tbuckley/cabot-search huggingface dataset:
Progression-free survival (PFS) and overall survival (OS) in patients (pts) with de-novo, high-volume metastatic castration-sensitive prostate cancer (dn-hv-mCSPC) undergoing intensified androgen deprivation therapy (ADT).
Authors: Umang Swami, Beverly Chigarira, Nicolas Sayegh, Taylor Ryan McFarland, Nishita Tripathi, Roberto Nussenzveig, Adam Kessel, Clara Tandar, Divyam Goel, Jackson Cheney, Blake Nordblad, Vinay Mathew Thomas, Deepika Sirohi, Benjamin L. Maughan, Neeraj Agarwal
Journal: Journal of Clinical Oncology (2022)

133 Background: In the PEACE-1 trial (Fizazi, ESMO 2021), in pts with dn-hv-mCSPC, the addition of abiraterone to ADT + docetaxel (triplet therapy arm) resulted in a median OS of 61 months (OS on ADT + docetaxel arm was 42 months). However, independent contribution of docetaxel to efficacy of ADT + abiraterone in the triplet therapy arm of PEACE-1 trial is not clear. Furthermore, the efficacy of an novel hormonal therapy (NHT) specifically in dn-hv-mCSPC population has not been reported (LATITUDE trial’s eligibility did not include volume status). Herein, our objective was to assess PFS and OS in a cohort of dn-hv-mCSPC pts undergoing intensified ADT with either NHT (i.e. novel androgen receptor or androgen synthesis inhibitors) or docetaxel. Methods: In this IRB-approved study, patient-level data were collected retrospectively. Eligibility: presence of dn-hv-mCSPC (hv per CHAARTED criteria) undergoing intensified ADT with either NHT or docetaxel started within 3 months of diagnosis. Study endpoints: PFS was calculated per PCWG-2 - defined PSA progression or radiographic progression or clinical progression whichever occurred first; OS was defined as start of therapy to date of death or censored at last follow-up. A multivariate analysis using the Cox proportional hazards (Cox-ph) model was used; the relationship between treatment intensification with both PFS and OS was assessed and adjusted for age at diagnosis, Gleason score, presence of visceral metastases, and PSA at baseline. Results: 85 pts with dn-hv-mCSPC were included: 45 received ADT + NHT; 40 received ADT + docetaxel. In the NHT vs docetaxel arms: median PFS were 23 vs 14 months; and median OS were 63 vs 36 months respectively. See the table for Cox-ph and adjusted co-variate results. Conclusions: We for the first-time report the real-world survival outcomes with ADT + NHT specifically in pts with dn-hv-mCSPC. In addition, in these hypothesis-generating data, the OS of pts with dn-hv-mCSPC undergoing ADT + NHT or ADT + docetaxel were similar to those in the triplet therapy arm or ADT + docetaxel arm of PEACE-1 trial respectively. A randomized trial in pts with dn-hv-mCSPC comparing ADT + NHT vs triplet therapy may better characterize the benefit of the docetaxel component in the triplet therapy.[Table: see text]
Clinical efficacy of atezolizumab plus bevacizumab and chemotherapy in<i>KRAS-</i>mutated non-small cell lung cancer with<i>STK11</i>,<i>KEAP1,</i>or<i>TP53</i>comutations: subgroup results from the phase III IMpower150 trial
Authors: Howard Jack West, Mark McCleland, Federico Cappuzzo, Martin Reck, Tony SK Mok, Robert M Jotte, Makoto Nishio, Eugene Kim, Stefanie Morris, Wei Zou, David Shames, Meghna Das Thakur, Geetha Shankar, Mark A Socinski
Journal: Journal for ImmunoTherapy of Cancer (2022)

