quick Uptakes

Pregnant People’s Paradox—Excluded From Vaccine Trials Despite Having a Higher Risk of COVID-19 Complications

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JAMA. Published online February 24, 2021. doi:10.1001/jama.2021.2264

This Medical News Quick Uptake discusses the evidence in favor of administering COVID-19 vaccines to pregnant individuals.

February 22, 2021
Viewpoint

Scientific Discovery and the Future of Medicine

New Insights Into Plaque Erosion as a Mechanism of Acute Coronary Syndromes

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JAMA. Published online February 22, 2021. doi:10.1001/jama.2021.0069

This Viewpoint summarizes the pathophysiology and clinical features of atherosclerotic plaque erosion as an underlying mechanism of acute coronary syndromes (ACS) distinct from plaque rupture and reviews evidence that antithrombotic therapy without PCI and stenting may be optimal treatment.

Editorial

The Reporting of Race and Ethnicity in Medical and Science Journals: Comments Invited

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JAMA. Published online February 22, 2021. doi:10.1001/jama.2021.2104
JAMA Insights

Identifying COVID-19 Risk Through Observational Studies to Inform Control Measures

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JAMA. Published online February 22, 2021. doi:10.1001/jama.2021.1995

This JAMA Insights Clinical Update from the CDC’s COVID-19 Response Team discusses the importance of observational data for identifying behaviors associated with SARS-CoV-2 transmission, and presents data suggesting that indoor eating or drinking poses the highest risk, presumably because of prolonged exposure to unmasked, non–physically distanced companions.

February 19, 2021
Research Letter

SARS-CoV-2 Positivity on or After 9 Days Among Quarantined Student Contacts of Confirmed Cases

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JAMA. Published online February 19, 2021. doi:10.1001/jama.2021.2392

This study describes coronavirus test positivity rates among elementary, middle, and high school student contacts of confirmed COVID-19 cases in a Florida county where schools required a negative test on day 9 before return to school on day 10.

Viewpoint

Health Policy

Overcoming the Market Dominance of Hospitals

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JAMA. Published online February 19, 2021. doi:10.1001/jama.2021.0079

This Viewpoint reviews the conditions which incentivize consolidation of health systems, hospitals, and physician practices into entities that decrease health care quality and increase prices, and in the context of financial pressures wrought by the COVID-19 pandemic proposes policy solutions that could protect patients against potential adverse effects of accelerating trends toward consolidation.

February 18, 2021
Medical News & Perspectives

The Price of Success—How to Evaluate COVID-19 Vaccines When They’re Available Outside of Clinical Trials

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JAMA. Published online February 18, 2021. doi:10.1001/jama.2021.0641

This Medical News feature examines the challenge of continuing or launching placebo-controlled trials of COVID-19 vaccines now that some have been authorized for use in the community.

February 17, 2021
Original Investigation

Effect of a Single High Dose of Vitamin D3 on Hospital Length of Stay in Patients With Moderate to Severe COVID-19: A Randomized Clinical Trial

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JAMA. Published online February 17, 2021. doi:10.1001/jama.2020.26848

This randomized trial compares the effects of a single 200 000-IU dose of vitamin D3 vs placebo on length of stay in patients hospitalized with moderate to severe COVID-19.

Research Letter

Discriminant Accuracy of the SOFA Score for Determining the Probable Mortality of Patients With COVID-19 Pneumonia Requiring Mechanical Ventilation

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JAMA. Published online February 17, 2021. doi:10.1001/jama.2021.1545

This cohort study investigates whether the Sequential Organ Failure Assessment (SOFA) score is accurate enough to discriminate death from survival, and thus perhaps be a ventilator triage tool, for US patients with coronavirus disease 2019 (COVID-19) hospitalized in intensive care units and requiring mechanical ventilation.

Viewpoint

SARS-CoV-2 Variants of Concern in the United States—Challenges and Opportunities

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JAMA. Published online February 17, 2021. doi:10.1001/jama.2021.2294

This Viewpoint from directors at the CDC and NIH describes measures that federal agencies are taking to rapidly characterize emerging coronavirus variants and monitor their implications for national pandemic response and control, including assessment of ongoing effectiveness of current diagnostics, therapeutics, and vaccines.

Editorial

Vitamin D3 to Treat COVID-19: Different Disease, Same Answer

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JAMA. Published online February 17, 2021. doi:10.1001/jama.2020.26850
February 15, 2021
Viewpoint

The US Regulatory System and COVID-19 Vaccines: The Importance of a Strong and Capable FDA

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JAMA. Published online February 15, 2021. doi:10.1001/jama.2021.1961

This Viewpoint examines the important role of the Food and Druf Administration (FDA) in facilitating the rapid development of coronavirus disease 2019 (COVID-19) vaccines.

February 12, 2021
JAMA Insights

Reports of Anaphylaxis After Receipt of mRNA COVID-19 Vaccines in the US—December 14, 2020-January 18, 2021

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JAMA. Published online February 12, 2021. doi:10.1001/jama.2021.1967

This JAMA Insights review provides clinical details of anaphylactic reactions reported to and verified by the CDC in the first month of use of the Pfizer-BioNTech and Moderna COVID-19 vaccines in the US, December 14, 2020-January 18, 2021.

February 11, 2021
Research Letter

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

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JAMA. Published online February 11, 2021. 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.

