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Signore A, Bentivoglio V, Varani M, Lauri C. Current Status of SPECT Radiopharmaceuticals for Specific Bacteria Imaging. Semin Nucl Med 2023; 53:142-151. [PMID: 36609002 DOI: 10.1053/j.semnuclmed.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Imaging infection still represents a challenge for researchers. Despite nuclear medicine (NM) offers valuable tools able to discriminate between infections and inflammation, there is an unmet clinical need to develop new strategies able to specifically target the causative pathogen, to select the best antimicrobial treatment for each patient and to accurately assess therapeutic efficacy. These aspects are commonly addressed by microbiology or histology but the diagnosis often relies on invasive procedures that are prone to contamination or sample bias and do not reflect the spatial heterogeneity of the infective process. Therefore, in the era of personalized medicine and treatment, a lot of efforts are in play to improve a personalized diagnosis. Molecular imaging is an ideal candidate for this purpose and, indeed, research is going fast to this direction aiming to find more selective and proper antimicrobial treatments and to overcome broad-spectrum antibiotic use, which still represents the major cause of bacterial drug-resistance. Several approaches for specifically image bacteria have been proposed and provided encouraging perspectives in preclinical studies. Nevertheless, the majority of these promising approaches are still confined in "bench stages" and crucial issues still need to be addressed before their translation in clinical practice. This review will focus on radiolabeled antibiotics for SPECT imaging of bacteria, their mechanisms of action, their potentiality and limitations for "bed-side" applications.
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Affiliation(s)
- Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy.
| | - Valeria Bentivoglio
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
| | - Michela Varani
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
| | - Chiara Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, "Sapienza" University of Rome, Italy
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2
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Signore A, Conserva M, Varani M, Galli F. Gamma camera imaging of bacteria. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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3
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Durkan K, Tuncel A, Yurt F. In vitro evaluation of 99m Tc-sultamicillin for infection imaging. Biopharm Drug Dispos 2021; 42:285-293. [PMID: 33904176 DOI: 10.1002/bdd.2281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/11/2021] [Accepted: 04/11/2021] [Indexed: 12/15/2022]
Abstract
Early detection of the site of infection non-invasively with radiolabeled molecules is important for the success of treatment. Technetium-99m labeled antibiotics have the potential to discriminate between bacterial infection and sterile inflammation. Sultamicillin is the tosylate salt of the double ester of sulbactam plus ampicillin. In this study, sultamicillin was labeled with 99m Tc according to the stannous chloride method. Quality control studies of radiolabeled sultamicillin were performed by radiochromatographic methods. In vitro binding assays were performed in live and heat-killed gram-positive Staphylococcus aureus and gram-negative Escherichia coli strains. The radiolabeling yield of 99m Tc-sultamicillin was determined as 97.8% ± 3.1% (n = 5). The maximum bacterial uptake of 99m Tc-sultamicillin was 80.7% ± 11.00% at 4 h for living S. aureus and 93.2% ± 4.40% at 2 h for E. coli. Bacterial uptake study results show that sultamicillin has the potential to be a nuclear imaging agent, especially in infections caused by gram-negative E. coli and gram-positive S. aureus.
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Affiliation(s)
- Kubra Durkan
- Nuclear Applications, Ege University Institute of Nuclear Sciences, Bornova, Izmir, Turkey
| | - Ayca Tuncel
- Nuclear Applications, Ege University Institute of Nuclear Sciences, Bornova, Izmir, Turkey
| | - Fatma Yurt
- Nuclear Applications, Ege University Institute of Nuclear Sciences, Bornova, Izmir, Turkey
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4
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Ordoñez AA, Jain SK. Imaging of Bacterial Infections. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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5
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Ordonez AA, Jain SK. Pathogen-Specific Bacterial Imaging in Nuclear Medicine. Semin Nucl Med 2018. [DOI: 10.1053/j.semnuclmed.2017.11.003
expr 890398765 + 809902709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
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Abstract
When serious infections are suspected, patients are often treated empirically with broad-spectrum antibiotics while awaiting results that provide information on the bacterial class and species causing the infection, as well as drug susceptibilities. For deep-seated infections, these traditional diagnostic techniques often rely on tissue biopsies to obtain clinical samples which can be expensive, dangerous, and has the potential of sampling bias. Moreover, these procedures and results can take several days and may not always provide reliable information. This combination of time and effort required for proper antibiotic selection has become a barrier leading to indiscriminate broad-spectrum antibiotic use. Exposure to nosocomial infections and indiscriminate use of broad-spectrum antibiotics are responsible for promoting bacterial drug-resistance leading to substantial morbidity and mortality, especially in hospitalized and immunosuppressed patients. Therefore, early diagnosis of infection and targeted antibiotic treatments are urgently needed to reduce morbidity and mortality caused by bacterial infections worldwide. Reliable pathogen-specific bacterial imaging techniques have the potential to provide early diagnosis and guide antibiotic treatments.
