tbuckley/cabot-search huggingface dataset:
Anti–PD-1 cancer immunotherapy induces central nervous system immune-related adverse events by microglia activation
Authors: Janaki Manoja Vinnakota, Rachael C. Adams, Dimitrios Athanassopoulos, Dominik Schmidt, Francesca Biavasco, Alexander Zähringer, Daniel Erny, Marius Schwabenland, Marlene Langenbach, Valentin Wenger, Henrike Salié, James Cook, Omar Mossad, Geoffroy Andrieux, Rick Dersch, Sebastian Rauer, Sandra Duquesne, Gianni Monaco, Phillipp Wolf, Thomas Blank, Philipp Häne, Melanie Greter, Burkhard Becher, Philipp Henneke, Dietmar Pfeifer, Bruce R. Blazar, Justus Duyster, Melanie Boerries, Natalie Köhler, Chintan M. Chhatbar, Bertram Bengsch, Marco Prinz, Robert Zeiser
Journal: Science Translational Medicine (2024)

Cancer treatment with anti-PD-1 immunotherapy can cause central nervous system immune-related adverse events (CNS-irAEs). The role of microglia in anti-PD-1 immunotherapy-induced CNS-irAEs is unclear. We found that anti-PD-1 treatment of mice caused morphological signs of activation and major histocompatibility complex (MHC) class II up-regulation on microglia. Functionally, anti-PD-1 treatment induced neurocognitive deficits in mice, independent of T cells, B cells, and natural killer cells. Instead, we found that microglia mediated these CNS-irAEs. Single-cell RNA sequencing revealed major transcriptional changes in microglia upon anti-PD-1 treatment. The anti-PD-1 effects were mediated by anti-PD-1 antibodies interacting directly with microglia and were not secondary to peripheral T cell activation. Using a proteomics approach, we identified spleen tyrosine kinase (Syk) as a potential target in activated microglia upon anti-PD-1 treatment. Syk inhibition reduced microglia activation and improved neurocognitive function without impairing anti-melanoma effects. Moreover, we analyzed CNS tissue from a patient cohort that had received anti-PD-1 treatment. Imaging mass cytometry revealed that anti-PD-1 treatment of patients was associated with increased surface marker expression indicative of microglia activation. In summary, we identified a disease-promoting role for microglia in CNS-irAEs driven by Syk and provide an inhibitor-based approach to interfere with this complication after anti-PD-1 immunotherapy.
WED-167 Recanalization for Budd-Chiari syndrome and development of a prognostic score: a multicentre study of 834 cases from China
Authors: Qiuhe Wang, Bohan Luo, Dongdong Xia, Chunqing Zhang, Ke Xu, Kewei Zhang, Mingsheng Li, Qingrong Fan, Wei Bai, Guohong Han
Journal: Journal of Hepatology (2024)
FRI-163-YI Pronounced vasculature phenotypes in new mouse models with ALGS and BA-associated mutations in Jag1
Authors: Anna Maria Frontino, Daniel V. Oliveira, Eliška Trampotová, Mitra Tavakoli, Noémi K.M. Van Hul, Oren Gozlan, Emma Andersson, Gabriela Pavlinková, David Sprinzak, Jan Mašek
Journal: Journal of Hepatology (2024)
Ancient and recent hybridization in the <i>Oreochromis</i> cichlid fishes
Authors: Adam G Ciezarek, Tarang K Mehta, Angela Man, Antonia G P Ford, Geraldine Dorcas Kavembe, Nasser Kasozi, Benjamin P Ngatunga, Asilatu H Shechonge, Rashid Tamatamah, Dorothy Wanja Nyingi, Avner Cnaani, Titus C Ndiwa, Federica Di Palma, George F Turner, Martin J Genner, Wilfried Haerty
Journal: Molecular Biology and Evolution (2024)

Abstract Cichlid fishes of the genus Oreochromis (tilapia) are among the most important fish for inland capture fisheries and global aquaculture. Deliberate introductions of non-native species for fisheries improvement and accidental escapees from farms have resulted in admixture with indigenous species. Such hybridization may be detrimental to native biodiversity, potentially leading to genomic homogenization of populations and the loss of important genetic material associated with local adaptation. By contrast, introgression may fuel diversification when combined with ecological opportunity, by supplying novel genetic combinations. To date, the role of introgression in the evolutionary history of tilapia has not been explored. Here we studied both ancient and recent hybridization in tilapia, using whole genome resequencing of 575 individuals from 23 species. We focused on Tanzania, a natural hotspot of tilapia diversity, and a country where hybridization between exotic and native species in the natural environment has been previously reported. We reconstruct the first genome-scale phylogeny of the genus and reveal prevalent ancient gene flow across the Oreochromis phylogeny. This has likely resulted in the hybrid speciation of one species, O. chungruruensis. We identify multiple cases of recent hybridization between native and introduced species in the wild, linked to the use of non-native species in both capture fisheries improvement and aquaculture. This has potential implications for both conservation of wild populations and the development of the global tilapia aquaculture industry.
Matt Morgan: Words matter
Authors: Matt Morgan
Journal: BMJ (2024)

