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Mondal J, Wu Y, Mishra A, Akbaridoust F, Marusic I, Ghosh P, Ashokkumar M. Bubble oscillations at low frequency ultrasound for biological applications. ULTRASONICS SONOCHEMISTRY 2024:106816. [PMID: 38433032 DOI: 10.1016/j.ultsonch.2024.106816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 01/23/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Bubbles oscillating in the presence of ultrasound is commonly employed in biomedical applications for drug delivery, ultrasound enhanced thrombolysis, and the transport and manipulation of cells. This is possible because bubbles tend to interact with the ultrasound to undergo periodic shape changes known as shape-mode oscillation, concomitant with the generation of liquid agitation or streaming. This phenomenon is examined both experimentally and theoretically on a single bubble at a frequency of (45 ± 1) kHz. Effects of ultrasonic frequency and power on the flowfield were explored. Experiments revealed different trends in the development of liquid streaming velocities at different acoustic forcing conditions (5.53, 6.80 and 7.02 Vpp), with lowest (0.5 mm/s) and highest (1.1 mm/s) values of time-averaged mean streaming velocity occurring at 6.80 Vpp and 7.02 Vpp, respectively. Simulations captured the simultaneous evolution of bubble-shapes that helped create flow vortices in the liquid surrounding the bubble. These vortices collectively responsible in generating signature patterns in the liquid for a dominant shape-mode of the bubble, and could also generate localised shear stresses for practical application. The velocity and pressure profiles in the liquid around the bubble confirmed the connection of the applied and reflected soundwaves in driving this phenomenon.
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Affiliation(s)
- Joydip Mondal
- School of Chemistry, University of Melbourne, VIC 3010, Australia; Cryogenic Engineering Centre, IIT Khargapur, Kharagpur 721302, India
| | - Yue Wu
- School of Chemistry, University of Melbourne, VIC 3010, Australia; College of Food Science and Technology, Nanjing Agricultural University, Nanjing 210095, China.
| | - Arpit Mishra
- Mechanical Engineering and Materials Science at Duke University, Durham, NC27708, USA
| | - Farzan Akbaridoust
- Mechanical Engineering Department, University of Melbourne, VIC 3010, Australia
| | - Ivan Marusic
- Mechanical Engineering Department, University of Melbourne, VIC 3010, Australia
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Scientific and Clinical Abstracts From WOCNext® 2022: Fort Worth, Texas ♦ June 5-8, 2022. J Wound Ostomy Continence Nurs 2022; 49:S1-S99. [PMID: 35639023 DOI: 10.1097/won.0000000000000882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kotronis G, Vas PRJ. Ultrasound Devices to Treat Chronic Wounds: The Current Level of Evidence. INT J LOW EXTR WOUND 2020; 19:341-349. [DOI: 10.1177/1534734620946660] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic wounds cause considerable morbidity and utilize significant health care resources. In addition to addressing wound etiology and treating infection, regular debridement is a key component of wound care with a proven ability to accelerate healing. In this regard, a significant innovation in wound care has been the development of ultrasound debridement technology. The purpose of this review is to evaluate the current evidence behind the technology with an emphasis on noncontact low-frequency (NCLF) ultrasound. A number of studies, especially those evaluating NCLF technology, have demonstrated the potential of ultrasound debridement to effectively remove devitalized tissue, control bioburden, alleviate pain, and expedite healing. However, most of the studies are underpowered, involve heterogeneous ulcer types, and demonstrate significant methodological limitations making comparison between studies difficult; there is a paucity of data on cost-effectiveness. Future clinical trials on ultrasound debridement technology must address the design issues prevalent in current studies, and report on clinically relevant endpoints before adoption into best-practice algorithms can be recommended.
