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Scendoni R, Cingolani M, Cembriani F, Fedeli P, Tambone V, Terranova C, De Micco F. Over-the-counter emergency contraception in Italy: ethical reflections and medico-legal issues. Front Glob Womens Health 2023; 4:1205208. [PMID: 37790088 PMCID: PMC10544570 DOI: 10.3389/fgwh.2023.1205208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/06/2023] [Indexed: 10/05/2023] Open
Abstract
Although more than ten years have passed since the marketing of Ulipristal acetate in Europe, emergency contraception remains a complex issue with many scientific, legal, ethical and social implications. The topic is an example of the differences that can exist between scientific evidence, the certainties on which law is based, and social implications. This paper shows the incompleteness of the scientific reconstruction on the effects of emergency hormonal contraceptives and the dangerousness of the decision to alienate the supply of over-the-counter drugs from the general rules of health care. This report shows the incompleteness of the scientific reconstruction on the effects of emergency hormonal contraceptives and the dangerousness of the decision to alienate the supply of over-the-counter drugs from the general rules of health care. Various ethical and medico-legal issues will be addressed, also focusing attention on underage women whose sexual and reproductive health requires not abandoning them, but actually taking charge of them without medicalizing their choices.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine, University of Macerata, Macerata, Italy
| | - Fabio Cembriani
- Operative Unit of Legal Medicine, Provincial Authority for Health Services of Trento, Trento, Italy
| | | | - Vittoradolfo Tambone
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Corrado Terranova
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Gynaecology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
| | - Francesco De Micco
- Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
- Research Unit of Bioethics and Humanities, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
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Use of third molar eruption based on Gambier's criteria in assessing dental age. Int J Legal Med 2023; 137:691-699. [PMID: 36707450 DOI: 10.1007/s00414-023-02953-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/16/2023] [Indexed: 01/29/2023]
Abstract
The biological aspects of determining the dental age of subadults represent an important interdisciplinary scientific link with applications in criminal law and in forensic anthropology and dentistry. In criminal procedural law, it is necessary to determine the exact age of an undocumented person in view of the application of the provisions on juvenile offenders and minor victims. Chronological age can be estimated from the development of the third molars, as these are the only teeth that develop at the age of 18. The aim of this study was to verify the applicability of the Gambier method based on the eruption of the third permanent molars in the mandible and maxilla, to contribute to forensic age assessment. The analyzed group that met the criteria consisted of 811 orthopantomograms (OPGs) (339 females and 472 males) between the ages of 13 and 25 years. The OPGs were retrospectively analyzed according to the method of Gambier et al. (Int J Legal Med 133:625-632, 29), which refers to the eruption stages of the third molar. Differences between eruption stages of maxillary and mandibular third molars were statistically significant in both biological sexes. Intersexual differences in mean age were significant only at stage 3 for any M3 tooth and at stage 1 for mandibular M3. There were no statistically significant differences between the left and right mandibular and maxillary third molars, respectively. Differences between mandibular and maxillary M3 were significant only for stage 1 in males on the left side and for stage 2 in both sexes and sides. The method used allowed the best classification of individuals into minor and adult groups (based on phase D-90.41% of individuals, based on the third stage of the mandibular left third molar-86.29%). Based on the results obtained, we can assume that the method cannot be used alone in the initial examination of living individuals, since all four third molars must be assessed and there are no additional findings from practice.
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Klingberg G, Benchimol D, Berlin H, Bring J, Gornitzki C, Odeberg J, Tranæus S, Twetman S, Wernersson E, Östlund P, Domeij H. How old are you? A systematic review investigating the relationship between age and mandibular third molar maturity. PLoS One 2023; 18:e0285252. [PMID: 37200251 DOI: 10.1371/journal.pone.0285252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 04/18/2023] [Indexed: 05/20/2023] Open
Abstract
INTRODUCTION AND OBJECTIVE Radiographic evaluation of the maturity of mandibular third molars is a common method used for age estimation of adolescents and young adults. The aim of this systematic review was to examine the scientific base for the relationship between a fully matured mandibular third molar based on Demirjian's method and chronological age, in order to assess whether an individual is above or below the age of 18 years. METHODS The literature search was conducted in six databases until February 2022 for studies reporting data evaluating the tooth maturity using Demirjian´s method (specifically stage H) within populations ranging from 8 to 30 years (chronological age). Two reviewers screened the titles and abstracts identified through the search strategy independently. All studies of potential relevance according to the inclusion criteria were obtained in full text, after which they were assessed for inclusion by two independent reviewers. Any disagreement was resolved by a discussion. Two reviewers independently evaluated the risk of bias using the assessment tool QUADAS-2 and extracted the data from the studies with low or moderate risk of bias. Logistic regression was used to estimate the relationship between chronological age and proportion of subjects with a fully matured mandibular third molar (Demirjian´s tooth stage H). RESULTS A total of 15 studies with low or moderate risk of bias were included in the review. The studies were conducted in 13 countries and the chronological age of the investigated participants ranged from 3 to 27 years and the number of participants ranged between 208 and 5,769. Ten of the studies presented the results as mean age per Demirjian´s tooth stage H, but only five studies showed the distribution of developmental stages according to validated age. The proportion of subjects with a mandibular tooth in Demirjian´s tooth stage H at 18 years ranged from 0% to 22% among males and 0 to 16% in females. Since the studies were too heterogenous to perform a meta-analysis or a meaningful narrative review, we decided to refrain from a GRADE assessment. CONCLUSION The identified literature does not provide scientific evidence for the relationship between Demirjian´s stage H of a mandibular third molar and chronologic age in order to assess if an individual is under or above the age of 18 years.
