tbuckley/cabot-search huggingface dataset:
Harmonic Motion Imaging of Pancreatic Tumor Stiffness Indicates Disease State and Treatment Response
Authors: Thomas Payen, Paul E. Oberstein, Niloufar Saharkhiz, Carmine F. Palermo, Stephen A. Sastra, Yang Han, Alireza Nabavizadeh, Irina R. Sagalovskiy, Barbara Orelli, Vilma Rosario, Deborah Desrouilleres, Helen Remotti, Michael D. Kluger, Beth A. Schrope, John A. Chabot, Alina C. Iuga, Elisa E. Konofagou, Kenneth P. Olive
Journal: Clinical Cancer Research (2019)

Pancreatic ductal adenocarcinoma (PDA) is a common, deadly cancer that is challenging both to diagnose and to manage. Its hallmark is an expansive, desmoplastic stroma characterized by high mechanical stiffness. In this study, we sought to leverage this feature of PDA for two purposes: differential diagnosis and monitoring of response to treatment.Harmonic motion imaging (HMI) is a functional ultrasound technique that yields a quantitative relative measurement of stiffness suitable for comparisons between individuals and over time. We used HMI to quantify pancreatic stiffness in mouse models of pancreatitis and PDA as well as in a series of freshly resected human pancreatic cancer specimens.In mice, we learned that stiffness increased during progression from preneoplasia to adenocarcinoma and also effectively distinguished PDA from several forms of pancreatitis. In human specimens, the distinction of tumors versus adjacent pancreatitis or normal pancreas tissue was even more stark. Moreover, in both mice and humans, stiffness increased in proportion to tumor size, indicating that tuning of mechanical stiffness is an ongoing process during tumor progression. Finally, using a brca2-mutant mouse model of PDA that is sensitive to cisplatin, we found that tissue stiffness decreases when tumors respond successfully to chemotherapy. Consistent with this observation, we found that tumor tissues from patients who had undergone neoadjuvant therapy were less stiff than those of untreated patients.These findings support further development of HMI for clinical applications in disease staging and treatment response assessment in PDA.
Mitochondrial Double‐Stranded RNA in Exosome Promotes Interleukin‐17 Production Through Toll‐Like Receptor 3 in Alcohol‐associated Liver Injury
Authors: Jun‐Hee Lee, Young‐Ri Shim, Wonhyo Seo, Myung‐Ho Kim, Won‐Mook Choi, Hee‐Hoon Kim, Ye Eun Kim, Keungmo Yang, Tom Ryu, Jong‐Min Jeong, Hei‐Gwon Choi, Hyuk Soo Eun, Seok‐Hwan Kim, Hyejin Mun, Je‐Hyun Yoon, Won‐Il Jeong
Journal: Hepatology (2019)

