tbuckley/cabot-search huggingface dataset:
ACTR-21. A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED PHASE 3 TRIAL OF DEPATUXIZUMAB MAFODOTIN (ABT-414) IN EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) AMPLIFIED (AMP) NEWLY DIAGNOSED GLIOBLASTOMA (nGBM)
Authors: Andrew Lassman, Stephanie Pugh, Tony Wang, Kenneth Aldape, Hui Gan, Matthias Preusser, Michael Vogelbaum, Erik Sulman, Minhee Won, Peixin Zhang, Golnaz Moazami, Marian Macsai, Mark Gilbert, Earle Bain, Vincent Blot, Peter Ansell, Suvajit Samanta, Madan Kundu, Clemens Seidel, Filip De Vos, Sigmund Hsu, Andrés Cardona, Giuseppe Lombardi, Dmitry Bentsion, Richard Peterson, Craig Gedye, Christine Lebrun-Frénay, Antje Wick, Walter Curran, Minesh Mehta
Journal: Neuro-Oncology (2019)

Abstract BACKGROUND Approximately 50% of nGBMs harbor EGFR-amp. Depatuxizumab mafodotin (depatux-m) is an antibody drug conjugate: a monoclonal antibody that binds activated EGFR (wild-type and EGFRvIII mutant) linked to a microtubule-inhibitor toxin. Pre-clinical and earlier clinical trials suggested efficacy. METHODS RTOGF 3508/AbbVie M13-813 (INTELLANCE-1, NCT02573324) was a phase 3 academic-industry collaboration (RTOG-Foundation, AbbVie). Eligible adults (KPS ≥ 70, EGFR-amp nGBM, centrally confirmed histology and biomarkers) were randomized 1:1 to radiotherapy (RT) and temozolomide and either depatux-m (2.0 mg/kg during RT, 1.25 mg/kg thereafter, q 14 days) or placebo, stratified by region of world, RPA class, MGMT methylation, and EGFRvIII mutation. Primary endpoint was overall survival (OS), with 640 patients planned for randomization; 441 events yielded 85% power to detect 25% reduction in hazard of death (HR 0.75), one-sided 2.5% level of significance by stratified weighted log-rank. RESULTS 2229 patients were screened and 639 (median age 60, range 22–84; 394 men, 62%) randomized. Pre-specified interim analysis after 346 events (≥ 75% required) found no OS improvement for depatux-m over placebo (median 18.9 vs. 18.7 months, HR 1.01, 95% CI 0.82–1.25, one-sided p= 0.63). Progression-free survival (PFS) trended toward depatux-m (median 8.0 vs. 6.3 months; HR 0.84, 95% CI 0.70–1.02), particularly among the ~50% with EGFRvIII mutation (median 8.3 vs. 5.9 months, HR 0.72, 95% CI 0.56–0.93) but without an OS improvement (median 19.8 vs. 18.2, HR=0.95, 95% CI 0.71–1.27). Ocular side effects (grade ≥ 1) occurred in 95% of depatux-m treated patients, 61% grade 3–4, causing 12% to discontinue, and were the most common treatment related adverse events. CONCLUSION Interim analysis demonstrated no OS benefit for treating EGFR-amp nGBM with depatux-m. PFS trended toward favoring depatux-m, particularly in the EGFRvIII harboring subgroup. No new important safety risks were identified. The trial was stopped for futility. Active patients are permitted to continue treatment.
Imbalance in T Cell Subsets Triggers the Autoimmune Toxicity of PI3K Inhibitors in CLL
Authors: Deepti Gadi, Siddha Kasar, Alec Griffith, Pui Yan Chiu, Svitlana Tyekucheva, Vanessa Rai, Alexander R. Vartanov, Stacey M. Fernandes, Yang Pan, James A Lederer, Barbara Sherry, Jennifer R. Brown
Journal: Blood (2019)
Venetoclax in Combination with Gilteritinib in Patients with Relapsed/Refractory Acute Myeloid Leukemia: A Phase 1b Study
Authors: Alexander E. Perl, Naval G. Daver, Keith W. Pratz, Joseph Maly, Wan-Jen Hong, Erkut Bahceci, Bo Tong, Tian Tian, Kimberley Dilley
Journal: Blood (2019)
Blinatumomab/Lenalidomide in Relapsed/Refractory Non-Hodgkin's Lymphoma: A Phase I California Cancer Consortium Study of Safety, Efficacy and Immune Correlative Analysis
Authors: Christina Poh, Paul Frankel, Christopher Ruel, Mehrdad Abedi, Emily Schwab, Caitlin L. Costello, Jasmine Zain, Lihua E Budde, Basem M. William, Francine M. Foss, Brian A Jonas, Aaron Seth Rosenberg, Edward Newman, Joseph Tuscano
Journal: Blood (2019)
RARE-55. RIT1 MUTATION ASSOCIATED WITH SPINAL NEUROFIBROMATOSIS
Authors: Mark Anderson, Nawal Shaikh, Eugene Long, Joseph Maher
Journal: Neuro-Oncology (2019)