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Affiliation(s)
- Gunilla Klingberg
- Faculty of Odontology, Department of Pediatric Dentistry, Malmö University, Malmö, Sweden
| | - Daniel Benchimol
- Department of Dental Medicine, Division of Oral Diagnostics and Rehabilitation, Karolinska Institutet, Huddinge, Sweden
| | - Henrik Berlin
- Faculty of Odontology, Department of Pediatric Dentistry, Malmö University, Malmö, Sweden
| | | | - Carl Gornitzki
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Jenny Odeberg
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Sofia Tranæus
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment-Odontology, Malmö University, Malmö, Sweden
| | - Svante Twetman
- Faculty of Health and Medical Sciences, Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Emma Wernersson
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Pernilla Östlund
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment-Odontology, Malmö University, Malmö, Sweden
| | - Helena Domeij
- Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
- Faculty of Odontology, Health Technology Assessment-Odontology, Malmö University, Malmö, Sweden
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Scendoni R, Kelmendi J, Arrais Ribeiro IL, Cingolani M, De Micco F, Cameriere R. Anthropometric analysis of orbital and nasal parameters for sexual dimorphism: New anatomical evidences in the field of personal identification through a retrospective observational study. PLoS One 2023; 18:e0284219. [PMID: 37134065 PMCID: PMC10155994 DOI: 10.1371/journal.pone.0284219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 03/26/2023] [Indexed: 05/04/2023] Open
Abstract
Orbital and nasal parameters among modern humans show considerable variation, which affects facial shape, and these characteristics vary according to race, region, and period in evolution. The aim of the study was to ascertain whether there are sex differences in the orbital and/or nasal indexes and/or the single measurements used to calculate these in a Kosovar population. The following parameters were taken into consideration: orbital height (OH), orbital width (OW), nasal height (NH), and nasal width (NW). The ratios between orbital index/nasal index (RONI) were calculated. All measurements were obtained from a population sample comprising 408 individuals. The accuracy in sex prediction was 52.86% (CI95% = 45.05%-60.67%) for NW and 64.96% for NH (CI95% = 57.50%- 72.42%). The difference between male and female indexes was statistically significant (P < 0.05). The anthropometric study revealed that only NW and NH are configured as predictors of sexual dimorphism. It could be useful to increase the number of samples to test the discriminant function in other population groups.
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Affiliation(s)
- Roberto Scendoni
- Department of Law, Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy
| | - Jeta Kelmendi
- Faculty of Medicine, Department of Orthodontic, University of Prishtina, Alma Mater Europaea, Campus Rezonanca, Prishtina, Kosovo
| | | | - Mariano Cingolani
- Department of Law, Institute of Legal Medicine (AgEstimation Project), University of Macerata, Macerata, Italy
| | - Francesco De Micco
- Bioethics and Humanities Research Unit, Campus Bio-Medico University of Rome, Rome, Italy
- Department of Clinical Affairs, Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | - Roberto Cameriere
- Department of Forensic Medicine (AgEstimation Project), University of Molise, Campobasso, Italy
- Department of Forensic Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
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Accuracy of Demirjian’s and Cameriere’s Methods for Age Estimation in 6- to 10-Year-Old Iranian Children Using Panoramic Radiographs. Int J Dent 2022; 2022:4948210. [PMID: 36051896 PMCID: PMC9427255 DOI: 10.1155/2022/4948210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 06/07/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study assessed the accuracy of Demirjian's and Cameriere's methods for age estimation in Iranian children using panoramic radiographs. Materials and Methods This cross-sectional study evaluated 212 panoramic radiographs of 6- to 10-year-old children retrieved from the archives of an oral and maxillofacial radiology department from 2011 to 2017. The chronological age of children at the time of radiography was determined by subtracting the date of radiography from their birth date. The developmental stage of 7 permanent left mandibular teeth was determined according to Demirjian's method. The stage of dental maturation was determined according to Cameriere's method by using the normalized values for 7 permanent left mandibular teeth and the number of teeth with complete root development. The error value of the two methods was calculated by comparing them with the actual chronological age of male and female children, and the absolute error values of the two methods were compared with paired t-tests. Results The mean error value of Demirjian's and Cameriere's methods was found to be 0.84 and −0.06 in girls and 0.93 and 0.04 in boys, respectively. Significant differences were noted in the absolute error of the two methods compared with the chronological age of male and female children (both Ps < 0.001). Conclusion In conclusion, this study indicated that Cameriere's method was more accurate than Demirjian's method for age estimation in Iranian children.
