tbuckley/cabot-search huggingface dataset:
BREAKWATER: Randomized phase 3 study of encorafenib (enco) + cetuximab (cet) ± chemotherapy for first-line treatment (tx) of <i>BRAF</i> V600E-mutant (BRAFV600) metastatic colorectal cancer (mCRC).
Authors: Scott Kopetz, Axel Grothey, Rona Yaeger, Fortunato Ciardiello, Jayesh Desai, Tae Won Kim, Tim Maughan, Eric Van Cutsem, Harpreet Singh Wasan, Takayuki Yoshino, Michelle L. Edwards, Adele Golden, Ashwin Gollerkeri, Josep Tabernero
Journal: Journal of Clinical Oncology (2022)

TPS211 Background: Approximately 10% of patients (pts) with mCRC have BRAF mutations (mostly V600E). First-line tx options for BRAF V600E mCRC are limited to cytotoxic chemotherapy ± anti-VEGF or anti-EGFR; or immune checkpoint inhibitors in pts with MSI-H tumors. In Europe, Japan, and USA, the combination of BRAF inhibitor enco + EGFR inhibitor cet is approved for tx of BRAF V600E mCRC after prior therapy. In BEACON CRC, enco + cet resulted in a median overall survival (OS) of 9.3 months (95% confidence interval [CI]: 8.0–11.3) and an objective response rate (ORR) of 19.5% (95% CI: 14.5%–25.4%) in previously treated pts with BRAF V600E mCRC (median follow-up: 12.8 months); 57.4% of pts had grade 3/4 adverse events (AEs), and 9% discontinued due to AEs. Given the poor prognosis of pts with BRAF V600E mCRC and based on the efficacy and tolerability of enco + cet from BEACON CRC, the BREAKWATER study will evaluate the efficacy and safety of enco + cet ± chemotherapy in tx-naive pts with BRAF V600E mCRC. Methods: BREAKWATER is an open-label, global, multicenter, randomized, phase 3 study with a safety lead-in (SLI). Approximately 60 and 870 pts will be enrolled in the SLI and phase 3 parts of the study, respectively. Pts must have mCRC with BRAF V600E-mutation (determined using tumor tissue or blood); ECOG performance status 0/1; and adequate bone marrow, hepatic, and renal function. Pts in the SLI must have evaluable disease (RECIST v1.1) and have received ≤ 1 prior tx regimen; those previously treated with a BRAF or EGFR inhibitor, or both oxaliplatin and irinotecan, will be excluded. Pts in the phase 3 study must have measurable disease and be tx naive for metastatic disease. Study tx and endpoints are shown in the table. Enrollment began on 06-Jan-2021. Clinical trial information: NCT04607421. [Table: see text]
From the Health Care Financing Administration
Authors: G. R. Wilensky
Journal: JAMA (1992)

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
Olaparib maintenance monotherapy for non-germline BRCA1/2-mutated (non-gBRCAm) platinum-sensitive relapsed ovarian cancer (PSR OC) patients (pts): Phase IIIb OPINION primary analysis.
Authors: Andres Poveda, Stephanie Lheureux, Nicoletta Colombo, David Cibula, Kristina Lindemann, Johanne I Weberpals, Maria Bjurberg, Ana Oaknin, Magdalena Sikorska, Antonio Gonzalez Martin, Radoslaw Madry, María Jesus Rubio, Jonathan A. Ledermann, Richard Davidson, Christopher Blakeley, James Bennett, Jessica Brown, Erik Skof
Journal: Journal of Clinical Oncology (2021)

