Receiving nutrition and exercise support before surgery may help reduce postoperative complications and shorten hospital stays, a meta-analysis found.
Science Journals
The rondeau is a 15-line fixed form in French lyric poetry that was popular during the 13th to 15th centuries and was often set to music like other received forms currently found in English, with regular rhyme schemes and repeated lines. The poem “Autoimmune Rondeau” draws on this history, creating a kind of healing music around the experience of autoimmune disease. The rhyme scheme and repeated line “It’s self on self” evoke the interplay between the disordered immune system and a patient’s own body. The references to mythological twins further deepen this comparison: Castor and Pollux, whose bond was famously strong and who battled alongside one another in the Trojan War, suggest periods when autoimmune disease abates, while Romulus and Remus, who fought over where to build Rome before Romulus killed his brother and then founded the great city, suggest autoimmune attacks so serious as to be fatal. Yet the speaker refuses to bow to pain and suffering: by choosing the rondeau form, with its soothing, musical beauty, we are reminded that although the songs and dances of its origins certainly addressed the mournful themes of unrequited love and separation from God in heaven, they ultimately celebrated life’s joys and pleasures. Thus the poem’s rhetorical question resonates: “Does [the] punishment match the crime?” Whether the speaker is allowing readers a moment of bemused irony or simply joining them in the human absurdity of fate, what is clearest is that even as we confront dire illness, poetry can still invite us to sing, dance, and even smile.
This study evaluated whether a multicomponent parental support package targeting perinatal stressors reduced occupational burnout among pregnant and postpartum physicians in training.
This Viewpoint discusses the importance of evidence-based dietary guidelines for the health of children and adolescents, summarizes the strengths of the 2025-2030 Dietary Guidelines for Americans as well as concerns and challenges, and suggests government policy actions needed from the perspective of pediatric health care professionals and researchers.
This Perspective examines a new Centers for Medicare & Medicaid Services (CMS) approach to outcome-aligned Medicare payments for technology-enabled long-term care.
In Reply We thank Drs Meng and Li for their thoughtful comments on our Review article and for the additional context on treatment strategies and risk factors for gastric cancer.
Excessive alcohol consumption poses significant health risks and is closely associated with oxidative damage. The KEAP1-NRF2-ARE signaling pathway serves as the primary antioxidant system. However, current small molecule inhibitors are all covalently bound to KEAP1, meaning that once bound, they are not easily dissociated, while continuous inhibition of KEAP1 exhibits severe side effects. In this study, BLI, CETSA, Pull-down, Co-IP, and HDX-MS assay analysis were conducted to detect the KEAP1 binding behavior of natural product, capsaicin (CAP), both in vitro and in cells. The ethanol-induced acute gastric mucosal damage rat model was also established to evaluate the therapeutic effect of CAP. Our findings demonstrated that CAP mitigated mitochondrial damage, facilitated the nuclear translocation of NRF2, leading to the up-regulation of downstream antioxidant response elements, HMOX1, TXN, GSS, and NQO1 in GES-1 cells. Furthermore, CAP directly bind to KEAP1 and inhibit the interaction between KEAP1 and NRF2. In the KEAP1-knockout 293T cells, CAP failed to activate NRF2 expression. We identified that CAP non-covalently bound to the Kelch domain and allosterically regulated three specific regions of KEAP1: L342-L355, D394-G423, and N482-N495. To improve drug solubility and delivery efficiency, we developed IR-Dye800 modified albumin-coated CAP nanoparticles. The nanoparticles significantly reduced the gastric mucosal inflammation and activated NRF2 downstream genes in vivo. Our hypothesis was further verified our hypothesis in Nrf2-knockout mice. This study provides new insights that CAP is a safe and novel NRF2 agonist by allosterically regulating KEAP1, which may contribute to the development of lead drugs for oxidative stress-related illness, e.g., aging, cancer, neurodegenerative, and cardiovascular diseases.
Perception relies on the neural representation of sensory stimuli. Primary sensory cortical representations have been extensively studied, but how sensory information propagates to memory-related multisensory areas has not been well described. We studied this question in the olfactory cortico-hippocampal pathway in mice. We recorded single units in the anterior olfactory nucleus (AON), the anterior piriform cortex (aPCx), the lateral entorhinal cortex (LEC), the hippocampal CA1 subfield, and the subiculum (SUB) while animals performed a non-associative learning paradigm involving novel and familiar stimuli. In the AON, neurons were broadly tuned to different chemicals, and their responses were strongly modulated by experience. From the AON to hippocampal structures, the selectivity of neurons for specific odorants increased, concurrent with the development of population-level odor representations, which became independent of novelty and familiarity. While both stimulus identity and experience were thus reflected in all regions, their neural representations progressively separated. Our findings provide a potential mechanism for how sensory representations are transformed to support stimulus identification and implicit memories.
