tbuckley/cabot-search huggingface dataset:
Abstract 178: Measurements of coronary aneurysms due to Kawasaki Disease by Dual-Source Computed Tomography (DSCT)
Authors: Nobuyuki Tsujii, Etsuko Tsuda, Suzu Kanzaki, Kenichi Kurosaki
Journal: Circulation (2015)

Background: Diameters of coronary artery aneurysms (CAAs) due to KD in the acute phase can strongly predict long-term prognosis of coronary artery lesions. Recently, Computed Tomography Angiography (CTA) has been used in the diagnosis of coronary artery lesion (CAL). Purpose: The purpose of this study was to determine whether measurements of coronary artery diameters by CTA using DSCT can be used instead of coronary angiograms (CAG) during cardiac catheterization. Methods: Twenty five pts (22 males and 3 females) with CAL due to KD were evaluated. Their ages ranged from 5 months to 38 years (median 11years). CTA was performed between July 2007 and July 2013, and CAG was done within one year. A prospective Electrocardiogram (ECG) -triggered CTA was performed on a DSCT (SOMATOM® Definition (from July 2007 to October 2009) or SOMATOM® Definition Flash (from October 2009 to July 2013); Siemens Healthcare, Germany). ECG-gated scans were performed in 19 cases and Flash Spiral scans in 6 cases. Two pediatric cardiologists measured the diameters of CAAs twice in each maximum intensity projection (MIP), curved multi planer reconstruction (MPR) and CAG. We measured 161 segments in total (segment1-3,5-7,11,13). Diagnostic accuracy was expressed as κ coefficient. A Bland-Altman analysis was also used to assess the inter-observer, intra-observer and inter-material agreement. Results: The visualization capability of coronary arteries was excellent. One segment was not visualized by CTA. Detection rate in CTA, comparing with CAG, was 99.7%, and the diagnostic quality of CTA was excellent (κ=0.93). Excellent inter-observer agreement for diameters of CAAs was obtained for MIP, MPR and CAG and for the intra-observer agreement. The inter-modality agreement was also excellent (MPR-CAG : y=0.9x+0.40, r=0.97 ,p&lt;0.01 MIP-CAG : y=1.0x+0.1, r=0.94, p&lt;0.01). We also studied the diameters in normal segments. We also obtained good correlation between inter-observer, intra-observer and inter-modality (MPR-CAG : y=1.0x, r=0.89 , p&lt;0.01 MIP-CAG : y=1.0x+0.1, r=0.88, p&lt;0.01). Conclusion: We found a significant good correlation in the measurements of coronary artery between CTA and CAG. Measurement of the diameters of coronary artery by CTA is reliable and useful.
Hydatidiform Mole
Authors: Joseph Benezra
Journal: JAMA (1975)

<h3>To the Editor.—</h3> I refer to the article "Serum Creatinine, Urea, and Protein Level Changes in Hydatidiform Mole" by Pour-Reza et al (230:580, 1974). Provided that their controls were properly chosen, protein intake or deficiencies, which were not discussed, should be comparable in both groups. A more reasonable conclusion is that a molar pregnancy makes greater demands than normal on body stores of nitrogen.
Proximal Atrioventricular Bundle, Atrioventricular Node, and Distal Atrioventricular Bundle Are Distinct Anatomic Structures With Unique Histological Characteristics and Innervation
Authors: Darlene K. Racker, Alan H. Kadish
Journal: Circulation (2000)

