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Le MH, Nguyen TK, Pham TT, Pham TT, Tran VD. Effectiveness of a Health Education Program in Hypertensive Patients with Dyslipidemia and/or Microalbuminuria: A Quasi-Experimental Study in Vinh Long Province, Vietnam. Healthcare (Basel) 2023; 11:2208. [PMID: 37570448 PMCID: PMC10418689 DOI: 10.3390/healthcare11152208] [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: 06/19/2023] [Revised: 07/25/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
INTRODUCTION Hypertension, a major health concern, is associated with significant mortality and disease burden worldwide, including Vietnam. Comprehensive interventions targeting medication, lifestyle modifications, dyslipidemia (DLP), and microalbuminuria (MAU) are vital for effective hypertension management and reducing the risk of cardiovascular disease complications (CDV). While medication interventions have proven efficacy, the evidence regarding the effectiveness of community-based health education interventions in managing DLP and MAU is limited. Therefore, this study aims to evaluate the effectiveness of community health education interventions in reducing hypertension risk factors and achieving hypertension management objectives, as well as managing DLP and MAU among hypertension patients. METHODS A quasi-experimental study was conducted on 330 hypertensive patients with dyslipidemia (DLP) and/or microalbuminuria (MAU) who were divided into a control group (n = 164) and an intervention group (n = 166). The control group received standard national hypertension management, while the intervention group received additional intensive health education provided by trained volunteers. The effectiveness of the intervention was assessed by comparing outcomes such as lifestyle factors, BMI control, treatment adherence, hypertension control, and DLP and MAU status between the two groups before and after a two-year intervention period. RESULTS The health education intervention resulted in significant reductions in dietary risk factors, specifically in fruit and vegetable consumption (p < 0.001). There was a lower prevalence of high salt intake in the intervention group compared to the control group (p = 0.002), while no significant differences were observed in other dietary factors. Smoking habits and low physical activity significantly decreased in the intervention group, with a notable disparity in physical activity proportions (p < 0.001). Both groups showed significant improvements in achieving hypertension management targets, with the intervention group demonstrating superior outcomes. The intervention was effective in reducing the prevalence of risk factors, particularly treatment non-adherence, blood pressure control, and low physical activity. Additionally, the intervention group had a higher likelihood of achieving DLP and MAU control compared to the control group. CONCLUSIONS This study underscored the additional positive impact of incorporating health education by non-professional educators in achieving favorable outcomes, including better control of BMI, blood pressure, medication adherence, and management of dyslipidemia (DLP) and microalbuminuria (MAU). Further research is warranted to fully explore the potential of health education in primary healthcare settings and maximize its effectiveness.
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Affiliation(s)
- Minh Huu Le
- Department of Epidemiology, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam;
| | - Trung Kien Nguyen
- Department of Physiology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam;
| | - Thi Tam Pham
- Department of Nutrition and Food Safety, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam;
| | - Trung Tin Pham
- Department of Health Organization and Management, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
| | - Van De Tran
- Department of Health Organization and Management, Can Tho University of Medicine and Pharmacy, Can Tho 900000, Vietnam
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Tinsel I, Schmoor C, Börger M, Kamp M, Kaier K, Hardt H, Kloppe T, Rakebrandt A, Scherer M, Bergmann A, Görbing T, Kutter S, Riemenschneider H, Maun A. Encouragement of patients' self-management in primary care for the prevention of cardiovascular diseases (DECADE): protocol for a cluster randomised controlled trial. BMJ Open 2023; 13:e071230. [PMID: 37185187 PMCID: PMC10151245 DOI: 10.1136/bmjopen-2022-071230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Cardiovascular diseases are the most common cause of death in Germany and among the most frequent reasons for encounters in primary care. Most patients with cardiovascular risks (CVRs) have difficulties implementing health-promoting behavioural changes. In this study, a complex intervention containing evidence-based patient materials and structured follow-up consultations are intended to strengthen patients' self-management to improve health behaviour. METHODS AND ANALYSIS In this cluster randomised controlled trial, we investigate the effects of the intervention "Decision aid, action planning and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases" (DECADE) using a 2×2 design. All patients, including the control group (CG), receive a CVR calculation. Three intervention groups (IGs) receive one or both of two different components of the DECADE intervention: IG1 (patient materials), IG2 (follow-up consultations) and IG3 (patient materials and follow-up consultations). The study was planned to be conducted with 77 general practitioners in 3 German regions and a target sample size of 924 patients. The observation period for each patient amounts to 12 months with three patient surveys: baseline (t0), after 6 and 12 months (t1 and t2). The primary outcome is patient activation (Patient Activation Measure 13 (PAM13-D)) at t1. Secondary outcomes include PAM13-D at t2 and further patient-reported and clinical outcomes at t1 and t2. We will also analyse the cost-effectiveness of the intervention, the degree of usage and satisfaction with the intervention. ETHICS AND DISSEMINATION The study was first approved by the lead ethics committee of the University of Freiburg on 15 April 2021 (vote number: 21-1078) and subsequently by the other ethics committees in the study regions (Ethics committee of medical association Baden-Württemberg (B-F-2021-078), Ethics Committee of the Technische Universität Dresden, Dresden (BO-EK-251052021), Ethics Committee of the State Chamber of Physicians of Saxony (EK-BR-92/21-1), Ethics Committee of the Hamburg Medical Association (2021-200013-BO-bet)). Informed consent is required for patients to participate in the study. The results of this study will be published in peer-reviewed journals and presented at congresses by the DECADE team. The DECADE lead management will communicate the results to the funder of this study. TRIAL REGISTRATION NUMBER German Clinical Trials Register, DRKS00025401 (registration date: 21 June 2021); International Clinical Trials Registry Platform, DRKS00025401.
