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In-situ forming PLGA implants: Towards less toxic solvents. Int J Pharm 2024; 657:124121. [PMID: 38621617 DOI: 10.1016/j.ijpharm.2024.124121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/11/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
In-situ forming poly(lactic-co-glycolic acid) (PLGA) implants offer a great potential for controlled drug delivery for a variety of applications, e.g. periodontitis treatment. The polymer is dissolved in a water-miscible solvent. The drug is dissolved or dispersed in this solution. Upon contact with aqueous body fluids, the solvent diffuses into the surrounding tissue and water penetrates into the formulation. Consequently, PLGA precipitates, trapping the drug. Often, N-methyl-2-pyrrolidine (NMP) is used as a water-miscible solvent. However, parenteral administration of NMP raises toxicity concerns. The aim of this study was to identify less toxic alternative solvent systems for in-situ forming PLGA implants. Various blends of polyethylene glycol 400 (PEG 400), triethyl citrate (TEC) and ethanol were used to prepare liquid formulations containing PLGA, ibuprofen (as an anti-inflammatory drug) and/or chlorhexidine dihydrochloride (as an antiseptic agent). Implant formation and drug release kinetics were monitored upon exposure to phosphate buffer pH 6.8 at 37 °C. Furthermore, the syringeability of the liquids, antimicrobial activity of the implants, and dynamic changes in the latter's wet mass and pH of the release medium were studied. Importantly, 85:10:5 and 60:30:10 PEG 400:TEC:ethanol blends provided good syringeability and allowed for rapid implant formation. The latter controlled ibuprofen and chlorhexidine release over several weeks and assured efficient antimicrobial activity. Interestingly, fundamental differences were observed concerning the underlying release mechanisms of the two drugs: Ibuprofen was dissolved in the solvent mixtures and partially leached out together with the solvents during implant formation, resulting in relatively pronounced burst effects. In contrast, chlorhexidine dihydrochloride was dispersed in the liquids in the form of tiny particles, which were effectively trapped by precipitating PLGA during implant formation, leading to initial lag-phases for drug release.
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Tests on the prototype of the Optical Hinge for the Wide Angle Viewing System to ITER gamma radiation conditions. FUSION ENGINEERING AND DESIGN 2023. [DOI: 10.1016/j.fusengdes.2023.113680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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EL MANEJO MULTIDISCIPLINAR MEJORA EL DIAGNÓSTICO GENÉTICO DE LAS ENFERMEDADES RENALES HEREDITARIAS EN LA ERA DE NEXT GENERATION SEQUENCING (NGS). Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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4
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Racial disparities in the contemporary utilization and outcomes of left atrial appendage occlusion in the United States. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Racial and socioeconomic disparities in the utilization of percutaneous structural heart disease interventions have been described in previous years, reflecting significant gaps. However, it is unclear if increased awareness has created meaningful changes in the utilization of left atrial appendage occlusion (LAAO) in underrepresented populations.
Purpose
We aim to further clarify current practices in the United States and answer questions to help guide further efforts in attenuating health disparities.
Methods
The National Inpatient Sample (NIS) was queried from 2016–2019 to identify all patients >65 years of age diagnosed with atrial fibrillation or atrial flutter who underwent left atrial appendage occlusion (LAAO) using the international classification of diseases, tenth revision clinical modification (ICD-10-CM) codes. We selected this age cutoff to minimize confounding bias from lack of insurance coverage as patients age 65 and older qualify for the Center of Medicare & Medicaid Services. We excluded patients with missing race information. In addition, we confined our analysis to patients of White, Black, and Hispanic ethnicity because the number of other races was insufficient for meaningful analysis. Multivariate linear and logistic regression analysis was performed to compare the odds of procedure utilization, in-hospital mortality, and significant periprocedural complications among study groups.
