Janet Wittes, Eugene Braunwald, Margaret A Chesney, Harvey Jay Cohen, David DeMets, Johanna Dwyer, Victor Vogel, LeRoy Walters, Salim Yusuf
{"title":"Menopausal Hormone Labels Should Rely on Evidence, Not Opinion.","authors":"Janet Wittes, Eugene Braunwald, Margaret A Chesney, Harvey Jay Cohen, David DeMets, Johanna Dwyer, Victor Vogel, LeRoy Walters, Salim Yusuf","doi":"10.1001/jama.2026.1308","DOIUrl":"https://doi.org/10.1001/jama.2026.1308","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Alcohol-Related Emergency Department Visits Increase.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.26380","DOIUrl":"https://doi.org/10.1001/jama.2025.26380","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Home Blood Pressure Monitoring Remains Low Despite Assistance.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.26381","DOIUrl":"https://doi.org/10.1001/jama.2025.26381","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Water Fluoridation Not Associated With Adverse Birth Outcomes.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.26384","DOIUrl":"https://doi.org/10.1001/jama.2025.26384","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High BMI May Increase Dementia Risk.","authors":"Samantha Anderer","doi":"10.1001/jama.2025.26383","DOIUrl":"https://doi.org/10.1001/jama.2025.26383","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanisms Are Emerging for COVID-19 Vaccine-Associated Myocarditis.","authors":"Jennifer Abbasi","doi":"10.1001/jama.2025.25866","DOIUrl":"https://doi.org/10.1001/jama.2025.25866","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tenecteplase for Acute Non-Large Vessel Occlusion Ischemic Stroke: Research Summary.","authors":"","doi":"10.1001/jama.2026.0263","DOIUrl":"https://doi.org/10.1001/jama.2026.0263","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":"e260263"},"PeriodicalIF":55.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gaoting Ma, Ran Mo, Yingting Zuo, Qingfeng Ma, Guangjian Zhao, Xiaoxi Yao, Ji Liang, Li Zhou, Yong He, Faqing Long, Zhengzhou Yuan, Lei Liu, Guosheng Han, Yan Tan, Zhibing Ai, Chunsheng Cai, Juan Liu, Liyong Zhang, Haihua Yang, Tingyu Yi, Li Li, Yao Fu, Yanxing Zhang, Xiangzhong Shao, Zhipeng Yu, Saizhen Wu, Yanqiu Du, Lingqun Mao, Hongling Guo, Xufeng Chen, Yifei Chen, Qiong Zhao, Liyi Chi, Yi Liu, Haochun Zhang, Guangzong Li, Shujuan Meng, Yifan Wu, Jieying Wu, Ziying Jiang, Shaoyuan Lei, Daiquan Gao, Lianmei Zhong, Jens Fiehler, Duolao Wang, Thanh N Nguyen, Jeffrey L Saver, Junwei Hao
Importance: The efficacy and safety of intravenous tenecteplase in non-large vessel occlusion acute ischemic stroke beyond 4.5 hours after symptom onset remain uncertain.
Objective: To assess the efficacy and safety of intravenous tenecteplase administered 4.5 to 24 hours after stroke onset in patients with non-large vessel occlusion and salvageable brain tissue.
Design, setting, and participants: This randomized, open-label, blinded end-point clinical trial was conducted at 48 centers in China. A total of 566 patients with non-large vessel occlusion stroke and evidence of potentially salvageable tissue determined on perfusion imaging presenting within 4.5 to 24 hours of the time last seen well were recruited between June 2, 2023, and August 4, 2025 (final follow-up, October 28, 2025).
Interventions: Patients were randomly assigned 1:1 using a minimization algorithm to receive intravenous tenecteplase (0.25 mg/kg; maximum dose, 25 mg; n = 282) or standard medical treatment (n = 284).