Abstract Neurofibromatosis type 1 is defined clinically and molecularly by the presence of a mutation in neurofibromin, resulting in typical cutaneous, peripheral nerve and nerve root neurofibromas through the changes in regulation of the RAS pathway. A 33-year-old right-handed African-American female presented with a complaint of back pain, radiating down the legs and arms worsening over several years. On physical exam, the patient had no cutaneous neurofibromas, café-au-lait spots, or axillary freckling. MRI spine revealed diffuse symmetric fusiform nerve sheath tumors throughout the cervical, thoracic, and lumbar spine favored to represent neurofibromatosis. Genetics evaluation with pedigree revealed no family history of genetic disorders. Genetic testing was positive solely for a c.293A &gt;G transition in exon 5 of the RIT1 gene, previously reported as a cause of the RASopathy Noonan syndrome, type-8. RASopathies are conditions caused by mutations in the proteins of the RAS-MAPK pathway. Noonan Syndrome can present with some combination of abnormalities of the ears, webbing of the neck, developmental delay, and cardiac abnormalities. This patient was without external phenotypic characteristics of Noonan Syndrome, yet was found to have a mutation in this pathway. RIT1 mutation has been previously described rarely with glioma development. Alternate mutations in the RAS-MAPK pathway should be considered in the differential for patients with spinal neurofibromatosis when typical neurofibromatosis mutations are absent.
What Can We Expect after Performing Allogeneic Stem Cell Transplantation for Adult T Lymphoma in Patients from Romania, Europe?
Authors: Alina Daniela Daniela Tanase, Oana Gabriela Craciun, Lavinia Lipan, Adela Ranete, Diana Laura Stefan, Zsofia Varady, Horia Bumbea, Andrei Colita, Olivier Hermine, Segiu Pasca, Patric Teodorescu, Ciprian Tomuleasa
Journal: Blood (2019)
Medical education in the United States 1974-1975
Authors: R H YOUNG
Journal: JAMA (1975)

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
Systemic Lupus Erythematosus
Authors: P. R. J. Burch
Journal: JAMA (1966)

<h3>To the Editor:—</h3> We should like to acknowledge your generous reference to our studies in your editorial (<b>193</b>:1049, 1965). May we, however, point out that our discussion of the etiology and pathogenesis of systemic lupus erythematosus appeared in the<i>American Journal of Medicine</i>(<b>38</b>:793, 1965), and not in the<i>Annals of Internal Medicine</i>. The analysis of statistical and genetical features of manic-depressive psychosis was given in the<i>British Journal of Psychiatry</i>(<b>110</b>:808, 1964), and not in the<i>British Journal of Psychology</i>. Interested readers might like to consult the<i>Quarterly Review of Biology</i>(<b>40</b>: 252, 1965) for a discussion of the form of somatic mutation that may be involved in the pathogenesis of systemic lupus erythematosus and other spontaneous disturbed-tolerance autoimmune diseases.
Wellbeing, not more beings, to tackle lack of consultant physicians
Authors: Jack O Lyon
Journal: BMJ (2019)

The lack of consultancy posts being filled is concerning.1 I fear the consequences for training, staff morale, and patient safety.