Results
We identified a total of 14,103,690 patients >65 years of age diagnosed with either atrial fibrillation or atrial flutter. Of those, 53,350 (0.38%) underwent LAAO. The mean age of the sample was 79±7.6 years. Compared to White patients, Black patients had lesser odds of undergoing LAAO when controlling for multiple confounders (AOR = 0.49, 95% CI 0.44–0.55, p<0.001). Among Hispanic patients, there was no statistically significant difference in the odds of undergoing LAAO compared to White patients. There was no statistically significant difference in mortality, vascular complications, non-home discharge, stroke, transient ischemic attack, pericardial tamponade, and length of stay in patients undergoing LAAO among different ethnicities.
Conclusions
Significant disparities, including procedure utilization and patient characteristics prior to the procedure, such as household income, still exist among Black patients compared to White patients undergoing the LAAO in the United States. Nevertheless, adjusted odds of in-hospital outcomes were similar among Black, Hispanic, and White patients. Further research is necessary to identify what mitigation strategies could be effective and what can be changed to close the remaining gap.
Funding Acknowledgement
Type of funding sources: None.
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Effect of frailty on in-hospital outcomes after transcatheter mitral valve repair. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Mitral regurgitation (MR) is a common valvular disorder associated with significant morbidity and mortality. Transcatheter mitral valve repair (TMVr) is a minimally invasive procedure indicated for the treatment of selected patients with moderate-severe or severe primary MR. Despite a lack of a universal definition, frailty has been associated with poor post-procedural outcomes. Albeit several trials have examined individual prognostic factors in this population, there is a paucity of data regarding the effect of frailty on in-hospital outcomes after TMVr.
Purpose
To further elucidate the association of frailty with in-hospital outcomes in patients undergoing TMVr.
Methods
The national inpatient sample (NIS) database, which is part of the Healthcare Cost and Utilization Project (HCUP), was queried from 2016 to 2019 to identify all who underwent TMVr. International classification of diseases, tenth revision clinical modification (ICD-10-CM) codes were used to divide patients into frail and non-frail study groups. Frailty was defined using Johns Hopkins Adjusted Clinical Groups diagnosis cluster for frailty. Multivariate linear and logistic regression analysis was performed to compare in-hospital mortality, hospital length of stay, non-home discharge, and iatrogenic cardiac complications among Frail and Non-Frail groups.
Results
A total of 30,660 patients who underwent TMVr were identified. The mean age was 76±11.6 years. Of those, 2,950 (9.6%) were identified as frail. The overall in-hospital mortality rate for the entire study population was 1.89%. Compared to non-frail patients, those identified as frail had greater odds of in-hospital mortality (AOR= 2.13, 95% CI 1.29–3.51, p<0.001) and non-home discharge (AOR= 4.34, 95% CI 3.54–5.32, p<0.001). However, there was no statistically significant difference in hospital length of stay and rates of iatrogenic cardiac complications.
Conclusions
Frailty models continue to be underutilized as a prognostic tool in clinical practice. After following HCUP guidelines, our analysis found that frailty is independently associated with increased in-hospital mortality and non-home discharge in patients undergoing TMVr. Therefore, we recommend that further efforts in incorporating frailty models in the pre-procedural assessment of patients undergoing TMVr should be sought along with a standardized predictive model for defining frailty.
Funding Acknowledgement
Type of funding sources: None.
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Impact of left bundle branch block in patients with takotsubo cardiomyopathy. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Takotsubo cardiomyopathy (TCM) is a syndrome characterized by reversible left-ventricular regional systolic dysfunction in the absence of obstructive coronary artery disease (CAD). The presence of left bundle branch block (LBBB) has been described as an independent predictor of mortality in patients with CAD. One study using the National Inpatient Sample (NIS) for 2016 found that the presence of LBBB was associated with worse outcomes in patients with TCM.
Purpose
To better clarify the association between LBBB and various in-hospital outcomes in patients with TCM.