Main outcomes and measures: The primary efficacy outcome was an excellent functional outcome, defined as a score of 0 or 1 on the modified Rankin Scale at 90 days. Safety outcomes included symptomatic intracranial hemorrhage within 36 hours and mortality within 90 days.
Results: Among the 570 patients randomized, 566 were included in the primary analysis (median age, 68 [IQR, 59-75] years; 196 female [34.6%]). An excellent functional outcome was observed in 123 of 282 patients (43.6%) in the tenecteplase group and 97 of 284 (34.2%) in the control group (risk ratio, 1.28 [95% CI, 1.04-1.57]; P = .02). The incidence of symptomatic intracranial hemorrhage at 2.8% was higher with tenecteplase than with standard medical treatment at 0% (risk difference, 2.85% [95% CI, 1.16%-5.54%]; P = .004), and the mortality at 90 days was 5.0% and 3.2%, respectively (risk ratio, 1.57 [95% CI, 0.69-3.57]; P = .28).
Conclusions and relevance: Among patients with non-large vessel occlusion acute ischemic stroke and salvageable brain tissue, intravenous tenecteplase administered 4.5 to 24 hours after onset resulted in a greater likelihood of an excellent functional outcome at 90 days than standard care but had an increased risk of symptomatic intracranial hemorrhage.
重要性：静脉注射替奈普酶治疗非大血管闭塞性急性缺血性卒中超过症状出现4.5小时的有效性和安全性仍不确定。目的：评价脑卒中后4.5 ~ 24小时静脉注射替奈普酶治疗非大血管闭塞且脑组织可抢救的患者的疗效和安全性。设计、环境和参与者：这项随机、开放标签、盲法终点临床试验在中国的48个中心进行。在2023年6月2日至2025年8月4日期间（最终随访时间为2025年10月28日），共招募了566例非大血管闭塞性卒中患者，并通过灌注成像确定了在最后一次见井时间4.5至24小时内出现的潜在可挽救组织的证据。干预措施：采用最小化算法将患者按1:1随机分配，接受静脉注射替奈普酶（0.25 mg/kg；最大剂量25 mg； n = 282）或标准药物治疗（n = 284）。主要结局和测量：主要疗效结局是一个优秀的功能结局，定义为在90天的改进兰金量表上得分为0或1。安全性指标包括36小时内出现症状性颅内出血，90天内死亡。结果：随机纳入的570例患者中，566例纳入初步分析，中位年龄68岁[IQR， 59-75]岁，女性196例[34.6%]。282例替奈普酶组患者中有123例（43.6%）功能预后良好，284例对照组中有97例（34.2%）功能预后良好（风险比1.28 [95% CI, 1.04-1.57]; P = 0.02）。替奈普酶组症状性颅内出血的发生率为2.8%，高于标准药物治疗组的发生率为0%(风险差为2.85% [95% CI, 1.16%-5.54%]；004)， 90天死亡率分别为5.0%和3.2%（风险比1.57 [95% CI, 0.69-3.57]; P = 0.28）。结论和相关性：在非大血管闭塞急性缺血性卒中和脑组织可抢救的患者中，在发病后4.5至24小时静脉注射替奈普酶比标准治疗更有可能在90天获得良好的功能结果，但有症状性颅内出血的风险增加。试验注册：ClinicalTrials.gov标识符：NCT05752916。
{"title":"Tenecteplase for Acute Non-Large Vessel Occlusion 4.5 to 24 Hours After Ischemic Stroke: The OPTION Randomized Clinical Trial.","authors":"Gaoting Ma, Ran Mo, Yingting Zuo, Qingfeng Ma, Guangjian Zhao, Xiaoxi Yao, Ji Liang, Li Zhou, Yong He, Faqing Long, Zhengzhou Yuan, Lei Liu, Guosheng Han, Yan Tan, Zhibing Ai, Chunsheng Cai, Juan Liu, Liyong Zhang, Haihua Yang, Tingyu Yi, Li Li, Yao Fu, Yanxing Zhang, Xiangzhong Shao, Zhipeng Yu, Saizhen Wu, Yanqiu Du, Lingqun Mao, Hongling Guo, Xufeng Chen, Yifei Chen, Qiong Zhao, Liyi Chi, Yi Liu, Haochun Zhang, Guangzong Li, Shujuan Meng, Yifan Wu, Jieying Wu, Ziying Jiang, Shaoyuan Lei, Daiquan Gao, Lianmei Zhong, Jens Fiehler, Duolao Wang, Thanh N Nguyen, Jeffrey L Saver, Junwei Hao","doi":"10.1001/jama.2026.0210","DOIUrl":"10.1001/jama.2026.0210","url":null,"abstract":"<p><strong>Importance: </strong>The efficacy and safety of intravenous tenecteplase in non-large vessel occlusion acute ischemic stroke beyond 4.5 hours after symptom onset remain uncertain.