Science Journals

This study uses Canadian administrative data to evaluate 1-year mortality among opioid overdose survivors in Ontario, Canada, and characterize postoverdose mortality risk after the widespread availability of fentanyl.

This Perspective discusses the merits of whole-body magnetic resonance imaging (MRI) screening in the general population.

This study examines maternal and obstetric risks of birth after uterus transplant and neonatal outcomes.

To the Editor Dr Patel and colleagues reported impressive results regarding a lay health worker–led symptom intervention that reduced emergency department use and hospitalizations among older adults with cancer. While the reported reduction in hospitalizations is remarkably higher than many previous electronic patient-reported outcome trials, the mechanism driving this magnitude of effect warrants further scrutiny before broad implementation.

In this narrative medicine essay, a psychiatrist and residency program director discusses how her lung cancer diagnosis caused her to shift her priorities regarding work and home life.

To the Editor The recently published PACBACK trial reported no significant differences in low back pain scores between groups randomized to undergo spinal manipulations, medical management, and self-management. This study included exclusively chiropractic and physical therapist–administered spinal manipulations and did not evaluate manipulative treatments performed by US-trained osteopathic physicians. Although it is valuable to examine different modalities of treatment for such a common and debilitating condition, the exclusion of osteopathic physician–performed manipulations raises concerns about this study’s conclusion that manipulations do not affect back pain scores.

This descriptive analysis study examines trends in manufacturer-sponsored coupon use, coupon amounts, and patient out-of-pocket spending among patients with commercial insurance.

This randomized clinical trial examines the effectiveness of a whole health team intervention in veterans with chronic pain compared with cognitive behavioral therapy and usual care in reducing long-term pain interference.

To the Editor The PACBACK randomized clinical trial by Dr Bronfort and colleagues evaluated spinal manipulation combined with clinician-supported biopsychosocial self-management for acute low back pain. Although the study addresses an important clinical question, we have some concerns.

The US Centers for Disease Control and Prevention (CDC) reported that most health care workers were vaccinated against influenza whereas less than half were vaccinated against COVID-19 during the 2024-2025 respiratory virus season.

Diverticulitis, a digestive condition characterized by inflammation within the large intestine, may peak in warmer months, according to research published in JAMA Surgery.

In this narrative medicine essay, as a pediatric critical care physician prepares to move to a new hospital building, he reflects on the memories that the old building held, including the death of his infant grandson.

To the Editor The ADJUST-DVT study prospectively validated the use of an age-adjusted D-dimer threshold to exclude suspected DVT. Although this represents an important methodological advance, several aspects warrant critical appraisal.

To the Editor In the Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK) randomized clinical trial, Dr Bronfort and colleagues reported that clinician-supported biopsychosocial self-management, alone or combined with spinal manipulation, led to statistically significant but small reductions in low back pain–related disability over 12 months vs guideline-based medical care, without differences in pain intensity. The time-averaged, adjusted between-group differences in the Roland-Morris Disability Questionnaire (RMDQ; range, 0-24) scores were −1.2 points for supported self-management and −1.1 points for supported self-management with spinal manipulation. A 2- to 3-point change on the RMDQ has been proposed as a minimally important difference, although such thresholds can vary by population and estimation approach. Even when a modest mean difference coexists with large improvements for some individuals, it remains uncertain whether the observed disability signal reflects gains in physical capacity, improved coping with symptoms, or changes in appraisal of activity limitation.

And what if the whole thing works—the small white pill dissolving in the acid of his stomach, finding the blood, crossing into the brain where the receptor opens, the synapse strengthens, and what happened is not all he is— what if tonight he sleeps without the dream and tomorrow he sits across from his daughter, his hands flat on the table, just hands, and the plate he passes her is only a plate, not a thing that could become a thing, and she learns this in her body the way we learn without language, without knowing we’re learning, until one day she’s a woman who doesn’t flinch when a man walks into a room—just a man, just a room, just a house—I hand him the cup and he looks at me and I think: what if this is the beginning of something I’ll never see the end of, what if it’s already traveling out of my hands toward a future where a girl I’ll never meet lives without the alphabet of danger, and I move to the next window, the next cup, the next invisible repair, not knowing what I’ve done, if I’ve done anything at all.

Perhaps surprising in the emerging world of personalized, precision medicine, the physiologic targets of many pharmacologic agents, especially psychiatric medicines, remain poorly understood, even as they continue to be widely prescribed. Similarly, exactly how poetry and other art forms have their profound effects on us also remains mysterious, even as research into possible underlying neural pathway activation proceeds (albeit less intensively). In the poem “Mechanism of Action,” the clinician’s faith in treatments prescribed without fully knowing how they work is intriguingly compared with how we may also just as hopefully rely on art for its therapeutic effects. The speaker of the poem wonders at the possible potency of a drug, “the small white pill” he administers to a patient, and whether it might not only modulate minute neural structures, as “the receptor opens” and “the synapse strengthens,” but also change the course of entire lives. Just as the medicine crosses the blood-brain barrier, so then poetry crosses into the realm of dreams and imagination, perhaps influencing the same neural circuitry and reshaping our thinking “the way we learn without language,/without knowing we’re learning,/until one day she’s a woman who doesn’t flinch/when a man walks into a room.” The medication, and the speaker’s belief in its healing effects, diffuses through the pharmacology of poetry into us as readers, as we too feel intoxicated by the twin power and uncertainty of “the next invisible repair, not knowing/what I’ve done, if I’ve done anything at all.”

This Perspective considers a licensure framework for autonomous clinical artificial intelligence (AI) in light of the clinical care workforce shortage.

Using the lipid biomarker apolipoprotein B (apoB) may help improve cardiovascular disease risk assessment, particularly in younger adults, a recent study found.

This Medical News article discusses findings that genetic variants may affect patients’ responses to glucagon-like peptide-1 receptor agonists such as semaglutide and tirzepatide.

This study aimed to determine whether the US Department of Veterans Affairs (VA) whole health team approach reduces pain interference more than cognitive behavioral therapy and usual care among veterans with chronic pain.

To the Editor Age-adjusted thresholds are used to improve the diagnostic yield of D-dimer testing in suspected pulmonary embolism, but prospective management data in suspected deep vein thrombosis (DVT) have been limited. In a recent study reported by Dr Le Gal and colleagues, the primary outcome focused on patients with D-dimer values between the conventional cutoff and their age-adjusted cutoff. Use of the age-adjusted cutoff increased the proportion of negative D-dimer results from 24.5% to 31.9% by identifying 161 additional patients with D-dimer values between 500 µg/L and their age-adjusted threshold.

This randomized clinical trial evaluates whether embolization of the middle meningeal artery as an adjunct to surgical drainage reduces recurrence and poor outcomes in patients with symptomatic chronic subdural hematoma compared with surgical drainage alone.

This narrative review examines the efficacy of cardiac resynchronization therapy, including biventricular pacing and conduction system pacing, in patients with cardiac dyssynchrony due to conduction system disease.

The US Centers for Disease Control and Prevention (CDC) reported that cases of extensively drug-resistant Shigella infections have increased significantly since 2015.