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Eby P, Peel AJ, Hoegh A, Madden W, Giles JR, Hudson PJ, Plowright RK. Pathogen spillover driven by rapid changes in bat ecology. Nature 2023; 613:340-344. [PMID: 36384167 PMCID: PMC9768785 DOI: 10.1038/s41586-022-05506-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022]
Abstract
During recent decades, pathogens that originated in bats have become an increasing public health concern. A major challenge is to identify how those pathogens spill over into human populations to generate a pandemic threat1. Many correlational studies associate spillover with changes in land use or other anthropogenic stressors2,3, although the mechanisms underlying the observed correlations have not been identified4. One limitation is the lack of spatially and temporally explicit data on multiple spillovers, and on the connections among spillovers, reservoir host ecology and behaviour and viral dynamics. We present 25 years of data on land-use change, bat behaviour and spillover of Hendra virus from Pteropodid bats to horses in subtropical Australia. These data show that bats are responding to environmental change by persistently adopting behaviours that were previously transient responses to nutritional stress. Interactions between land-use change and climate now lead to persistent bat residency in agricultural areas, where periodic food shortages drive clusters of spillovers. Pulses of winter flowering of trees in remnant forests appeared to prevent spillover. We developed integrative Bayesian network models based on these phenomena that accurately predicted the presence or absence of clusters of spillovers in each of the 25 years. Our long-term study identifies the mechanistic connections between habitat loss, climate and increased spillover risk. It provides a framework for examining causes of bat virus spillover and for developing ecological countermeasures to prevent pandemics.
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Affiliation(s)
- Peggy Eby
- School of Biological, Earth, and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Planetary Health and Food Security, Griffith University, Nathan, Queensland, Australia.,Center for Large Landscape Conservation, Bozeman, MT, USA
| | - Alison J Peel
- Centre for Planetary Health and Food Security, Griffith University, Nathan, Queensland, Australia
| | - Andrew Hoegh
- Department of Mathematical Sciences, Montana State University, Bozeman, MT, USA
| | - Wyatt Madden
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, MT, USA.,Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - John R Giles
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peter J Hudson
- Center for Infectious Disease Dynamics, Pennsylvania State University, State College, PA, USA
| | - Raina K Plowright
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, MT, USA. .,Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, USA.
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Becker DJ, Eby P, Madden W, Peel AJ, Plowright RK. Ecological conditions predict the intensity of Hendra virus excretion over space and time from bat reservoir hosts. Ecol Lett 2023; 26:23-36. [PMID: 36310377 DOI: 10.1111/ele.14007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 12/27/2022]
Abstract
The ecological conditions experienced by wildlife reservoirs affect infection dynamics and thus the distribution of pathogen excreted into the environment. This spatial and temporal distribution of shed pathogen has been hypothesised to shape risks of zoonotic spillover. However, few systems have data on both long-term ecological conditions and pathogen excretion to advance mechanistic understanding and test environmental drivers of spillover risk. We here analyse three years of Hendra virus data from nine Australian flying fox roosts with covariates derived from long-term studies of bat ecology. We show that the magnitude of winter pulses of viral excretion, previously considered idiosyncratic, are most pronounced after recent food shortages and in bat populations displaced to novel habitats. We further show that cumulative pathogen excretion over time is shaped by bat ecology and positively predicts spillover frequency. Our work emphasises the role of reservoir host ecology in shaping pathogen excretion and provides a new approach to estimate spillover risk.