Background and Aims Mitochondrial double‐stranded RNA (mtdsRNA) and its innate immune responses have been reported previously; however, mtdsRNA generation and its effects on alcohol‐associated liver disease (ALD) remain unclear. Here, we report that hepatic mtdsRNA stimulates toll‐like receptor 3 (TLR3) in Kupffer cells through the exosome (Exo) to enhance interleukin (IL)‐17A (IL‐17A) production in ALD. Approach and Results Following binge ethanol (EtOH) drinking, IL‐17A production primarily increased in γδ T cells of wild‐type (WT) mice, whereas the production of IL‐17A was mainly facilitated by CD4 + T cells in acute‐on‐chronic EtOH consumption. These were not observed in TLR3 knockout (KO) or Kupffer cell–depleted WT mice. The expression of polynucleotide phosphorylase, an mtdsRNA‐restricting enzyme, was significantly decreased in EtOH‐exposed livers and hepatocytes of WT mice. Immunostaining revealed that mtdsRNA colocalized with the mitochondria in EtOH‐treated hepatocytes from WT mice and healthy humans. Bioanalyzer analysis revealed that small‐sized RNAs were enriched in EtOH‐treated Exos (EtOH‐Exos) rather than EtOH‐treated microvesicles in hepatocytes of WT mice and humans. Quantitative real‐time PCR and RNA sequencing analyses indicated that mRNA expression of mitochondrial genes encoded by heavy and light strands was robustly increased in EtOH‐Exos from mice and humans. After direct treatment with EtOH‐Exos, IL‐1β expression was significantly increased in WT Kupffer cells but not in TLR3 KO Kupffer cells, augmenting IL‐17A production of γδ T cells in mice and humans. Conclusions EtOH‐mediated generation of mtdsRNA contributes to TLR3 activation in Kupffer cells through exosomal delivery. Consequently, increased IL‐1β expression in Kupffer cells triggers IL‐17A production in γδ T cells at the early stage that may accelerate IL‐17A expression in CD4 + T cells in the later stage of ALD. Therefore, mtdsRNA and TLR3 may function as therapeutic targets in ALD.
Pd@Au Bimetallic Nanoplates Decorated Mesoporous MnO<sub>2</sub> for Synergistic Nucleus‐Targeted NIR‐II Photothermal and Hypoxia‐Relieved Photodynamic Therapy
Authors: Yiyi Zhang, Fan Lv, Yaru Cheng, Zhipeng Yuan, Fan Yang, Conghui Liu, Yu Cao, Kai Zhang, Huiting Lu, Shah Zada, Shaojun Guo, Haifeng Dong, Xueji Zhang
Journal: Advanced Healthcare Materials (2019)

Abstract Bimetallic nanoparticles have received considerable attention owing to synergistic effect and their multifunctionality. Herein, new multifunctional Pd@Au bimetallic nanoplates decorated hollow mesoporous MnO 2 nanoplates (H‐MnO 2 ) are demonstrated for achieving not only nucleus‐targeted NIR‐II photothermal therapy (PTT), but also tumor microenvironment (TME) hypoxia relief enhanced photodynamic therapy (PDT). The Pd@Au nanoplates present a photothermal conversion efficiency (PTCE) as high as 56.9%, superior to those PTAs activated in the NIR‐II region such as Cu 9 S 5 nanoparticles (37%), Cu 3 BiS 3 nanorods (40.7%), and Au/Cu 2− x S nanocrystals (43.2%). They further functionalize with transactivator of transcription (TAT) moiety for cell nuclear‐targeting and biodegradable hollow mesoporous MnO 2 (≈100 nm) loaded with photosensitizer Ce6 (TAT‐Pd@Au/Ce6/PAH/H‐MnO 2 ) to construct a hierarchical targeting nanoplatform. The as‐made TAT‐Pd@Au/Ce6/PAH/H‐MnO 2 demonstrates good premature renal clearance escape ability and increased tumor tissue accumulation. It can be degraded in acidic TME and generate O 2 by reacting to endogenous H 2 O 2 to relieve the hypoxia for enhanced PDT, while the released small TAT‐Pd@Au nanoplates can effectively enter into the nucleus to mediate PTT. As a result, a remarkable therapeutic effect is achieved owing to the synergistic PTT/PDT therapy. This hierarchical targeting, TME‐responsive, cytoplasm hypoxia relief PDT, and nuclear NIR‐II PTT synergistic therapy can pave a new avenue for nanomaterials‐based cancer therapy.
A new nutrition manifesto for a new nutrition reality
Authors: Francesco Branca, Alessandro Demaio, Emorn Udomkesmalee, Phillip Baker, Victor M Aguayo, Simon Barquera, Katie Dain, Lindsay Keir, Anna Lartey, Gladys Mugambi, Stineke Oenema, Ellen Piwoz, Ruth Richardson, Sudhvir Singh, Lucy Sullivan, Gerda Verburg, Patrizia Fracassi, Lina Mahy, Lynnette M Neufeld
Journal: The Lancet (2019)
Use of professional-mode flash glucose monitoring, at 3-month intervals, in adults with type 2 diabetes in general practice (GP-OSMOTIC): a pragmatic, open-label, 12-month, randomised controlled trial
Authors: John Furler, David O'Neal, Jane Speight, Irene Blackberry, Jo-Anne Manski-Nankervis, Sharmala Thuraisingam, Katie de La Rue, Louise Ginnivan, Rebecca Doyle, Elizabeth Holmes-Truscott, Kamlesh Khunti, Kim Dalziel, Jason Chiang, Ralph Audehm, Mark Kennedy, Malcolm Clark, Alicia Jenkins, Amelia J Lake, Andrzej S Januszewski, Max Catchpool, Danny Liew, Philip Clarke, James Best
Journal: The Lancet Diabetes & Endocrinology (2019)
Sex‐ and age‐related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long‐Term Registry
Authors: Mitja Lainščak, Ivan Milinković, Marija Polovina, Marisa G. Crespo‐Leiro, Lars H. Lund, Stefan D. Anker, Cécile Laroche, Roberto Ferrari, Andrew J.S. Coats, Theresa McDonagh, Gerasimos Filippatos, Aldo P. Maggioni, Massimo F. Piepoli, Giuseppe M.C. Rosano, Frank Ruschitzka, Dragan Simić, Milika Ašanin, Jean‐Christophe Eicher, Mehmet B. Yilmaz, Petar M. Seferović
Journal: European Journal of Heart Failure (2019)
Effects of Subsequent Systemic Anticancer Medication Following First-Line Lenvatinib: A Post Hoc Responder Analysis from the Phase 3 REFLECT Study in Unresectable Hepatocellular Carcinoma
Authors: Angel Alsina, Masatoshi Kudo, Arndt Vogel, Ann-Lii Cheng, Won Young Tak, Baek-Yeol Ryoo, Thomas R. Jeffry Evans, Carlos López López, Bruno Daniele, Soamnauth Misir, Min Ren, Namiki Izumi, Shukui Qin, Richard S. Finn
Journal: Liver Cancer (2019)