Background The efficacy of atezolizumab (A) and/or bevacizumab (B) with carboplatin/paclitaxel (CP) chemotherapy was explored in the phase III, randomized IMpower150 study in patients with non-squamous non-small cell lung cancer (NSCLC) according to KRAS mutations (m KRAS ) and co-occurring STK11 , KEAP1, or TP53 mutations. Methods Mutation status was determined by circulating tumor DNA next-generation sequencing. Overall survival (OS) and progression-free survival (PFS) were analyzed in a mutation-evaluable intention-to-treat population (MEP; n=920) and SP263 (programmed cell death ligand 1 (PD-L1)) biomarker-evaluable population (n=774). Results Within the m KRAS population (24.5% of MEP), ABCP showed numerical improvements vs BCP in median OS (19.8 vs 9.9 months; HR 0.50; 95% CI 0.34 to 0.72) and PFS (8.1 vs 5.8 months; HR 0.42; 95% CI 0.29 to 0.61)—greater than with ACP (OS: 11.7 vs 9.9 months; HR 0.63; 95% CI 0.43 to 0.91; PFS: 4.8 vs 5.8 months; HR 0.80; 95% CI 0.56 to 1.13) vs BCP. Across PD-L1 subgroups in m KRAS patients, OS and PFS were longer with ABCP vs BCP, but OS with ACP was similar to BCP in PD-L1-low and PD-L1-negative subgroups. Conversely, in KRAS -WT patients, OS was longer with ACP than with ABCP or BCP across PD-L1 subgroups. KRAS was frequently comutated with STK11 , KEAP1, and TP53 ; these subgroups conferred different prognostic outcomes. Within the m KRAS population, STK11 and/or KEAP1 mutations were associated with inferior OS and PFS across treatments compared with STK11 -WT and/or KEAP 1-WT. In m KRAS patients with co-occurring m STK11 and/or m KEAP1 (44.9%) or m TP53 (49.3%), survival was longer with ABCP than with ACP or BCP. Conclusions These analyses support previous findings of mutation of STK11 and/or KEAP1 as poor prognostic indicators. While clinical efficacy favored ABCP and ACP vs BCP in these mutational subgroups, survival benefits were greater in the m KRAS and KEAP1 -WT and STK11 -WT population vs m KRAS and m KEAP1 and m STK11 population, suggesting both prognostic and predictive effects. Overall, these results suggest that atezolizumab combined with bevacizumab and chemotherapy is an efficacious first-line treatment in metastatic NSCLC subgroups with m KRAS and co-occurring STK11 and/or KEAP1 or TP53 mutations and/or high PD-L1 expression.
Endoscopic submucosal dissection: evolving role and position in the management of Barrett’s neoplasia
Authors: Madhav Desai, Prateek Sharma
Journal: Endoscopy (2022)

Endoscopic mucosal resection (EMR) is an integral component of diagnosis, staging, and treatment of Barrett’s neoplasia [1]. EMR can cure the majority of T1a cancers [2]. Conversely, T1b cancers are considered to be better managed with esophagectomy owing to the risk of lymph node metastasis (LNM). Surgery has also been shown to improve overall survival compared with EMR for T1b tumors [3]. While the risk of LNM with T1a cancer is negligible, favoring endoscopic resection due to its low risk of morbidity and mortality, the risk of LNM for T1b cancer is not clear. Previous surgical series have reported an increasing rate of LNM based on invasion depth (sm1 0–22 %, sm2/3 36 %–54 %). However, recent studies based on endoscopic resection data report substantially lower LNM rates for submucosal cancer (0–14 %) [3] [4]. The risk of LNM compared with rates of surgical morbidity has so far dictated the management of T1b esophageal adenocarcinoma (EAC). Therefore, precise rates of LNM are required to guide individual management and this may require use of additional testing, including endoscopic ultrasound and cross-sectional imaging, in addition to precise histopathological assessment of the resected lesion.
Fatal heat stroke in a long distance runner.
Authors: F Ellis, I Campbell
Journal: BMJ (1983)