Cardiovascular-kidney-metabolic (CKM) syndrome was linked to cancer risk in a recent study, with increased risk as illness progressed.
In Reply We are grateful to Dr Leiva-Murillo for his commentary regarding our Review of IgAN in adults. Leiva-Murillo’s concern relates to a sentence in the abstract that states that “[u]p to 50% of patients with IgAN develop kidney failure within 10 years of diagnosis.” The evidence base for this statement is provided in the prognosis section: “Among 2299 adults with biopsy-proven IgAN included in a national registry–based study in the UK, 50% developed the composite outcome of death, kidney failure, or an eGFR less than 15 mL/min/1.73 m2 at a median (IQR) of 10.8 (10.0-12.0) years after diagnosis.”
This Review summarizes current evidence regarding the diagnosis and treatment of amyotrophic lateral sclerosis.
This randomized trial assesses the effect of intravenous tirofiban vs placebo on 90-day outcome among patients with acute ischemic stroke and an inadequate clinical response to intravenous tenecteplase.
Stimulating brain areas connected to the hippocampus may improve memory function in humans.
This study evaluated whether adjunctive intravenous tirofiban improves functional outcomes in patients with acute ischemic stroke without large or medium vessel occlusion or a cardioembolic etiology who show inadequate response to tenecteplase.
To the Editor A recent article provided a clear and clinically useful overview of post–intensive care syndrome (PICS), emphasizing physical, cognitive, and psychological sequelae; early screening; and multidisciplinary follow-up. However, we contend that the proposed framework of PICS underrepresents spiritual distress and bereavement—domains that may meaningfully shape recovery trajectories for both patients and families after critical illness. As PICS is framed as a conceptual construct rather than a diagnosis, we believe there is an opportunity to broaden its scope to intentionally include spiritual and bereavement-related dimensions that shape recovery and long-term well-being.
To the Editor A recent article on PICS provided an excellent synthesis of the cognitive and emotional difficulties experienced by ICU survivors.
In Reply I agree with Dr Byrne-Martelli and colleagues that addressing spiritual distress and bereavement is essential to providing truly holistic care for survivors of critical illness and their families. Although PICS is classically defined as new or worsening impairments in physical, cognitive, or mental health status persisting beyond hospitalization, highlighted in my Insights article, its scope remains debated. Although some contend that the current syndrome-based definition is overly broad, others think it should expand to include impairments in social health and quality of life—domains that encompass spiritual well-being and identity reconstruction. This tension underscores the challenge of defining PICS in a way that is both clinically rigorous and reflects survivors’ lived experiences.
This JAMA Patient Page describes common symptoms and causes of benign paroxysmal positional vertigo, risk factors, and diagnosis and treatment.
To the Editor We read with great interest the Review article on gastric cancerand would like to address 2 key points regarding the treatment and risk factors for gastric cancer.
To the Editor The recent Review on IgA nephropathy (IgAN) in adults provided an excellent summary of key aspects of the disease. However, a statement in the Abstract could lead to an overly uniform prognostic interpretation and warrants clarification.
In this narrative medicine essay, a retired family physician muses over the predigital tools he collected to help him meet his patients’ health challenges and reflects on how much medicine was integrated into his own life.
Prescribing of nonstatin lipid-lowering therapies has increased in the US, but nonstatins still represent a small share of low-density lipoprotein cholesterol (LDL-C)–lowering treatments, according to a national prescription database study published in JAMA Cardiology.
A new study found that older adults may experience cognitive decline up to 8 years before a cardiovascular event, potentially offering an early warning signal.
This Viewpoint discusses how restructuring the Health Resources and Services Administration (HRSA) could affect access to health care in underserved areas by disrupting international medical graduates’ ability to obtain J-1 visa waivers.
Graduate medical education looks very different in 2026 than it did in the early 1800s, with the many changes since that time including formalization and funding for teaching hospitals, efforts at work-hour limitations, and an emphasis on competency-based education. Yet, given the demands of the profession, graduate medical education remains a very challenging training—cognitively, physically, and emotionally.