Methods
The NIS database was queried from 2016–2019 to identify all admissions with a primary diagnosis of TCM that had a cardiac catheterization to improve the specificity of the diagnosis. International classification of diseases, tenth revision clinical modification (ICD-10-CM) codes were used to divide patients based on the presence or absence of LBBB. A 1:3 propensity score matching based on age, race, gender, and risk factor stratification was used to reduce selection bias. Multivariate linear and logistic regression analysis was performed to compare various outcomes among both groups.
Results
A total of 27,125 patients admitted with a primary diagnosis of TCM that also underwent diagnostic coronary angiography were identified. In the study sample, 955 (3.5%) were determined to have a LBBB. After calculating propensity scores, 955 patients with LBBB were paired to 2,865 patients without LBBB. LBBB was associated with higher rates of ventricular arrhythmias (AOR=3.098, 95% CI 1.483–6.471, p=0.003); however, it was not statistically associated with cardiogenic shock, sudden cardiac arrest (SCA), acute kidney injury, acute heart failure, and hospital length of stay. In addition, there was no statistical difference in intra-hospital mortality.
Conclusions
LBBB is associated with left ventricular dyssynchrony. It has been proposed that intraventricular dyssynchrony might be a predisposing factor for ventricular arrhythmias (VA) and SCA. Several trials have demonstrated that cardiac resynchronization therapy alone (i.e., without defibrillation) reduces the rate of VA and SCA. The mechanism for this improvement is unclear but may be related to hemodynamic improvement from ventricular synchrony in heart failure (HF). In fact, LBBB has been reported as an independent risk factor for all-cause mortality and SCA at one year in patients with HF. Our analysis did not find any significant association between LBBB and SCA but did find an association with VA. Moreover, there were not enough events of intra-hospital mortality to assess a possible association between LBBB and mortality. Therefore, a prospective study with a longer follow-up would be needed to clarify the role of LBBB in mortality and establish causality between LBBB and VA in patients with TCM.
Funding Acknowledgement
Type of funding sources: None.
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RESPONSE TO AZACITIDINE IN PATIENTS WITH CHRONIC MYELOMONOCYTIC LEUKEMIA ACCORDING TO OVERLAP MYELODYSPLASTIC/MYELOPROLIFERATIVE NEOPLASMS CRITERIA. Leuk Res 2022; 116:106836. [DOI: 10.1016/j.leukres.2022.106836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
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High rate of autonomic neuropathy in Cornelia de Lange Syndrome. Orphanet J Rare Dis 2021; 16:458. [PMID: 34717699 PMCID: PMC8556971 DOI: 10.1186/s13023-021-02082-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background Cornelia de Lange Syndrome (CdLS) is a rare congenital disorder characterized by typical facial features, growth failure, limb abnormalities, and gastroesophageal dysfunction that may be caused by mutations in several genes that disrupt gene regulation early in development. Symptoms in individuals with CdLS suggest that the peripheral nervous system (PNS) is involved, yet there is little direct evidence. Method Somatic nervous system was evaluated by conventional motor and sensory nerve conduction studies and autonomic nervous system by heart rate variability, sympathetic skin response and sudomotor testing. CdLS Clinical Score and genetic studies were also obtained. Results Sympathetic skin response and sudomotor test were pathological in 35% and 34% of the individuals with CdLS, respectively. Nevertheless, normal values in large fiber nerve function studies. Conclusions Autonomic nervous system (ANS) dysfunction is found in many individuals with Cornelia de Lange Syndrome, and could be related to premature aging. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02082-y.
