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Hussain MRA, Ali M, Sugiyama A, Hiebert L, Rahman MA, Azam G, Ouoba S, E B, Ko K, Akita T, Ward JW, Tanaka J. The impact of COVID-19 on hepatitis B and C virus prevention, diagnosis, and treatment in Bangladesh compared with Japan and the global perspective. BMC Health Serv Res 2023; 23:1137. [PMID: 37872525 PMCID: PMC10594740 DOI: 10.1186/s12913-023-10138-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
AIM This study aimed to assess the effect of COVID-19 on hepatitis-related services in Bangladesh and compared the situation with same study conducted in Japan and globally. METHODS We conducted an online cross-sectional questionnaire survey among the clinicians of four societies associated with liver disease in Bangladesh from October to December 2022. The questionnaire included the same questions as a survey conducted in Japan and globally. RESULTS A total of 83 clinicians from 8 divisions in Bangladesh participated; 66.3% were heads of departments/institutions. Except for HCV treatment initiation, more than 30% of clinicians reported a 76-99% decline in all services. Compared to Japan and the global survey, there was a significantly higher decline in all HBV and HCV services in Bangladesh. To resume services back to pre-COVID-19 levels, Patient anxiety and fear (Bangladesh Survey: 80.7% vs Japan Survey: 67.4% vs Global Survey: 37.9%, p < 0.0001), loss of space due to COVID-19 (Bangladesh Survey: 63.9% vs Japan Survey: 34.7% vs Global Survey: 19.4%, p < 0.0001) were the main challenges. As part of the mitigation strategy, usage of telemedicine (Bangladesh Survey: 83.1% vs. Japan Survey: 67.3% vs Global Survey: 78.6% p < 0.0001), COVID-19 benefits, such as increased laboratory testing platforms (Bangladesh Survey: 77.1% vs Japan Survey: 17.9% vs Global Survey: 41.8%, p < 0.0001) was reported significantly higher in Bangladesh than in Japan and global survey. CONCLUSION All the services-related to HBV and HCV were highly affected during greatest impact month of COVID-19 in Bangladesh and the decline level was higher than Japan and global survey. Repeated countermeasures of COVID-19 and constrained healthcare-system were the probable reasons in Bangladesh. Positive impact resulting from COVID-19 countermeasures should be utilized in the national hepatitis program in Bangladesh.
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Affiliation(s)
- Md Razeen Ashraf Hussain
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
| | - Mohammad Ali
- Department of Hepato-Biliary-Pancreatic Surgery & Liver Transplant, BIRDEM General Hospital, Dhaka, Bangladesh
- National Liver Foundation of Bangladesh, Dhaka, Bangladesh
| | - Aya Sugiyama
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
| | - Lindsey Hiebert
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
- Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, GA, USA
| | - M Anisur Rahman
- Department of Gastrointestinal Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM General Hospital, Dhaka, Bangladesh
| | - Golam Azam
- Department of Gastrointestinal Hepatobiliary & Pancreatic Disorders (GHPD), BIRDEM General Hospital, Dhaka, Bangladesh
| | - Serge Ouoba
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
- Unité de Recherche Clinique de Nanoro (URCN), Institut de Recherche en Science de La Santé (IRSS), Nanoro, Burkina Faso
| | - Bunthen E
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
- National Payment Certification, National Social Protection Council, Ministry of Economic and Finance, Phnom Penh, Cambodia
| | - Ko Ko
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
| | - Tomoyuki Akita
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan
| | - John W Ward
- Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur, GA, USA
| | - Junko Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-Ku, Hiroshima-Shi, 734-8551, Japan.
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Ali M, Rahman MA, Njuguna H, Rahman S, Hossain R, Sayeed A, Ahmed F, Alam S, Azam G, Safwath SA, Alam M. High Prevalence of Hepatitis B and C Virus Infections Among Rohingya Refugees in Bangladesh: A Growing Concern for the Refugees and the Host Communities. Clin Liver Dis (Hoboken) 2022; 19:1-6. [PMID: 35106141 PMCID: PMC8785913 DOI: 10.1002/cld.1197] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Content available: Audio Recording.
