tbuckley/cabot-search huggingface dataset:
HBV genotypes and outcome of HBV infection
Authors: Anna S. F. Lok
Journal: Hepatology (2005)

We thank Drs. Kao and Chen for their comments on our recent editorial.1 They provided additional data to support the finding that in Taiwan, HBV genotype B is associated with HCC at a younger age, suggesting that the subtype of HBV genotype B encountered in Taiwan is associated with accelerated progression to HCC. Recent studies showed that there are two major subtypes of HBV genotype B: Ba, which represents recombination between genotype B and C and is found in many parts of Asia; and Bj, which does not have recombination with genotype C and is predominantly found in Japan.2 It is certainly possible that the discrepant findings between studies from Taiwan and Japan are related to different subtypes of genotype B. However, Ba is also the predominant subtype in China and yet studies from Hong Kong and China found that patients with genotype B had lower risk of HCC than those with genotype C.3 We agree that each HBV genotype may be associated with more than one phenotype and that further studies are needed to identify the factors that are associated with each phenotype. Anna S. F. Lok M.D.*, * Division of Gastroenterology University of Michigan Medical Center Ann Arbor, MI.
The prevention of adolescent pregnancy
Authors: E. R. McAnarney
Journal: JAMA (1989)

THE PREVENTION of adolescent pregnancy and its consequences must be considered at several levels.<i>Primary prevention</i>focuses on preventing pregnancy by the development of responsible sexual behaviors by means such as influencing cultural attitudes and values, teaching about sexuality in the clinical environment, and discussing the subject in school.<i>Secondary prevention</i>considers the prevention of pregnancy by encouraging contraception for sexually active young people.<i>Tertiary prevention</i>addresses the prevention of morbidity in young mothers and their children through adequate prenatal care and follow-up. Although most professionals agree that abortion is not a desirable form of pregnancy prevention, it should be included in discussions of tertiary prevention. It is difficult to separate the different levels of prevention in an absolute sense. For example, the physician may provide primary and secondary prevention services in the office, and sex and family life education may cover all levels. The following principles underlie this report:
Association News
Journal: JAMA (1930)

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
Donor B-Cell Alloantibody Deposition and Germinal Center Formation Are Required for the Development of Murine Chronic Gvhd and Bronchiolitis Obliterans
Authors: Mathangi Srinivasan, Ryan Flynn, Andrew Price, Ann Ranger, Jeffrey L Browning, Patricia A Taylor, Jerome Ritz, Joseph H. Antin, William J Murphy, Leo Luznik, Mark Shlomchik, Angela Panoskaltsis-Mortari, Bruce R. Blazar
Journal: Blood (2011)
SHAPE OF THE MOUSE ENCEPHALOMYELITIS VIRUS
Journal: JAMA (1942)

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
PUBLIC ACCUSATIONS AGAINST HOSPITALS.
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
Adding clarity to the universal health coverage picture
Authors: None The Lancet Global Health
Journal: The Lancet Global Health (2017)

It has been a busy year for universal health coverage (UHC) advocates. A series of high-level meetings and events (World Health Assembly, WHO DG election, UN General Assembly, to name only a few) have signalled strong political interest in their cause. As 2017 comes to a close, the anniversary of the UN's 2012 endorsement of UHC, on December 12, is the last de facto opportunity to ramp up advocacy for access to quality care without the risk of financial hardship for everyone around the globe. This year, celebrations will include a 4-day UHC Forum in Tokyo, Japan (Dec 12–15), where more high-level political and technical discussions will take place.
Effects of Chloroform and Bromodichloromethane on DNA Synthesis in Male F344 Rat Kidney
Authors: Michael M. Lipsky, Mary Skinner, Christine O'Connell
Journal: Environmental Health Perspectives (1993)

