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Fiandra C, Rosati S, Arcadipane F, Dinapoli N, Fato M, Franco P, Gallio E, Scaffidi Gennarino D, Silvetti P, Zara S, Ricardi U, Balestra G. Active bone marrow segmentation based on computed tomography imaging in anal cancer patients: A machine-learning-based proof of concept. Phys Med 2023; 113:102657. [PMID: 37567068 DOI: 10.1016/j.ejmp.2023.102657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/30/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE Different methods are available to identify haematopoietically active bone marrow (ActBM). However, their use can be challenging for radiotherapy routine treatments, since they require specific equipment and dedicated time. A machine learning (ML) approach, based on radiomic features as inputs to three different classifiers, was applied to computed tomography (CT) images to identify haematopoietically active bone marrow in anal cancer patients. METHODS A total of 40 patients was assigned to the construction set (training set + test set). Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography (18FDG-PET) images were used to detect the active part of the pelvic bone marrow (ActPBM) and stored as ground-truth for three subregions: iliac, lower pelvis and lumbosacral bone marrow (ActIBM, ActLPBM, ActLSBM). Three parameters were used for the correspondence analyses between 18FDG-PET and ML classifiers: DICE index, Precision and Recall. RESULTS For the 40-patient cohort, median values [min; max] of the Dice index were 0.69 [0.20; 0.84], 0.76 [0.25; 0.89], and 0.36 [0.15; 0.67] for ActIBM, ActLSBM, and ActLPBM, respectively. The Precision/Recall (P/R) ratio median value for the ActLPBM structure was 0.59 [0.20; 1.84] (over segmentation), while for the other two subregions the P/R ratio median has values of 1.249 [0.43; 4.15] for ActIBM and 1.093 [0.24; 1.91] for ActLSBM (under segmentation). CONCLUSION A satisfactory degree of overlap compared to 18FDG-PET was found for 2 out of the 3 subregions within pelvic bones. Further optimization and generalization of the process is required before clinical implementation.
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Affiliation(s)
- C Fiandra
- Department of Oncology, University of Turin, Turin, Italy.
| | - S Rosati
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - F Arcadipane
- Department of Oncology, University of Turin, Turin, Italy
| | - N Dinapoli
- UOC Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - M Fato
- Department of Informatics, Bioengineering, Robotics and System Engineering (DIBRIS), University of Genova, Genova, Italy
| | - P Franco
- Department of Oncology, University of Turin, Turin, Italy
| | - E Gallio
- Medical Physics Unit, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - D Scaffidi Gennarino
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - P Silvetti
- Department of Oncology, University of Turin, Turin, Italy
| | - S Zara
- Tecnologie Avanzate, Torino, Italy
| | - U Ricardi
- Department of Oncology, University of Turin, Turin, Italy
| | - G Balestra
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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Olivero F, Franco P, Ferreri F, Gardini AC, Andrikou K, Arcadipane F, Gastino A, De Luca V, Cascinu S, Ricardi U. PO-0806: Prognostic value of eosinophil levels in oropharyngeal cancer: a retrospective multicentric study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00823-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bagnasco D, Aloè T, Sclifò F, Ferrantino MG, Marugo F, Arcadipane F, Manfredi A, Canonica GW, Passalacqua G. When to stop biologicals. Severe asthma exacerbation after mepolizumab discontinuation. Eur Ann Allergy Clin Immunol 2020; 51:135-137. [PMID: 31081606 DOI: 10.23822/eurannaci.1764-1489.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- D Bagnasco
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - T Aloè
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - F Sclifò
- Emergency Department, Ospedale Policlinico San Martino, Genoa, Italy
| | - M G Ferrantino
- Respiratory Diseases, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - F Marugo
- Respiratory Diseases, Ospedale La Colletta, Arenzano, Italy
| | - F Arcadipane
- Respiratory Diseases, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - A Manfredi
- Respiratory Diseases, Ospedale La Colletta, Arenzano, Italy
| | - G W Canonica
- Personalized Medicine Clinic Asthma and Allergy, Humanitas Clinical and Research Center, Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
| | - G Passalacqua
- Allergy and Respiratory Diseases, IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
