JAMA (Journal of the American Medical Association)

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Stopping Alzheimer Disease https://jamanetwork.com/journals/jama/fullarticle/2850604 This Perspective discusses progress made in Alzheimer disease prevention during the last 50 years.

Trends in Newborn Hepatitis B Virus Vaccination—Reply https://jamanetwork.com/journals/jama/fullarticle/2850605 In Reply We appreciate the thoughtful comments of Dr Dysart and colleagues regarding our Research Letter on US newborn HBV vaccination rates. Their observations highlight important considerations for research using aggregated electronic health record data, and we welcome the opportunity to clarify several methodological points.

Trends in Newborn Hepatitis B Virus Vaccination https://jamanetwork.com/journals/jama/fullarticle/2850606 To the Editor Dr Rothman and colleagues reported trends in newborn hepatitis B virus (HBV) vaccination in Epic Cosmos, a large-scale electronic health record database. They found that vaccinations rose from 67.5% in January 2017, peaked at 83.5% in February 2023, and then declined to 73.2% in August 2025. As pediatricians and neonatologists who observe HBV vaccine declination, we applaud the authors for quantifying this public health issue.

National Trends in Patient-Clinician Communication https://jamanetwork.com/journals/jama/fullarticle/2850607 This cross-sectional study examines trends in US patient portal messaging, telehealth and telephone encounters, and office visits, assessing differences in messaging by various patient sociodemographic characteristics.

National Trends in Patient Messaging https://jamanetwork.com/journals/jama/fullarticle/2850608 Over the past decade, the electronic inbox has become a defining feature of modern clinical practice. Patient portal messaging—direct communication between patients and clinicians via a portal in the electronic health record—has evolved from a supplementary communication tool to a central modality of care delivery. Prior studies have linked growing message volume to increased after-hours use of the electronic health record and clinician burnout, raising concerns that asynchronous communication, while convenient for patients, may contribute to unsustainable workloads. The COVID-19 pandemic accelerated these changes through both telehealth visits and patient portal messaging. Yet despite widespread recognition of this shift, national trends in patient portal messaging have not been described, nor how messaging relates to more traditional care modalities, such as telephone encounters and office visits.

Toward Inclusive Clinical Trials https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850554 Clinical research plays a foundational role in advancing medical knowledge, improving care delivery, and refining treatment strategies. Yet, disparities in research participation compromise fairness, generalizability, and trustworthiness of findings. Using data from the RETAIN (Randomized Evaluation of Trial Acceptability by Incentive) study, which assessed the impact of $0, $200, and $500 incentives on enrollment in a smoking cessation trial among participants with major depressive disorder, Benson et al explore in this issue of JAMA Internal Medicine whether financial incentives are associated with reduced enrollment disparities in randomized clinical trials. Of note, of 3 trials originally included in RETAIN, only findings from the smoking cessation trial were included in this secondary analysis. The current analysis revealed that greater financial incentives significantly mitigated enrollment gaps between Black and White participants. Specifically, Black participants had a 15.9–percentage point lower enrollment rate than White participants without an incentive, but this gap was eliminated with $200 and $500 incentives. However, incentives did not significantly impact enrollment disparities by sex, educational level, or age.

Deprescribing Inappropriate Medicines Across a Health System https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850555 Less is More

APOL1 and Black Kidney Donors—Reducing Risk or Opportunity? https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2850556 Apolipoprotein L1 (APOL1) is a human serum protein that acts as an innate immune defense against African trypanosomes, protecting against sleeping sickness (human African trypanosomiasis). Through evolutionary pressure, specific APOL1 gene variants (G1/G2) evolved in sub-Saharan Africa to counteract parasite resistance and are found almost exclusively in people of African or Caribbean heritage. However, the presence of 2 APOL1 alleles (G1/G1, G1/G2, or G2/G2) has shown a 51% increased risk for chronic kidney disease (CKD) and 2-fold increased risk of progression to kidney failure vs zero or 1 allele; increased risk is confined to 2 APOL1 alleles (high-risk genotype), with a kidney failure incidence of 35.22 per 100 person-years, vs 15.22 per 100 person-years and 12.69 per 100 person-years for 0 or 1 APOL1 allele, respectively. For potential living kidney donors, there is limited evidence to guide risk assessment for donation in the presence of 2 APOL1 alleles. Informing that need, in this issue of JAMA Internal Medicine, Hsu and colleagues from the APOL1 Long-Term Kidney Transplantation Outcomes Network present results from the Living Donor Extended Time Outcomes study. In this retrospective cohort study, previous living kidney donors (445 Black donors and 208 White donors) were contacted and invited to participate in a home-based research visit approximately 2 decades after donation. The critical finding is that Black kidney donors with 2 APOL1 alleles had considerably increased risk of developing an estimated glomerular filtration rate (eGFR) lower than 45 mL/min/1.73 m2 (relative risk, 2.31; 95% CI, 1.16-4.61) compared to Black kidney donors with 0 or 1 APOL1 allele. After adjusting for eGFR at time of donation, there remained statistically significant associations between APOL1 high-risk genotypes and higher risk of developing eGFR lower than 60 mL/min/1.73 m2 among Black kidney donors (relative risk, 1.50; 95% CI, 1.18-1.90).