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Design overview of ex-vessel components for the Wide Angle Viewing System diagnostic for ITER Equatorial Port 12. FUSION ENGINEERING AND DESIGN 2021. [DOI: 10.1016/j.fusengdes.2021.112651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Fully integrated high-throughput methodology for the study of Ni- and Cu-supported catalysts for glucose hydrogenation. Catal Today 2019. [DOI: 10.1016/j.cattod.2019.05.041] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Diffuse large B cell lymphoma in the elderly. A retrospective analysis of standard versus alternative treatments. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz251.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Impact of extended-spectrum β-lactamases and carbapenem-resistant Gram-negative infections on sepsis mortality at the emergency department: a cohort study. J Hosp Infect 2018; 101:190-191. [PMID: 29792969 DOI: 10.1016/j.jhin.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 05/15/2018] [Indexed: 12/22/2022]
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13
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Metástasis en ciego de un cáncer lobulillar de mama diagnosticada con 18 F-FDG PET/TC. Rev Esp Med Nucl Imagen Mol 2017; 36:408. [DOI: 10.1016/j.remn.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 11/15/2022]
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14
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Caecal metastasis from lobular breast cancer diagnosed using 18 F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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15
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[Ataxia telangiectasia-like disorder -a child with a novel variant in MRE11A gene]. Rev Neurol 2017; 65:143-144. [PMID: 28699156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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16
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Phenomenological friction equation for turbulent flow of Bingham fluids. Phys Rev E 2017; 96:023107. [PMID: 28950622 DOI: 10.1103/physreve.96.023107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Indexed: 06/07/2023]
Abstract
Most discussions in the literature on the friction coefficient of turbulent flows of fluids with complex rheology are empirical. As a rule, theoretical frameworks are not available even for some relatively simple constitutive models. In the present work, a formula is proposed for the evaluation of the friction coefficient of turbulent flows of Bingham fluids. The developments combine a fresh analysis for the description of the microscales of Kolmogorov and the phenomenological turbulence model of Gioia and Chakraborty [G. Gioia and P. Chakraborty, Phys. Rev. Lett. 96, 044502 (2006)PRLTAO0031-900710.1103/PhysRevLett.96.044502]. The resulting Blasius-type friction equation is tested against some experimental data and shows good agreement over a significant range of Hedstrom and Reynolds numbers. Comments on pressure measurements in yielding fluids are made. The limits of the proposed model are also discussed.
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Clinical and Biological Significance of Y Chromosome Loss in a Series of 2,423 Male Patients with MDS and CMML. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30321-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Calculating IPSS-R by Enumerating Bone Marrow Blasts from Nonerythroid Cellularity Improves Outcome Prediction in MDS with Erythroid Predominance. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30351-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Response to Azacitidine in a Series of 94 Patients with Chronic Myelomonocytic Leukemia from the Spanish Group of Myelodysplastic Syndromes. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30232-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prognostic Implication of the Percentage of Erythroid Cells in Bone Marrow at Diagnosis in Patients with Myelodysplastic Syndrome. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30375-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Mutational and Clonal Dynamics During Progression from MDS to SAML by Whole-Exome and Targeted-Deep Sequencing. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3). Crit Care 2017. [PMCID: PMC5374603 DOI: 10.1186/s13054-017-1628-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Percepción de la cultura de seguridad de pacientes en profesionales de una institución argentina. ENFERMERÍA UNIVERSITARIA 2017. [DOI: 10.1016/j.reu.2016.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Pneumococcal vaccination coverages among low-, intermediate-, and high-risk adults in Catalonia. Hum Vaccin Immunother 2016; 12:2953-2958. [PMID: 27454779 DOI: 10.1080/21645515.2016.1210744] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
There is scarce data about pneumococcal vaccination coverages among adults in recent years. We investigated current pneumococcal vaccination coverages in Catalonia, Spain, with a cross-sectional population-based study including 2,033,465 individuals aged 50 y or older assigned to the Catalonian Health Institute at 01/01/2015 (date of survey). A previously validated institutional research clinical Database was used to classify study subjects by their vaccination status for both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), to identify comorbidities and underlying conditions, and establish the risk stratum of each individual: High risk stratum: functional or anatomic asplenia, cochlear implants, CSF leaks, or immunocompromising conditions; medium risk stratum: immunocompetent persons with history of chronic cardiac or respiratory disease, liver disease, diabetes mellitus, alcoholism and/or smoking; low risk stratum: persons without high or medium risk conditions. Of the total 2,033,465 study population, an amount of 789,098 (38.8%) had received PPVS23, whereas 5031 (0.2%) had received PCV13. PPSV23 coverages increased largely with increasing age: 4.8% in 50-59 y vs 35.5% in 60-69 y vs 71.9% in 70-79 y vs 79.5% in 80 y or older; p < 0.001). PCV13 coverages also increased with age, although they were very low in all age groups. PPSV23 coverages were 59.2% in high risk stratum, 48.3% in medium risk stratum and 28.1% in low risk stratum (p < 0.001). For the PCV13, uptakes were 1.2%, 0.3% and 0.1% in high, medium and low stratum, respectively (p < 0.001). In conclusion, pneumococcal vaccination coverages in Catalonian adults are not optimal, being especially small for the PCV13 (even in high-risk subjects).