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Gallio E, Rosati S, Fiandra C, Arcadipane F, Lesca A, Silvetti P, Balestra G, Ricardi U, Franco P. EP-1918 Active bone marrow identification in the pelvis using texture analysis of CT features. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32338-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fiandra C, Trino E, Arcadipane F, Olivero F, Ricardi U, Franco P. EP-1992 Dose warping protocol for interfraction variation in Bladder filling in ano-rectal cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32412-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Iorio C, Martini S, Arcadipane F, Olimpio E, Franco P, Ricardi U. EP-1174 Assessment of nausea and dysgeusia in head and neck cancer patients undergoing radiotherapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31594-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Martini S, Iorio G, Arcadipane F, Franco P, Ricardi U. EP-1428 Volumetric modulated arc therapy (VMAT) in the treatment of oesophageal cancer patients. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31848-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martini S, lorio G, Olimpio E, Arcadipane F, Franco P, Ricardi U. PO-133 Prospective assessment of dysgeusia during radiotherapy for head and neck cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30299-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Franco P, Montagnani F, Arcadipane F, Casadei C, Andrikou K, Franco G, Scartozzi M, Mistrangelo M, Fornaro L, Cassoni P, Cascinu S, Ricardi U, Casadei Gardini A. Immune Inflammation Indicators Predict Outcome in Anal Cancer Patients Undergoing Concurrent Chemoradiation. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Franco P, Arcadipane F, Mistrangelo M, Cassoni P, Martini S, Iorio G, Elisabetta T, Racca P, Morino M, Ricardi U. Comparing simultaneous vs sequential boost strategies during concurrent chemo-radiation for anal cancer: Results of a retrospective observational study. Eur J Surg Oncol 2018. [DOI: 10.1016/j.ejso.2018.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Franco P, Montagnani F, Arcadipane F, Casadei C, Andrikou K, Martini S, Iorio G, Scartozzi M, Mistrangelo M, Fornaro L, Cassoni P, Cascinu S, Ricardi U, Casadei Gardini A. EP-1461: Immune inflammation indicators in anal cancer patients treated with concurrent chemo-radiation. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31770-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Martini S, Iorio G, Franco P, Montagnani F, Arcadipane F, Casadei C, Andrikou K, Scartozzi M, Mistrangelo M, Fornaro L, Cassoni P, Cascinu S, Ricardi U, Casadei Gardini A. EP-1487: The prognostic role of haemoglobin in patients undergoing concurrent chemo-radiation for anal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31796-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Arcadipane F, Osella-Abate S, Vella A, Franco P, Martini S, Iorio G, Rondi N, Bartoncini S, Rovea P, Castellano I, Ricardi U. PO-0739: Role of ki67, tumor size and lymph nodal status as a prognostic index in breast cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31049-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Franco P, Arcadipane F, Martini S, Iorio G, Ricardi U. SP-0145: Hematologic toxicity during RT for pelvic malignancies: how to reduce it? Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30455-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Franco P, Osella-Abate S, Vella A, Arcadipane F, Cassoni P, Ricardi U, Castellano I. A prognostic index employing ki67, tumor size and lymph nodal status in luminal breast cancer patients undergoing breast conservation and adjuvant radiotherapy. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30411-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Iorio G, Martini S, Franco P, Fiandra C, Arcadipane F, Trino E, Giglioli F, Ragona R, Ricardi U. EP-1486: Incorporating 18FDG-PET to define bone marrow into automatic treatment planning for anal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31795-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Franco P, Arcadipane F, Racca P, Mistrangelo M, Cassoni P, Morino M, Ricardi U. Image-guided SIB-IMRT for the treatment of anal cancer patients. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx422.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Arcadipane F, Lepinoy A, Franco P, Ceccarelli M, De Bari B, Lestrade L, Furfaro G, Mistrangelo M, Créhange G, Ricardi U. EP-1258: High precision SIB-IMRT versus conventional radiotherapy in anal cancer: a propensity score analysis. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Arcadipane F, Franco P, Martini S, Furfaro G, Ceccarelli M, Mistrangelo M, Rondi N, Cassoni P, Racca P, Ricardi U. EP-1265: Image-guided SIB-IMRT for the treatment of anal cancer patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31700-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Franco P, Arcadipane F, Ragona R, Lesca A, Gallio E, Mistrangelo M, Cassoni P, Baccega M, Racca P, Faletti R, Rondi N, Morino M, Ricardi U. PV-0324: FDG-PET based pelvic bone marrow dose predicts for blood cell nadirs in CT-RT for anal cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30766-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Franco P, Arcadipane F, Ragona R, Mistrangelo M, Cassoni P, Di Muzio J, Rondi N, Morino M, Racca P, Ricardi U. OC-0240: Lumbarsacral bone marrow modeling of acute hematological toxicity in chemoradiation for anal cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31489-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boschetti A, Bartoncini S, Fiandra C, Guarneri A, Cavallin C, Arcadipane F, Trino E, Levis M, Ragona R, Ricardi U. EP-2114: 3D-Transabdominal Ultrasound and ConeBeam-CT: comparison of prostate positioning. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33365-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Franco P, Ragona R, Arcadipane F, Mistrangelo M, Cassoni P, Rondi N, Morino M, Racca P, Ricardi U. Dosimetric predictors of acute hematologic toxicity during concurrent intensity-modulated radiotherapy and chemotherapy for anal cancer. Clin Transl Oncol 2016; 19:67-75. [PMID: 27037814 DOI: 10.1007/s12094-016-1504-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 03/15/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aimed at investigating whether the irradiated volume of pelvic bone marrow (PBM) and specific subsites may predict the occurrence of acute hematologic toxicity (HT) in anal cancer patients undergoing concurrent chemo-radiation. METHODS 50 patients, submitted to IMRT and concurrent chemotherapy, were analyzed. Several bony structures were defined on planning-CT: PBM and lumbar-sacral (LSBM), lower pelvis (LPBM) and iliac (IBM) bone marrow. On dose-volume histograms, dosimetric parameters were taken. Endpoints included white blood-cell-count (WBC), absolute-neutrophil-count (ANC), hemoglobin (Hb) and platelet nadirs and acute hematologic toxicity (HT) according to RTOG scoring scale. Generalized linear modeling was used to find correlations between dosimetric variables and blood cell nadirs, while logistic regression analysis was used to test correlation with ≥G3 HT. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the optimal cut-off points for predictive dosimetric variables with the Youden method. RESULTS Maximum detected acute HT comprised 38 % of ≥G3 leukopenia and 32 % of ≥G3 neutropenia. Grade 2 anemia was observed in 4 % of patients and ≥G3 thrombocytopenia in 10 %. On multivariate analysis a higher PBM-V 20 was associated with lower WBC nadir. Increased LSBM-V 40 was correlated with a higher likelihood to develop ≥G3 HT. A cut-off point at 41 % for LSBM-V 40 was found. Patients with LSBM-V 40 ≥41 % were more likely to develop ≥G3 HT (55.3 vs. 32.4 %; p < 0.01). CONCLUSIONS Increased low-dose to pelvic bony structures significantly predicted for WBC decrease. Medium-high dose to specific osseous subsites was associated with a higher probability of HT. LSBM-V 40 was a strong predictor of ≥G3 HT. A threshold at 41 % for LSBM-V 40 could be used to limit HT.
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Affiliation(s)
- P Franco
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy.
| | - R Ragona
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
| | - F Arcadipane
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
| | - M Mistrangelo
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - P Cassoni
- Department of Medical Sciences, Pathology Unit, University of Torino, Turin, Italy
| | - N Rondi
- Department of Medical Imaging and Radiotherapy, Radiation Oncology, AOU Città della Salute e della Scienza, Turin, Italy
| | - M Morino
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - P Racca
- Oncological Centre for Gastrointestinal Neoplasm, Medical Oncology 1, AOU Città della Salute e della Scienza, Turin, Italy
| | - U Ricardi
- Department of Oncology, Radiation Oncology, University of Turin School of Medicine, Via Genova 3, 10126, Turin, Italy
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Franco P, Arcadipane F, Di Muzio J, Ricardi U. EP-1457: Delineation of radiation treatment volumes: a regional network based on the software Radiotherap-e. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32707-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Franco P, Arcadipane F, Segantin M, Munoz F, Migliaccio F, Sciacero P, Mistrangelo M, Angelini V, Racca P, Morino M, Cassoni P, Ricardi U. EP-1217: SIB-IMRT combined with concurrent chemotherapy for anal cancer: 4-year results of a consecutive case series. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)41209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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