tbuckley/cabot-search huggingface dataset:
CD4/CD8 T-Cell Selection Affects Chimeric Antigen Receptor (CAR) T-Cell Potency and Toxicity: Updated Results From a Phase I Anti-CD22 CAR T-Cell Trial
Authors: Nirali N. Shah, Steven L. Highfill, Haneen Shalabi, Bonnie Yates, Jianjian Jin, Pamela L. Wolters, Amanda Ombrello, Seth M. Steinberg, Staci Martin, Cindy Delbrook, Leah Hoffman, Lauren Little, Anusha Ponduri, Haiying Qin, Haris Qureshi, Alina Dulau-Florea, Dalia Salem, Hao-Wei Wang, Constance Yuan, Maryalice Stetler-Stevenson, Sandhya Panch, Minh Tran, Crystal L. Mackall, David F. Stroncek, Terry J. Fry
Journal: Journal of Clinical Oncology (2020)

PURPOSE Patients with B-cell acute lymphoblastic leukemia who experience relapse after or are resistant to CD19-targeted immunotherapies have limited treatment options. Targeting CD22, an alternative B-cell antigen, represents an alternate strategy. We report outcomes on the largest patient cohort treated with CD22 chimeric antigen receptor (CAR) T cells. PATIENTS AND METHODS We conducted a single-center, phase I, 3 + 3 dose-escalation trial with a large expansion cohort that tested CD22-targeted CAR T cells for children and young adults with relapsed/refractory CD22+ malignancies. Primary objectives were to assess the safety, toxicity, and feasibility. Secondary objectives included efficacy, CD22 CAR T-cell persistence, and cytokine profiling. RESULTS Fifty-eight participants were infused; 51 (87.9%) after prior CD19-targeted therapy. Cytokine release syndrome occurred in 50 participants (86.2%) and was grade 1-2 in 45 (90%). Symptoms of neurotoxicity were minimal and transient. Hemophagocytic lymphohistiocytosis–like manifestations were seen in 19/58 (32.8%) of subjects, prompting utilization of anakinra. CD4/CD8 T-cell selection of the apheresis product improved CAR T-cell manufacturing feasibility as well as heightened inflammatory toxicities, leading to dose de-escalation. The complete remission rate was 70%. The median overall survival was 13.4 months (95% CI, 7.7 to 20.3 months). Among those who achieved a complete response, the median relapse-free survival was 6.0 months (95% CI, 4.1 to 6.5 months). Thirteen participants proceeded to stem-cell transplantation. CONCLUSION In the largest experience of CD22 CAR T-cells to our knowledge, we provide novel information on the impact of manufacturing changes on clinical outcomes and report on unique CD22 CAR T-cell toxicities and toxicity mitigation strategies. The remission induction rate supports further development of CD22 CAR T cells as a therapeutic option in patients resistant to CD19-targeted immunotherapy.
Abstract 11001: Eicosanoid Variation is Strongly Related to Blood Pressure in the General Population
Authors: Joonatan Palmu, Jeramie Watrous, Aki Havulinna, Kim Lagerborg, Aaro Salosensaari, Leo Lahti, Scott Ritchie, Michael Inouye, Susan Cheng, Veikko Salomaa, Mohit Jain, Teemu Niiranen
Journal: Circulation (2018)

Introduction: Epidemiologic and animal studies have suggested an association between systemic inflammation and blood pressure (BP) regulation, though the mechanistic factors linking inflammation an...
US-Acquired Chagas Disease Case Found After Blood Donation
Authors: Bridget M. Kuehn
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 17675: Long-Term Prognostic Implications of Jugular Venous Distension Among Patients Hospitalized With Acute Heart Failure
Authors: Fernando Chernomordik, Anat Berkovitch, Edward Koifman, Ilan Goldenberg, Robert Klempfner
Journal: Circulation (2013)