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Affiliation(s)
| | - Prashanth R. J. Vas
- King’s College Hospital NHS Foundation Trust, London, UK
- King’s Health Partners’ Institute of Diabetes, Endocrinology and Obesity, London, UK
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Scientific and Clinical Abstracts From WOCNext 2020 Reimagined. J Wound Ostomy Continence Nurs 2020. [DOI: 10.1097/won.0000000000000650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Use of Thermal Imaging to Identify Deep-Tissue Pressure Injury on Admission Reduces Clinical and Financial Burdens of Hospital-Acquired Pressure Injuries. Adv Skin Wound Care 2020; 32:312-320. [PMID: 31192867 PMCID: PMC6716560 DOI: 10.1097/01.asw.0000559613.83195.f9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A deep-tissue pressure injury (DTPI) is a serious type of pressure injury that begins in tissue over bony prominences and can lead to the development of hospital-acquired pressure injuries (HAPIs). Using a commercially available thermal imaging system, study authors documented a total of 12 thermal anomalies in 9 of 114 patients at the time of admission to one of the study institution’s ICUs over a 2-month period. An intensive, proven wound prevention protocol was immediately implemented for each of these patients. Of these 12 anomalies, 2 ultimately manifested as visually identifiable DTPIs. This represented a 60% reduction in the authors' institution’s historical DTPIs/HAPI rate. Because these DTPIs were documented as present on admission using the thermal imaging tool, researchers avoided a revenue loss associated with nonreimbursed costs of care and also estimated financial benefits associated with litigation expenses known to be generated with HAPIs. Using thermal imaging to document DTPIs when patients present has the potential to significantly reduce expenses associated with pressure injury litigation. The clinical and financial benefits of early documentation of skin surface thermal anomalies in anatomical areas of interest are significant.
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Rastogi A, Bhansali A, Ramachandran S. Efficacy and Safety of Low-Frequency, Noncontact Airborne Ultrasound Therapy (Glybetac) For Neuropathic Diabetic Foot Ulcers: A Randomized, Double-Blind, Sham-Control Study. INT J LOW EXTR WOUND 2019; 18:81-88. [PMID: 30836809 DOI: 10.1177/1534734619832738] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The diabetic foot ulcer (DFU) healing rates remain dismally low. Therefore, many adjunctive therapies have been evaluated including ultrasound therapy. The prior studies with noncontact, low-frequency ultrasound were retrospective, single arm, unblinded, or with historical controls. The aim of the present study was to compare the efficacy of noncontact, low-frequency airborne ultrasound (Glybetac) therapy with sham therapy added to standard treatment in patients with neuropathic, clinically infected, or noninfected DFU (wound size >2 cm2), Wagner grades 2 and 3. Patients received ultrasound or sham therapy for 28 days dosed daily for first 6 days followed by twice a week for next 3 weeks along with standard of care. The primary outcome was percentage of patients with at least >50% decrease in wound area at 4 week of intervention. Fifty-eight patients completed the study protocol. The duration of wound was 15.8 ± 11.2 weeks and 12.1 ± 10.9 weeks and wound area of 11.3 ± 8.2 cm2 and 14.8 ± 13.8 cm2 ( P = .507) in the ultrasound and sham groups, respectively. A >50% reduction in wound area was observed in 97.1% and 73.1% subjects ( P = .042) in ultrasound and sham groups, respectively. Wound contraction was faster in the first 2 weeks with ultrasound therapy, 5.3 cm2, compared with 3.0 cm2 ( P = .025) with sham treatment. Overall, wound area reduction of 69.4 ± 23.2% and 59.6 ± 24.9% ( P = .126) was observed at 4 weeks in the ultrasound and sham groups, respectively. We conclude that the airborne low-frequency ultrasound therapy improves and hastens the healing of chronic neuropathic DFU when combined with standard wound care.
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Affiliation(s)
- Ashu Rastogi
- 1 Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Anil Bhansali
- 1 Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Scientific and Clinical Abstracts From the WOCN® Society's 50th Annual Conference. J Wound Ostomy Continence Nurs 2018. [DOI: 10.1097/won.0000000000000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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New techniques for wound management: A systematic review of their role in the management of chronic wounds. Arch Plast Surg 2018; 45:102-110. [PMID: 29506339 PMCID: PMC5869421 DOI: 10.5999/aps.2016.02019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Revised: 05/26/2017] [Accepted: 11/07/2017] [Indexed: 12/17/2022] Open
Abstract
Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.
