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Sacco M, Zibetti A, Bonetta C, Scalise C, Abenavoli L, Guarna F, Gratteri S, Ricci P, Aquil I. KAMBO: NATURAL DRUG OR POTENTIAL TOXIC AGENT? A LITERATURE REVIEW OF ACUTE POISONING CASES. Toxicol Rep 2022; 9:905-913. [PMID: 35515815 PMCID: PMC9061256 DOI: 10.1016/j.toxrep.2022.04.005] [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: 04/30/2021] [Revised: 04/07/2022] [Accepted: 04/11/2022] [Indexed: 11/14/2022] Open
Abstract
Kambo is the name of a natural substance derived from the glandular secretions of the amphibian Phyllomedusa bicolor, a species native to regions in South America. The communities living in these areas administer the substance generally transdermally during rituals for religious-purifying purposes, producing small skin burns. The scientific literature has reported some cases of intoxication following the use of Kambo but this aspect is still poorly understood. In fact, no shared therapy protocols exist for these events nor any real legislation on Kambo. The purpose of this work was to examine all cases of acute intoxication resulting from the administration of Kambo and published over the last 10 years, illustrating clinical signs, laboratory findings, instrumental tests, and therapy. The several cases identified in our review confirm that acute Kambo intoxication can occur, with serious and life-threatening effects. We developed a protocol aimed at the early diagnosis of cases of suspected acute intoxication by creating a treatment algorithm. The study aims to investigate the pathophysiology of these events in humans, proposing a protocol for the diagnosis and treatment of these cases that can be used by healthcare professionals. The use of Kambo has spread for distribution worldwide through numerous websites. The literature review confirmed that acute Kambo intoxication include possible side effects. Intoxication may affect various systems with laboratory or instrumental alterations. Intoxication may be reversible if promptly diagnosed and treated. An algorithm with adequate triage can support diagnosis and treatment.
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2
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Thompson C, Williams ML. Review of the physiological effects of Phyllomedusa bicolor skin secretion peptides on humans receiving Kambô. TOXICOLOGY RESEARCH AND APPLICATION 2022. [DOI: 10.1177/23978473221085746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Kambô is an Amazonian ritual which includes the application of the defensive secretion of the Phyllomedusa bicolor frog to superficial burns made on the skin of human participants. The secretion, which contains a range of biologically active linear peptides, induces a short purgative experience that is extensively reported by participants to leave them with positive physical, emotional and spiritual after-effects. Various peptides identified in the secretion exert analgesic, vascular, and gastric effects in vivo, and antimicrobial and anti-cancer effects, among others, in vitro. While there has been some investigation into the physiological effects of various individual peptides isolated from the P. bicolor secretion, very little is known about the putative synergistic effects of concurrent administration of the complete substance through the transdermal methods used traditionally in the Kambô ritual. In this review and commentary, the authors summarize the existing biological information from animal research on peptides from the P. bicolor secretion, then consider the evidence in the context of Kambô administration to humans. The presented information suggests that specific peptides are likely to contribute to analogous physiological effects of Kambô in humans. The possibility that beyond their physiological action, the experiential or phenomenological component of these effects may have therapeutic applications is discussed, concluding with a consideration of the feasibility of human clinical research.