muscular 29 year old man, was admitted with a high body temperature, tachycardia, and peripheral circulatory failure with a metabolic acidosis.Over the next six hours the metabolic acidosis progressed and he developed wide- spread haemorrhages in muscle and in mucous membranes and skin.On further inquiry we note he was found to have hypertonicity of muscles and hyperreflexia.Also, just before the terminal cardiac arrest he was severely acidotic with a pH of 7 08 and a base excess of -19 7. The serum lactate concentration at that time was raised at 2 9 mmol/l (26-1 mg/100 ml) (normal 1-8 mmol/l (16 2 mg/100 ml)).We believe that malignant hyperpyrexia could explain the clinical findings.This diagnosis carries an important therapeutic implication, as dantrolene has been shown to be effective in treating this condition.
Effect of Transcutaneous Magnetic Stimulation in Patients With Ventricular Tachycardia Storm
Authors: Timothy M. Markman, Naga Venkata K. Pothineni, Tarek Zghaib, Jeffrey Smietana, Daniel McBride, Nigel A. Amankwah, Kristin A. Linn, Ramanan Kumareswaran, Matthew Hyman, Jeffrey Arkles, Pasquale Santangeli, Robert D. Schaller, Gregory E. Supple, David S. Frankel, Rajat Deo, David Lin, Michael P. Riley, Andrew E. Epstein, David J. Callans, Francis E. Marchlinski, Roy Hamilton, Saman Nazarian
Journal: JAMA Cardiology (2022)

Autonomic neuromodulation provides therapeutic benefit in ventricular tachycardia (VT) storm. Transcutaneous magnetic stimulation (TcMS) can noninvasively and nondestructively modulate a patient's nervous system activity and may reduce VT burden in patients with VT storm.To evaluate the safety and efficacy of TcMS of the left stellate ganglion for patients with VT storm.This double-blind, sham-controlled randomized clinical trial took place at a single tertiary referral center between August 2019 and July 2021. The study included 26 adult patients with 3 or more episodes of VT in 24 hours.Patients were randomly assigned to receive a single session of either TcMS that targeted the left stellate ganglion (n = 14) or sham stimulation (n = 12).The primary outcome was freedom from VT in the 24-hour period following randomization. Key secondary outcomes included safety of TcMS on cardiac implantable electronic devices, as well as burden of VT in the 72-hour period following randomization.Among 26 patients (mean [SD] age, 64 [13] years; 20 [77%] male), a mean (SD) of 12.7 (10.3) episodes of VT occurred within the 24 hours preceding randomization. Patients had recurrent VT despite taking a mean (SD) of 2.0 (0.6) antiarrhythmic drugs (AADs), and 11 patients (42%) required mechanical hemodynamic support at the time of randomization. In the 24-hour period after randomization, VT recurred in 4 of 14 patients (29% [SD 47%]) in the TcMS group vs 7 of 12 patients (58% [SD 51%]) in the sham group (P = .20). In the 72-hour period after randomization, patients in the TcMS group had a mean (SD) of 4.5 (7.2) episodes of VT vs 10.7 (13.8) in the sham group (incidence rate ratio, 0.42; P < .001). Patients in the TcMS group were taking fewer AADs 24 hours after randomization compared with baseline (mean [SD], 0.9 [0.8] vs 1.8 [0.4]; P = .001), whereas there was no difference in the number of AADs taken for the sham group (mean [SD], 2.3 [0.8] vs 1.9 [0.5]; P = .20). None of the 7 patients in the TcMS group with a cardiac implantable electronic device had clinically significant effects on device function.In this randomized clinical trial, findings support the potential for TcMS to safely reduce the burden of VT in the setting of VT storm in patients with and without cardiac implantable electronic devices and inform the design of future trials to further investigate this novel treatment approach.ClinicalTrials.gov Identifier: NCT04043312.
SWOG 1318: A Phase II Trial of Blinatumomab Followed by POMP Maintenance in Older Patients With Newly Diagnosed Philadelphia Chromosome–Negative B-Cell Acute Lymphoblastic Leukemia
Authors: Anjali S. Advani, Anna Moseley, Kristen M. O'Dwyer, Brent L. Wood, Min Fang, Matthew J. Wieduwilt, Ibrahim Aldoss, Jae H. Park, Rebecca B. Klisovic, Maria R. Baer, Wendy Stock, Rupali R. Bhave, Megan Othus, Richard C. Harvey, Cheryl L. Willman, Mark R. Litzow, Richard M. Stone, Elad Sharon, Harry P. Erba
Journal: Journal of Clinical Oncology (2022)