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Wiegand C, Bittenger K, Galiano RD, Driver VR, Gibbons GW. Does noncontact low-frequency ultrasound therapy contribute to wound healing at the molecular level? Wound Repair Regen 2017; 25:871-882. [PMID: 29098740 DOI: 10.1111/wrr.12595] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/09/2017] [Indexed: 12/21/2022]
Abstract
Noncontact low-frequency ultrasound (NLFU) is used to treat various types of chronic wounds including venous, diabetic, and pressure ulcers. The objective for this substudy of the IN BALANCE RCT VLU trial was to characterize and compare the NLFU treatment group and patients receiving standard of care (SOC) with respect to the effect of the assigned study treatment on content/quantity of inflammatory cytokines and fibrinogen as well as bacteria. Higher mean wound area reduction was observed in the NLFU treatment group (67.0%) compared to the SOC group (41.6%, p < 0.05). Hypertension, diabetes type II, coronary artery disease, and anemia were identified as the most common comorbidities of the Chronic venous leg ulcer (CVLU) patients included in the study. Pseudomonas, Corynebacterium, and unclassified Enterobacteriaceae were dominant in the highest number of samples. Anaerococcus, Peptoniphilus, and Finegoldia, had the highest median proportion in the samples overall. Peptoniphilus abundance decreased more in the NLFU treatment group relative to SOC; similar trends were observed for Anaerococcus and Finegoldia. Progression of mediators like TNF-alpha, IL-1beta, IL-6, IL-8, and IL-10 as well as PF4, TGF-beta, and fibrinogen was monitored and trends for several of the mediators were identified. Fibrinogen amounts were significantly reduced over time in the NLFU treatment group (p < 0.05). IL-8 levels declined in wound fluid from NLFU responders as well as SOC responders. Bacterial load (total bacterial abundance) determined local parameters of ulcer inflammation. If a bioburden of ≥ 10E5 was found compared to < 10E5 , levels of IL-1beta, IL-8, and TNF-alpha were significantly higher. In conclusion, NLFU treatment is an effective adjuvant tool for CVLU therapy. This study demonstrates that it improves wound healing by equally inhibiting abundant levels of pro-inflammatory cytokines as well as by reducing the overall bacterial burden.
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Affiliation(s)
- Cornelia Wiegand
- Department of Dermatology, University Hospital Jena, Jena, Germany
| | - Kyle Bittenger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Robert D Galiano
- Division of Plastic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Vickie R Driver
- Department of Orthopedic Surgery, Brown University, Providence, Rhode Island
| | - Gary W Gibbons
- Center for Wound Healing, South Shore Hospital, Weymouth, Massachusetts
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Use of Noncontact Low-Frequency Ultrasound in Deep Tissue Pressure Injury: A Retrospective Analysis. J Wound Ostomy Continence Nurs 2017; 44:336-342. [PMID: 28549050 DOI: 10.1097/won.0000000000000342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to examine the effect of noncontact low-frequency ultrasound (NLFU) on deep tissue pressure injury (DTPI), both hospital-acquired and those present on admission (POA). DESIGN Retrospective, descriptive study. SAMPLE AND SETTING Medical records from 44 adult patients with a DTPI treated with NLFU were reviewed; 22 had a hospital-acquired DTPI (HADTPI) and 22 had DTPI POA. Their mean age was 71.3 ± 16.3 years (mean ± SD); 52% were male. The study setting was a 318-bed community hospital in the Mid-Atlantic region of the United States. METHODS Data were collected from the medical records including demographic and relevant clinical characteristics, DTPI measurements, and DTPI evolution/resolution. Data were summarized and examined using descriptive statistics (eg, frequencies and percentages and means and standard deviations). Differences between groups were examined using paired t tests or the Mann-Whitney U test and the chi-square test as appropriate. In addition, the heel DTPI subgroup (N = 8) was examined separately due to the small sample size. RESULTS All patients with HADTPI and DTPI POA treated with NLFU exhibited a statistically significant decrease in injury size from initiation to discontinuation of NLFU therapy (24.6 cm vs 14.4 cm, P = .02). No statistically significant difference in wound resolution was found between HADTPI versus DTPI POA (27% vs 18%, P = .47). Mean size of both HADTPI and DTPI POA decreased significantly from 15.9 to 13.4 cm (P = .045) by NLFU therapy. Wounds were classified as resolved at completion of treatment in 23% (10 out of 44) of all treated patients. Of all patients with the potential to be resolved (not discharged early or expired) 63% (10 out of 16) had wounds classified as resolved. CONCLUSION Study findings suggest that NLFU is a viable and promising treatment option for both HADTPI and DTPI POA. Future studies are needed to confirm these results and to examine efficacy and feasibility of DTPI across care settings.