5545 Background: In the Phase II Study 19 trial (NCT00753545; Ledermann et al Lancet Oncol 2014), maintenance olaparib improved progression-free survival (PFS) vs placebo in PSR OC pts, including non-BRCAm pts. A significant PFS benefit was also seen with maintenance olaparib vs placebo in gBRCAm PSR OC pts in the Phase III SOLO2 trial (NCT01874353; Pujade-Lauraine et al Lancet Oncol 2017). To investigate olaparib maintenance monotherapy in non-gBRCAm PSR OC pts who had received ≥2 prior lines of platinum-based chemotherapy (PBC), we performed the Phase IIIb, single-arm, OPINION study (NCT03402841). Methods: Pts had high-grade serous or endometrioid OC and were in complete response (CR) or partial response (PR) to PBC. Pts received maintenance olaparib (tablets; 300 mg bid) until disease progression or unacceptable toxicity. The primary endpoint was investigator-assessed PFS (modified RECIST v1.1). Secondary endpoints included PFS by homologous recombination deficiency (HRD) and somatic BRCA mutation (sBRCAm) status determined by central Myriad tumor and germline testing; and time to first subsequent treatment (TFST). The primary analysis was planned for 18 months (mo) after the last patient was enrolled. Results: 279 pts were enrolled from 17 countries (mean age: 64 years); 253 pts (90.7%) were confirmed non-gBRCAm. At data cut-off (Oct 2, 2020), median PFS was 9.2 mo (95% CI 7.6–10.9), with 210 PFS events (75.3% maturity). 65.3%, 38.5% and 24.3% of pts were progression-free (PF) at 6, 12 and 18 mo, respectively. The Table shows PFS in key subgroups. Median TFST was 13.9 mo (95% CI 11.5–16.4). Median exposure to olaparib was 9.4 mo (range 0.0–31.9). Grade ≥3 treatment-emergent adverse events (TEAEs) occurred in 29.0% of pts and serious TEAEs in 19.7% of pts. TEAEs led to dose interruption, dose reduction and treatment discontinuation in 47.0%, 22.6% and 7.5% of pts, respectively. Conclusions: Our findings support the use of olaparib maintenance therapy in non-gBRCAm PSR OC pts, consistent with our interim analysis and previous trials in this setting. Clinical trial information: NCT03402841. [Table: see text]
Error in Table
Authors: Andrea Angeletti, Pietro Ravani, Gian Ghiggeri
Journal: JAMA Pediatrics (2021)

Jill L. Maron, MD, MPH; Stephen F. Kingsmore, MD; Kristen Wigby, MD; Shimul Chowdhury, PhD; David Dimmock, MD; Brenda Poindexter, MD, MS; Kristen Suhrie, MD; Jerry Vockley, MD, PhD; Thomas Diacovo, MD; Bruce D. Gelb, MD; Annemarie Stroustrup, MD, MPH; Cynthia M. Powell, MD; Andrea Trembath, MD, MPH; Matthew Gallen, MPH; Thomas E. Mullen, PhD; Pranoot Tanpaiboon, MD; Dallas Reed, MD; Anne Kurfiss, MPH; Jonathan M. Davis, MD
Medicolegal
Journal: JAMA (1931)

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
Addiction medicine
Authors: R. Frances
Journal: JAMA (1992)

Addiction psychiatry achieved formal recognition as a subspecialty this year with the American Board of Medical Specialists approval of a certification process, including fellowships and an examination for added qualifications in addiction psychiatry through the American Board of Psychiatry and Neurology. The first examination for subspecialty certification will occur in April 1993. Psychiatry is taking a leading role in recognizing the growing complexity of addiction medicine. Recently, the Group for the Advancement of Psychiatry Committee on Alcoholism and Addictions published a position report describing the role of the psychiatrist in the evaluation and treatment of patients with substance use disorders.<sup>1</sup>In addition, there is growing support for other medical specialties to develop American Board of Medical Specialists credentials in addiction medicine. Guidelines for postgraduate training in addiction medicine have been developed, and in 1991, there were 48 postresidency addiction fellowship programs, with 161 graduates and 122 fellows in training.
Effect of Dapagliflozin on Hematocrit in Patients With Type 2 Diabetes at High Cardiovascular Risk: Observations From DECLARE-TIMI 58
Authors: Ahmed A. Kolkailah, Stephen D. Wiviott, Itamar Raz, Sabina A. Murphy, Ofri Mosenzon, Deepak L. Bhatt, Lawrence A. Leiter, John P.H. Wilding, Ingrid Gause-Nilsson, Marc S. Sabatine, Darren K. McGuire
Journal: Diabetes Care (2022)
Diabetes mellitus prevents ischemic preconditioning by prodromal angina in patients with a first anterior wall acute myocardial infarction Masaharu Ishihara, Hikaru Sato, Takuji Kawagoe, Yuji Shimatani, Satoshi Kurisu, Kenji Nishioka, Yasuyuki Kouno, Takashi Umemura, Shuji Nakamura.Hiroshima City Hospital, Hiroshima, Japan
Journal: Journal of the American College of Cardiology (2001)
Visualization of ventricular early excitation site induced by ventricular pacing using phase imaging Satoshi Nakatani, Hideaki Kanzaki, Akihisa Hanatani, Keiji Hirooka, Yoshio Yasumura, Masakazu Yamagishi, Kunio Miyatake. National Cardiovascular Center, Suita, Japan
Journal: Journal of the American College of Cardiology (2001)
Intracoronary blood flow velocity analysis of suboptimal balloon angioplasty versus stent implantation: A subanalysis of the DEBATE-II trial Jan J. Piek, Michiel Voskuil, Mariano Albertal, Eric Boersma, Bernard de Bruyne, Stephane Carlier, Jose Eduardo Soussa, Toshiya Muramatsu, Chris Vrints, Martijn Meuwissen, Steven Chamuleau, Patrick W. Serruys. Academic Medical Center, Amsterdam, The Netherlands, Thoraxcenter, Rotterdam, The Netherlands
Journal: Journal of the American College of Cardiology (2001)
Abstract 483: Effect of Glucose on Endothelial Cell Expression of Inflammation-Related miRNAs
Authors: Jamie Hijmans, Ma’ayan Levy, Whitney Reiakvam, Lillian Bruster, Kelly Stockelman, Zoë Goldthwaite, Tyler Bammert, Jared Greiner, Christopher DeSouza
Journal: Circulation Research (2017)