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Understanding the relationship between subsequent-line therapies and overall survival (OS) is important for maximizing OS for patients with hepatocellular carcinoma. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; In this post hoc analysis, we investigated OS in lenvatinib- and sorafenib-treated patients from the REFLECT study, who then received subsequent anticancer medication during the survival follow-up period. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; The follow-up period commenced at the first off-treatment visit after stopping the study medication and continued until study termination, withdrawal of consent, or death. OS and objective response rate were calculated for patients who did or did not receive poststudy anticancer medication for both treatment arms, as well as for the overall cohort. We investigated the subset of patients who responded to first-line treatment and subsequently received anticancer medication. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The OS for patients initially randomized to first-line lenvatinib (versus first-line sorafenib) and who then received any subsequent anticancer medication was 20.8 vs. 17.0 months (hazard ratio [HR] 0.87; 95% CI 0.67–1.14). The OS for patients who initially received first-line lenvatinib (versus first-line sorafenib) and who did not receive any subsequent anticancer medication was 11.5 vs. 9.1 months (HR 0.90; 95% CI 0.75–1.09). Responders to first-line lenvatinib who received subsequent medication had a median OS of 25.7 months (95% CI 18.5–34.6); responders to first line-sorafenib who received subsequent medication had a median OS of 22.3 months (95% CI 14.6–not evaluable). &lt;b&gt;&lt;i&gt;Conclusions:&lt;/i&gt;&lt;/b&gt; In this post hoc analysis of all patients in the REFLECT study who received subsequent anticancer medication, OS was increased compared with patients who did not receive any subsequent anticancer medication. In a subset analysis of responders who had received subsequent anticancer medication, use of first-line lenvatinib led to a slightly longer median OS; more research is needed on the benefits of using first-line lenvatinib compared with sorafenib.
Using a detachable snare, the cowboy method, to troubleshoot stent dysfunction after endoscopic ultrasound-guided hepaticogastrostomy
Authors: Nozomi Okuno, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Hiroki Koda, Akira Miyano
Journal: Endoscopy (2019)