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Publisher's Note: Phenomenological Blasius-type friction equation for turbulent power-law fluid flows [Phys. Rev. E 92, 063006 (2015)]. Phys Rev E 2016; 93:049903. [PMID: 27182589 DOI: 10.1103/physreve.93.049903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Indexed: 06/05/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevE.92.063006.
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Impact of anaemia on health-related quality of life and cardiac remodelling in patients with lower risk myelodysplastic syndromes. Results of GlobQoL study. Eur J Cancer Care (Engl) 2016; 26. [PMID: 26729645 DOI: 10.1111/ecc.12426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/01/2022]
Abstract
The aim of this study was to analyse the eventual changes in health-related quality of life (HRQoL) and left ventricular function (LVF) over a 1-year follow-up period in a cohort of patients with lower risk myelodysplastic syndromes (MDS) receiving standard supportive treatment, in order to identify potential clues for early clinical intervention, as well as to analyse how they relate to haemoglobin levels and other aspects of the disease. A total of 39 adult anaemic patients with lower risk MDS were included in a prospective, observational, multi-centre study. Changes in performance status, functional capacity and HRQoL were collected by using standardised measures (ECOG scale; SPPB, Short Physical Performance Battery; SF-36, Short-Form 36 questionnaire; QLQ-C30, Quality of Life Core Questionnaire; FACT-An, Functional Assessment of Cancer Therapy-Anaemia scale questionnaires respectively). Need for transfusion (Linear Analogue Scale Assessment), as perceived independently by the patient and the haematologist, was also recorded. No changes in HRQoL (or LVF) were found, except for slight reductions in SF-36 physical function (P = 0.034), SPPB gait speed (P = 0.038) and FACT-An score (P = 0.029), all without apparent immediate clinical relevance for HRQoL, that were unrelated to changes in haemoglobin level. Periodical evaluation of gait speed may assist the clinician in early detection of patient's occult functional decline before it becomes clinically relevant.
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Phenomenological Blasius-type friction equation for turbulent power-law fluid flows. PHYSICAL REVIEW. E, STATISTICAL, NONLINEAR, AND SOFT MATTER PHYSICS 2015; 92:063006. [PMID: 26764803 DOI: 10.1103/physreve.92.063006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Indexed: 06/05/2023]
Abstract
We propose a friction formula for turbulent power-law fluid flows, a class of purely viscous non-Newtonian fluids commonly found in applications. Our model is derived through an extension of the friction factor analysis based on Kolmogorov's phenomenology, recently proposed by Gioia and Chakraborty. Tests against classical empirical data show excellent agreement over a significant range of Reynolds number. Limits of the model are also discussed.