Hyperglycemia is an independent risk factor for cardiovascular disease (CVD). A key factor underlying hyperglycemia-related CVD risk is endovascular inflammation. The mechanisms underlying hyperglycemia induced endovascular inflammation are not clear. It is now recognized that microRNAs (miRs) play a pivotal role in regulating cellular inflammation pathways, vascular health and, in-turn, cardiovascular disease (CVD). It is currently unknown whether high glucose concentrations adversely affect the expression of inflammation-related miRs in endothelial cells; if so, miR dysregulation may provide novel insight into the proinflammatory endothelial phenotype associated with hyperglycemia. The aim of this study was to determine the effect of high glucose concentrations on the expression of inflammation-related miRs (miR-34a, -92a, -126, -146a, -150, -155 and -181b). Cultured human umbilical vein endothelial cells were harvested on the 3rd passage and plated in 6-well plates at a density of 5.0x10 5 cells/condition. Cells were incubated with RPMI 1640 media containing 25mM D-glucose (concentration representing a hyperglycemic state) or 5mM D-glucose (control condition) for 48 hours. Thereafter, RNA was extracted from 1.0x10 5 cells and miRs were reverse transcribed and expression was determined by RT-PCR. Cellular expression was normalized to RNU6 and calculated as fold change in ΔΔCt from control (N=6, experimental units). There was no effect of high glucose concentrations on the expression of proinflammatory miRs: miR-34a (0.93±0.18 fold), -92a (0.93±0.07 fold) and -155 (0.85±0.10 fold). However, cellular expression of anti-inflammatory miRs: miR-146a (0.64±0.06 fold), -150 (0.69±0.12 fold), and -181b (0.73±0.07 fold), were significantly reduced (~60%, ~45%, and ~40% respectively; P&lt;0.05) in response to the high glucose condition. Lower cellular expression of miR-146a, miR-150 and miR-181b is consistent with a pro-inflammatory endothelial phenotype. These miRs directly target and suppress NF-kB activation and immune cell activation, primary mediators of cellular inflammation. The seminal and novel finding of this study is that high glucose concentration compromises endothelial cell expression of key anti-inflammatory miRs.
Effect of immune checkpoint inhibitor (ICI) treatment in hepatocellular carcinoma (HCC) based on underlying liver disease.
Authors: Linda Wu, Emilia Bagiella, Michelle Rudshteyn, Deirdre Jill Cohen
Journal: Journal of Clinical Oncology (2022)