Background: Jugular venous distension (JVD) is a simple clinical marker of heart failure (HF) severity, yet data regarding the prognostic implications of this finding in the ’real-life’ setting are...
Transfer of cGAMP into Bystander Cells via LRRC8 Volume-Regulated Anion Channels Augments STING-Mediated Interferon Responses and Anti-viral Immunity
Authors: Chun Zhou, Xia Chen, Rosa Planells-Cases, Jiachen Chu, Li Wang, Limin Cao, Zhihong Li, Karen I. López-Cayuqueo, Yadong Xie, Shiwei Ye, Xiang Wang, Florian Ullrich, Shixin Ma, Yiyuan Fang, Xiaoming Zhang, Zhikang Qian, Xiaozheng Liang, Shi-Qing Cai, Zhengfan Jiang, Dongming Zhou, Qibin Leng, Tsan S. Xiao, Ke Lan, Jinbo Yang, Huabin Li, Chao Peng, Zhaozhu Qiu, Thomas J. Jentsch, Hui Xiao
Journal: Immunity (2020)
Covid-19: Guidance is urgently needed on who should be treated in event of shortages, say lawyers
Authors: Clare Dyer
Journal: BMJ (2020)

Healthcare lawyers and doctors’ defence bodies have said that national guidance is urgently needed on how to allocate scarce resources such as ventilators during the covid-19 pandemic.

The calls came as a law firm threatened to seek a judicial review of the government’s failure to issue official guidance on how doctors should decide between patients if not everyone who needs intensive care treatment can access it.

Rook Irwin Sweeney, newly set up by solicitors from the leading law firm Irwin Mitchell, has written a letter before action to Matt Hancock, the health and social care secretary for England, and to NHS England. Acting for a group of disabled campaigners, the firm is challenging the government’s failure to provide guidance for doctors who have to decide who should get lifesaving treatment. The letter asked for …
A dermatologic manifestation of COVID-19: Transient livedo reticularis
Authors: Iviensan F. Manalo, Molly K. Smith, Justin Cheeley, Randy Jacobs
Journal: Journal of the American Academy of Dermatology (2020)

COVID-19 can present with a rash and be mistaken for dengueJournal of the American Academy of DermatologyVol. 82Issue 5PreviewTo the Editor: We found the report "What are we doing in the dermatology outpatient department amidst the raging of 2019-CoV?" to be very interesting.1 Chen et al pointed out the need for a dermatology department to recognize and deal with this infection. Full-Text PDF Reply to: "A dermatologic manifestation of COVID-19: Transient livedo reticularis"Journal of the American Academy of DermatologyVol. 83Issue 2PreviewTo the Editor: I enthusiastically read the article by Manalo et al, "A dermatologic manifestation of COVID-19: Transient livedo reticularis."1 The authors should be commended for quickly recognizing and reporting possible cutaneous findings of COVID-19. Full-Text PDF Could antiphospholipid antibodies contribute to coagulopathy in COVID-19?Journal of the American Academy of DermatologyVol. 83Issue 3PreviewTo the Editor: We read with great interest the article by Manalo et al.1 Coronavirus disease 2019 (COVID-19) patients may develop a thrombophilic state, and extensive microthrombosis has been found at autoptic examination in numerous organs.2 We agree with Manalo et al1 that it is likely that this phenomenon does not spare the skin, where it plausibly expresses itself through livedo reticularis and acral ischemia.1,2 Hypercoagulability in COVID-19 patients should not be underestimated because in the worst-case scenario it may lead to death by causing pulmonary embolism or disseminated intravascular coagulation. Full-Text PDF
Rates of Postoperative Recurrence of Crohn’s Disease and Effects of Immunosuppressive and Biologic Therapies
Authors: Pauline Rivière, Séverine Vermeire, Marie Irles-Depe, Gert Van Assche, Paul Rutgeerts, Quentin Denost, Albert Wolthuis, Andre D’Hoore, David Laharie, Marc Ferrante
Journal: Clinical Gastroenterology and Hepatology (2020)
Combined Mesenchymal Stromal Cell Therapy and Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome. A Randomized Controlled Trial in Sheep
Authors: Jonathan E. Millar, Nicole Bartnikowski, Margaret R. Passmore, Nchafatso G. Obonyo, Maximillian V. Malfertheiner, Viktor von Bahr, Meredith A. Redd, Louise See Hoe, Katrina K. Ki, Sanne Pedersen, Andrew J. Boyle, J. Kenneth Baillie, Kiran Shekar, Nathan Palpant, Jacky Y. Suen, Michael A. Matthay, Daniel F. McAuley, John F. Fraser
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