As a medical student graduating soon, I struggle to see how effective training will occur if teams are not being taught from the top down. Registrars will be forced to work the jobs of consultants, …
NIMG-32. CHALLENGES OF IMAGING INTERPRETATION TO PREDICT OLIGODENDROGLIOMA GRADE
Authors: Orwa Aboud, Mark Gilbert, Terri Armstrong, Elizabeth Vera, Jing Wu, Kathleen Wall, Brett Theeler, Christine Siegel, Jennifer Reyes, Nicole Leggiero, Sonja Crandon, Christine Cordova, Lisa Boris, Christine Bryla, Eric Burton, Ramya Antony, Martha Quezado, Ritu Shah, Marta Penas-Prado
Journal: Neuro-Oncology (2019)

Abstract BACKGROUND A recent report examining 75 Oligodendrogliomas indicated that specific imaging features may help predict grading and guide target selection for biopsy when resection is not possible. This report attempted to validate these findings in a separate sample and evaluate interrater reliability. METHODS Two Neuro-Oncologists, blinded to radiology report and grading reviewed diagnostic pre-radiation MRI. Imaging features and reviewer interpretations were evaluated included contrast enhancement, necrosis, calcification, and restricted diffusion; examiner concordance is reported. RESULTS Sixty-two patients with diagnosis of Oligodendroglioma (50 WHO grade II, 12 WHO grade III); 54 were molecularly confirmed as IDH-mutant/1p19q co-deleted based on the NOB Natural History Study. Four patients (grade III) were excluded due to lack of imaging studies. Among 58 evaluable patients, their location was frontal (n=32), temporal (n=14), parietal (n=4), occipital (n=1), and multi-lobe (n=11). Extent of resection: gross total 9, subtotal 36, biopsy 17. Partial to extensive contrast enhancement was present in 18/58 patients (6 grade II, 33%; 12 grade III, 67%); Kappa interrater agreement k= 0.37 on grade II and k=0.50 on grade III; extensive enhancement was present in 4/58 (all grade III), k= 0.70. Necrosis noted in 7/58 patients (all grade III), k=0.61. Calcification noted in 7/17 patients reviewed (all grade III), k=1.0; restriction noted in only 2/39 patients reviewed (all grade III), k=1.0. CONCLUSIONS THE presence of extensive enhancement, necrosis, calcification and restricted diffusion were only present in grade III with substantial agreement between readers, but there was lower agreement for partial enhancement. Image reviewers commented on the variability of enhancement intensity in normal structures between scans, likely contributing to this poor concordance. Tumor areas with extensive enhancement and/or necrosis are associated with higher grade and can guide biopsy if resection is not feasible. Discrepancies in imaging interpretation may be ameliorated by implementing a standardized imaging protocol.
Trispecific antibodies enhance the therapeutic efficacy of tumor-directed T cells through T cell receptor co-stimulation
Authors: Lan Wu, Edward Seung, Ling Xu, Ercole Rao, Dana M. Lord, Ronnie R. Wei, Virna Cortez-Retamozo, Beatriz Ospina, Valeriya Posternak, Gregory Ulinski, Peter Piepenhagen, Elisa Francesconi, Nizar El-Murr, Christian Beil, Patrick Kirby, Aiqun Li, Jennifer Fretland, Rita Vicente, Gejing Deng, Tarik Dabdoubi, Beatrice Cameron, Thomas Bertrand, Paul Ferrari, Stéphanie Pouzieux, Cendrine Lemoine, Catherine Prades, Anna Park, Huawei Qiu, Zhili Song, Bailin Zhang, Fangxian Sun, Marielle Chiron, Srinivas Rao, Katarina Radošević, Zhi-yong Yang, Gary J. Nabel
Journal: Nature Cancer (2019)
Effective Targeting of PRAME-Positive Tumors with Bispecific T Cell-Engaging Receptor (TCER®) Molecules
Authors: Sebastian Bunk, Martin Hofmann, Felix Unverdorben, Meike Hutt, Gabriele Pszolla, Frank Schwöbel, Claudia Wagner, Sara Yousef, Heiko Schuster, Sarah Missel, Oliver Schoor, Toni Weinschenk, Harpreet Singh-Jasuja, Dominik Maurer, Carsten Reinhardt
Journal: Blood (2019)
Association of Sex With Outcomes in Patients Undergoing Percutaneous Coronary Intervention
Authors: Ply Chichareon, Rodrigo Modolo, Laura Kerkmeijer, Mariusz Tomaniak, Norihiro Kogame, Kuniaki Takahashi, Chun-Chin Chang, Hidenori Komiyama, Tiziano Moccetti, Suneel Talwar, Antonio Colombo, Luc Maillard, Peter Barlis, Joanna Wykrzykowska, Jan J. Piek, Scot Garg, Christian Hamm, Philippe Gabriel Steg, Peter Jüni, Marco Valgimigli, Stephan Windecker, Yoshinobu Onuma, Roxana Mehran, Patrick W. Serruys
Journal: JAMA Cardiology (2019)