I've just returned from our annual family trip to the amazing Hay Festival of Literature and Arts, one of the world's largest book events, nestled in the green of mid-Wales.The tradition started when my daughter became obsessed with Julia Donaldson's The Gruffalo, but the march of time has morphed her tastes into young adult themes of love, sex, and murder.Just as traditional as the trip itself were the accompanying rain showers, prompting a dash to the undercover deckchairs where we ate and read, and I started writing this column.It was there that I realised-in medicine just as in literature-words matter.I was surrounded by words: words of hope for the future, pleas for help from war zones, words seeking understanding, and words that made people smile.These were written and spoken at more than 800 events in 11 days, by 700 people from Bonnie Taylor to Theresa May.Thankfully, there was no dancing.Thousands of books were sold, and millions of words were read every day by the 300 000 visitors.Yet these statistics are dwarfed in just a single day in my own hospital.There are more patient encounters where I work daily than there are events at Hay, more clinics than speeches, more words written about patients than visitors like me on those deckchairs.But medicine often forgets the power of simple words, distracted by the importance of verbal communication skills, simulation training workshops, and human factors courses.These things are important, but let's not forget about the millions of written words that affect patients and staff every day.
WED-373-YI Epidemiological data and clinical profiles of hepatitis B surface antigen levels in chronic hepatitis B: implications for novel drug development
Authors: Rex Wan-Hin Hui, Trevor Kwan-Hung Wu, Ryan Hin-Man Leung, Lung Yi Loey Mak, Danny Ka-HoWong, James Fung, Wai-Kay Seto, Man-Fung Yuen
Journal: Journal of Hepatology (2024)
THU-398 Metabolic factors predict significant liver fibrosis in people who use drugs (PWUD) and general population with HCV infection. Time to re-consider the follow-up strategy in chronic hepatitis C patients
Authors: Hariklia Kranidioti, Olga Anagnostou, Georgios Kontos, Sofia Vasileiadi, Anestis Goulas, Nikolaos Papadopoulos, Melanie Deutsch, Spilios Manolakopoulos
Journal: Journal of Hepatology (2024)
THU-402 Higher cardiovascular burden in people living with HIV (PLWH) with metabolic syndrome and history of HCV infection
Authors: Alessia Siribelli, Michele Bellomo, Camilla Muccini, Riccardo Lolatto, Giulia Morsica, Sara Diotallevi, Nicola Gianotti, Simona Bossolasco, Costanza Bertoni, Vincenzo Spagnuolo, Antonella Castagna, Hamid Hasson
Journal: Journal of Hepatology (2024)
THU-386-YI Renin-angiotensin inhibitor intake is associated with improved survival in patients with chronic hepatitis C viral infection following SVR-data from the german hepatitis C-registry (DHC-R)
Authors: Tammo Lambert Tergast, Marie Griemsmann, Leyla Valiyeva, Peter Buggisch, Stefan Mauss, Hartwig Klinker, Klaus H.W. Boeker, Christine John, Ralf Link, Stefan Zeuzem, Thomas Berg, Heiner Wedemeyer
Journal: Journal of Hepatology (2024)
Neighborhood Deprivation and Breast Cancer Mortality Among Black and White Women
Authors: Lauren E. Barber, Maret L. Maliniak, Leah Moubadder, Dayna A. Johnson, Jasmine M. Miller-Kleinhenz, Jeffrey M. Switchenko, Kevin C. Ward, Lauren E. McCullough
Journal: JAMA Network Open (2024)

Neighborhood deprivation has been associated with increased breast cancer mortality among White women, but findings are inconsistent among Black women, who experience different neighborhood contexts. Accounting for interactions among neighborhood deprivation, race, and other neighborhood characteristics may enhance understanding of the association.
Open Retromuscular Sugarbaker vs Keyhole Mesh Placement for Parastomal Hernia Repair
Authors: Sara M. Maskal, Ryan C. Ellis, Aldo Fafaj, Adele Costanzo, Jonah D. Thomas, Ajita S. Prabhu, David M. Krpata, Lucas R. A. Beffa, Chao Tu, Xinyan Zheng, Benjamin T. Miller, Michael J. Rosen, Clayton C. Petro
Journal: JAMA Surgery (2024)