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De Micco F, Fineschi V, Banfi G, Frati P, Oliva A, Travaini GV, Picozzi M, Curcio G, Pecchia L, Petitti T, Alloni R, Rosati E, De Benedictis A, Tambone V. From COVID-19 Pandemic to Patient Safety: A New “Spring” for Telemedicine or a Boomerang Effect? Front Med (Lausanne) 2022; 9:901788. [PMID: 35783642 PMCID: PMC9240206 DOI: 10.3389/fmed.2022.901788] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/26/2022] [Indexed: 12/22/2022] Open
Abstract
During the Covid-19 health emergency, telemedicine was an essential asset through which health systems strengthened their response during the critical phase of the pandemic. According to the post-pandemic economic reform plans of many countries, telemedicine will not be limited to a tool for responding to an emergency condition but it will become a structural resource that will contribute to the reorganization of Healthcare Systems and enable the transfer of part of health care from the hospital to the home-based care. However, scientific evidences have shown that health care delivered through telemedicine can be burdened by numerous ethical and legal issues. Although there is an emerging discussion on patient safety issues related to the use of telemedicine, there is a lack of reseraches specifically designed to investigate patient safety. On the contrary, it would be necessary to determine standards and specific application rules in order to ensure safety. This paper examines the telemedicine-risk profiles and proposes a position statement for clinical risk management to support continuous improvement in the safety of health care delivered through telemedicine.
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Affiliation(s)
- Francesco De Micco
- Bioethics and Humanities Research Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences (SAIMLAL), Sapienza University of Rome, Rome, Italy
- *Correspondence: Vittorio Fineschi
| | - Giuseppe Banfi
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences (SAIMLAL), Sapienza University of Rome, Rome, Italy
| | - Antonio Oliva
- Department of Health Surveillance and Bioethics, Section of Legal Medicine, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Mario Picozzi
- Department of Biotechnology and Science of Life, Center for Clinical Ethics, Insubria University, Varese, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | - Tommasangelo Petitti
- Hygiene, Public Health and Statistics, Campus Bio-Medico University of Rome, Rome, Italy
- Department of Medical Affairs, Fondazione Don Carlo Gnocchi Onlus, Rome, Italy
| | - Rossana Alloni
- Bioethics and Humanities Research Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Enrico Rosati
- Casa di Cura “Auxologico Roma–Buon Pastore”, Rome, Italy
| | - Anna De Benedictis
- Nursing Science Research Unit, Campus Bio-Medico University of Rome, Rome, Italy
| | - Vittoradolfo Tambone
- Bioethics and Humanities Research Unit, Campus Bio-Medico University of Rome, Rome, Italy
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Brotons A, Remy F, Foti B, Philip-Alliez C. Concordances and correlations between chronological, dental and bone ages: A retrospective study in French individuals. Forensic Sci Int 2021; 331:111150. [PMID: 34959020 DOI: 10.1016/j.forsciint.2021.111150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 11/04/2022]
Abstract
Bone and dental maturations are subject to physiological, environmental and pathological variables and are unique to each individual. Numerous methods for age estimation appeared to answer a new demand explained by the contemporary migratory movements and the increase of the crime rates. The objective of this study was to observe the relationships between skeletal and dental maturation stages to estimate which methods can be applied to a French population. This retrospective study was based on panoramic and cephalometric radiographs belonging to 192 (101 females and 91 males) orthodontic patients aged between 9 and 19 years, inhabitants of the Provence-Alpes-Côte d'Azur region. The Demirjian method based on dental calcification was used to estimate dental age. For the assessment of skeletal maturity and bone age, the Cervical Vertebral Maturation (CVM) method (Baccetti et al.) and its computerized version (Decocq et al.) were used. Spearman's correlation tests were performed to estimate the correlation between dental calcification stages and those of cervical vertebral maturation among the study population. The methods of Lin's concordance correlation coefficient and Bland and Altman were used to analyze the concordance between bone, dental and chronological ages. A moderate but statistically significant correlation was obtained between dental and skeletal developmental stages (R = 0.383-0.618). The tooth showing the highest correlation with vertebral stages was the second molar for both sexes. Earlier vertebral maturation stage affiliation was observed in girls. The results confirmed that bone and dental maturations can be assessed to estimate relevant biological ages for children in orthodontic or forensic contexts.