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Affiliation(s)
| | - Martin L Williams
- Turner Institute of Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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3
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How to Transform an Exceptional Case Report Into a Therapy: Following the Frog Out of the Box. Hemasphere 2021; 5:e629. [PMID: 34386709 PMCID: PMC8354625 DOI: 10.1097/hs9.0000000000000629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/02/2021] [Indexed: 11/26/2022] Open
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Majić T, Sauter M, Bermpohl F, Schmidt TT. Connected to the spirit of the frog: An Internet-based survey on Kambô, the secretion of the Amazonian Giant Maki Frog ( Phyllomedusa bicolor): Motivations for use, settings and subjective experiences. J Psychopharmacol 2021; 35:421-436. [PMID: 33663248 PMCID: PMC8058834 DOI: 10.1177/0269881121991554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND/AIM Kambô is a name for the secretion of the Giant Maki Frog (Phyllomedusa bicolor), which has been used by indigenous cultures from the Amazonas basin and has recently become popular in alternative healing circles in Western countries, with a certain overlap with psychedelic self-exploration. METHODS We carried out an online-based survey in English (54.92%) and German investigating motivations for using Kambô, settings in which rituals take place, and subjective experiences during and after the application. RESULTS Participants (n = 386, mean age: 38.08 years, (standard deviation = 9.95)) were well-educated individuals with an increased lifetime prevalence of the use of ayahuasca (67.88%). A plethora of motivations for using Kambô was reported, including general healing, detoxification and spiritual growth. Acute effects included severe physical reactions and mild psychoactive effects, most surprisingly, the feeling of being connected to the frog's spirit (41.97%), whereas predominantly positive persisting psychological effects were reported. Few participants reported long-lasting physical (2.85%) or mental (1.81%) health problems which they attributed to Kambô. Of the participants, 87.31% reported an increase in personal well-being or life satisfaction, and 64.26% considered Kambô to have been at least of 'very much' spiritual significance for their lives. CONCLUSIONS The majority of users claimed beneficial effects including more health-orientated behaviors, whereas only very few participants complained about new health problems which they ascribed to Kambô. In retrospect, Kambô was given a high personal and spiritual significance by many participants. Additional research is needed to determine in how far reported effects are modulated by setting and subjective expectations.
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Affiliation(s)
- Tomislav Majić
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Meike Sauter
- Department of Psychosomatic Medicine and Psychotherapy, Helios Clinic Emil von Behring, Berlin, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Timo T Schmidt
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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Peleg Hasson S, Shachar E, Kessner R, Shpigel S, Wolf I. Kambô-Induced Systemic Inflammatory Response: A Case Report of Acute Disease Progression of Cholangiocarcinoma. Integr Cancer Ther 2021; 20:1534735421999106. [PMID: 33719640 PMCID: PMC8743964 DOI: 10.1177/1534735421999106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Kambô is a cleansing ritual involving the application of a toxin produced by the giant leaf frog (Phyllomedusa bicolor). The Kambô ritual has increasingly been adopted among cancer patients in Europe. Accumulating data indicate various adverse effects. We report another severe adverse reaction to Kambô, a systemic inflammatory response syndrome mimicking disease progression in a patient with cholangiocarcinoma. We describe a systemic reaction to Kambô, manifested as tachycardia, tachypnea, impaired liver cholestatic enzymes, and enlargement of lymphadenopathy mimicking disease progression. The clinical features and onset of symptoms, the rapid reaction, and the lack of other identified causes make the diagnosis of Kambô-induced SIRS highly probable. This case report calls for future studies examining standard oncological care such as chemotherapy, radiotherapy, and immunotherapy in conjunction with alternative therapy. Additionally, greater awareness and physician education should be promoted, encouraging inquiry of oncology patients’ administration of alternative, complementary, and integrative medicine.
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Affiliation(s)
- Shira Peleg Hasson
- Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Eliya Shachar
- Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Rivka Kessner
- Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shulim Shpigel
- Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ido Wolf
- Tel Aviv University, Tel Aviv, Israel.,Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Schmidt TT, Reiche S, Hage CLC, Bermpohl F, Majić T. Acute and subacute psychoactive effects of Kambô, the secretion of the Amazonian Giant Maki Frog (Phyllomedusa bicolor): retrospective reports. Sci Rep 2020; 10:21544. [PMID: 33298999 PMCID: PMC7725827 DOI: 10.1038/s41598-020-78527-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/20/2020] [Indexed: 01/30/2023] Open
Abstract
Kambô, the secretion of the Amazonian Giant Leaf Frog (Phyllomedusa bicolor) contains a plethora of bioactive peptides and was originally used by indigenous communities from the Amazon basin as medicine for improving hunting capacities. In the last 20 years, Kambô has spread to Western urban healing circles. To date it is still controversial whether the acute effects of Kambô include alterations of consciousness similar to known psychoactive substance like serotonergic psychedelics. Here we retrospectively assessed psychological effects of Kambô in a sample of anonymous users (n = 22, mean age: 39 years, ± 8.5; 45.5% female), administering standardized questionnaires for the assessment of altered states of consciousness (ASC), including the Altered States of Consciousness Rating Scale, the Phenomenology of Consciousness Inventory (PCI), the Mystical Experience Questionnaire (MEQ), the Challenging Experience Questionnaire (CEQ) for acute effects and the Persisting Effects Questionnaire (PEQ) and a scale assessing connectedness for subacute effects. The intensity of retrospectively reported acute psychological effects remained on a mild to moderate level, with no psychedelic-type distortions of perception or thinking. Conversely, persisting effects were predominantly described as positive and pleasant, revealing high scores on measures of personal and spiritual significance.