The Sky He Never Saw Again https://jamanetwork.com/journals/jamaneurology/fullarticle/2850586 This essay descibes the author’s experience of her father’s time in an intensive care unit.

Clinical Associations of Cerebrospinal Fluid TMEM106B in Familial and Sporadic Frontotemporal Dementia https://jamanetwork.com/journals/jamaneurology/fullarticle/2850587 This cross-sectional study among 2 independent cohorts investigates the clinical associations of cerebrospinal fluid TMEM106B protein levels in frontotemporal lobar degeneration.

Reversible Bilateral Hypoglossal Palsy and Peripheral Nerve Vasculitis https://jamanetwork.com/journals/jamaneurology/fullarticle/2850588 This case report discusses an unusual presentation of peripheral nervous system vasculitis with bilateral hypoglossal nerve involvement in a woman aged 50 years who presented with subacute asymmetric weakness, severe neuropathic pain, and dysarthria.

FDA Advises Against Over-the-Counter Skin Lightening Products https://jamanetwork.com/journals/jama/fullarticle/2850664 The US Food and Drug Administration (FDA) released a warning advising consumers against using over-the-counter skin lightening products, which may contain high levels of mercury or hydroquinone.

About 1 in 5 US Youth Use AI Chatbots for Mental Health Advice https://jamanetwork.com/journals/jama/fullarticle/2850665 Approximately 19% of US adolescents and young adults reported using an artificial intelligence (AI) chatbot for mental health advice in 2025, according to a study published in JAMA Pediatrics.

Postoperative Delirium May Predict Long-Term Cognitive Decline https://jamanetwork.com/journals/jama/fullarticle/2850666 Delirium after surgery may be a strong predictor of long-term cognitive decline in older adults independent of illness or frailty, a recent study suggests.

Audio Highlights June 18, 2026 https://jamanetwork.com/journals/jama/fullarticle/2850779 Listen to the JAMA Editor’s Summary for an overview and discussion of the important articles appearing in JAMA.

Cardiac Tamponade Captured in Dual-Phase Computed Tomography https://jamanetwork.com/journals/jamacardiology/fullarticle/2850511 This case report discusses instantaneous cardiac tamponade due to hemorrhagic pericardial effusion captured on computed tomography imaging in a previously hemodynamically stable patient with acute chest pain.

Error in Correction Notice Reference https://jamanetwork.com/journals/jamacardiology/fullarticle/2850512 The correction notice titled “Error in Byline,” published on January 29, 2025, was corrected to fix an error in the reference; the correct journal is JAMA Cardiology, and the correct doi is 10.1001/jamacardio.2024.2824. This article was corrected online.

Prone Positioning in Infants With Acute Bronchiolitis Research Summary https://jamanetwork.com/journals/jama/fullarticle/2850557 This study aimed to determine if prone positioning for infants aged 6 months or younger with moderate to severe acute bronchiolitis receiving high-flow nasal cannula support (HFNC) reduces escalation of care to noninvasive or invasive ventilation.

Prone Positioning in Infants With Acute Bronchiolitis https://jamanetwork.com/journals/jama/fullarticle/2850558 This randomized trial assesses the effect of prone positioning in infants with moderate to severe bronchiolitis receiving high-flow nasal cannula (HFNC) support on the need for escalation of care to noninvasive or invasive ventilation within 72 hours.