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Affiliation(s)
- Daniel J Becker
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, USA.,Department of Biology, University of Oklahoma, Norman, Oklahoma, USA
| | - Peggy Eby
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, Australia.,Centre for Planetary Health and Food Security, Griffith University, Queensland, Australia
| | - Wyatt Madden
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, USA
| | - Alison J Peel
- Centre for Planetary Health and Food Security, Griffith University, Queensland, Australia
| | - Raina K Plowright
- Department of Microbiology and Immunology, Montana State University, Bozeman, Montana, USA
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Lau MSY, Becker A, Madden W, Waller LA, Metcalf CJE, Grenfell BT. Comparing and linking machine learning and semi-mechanistic models for the predictability of endemic measles dynamics. PLoS Comput Biol 2022; 18:e1010251. [PMID: 36074763 PMCID: PMC9455846 DOI: 10.1371/journal.pcbi.1010251] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
Measles is one the best-documented and most-mechanistically-studied non-linear infectious disease dynamical systems. However, systematic investigation into the comparative performance of traditional mechanistic models and machine learning approaches in forecasting the transmission dynamics of this pathogen are still rare. Here, we compare one of the most widely used semi-mechanistic models for measles (TSIR) with a commonly used machine learning approach (LASSO), comparing performance and limits in predicting short to long term outbreak trajectories and seasonality for both regular and less regular measles outbreaks in England and Wales (E&W) and the United States. First, our results indicate that the proposed LASSO model can efficiently use data from multiple major cities and achieve similar short-to-medium term forecasting performance to semi-mechanistic models for E&W epidemics. Second, interestingly, the LASSO model also captures annual to biennial bifurcation of measles epidemics in E&W caused by susceptible response to the late 1940s baby boom. LASSO may also outperform TSIR for predicting less-regular dynamics such as those observed in major cities in US between 1932–45. Although both approaches capture short-term forecasts, accuracy suffers for both methods as we attempt longer-term predictions in highly irregular, post-vaccination outbreaks in E&W. Finally, we illustrate that the LASSO model can both qualitatively and quantitatively reconstruct mechanistic assumptions, notably susceptible dynamics, in the TSIR model. Our results characterize the limits of predictability of infectious disease dynamics for strongly immunizing pathogens with both mechanistic and machine learning models, and identify connections between these two approaches. Machine learning techniques in infectious disease modeling have grown in popularity in recent years. However, systematic investigation into the comparative performance of these approaches with traditional mechanistic models are still rare. In this paper, we compare one of the most widely used semi-mechanistic models for measles (TSIR) with a commonly used machine learning approach (LASSO), comparing performance and limits in predicting short to long term outbreaks of measles, one of the best-documented and most-mechanistically-studied non-linear infectious disease dynamical systems. Our results show that in general the LASSO outperform TSIR for predicting less-regular dynamics, and it can achieve similar performance in other scenarios when compared to the TSIR. The LASSO also has the advantages of not requiring explicit demographic data in model training. Finally, we identify connections between these two approaches and show that the LASSO model can both qualitatively and quantitatively reconstruct mechanistic assumptions, notably susceptible dynamics, in the TSIR model.
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Affiliation(s)
- Max S. Y. Lau
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, United States of America
- * E-mail:
| | - Alex Becker
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, United States of America
| | - Wyatt Madden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, United States of America
| | - Lance A. Waller
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, United States of America
| | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, United States of America
| | - Bryan T. Grenfell
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, United States of America
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Cherne MD, Gentry AB, Nemudraia A, Nemudryi A, Hedges JF, Walk H, Blackwell K, Snyder DT, Jerome M, Madden W, Hashimi M, Sebrell TA, King DB, Plowright RK, Jutila MA, Wiedenheft B, Bimczok D. Severe Acute Respiratory Syndrome Coronavirus 2 Is Detected in the Gastrointestinal Tract of Asymptomatic Endoscopy Patients but Is Unlikely to Pose a Significant Risk to Healthcare Personnel. Gastro Hep Adv 2022; 1:844-852. [PMID: 35765598 PMCID: PMC9225937 DOI: 10.1016/j.gastha.2022.06.002] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Background and Aims Recent evidence suggests that the gut is an additional target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, whether SARS-CoV-2 spreads via gastrointestinal secretions remains unclear. To determine the prevalence of gastrointestinal SARS-CoV-2 infection in asymptomatic subjects, we analyzed gastrointestinal biopsy and liquid samples from endoscopy patients for the presence of SARS-CoV-2. Methods We enrolled 100 endoscopic patients without known SARS-CoV-2 infection (cohort A) and 12 patients with a previous COVID-19 diagnosis (cohort B) in a cohort study performed at a regional hospital. Gastrointestinal biopsies and fluids were screened for SARS-CoV-2 by polymerase chain reaction (PCR), immunohistochemistry, and virus isolation assay, and the stability of SARS-CoV-2 in gastrointestinal liquids in vitro was analyzed. Results SARS-CoV-2 ribonucleic acid was detected by PCR in the colonic tissue of 1/100 patients in cohort A. In cohort B, 3 colonic liquid samples tested positive for SARS-CoV-2 by PCR and viral nucleocapsid protein was detected in the epithelium of the respective biopsy samples. However, no infectious virions were recovered from any samples. In vitro exposure of SARS-CoV-2 to colonic liquid led to a 4-log-fold reduction of infectious SARS-CoV-2 within 1 hour (P ≤ .05). Conclusion Overall, the persistent detection of SARS-CoV-2 in endoscopy samples after resolution of COVID-19 points to the gut as a long-term reservoir for SARS-CoV-2. Since no infectious virions were recovered and SARS-CoV-2 was rapidly inactivated in the presence of colon liquids, it is unlikely that performing endoscopic procedures is associated with a significant infection risk due to undiagnosed asymptomatic or persistent gastrointestinal SARS-CoV-2 infections.
