tbuckley/cabot-search huggingface dataset:
Does influx from endemic areas mean more transfusion-associated Chagas' disease?
Authors: A. Skolnick
Journal: JAMA (1989)

BLOOD BANKS are facing another threat in addition to the hepatitis B and human immunodeficiency viruses (HIV). Two US cases of Chagas' disease have been traced to blood transfusions from asymptomatic donors who carried the causative parasite,<i>Trypanosoma cruzi</i>, from Central or South America, where it is endemic and a major cause of morbidity and mortality. Some experts fear more transfusion-associated cases will be seen unless measures are taken. <h3>Looking at Donors</h3> A transfusion-related case in California led Peter R. Kerndt, MD, Los Angeles County (Calif) Health Department; Louis V. Kirchhoff, MD, MPH, University of Iowa College of Medicine, Iowa City; and colleagues to survey blood donated at the Los Angeles County-University of Southern California Hospital blood bank, where annually about 40% of the 5000 donors are from Latin America, about half from Chagas' disease endemic areas. In their study of 1000 consecutive blood donors, Kerndt and colleagues found 1
Liver Function in Acute Myocardial Infarction
Journal: JAMA (1963)

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
PASSING OF PATHOGNOMONIC SYMPTOMS.
Journal: JAMA (1905)

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
Book Review Abdominal and Genito-Urinary Injuries . Military Surgical Manuals: Vol. III. Prepared under the auspices of the Committee on Surgery of the Division of Medical Sciences, National Research Council. 8°, cloth, 243 pp., with 28 figures. Philadelphia and London: W. B. Saunders Company, 1942. $3.00.
Journal: New England Journal of Medicine (1943)
Availability of National Cancer Institute Monograph #48
Journal: JNCI Journal of the National Cancer Institute (1978)

Journal Article Availability of National Cancer Institute Monograph #48 Get access JNCI: Journal of the National Cancer Institute, Volume 61, Issue 5, November 1978, Page 1367, https://doi.org/10.1093/jnci/61.5.1367-c Published: 01 November 1978
Studies of breast-feeding and infections. How good is the evidence?
Authors: H. Bauchner
Journal: JAMA (1986)

We assessed the extent to which studies of the association between breast-feeding and infection met four important methodological standards that relate to both the scientific validity and the generalizability of the studies. Of the 20 studies (14 cohort, six case-control), only six met three or four of the methodological standards. Four of these six studies found that breast-feeding was not protective against infections and two found that breast-feeding was protective against infections. In the three studies in which statistical adjustments were made for three additional potentially important confounding variables—size of the family, smoking of cigarettes by the mother, and the mother's level of education—the apparent protective effect of breast-feeding against respiratory tract infections disappeared after the adjustments were made. We found that most of the studies have major methodological flaws that may have compromised their conclusions. The studies that met important methodological standards and controlled for confounding variables suggest that breast-feeding has at most a minimal protective effect in industrialized countries. (<i>JAMA</i>1986;256:887-892)
Life
Authors: Neelam Vashi
Journal: Annals of Internal Medicine (2007)

Ad Libitum4 September 2007LifeNeelam Vashi, BANeelam Vashi, BAFrom Feinberg School of Medicine, Northwestern University, Chicago, IL 60611.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-147-5-200709040-00004 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail He was only 52 years old. He lay in bed all day with his curled-up mustache, short buzzed hair, and long, skinny legs. I walked into his room, saw that his teeth were a little pink, and remembered that they had served Jell-O at dinner. So I asked him how he liked the Jell-O that day. “What Jell-O?” he asked. Oh yeah. He had a small-bowel obstruction; there was no eating Jell-O for Mr. D. In fact, he had a platelet count of 52 000, and the pink I saw was bleeding from his gums that was staining his teeth.I ... Author, Article, and Disclosure InformationAffiliations: From Feinberg School of Medicine, Northwestern University, Chicago, IL 60611.Current Author Address: Neelam Vashi, BA, Northwestern University, 303 East Chicago Avenue, Ward Building 3-130, Chicago, IL 60611. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 4 September 2007Volume 147, Issue 5Page: 303KeywordsDrugsEatingHappinessHemorrhageInterleukinsMemoryPlateletsStaining ePublished: 4 September 2007 Issue Published: 4 September 2007 Copyright & PermissionsCopyright © 2007 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Progression of Cystic Pancreatic Neoplasms – a Uni-Center Cohort Study Over 6 Years
Authors: M Kaess, D Amissah, W Schorr, J Schedel, O Pech
Journal: Endoscopy (2021)

Aims The purpose of this study was to evaluate the malignant potential of pancreatic cystic lesions and the precision of endosonographic diagnoses including the early detection of cysts with malignant potential.
Tariff on Surgical Instruments
Authors: J C LeHardy
Journal: JAMA (1913)