Endoscopic ultrasound (EUS)-guided biliary drainage, such as by EUS-guided choledochoduodenostomy (EUS-CDS) or EUS-guided hepaticogastrostomy (EUS-HGS), is a popular technique. Recently, these techniques have been used not only as alternative methods of drainage but also for primary drainage [1] [2]. Therefore, it is necessary to prevent and troubleshoot adverse events. A stent that is placed from the stomach may sometimes deviate into the esophagus after EUS-HGS, causing severe reflux esophagitis with the secretion of bile. Herein, we report a unique and effective management of this adverse event.
Efficacy of Cetuximab Based Chemotherapy after Immunotherapy Treatments (IT) in Recurrent/Metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC) Patients (pts)
Authors: A. Hernando-Calvo, O. Mirallas, D. Marmolejo, E. Felip, E. Garralda, G. Villacampa Javierre, B. Feliu, S. Martínez, R. Gutierrez, R. Dienstmann, I. Braña
Journal: Annals of Oncology (2019)
Fatty airways: a source of good and bad fats?
Authors: Christopher E. Brightling, Andrew B. Tobin, Graeme Milligan
Journal: European Respiratory Journal (2019)

<b>Adipose tissue is increased around the airway in asthma and is associated with BMI, airway inflammation and disease severity. Fat in the airway might contribute both positively and negatively to the immunobiology of asthma.</b>http://bit.ly/2CgOGsY
Progress and Opportunities to Advance Clinical Cancer Therapeutics Using Tumor Dynamic Models
Authors: René Bruno, Dean Bottino, Dinesh P. de Alwis, Antonio T. Fojo, Jérémie Guedj, Chao Liu, Kristin R. Swanson, Jenny Zheng, Yanan Zheng, Jin Y. Jin
Journal: Clinical Cancer Research (2019)

Abstract There is a need for new approaches and endpoints in oncology drug development, particularly with the advent of immunotherapies and the multiple drug combinations under investigation. Tumor dynamics modeling, a key component to oncology “model-informed drug development,” has shown a growing number of applications and a broader adoption by drug developers and regulatory agencies in the past years to support drug development and approval in a variety of ways. Tumor dynamics modeling is also being investigated in personalized cancer therapy approaches. These models and applications are reviewed and discussed, as well as the limitations and issues open for further investigations. A close collaboration between stakeholders like clinical investigators, statisticians, and pharmacometricians is warranted to advance clinical cancer therapeutics.
Macrophage MerTK Promotes Liver Fibrosis in Nonalcoholic Steatohepatitis
Authors: Bishuang Cai, Paola Dongiovanni, Kathleen E. Corey, Xiaobo Wang, Igor O. Shmarakov, Ze Zheng, Canan Kasikara, Viralkumar Davra, Marica Meroni, Raymond T. Chung, Carla V. Rothlin, Robert F. Schwabe, William S. Blaner, Raymond B. Birge, Luca Valenti, Ira Tabas
Journal: Cell Metabolism (2019)
Paracentesis‐Induced Circulatory Dysfunction With Modest‐Volume Paracentesis Is Partly Ameliorated by Albumin Infusion in Acute‐on‐Chronic Liver Failure
Authors: Vinod Arora, Rajan Vijayaraghavan, Rakhi Maiwall, Amrish Sahney, Sherin Sarah Thomas, Rehmat Ali, Priyanka Jain, Guresh Kumar, Shiv Kumar Sarin
Journal: Hepatology (2019)