Rationale: Mesenchymal stromal cell (MSC) therapy is a promising intervention for acute respiratory distress syndrome (ARDS), although trials to date have not investigated its use alongside extracorporeal membrane oxygenation (ECMO). Recent preclinical studies have suggested that combining these interventions may attenuate the efficacy of ECMO.Objectives: To determine the safety and efficacy of MSC therapy in a model of ARDS and ECMO.Methods: ARDS was induced in 14 sheep, after which they were established on venovenous ECMO. Subsequently, they received either endobronchial induced pluripotent stem cell-derived human MSCs (hMSCs) (n = 7) or cell-free carrier vehicle (vehicle control; n = 7). During ECMO, a low Vt ventilation strategy was employed in addition to protocolized hemodynamic support. Animals were monitored and supported for 24 hours. Lung tissue, bronchoalveolar fluid, and plasma were analyzed, in addition to continuous respiratory and hemodynamic monitoring.Measurements and Main Results: The administration of hMSCs did not improve oxygenation (PaO2/FiO2 mean difference = -146 mm Hg; P = 0.076) or pulmonary function. However, histological evidence of lung injury (lung injury score mean difference = -0.07; P = 0.04) and BAL IL-8 were reduced. In addition, hMSC-treated animals had a significantly lower cumulative requirement for vasopressor. Despite endobronchial administration, animals treated with hMSCs had a significant elevation in transmembrane oxygenator pressure gradients. This was accompanied by more pulmonary artery thromboses and adherent hMSCs found on explanted oxygenator fibers.Conclusions: Endobronchial hMSC therapy in an ovine model of ARDS and ECMO can impair membrane oxygenator function and does not improve oxygenation. These data do not recommend the safe use of hMSCs during venovenous ECMO.
Histologic features of melanoma associated with germline mutations of CDKN2A, CDK4, and POT1 in melanoma-prone families from the United States, Italy, and Spain
Authors: Michael R. Sargen, Donato Calista, David E. Elder, Daniela Massi, Emily Y. Chu, Míriam Potrony, Ruth M. Pfeiffer, Cristina Carrera, Paula Aguilera, Llucia Alos, Susana Puig, Rosalie Elenitsas, Xiaohong R. Yang, Margaret A. Tucker, Maria Teresa Landi, Alisa M. Goldstein
Journal: Journal of the American Academy of Dermatology (2020)
Hypertension in the Inner City
Authors: FRANK A. FINNERTY, LAWRENCE W. SHAW, CLIFTON K. HIMMELSBACH
Journal: Circulation (1973)

Sixty-one percent (6480 of 10,564) of the subjects in three census tracts were screened simply and efficiently in supermarkets. The prevalence of hypertension in the subjects over 25 years of age was 24%. Fifty percent (457 of 953) found to be hypertensive on initial screening failed to keep their first verification appointment. The number was reduced to 279 (29%) by personal contact or home visits by one of the cardiovascular group. Subsequent experience demonstrated that dropouts could be reduced to under 5% by scheduling the verification visit 24-48 hours after initial screening. At the second verification visit there were originally 108 "no-shows" which could be reduced to 36 by personal contact. Because of a fall in diastolic blood pressure below 90 mm Hg during the two verification visits, 296 patients were excluded from the study. Of the 953 initially hypertensive subjects, 284 (30%) were available for study. These patients were randomized into three groups, a stepped-up care group (group A) and two usual medical care groups (groups B and C). Of the original 98 patients, 84% are currently being followed in group A, whereas only 33% in group B and 17% in group C are under medical care. The diastolic blood pressure has returned to normal in 70% in group A, in 10% in group B, and in 17% in group C.
SLFN11 inhibits hepatocellular carcinoma tumorigenesis and metastasis by targeting RPS4X via mTOR pathway
Authors: Chenhao Zhou, Chunxiao Liu, Wenjie Liu, Wanyong Chen, Yirui Yin, Chia-Wei Li, Jennifer L Hsu, Jialei Sun, Qiang Zhou, Hui Li, Bo Hu, Peiyao Fu, Manar Atyah, Qianni Ma, Yang Xu, Qiongzhu Dong, Mien-Chie Hung, Ning Ren
Journal: Theranostics (2020)