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Evolution of maple syrup urine disease in patients diagnosed by newborn screening versus late diagnosis. Eur J Paediatr Neurol 2015; 19:652-9. [PMID: 26232051 DOI: 10.1016/j.ejpn.2015.07.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 06/14/2015] [Accepted: 07/02/2015] [Indexed: 02/02/2023]
Abstract
Maple syrup urine disease (MSUD) is a rare metabolic disorder for which the newborn screening (NBS) is possible but it has not been yet implemented for most Spanish regions. In the present study, we assess the clinical features and outcome of 14 MSUD Spanish patients with similar treatment protocol diagnosed either by NBS or by clinical symptoms. Eight patients were detected by NBS, four classic and four moderate MSUD. The average age at detection was 4.6 days, the mean plasmatic concentration of leucine at diagnosis was 1807 μM; the average number of days with leucine >1000 μM was 0.7 (0-4) and the mean number of total hospitalizations was 1.6 (0-5). Mean follow-up time was 70 months. They had good evolution: all remain asymptomatic, but 2 patients have attention deficit and hyperactivity disorder. Six patients with late diagnosis of classic MSUD were followed during 41 months. All presented with acute encephalopathy during the first month of life, mean leucine levels of 2355 μM, mean number of days with leucine >1000 μM of 6.6 (1-13) and mean number of total hospitalizations of 5.3 (4-7). Only two patients have a psychomotor development index in the lower limit (80 and 83). For all patients a good genotype-phenotype correlation was found and four novel mutations were identified: p.A311H, p.T84S, p.T397L, pL398P. Our study support that NBS improves prognosis of MSUD patients. But early diagnosis and an aggressive treatment together with a close monitoring of leucine levels improve neurological evolution in MSUD patients, even for those not detected by NBS.
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Detection and quantification of 41 antibiotic residues’ in Gilthead sea bream ( Sparus aurata ) from aquaculture origin, using a multiclass and multi-residue UHPLC-MS/MS method. Toxicol Lett 2015. [DOI: 10.1016/j.toxlet.2015.08.286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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AB0965 Single Nucleotide Polymorphisms in TNFA1P3 and PTPN2 Are Associated with a Poor Outcome in Juvenile Idiopathic Arthritis. Data From Reuma.PT. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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83 PERCENTAGE OF BLASTS IN CHRONIC MYELOMONOCYTIC LEUKEMIA TYPE-1 HAS NO IMPACT ON OVERALL SURVIVAL IN A SERIES OF PATIENTS FROM THE SPANISH REGISTRY OF MDS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30084-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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211 SPANISH REGISTRY OF ERYTHROPOIETIC STIMULATING AGENTS STUDY: THE LARGEST RETROSPECTIVE STUDY OF ESAS FOR THE TREATMENT OF ANEMIA IN LOWER RISK MDS PATIENTS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30212-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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171 A TWO-STEP APPROACH FOR THE ANALYSIS OF SPLICING GENES IN MYELODYSPLASTIC SYNDROMES WITH RING SIDEROBLASTS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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261 ERYTHROLEUKEMIA APPEARS TO BE A CONTINUUM OF MDS WITH ERYTHROID HYPERPLASIA AND SHARES OUTCOME AND CYTOGENETIC FEATURES WITH RAEB-1 WITH ≥50% ERYTHROPOIESIS. Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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244 MYELOFIBROSIS (MF) AS A PROGNOSTIC TOOL FOR OVERALL SURVIVAL IN MYELODYSPLASTIC SYNDROMES: A PROSPECTIVE EVALUATION INCLUDING MUTATIONAL ANALYSIS BY NEXT GENERATION SEQUENCING (NGS). Leuk Res 2015. [DOI: 10.1016/s0145-2126(15)30245-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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The protein oxidation repair enzyme methionine sulfoxide reductase a modulates Aβ aggregation and toxicity in vivo. Antioxid Redox Signal 2015; 22:48-62. [PMID: 24988428 PMCID: PMC4270145 DOI: 10.1089/ars.2013.5803] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIMS To examine the role of the enzyme methionine sulfoxide reductase A-1 (MSRA-1) in amyloid-β peptide (Aβ)-peptide aggregation and toxicity in vivo, using a Caenorhabditis elegans model of the human amyloidogenic disease inclusion body myositis. RESULTS MSRA-1 specifically reduces oxidized methionines in proteins. Therefore, a deletion of the msra-1 gene was introduced into transgenic C. elegans worms that express the Aβ-peptide in muscle cells to prevent the reduction of oxidized methionines in proteins. In a constitutive transgenic Aβ strain that lacks MSRA-1, the number of amyloid aggregates decreases while the number of oligomeric Aβ species increases. These results correlate with enhanced synaptic dysfunction and mislocalization of the nicotinic acetylcholine receptor ACR-16 at the neuromuscular junction (NMJ). INNOVATION This approach aims at modulating the oxidation of Aβ in vivo indirectly by dismantling the methionine sulfoxide repair system. The evidence presented here shows that the absence of MSRA-1 influences Aβ aggregation and aggravates locomotor behavior and NMJ dysfunction. The results suggest that therapies which boost the activity of the Msr system could have a beneficial effect in managing amyloidogenic pathologies. CONCLUSION The absence of MSRA-1 modulates Aβ-peptide aggregation and increments its deleterious effects in vivo.
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Azacitidine frontline therapy for unfit acute myeloid leukemia patients: clinical use and outcome prediction. Leuk Res 2014; 39:296-306. [PMID: 25601157 DOI: 10.1016/j.leukres.2014.12.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/02/2014] [Accepted: 12/22/2014] [Indexed: 01/03/2023]
Abstract
Hypomethylating agents are able to prolong the overall survival of some patients diagnosed with acute myeloid leukemia. The aim of this study was to evaluate the clinical use of azacitidine as front-line therapy in unfit acute myeloid leukemia (AML) patients and to develop a clinical prediction model to identify which patients may benefit more from the drug. One hundred and ten untreated unfit AML patients received front-line azacitidine therapy in Spain, and response and survival were evaluated in them following European LeukemiaNet (ELN) guidelines. A clinical prediction rule was obtained from this population that was validated and refined in 261 patients treated in France, Austria and Italy. ELN response was achieved in 21.0% of the 371 patients (CI95% 17.0-25.5) and did not depend on bone marrow blast cell percentage. Median overall survival was 9.6 months (CI95% 8.5-10.8) and 40.6% of the patients were alive at 1 year (CI95% 35.5-45.7). European ALMA score (E-ALMA), based on performance status, white blood cell counts at azacitidine onset and cytogenetics, discriminated three risk groups with different survival and response rates. Azacitidine seems a reasonable therapeutic option for most unfit AML patients, i.e. those displaying a favorable or intermediate E-ALMA score.