<h3>Importance</h3> Women experience worse ischemic and bleeding outcomes after percutaneous coronary intervention (PCI). <h3>Objectives</h3> To assess the association of sex with patient outcomes at 2 years after contemporary PCI and with the efficacy and safety of 2 antiplatelet strategies. <h3>Design, Setting, and Participants</h3> This study is a prespecified subgroup analysis of the investigator-initiated, prospective, randomized GLOBAL LEADERS study evaluating 2 strategies of antiplatelet therapy after PCI in an unselected population including 130 secondary/tertiary care hospitals in different countries. The main study enrolled 15 991 unselected patients undergoing PCI between July 2013 and November 2015. Patients had an outpatient clinic visit at 30 days and 3, 6, 12, 18, and 24 months after the index procedure. Data were analyzed between January 1, 2019, and March 31, 2019. <h3>Interventions</h3> Eligible patients were randomized to either the experimental or reference antiplatelet strategy. Experimental strategy consisted of 1 month of dual antiplatelet therapy (DAPT) followed by 23 months of ticagrelor monotherapy, while the reference strategy comprised of 12 months of DAPT followed by 12 months of aspirin monotherapy. <h3>Main Outcomes and Measures</h3> The primary efficacy end point was the composite of all-cause mortality and new Q-wave myocardial infarction at 2 years. The secondary safety end point was Bleeding Academic Research Consortium type 3 or 5 bleeding. <h3>Results</h3> Of the 15 968 patients included in this study, 3714 (23.3%) were women. The risk of the primary end point at 2 years was similar between women and men (adjusted hazard ratio [HR], 1.00; 95% CI, 0.83-1.20). Compared with men, women had higher risk of Bleeding Academic Research Consortium type 3 or 5 bleeding (adjusted HR, 1.32; 95% CI, 1.04-1.67) and hemorrhagic stroke at 2 years (adjusted HR, 4.76; 95% CI, 1.92-11.81). At 2 years, there was no between-sex difference in the efficacy and safety of the 2 antiplatelet strategies. At 1 year, compared with DAPT, ticagrelor monotherapy was associated with a lower risk of bleeding in men (HR, 0.72; 95% CI, 0.53-0.98) but not in women (HR, 1.23; 95% CI, 0.80-1.89;<i>P</i>for interaction = .045). <h3>Conclusions and Relevance</h3> Compared with men, women experienced a higher risk of bleeding and hemorrhagic stroke after PCI. The effect of 2 antiplatelet strategies on death and Q-wave myocardial infarction following PCI did not differ between the sexes at 2 years. <h3>Trial Registration</h3> ClinicalTrials.gov identifier:NCT01813435
Psychiatry and the Medical Curriculum
Authors: T. Kennedy
Journal: BMJ (1963)