Chemotherapy outcomes in older patients with Philadelphia (Ph) chromosome-negative B-acute lymphoblastic leukemia (ALL) are very poor. Here, we evaluated blinatumomab as induction and consolidation therapy followed by prednisone, vincristine, 6-mercaptopurine, and methotrexate (POMP) maintenance chemotherapy in this patient population.
PROPORTIONATE AND ABSOLUTE PULMONARY EMBOLISM MORTALITY IN ONCOLOGY IN THE UNITED STATES FROM 1999-2019
Authors: Scott Janus, Tarek Chami, Haytham Mously, Jamal Hajjari, Mohamad Karnib, Taha Al-Juhaishi, Sadeer Al-Kindi, Sadeer Al-Kindi
Journal: JACC CardioOncology (2022)
Population control.
Authors: K Norcross
Journal: BMJ (1977)

reduced to 3 tsg min, and blood sugar two hours later was 8 9 mmoll, and 10 hours later 4 5 mmol 1. Urine tests returned to normal four hours after the reduction and remained normal despite continued high doses of corticosteroids.A later glucose tolerance test while 15 mg day of prednisone was being taken was normai.
BMA negotiates more fee increases
Journal: BMJ (1983)

Mental Health Act CommissionFPC inquiryThe Department of Health and Social Security has announced that Lord Colville of Culross will chair the Mental Health Act Commission, which will monitor the conditions and treat- ment of patients detained in hospital under the Mental Health Act.The commission will assume its statutory functions on 30 September.Among its main duties will be: * Visiting hospitals and nursing homes where there are detained patients, to monitor the way the powers of the Mental Health Act are used, and to investigate the complaints of individual patients.* Monitoring the new "consent to treatment" provisions of the Act, and appointing psychia- trists to give second opinions where these have to be sought before a particular form of treat- ment can be undertaken.* Preparing proposals for a code of practice on admissions procedures and on matters re- lating to medical treatment of mentally dis- ordered patients.* Considering applications for review of decisions to withhold patients' correspondence.* Reporting every two years to the Secretary of State on its activities, in a report that the Secretary of State will lay before parliament.* Providing a forum for discussion of and sub- sequent guidance on mental health matters, particularly in relation to detained patients.
Omitted Information on Data and Safety Monitoring Board
Journal: JAMA Network Open (2022)