We have been investigating the actions of chloroform (CHC13) and bromodichloromethane (BDCM) in rat kidney after different routes of exposure.Male F344 rats were exposed by gavage with corn oil or water as the diluting vehicle.All experiments lasted 30 days with gavage expo- sures 5 days per week for 4 weeks (20 doses).All animals were injected IP with bromodeoxyuri- dine (BrdU) 3 times over a 6-day period at 50 mg/kg/injection.Kidney tissue was fixed and slides were stained with hematoxylin and eosin for routine viewing and by the PAP (peroxidase- antiperoxidase) technique using anti-BrdU to label cells in DNA synthesis.There were no signif- icant changes in gross parameters evaluated between the control rats and the rats exposed to CHCl3 or BDCM.Rats exposed via corn oil gavage to CHC13 displayed a segment-specific epithe- lial cell necrosis (6/6 high dose, 2/6 low dose).The lesions were primarily localized to the second segment of the proximal tubule, although some spread to cells in the first segment was occa- sionally observed.No histologic lesions were observed in the kidneys of rats exposed to BDCM.Preliminary results indicate a significant increase in DNA synthesis in the CHCI3-treated rats and a slight increase in DNA synthesis in BDCM-treated rats with corn oil as the diluent.The increase in BrdU labeling was primarily in cells of the S2 segment of the proximal tubule and interstitial cells of CHC13-exposed animals and in cells of the S3 segment of BDCM-exposed ani- mals.The rats exposed using water as the vehicle did not show significant pathology (except for one rat in the high-dose CHC13 group, which had mild necrosis of proximal tubule epithelium).There were no changes in DNA synthesis in the CHCL3-treated rat kidneys when water was used as the vehicle.There was a slight increase in total DNA synthesis in the BDCM-treated rat kidneys, and the increase was mainly in the third segment of the proximal tubule.These data indicate differences in histopathologic alterations and levels of DNA synthesis that appear to depend on the vehicle that the chemicals were dissolved in and/or the route of administration.CHC13-induced pathologic alterations were more severe in the animals exposed by corn oil gav- age.BDCM, an established renal carcinogen in rats, failed to induce any histopathologic alter- ations under the different experimental conditions of this study.
THE EARLY DIAGNOSIS OF DIPHTHERIA AND THE PHYSICIAN'S DUTY WHEN CONFRONTED WITH CASES OF DOUBTFUL CHARACTER, PRESENTING SYMPTOMS OF DIPHTHERIA.
Journal: JAMA (1895)

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
Front &amp; Back Matter
Authors: Santosh K. Chaturvedi, Kausik Goswami, Vera K. Tsenkova, Deborah Carr, Christopher L. Coe, Carol D. Ryff, Willoughby B. Britton, Patricia L. Haynes, Keith W. Fridel, Richard R. Bootzin, Julia Applebaum, Boris Nemets, Zeev Kaplan, Eliezer Witztum, R.H. Belmaker, Direnc Sakarya, Cengiz Gunes, Erdinc Ozturk, Vedat Sar, Daisuke Nishi, Yuichi Koido, Naoki Nakaya, Toshimasa Sone, Hiroko Noguchi, Kei Hamazaki, Tomohito Hamazaki, Yutaka Matsuoka, Michael Maes, Frank N.M. Twisk, Karl Ringel, Alexander Konnopka, Rainer Schaefert, Sven Heinrich, Claudia Kaufmann, Melanie Luppa, Wolfgang Herzog, Hans-Helmut König, Sylvie Hébert, Barbara Canlon, Dan Hasson, Hanspeter Moergeli, Lutz Wittmann, Ulrich Schnyder, John M. Kelley, Ted J. Kaptchuk, Cristina Cusin, Samuel Lipkin, Maurizio Fava, Charles-Siegfried Peretti, Charles Roger Peretti, Elizabeth Kozora, Dimitri Papathanassiou, Virginie-Anne Chouinard, Guy Chouinard, Satz Mengensatzproduktion, Druck Reinhardt Druck Basel, Druck Reinhardt Druck Basel
Journal: Psychotherapy and Psychosomatics (2012)
NATURAL PIGMENTS AND VITAMINS
Journal: JAMA (1934)