Paracentesis-induced circulatory dysfunction (PICD) is a serious complication of large-volume (>5 L) paracentesis in cirrhosis and is reduced with albumin infusion. There is a lack of data on PICD in acute-on-chronic liver failure (ACLF). Because ACLF patients have greater hemodynamic derangements than patients with decompensated cirrhosis, we investigated whether PICD could develop with modest-volume paracentesis (MVP) and the role of albumin infusion.A total of 80 ACLF patients undergoing <5 L paracentesis were randomized to receive albumin (8 g/dL of ascitic fluid; n = 40) or no albumin (n = 40) and serially followed to detect PICD. Baseline characteristics were comparable between groups, including volume of ascitic tap (4.16 ± 0.23 versus 4.14 ± 0.27 L; P = 0.72) and plasma renin activity (PRA; 20.5 ± 7.03 versus 23.2 ± 8.24 ng/mL/hour; P = 0.12). PICD was more frequent in the no-albumin group than the albumin group (70% versus 30%; P = 0.001), with higher incidence of hepatic encephalopathy (50% versus 27.5%; P = 0.04), hyponatremia (67.5% versus 22.5%; P < 0.001), acute kidney injury (62.5% versus 30%; P = 0.001), and in-house mortality (62.5% versus 27.5%; P = 0.003). PRA of 25.15 ng/mL at day 3 had sensitivity and specificity of 71% and 68%, respectively, for development of PICD at day 6. Albumin infusion decreased the incidence of PICD at day 6 (odds ratio, 0.068; 95% confidence interval, 0.011-0.43; P = 0.005).PICD is common and develops even with MVP in ACLF patients. Albumin infusion decreases the incidence of PICD and mortality in patients with ACLF. Clinical trial identifier: NCT02467348.
BMP7 aberrantly induced in the psoriatic epidermis instructs inflammation-associated Langerhans cells
Authors: Izabela Borek, René Köffel, Julia Feichtinger, Melanie Spies, Elisabeth Glitzner-Zeis, Mathias Hochgerner, Tommaso Sconocchia, Corinna Krump, Carmen Tam-Amersdorfer, Christina Passegger, Theresa Benezeder, Julia Tittes, Anna Redl, Clemens Painsi, Gerhard G. Thallinger, Peter Wolf, Georg Stary, Maria Sibilia, Herbert Strobl
Journal: Journal of Allergy and Clinical Immunology (2019)
Outcomes in Pediatric Patients with Severe Aplastic Anemia Treated with Standard Immunosuppression and Eltrombopag
Authors: Emma M. Groarke, Bhavisha A Patel, Carrie Diamond, Fernanda Gutierrez-Rodrigues, Alana Vicente, Olga Rios, Jennifer Lotter, Daniela Baldoni, Ruba Shalhoub, Colin Wu, Neal S. Young
Journal: Blood (2019)
Neurosurgery is highest paid specialty in the US, survey shows
Authors: Janice Hopkins Tanne
Journal: BMJ (2019)

Neurosurgeons are the highest paid US doctors, but internists and family medicine doctors are the most in demand, according to a new survey.1

In 2018, neurosurgeons reported annual compensation of $616 823 (£462 910, €554 697), followed by thoracic surgeons with $584 287, and orthopaedic surgeons with $526 385 (fig 1).



Fig 1 
Top and bottom five US specialties in terms of pay



Other high salary specialties were radiation oncology with $486 089, vascular surgery with $484 740, dermatology with $455 255, cardiology with …
Genomic and Phenotypic Characterization of a Broad Panel of Patient-Derived Xenografts Reflects the Diversity of Glioblastoma
Authors: Rachael A. Vaubel, Shulan Tian, Dioval Remonde, Mark A. Schroeder, Ann C. Mladek, Gaspar J. Kitange, Alissa Caron, Thomas M. Kollmeyer, Rebecca Grove, Sen Peng, Brett L. Carlson, Daniel J. Ma, Gobinda Sarkar, Lisa Evers, Paul A. Decker, Huihuang Yan, Harshil D. Dhruv, Michael E. Berens, Qianghu Wang, Bianca M. Marin, Eric W. Klee, Andrea Califano, Daniel H. LaChance, Jeanette E. Eckel-Passow, Roel G. Verhaak, Erik P. Sulman, Terry C. Burns, Fredrick B. Meyer, Brian P. O'Neill, Nhan L. Tran, Caterina Giannini, Robert B. Jenkins, Ian F. Parney, Jann N. Sarkaria
Journal: Clinical Cancer Research (2019)