Background —Direct 3D analysis (ie, stereotaxic analysis of 3 planes) has shown that the atrioventricular (AV) node (AVN) is continuous with only specialized myocardium of the proximal AV bundle (PAVB) and distal AV bundle (DAVB) or His bundle. The purpose of the present study was to determine whether the PAVB, AVN, and DAVB possess histological features distinct from each other and from the ordinary myocardium. Methods and Results —A protocol that preserves the cytoplasmic and interstitial integrity of the tissue and permits serial sections of the AV junction region to be made in 3 orthogonal planes showed that the PAVB, AVN, and DAVB are characterized by myocardium aggregated into fascicles containing ≈8 myofibers. Myofibers within the fascicles are coiled or spiraled about each other; and spiraling is most compact in the PAVB. Collagen encases individual fascicles and segregates primary fascicles into secondary fascicles. Fascicles, and not myofibers, are in parallel array in the PAVB, interwoven in the AVN, and parallel in the DAVB. Narrow junctions of parallel fascicles separate the AVN from the PAVB and DAVB. Myocytes, which are largest in DAVB, possess clear perinuclear regions; thin finger-like end processes, which are most numerous in the AVN; uniform, delicate cross-striations; and intercalated disks, which are broader in the PAVB and form short stacks in the AVN. Sheaves of nerve terminals, including boutons, are as found in skeletal muscle. Conclusions —The PAVB, AVN, and DAVB have distinct histological features. Collagen septation of primary and secondary fascicles presents natural barriers within the tissues and to surrounding myocardium and structures. These findings confirm that the AV junction region contains a specialized conduction system that is anatomically isolated from ordinary myocardium.
ORIGINAL INVESTIGATIONS ON THE NATURAL HISTORY, (SYMPTOMS AND PATHOLOGY) OF YELLOW FEVER. 1854-1894.
Authors: JOSEPH JONES
Journal: JAMA (1895)

<h3>Chapter VII.</h3><h3>EXAMINATION OF FLUID BLOOD FROM CAVITIES OF HEART THREE HOURS AFTER DEATH.</h3> The blood after its abstraction coagulated, forming a loose clot; the fibrin, however, dissolved and no serum was separated. Under the microscope the blood corpuscles presented no special alterations; when spread upon the glass slide, and also during the coagulation of the blood, they rapidly agglomerated together, forming rouleaux, as in inflammation in the blood of the horse. The running together of the colored corpuscles was as rapid and as complete as in cases of well marked inflammation. It was impossible to determine the weight of the fibrin, or to collect pure serum, free from colored blood corpuscles and the coloring matter of the red corpuscles, as the fibrin rapidly dissolved after its partial separation. The fibrin was in very small amount, and apparently not one-thirtieth of the usual proportion. Specific gravity of blood from cavities
Recommendations for Test Performance and Interpretation From the Second National Conference on Serologic Diagnosis of Lyme Disease
Journal: JAMA (1995)

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
An appraisal of the criteria of cerebral death. A summary statement. A collaborative study
Journal: JAMA (1977)

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
Clinical Lectures on Illustrations of the Variability of the Symptoms of Aneurysm of the Arch of the Aorta: Delivered at the Western Infirmary, Glasgow
Authors: T. M. Anderson
Journal: BMJ (1892)

Dittel's Operation or Lateral Prostatectomy.-This was de- vised by Dittel as a means for dealing with the lateral lobes, but was first performed by Kuster.A catheter is passed into the urethra and the rectum plugged.An incision is then made around the sphincter ani on one side, opening up the ischio-rectal fossa ; the rectum is separated from the prostate, and a wedge-shaped portion excised from the under or pos- terior surface of each lobe.The object is to allow the inner or urethral surfaces to recede from each other, and leave a wider channel.The 3 cases in which Kfister operated suc- ceeded fairly well so far as the return of voluntary urination was concerned; but in one a vesicula seminalis was opened, and in 2 a urethral fistula was left.Heemorrhage does not appear to have been severe.The operation is interesting as showing the very great importance attached by Dittel to the usually neglected lateral lobes.McGill, however, has proved that they can nearly always be excised as freely through the suprapubic incision; and there is no doubt this is the prefer- able route so long as the bladder is of fair size, and not small or rigid; when this is the case, if drainage will not suffice and prostatectomy is indicated, Dittel's operation is the only one that fulfils the conditions.
LAW AND MEDICINE
Authors: Richard P. Bergen
Journal: JAMA (1968)

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
AMA-RPS instrumental in achieving new maternity leave policy
Journal: JAMA (1991)