BwDKCALJOURNAL-~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~EIA they also form the bulk of patients de- scribed in most follow-up studies quoted by Dr. Sim (e.g., Ekblad, Siegfried, etc.).Dr. Sim very surprisingly does not men- tion this group, unless they are included in his dismissal of socio-economic cases.They are of course not the same, and in Scandinavia, where socio-economic grounds are recognized by the law as indicators for termination, investigators like Ekblad,' Hd6k,2 and others keep these groups strictly separate.Personality disorders or abnormal ingrained'
Outcomes for Double Hit Lymphoma Patients Identified Via Routine Vs Selective Testing for MYC Rearrangement
Authors: Zachary AK Frosch, Sunita Dwivedy Nasta, Stephen J. Schuster, Jakub Svoboda, Stefan K. Barta, James N. Gerson, Elise A. Chong, Emily C. Ayers, Joanna M Rhodes, Alexa Koike, Jennifer J.D. Morrissette, Daniel J. Landsburg
Journal: Blood (2019)
Prostate Cancer Outcomes Following Solid-Organ Transplantation: A SEER-Medicare Analysis
Authors: Stanley L Liauw, Sandra A Ham, Lauren C Das, Sonali Rudra, Vignesh T Packiam, Matthew Koshy, Ralph R Weichselbaum, Yolanda T Becker, Adam S Bodzin, Scott E Eggener
Journal: JNCI Journal of the National Cancer Institute (2019)

Immunosuppressive regimens associated with organ transplantation increase the risk of developing cancer. Transplant candidates and recipients with prostate cancer are often treated, even if low-risk features would ordinarily justify active surveillance.Using SEER-Medicare, we identified 163 676 men aged 66 years and older diagnosed with nonmetastatic prostate cancer. History of solid organ transplant was identified using diagnosis or procedure codes. A propensity score-matched cohort was identified by matching transplanted men to nontransplanted controls by age, race, region, year, T-stage, grade, comorbidity, and cancer therapy. Fine-Gray competing risk models assessed associations between transplant status and prostate cancer-specific mortality (PCSM) and overall mortality (OM).We identified 620 men (0.4%) with transplant up to 10 years before (n = 320) or 5 years after (n = 300) prostate cancer diagnosis and matched them to 3100 men. At 10 years, OM was 55.7% and PCSM was 6.0% in the transplant cohort compared with 42.4% (P < .001) and 7.6% (P = .70) in the nontransplant cohort, respectively. Adjusted models showed no difference in PCSM for transplanted men (hazard ratio = 0.88, 95% confidence interval = 0.61 to 1.27, P = .70) or differences by prostate cancer therapy. Among 334 transplanted men with T1-2N0, well or moderately differentiated "low-risk" prostate cancer, PCSM was similar for treated and untreated men (hazard ratio = 0.92, 95% confidence interval = 0.47 to 1.81).Among men aged 66 years and older with prostate cancer, an organ transplant is associated with higher OM but no observable difference in PCSM. These findings suggest men with prostate cancer and previous or future organ transplantation should be managed per usual standards of care, including consideration of active surveillance for low-risk cancer characteristics.
Biobanking and cryopreservation of human lung explants for omic analysis
Authors: Sarah G. Chu, Sergio Poli De Frias, Yuichi Sakairi, Rachel S. Kelly, Robert Chase, Kazuhisa Konishi, Ashley Blau, Ellen Tsai, Konstantin Tsoyi, Robert F. Padera, Lynette M. Sholl, Hilary J. Goldberg, Hari R. Mallidi, Phillip C. Camp, Souheil Y. El-Chemaly, Mark A. Perrella, Augustine M.K. Choi, George R. Washko, Benjamin A. Raby, Ivan O. Rosas
Journal: European Respiratory Journal (2019)