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Affiliation(s)
- Timo Torsten Schmidt
- Department of Education and Psychology, Neurocomputation and Neuroimaging Unit (NNU), Freie Universität Berlin, Berlin, Germany.,Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Simon Reiche
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Caroline L C Hage
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Felix Bermpohl
- Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany
| | - Tomislav Majić
- Research Group Psychotropic Substances, Psychiatric University Clinic at Hospital St. Hedwig, Charité Universitätsmedizin Berlin, Berlin, Germany. .,Berlin Institute of Health, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Charité Mitte, Berlin, Germany.
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Robalino Gonzaga ES, Chamorro M, Ganti L, Schneider R. Kambo Frog Poison as a Cause of Esophageal Rupture. Cureus 2020; 12:e10677. [PMID: 33133843 PMCID: PMC7592631 DOI: 10.7759/cureus.10677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The authors present a case of a patient who used Kambo frog poison for body cleansing that induced severe vomiting and led to esophageal rupture followed by tension pneumothorax and septic shock. Kambo is the waxy substance secreted by the nocturnal giant tree frog Phyllomedusa bicolor. Kambo, which is poisonous, is commonly believed in South America to have cleansing and healing properties. As alternative medicine becomes more common, and as more tourists frequent our hospitals, knowledge of these types of ritual related exposures is important for the practicing emergency physician to be aware of.
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Affiliation(s)
| | - Maria Chamorro
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
| | - Latha Ganti
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA.,Emergency Medicine, Envision Physician Services, Plantation, USA.,Emergency Medical Services, Polk County Fire Rescue, Bartow, USA
| | - Robert Schneider
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, USA
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Dermatomyositis induced by the secretion of Phyllomedusa bicolor or Kambô frog - A case report. Toxicon 2020; 184:57-61. [PMID: 32473255 DOI: 10.1016/j.toxicon.2020.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 12/30/2022]
Abstract
The Amazonian Kambô frog, Phyllomedusa bicolor, is commonly known for the potential benefits of its secretion. The Kambô ritual consists in applying the toxin directly to a freshly burnt skin area, since it is believed by natives and shamans to purify and strengthen the body and mind of the user. We describe a 33-year old female with a history of periodic use of Kambô toxin who presented with a 3-week course of asthenia, malaise, myalgia, and proximal muscle weakness predominantly in the lower limbs. She had elevated muscle enzymes and an abnormal electromyography. We used the 2017 European League Against Rheumatism and American College of Rheumatology classification criteria to establish the diagnosis of dermatomyositis. The patient demonstrated clinical response to prednisone, with a complete recovery of signs and symptoms after 8 weeks of treatment. To our knowledge, this is the first case report of dermatomyositis possibly associated with the use of Kambô. The Kambô cleansing ritual is becoming popular in first world countries, but its use may lead to serious side-effects, sometimes life-threatening. In patients presenting with signs and symptoms suggestive of dermatomyositis and a skin line of circle-shaped burns, Phyllomedusa bicolor skin secretion exposure should be suspected.
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Bartels EJH, Dekker D, Amiche M. Dermaseptins, Multifunctional Antimicrobial Peptides: A Review of Their Pharmacology, Effectivity, Mechanism of Action, and Possible Future Directions. Front Pharmacol 2019; 10:1421. [PMID: 31849670 PMCID: PMC6901996 DOI: 10.3389/fphar.2019.01421] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022] Open
Abstract
Dermaseptins are a group of α-helical shaped polycationic peptides isolated from the Hylid frogs, with antimicrobial effects against bacteria, parasites, protozoa, viruses in vitro. Besides, anti-tumor effects have been demonstrated. However, few animal experiments and no clinical trials have been conducted thus far. This review summarizes the current knowledge on the pharmacology, ethno pharmacology, effectivity against infectious pathogens and tumors cells and the mechanism of action of the Dermaseptins. Future research should focus on further clarification of the mechanisms of action, the effectivity of Dermaseptins against several cancer cell lines and their applicability in humans.