396 Background: While treatment of unresectable HCC remains challenging, ICI either alone or in combination with bevacizumab, has become a standard therapy. Overall, HCC outcomes are improved with the use of ICI, but only a small percentage of patients respond. As a result, there remains a need for biomarker discovery for optimal patient selection. Emerging evidence suggests that patients with non-viral causes of HCC, including nonalcoholic steatohepatitis (NASH) and alcohol use, may not derive the same benefit from ICI as patients with viral causes of HCC. A recent study by Pfister et al. (2021) demonstrated in preclinical models that NASH-related aberrant T cell activation and impaired immune surveillance play a role in reducing responsiveness to ICI. Our study aimed to use real-world data to evaluate whether there is a difference in overall survival (OS) following treatment with ICI in patients with viral-induced compared to those with non-viral-induced HCC. Methods: We conducted a retrospective chart review of all patients with unresectable HCC at Mount Sinai Health System who received ICI from 1/2017 to 6/2021. The primary outcome investigated was OS of patients with viral etiologies compared to non-viral etiologies of HCC. Results: A total of 349 patients were included. The cohort was predominantly male (84%), with median age of 63 years. 86% of patients were cirrhotic. 246 (70%) patients had HCC with a viral etiology, with the majority (67.5%) due to hepatitis C infection. 103 patients (30%) had non-viral causes of HCC, with 47% due to NASH and 39% due to alcohol. At the time of ICI initiation, most patients (66%) had Child Pugh (CP) class A liver disease and performance status (PS) ECOG 0 (71%). Nivolumab was the most common ICI given (87%) and 79% of patients received ICI as first-line therapy. The viral and non-viral HCC groups were evenly matched in terms of sex, age, cirrhosis, ECOG PS, type of ICI, and line of therapy. With a median duration of follow-up of 10.5 months (range: 1.4-62.4 months), the median OS (mOS) of patients with viral HCC was 19.3 months (95% CI: 14.2-26.6) and mOS of patients with non-viral HCC was 11.4 months (95% CI: 9.3-17.7; P = 0.08). The hazard ratio, adjusted for CP class and stage, for viral HCC treated with ICI was 0.81 (95% CI: 0.583-1.127; P = 0.21). Conclusions: Patients with viral-induced HCC appear to have improved OS when treated with ICI compared to patients with non-viral-induced HCC, but the difference is not statistically significant. Further studies are required to better understand the mechanisms underlying response to ICI in HCC.
Abstract P024: Nonsustained Ventricular Tachycardia is Independently Associated With Lower Cognitive Function: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Faye L Norby, Alvaro Alonso, Mary R Rooney, Ankit Maheshwari, Ryan J Koene, Elsayed Z Soliman, Laura R Loehr, Thomas H Mosley, Josef Coresh, Lin Y Chen
Journal: Circulation (2018)

Introduction: -- Atrial fibrillation is associated with greater cognitive decline and increased risk of dementia. Little is known about whether other arrhythmias, such as nonsustained ventricular tachycardia (NSVT), are associated with cognition. We aimed to assess the cross-sectional association of NSVT with cognitive test scores in the Atherosclerosis Risk in Communities (ARIC) study. Methods: We included 1367 (mean age, 79 ± 5 years; 55% female; 19% non-white race) participants who underwent cognitive tests and ≥2 days of heart rhythm recording using the Zio ® Patch (a non-invasive, leadless, 2-week ambulatory continuous ECG recording device by iRhythm Technologies, Inc.) in July 2013-February 2017. NSVT was defined as a wide complex tachycardia &gt;4 beats with a rate &gt;100 beats per minute. Burden was calculated as the number of NSVT episodes divided by recording time and split on the median into higher burden and lower burden. Cognitive domain-specific factor scores consisted of tests of memory, executive function and language. We used multiple linear regression to assess the association of NSVT with standardized z-scores of each cognitive domain. Results: The mean recording time of the Zio ® Patch was 12.6 ± 2.5 days. There were 399 (29%) participants with NSVT recorded, ranging from 0.5-439 episodes per week (median = 0.59; interquartile range = 0.51-1.50). Presence of NSVT was associated with lower memory and lower executive function, but not impaired language (Table). The associations were restricted to participants with higher burden of NSVT compared to those without NSVT (-0.22 z-score units, 95% confidence interval (CI) -0.41, -0.04 for memory, and -0.23, 95%CI -0.41, -0.05 for executive function) (Table). Conclusion: Presence and higher burden of NSVT are independently associated with lower cognitive function, specifically executive function and memory. Further research is warranted to elucidate the underlying mechanism.
Abstract P168: The Association of Longitudinal Changes in Metabolic Syndrome With Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study
Authors: Tolulope A Adesiyun, Lucia Kwak, Kavita Sharma, Vijay Nambi, Erin D Michos, Ian Neeland, Roger S Blumenthal, Christie M Ballantyne, Elizabeth Selvin, Josef Coresh, Chiadi E Ndumele
Journal: Circulation (2018)