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Affiliation(s)
- Alvaro A Ordonez
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sanjay K Jain
- Center for Infection and Inflammation Imaging Research, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
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7
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Dutta J, Naicker T, Ebenhan T, Kruger HG, Arvidsson PI, Govender T. Synthetic approaches to radiochemical probes for imaging of bacterial infections. Eur J Med Chem 2017; 133:287-308. [DOI: 10.1016/j.ejmech.2017.03.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/23/2017] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
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8
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Radiosynthesis and preliminary biological evaluation of 99mTc-labeled 2-methyl-2-pentylmalonic acid as an apoptosis imaging agent. J Radioanal Nucl Chem 2017. [DOI: 10.1007/s10967-017-5275-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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9
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Rasheed R, Naqvi SAR, Gillani SJH, Zahoor AF, Jielani A, Saeed N. 99m
Tc-tazobactam, a novel infection imaging agent: Radiosynthesis, quality control, biodistribution, and infection imaging studies. J Labelled Comp Radiopharm 2017; 60:242-249. [DOI: 10.1002/jlcr.3494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/31/2017] [Accepted: 02/05/2017] [Indexed: 01/23/2023]
Affiliation(s)
- Rashid Rasheed
- Institute of Nuclear Medicine Oncology and Radiotherapy (INOR); Abbottabad Pakistan
- Department of Chemistry; Government College University; Faisalabad-38000 Pakistan
| | - Syed Ali Raza Naqvi
- Department of Chemistry; Government College University; Faisalabad-38000 Pakistan
| | | | - Ameer Fawad Zahoor
- Department of Chemistry; Government College University; Faisalabad-38000 Pakistan
| | - Asif Jielani
- Institute of Nuclear Medicine Oncology and Radiotherapy (INOR); Abbottabad Pakistan
| | - Nidda Saeed
- Department of Pharmacy, Clinical Practice; COMSATS Institute of Information Technology; Abbottabad Pakistan
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Ahmed MT, Naqvi SAR, Rasheed R, Zahoor AF, Usman M, Hussain Z. Technetium-99m-Labeled Sulfadiazine: a Targeting Radiopharmaceutical for Scintigraphic Imaging of Infectious Foci Due To Escherichia coli in Mouse and Rabbit Models. Appl Biochem Biotechnol 2017; 183:374-384. [DOI: 10.1007/s12010-017-2451-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2016] [Accepted: 03/02/2017] [Indexed: 12/15/2022]
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11
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Akbar MU, Ahmad MR, Shaheen A, Mushtaq S. A review on evaluation of technetium-99m labeled radiopharmaceuticals. J Radioanal Nucl Chem 2016. [DOI: 10.1007/s10967-016-5019-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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12
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Auletta S, Galli F, Lauri C, Martinelli D, Santino I, Signore A. Imaging bacteria with radiolabelled quinolones, cephalosporins and siderophores for imaging infection: a systematic review. Clin Transl Imaging 2016; 4:229-252. [PMID: 27512687 PMCID: PMC4960278 DOI: 10.1007/s40336-016-0185-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 05/17/2016] [Indexed: 12/20/2022]
Abstract
Bacterial infections are still one of the main causes of patient morbidity and mortality worldwide. Nowadays, many imaging techniques, like computed tomography or magnetic resonance imaging, are used to identify inflammatory processes, but, although they recognize anatomical modifications, they cannot easily distinguish bacterial infective foci from non bacterial infections. In nuclear medicine, many efforts have been made to develop specific radiopharmaceuticals to discriminate infection from sterile inflammation. Several compounds (antimicrobial peptides, leukocytes, cytokines, antibiotics…) have been radiolabelled and tested in vitro and in vivo, but none proved to be highly specific for bacteria. Indeed factors, including the number and strain of bacteria, the infection site, and the host condition may affect the specificity of tested radiopharmaceuticals. Ciprofloxacin has been proposed and intensively studied because of its easy radiolabelling method, broad spectrum, and low cost, but at the same time it presents some problems such as low stability or the risk of antibiotic resistance. Therefore, in the present review studies with ciprofloxacin and other radiolabelled antibiotics as possible substitutes of ciprofloxacin are reported. Among them we can distinguish different classes, such as cephalosporins, fluoroquinolones, inhibitors of nucleic acid synthesis, inhibitors of bacterial cell wall synthesis and inhibitors of protein synthesis; then also others, like siderophores or maltodextrin-based probes, have been discussed as bacterial infection imaging agents. A systematic analysis was performed to report the main characteristics and differences of each antibiotic to provide an overview about the state of the art of imaging infection with radiolabelled antibiotics.