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Affiliation(s)
- Mohammad Ali
- National Liver Foundation of BangladeshDhakaBangladesh
| | - M Anisur Rahman
- Department Of Gastro intestinal Hepatobiliary & Pancreatic Disorders (GHPD)BIRDEM General HospitalDhakaBangladesh
| | - Henry Njuguna
- Coalition for Global Hepatitis EliminationTask Force for Global HealthDecaturGA
| | - Salimur Rahman
- Department of HepatologyBangabandhu Sheikh Mujib Medical University (BSMMU)DhakaBangladesh
| | - Rabiul Hossain
- Department of Gastroenterology Lab Aid Specialized HospitalDhakaBangladesh
| | - Abu Sayeed
- Department of MedicineChittagong Medical College HospitalChittagongBangladesh
| | - Faruque Ahmed
- Department of GastroenterologySheikh Russel National Gastro Liver Institute & HospitalDhakaBangladesh
| | - Shahinul Alam
- Department of HepatologyBangabandhu Sheikh Mujib Medical University (BSMMU)DhakaBangladesh
| | - Golam Azam
- Department Of Gastro intestinal Hepatobiliary & Pancreatic Disorders (GHPD)BIRDEM General HospitalDhakaBangladesh
| | - Syed Alamgir Safwath
- Department of GastroenterologyJalalabad Ragib‐Rabeya Medical CollegeSylhetBangladesh
| | - Mahabubul Alam
- Department of HepatologyBangabandhu Sheikh Mujib Medical University (BSMMU)DhakaBangladesh
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Alam S, Fahim SM, Chowdhury MAB, Hassan MZ, Azam G, Mustafa G, Ahsan M, Ahmad N. Prevalence and risk factors of non-alcoholic fatty liver disease in Bangladesh. JGH Open 2018; 2:39-46. [PMID: 30483562 PMCID: PMC6206991 DOI: 10.1002/jgh3.12044] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 12/18/2017] [Accepted: 01/31/2018] [Indexed: 12/18/2022]
Abstract
Background and Aim Non‐alcoholic fatty liver disease (NAFLD) is a significant cause of hepatic dysfunction and liver‐related mortality. As there is a lack of population‐based prevalence data in a representative sample of general population, we aimed to estimate the prevalence and risk factors of NAFLD in Bangladesh. Methods A cross‐sectional study was conducted both in urban and rural areas of Bangladesh from December 2015 to January 2017. Data were collected using a pretested structured questionnaire followed by ultrasonography of hepatobiliary system for screening of NAFLD. Multivariate logistic regression was used to estimate the risk factors of NAFLD. Results A total of 2782 (1694 men and 1088 women) participants were included in the study, with a mean age of 34.21 (±12.66) years. The overall prevalence of NAFLD was 33.86% (95% confidence interval [CI]: 32.12, 35.64). Females living in the rural areas and midlife adults (45–54 years) had the highest prevalence of NAFLD (P < 0.05). Multivariable logistic regression model demonstrated that increasing age, diabetes, elevated body mass index, and married individuals are significantly associated with NAFLD. Individuals with diabetes (adjusted odds ratio: 2.71, 95% CI: 1.85, 3.97) and hypertension were at a higher risk of having NAFLD. The odds of having NAFLD were 4.51 (95% CI: 3.47, 5.86) and 10.71 (95% CI: 7.80, 14.70) times higher among overweight and obese participants, respectively, as compared to normal‐weight participants. Conclusions About one‐third of the population of Bangladesh is affected by NAFLD. Individuals with higher body mass index (overweight and obese), diabetics, midlife adults, married individuals, and rural women were more at risk of having NAFLD than others.
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Affiliation(s)
- Shahinul Alam
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Shah Mohammad Fahim
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | | | - Md. Zakiul Hassan
- Programme for Emerging Infections, Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b)DhakaBangladesh
| | - Golam Azam
- Department of Gastrointestinal Hepatobiliary and Pancreatic disorders (GHPD)BIRDEMDhakaBangladesh
| | - Golam Mustafa
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Mainul Ahsan
- Department of Radiology and ImagingBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
| | - Nooruddin Ahmad
- Department of HepatologyBangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh
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Azam G. Justification of Galston's liberal pluralism. Springerplus 2016; 5:1291. [PMID: 27547665 PMCID: PMC4977235 DOI: 10.1186/s40064-016-2993-8] [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] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 08/03/2016] [Indexed: 11/24/2022]
Abstract
Liberal multicultural theories developed in late twenty-first century aims to ensure the rights of the minorities, social justice and harmony in liberal societies. Will Kymlicka is the leading philosopher in this field. He advocates minority rights, their autonomy and the way minority groups can be accommodated in a liberal society with their distinct cultural identity. Besides him, there are other political theorists on the track and Galston is one of them. He disagrees with Kymlicka on some crucial points, particularly regarding the scope of civil rights of the minority groups and the responsibilities of both majority and minority groups for the sake of social harmony and justice. He tries to develop a moral theory of mutualism based on inter-community toleration and constitutionalism. Considering toleration as one of the fundamental liberal virtues he contends that the majority government has the responsibility to make arrangement both for the members of majority and minority groups so that they can build inter personal relation and learn toleration. The paper critically justifies the feasibility of his theory in a liberal society and claims that although Galston’s theory has a higher possibility to be accommodated in liberal societies, it eventually fails.