Rafael Diaz, MD; Andrés Orlandini, MD; Noelia Castellana, MSc; Alberto Caccavo, MD; Pablo Corral, MD; Gonzalo Corral, MD; Carolina Chacón, MD; Pablo Lamelas, MD; Fernando Botto, MD; María Luz Díaz, MD; Juan Manuel Domínguez, MD; Andrea Pascual, Ing; Carla Rovito, MRA; Agustina Galatte, MD; Franco Scarafia, MSc, MD; Omar Sued, MD; Omar Gutierrez, MD; Sanjit S. Jolly, MD, MSc; José M. Miró, PhD; John Eikelboom, MBBS, MSc; Mark Loeb, MD, MSc; Aldo Pietro Maggioni, PhD; Deepak L. Bhatt, MD, MPH; Salim Yusuf, DPhil; ECLA PHRI COLCOVID Trial Investigators; Lorena Lopez; Juan Muntaner; Antonela Bobato; Gonzalo Corral; Gustavo Benavent; Diego Espinel; Sandra M. Del Valle Almagro; Eleonora E. Montenegro; Adrian Núñez; Lisandro Pérez Valega; Martin Christin; Leda Guzzi; Gabriela Finelli; Lilina B. Schiavi; Eduardo Ferro Queirel; Luis M. Moltrasio; Horacio A. Fermín; Jorge V. Martínez; Omar Gutiérrez; Eleonora Cunto; Pablo A. Saúl; María del Pilar Cabrera Maciel; Javier Muntaner; Damián Lerman; Paula I. Truccolo; Adrián Armano; Esther V. Jalife; Romina M. Bertuzzi; María Inés Jean Charles; Pablo A. Fernandez; Alberto Caccavo; Nicolás Vittal; Lucia Lampone Tappata; Diego M. Murizzi; Brenda L. Fernandez; Antonio Montes de Oca; Guadalupe Diaz Vega; Felipe N. Queti; Luis A. Calafell; Mariano Sequeira; Ricardo León de la Fuente; Julio Núñez Burgos; Sonia Del Valle Armaraz; Patricia Flores; Mariana Bellanting; Narela Blazevich; Baltasar Finucci Curi; Romina P. Cabrini; Martín E. Langone; Álvaro E. Figueroa; Maria T. Iglesias; Maria Carolina Alvero; Cesar G. Lemir; José Bonorino; María Laura Pereyra; Ezequiel Barral; Mariela Rasmussen; María F. Daglio; Mariano D. Estofan; Francisco M. Perea; Sebastián E. Duhalde; María Fernanda Motta; Ignacio Romero; Guillermo Isa Massa; Celso F. García; Rubén García Durán; Elena Cornejo Pucci; Silvia Saavedra; Carolina Bozikovich; Luciano Lovesio; María J. Fernandez Moutin; Cristian C. G. Forciniti; Hugo Colombo; Nicolas Sabas; Leonardo Pilón; Adriana P. Steren
BRAIN WEIGHT AS INDEX OF INTELLIGENCE.
Journal: JAMA (1899)

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
IONIC MEDICATION
Authors: D. Campbell
Journal: BMJ (1923)

IONIC MEDICATION.I m 409 one of the best diuretics we have.A dose of urea, 10 to 15 grams each morning, will often get rid of obstinate oedema.It should be noted that there is no excess of urea in the blood during uraemia; if there were there would be a good diuresis and no uraemic convulsions.To sum up, I would advise that a patient with nephritis should have a slop diet for about ten days, and that the diet should gradually be increased to include fish, eggs, aud meat, although there is sti albuminDria.Also do not keep a iephritic patient in bed too long.A certain amount of exercise in a warm room helps to lessen the oedema, besides giving the child a happier tima
Medical News
Journal: JAMA (1913)

<h3>ARKANSAS</h3><h3>New Officers.</h3> —Fulton County Medical Association organized at Salem, April 5: president, Dr. C. W. Culp, Mammoth Springs; secretary-treasurer, Dr. J. L. Weathers, Salem.—Ouachita Medical Society at Camden, April 4: president, Dr. J. W. Meek; secretary treasurer, Dr. Calvin S. Early, both of Camden. <h3>Personal.</h3> —Dr. T. M. Rice, Avoca, was awarded the verdict at Bentonville, April 4, in the suit brought against him by W. L. Roller for $10,000 for alleged malpractice.—Dr. W. A. Harvey, Berryville, was caught under a falling tree in a windstorm and seriously injured. He was not found by searching parties for two days, and was then almost dead from exposure. <h3>Disastrous Fire in Hot Springs.</h3> —As the result of an explosion in the basemen of the building occupied by the Central Sanatorium, Hot Springs, the building and the adjoining building were destroyed, burning out the offices of Dr. E. F.
Lectures on the Histology of the Eye
Authors: J. W. Hulke
Journal: BMJ (1870)