Hepatocellular carcinoma (HCC) remains one of the most refractory malignancies worldwide. Schlafen family member 11 (SLFN11) has been reported to play an important role in inhibiting the production of human immunodeficiency virus 1 (HIV-1). However, whether SLFN11 also inhibits hepatitis B virus (HBV), and affects HBV-induced HCC remain to be systematically investigated. Methods: qRT-PCR, western blot and immunohistochemical (IHC) staining were conducted to investigate the potential role and prognostic value of SLFN11 in HCC. Then SLFN11 was stably overexpressed or knocked down in HCC cell lines. To further explore the potential biological function of SLFN11 in HCC, cell counting kit-8 (CCK-8) assays, colony formation assays, wound healing assays and transwell cell migration and invasion assays were performed in vitro. Meanwhile, HCC subcutaneous xenograft tumor models were established for in vivo assays. Subsequently, immunoprecipitation (IP) and liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) analyses were applied to understand the molecular mechanisms of SLFN11 in HCC. Co-IP, immunofluorescence and IHC staining were used to analyze the relationship between ribosomal protein S4 X-linked (RPS4X) and SLFN11. Finally, the therapeutic potential of SLFN11 with mTOR pathway inhibitor INK128 on inhibiting HCC growth and metastasis was evaluated in vitro and in vivo orthotopic xenograft mouse models. Results: We demonstrate that SLFN11 expression is decreased in HCC, which is associated with shorter overall survival and higher recurrence rates in patients. In addition, we show that low SLFN11 expression is associated with aggressive clinicopathologic characteristics. Moreover, overexpression of SLFN11 inhibits HCC cell proliferation, migration, and invasion, facilitates apoptosis in vitro, and impedes HCC growth and metastasis in vivo, all of which are attenuated by SLFN11 knockdown. Mechanistically, SLFN11 physically associates with RPS4X and blocks the mTOR signaling pathway. In orthotopic mouse models, overexpression of SLFN11 or inhibition of mTOR pathway inhibitor by INK128 reverses HCC progression and metastasis. Conclusions: SLFN11 may serve as a powerful prognostic biomarker and putative tumor suppressor by suppressing the mTOR signaling pathway via RPS4X in HCC. Our study may therefore offer a novel therapeutic strategy for treating HCC patients with the mTOR pathway inhibitor INK128.
SARS-CoV-2 Viral Load in Clinical Samples from Critically Ill Patients
Authors: Yongbo Huang, Sibei Chen, Zifeng Yang, Wenda Guan, Dongdong Liu, Zhimin Lin, Yu Zhang, Zhiheng Xu, Xiaoqing Liu, Yimin Li
Journal: American Journal of Respiratory and Critical Care Medicine (2020)

We are in unprecedented times, and healthcare teams may face tremendously difficult decisions related to rationing ventilators and offering intensive care.As states and institutions consider revising existing triage plans or formulating new ones, decision-makers should be careful to avoid language that excludes patients from receiving care because of an underlying condition without carefully considering the prognosis for those individuals.It is vitally important that crisis standards of care factor in accurate, disease-specific prognostic information as patients are triaged.
Ten-Year Results of FAST: A Randomized Controlled Trial of 5-Fraction Whole-Breast Radiotherapy for Early Breast Cancer
Authors: Adrian Murray Brunt, Joanne S. Haviland, Mark Sydenham, Rajiv K. Agrawal, Hafiz Algurafi, Abdulla Alhasso, Peter Barrett-Lee, Peter Bliss, David Bloomfield, Joanna Bowen, Ellen Donovan, Andy Goodman, Adrian Harnett, Martin Hogg, Sri Kumar, Helen Passant, Mary Quigley, Liz Sherwin, Alan Stewart, Isabel Syndikus, Jean Tremlett, Yat Tsang, Karen Venables, Duncan Wheatley, Judith M. Bliss, John R. Yarnold
Journal: Journal of Clinical Oncology (2020)