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
Toxicity of benorylate.
Authors: M Aylward
Journal: BMJ (1973)

tion of about I million there are some 34 school clinic sessions per week, and the hospitals, alceady full, just could not fit in the extra sessions.Fortunately all but four of these clinics are run by S.H.M.O.s or the equivalent who have also assistant sessions at the regional eye unit and our si subsidiary hospitals, so that an adequate re- lationship of the two services is obtained.-Iam, etc., JOHN PRIMROSE Romford, EssexPractice in the United States Sut,-I am a British paediatrician in the United States on a one year fellowship.Before he comes to the United States a hospital doctor needs the E.C.F.M.G. certificate.He may then be under the impression that no further qualifications are necessary during the course of a one-year stay here.Many doctors in the past have discovered on arrival in America that they cannot sur- vive on
Epidemiology of Summer Camp Accidents
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
Malignant Tumors of the Liver and Lungs in an Area with A PVC Industry
Authors: M. Saric, Z. Kulcar, M. Zorica, I. Gelic
Journal: Environmental Health Perspectives (1976)

The incidence of malignant tumors of the lung and bronchus and of cytologically confirmed primary malignant tumor of the liver was analyzed for a 4-yr period in a city with several factories, including a PVC industry. Prior to the study two cases of angio-sarcoma of the liver were diagnosed in workers employed in PVC production. The total incidence of analyzed tumors was only slightly higher than predicted. The tumors of the liver recorded did not show any dependence on place of work or residence. During the period of observation, malignant tumors of the bronchus (lung) were not recorded in the PVC industry. Their rate in the area in which the PVC industry is situated was approximately the same as that for the entire city area. The study does not indicate that the occurrence of malignant tumors other than angiosarcoma is associated with exposure to vinyl chloride.
YELLOW FEVER.
Journal: JAMA (1894)

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
PRIMARY AMYLOIDOSIS
Journal: JAMA (1960)

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
THE PHENOMENON OF HYPERSUSCEPTIBILITY.
Journal: JAMA (1907)

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
190P Observational cohort study of 1st line bevacizumab combined with chemotherapy in metastatic colorectal cancer (HGCSG0802): Sub-group analysis by the Glasgow Prognostic Score (GPS)
Authors: T. Sasaki, S. Yuki, Y. Kawamoto, K. Harada, T. Meguro, T. Miyagishima, M. Nakamura, A. Sato, I. Iwanaga, M. Tateyama, K. Hatanaka, K. Eto, H. Okuda, O. Muto, M. Abe, A. Oba, S. Kato, K. Miyashita, Y. Sakata, Y. Komatsu
Journal: Annals of Oncology (2016)
ETHNIC LABELS
Authors: MORTON HAMBURGER
Journal: Annals of Internal Medicine (1969)

Letters and Comments1 September 1969ETHNIC LABELSMORTON HAMBURGER, M.D.MORTON HAMBURGER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-71-3-662 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:Let me tell you how happy the next to the last paragraph of your editorial, "Ethnic Labels in Medical Writing" (Ann. Intern. Med. 70: 1042, 1969), has made me. For well over a decade a couple of us have been carrying on a campaign to eradicate the stilted, inappropriate yet traditional use of the words "male" and "female" instead of man, woman, boy, or girl. Our students and house staff, although I am sure they sometimes smile inwardly at this idiosyncrasy of a senior faculty member, nevertheless have gotten into the habit of referring to patients as... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Department of Internal Medicine General Hospital College of Medicine University of Cincinnati Cincinnati, Ohio 45229 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1969Volume 71, Issue 3Page: 662-664KeywordsHabits Issue Published: 1 September 1969 PDF DownloadLoading ...
This Week in &lt;EMPH&gt;JAMA&lt;/EMPH&gt;
Journal: JAMA (2006)

A Piece of My Mind"I attend medical school in San Francisco, which my family views as a highly suspicious place, full of sin and odd ways of living.Medical school with its rarefied education and esoteric jargon is one more way to distance myself from my past."From "Family Medicine."
A study examining if long‐term use of a biologic, including stopping and restarting, is safe and effective in people with psoriasis
Journal: British Journal of Dermatology (2020)

Psoriasis is a chronic disease that causes itchy, scaly patches on the skin and affects up to 3% of people worldwide. People with moderate‐to‐severe psoriasis may be prescribed injectable medications called biologics. However, people with psoriasis may need to receive medication for an extended period of time, so it is important to know if biologics keep skin clear and are safe to use long‐term. Further, people with psoriasis sometimes stop and restart treatments, so it is important to understand if biologics keep skin clear even after a gap in treatment.