</p><p><strong>Objective: </strong>To assess the efficacy and safety of intravenous tenecteplase administered 4.5 to 24 hours after stroke onset in patients with non-large vessel occlusion and salvageable brain tissue.</p><p><strong>Design, setting, and participants: </strong>This randomized, open-label, blinded end-point clinical trial was conducted at 48 centers in China. A total of 566 patients with non-large vessel occlusion stroke and evidence of potentially salvageable tissue determined on perfusion imaging presenting within 4.5 to 24 hours of the time last seen well were recruited between June 2, 2023, and August 4, 2025 (final follow-up, October 28, 2025).</p><p><strong>Interventions: </strong>Patients were randomly assigned 1:1 using a minimization algorithm to receive intravenous tenecteplase (0.25 mg/kg; maximum dose, 25 mg; n = 282) or standard medical treatment (n = 284).</p><p><strong>Main outcomes and measures: </strong>The primary efficacy outcome was an excellent functional outcome, defined as a score of 0 or 1 on the modified Rankin Scale at 90 days. Safety outcomes included symptomatic intracranial hemorrhage within 36 hours and mortality within 90 days.</p><p><strong>Results: </strong>Among the 570 patients randomized, 566 were included in the primary analysis (median age, 68 [IQR, 59-75] years; 196 female [34.6%]). An excellent functional outcome was observed in 123 of 282 patients (43.6%) in the tenecteplase group and 97 of 284 (34.2%) in the control group (risk ratio, 1.28 [95% CI, 1.04-1.57]; P = .02). The incidence of symptomatic intracranial hemorrhage at 2.8% was higher with tenecteplase than with standard medical treatment at 0% (risk difference, 2.85% [95% CI, 1.16%-5.54%]; P = .004), and the mortality at 90 days was 5.0% and 3.2%, respectively (risk ratio, 1.57 [95% CI, 0.69-3.57]; P = .28).</p><p><strong>Conclusions and relevance: </strong>Among patients with non-large vessel occlusion acute ischemic stroke and salvageable brain tissue, intravenous tenecteplase administered 4.5 to 24 hours after onset resulted in a greater likelihood of an excellent functional outcome at 90 days than standard care but had an increased risk of symptomatic intracranial hemorrhage.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05752916.</p>","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12878635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Instruments of Precision, and Progress in Science.","authors":"","doi":"10.1001/jama.2025.15710","DOIUrl":"https://doi.org/10.1001/jama.2025.15710","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jean-Stephane David, Philippe Mahiou, Dominique Savary
{"title":"Novel Airflow System for Use in Critical Avalanche Burial.","authors":"Jean-Stephane David, Philippe Mahiou, Dominique Savary","doi":"10.1001/jama.2025.25080","DOIUrl":"https://doi.org/10.1001/jama.2025.25080","url":null,"abstract":"","PeriodicalId":17196,"journal":{"name":"Journal of the American Medical Association","volume":" ","pages":""},"PeriodicalIF":55.0,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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