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THU0011 The SLICC 2012 Classification Criteria Have Higher Sensitivity for SLE than the ACR 1997 Criteria: A Study of 2055 Patients from A Real-Life, Multicenter, International SLE Cohort. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0413 Hepatitis B Serologic Profile and Reactivation in Rheumatic Patients Treated with Biological Therapies – Single Centre Experience. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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AB0881 Biologic Disease Modifying Anti-Rheumatic Drug Use in the Treatment of Juvenile Idiopathic Arthritis: Data from the Rheumatic Diseases Portuguese Register, Reuma.Pt. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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THU0033 Overactive Bladder Symptom Bother is Increased in Patients with Systemic Lupus Erythematosus and SjÖGren's Syndrome: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Diagnosis of ganglionar tuberculosis by endoscopic ultrasonography. Endosc Ultrasound 2014; 3:S12. [PMID: 26425509 PMCID: PMC4569907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The endoscopic ultrasonography (EUS) is an endoscopic technique of proven clinical validity today, having a significant impact on the diagnosis and evaluation of several diseases with a low complication rate. The EUS-fine-needle aspiration (FNA) allows the evaluation of subepithelial lesions, extra-luminal lymph nodes or the gastrointestinal tract that are difficult to access by other methods with safe and high diagnostic accuracy. AIMS AND METHODS In the case reported, the EUS-FNA was useful for the differential diagnosis with residual biliary microlithiasis and the diagnosis of non-oncologic pathology. RESULTS Male, white, 35-year-old, human immunodeficiency virus and tuberculosis treatment for about 5 months presented with jaundice. No fever, weight loss or abdominal pain. Choluria and hipocholia. History of cholecystectomy for about 1 year due to cholelithiasis. Laboratory tests showed cholestatic jaundice (direct hyperbilirrubinemia). Abdominal ultrasound showed liver without particularities, without biliary dilatation or filling defects. Initially suspected hepatitis due tuberculosis drugs so, the treatment was suspended. After a week with no drugs, no improvement in jaundice was observed. In contrast, a progressive increase indirect bilirubin. EUS performed with identification of mass along the distal common bile duct near the duodenal papilla. FNA performed with the presence of lymphocytes and tuberculosis bacile positive. After, endoscopic retrograde cholangiopancreatography was performed with sphincterotomy and placement of endoprosthesis for biliary drainage. The tuberculosis drugs were restarted with the plan to complete. The jaundice was resoluted. The patient completed 9 months of treatment and abdominal tomography has not identified a mass in that place. CONCLUSION The EUS-FNA was proven to be a useful tool for diagnosis of non-oncologic pathologies like tuberculosis.
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A4.4 Zoledronate efficacy and safety in active paget’s disease- long-term follow-up and retreatment in clinical practice. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2013-205124.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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[Chronic recurrent multifocal osteomyelitis: case series of four patients treated with biphosphonates]. ACTA REUMATOLOGICA PORTUGUESA 2014; 39:38-45. [PMID: 24811460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To report and describe a series of four cases of chronic recurrent multifocal osteomyelitis (CRMO) and to discuss therapeutic options, particularly bisphosphonate therapy. METHODS Retrospective review of four CRMO cases in two Pediatric Units in Lisbon, between 2005 and 2010. RESULTS Median age of first CRMO symptoms was 11.3 years (range 9-13). The more affected sites were the metaphysis of the long bones, pelvis and coxofemoral joints. Median number of initial bony lesions for each patient was 2.3 (range 1-3) at onset and 3.8 (range 2-6) during the disease course. All patients failed to respond to NSAIDs therapy. Two patients received corticosteroids, with clinical disease remission in only one of them. All patients received bisphosphonates (alendronate in two and pamidronate in two), all with good clinical response and induction of clinical remission in two of them. After a median follow-up period of 4.3 years (range 4-5), three patients are clinically asymptomatic and one patient remains with chronic residual pain. CONCLUSIONS The treatment of CRMO is not standardized. Bisphosphonate therapy can be of benefit to patients with relapsing symptoms. Randomized controlled multicentric trials are needed to provide better evidence for universal recommendation and definition of bisphosphonate therapy protocol.
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PReS-FINAL-2163: Disease activity in a juvenile idiopathic arthritis population after 5 years follow-up. Pediatr Rheumatol Online J 2013. [PMCID: PMC4045024 DOI: 10.1186/1546-0096-11-s2-p175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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PReS-FINAL-2095: Older age predicts poor response to 6-months methotrexate therapy in a juvenile idiopathic arthritis cohort of patients. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043502 DOI: 10.1186/1546-0096-11-s2-p107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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THU0331 Management of osteoporosis in children: Experience from a pediatric rheumatology center. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0378 Rituximab use in systemic lupus erythematosus patients: the experience of two central hospitals in lisbon. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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SAT0481 Disease Activity in a Juvenile Idiopathic Arthritis Population after 5 Years Follow-Up. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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AB1188 Long-term safety of anti TNF therapy in children: Experience from a single center:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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