CINXE.COM

<!DOCTYPE html><html lang="en-US"><head><title>Just a moment...</title><meta http-equiv="Content-Type" content="text/html; charset=UTF-8"><meta http-equiv="X-UA-Compatible" content="IE=Edge"><meta name="robots" content="noindex,nofollow"><meta name="viewport" content="width=device-width,initial-scale=1"><style>*{box-sizing:border-box;margin:0;padding:0}html{line-height:1.15;-webkit-text-size-adjust:100%;color:#313131;font-family:system-ui,-apple-system,BlinkMacSystemFont,Segoe UI,Roboto,Helvetica Neue,Arial,Noto Sans,sans-serif,Apple Color Emoji,Segoe UI Emoji,Segoe UI Symbol,Noto Color Emoji}body{display:flex;flex-direction:column;height:100vh;min-height:100vh}.main-content{margin:8rem auto;max-width:60rem;padding-left:1.5rem}@media (width <= 720px){.main-content{margin-top:4rem}}.h2{font-size:1.5rem;font-weight:500;line-height:2.25rem}@media (width <= 720px){.h2{font-size:1.25rem;line-height:1.5rem}}#challenge-error-text{background-image:url(data:image/svg+xml;base64,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);background-repeat:no-repeat;background-size:contain;padding-left:34px}@media (prefers-color-scheme:dark){body{background-color:#222;color:#d9d9d9}}</style><meta http-equiv="refresh" content="390"></head><body class="no-js"><div class="main-wrapper" role="main"><div class="main-content"><noscript><div class="h2"><span id="challenge-error-text">Enable JavaScript and cookies to continue</span></div></noscript></div></div><script>(function(){window._cf_chl_opt={cvId: '3',cZone: "www.acpjournals.org",cType: 'managed',cRay: '92c17cd27d179cc9',cH: '2GzMwQXN6pEUC.H_cDO734CMBbBGdiNIg2yqaCQr.cY-1743944630-1.2.1.1-2nQ1YLMFvqO52h0mUG1Peu5ujniV4KmxoOqn6DEeiMeDVJbe83dHOQ1f8OuJhipp',cUPMDTk: "\/doi\/10.7326\/M13-2771?__cf_chl_tk=XYLe8qcaZkCK92iM7rgt_oYpRV4G5ige2YeCDzXCdwk-1743944630-1.0.1.1-derGniv6KpjhbEKgXT5Hd6ywJqGStAWV4xweKiAkJfQ",cFPWv: 'g',cITimeS: '1743944630',cTTimeMs: '1000',cMTimeMs: '390000',cTplC: 0,cTplV: 5,cTplB: 'cf',cK: "",fa: "\/doi\/10.7326\/M13-2771?