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
Low Back Pain
Authors: Walter R. Miller
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I sincerely wish to protest an answer appearing in the Questions and Answers section ofThe Journal(<b>175</b>:642 [Feb. 18] 1961). As a diplomate of the American Board of Orthopaedic Surgery since 1952, it has been my privilege to review books for the Bureau of Medicine and Surgery of the Navy. Occasionally, a book was sent which was not my choice from a list of new orthopedic books. Over a year ago, I reviewed<i>Ligament and Tendon Relaxation Treated by Prolotherapy</i>by G. S. Hackett. Attempting to view this publication without bias or cant and in the most dispassionate frame of mind, I became more amazed with each page. Such statements in Questions and Answers as, "The treatment is by prolotherapy, rehabilitation of an incompetent structure by induced proliferation of new bone and fibrous tissue cells. A proliferant, such as sodium psylliate, is combined with
Dysphagia Aortica
Authors: Anthony A. Hilliard, Narayana S. Murali, A. Scott Keller
Journal: Annals of Internal Medicine (2005)

Letters1 February 2005Dysphagia AorticaAnthony A. Hilliard, MD, Narayana S. Murali, MD, and A. Scott Keller, MDAnthony A. Hilliard, MDFrom Mayo Clinic, Rochester, MN 55905.Search for more papers by this author, Narayana S. Murali, MDFrom Mayo Clinic, Rochester, MN 55905.Search for more papers by this author, and A. Scott Keller, MDFrom Mayo Clinic, Rochester, MN 55905.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-3-200502010-00031 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Editor's Note:The lead author of the following Clinical Observation was one of a dozen Associates of the American College of Physicians selected to present a clinical vignette at the 2004 Annual Session in New Orleans. We are proud to present this case report through a special arrangement with the Council of Associates of the College.TO THE EDITOR:Background: Dysphagia is a subjective awareness of difficulty in swallowing caused by impaired progression of matter from the oropharynx to the stomach. Dysphagia can have mechanical, oropharyngeal (neuromuscular), or functional causes (1). Mechanical dysphagia is due to obstruction from an intrinsic or ...References1. Habermann TM. Mayo Clinic Internal Medicine Board Review. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2004:253. Google Scholar2. Wilkinson JM, Euinton HA, Smith LF, Bull MJ, Thorpe JA. Diagnostic dilemmas in dysphagia aortica. Eur J Cardiothorac Surg. 1997;11:222-7. [PMID: 9080147] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic, Rochester, MN 55905. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDysphagia due to Physiological Constriction after Stroke: A Case ReportEsophageal Disease in Older PatientsTransmitted cardiovascular pulsations on high resolution esophageal impedance manometry, and their significance in dysphagiaNonaneurysmatic Dysphagia Aortica in the Elderly: Three Case Reports and Literature ReviewPersistent Dyspepsia Due to Dysphagia Aortica Successfully Treated with the Laparoscopic ApproachBenign esophageal lesions: Endoscopic and pathologic featuresEsophageal Disease in Older PatientsA Case of Dysphagia Aortica in an Elderly PatientAggravation of Dysphagia Aortica After Wearing the Abdominal BinderDysphagia and Weight Loss in an Elderly PersonOral sensorimotor function for feeding in patients with tetanusA Patient With Dysphagia due to an Aortic AneurysmDYSPHAGIA AND ENLARGED THORACIC AORTIC ANEURYSM: IS THERE EVER A CAUSAL RELATIONSHIP? 1 February 2005Volume 142, Issue 3Page: 230-231KeywordsAngiographyAortaComputed axial tomographyDysphagiaElderlyEsophagusGastroesophageal reflux diseaseHypertensionKyphosis ePublished: 1 February 2005 Issue Published: 1 February 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Small slam
Journal: JAMA (1973)

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
Mutagenic Activity Associated with By-Products of Drinking Water Disinfection by Chlorine, Chlorine Dioxide, Ozone and UV-Irradiation
Authors: B. C. J. Zoeteman, J. Hrubec, E. de Greef, H. J. Kool
Journal: Environmental Health Perspectives (1982)