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Affiliation(s)
- Golam Azam
- Department of Philosophy, Dhaka University, 2032, Arts Building, Dhaka, 1000 Bangladesh
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Abstract
There are many studies, including those of J. Pucher et al. and S. C. Anderson, that found higher costs to be associated with transit operating subsidies. However, none of them investigated the effect of state and local federal subsidy formulas on cost efficiency of transit operations. In this article, the subsidy-cost relationship is derived by using the federal operating subsidy formula directly within the transit firm's optimizing framework, and the resulting system of equations is estimated. Our results demonstrate that there exists a positive cost-subsidy relationship that conforms with the previous studies and that the formula results in very little capital bias.
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Al Baker SM, Azam G, Rahman F, Rahman MM, Haque K. PM209 Correlation Of The Ecg Changes (St Segment Depression With Or Without T Wave Inversion In Lateral Leads 1, Avl.V4-V6) With Coronary Angiographic Findings In Acs Patients. Glob Heart 2014. [DOI: 10.1016/j.gheart.2014.03.1594] [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] Open
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Rahman A, Ahmed M, Ahmed M, Chaudhury S, Husnayen M, Azam G, Islam N. AS-192: Clinical Outcomes of the New Zotarolimus-Eluting Stent in Different Clinical Subjects. Am J Cardiol 2010. [DOI: 10.1016/j.amjcard.2010.01.239] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Alam S, Azam G, Mustafa G, Azad AK, Haque I, Gani S, Ahmad N, Alam K, Khan M. Natural course of fulminant hepatic failure: the scenario in Bangladesh and the differences from the west. Saudi J Gastroenterol 2009; 15:229-33. [PMID: 19794267 PMCID: PMC2981838 DOI: 10.4103/1319-3767.56094] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Accepted: 02/21/2009] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND/AIM Fulminant hepatic failure (FHF) is a devastating complication of acute viral hepatitis, leading to death in most cases. The etiology and predictors of outcome differ according to the geographical region. This study was conducted with the aim of evaluating the etiology, complications, and outcome of FHF in Bangladesh. PATIENTS AND METHODS In this prospective study, we included 67 consecutive cases of FHF presenting to the Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, between November 2003 and May 2008. Thirty-nine of the patients were male and 28 were female. Data was analyzed using SPSS, version 13.0. RESULTS The mean age of the subjects was 31.9 +/- 11 .7 years. Hepatitis E virus (HEV) was the commonest etiological factor for FHF (50 cases, 74.6%); of the 50 cases with HEV infection, 43 (64.2%) were not coinfected with any other virus, four cases were Hepatitis B virus (HBV) carriers, and three had coinfection with hepatitis A virus (HAV). HBV was the cause of FHF in nine (13.4%) patients. HCV, paracetamol, and alcohol were not responsible for any of the cases. Most of the patients (57 patients, 85%) developed FHF within 2 weeks of the onset of jaundice. Of the 67 patients, 49 (73.1%) died. Cerebral edema was the single most common cause of death (48 patients, 71.6%). Other complications were renal failure (23 patients, 34.3%), sepsis (15 patients, 22.4%), electrolyte imbalance (12 patients 17.9%), and bleeding tendency (7 patients, 10.4%). Occurrence of cerebral edema, longer prothrombin time, higher grade of encephalopathy, and longer jaundice-to-encephalopathy interval had significant negative influence on outcome. CONCLUSIONS The etiology of FHF in Bangladesh is different from that in the West. Prolongation of prothrombin time and occurrence of cerebral edema are predictors of the worst prognosis.