Viewpoint

Continued Increases in Overdose Deaths Related to Synthetic Opioids: Implications for Clinical Practice

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JAMA. Published online February 11, 2021. doi:10.1001/jama.2021.1169

This Viewpoint summarizes a 2021 MMWR report documenting a concerning rise in illicit and synthetic opioid overdose deaths in the US between 2013 and 2019 and proposes strategies to connect clinicians and health systems with public health, public safety, and other community partners to share data, monitor trends, and better respond to the overdose epidemic.

Editorial

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

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JAMA. Published online February 11, 2021. doi:10.1001/jama.2021.2088
February 10, 2021
Research Letter

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

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JAMA. Published online February 10, 2021. doi:10.1001/jama.2021.1534

This study uses police department registry data to describe trends in incidence of firearm shootings and deaths 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.

Viewpoint

Involving Pregnant Individuals in Clinical Research on COVID-19 Vaccines

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JAMA. Published online February 10, 2021. doi:10.1001/jama.2021.1865

This Viewpoint from the National Institute of Child Health and Human Development emphasizes the need to use existing data sources and develop partnerships, infrastructure, and ethical and regulatory standards to generate data about the safety and efficacy of COVID-19 vaccination in pregnant individuals.

JAMA Insights

Effectiveness of Mask Wearing to Control Community Spread of SARS-CoV-2

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JAMA. Published online February 10, 2021. doi:10.1001/jama.2021.1505

This JAMA Insights CDC review summarizes accumulating evidence that mask wearing reduces spread of SARS-CoV-2 infection and that universal mandatory mask wearing policies reduce infections and deaths and emphasizes face masks are one component of pandemic control measures, including physical distancing and handwashing, pending natural or vaccine-induced population immunity.

Medical News & Perspectives

Researchers Investigate What COVID-19 Does to the Heart

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JAMA. Published online February 10, 2021. doi:10.1001/jama.2021.0107

This Medical News article discusses reports of myocardial injury and myocarditis among patients with COVID-19.

JAMA Live Highlights

Experts Discuss COVID-19—Vaccine Doses, Virus Variants, and More

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JAMA. Published online February 10, 2021. doi:10.1001/jama.2021.1101

JAMA Live Highlights features comments from livestream interviews by JAMA Network Editor in Chief Howard Bauchner, MD. His discussions with experts in clinical care, public health, and health policy focus on critical issues related to the coronavirus disease 2019 (COVID-19) pandemic. Comments have been edited for clarity.

February 8, 2021
Viewpoint

COVID-19 Vaccination in Pregnant and Lactating Women

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JAMA. Published online February 8, 2021. doi:10.1001/jama.2021.1658

This Viewpoint discusses the need for shared decision-making when counseling pregnant and nursing women about the unstudied benefits and risks COVID-19 vaccination, calling for rigorously designed studies with real-time, proactive data collection to establish evidence as quickly as possible about coronavirus vaccine safety in mothers and their infants.

The Triple Aim Applied to Correctional Health Systems

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JAMA. Published online February 8, 2021. doi:10.1001/jama.2021.0263

This Viewpoint characterizes correctional health care as a separate health system in the US responsible for the lives of 2 million citizens, but largely neglected by the quality improvement movement, and discusses ways to improve care, outcomes, and health care value for incarcerated individuals and populations.

JAMA Insights

Women's Health

Pregnancy, Postpartum Care, and COVID-19 Vaccination in 2021

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JAMA. Published online February 8, 2021. doi:10.1001/jama.2021.1683

This JAMA Insights review summarizes the epidemiology of SARS-CoV-2 infection in pregnant and lactating women, its effects on perinatal outcomes, and compiles guidance from the CDC, FDA, and obstetrics-gynecology specialty organizations on the safety of coronavirus vaccines during pregnancy and while breastfeeding.

February 5, 2021
JAMA Patient Page

Monoclonal Antibodies for COVID-19

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JAMA. Published online February 5, 2021. doi:10.1001/jama.2021.1225

This JAMA Patient Page describes use of monoclonal antibodies for treatment of nonsevere COVID-19, which may help prevent progression to severe infection.

February 4, 2021
Research Letter

Prevalence of SARS-CoV-2 in Karnataka, India

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JAMA. Published online February 4, 2021. doi:10.1001/jama.2021.0332

In the context of large numbers of workers moving from urban to rural areas with less strict lockdown policies in low- and middle-income countries, this study describes community-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence in urban vs rural areas of Karnataka state, India.

February 3, 2021
JAMA Patient Page

Necessity of 2 Doses of the Pfizer and Moderna COVID-19 Vaccines

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JAMA. Published online February 3, 2021. doi:10.1001/jama.2021.1375

This JAMA Patient Page describes how the new Pfizer and Moderna COVID-19 vaccines available in the US work and explains why 2 doses of these vaccines are needed to confer adequate immunity.

February 2, 2021
Research Letter

Telehealth Use Among Safety-Net Organizations in California During the COVID-19 Pandemic

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JAMA. Published online February 2, 2021. doi:10.1001/jama.2021.0282

This study describes trends in use of in-person, telephone, and video primary care and behavioral health visits to California Federally Qualified Health Centers from 2019 to August 2020 before and during the coronavirus disease 2019 (COVID-19) pandemic.

February 1, 2021
Original Investigation

Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children

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JAMA. Published online February 1, 2021. doi:10.1001/jama.2021.0694

This cohort study estimates the association between use of intravenous immunoglobulins (IVIG) plus methylprednisolone vs IVIG alone as initial therapy for multisystem inflammatory syndrome in children (MIS-C) and treatment failure defined as fever persistence at 2 days or fever recurrence within 7 days..

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