PRESIDENT AND GENTLEMEN,-In the course of lectures on the minute anatomy of the eye which I had the honour of delivering here, last summer, I described the histology of the cornea and vitreous humour, of the retina and tunica uvea.There remain for this course the parts con- cerned in the accommodation of the eye, and the conjunctiva, sclerotic, and optic nerve, an account of which will complete the normal anatomy of the eyeball.I propose to devote to-day to the apparatus of accom- modation; Wednesday to the conj unctiva, sclerotic, and the optic nerve, including, if time permit, the histology of neuritis; and on Friday to give you some account of the anatomy of tumours and new growths originating on or inside the eyeball.Tlze Apparatus of Accomtmodation.-Let me, in the first place, en- deavour to explain what the term accommodation technically means.That we cannot see perfectly distinctly at the same instant two objects placed at different distances before the eye, is a fact of the truth of which a moment's attention suffices to convince the most unobservant person.The fact is most easily realised when the objects are near; for when they lie at a great distance from the spectator the minor distinctness of one of them is less appreciable; but when they are relatively
Abiraterone decanoate (PRL-02): Pharmacology of a single intramuscular (IM) depot injection compared to oral abiraterone acetate (AA) in intact male rats.
Authors: William R. Moore, Matthew Sharp, Joel Robert Eisner, Caroline Bell, Stuart Freeman, Tony Leesnitzer, Robert Schotzinger
Journal: Journal of Clinical Oncology (2022)

160 Background: Oral AA is a standard of care for metastatic prostate cancer. The recommended daily AA 1000 mg dose produces high peak and low trough plasma concentrations that are associated with safety issues (e.g., hepatotoxicity) and inadequate efficacy, respectively. PRL-02 is a novel abiraterone prodrug undergoing evaluation in patients with advanced prostate cancer (NCT04729114). In chemically-castrate monkeys, single doses of PRL-02 suppressed androgens for 14 weeks at much lower plasma exposures than AA (Moore et al, ASCO GU 2021). The present study in intact male rats evaluated the systemic exposures and activity of PRL-02 compared to daily oral AA at 7 and/or 14 days post-treatment start. Methods: Sexually mature male rats (n=4 per timepoint) were administered a single IM dose of PRL-02 (90 mg/kg), daily AA (90 mg/kg) or IM/oral vehicle (VEH). Biological samples were collected on Day 7 (PRL-02/VEH; 0h) or Day 14 (PRL-02/AA/VEH; 2, 6 and 24h) post-dosing. Drug and androgen concentrations were determined by LC-MS/MS. Testicular CYP17 hydroxylase activity was measured ex vivo on Day 14. Results: The Day 14 plasma exposure from abiraterone was greater from AA (5.6 - 210 ng/mL) than from PRL-02 (1.15 – 1.37 ng/mL). However, for Day 14 tissue exposures (AUC 0-24 ) from ‘total abiraterone equivalents’ (TAE; concentration of free abiraterone plus abiraterone from prodrug) were greater from PRL-02 in adrenal, testes, lymph node and bone target tissues than from oral AA; exposures from AA were only greater in non-target tissues such as liver and brain (Table). There was no measurable Day 14 CYP17 hydroxylase activity in testes following PRL-02 or AA dosing; inhibition appeared irreversible from PRL-02 and AA. Compared to VEH, a single IM dose of PRL-02 resulted in 81% and 75% reductions in plasma testosterone (T) on Days 7 and 14 post-dose, and an 80% reduction in testicular T on Day 14. Daily AA resulted in a 98% reduction in plasma T after 14 days. Conclusions: Single-dose IM PRL-02 blocked testicular CYP17 enzyme activity as effectively as daily AA in intact male rats and produced a durable large reduction in plasma T. The pharmacological activity, tissue and plasma distribution of TAE from IM PRL-02 in the rat model, along with results from prior monkey model studies, suggest the potential for a greater therapeutic index than from daily oral AA and support the ongoing evaluation of IM PRL-02 in patients with advanced prostate cancer.[Table: see text]
"COVERING" IN OHIO.
Journal: JAMA (1899)

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