A retrospective epidemiological study in The Netherlands showed a statistical association between chlorination by-products in drinking water and cancer of the esophagus and stomach for males. A pilot-plant study with alternative disinfectants was carried out with stored water of the Rivers Rhine and Meuse. It was demonstrated that the increase of direct acting mutagens after treatment with chlorine dioxide is similar to the effect of chlorination. Ozonation of Rhine water reduced the mutagenic activity for Salmonella typhimurium TA 98 both with and without metabolic activation. UV alone hardly affects the mutagenicity of the stored river water for S. typh. TA 98. In all studies, practically no mutagenic activity for S. typh. TA 100 was found. Although remarkable changes in the concentration of individual organic compounds are reported, the identity of the mutagens detected is yet unclear. Compounds of possible interest due to their removal by ozonation are 1,3,3-trimethyloxindole, dicyclopentadiene and several alkylquinolines. Compounds which might be responsible for the increased mutagenicity after chlorination are two brominated acetonitriles and tri(2-chlorethyl) phosphate. Furthermore, the concentration procedure with adsorption on XAD resin and the subsequent elution step may have affected the results. It is proposed to focus further research more on the less volatile by-products of disinfection than on the trihalomethanes.
金色葡萄球菌早期定殖和防护特应性湿疹
Authors: F.L. Nowrouzian, A. Ljung, S. Nilsson, B. Hesselmar, I. Adlerberth, A.E. Wold
Journal: British Journal of Dermatology (2019)

特应性湿疹会导致皮肤瘙痒和失眠。它也与出现哮喘和过敏性鼻炎的风险增加相关。和这类过敏性疾病一样,特应性湿疹在西方社会很常见,但在贫穷和卫生环境较差的地区不常见。因此,在婴儿期缺乏免疫刺激(是指暴露于有助于免疫系统发育的某些虫类或“微生物”)可能是这类疾病的深层病因。金色葡萄球菌是一种寄生在皮肤上的细菌,而且通常在婴儿的肠道内定殖(生存并繁殖),在此它可以达到极高的数量。它会产生称作“超抗原”的毒素,其通常可导致“食物中毒”。但本次研究建议,让金色葡萄球菌在肠道内定殖实际上可能对幼儿有益。某些金色葡萄球菌菌株明显会降低幼儿出现湿疹的风险。研究者对一群婴儿从出生后进行了跟踪。他们从2个月大以内的幼儿的大便中培养了(采集样本并使其在实验室中生长)金色葡萄球菌,并就菌株是否携带超抗原基因及某些称作粘附素的蛋白对其进行了特征描述。科学家建议,虽然金色葡萄球菌肠道定殖率在出现特应性湿疹的婴儿与未出现的婴儿之间没有差异,但未出现湿疹的婴儿肠道内往往携带可产生egc型超抗原和弹力蛋白结合粘附素的金色葡萄球菌菌株。作者推测,在今天的清洁环境中,金色葡萄球菌定殖可能有助于启动幼儿的免疫系统,但以往其在不卫生的环境下自然启动。或许在未来可能会利用金色葡萄球菌的免疫激活成分开发一种湿疹预防药物。
Cover Image, Volume 39, Issue 3
Authors: Jiajun Wang, Xiujing Dou, Jing Song, Yinfeng Lyu, Xin Zhu, Lin Xu, Weizhong Li, Anshan Shan
Journal: Medicinal Research Reviews (2019)

On the cover: The cover image is based on the Review Article Antimicrobial peptides: Promising alternatives in the post feeding antibiotic era by Jiajun Wang et al., https://doi.org/10.1002/med.21542.
Specialty Boards
Authors: John C. Beck
Journal: JAMA (1976)

<h3>To the Editor.—</h3> We are writing in reference to Dr Aring's commentary (235:1849, 1976), with additional comments on his previous editorial on recertification (233:1063, 1975). The sole objective of specialty boards since their inception has been the evaluation and certification of individual competence in a given specialty. Their prime purpose has<i>not</i>been to "evaluate the quality of education." In evaluating individuals for certification, the boards do not rely exclusively on an examination. Eligibility for certification consists generally of the satisfactory completion of an accredited program of graduate medical education, coupled with a recommendation of the supervisory faculty through the program director. Only after such eligibility is established is the candidate considered ready to sit for the external examination. Program directors are given major responsibility for specialty training and certification. They recruit and appoint candidates, offer them an appropriate milieu in which to learn, evaluate performance internally, and on the
Age of Domestic Animals.
Journal: JAMA (1892)

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