Durable parastomal hernia repair remains elusive. There is limited evidence comparing the durability of the open retromuscular Sugarbaker and keyhole mesh configurations.
Time From Colorectal Cancer Surgery to Adjuvant Chemotherapy
Authors: Mikail Gögenur, Andreas Weinberger Rosen, Timothy Iveson, Rachel S. Kerr, Mark P. Saunders, Jim Cassidy, Josep Tabernero, Andrew Haydon, Bengt Glimelius, Andrea Harkin, Karen Allan, Sarah Pearson, Kathleen A. Boyd, Andrew H. Briggs, Ashita Waterston, Louise Medley, Richard Ellis, Amandeep S. Dhadda, Mark Harrison, Stephen Falk, Charlotte Rees, Rene K. Olesen, David Propper, John Bridgewater, Ashraf Azzabi, David Cunningham, Tamas Hickish, Simon Gollins, Harpreet S. Wasan, Caroline Kelly, Ismail Gögenur, Niels Henrik Holländer
Journal: JAMA Surgery (2024)

The timing of adjuvant chemotherapy after surgery for colorectal cancer and its association with long-term outcomes have been investigated in national cohort studies, with no consensus on the optimal time from surgery to adjuvant chemotherapy.
Poetry and Seeing the Sacred in Medicine
Authors: Rafael Campo
Journal: JAMA (2024)

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 2024 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
Surgical Approach and Long-Term Recurrence After Ventral Hernia Repair
Authors: Brian T. Fry, Ryan A. Howard, Jyothi R. Thumma, Edward C. Norton, Justin B. Dimick, Kyle H. Sheetz
Journal: JAMA Surgery (2024)

The prevalence of robotic-assisted anterior abdominal wall (ventral) hernia repair has increased dramatically in recent years, despite conflicting evidence of patient benefit. Whether long-term hernia recurrence rates following robotic-assisted repairs are lower than rates following more established laparoscopic or open approaches remains unclear.
Patient Safety and Satisfaction With Fully Remote Management of Radiation Oncology Care
Authors: John J. Cuaron, Sean McBride, Fumiko Chino, Dhwani Parikh, Marisa Kollmeier, Gerri Pastrana, Keri Wagner, Andrew Tamas, Daniel Gomez
Journal: JAMA Network Open (2024)

Patients of Memorial Sloan Kettering Cancer Center in New York, New York, are now offered a choice of either in-person or remote telehealth visits for radiation oncology care. However, safety and satisfaction among patients receiving treatment with fully remote physician management is unclear.
Radiance
Authors: Ronnie Sirmans
Journal: JAMA (2024)

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 2024 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
Postpartum Ambulatory Blood Pressure Patterns Following New-Onset Hypertensive Disorders of Pregnancy
Authors: Alisse Hauspurg, Kripa Venkatakrishnan, Latima Collins, Malamo Countouris, Jacob Larkin, Beth Quinn, Nuzhat Kabir, Janet Catov, Lara Lemon, Hyagriv Simhan
Journal: JAMA Cardiology (2024)

After a hypertensive disorder of pregnancy, hypertension can worsen in the postpartum period following hospital discharge. Risk factors for ongoing hypertension and associated outcomes have not been well characterized.
Low-Dose Corticosteroids for Critically Ill Adults With Severe Pulmonary Infections
Authors: Romain Pirracchio, Balasubramanian Venkatesh, Matthieu Legrand
Journal: JAMA (2024)

Importance Severe pulmonary infections, including COVID-19, community-acquired pneumonia, influenza, and Pneumocystis pneumonia, are a leading cause of death among adults worldwide. Pulmonary infections in critically ill patients may cause septic shock, acute respiratory distress syndrome, or both, which are associated with mortality rates ranging between 30% and 50%. Observations Corticosteroids mitigate the immune response to infection and improve outcomes for patients with several types of severe pulmonary infections. Low-dose corticosteroids, defined as less than or equal to 400 mg hydrocortisone equivalent daily, can reduce mortality of patients with severe COVID-19, community-acquired pneumonia, and Pneumocystis pneumonia. A randomized clinical trial of 6425 patients hospitalized with COVID-19 who required supplemental oxygen or noninvasive or invasive mechanical ventilation reported that dexamethasone 6 mg daily for 10 days decreased 28-day mortality (23% vs 26%). A meta-analysis that included 7 randomized clinical trials of 1689 patients treated in the intensive care unit for severe bacterial community-acquired pneumonia reported that hydrocortisone equivalent less than or equal to 400 mg daily for 8 days or fewer was associated with lower 30-day mortality compared with placebo (10% vs 16%). In a meta-analysis of 6 randomized clinical trials, low-dose corticosteroids were associated with lower mortality rates compared with placebo for patients with HIV and moderate to severe Pneumocystis pneumonia (13% vs 25%). In a predefined subgroup analysis of a trial of low-dose steroid treatment for septic shock, patients with community-acquired pneumonia randomized to 7 days of intravenous hydrocortisone 50 mg every 6 hours and fludrocortisone 50 μg daily had decreased mortality compared with the placebo group (39% vs 51%). For patients with acute respiratory distress syndrome caused by various conditions, low-dose corticosteroids were associated with decreased in-hospital mortality (34% vs 45%) according to a meta-analysis of 8 studies that included 1091 patients. Adverse effects of low-dose corticosteroids may include hyperglycemia, gastrointestinal bleeding, neuropsychiatric disorders, muscle weakness, hypernatremia, and secondary infections. Conclusions and Relevance Treatment with low-dose corticosteroids is associated with decreased mortality for patients with severe COVID-19 infection, severe community-acquired bacterial pneumonia, and moderate to severe Pneumocystis pneumonia (for patients with HIV). Low-dose corticosteroids may also benefit critically ill patients with respiratory infections who have septic shock, acute respiratory distress syndrome, or both.
Racial Discrimination and Risk for Internalizing and Externalizing Symptoms Among Black Youths
Authors: Assaf Oshri, Ava Jane Reck, Sierra E. Carter, Lucina Q. Uddin, Charles F. Geier, Steven R. H. Beach, Gene H. Brody, Steven M. Kogan, Larry H. Sweet
Journal: JAMA Network Open (2024)

Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US.
Climate Change and Cardiovascular Health
Authors: Dhruv S. Kazi, Ethan Katznelson, Chia-Liang Liu, Nora M. Al-Roub, Richard S. Chaudhary, Diane E. Young, Megan McNichol, Loretta J. Mickley, Daniel B. Kramer, Wayne E. Cascio, Aaron S. Bernstein, Mary B. Rice
Journal: JAMA Cardiology (2024)

Climate change may increase the risk of adverse cardiovascular outcomes by causing direct physiologic changes, psychological distress, and disruption of health-related infrastructure. Yet, the association between numerous climate change-related environmental stressors and the incidence of adverse cardiovascular events has not been systematically reviewed.
<i>Limosilactobacillus reuteri</i> 6475 and Prevention of Early Postmenopausal Bone Loss
Authors: Giulia Gregori, Aldina Pivodic, Per Magnusson, Lisa Johansson, Ulrika Hjertonsson, Emma Brättemark, Mattias Lorentzon
Journal: JAMA Network Open (2024)

Daily supplementation with the probiotic Limosilactobacillus reuteri ATCC PTA 6475 (L reuteri) vs placebo has previously been demonstrated to reduce bone loss in an estrogen deficiency mice model and older women, although the magnitude of the effect was small. We hypothesized that long-term treatment with L reuteri could result in clinically relevant skeletal benefits in postmenopausal osteoporosis.
Caution Warranted in Robotic Ventral Hernia Repair
Authors: Aymen H. Sadaka, Kamal M. F. Itani
Journal: JAMA Surgery (2024)

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 Surgery HomeNew OnlineCurrent IssueFor Authors Podcast 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) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 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 Surgery journal
Sodium-Glucose Cotransporter-2 Inhibitors and Nephritis Among Patients With Systemic Lupus Erythematosus
Authors: Fu-Shun Yen, Shiow-Ing Wang, Chih-Cheng Hsu, Chii-Min Hwu, James Cheng-Chung Wei
Journal: JAMA Network Open (2024)

Lupus nephritis is a major complication of systemic lupus erythematosus (SLE). Randomized clinical trials have shown nephroprotective and cardioprotective effects of sodium-glucose cotransporter-2 inhibitors (SGLT2is).
Reflections of an Editorial Fellow—A Window Into Medical Publishing
Authors: Vinay Guduguntla
Journal: JAMA Cardiology (2024)

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 Cardiology HomeNew OnlineCurrent IssueFor Authors Podcast 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) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2024 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 Cardiology journal
Worst Itch Numeric Rating Scale for Prurigo Nodularis
Authors: Shawn G. Kwatra, Gil Yosipovitch, Brian Kim, Sonja Stander, Stephanie Rhoten, Cristina Ivanescu, Nadine Haeusler, Ella Brookes, Jerome Msihid, Melanie Makhija, Ashish Bansal, Ryan B. Thomas, Donia Bahloul
Journal: JAMA Dermatology (2024)

Prurigo nodularis (PN) is a debilitating skin disease characterized by the hallmark symptom of chronic itch; the intensity of itch in PN was assessed using the Worst Itch Numeric Rating Scale (WI-NRS) to evaluate the primary efficacy end point of 2 recent phase 3 studies of dupilumab treatment for PN.
Coronary In-Stent Restenosis Treated With Paclitaxel-Coated Balloon vs Uncoated Balloon
Authors: Allison Kratka, Rita F. Redberg
Journal: JAMA (2024)

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 2024 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