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Affiliation(s)
- Shahinul Alam
- Departments of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.
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Raj M, Abd Elmageed Z, Zhou J, Gaur R, Nguyen L, Azam G, Rao P, Ouhtit A. Synergistic action of dietary phyto-antioxidants on survival and proliferation of ovarian cancer cells. Gynecol Oncol 2008. [DOI: 10.1016/j.ygyno.2008.07.090] [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: 11/15/2022]
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Alam S, Azam G, Mustafa G, Ahmad N, Islam B, Podder PK, Khan M. Pretreatment and on-treatment predictors of viral breakthrough in lamivudine therapy for chronic hepatitis B. Hepatol Int 2008; 2:494-7. [PMID: 19669325 DOI: 10.1007/s12072-008-9095-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2008] [Accepted: 08/07/2008] [Indexed: 01/17/2023]
Abstract
PURPOSE There are remarkable advances in the treatment of chronic hepatitis B (CHB) in the last few years. Unfortunately, prolonged antiviral treatment is associated with increasing risk of drug resistance/viral breakthrough (VBT), which may lead to flare-up and rapid decompensation. We have designed this study to predict the pretreatment and on-treatment factors responsible for development of VBT. METHODS This study was conducted during the period of February 2000 to November 2007. We have included 423 patients who received lamivudine (LAM) therapy for at least 1 year and at least 2 follow-ups at 6 months' interval. Follow-up period was 12-78 months. Chi-square test, student's t test, and logistic regression analysis were performed to prove the validity. RESULTS Of the 423 study cases, 367 (86.8%) were of male patients and 261 (61.7%) patients were HBeAg positive; the age of the patients was 30.8 +/- 12.9 years. Development of VBT was 4.4, 22.8, 45.3, and 74% at 1, 2, 3, and 4 or more years, respectively. Pretreatment high HBV DNA (P = 0.005) and female sex (P = 0.01) were associated with VBT and pretherapy ALT (P = 0.698), HBeAg status (P = 0.273), and age (P = 0.059) were not associated. Duration of treatment, failure to lose HBeAg at 1 year, and HBV DNA nonresponder at 6 months were significantly (P = 0.001) associated with development of VBT. CONCLUSION Persistence of HBeAg at 1 year and HBV DNA nonresponder at 6 months are good predictors of development of VBT.
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Affiliation(s)
- Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh,
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Rahman F, Banerjee S, Ahmed CM, Jamil AA, Uddin MS, Alam S, Bhattcharjo B, Azam G, Sarker H, Shamim K, Rashid H, Diva F, Jaman M, Hossain Z, Ahsan SA, Siddique AB, Khalil M, Haque SS, Uddin MJ, Hasan KA, Khaleque MA, Rashid M. Evaluation of stentangioplasty in university cardiac center. Mymensingh Med J 2007; 16:197-203. [PMID: 17703159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
In this ongoing prospective study conducted in University Cardiac Center, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2004 to January 2006. Fifty (50) patients (mean age 56+/-7.2 years) underwent stentangioplasty were evaluated. The study group of 50 patients consisted of 42 (84%) men and 08 (16%) women. The aim of this study was to evaluate in-hospital success, failure and complications during the procedures. About risk factors 19(38%) had hypertension, 13(26%) were smoker, 11(22%) suffered from diabetes mellitus, 05(10%) had family history of ischaemic heart disease. Average left ventricular ejection fraction was 54+/-7. Target vessel percutaneous coronary angioplasty (PTCA) were done in 61 vessel, intracoronary stent implanted in 58 vessels, direct stenting were done in 35 cases, failed PTCA were in 03(6%) cases and two had dissection. The native vessels had a mean reference diameter of 2.91 mm and their luminal diameter increased significantly after percutaneous coronary intervention (PCI). All the patients were discharged by one to three days of the procedure with improvement of their clinical condition. In conclusion, intracoronary stent deployment in coronary artery stenosis following balloon angioplasty is a valid and beneficial strategy with good in-hospital results.
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Affiliation(s)
- F Rahman
- Department of Cardiology, University Cardiac Center, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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Azam G, Convert G, Dufour J, Jasmin C, Mabire JP, Oweidat L, Sidi J. Hyperthermia system for deep-seated tumors. Recent Results Cancer Res 1986; 101:53-5. [PMID: 3952359 DOI: 10.1007/978-3-642-82530-9_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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