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Affiliation(s)
| | - Douwe Dekker
- Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mohamed Amiche
- Mondor Institute of Biomedical Research, INSERM U955 Team 7, School of Medicine, University Paris Est Créteil, Créteil, France
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10
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Byard RW. Is voluntary envenomation from the kambô ritual therapeutic or toxic? Forensic Sci Med Pathol 2019; 16:205-206. [PMID: 31630322 DOI: 10.1007/s12024-019-00192-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Roger W Byard
- Adelaide Medical School, The University of Adelaide, Level 2 Helen Mayo Building North, Frome Road, Adelaide, SA, 5005, Australia.
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Aquila I, Ricci P, Galassi A, Sacco MA, Malfa O, Gratteri S. Sudden death and Takayasu's arteritis: The role of histopathological investigation. Med Leg J 2019; 87:139-143. [PMID: 31414603 DOI: 10.1177/0025817219862484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
When death is sudden and unexpected, autopsy may not provide sufficient information to be sure of the cause of death. Some causes can only be identified by microscopy. We report a case of sudden death in a woman who suffered from vertigo and hypertension. The autopsy only showed sclerosis of the thoracic aorta, abdominal aorta and coronary arteries, and the toxicological results were negative and did not explain the cause of death. A microscopic and immunohistochemical analysis of samples from various organs was carried out. The histopathological examination revealed eosinophilia in the aortic wall, consistent with a vasculitis such as Takayasu's arteritis. This case emphasises the association between systemic vasculitis and sudden death, as well as the role of histopathological investigation and the importance of post-mortem diagnosis to prevent similar fatal events among family members.
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Affiliation(s)
- Isabella Aquila
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Pietrantonio Ricci
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | | | - Matteo Antonio Sacco
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Orazio Malfa
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
| | - Santo Gratteri
- Institute of Legal Medicine, Magna Græcia University of Catanzaro, Catanzaro, Italy
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Silva FVAD, Monteiro WM, Bernarde PS. "Kambô" frog (Phyllomedusa bicolor): use in folk medicine and potential health risks. Rev Soc Bras Med Trop 2019; 52:e20180467. [PMID: 30942261 DOI: 10.1590/0037-8682-0467-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Francisco Vaniclei Araújo da Silva
- Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil.,Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Universidade Federal do Acre, Rio Branco, AC, Brasil
| | - Wuelton Marcelo Monteiro
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Manaus, AM, Brasil.,Diretoria de Ensino e Pesquisa, Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brasil
| | - Paulo Sérgio Bernarde
- Laboratório de Herpetologia, Centro Multidisciplinar, Campus Floresta, Universidade Federal do Acre, Cruzeiro do Sul, AC, Brasil.,Programa de Pós-Graduação Stricto Sensu em Ciências da Saúde na Amazônia Ocidental, Universidade Federal do Acre, Rio Branco, AC, Brasil
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Abstract
Kambô is an emerging ritual, which involves the application of the toxin produced by Phyllomedusa bicolor to a freshly burnt area to heal chronic diseases of the mind and body. Due to the widespread use of kambô, more cases of symptomatic health conditions are being discovered. In this case study, we report a patient with psychosis potentially due to the kambô ritual.
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Affiliation(s)
- Renitha Roy
- Frederick Memorial Hospital, West Virginia School of Osteopathic Medicine, Lewisburg, USA
| | - Aparna Baranwal
- Medical Student, West Virginia School of Osteopathic Medicine, Lewisburg, USA
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Ayahuasca and Kambo intoxication after alternative natural therapy for depression, confirmed by mass spectrometry. Forensic Toxicol 2017. [DOI: 10.1007/s11419-017-0394-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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