__cf_chl_f_tk=XYLe8qcaZkCK92iM7rgt_oYpRV4G5ige2YeCDzXCdwk-1743944630-1.0.1.1-derGniv6KpjhbEKgXT5Hd6ywJqGStAWV4xweKiAkJfQ",md: "a45fth074aFdUT66p4wul1VWfiIZqroEAgEdx_9oxzs-1743944630-1.2.1.1-ns2qYNp5bhEPdbokfr_U0Wr6jhhY7XmBwwWka8QOeAZh1IPHXPxR0PWd84HOiyByaaIaHXxDogIDeWDEBXRvmXe8WiKo_IzL9QzhY9hDZGRBkL9URxnhjSl7oa4aTb_6YYsBLPP.w.ZDq5mLkw3ouZrlPFGIwJZ00NNgZgsFgupHgl.Fz0M62jiun8.RCl6buXIzBdy7zEgKlPzhVHTKMfoD9fpbh.Q9nXJ9EKzvKenlx69l_cV8GbnVC11npZY3X7IeQ.BbFBQdPVb7UFSi0gATtT2FQn55d4MApJdw8BR.3E7gOdGzRdAl.5P_oHoM1IzFl2yWzrhG5efdZbEYfdrtmWq8V0i7AVlIKdm4BVnMk23bXm2hYFVo3QQ39vC9k0TSV7f91_8565QWVLNLos50Ts3p0qphZnjIaBDZrlBrlCf_Htj0W0Oj0NzNsA_Nzu2..pfZXEOfZh90.kVKVUR_4x_Q85QYhlso.vQ4.bp3WM9LdZTR9BOiHqJBVuMX4eAiiEHzY_6455l5K9tV.mDSUJiwrK9IynHQHJvLrMbldkiYAlVDUIOGBMpU1eHKOYTNoxA5W0dYEAvijg9EaSoF6Q0DoslGLDH1yP_AWTDA0yoONxJiliMDhu7rJsUlzhxKSSHcw6eFS3uctHEziVmnvjQEJnlcjaWV.zeObW6jbvkqxkbKUGBdbQ9vx_BDQNZKSOPKZLv2LQzmVd8PRTaMd6zYzfDCOvbX4V0jHH4oLPCJyXsuCQAKlonWAqu5SRcRFvZLyt3YXafLcBsnLa4I85FkfIQQZue8RwW6gEAiUyurmpWE4YpGw0iA_pdw1qJPdewyKiM9GDFUifdU.x.CBVGU0OOkPP_bhAbPupL2gdIlvAwE3l92ybQEvTOT1MB7AP8ING_nBzz_C49twnUl2pYsi7Rvh2zec6u4eyTpOpO0J8y_ORWgzBWr5Agw4tsOJ5xEyQVfCyvLHdtwUgmCQbN1gU_C0dOMRGKB3y1cL5dvfv1rjB_3LI2q6pDTRw68H6nd.G5McJU9hpHMTzPjv4gqRYf6OBzXT9S7SDe5vm4c8Zk2gwqQ4PfD2ix6egJ0AtIhwKCjAyhonSfn9B6q1VmGVA9TyCfBViXsmbfpoNQm_YTCND8RlJA6vOGZiazqvi0C1opwWvOaCEJfRuXv6JhI1S9bkJ4gXkVQfS6dPrR2Z6wyVebmy2WDUNzC6ulyy20hlLrXdi8bWVSV92J3LkXxBPy9cDwGFnZvsyfWvi1CL4MrgOKLOFJv34sv",mdrd: "2FGUPVwF5b8ecyQnGocDscOazYkHuWf4RkI3m51TPCU-1743944630-1.2.1.1-blmeFHOpcAR2PTVV1odLjt9KhzT9y8n9bc98t95pUsFWdvZo6Ks0R62t87y7FCeI.N81kv6duGp2vvoQLibsrO8EgErTZphYa1HUE49Gg0P.Iu7YVLqm7RDbGzoCcKZRmnk7HrTedNprWP8tJjJiVS8WkHbdynMZ5j6u8rC79cPTnVLUHNHm0g2MtZ_jSWr7WZkHpJ2eL5cz4mC1mVCPazE7bhUBnbvvvgI9Ihw5A_zx6srkdQmU4wZ4IOT0YRRA2IETDK0Vo3LpTqB.Dje_GTseAA4zQO90lA00mVIQCDMKBqkgZ3jnRcjomOGvD7_Mtxyrw35Gwxpc_hdwtzVHJnJBU34dGG4.3uyHzj6EFaA6kvpWSPwAHXjlmiWG.79fFOSoVYFJJ52RG99erIaEBoPEjZaUIyZWgPYQ18LF5Q8X.HcRhpzGWztHkXpc.KUzwz5EJHLtjePA25qH.cwZyvD3TRZAvqL1I0fqV4tW4Aodd0Oy2YJ2eK2TKqBh1BICI9fVy4VfUZls9cY.8O09Zqba.jwLEGBOUE8RzV2_527xmHfmt60_LyYMFjQp5PiB1wfNYL6bSndHRCGG6qVVzeFgmvVvw6GcmxVbpxFIVqH9Xz74tCTTXuISgvBqpb9Hq4ydKYRoEX4lbzVgSx6XDXEVlqmbjuwxfCqV2Izuj0cuO.doWP4HmyYYU4VCmz6HB6xGC3l7fSDzkUdRiC1vkfDTodxMkIeDIbGIKV0KArycIbicDT8c9y1ts_NkEBnH_3IJkOrZQq2KLpXW7JURu_EbvfvitLO1pl7Auf60u7qG8NZXe1qKi5tSlqo3kIS32h_Vvvi5tgwdJ13J.qqPgu4MbUJBCMTBAwB3Vcs1f70_ovvPcvBA_mfqNScGSmlH5e7PX0X8gC6D6Tu_BDbc8Tv_SVdzoqno5WBfBzsvhZ5Fbtf0V5GCFC12LfHYVAmakFVi_lNHmKMjDmAEbAGIxVccFhGUx76TLxmG2uEP3wVP8gwWatfRc3eMC3.SAqqhb72wsgKCxbSBlvTTGuATD2G9dGsKnecjPX1eiMwzb7fkL_IlqzaJ5t2P0lIZKalFSrOVUrkSTAw8cqGVv6QRhu3dF7cuwhUsTgizpRNDBEKCKQlhF5JwNFEvRFeALgRChvJplY9IWPikSRS9z.Q0JMMDWzEBBaaAt.sxlMgf_KX_nvtI5GoziCTSxT_F9NP5VHom_sRGg2OV9Jmr_YhXOY1JAoNjH_Ki2OhWYMfZJWmTJLAPnDHxQ3hO0MrT82XYzB2AvC01GWLJhqBt05ygoYjjVgc_NgEWM4JuJ4MmR0RdYv3c9akc1Kkbq9oG0QsSoGfOPEypkvwjh4GCRnGXQqKpjxhto1JCtcJTwSVfL._QxQUb8cOOSApa8Ilygf5SX3uMxp_BkFsP4dBaf7DWcN.eUITCbzuY4vT_6YS4EbooZzeoj3mNXkY2mLZxvj94LL.uuzMW7x7c_Bjuj9MI1u7b0YZm9w95NxcFGDesGwEEuBLq4.9tF2H1gPP.HIdO_qSov4xfEio4JaNr42Roym1hdxMpYMI.cB0W5Qrr.UkFxJVPjUFHxiekjW8tmVQbpJlql0Lgt.OsAP.22Z6usWB9NPl4rmywZeAhEBfL5IVg2DFKP7O8B3AGvKwaAOboRryFtZtZ8TBwRuLHW8QsDDqOsA_qrAXaKHMg0wFChys1JdMqI9Sef285wnFhXpWBcXL2PhgZUkBPIfyKYY0.xOYi31bquKpOyaJfDsrDZvS0U2kH5iHK3aVQIxeTpnd0bp8uS4Ko_q9m2MNhnEHq9zWp.Y0r8h0qUaecEBtEwu95XwxFNL2RIy4fJP0vVgQMSZuWATsKZd135nCx_4NY85ER7SGnnx1oPHgoeE8wi5Gbp0KyBoPA6KQqX3mGmCHzvZk1zZuH5Cj8oiYoZThzZgd1dYqqeg2qEz03Ac.i2JRcRjysDwMNcorAKtYb_HqLTxI2uuJVVHH6HugGATbuzBRhDgYt5ZX_RBDgjSJI1rF1mUtXLTcOxZ4ToKQtI2Xmg9ETLynQxzvaotT6iWb.BTDODqrO4sTL_ytUI8DtN00"};var cpo = document.createElement('script');cpo.src = '/cdn-cgi/challenge-platform/h/g/orchestrate/chl_page/v1?ray=92c17cd27d179cc9';window._cf_chl_opt.cOgUHash = location.hash === '' && location.href.indexOf('#') !== -1 ? '#' : location.hash;window._cf_chl_opt.cOgUQuery = location.search === '' && location.href.slice(0, location.href.length - window._cf_chl_opt.cOgUHash.length).indexOf('?') !== -1 ? '?' : location.search;if (window.history && window.history.replaceState) {var ogU = location.pathname + window._cf_chl_opt.cOgUQuery + window._cf_chl_opt.cOgUHash;history.replaceState(null, null, "\/doi\/10.7326\/M13-2771?__cf_chl_rt_tk=XYLe8qcaZkCK92iM7rgt_oYpRV4G5ige2YeCDzXCdwk-1743944630-1.0.1.1-derGniv6KpjhbEKgXT5Hd6ywJqGStAWV4xweKiAkJfQ" + window._cf_chl_opt.cOgUHash);cpo.onload = function() {history.replaceState(null, null, ogU);}}document.getElementsByTagName('head')[0].appendChild(cpo);}());</script></body></html>