Background: Metabolic syndrome (MS) is a risk factor for the development of heart failure (HF). However, little is known about how changes in MS over time are associated with HF risk. Hypothesis: We hypothesized that increasing MS components over time and a longer duration of MS would be associated with greater HF risk. Methods: We studied 8,104 participants at ARIC Visit 4 (1996-98) without baseline HF, coronary heart disease or diabetes. MS components were defined using AHA/NHLBI criteria for waist circumference, hyperglycemia, elevated blood pressure, low HDL-C and hypertriglyceridemia, and MS was diagnosed if ≥ 3 criteria were present. Using data on MS components from Visit 1 (1987-89) through 4, we used multivariate Cox regression models to evaluate associations of changes in MS components over time and duration of MS with incident HF occurring after Visit 4. Results: The mean age was 63 years (+/-6), with 58% female. Over a median follow-up of 16 years, there were 902 HF events. Compared to those without MS at Visits 1 and 4, those with MS at both time points had a hazard ratio (HR) for HF of 1.87 (95% CI 1.60-2.19), while those with no MS at Visit 1 but MS at Visit 4 (HR 1.38; 95% CI 1.16-1.64) and those with MS at Visit 1 but not at Visit 4 (1.51; 95% CI 1.13-2.00) had more modest risk associations. Among those without MS at Visit 1, those with 0 MS components at both Visits 1 and 4 had lowest HF risk (reference), with progressively higher risk seen for those who increased to 1-2 (HR 1.66; 95% CI 1.06-2.61), 3 (HR 2.15; 95% CI 1.37-3.38) and 4-5 (HR 2.55; 95% CI 1.58-4.13) MS components by Visit 4. Duration of MS had a positive association with HF risk (Figure), with a HR of 1.08 (95% CI 1.06-1.10) per year of MS duration. Conclusions: Progression in MS components over time and a longer duration of MS are associated with increased HF risk. Given the cardiovascular implications of these findings, particularly for the growing number of individuals developing MS components at an early age, strategies to prevent MS onset and progression should be implemented widely.
Two divergent haplotypes from a highly heterozygous lychee genome suggest independent domestication events for early and late-maturing cultivars
Authors: Guibing Hu, Junting Feng, Xu Xiang, Jiabao Wang, Jarkko Salojärvi, Chengming Liu, Zhenxian Wu, Jisen Zhang, Xinming Liang, Zide Jiang, Wei Liu, Liangxi Ou, Jiawei Li, Guangyi Fan, Yingxiao Mai, Chengjie Chen, Xingtan Zhang, Jiakun Zheng, Yanqing Zhang, Hongxiang Peng, Lixian Yao, Ching Man Wai, Xinping Luo, Jiaxin Fu, Haibao Tang, Tianying Lan, Biao Lai, Jinhua Sun, Yongzan Wei, Huanling Li, Jiezhen Chen, Xuming Huang, Qian Yan, Xin Liu, Leah K. McHale, William Rolling, Romain Guyot, David Sankoff, Chunfang Zheng, Victor A. Albert, Ray Ming, Houbin Chen, Rui Xia, Jianguo Li
Journal: Nature Genetics (2022)

Abstract Lychee is an exotic tropical fruit with a distinct flavor. The genome of cultivar ‘Feizixiao’ was assembled into 15 pseudochromosomes, totaling ~470 Mb. High heterozygosity (2.27%) resulted in two complete haplotypic assemblies. A total of 13,517 allelic genes (42.4%) were differentially expressed in diverse tissues. Analyses of 72 resequenced lychee accessions revealed two independent domestication events. The extremely early maturing cultivars preferentially aligned to one haplotype were domesticated from a wild population in Yunnan, whereas the late-maturing cultivars that mapped mostly to the second haplotype were domesticated independently from a wild population in Hainan. Early maturing cultivars were probably developed in Guangdong via hybridization between extremely early maturing cultivar and late-maturing cultivar individuals. Variable deletions of a 3.7 kb region encompassed by a pair of CONSTANS -like genes probably regulate fruit maturation differences among lychee cultivars. These genomic resources provide insights into the natural history of lychee domestication and will accelerate the improvement of lychee and related crops.
Fourth National Conference on the Medical Aspects of Sports
Journal: JAMA (1962)

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