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Affiliation(s)
- S. Auletta
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - F. Galli
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - C. Lauri
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - D. Martinelli
- Microbiology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - I. Santino
- Microbiology Unit, Department of Clinical and Molecular Medicine, “Sapienza” University of Rome, Rome, Italy
| | - Alberto Signore
- Nuclear Medicine Unit, Department of Medical-Surgical Sciences and of Translational Medicine, Faculty of Medicine and Psychology, St. Andrea Hospital, “Sapienza” University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
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13
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Mirshojaei SF. Advances in infectious foci imaging using 99mTc radiolabelled antibiotics. J Radioanal Nucl Chem 2015. [DOI: 10.1007/s10967-015-4003-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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14
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İlem-Özdemir D, Asikoglu M, Ozkilic H, Yilmaz F, Hosgor-Limoncu M, Ayhan S. 99mTc-Doxycycline hyclate: a new radiolabeled antibiotic for bacterial infection imaging. J Labelled Comp Radiopharm 2013; 57:36-41. [DOI: 10.1002/jlcr.3135] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/04/2013] [Accepted: 09/27/2013] [Indexed: 01/11/2023]
Affiliation(s)
- Derya İlem-Özdemir
- Faculty of Pharmacy; Department of Radiopharmacy; Ege University; Bornova Izmir Turkey
| | - Makbule Asikoglu
- Faculty of Pharmacy; Department of Radiopharmacy; Ege University; Bornova Izmir Turkey
| | - Hayal Ozkilic
- Faculty of Medicine; Department of Nuclear Medicine; Ege University; Bornova Izmir Turkey
| | - Ferda Yilmaz
- Faculty of Pharmacy; Department of Pharmaceutical Microbiology; Ege University; Bornova Izmir Turkey
| | - Mine Hosgor-Limoncu
- Faculty of Pharmacy; Department of Pharmaceutical Microbiology; Ege University; Bornova Izmir Turkey
| | - Semin Ayhan
- Faculty of Medicine; Department of Pathology; Celel Bayar University; Manisa Turkey
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15
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Erfani M, Doroudi A, Hadisi L, Andishmand A, Mirshojaei SF, Shafiei M. (99m) Tc-tricabonyl labeling of ofloxacin and its biological evaluation in Staphylococcus aureus as an infection imaging agent. J Labelled Comp Radiopharm 2013; 56:627-31. [PMID: 24285239 DOI: 10.1002/jlcr.3093] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 04/13/2013] [Accepted: 06/18/2013] [Indexed: 11/09/2022]
Abstract
Even in recent decades, one of the major causes of death and unhealthiness in the whole world is infection and inflammation. The use of radiopharmaceuticals is a powerful tool in managing the patients with infectious diseases. In this study, ofloxacin as a second-generation fluoroquinolone has been labeled with [(99m) Tc(CO)3 (H2 O)3 ](+) core to formulate a suitable infection imaging agent. Ofloxacin was radiolabeled with (99m) Tc using carbonyl core. Radioligand chemical analysis involved HPLC methods. Radioconjugate stability and lipophilicity were determined. Binding with Staphylococcus aureus and biodistribution in infected mice for labeled compound were studied. The radioligand was characterized by HPLC, and its radiochemical purity was more than 90%. In vitro stability studies have shown the complex was stable at least 6 h after labeling at room temperature. The n-octanol/water partition coefficient experiment exhibited logP = 1.52 ± 0.21 for (99m) Tc(CO)3 -ofloxacin. The complex showed specific binding to S. aureus. Biodistribution results showed that radioligand had high accumulation in the infected muscle in a mice (T/NT = 2.02 ± 0.12 at 4 h postinjection). On the basis of stability and infection site uptake ratio, suitability of this complex as a radiotracer for imaging of infections is recognized.
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Affiliation(s)
- Mostafa Erfani
- Nuclear Science Research School, Nuclear Science and Technology Research Institute (NSTRI), Atomic Energy Organization of Iran (AEOI), Tehran, Iran
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16
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Preparation and biological distribution of 99mTc-cefazolin complex, a novel agent for detecting sites of infection. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2593-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Fazli A, Salouti M, Mazidi M. 99mTc-ceftriaxone, as a targeting radiopharmaceutical for scintigraphic imaging of infectious foci due to Staphylococcus aureus in mouse model. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2523-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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18
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Mirshojaei SF, Erfani M, Shafiei M. Evaluation of 99mTc-ceftazidime as bacterial infection imaging agent. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2418-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Chattopadhyay S, Ghosh M, Sett S, Das MK, Chandra S, De K, Mishra M, Sinha S, Ranjan Sarkar B, Ganguly S. Preparation and evaluation of 99mTc-cefuroxime, a potential infection specific imaging agent: A reliable thin layer chromatographic system to delineate impurities from the 99mTc-antibiotic. Appl Radiat Isot 2012; 70:2384-7. [DOI: 10.1016/j.apradiso.2012.06.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 05/16/2012] [Accepted: 06/07/2012] [Indexed: 12/01/2022]
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20
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Motaleb MA, El-Kolaly MT, Ibrahim AB, Abd El-Bary A. Study on the preparation and biological evaluation of 99mTc–gatifloxacin and 99mTc–cefepime complexes. J Radioanal Nucl Chem 2011. [DOI: 10.1007/s10967-011-1058-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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