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Honaker JS, Forston MR, Davis EA, Weisner MM, Morgan JA, Sacca E. The effect of adjunctive noncontact low frequency ultrasound on deep tissue pressure injury. Wound Repair Regen 2016; 24:1081-1088. [DOI: 10.1111/wrr.12479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 09/08/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Jeremy S. Honaker
- Department of Dermatology, School of Medicine; Case Western Reserve University; Cleveland Ohio
| | - Michael R. Forston
- Department of Rehabilitative Services; Baptist Health Lexington; Lexington Kentucky
| | - Emily A. Davis
- Department of Nursing Education; Baptist Health Lexington; Lexington Kentucky
| | - Michelle M. Weisner
- Department of Rehabilitative Services; Baptist Health Lexington; Lexington Kentucky
| | - Jennifer A. Morgan
- Department of Rehabilitative Services; Baptist Health Lexington; Lexington Kentucky
| | - Emily Sacca
- Department of Rehabilitative Services; Baptist Health Lexington; Lexington Kentucky
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Scientific and Clinical Abstracts From the 2016 WOCN® Society & CAET Joint Conference. J Wound Ostomy Continence Nurs 2016. [DOI: 10.1097/won.0000000000000226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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White J, Ivins N, Wilkes A, Carolan-Rees G, Harding KG. Non-contact low-frequency ultrasound therapy compared with UK standard of care for venous leg ulcers: a single-centre, assessor-blinded, randomised controlled trial. Int Wound J 2015; 13:833-42. [PMID: 25619411 PMCID: PMC7949520 DOI: 10.1111/iwj.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Accepted: 09/29/2014] [Indexed: 11/30/2022] Open
Abstract
‘Hard‐to‐heal’ wounds are those which fail to heal with standard therapy in an orderly and timely manner and may warrant the use of advanced treatments such as non‐contact low‐frequency ultrasound (NLFU) therapy. This evaluator‐blinded, single‐site, randomised controlled trial, compared NLFU in addition to UK standard of care [SOC: (NLFU + SOC)] three times a week, with SOC alone at least once a week. Patients with chronic venous leg ulcers were eligible to participate. All 36 randomised patients completed treatment (17 NLFU + SOC, 19 SOC), and baseline demographics were comparable between groups. NLFU + SOC patients showed a −47% (SD: 38%) change in wound area; SOC, −39% (38%) change; and difference, −7·4% [95% confidence intervals (CIs) −33·4–18·6; P = 0·565]. The median number of infections per patient was two in both arms of the study and change in quality of life (QoL) scores was not significant (P = 0·490). NLFU + SOC patients reported a substantial mean (SD) reduction in pain score of −14·4 (14·9) points, SOC patients' pain scores reduced by −5·3 (14·8); the difference was −9·1 (P = 0·078). Results demonstrated the importance of high‐quality wound care. Outcome measures favoured NLFU + SOC over SOC, but the differences were not statistically significant. A larger sample size and longer follow‐up may reveal NLFU‐related improvements not identified in this study.
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Affiliation(s)
- Judith White
- Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Cardiff, UK.
| | - Nicola Ivins
- Wound Healing Research Unit, Cardiff University, School of Medicine, Cardiff, UK
| | - Antony Wilkes
- Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Cardiff, UK
| | - Grace Carolan-Rees
- Cedar, Cardiff and Vale University Health Board, Cardiff Medicentre, Cardiff, UK
| | - Keith G Harding
- Wound Healing Research Unit, Cardiff University, School of Medicine, Cardiff, UK
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Development and Psychometric Testing of the Honaker Suspected Deep Tissue Injury Severity Scale. J Wound Ostomy Continence Nurs 2014; 41:238-41. [DOI: 10.1097/won.0000000000000024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Scientific and Clinical Abstracts From the WOCN® Society's 46th Annual Conference. J Wound Ostomy Continence Nurs 2014. [DOI: 10.1097/won.0000000000000037] [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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Lee YJ, Park S, Kim JY, Kim CG, Cha SK. Clinical Nurses' Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis. J Korean Acad Nurs 2013; 43:526-35. [DOI: 10.4040/jkan.2013.43.4.526] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yun Jin Lee
- Department of Nursing, Severance Hospital, Seoul, Korea
| | - Seungmi Park
- Department of Nursing, Hoseo University, Asan, Korea
| | - Jung Yoon Kim
- Department of Plastic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chul-Gyu Kim
- Department of Nursing, Cheongju University, Cheongju, Korea
| | - Sun Kyung Cha
- Department of Nursing, Cheongju University, Cheongju, Korea
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