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Affiliation(s)
- Michelle D Cherne
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Andrew B Gentry
- Department of Gastroenterology, Bozeman Health Deaconess Hospital, Bozeman, Montana
| | - Anna Nemudraia
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Artem Nemudryi
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Jodi F Hedges
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Heather Walk
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Karlin Blackwell
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Deann T Snyder
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Maria Jerome
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Wyatt Madden
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
- Rollins School of Public Heath, Emory University, Atlanta, Georgia
| | - Marziah Hashimi
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - T Andrew Sebrell
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - David B King
- Department of Clinical Research, Bozeman Health Deaconess Hospital, Bozeman, Montana
| | - Raina K Plowright
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Mark A Jutila
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Blake Wiedenheft
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
| | - Diane Bimczok
- Department of Microbiology and Cell Biology, Montana State University, Bozeman, Montana
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Hoegh A, Peel AJ, Madden W, Ruiz Aravena M, Morris A, Washburne A, Plowright RK. Estimating viral prevalence with data fusion for adaptive two-phase pooled sampling. Ecol Evol 2021; 11:14012-14023. [PMID: 34707835 PMCID: PMC8525136 DOI: 10.1002/ece3.8107] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic has highlighted the importance of efficient sampling strategies and statistical methods for monitoring infection prevalence, both in humans and in reservoir hosts. Pooled testing can be an efficient tool for learning pathogen prevalence in a population. Typically, pooled testing requires a second-phase retesting procedure to identify infected individuals, but when the goal is solely to learn prevalence in a population, such as a reservoir host, there are more efficient methods for allocating the second-phase samples.To estimate pathogen prevalence in a population, this manuscript presents an approach for data fusion with two-phased testing of pooled samples that allows more efficient estimation of prevalence with less samples than traditional methods. The first phase uses pooled samples to estimate the population prevalence and inform efficient strategies for the second phase. To combine information from both phases, we introduce a Bayesian data fusion procedure that combines pooled samples with individual samples for joint inferences about the population prevalence.Data fusion procedures result in more efficient estimation of prevalence than traditional procedures that only use individual samples or a single phase of pooled sampling.The manuscript presents guidance on implementing the first-phase and second-phase sampling plans using data fusion. Such methods can be used to assess the risk of pathogen spillover from reservoir hosts to humans, or to track pathogens such as SARS-CoV-2 in populations.
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Affiliation(s)
- Andrew Hoegh
- Department of Mathematical SciencesMontana State UniversityBozemanMTUSA
| | - Alison J. Peel
- Centre for Planetary Health and Food SecurityGriffith UniversityNathanQLDAustralia
| | - Wyatt Madden
- Department of Microbiology and ImmunologyMontana State UniversityBozemanMTUSA
| | - Manuel Ruiz Aravena
- Department of Microbiology and ImmunologyMontana State UniversityBozemanMTUSA
| | - Aaron Morris
- Department of Veterinary MedicineUniversity of CambridgeCambridgeUK
| | | | - Raina K. Plowright
- Department of Microbiology and ImmunologyMontana State UniversityBozemanMTUSA
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Morrison B, Madden W, Gabay L. 136 Testosterone Replacement Therapy in Adolescents with Sickle Cell Disease Reverses Hypogonadism without Promoting Priapism. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.142] [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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Morrison B, Anele U, Metzger S, Madden W, Burnett A. 038 Validation of the Priapism Profile Impact Questionnaire. J Sex Med 2016. [DOI: 10.1016/j.jsxm.2016.02.040] [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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Morrison BF, Reid M, Madden W, Burnett AL. Testosterone replacement therapy does not promote priapism in hypogonadal men with sickle cell disease: 12-month safety report. Andrology 2013; 1:576-82. [PMID: 23606509 DOI: 10.1111/j.2047-2927.2013.00084.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 02/24/2013] [Accepted: 02/27/2013] [Indexed: 11/29/2022]