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
Re: Nobuaki Matsubara, Kim N. Chi, Mustafa Özgüroğlu, et al. Correlation of Prostate-specific Antigen Kinetics with Overall Survival and Radiological Progression-free Survival in Metastatic Castration-sensitive Prostate Cancer Treated with Abiraterone Acetate plus Prednisone or Placebos Added to Androgen Deprivation Therapy: Post Hoc Analysis of Phase 3 LATITUDE Study. Eur Urol. 2020:77:494–500. https://doi.org/10.1016/j.eururo.2019.11.021
Authors: B. Andes Hess
Journal: European Urology (2020)
A3.21 TNFα Influences<i>RasGRP1</i>and<i>RasGRP3</i>Expression Levels in PBMC, B and T Cells
Authors: ML Golinski, M Hiron, C Guillou, C Derambure, O Boyer, X Le Loët, O Vittecoq, T Lequerré
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Rheumatoid arthritis (RA) is the most common inflammatory arthritis. B and T lymphocytes play a central role in the pathophysiology of RA. <i>RasGRP</i> is a member of the CDC25 family of Ras guanyl nucleotide exchange factors. <i>RasGRP1</i> is expressed in T and B cells whereas <i>RasGRP3</i> is only expressed in B cells. In previous studies, we have shown that <i>RasGRP3</i> expression level significantly decreased in Peripheral blood mononuclear cells (PBMC) from RA patients responders to adalimumab after 3 months, leading to the question of TNFα involvement in pathways including RasGRP1 and RasGRP3. <h3>Objectives</h3> To study TNFα effects on <i>RasGRP1</i> and <i>RasGRP3</i> expression levels in vitro. <h3>Methods</h3> We measured by qRT-PCR, <i>RasGRP1</i> and <i>RasGRP3</i> expression levels, i) in PBMC from 3 healthy controls (HC), ii) in negative selected B and T cells from PBMC isolated from 3 buffy coat. In each condition, cells were cultured with or without BCR or TCR stimulation for 4 days and TNFα was added for 24 or 48 hours. Immunofluorescence staining was performed to cheque the cell purity and B and T cells stimulation by flow cytometry. To test the functionals effects of <i>RasGRP1</i> and <i>RasGRP3</i> overexpression in T and B cells respectively, IL-2 production was measured by ELISA in T-cells, and <i>Elk-1</i> expression level was measured by qRT-PCR in B cells before and after TNFα stimulation. In addition, TNFα effects on cell proliferation were evaluated by [<sup>3</sup>H] thymidine incorporation by the B and T cells. <h3>Results</h3> In B cells, TNFα induced an increase of <i>RasGRP1</i> (p &lt; 0.001) and <i>RasGRP3</i> (p &lt; 0.001) expression levels in absence of BCR stimulation. In the same way, in T cells, TNFα induced an increase of <i>RasGRP1</i> (p &lt; 0.001) and <i>RasGRP3</i> (p &lt; 0.001) expression levels in absence of TCR stimulation. Furthermore, TNFα induced a significantly increase of IL-2 production (p &lt; 0.05) in unstimulated T cells and of <i>Elk-1</i> expression level (p &lt; 0.01) in unstimulated B cells. However, TNFα have no effects on B and T cells proliferation. <h3>Conclusions</h3> This study suggests the <i>RasGRP1</i> and <i>RasGRP3</i> regulation by TNFα, independently of B and T cells stimulation. The increasing of <i>RasGRP3</i> and <i>RasGRP1</i> in B and T cells specifically <i>via</i> TNFα binding on its receptors could promote the activation and proliferation of B and T cells by an independent antigen pathway. This second pathway could explain the maintenance of B and T cells activation.
Prevention of Rh-haemolytic Disease: Final Results of the "High-risk" Clinical Trial: A COMBINED STUDY FROM CENTRES IN ENGLAND AND BALTIMORE
Journal: BMJ (1971)

The final results are reported of a trial of about 1,000 μg of anti-D gammaglobulin given intramuscularly to a selected high-risk group of Rh-negative primiparae just delivered of an ABO-compatible Rh-positive baby, the aim being to prevent them becoming immunized to Rh. Six months after delivery only 1 out of 173 treated mothers had been immunized as against 38 out of 176 controls. The crucial test of the prophylactic therapy depends on the presence or otherwise of anti-D at the end of a second Rh-positive pregnancy. Of 86 treated mothers two had antibodies at this time compared with 20 out of 65 controls. The results show a high degree of protection in this group of mothers.
Abstract P6-18-34: Treat ER+ight Canadian prospective observational study in HR+ advanced breast cancer: <i>3rd interim analysis</i>
Authors: C Doyle, N Califaretti, S Dent, N Iqbal, M Mates, S Kulkarni, P Bains, V Glenns, SR Perri, S Chia
Journal: Cancer Research (2019)