Previous studies of hypofractionated adjuvant whole-breast radiotherapy for early breast cancer established a 15- or 16-fraction (fr) regimen as standard. The FAST Trial (CRUKE/04/015) evaluated normal tissue effects (NTE) and disease outcomes after 5-fr regimens. Ten-year results are presented.
Kidney Function in Patients With Type 2 Diabetes After Vitamin D Supplementation—Reply
Authors: Ian H. de Boer, Leila R. Zelnick, JoAnn E. Manson
Journal: JAMA (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Determinants of survival in myelofibrosis patients undergoing allogeneic hematopoietic cell transplantation
Authors: Juan Carlos Hernández-Boluda, Arturo Pereira, Nicolaus Kröger, Dietrich Beelen, Marie Robin, Martin Bornhäuser, Emanuele Angelucci, Antonin Vitek, Igor Wolfgang Blau, Riitta Niittyvuopio, Jürgen Finke, Jan J. Cornelissen, Jakob Passweg, Peter Dreger, Eefke Petersen, Lothar Kanz, Jaime Sanz, Tsila Zuckerman, Nienke Zinger, Simona Iacobelli, Patrick Hayden, Tomasz Czerw, Donal McLornan, Ibrahim Yakoub-Agha
Journal: Leukemia (2020)
Divergent Neural Pathways Emanating from the Lateral Parabrachial Nucleus Mediate Distinct Components of the Pain Response
Authors: Michael C. Chiang, Eileen K. Nguyen, Martha Canto-Bustos, Andrew E. Papale, Anne-Marie M. Oswald, Sarah E. Ross
Journal: Neuron (2020)

The lateral parabrachial nucleus (lPBN) is a major target of spinal projection neurons conveying nociceptive input into supraspinal structures. However, the functional role of distinct lPBN efferents in diverse nocifensive responses have remained largely uncharacterized. Here we show that that the lPBN is required for escape behaviors and aversive learning to noxious stimulation. In addition, we find that two populations of efferent neurons from different regions of the lPBN collateralize to distinct targets. Activation of efferent projections to the ventromedial hypothalamus (VMH) or lateral periaqueductal gray (lPAG) drives escape behaviors, whereas activation of lPBN efferents to the bed nucleus stria terminalis (BNST) or central amygdala (CEA) generates an aversive memory. Finally, we provide evidence that dynorphin-expressing neurons, which span cytoarchitecturally distinct domains of the lPBN, are required for aversive learning.
Imaging of tumor colonization by <i>Escherichia coli</i> using <sup>18</sup>F-FDS PET
Authors: Sae-Ryung Kang, Eui Jeong Jo, Vu Hong Nguyen, Ying Zhang, Hee Seung Yoon, Ayoung Pyo, Dong-Yeon Kim, Yeongjin Hong, Hee-Seung Bom, Jung-Joon Min
Journal: Theranostics (2020)

Tumor-targeting bacteria have been actively investigated as a new therapeutic tool for solid tumors.However, in vivo imaging of tumor-targeting bacteria has not been fully established. 18F-fluorodeoxysorbitol (FDS) positron emission tomography (PET) is known to be capable of imaging Gram-negative Enterobacteriaceae infection.In the present study, we aimed to validate the use of 18 F-FDS PET for visualization of the colonization and proliferation of tumor-targeting Escherichia coli (E.coli) MG1655 in mouse tumor models.Methods: E. coli (5 × 10 7 colony forming unit) were injected intravenously into BALB/c mice bearing mouse colon cancer (CT26).Before and 1, 3, and 5 days after the bacterial injection, PET imaging was performed following i.v.injection of approximately 7.4 MBq of 18 F-FDS.Regions of interest were drawn in the engrafted tumor and normal organs including the heart, liver, lung, brain, muscle, and intestine.Semiquantitative analysis was performed using maximum standardized uptake value (SUVmax).Results: 18 F-FDS uptake was significantly higher in tumors colonized by live E. coli MG1655 than in uncolonized tumors (p < 0.001).The PET signals in the colonized tumors at 3 days after bacterial injection were 3.1-fold higher than those in the uncolonized tumors.Tumoral 18 F-FDS uptake correlated very strongly with the number of E. coli in tumors (r = 0.823, p < 0.0001).Cross sectional analysis of autoradiography, bioluminescence, and pathology revealed that the 18 F-FDS uptake sites in tumors matched the locations of E. coli MG1655. Conclusion:In conclusion, 18 F-FDS PET is expected to be useful for the semiquantitative visualization of tumor-targeting bacteria when bacterial cancer therapy is performed using Gram-negative Enterobacteriaceae such as E. coli.
Longevity Gene <i>KLOTHO</i> and Alzheimer Disease—A Better Fate for Individuals Who Carry <i>APOE</i> ε4
Authors: Dena B. Dubal, Jennifer S. Yokoyama
Journal: JAMA Neurology (2020)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Neurology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Neurology journal