Abstract
Hypogonadism, which is highly prevalent in men with sickle cell disease (SCD), affects quality of life and causes great morbidity. The safety of testosterone replacement therapy (TRT) in SCD in relation to priapism episodes is relatively unknown. Our aim was to monitor the safety of TRT in a cohort of seven hypogonadal men with SCD. Testosterone undecanoate (Nebido) 1 g was administered intramuscularly to adult men with homozygous SCD (Hb SS) having hypogonadism [serum total testosterone ≤12.0 nmol/L (346 ng/dL), reference range 12.5-38.1 nmol/L (360-1098 ng/dL)] for 12 months. Serum total testosterone, haemoglobin, haematocrit, renal and liver function tests, glucose and PSA measurements were done at baseline and 12-month follow-up. Trough serum total testosterone, haemoglobin and haematocrit were measured three monthly. Priapism events and adverse drug events were assessed every 3 months. International Index of Erectile Function (IIEF), Androgen Deficiency in the Ageing Male (ADAM) and World Health Organization Quality of Life (WHOQOL) questionnaires were administered at baseline, 6 and 12 months. Seven men with a mean age of 34.4 years were treated. Median total testosterone increased from 10.6 to 11.2 nmol/L (p = 0.46). Median serum lactate dehydrogenase levels decreased from 1445 to 1143.5 IU/L (p < 0.05), while all other laboratory indices remained stable. Injection site pain was the most frequently reported adverse event, with no increases in painful crises, hypersensitivity or oedema. After TRT, there was no significant increase in priapism frequency. Median questionnaire scores were increased for the IIEF (46-68, p = 0.018), reduced for ADAM (5.0-2.0, p = 0.016) and unchanged for WHOQOL (98-103, p = 0.086). TRT using testosterone undecanoate with eugonadal intent for hypogonadism appears to be safe in men with SCD. This treatment does not appear to promote priapism occurrences and rather it possibly improves sexual function. Future prospective evaluations in larger groups of hypogonadal men with SCD are necessary to confirm these findings.
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Affiliation(s)
- B F Morrison
- Department of Surgery, University of the West Indies, Mona, Jamaica.
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Howard R, McCay W, Dockery J, Madden W. Increased Mobility and Commitment to Exercise During Hospitalization Has a Positive Effect on Outcomes for Bone Marrow Transplant Patients at University of Alabama Hospital. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.651] [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: 10/18/2022]
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Madden W. How UAB Hospital'S BMT Unit Used Collaborative Partnerships to Answer the Call Of An Increased Need for House ICU Beds While Addressing Issues Of A Fluctuating Bmt Specialty Census. Biol Blood Marrow Transplant 2009. [DOI: 10.1016/j.bbmt.2008.12.435] [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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Carter BS, Madden W. The neonatologist as primary care physician. Am J Manag Care 1998; 4:249-54. [PMID: 10178494] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Although trained first as pediatricians, neonatologists are not typically viewed as primary care physicians. However, given their particular training and expertise, patient population, and interaction with families as the newborn's first physician in many settings, neonatologists may rightly be viewed as the most appropriate primary care physician for newborns with medical or surgical problems. We review the fundamental underpinnings of primary care medicine with particular attention to how the neonatologist functions in such capacities. Neonatologist can contribute greatly to ensuring continuity of care for the sick newborn, the comprehensive nature of that care, and the coordination of care. Neonatologists' interactions with elements of the community to which the newborn will be discharged are an asset, as is their ability to work as part of a team. Given recent changes in practice management, the availability of neonatologists in the United States, and the desire for full-service mother and infant care capabilities in community hospitals, the primary care role of neonatologists bears recognition and support in today's changing healthcare marketplace.
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Affiliation(s)
- B S Carter
- Section of Neonatology, Department of Pediatrics, Medical College of Georgia, Augusta 30912-3700, USA
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Madden W. The Children of Frankenstein. A Primer on Modern Technology and Human Values. Herbert J. Muller. Indiana University Press, Bloomington, 1970. xvi + 432 pp. $10. Science 1970. [DOI: 10.1126/science.168.3932.687-a] [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: 11/02/2022]
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