Abstract Treat ER+ight is the 1st prospective observational study in Canadian HR+ HER2– advanced breast cancer patients currently receiving endocrine therapy (ET) alone or in combination with targeted therapy (TT) in the first, second or third line setting (NCT02753686). Methods: This pre-planned interim analysis describes baseline characteristics, treatment patterns and safety/toxicity of patients enrolled in ET and ET+TT cohorts. At data cut-off (November 2017), 200 patients were enrolled from 24 sites since March 2016. The median follow-up time at data cut-off was 8.1 months and 182 patients were evaluable for this analysis. Results: ET (n=73)ET + TT (n=109)Baseline Patient and Disease Characteristics Median age, years (range)71 (37-92)65 (39-87), p=0.017ECOG 0-1 (%)6274Median time since primary BC diagnosis, years (range)5 (0-37)6 (0-31)Median time with advanced BC diagnosis, years (range)1 (0-16)1 (0-8)Sites of Metastases (%) Bone only4027Visceral6073Location of Metastases (%) Lungs5747Liver2348, p=0.006Bone4846Lymph Nodes2735Enrollment Therapy (%) Everolimus+exemestane-29Fulvestrant17-Palbociclib+letrozole-16Palbociclib+fulvestrant-12Tamoxifen11-Exemestane6-Letrozole3-Anastrozole2-Palbociclib+exemestane-1Everolimus+tamoxifen-0.5Unknown11Start Dose of Targeted Therapy Everolimus (n=53); 10, 7.5, 5mg (%)-72, 4, 24Palbociclib (n=54); 125, 100mg, unknown (%)-89, 9, 2On-Study Adverse Events ≥15% (all-grade, %) Fatigue2332Nausea1224Diarrhea1120Cough815Alopecia316Neutropenia017 Conclusions: The majority of patients enrolled (64%) were receiving endocrine-based targeted therapy (CDK4/6 inhibitor or mTOR inhibitor) combinations. ET+TT patients were younger with more visceral disease and liver metastases compared to patients receiving endocrine therapy alone. Real-world starting dose of targeted therapies appears to be lower than the approved full dose for 11% of patients receiving palbociclib and 28% of patients receiving everolimus. Incidence of reported all-grade adverse events appears to be lower than previously reported in randomized trials and may be a consequence of real-world under-reporting of adverse events as well as the heterogeneous nature of the treatment cohorts. There does however appear to be a trend toward increased incidence of adverse events in the ET+TT cohort compared to the ET cohort. Citation Format: Doyle C, Califaretti N, Dent S, Iqbal N, Mates M, Kulkarni S, Bains P, Glenns V, Perri SR, Chia S. Treat ER+ight Canadian prospective observational study in HR+ advanced breast cancer: 3rd interim analysis [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-34.
Spice allergy in celery‐sensitive patients
Authors: J. Stauger, B. Wuuthrich, S.G.O. Johansson
Journal: Allergy (1991)

Scratch tests (SCT) with powdered commercial spices were performed in 70 patients with positive skin tests to birch and/or mugwort pollens and celery. Positive SCT to aniseed, fennel, coriander and cumin ‐ all from the same botanical family (Apiaceae) as celery ‐were observed in more than 24 patients. Spices from unrelated families (red pepper, white pepper, ginger, nutmeg, cinnamon) elicited positive immediate skin test reactions only in three of 11 patients. Specific serum IgE to spices (determined in 41 patients with positive RAST to celery) up to class 3 were seen especially in patients with celery‐mugwort or celery‐birch‐mugwort association, and concerned various botanical families. Celery‐birch association pattern was linked to positive reactions (RAST classes 1–2) to spices from the Apiaceae family only. CLINICAL ASPECTS Allergy to spices is often observed in celery‐allergic patients. In cases with the mugwort‐celery association pattern several high RAST values (up to class 3) were seen to various spices from Apiaceae as well as from unrelated botanical families (celery‐mugwort‐spices association). This sensitization can be of clinical importance, as anaphylactic reactions to spices in food are well documented. The birch‐celery association pattern gave some positive RAST results of classes 1–2 to the spices from the Apiaceae family only ‐ suggesting cross‐reactivity between Apiaceae and Betulaceae, probably due to thermolabile allergens.
EPIDERMOPHYTOSIS
Journal: JAMA (1921)

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
Suppression of Epileptic Movements in Presence of Grand Mal Seizure Discharges
Journal: JAMA (1963)

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
Sane: Insane
Authors: Arthur Rifkin
Journal: JAMA (1973)

<h3>To the Editor.—</h3> Your recent EDITORIAL, "Sane: Insane" (223:1272, 1973), referring to the article by D. L. Rosenhan, "On Being Sane in Insane Places" (<i>Science</i>179:250, 1973), is supportive of Rosenhan's conclusions. We think such support is incorrect. Rosenhan purported to demonstrate that the sane cannot be distinguished from the insane in psychiatric hospitals. Rather, he showed that malingering was not distinguished from unfaked illness. His pseudopatients reported auditory hallucinations. These are symptoms qualitatively distinct from the usual waking experience even of the "existentially distressed." Either there is "something wrong" with the patient or he is malingering. That all the pseudopatients were incorrectly diagnosed is probably due to the absence of the best clue to uncovering malingering, manifest personal gain. Once diagnosed as schizophrenic, the patients were discharged with a diagnosis of schizophrenia in remission, which is consistent with the original mislabeling, but indicates that the psychiatrist correctly perceived both the
Obituaries
Journal: JAMA (1984)

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 Journals 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
HEREDITARY HYPERTENSION AND ARTERIOSCLEROSIS
Journal: JAMA (1922)

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