Biobanked, cryopreserved lung cells obtained from human lung tissue are viable and valuable resources for large-scale molecular phenotyping http://bit.ly/31gtpcP
Eph Receptor Tyrosine Kinases and Ephrin Ligands Are Epigenetically Inactivated in Acute Lymphoblastic Leukemia and Are Potential New Tumor Suppressor Genes in Human Leukemia.
Authors: Shao-qing Kuang, Zhi-Hong Fang, Gonzalo Lopez, Weigang Tong, Hui Yang, Guillermo Garcia-Manero
Journal: Blood (2007)
Blocking Lysosomal Two-Pore Channel 2 Function Inhibits Proliferation of Multidrug Resistant Leukemia Cells and Sensitizes Them to Vincristine Treatment
Authors: Martin Müller, Franz Geisslinger, Susanne Gerndt, Ramona Schütz, Yu-Kai Chao, Franz Bracher, Christian Grimm, Angelika Vollmar, Karin Bartel
Journal: Blood (2019)
Linear ubiquitin assembly complex regulates lung epithelial–driven responses during influenza infection
Authors: Patricia L. Brazee, Luisa Morales-Nebreda, Natalia D. Magnani, Joe G.N. Garcia, Alexander V. Misharin, Karen M. Ridge, G.R. Scott Budinger, Kazuhiro Iwai, Laura A. Dada, Jacob I. Sznajder
Journal: Journal of Clinical Investigation (2019)

Influenza A virus (IAV) is among the most common causes of pneumonia-related death worldwide. Pulmonary epithelial cells are the primary target for viral infection and replication and respond by releasing inflammatory mediators that recruit immune cells to mount the host response. Severe lung injury and death during IAV infection result from an exuberant host inflammatory response. The linear ubiquitin assembly complex (LUBAC), composed of SHARPIN, HOIL-1L, and HOIP, is a critical regulator of NF-κB-dependent inflammation. Using mice with lung epithelial-specific deletions of HOIL-1L or HOIP in a model of IAV infection, we provided evidence that, while a reduction in the inflammatory response was beneficial, ablation of the LUBAC-dependent lung epithelial-driven response worsened lung injury and increased mortality. Moreover, we described a mechanism for the upregulation of HOIL-1L in infected and noninfected cells triggered by the activation of type I IFN receptor and mediated by IRF1, which was maladaptive and contributed to hyperinflammation. Thus, we propose that lung epithelial LUBAC acts as a molecular rheostat that could be selectively targeted to modulate the immune response in patients with severe IAV-induced pneumonia.
ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases
Authors: Peter G. Middleton, Elisabeth J. Gade, Cristina Aguilera, Lucy MacKillop, Brenda M. Button, Courtney Coleman, Barbara Johnson, Charlotte Albrechtsen, Frank Edenborough, David Rigau, Peter G. Gibson, Vibeke Backer
Journal: European Respiratory Journal (2019)

This European Respiratory Society/Thoracic Society of Australia and New Zealand statement outlines a review of the literature and expert opinion concerning the management of reproduction and pregnancy in women with airways diseases: asthma, cystic fibrosis (CF) and non-CF bronchiectasis. Many women with these diseases are now living into reproductive age, with some developing moderate-to-severe impairment of lung function in early adulthood. The statement covers aspects of fertility, management during pregnancy, effects of drugs, issues during delivery and the post-partum period, and patients' views about family planning, pregnancy and parenthood. The statement summarises current knowledge and proposes topics for future research, but does not make specific clinical recommendations.
Antepartum Dental Radiography and Low Birth Weight
Authors: James Welsh
Journal: JAMA (2004)

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