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Affiliation(s)
- Adèle Brotons
- Mixed research unit 7268 ADES, Aix-Marseille University, Faculty of Medicine, Marseille, France.
| | - Floriane Remy
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.
| | - Bruno Foti
- Mixed research unit 7268 ADES, Aix-Marseille University, Faculty of Medicine, Marseille, France; UFR of Odontology, Aix-Marseille University, Marseille, France.
| | - Camille Philip-Alliez
- ODF Functional Unit, Timone Hospital, Marseille, France; Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.
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Age Estimation Based on Pulp–Tooth Volume Ratio of Anterior Teeth in Cone-Beam Computed Tomographic Images in a Selected Population: A Cross-Sectional Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11219984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The present study aimed to investigate the correlation between chronological age and pulp–tooth volume ratio in anterior teeth using cone beam computed tomographic (CBCT) images and provide equations for age estimation based on pulp–tooth volume ratio. In this cross-sectional study, CBCT images of 312 anterior teeth of the maxilla and mandible were examineαd. The chronological age and the sex of the patients were recorded. Tooth volume and pulp volume of the anterior teeth were measured using Mimics software, and then tooth–pulp volume ratio was calculated. Statistical analysis of data was performed using chi-square test, independent T-test, Pearson’s correlation, and linear regression (α = 0.05). Finally, equations were made based on the results of the regression analysis for age estimation in general and for males and females. The age of the subjects ranged between 16 and 69 years (mean 40.6 ± 12.74). The pulp–tooth volume ratio of the maxillary teeth was generally higher than the mandibular teeth. A significant inverse relationship between age and pulp–tooth volume ratio was observed for all anterior teeth. (p < 0.05). The strongest correlation between age and pulp–tooth volume ratio was reported for mandibular central incisor (r = −0.58, p < 0.001) and the weakest was for mandibular lateral incisor (r = −0.36, p = 0.012). Age estimation was most accurate among females using the maxillary central incisors (p < 0.001) and among males using the mandibular central incisors and maxillary canines (p = 0.003). Pulp–tooth volume ratio of mandibular central incisors, maxillary lateral incisors, and maxillary canines in males and maxillary and mandibular central incisors, maxillary lateral incisors, and maxillary and mandibular canines in females can be used for age estimation.
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Hostiuc S, Diaconescu I, Rusu MC, Negoi I. Age Estimation Using the Cameriere Methods of Open Apices: A Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9020237. [PMID: 33672206 PMCID: PMC7926662 DOI: 10.3390/healthcare9020237] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/15/2021] [Accepted: 02/17/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: To evaluate the actual variability of the mean difference between chronological and dental age using the Cameriere method of open apices and to test its accuracy in variable age groups. Method: We selected studies that contained data about the mean, standard deviation, and number of cases for chronological age, dental age and gender. We used a random-effects model. Statistical significance was estimated, at a p < 0.05, using prediction intervals. For the analysis of publication bias we used the funnel plot and Egger’s regression test for plot asymmetry. I2 was used to test the presence of heterogeneity between studies. The Z test was used to test for statistical differences between subgroups, with p < 0.05 being considered statistically significant. We also used 95% for confidence intervals and prediction intervals. Results: In boys, the average difference between chronological and dental age was 0.44 (0.26–0.63) years, while in girls the average difference between chronological and dental age was 0.34 (0.19–0.49) years. In the 6–7 years age group and in the 14–15 years age group, there was a statistically significant difference between dental and chronological age. Our study shows that the Cameriere method is useful for estimating the chronological age, with errors of less than one year. Conclusions: The Cameriere method of evaluating dental age using open apices is sufficiently accurate for forensic practice, at least in the 7–14 age-interval.
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Affiliation(s)
- Sorin Hostiuc
- Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 042122 Bucharest, Romania
- Correspondence: or ; Tel.: +40-723791072
| | - Ioana Diaconescu
- National Institute of Legal Medicine, 042122 Bucharest, Romania;
| | - Mugurel Constantin Rusu
- Department of Anatomy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Ionut Negoi
- Department of Surgery, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
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