Abstract Purpose: Glioblastoma is the most frequent and lethal primary brain tumor. Development of novel therapies relies on the availability of relevant preclinical models. We have established a panel of 96 glioblastoma patient-derived xenografts (PDX) and undertaken its genomic and phenotypic characterization. Experimental Design: PDXs were established from glioblastoma, IDH-wildtype (n = 93), glioblastoma, IDH-mutant (n = 2), diffuse midline glioma, H3 K27M-mutant (n = 1), and both primary (n = 60) and recurrent (n = 34) tumors. Tumor growth rates, histopathology, and treatment response were characterized. Integrated molecular profiling was performed by whole-exome sequencing (WES, n = 83), RNA-sequencing (n = 68), and genome-wide methylation profiling (n = 76). WES data from 24 patient tumors was compared with derivative models. Results: PDXs recapitulate many key phenotypic and molecular features of patient tumors. Orthotopic PDXs show characteristic tumor morphology and invasion patterns, but largely lack microvascular proliferation and necrosis. PDXs capture common and rare molecular drivers, including alterations of TERT, EGFR, PTEN, TP53, BRAF, and IDH1, most at frequencies comparable with human glioblastoma. However, PDGFRA amplification was absent. RNA-sequencing and genome-wide methylation profiling demonstrated broad representation of glioblastoma molecular subtypes. MGMT promoter methylation correlated with increased survival in response to temozolomide. WES of 24 matched patient tumors showed preservation of most genetic driver alterations, including EGFR amplification. However, in four patient–PDX pairs, driver alterations were gained or lost on engraftment, consistent with clonal selection. Conclusions: Our PDX panel captures the molecular heterogeneity of glioblastoma and recapitulates many salient genetic and phenotypic features. All models and genomic data are openly available to investigators.
Comparison of in vivo skin and in vitro blood lymphocyte models for the prediction of late normal tissue responses in breast radiotherapy (RT) patients.
Authors: Melvin Chua, Navita Somaiah, Sue Davies, Lone Gothard, Kai Rothkamm, John Yarnold
Journal: Journal of Clinical Oncology (2013)

11116 Background: Critical opinions for the lack of success of DNA double-strand break (DSB) repair as a predictive marker of normal tissue radiosensitivity include the argument that in vitro cellular responses correlate poorly with in vivo responses due to the modifying influence of tissue environment. In this study, we test the hypothesis that a DNA damage assay based on in vivo irradiated skin tissues better predicts clinical responses in human skin, as opposed to the same assay performed in ex vivo irradiated lymphocytes. Methods: DSB levels (24 h post-4 Gy) were quantified using γH2AX/53BP1 immunostaining in irradiated skin tissues and G 0 lymphocytes of 35 breast RT patients. Patients were selected on the basis of late RT effects in their breast and individuals with marked or minimal effects were classified as cases and controls, respectively. Risk factors of late effects established from multivariate analyses of outcomes of two breast RT trials were also considered in patient selection. They were 1) total RT dose, 2) RT dosimetry, 3) tumour bed boost, 4) breast size, 5) surgical cavity, and 6) axillary treatment. Results: Clinical parameters were balanced in both patient groups. Residual foci levels in skin epidermis and dermis were comparable between cases (n = 20) and controls (n = 15). Mean foci per cell were 3.29 in cases, 2.80 in controls for dermal fibroblasts (p = 0.07); 3.28 in cases, 2.60 in controls for endothelial cells (p = 0.08); 2.87 in cases, 2.41 in controls for superficial keratinocytes (p = 0.45); 2.32 in cases, 2.35 in controls for basal keratinocytes (p = 0.27). Residual foci levels in lymphocytes were however significantly higher among cases (foci per cell = 12.1) compared to controls (foci per cell = 10.3, p = 0.01). Of the different cell types, only residual foci levels of dermal fibroblasts and lymphocytes correlated with clinical severity (R = 0.722, p &lt; 0.001; 0.593, p = 0.01, respectively). Interestingly, foci levels were not correlated between skin cells and lymphocytes of the same patients. Conclusions: DSB repair of ex vivo irradiated lymphocytes appears to be a better predictive marker of late effects to breast RT than DSB repair of in vivo irradiated skin.
Implementation of Genetic Screening to Prevent Severe Cutaneous Adverse Drug Reactions Is Crucial—Rebuttal From the Devil’s Antagonist
Authors: Felix L. Chan, Roni P. Dodiuk-Gad
Journal: JAMA Dermatology (2019)

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 Dermatology 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 Dermatology journal