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Affiliation(s)
- Iris Tinsel
- Institute of Medical Biometry and Statistics, Section of Health Care Research and Rehabilitation Research, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Claudia Schmoor
- Clinical Trials Unit, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Maja Börger
- Institute of General Practice/Family Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Melanie Kamp
- Institute of General Practice/Family Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Hanna Hardt
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Kloppe
- Department of General Practice and Primary Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anja Rakebrandt
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Antje Bergmann
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Tina Görbing
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Susanne Kutter
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Henna Riemenschneider
- Department of General Practice, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Andy Maun
- Institute of General Practice/Family Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
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Paskaleva T, Tunc GC, Tornyova B, Dragusheva S, Petleshkova P, Dermendzhiev S, Panova B. Self-Management of the Elderly and the Old-Efficiency and Significance. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND: Self-management is an active approach to coping and assuming responsibility on the part of a person, independently or in collaboration with medical specialists, to manage his/her health status. In cases of chronic diseases, the stigma of an uncertain future is a norm; it dominates and often suppresses the everyday routine. In this context, the need of training in self-management appears to be a pressing one in socially significant diseases, and is aimed at helping patients, especially elderly and old ones, cope with the clinical symptoms, with the psycho-social consequences in the way of life and with the changes in risky behavior.
AIM: Researching the level of informity of people aged 65 or more, considering activities for self-observation and self-control and resources of health information.
MATERIALS AND METHODS: An anonymous survey of randomly selected 340 people aged 60 and over was conducted in the period from April 2020 to February 2021. Methods applied: Descriptive statistics with amount-measured quantities. To analyses the data there have been used: Dispersive analysis (one-way ANOVA), alternative analysis, non-parametric analysis-Pearson’s criterion of agreement (χ2 –ksi-square) at the testing of hypotheses for statistically significant correlation between factorial and resultative indices; and correlational analysis according to Spearman and graphic analysis. For standard of significance of the zero hypothesis, there has been perceived p < 0.05.
RESULTS: The obtained data serve as sufficient grounds to claim that the level of awareness of the use of simple diagnostic activities for self-management and self-control is inadequate in view of the predominant chronic conditions. The information requested by the respondents reflects significant educational needs connected mainly with their condition–77.9%, drug therapy–54.4%, behavioral risk factors and prophylactic measures and recommendations.
CONCLUSION: The respondents showed clearly expressed preferences, willingness, and desire to be informed by medical specialists–doctors and nurses. Their contribution in the sphere of health education so far has been insufficient, humble, and yet to develop its full potential.
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Lahera García A, Cano Jiménez A, Lahera Juliá V, García Vallejo O. Impacto de la formación en pacientes con diabetes y/o hipertensión para la prevención de la enfermedad renal y cardiovascular en el ámbito de Atención Primaria. Semergen 2022; 48:235-244. [DOI: 10.1016/j.semerg.2021.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022]
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Alves AM, Rodrigues A, Sa-Couto P, Simões JL. Effect of an Educational Nursing Intervention on the Mental Adjustment of Patients with Chronic Arterial Hypertension: An Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:170. [PMID: 35010430 PMCID: PMC8750213 DOI: 10.3390/ijerph19010170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 06/14/2023]
Abstract
The objective of this analytical and interventional prospective quantitative study was to assess the effect of an educational intervention performed by nurses for mental adjustment to chronic disease in patients with hypertension. A convenience sample was studied, composed of 329 participants with chronic hypertension, followed in a primary healthcare unit in the Central Region of Portugal. Data collection was carried out by applying the Mental Adjustment to Disease Scale (MADS) before and 1 month after the educational nursing intervention between September 2017 and February 2018. Prior to the application of the educational intervention, 43.5% of the participants were classified as "unadjusted" in at least one of the subscales of MADS. After the educational intervention, 21.3% of the participants classified as "unadjusted" became "adjusted" in all MADS subscales. The success rate of the intervention varied from 26.9% (in the fatalism subscale) to 44.6% (for the anxious concern subscale). Participants were more likely to be mentally "unadjusted" to hypertension if they lived with other family members, had an active professional situation before the diagnosis of hypertension, still had an active professional situation now, were under 65 years old, had a shorter time to diagnosis (1-2 years), and measured blood pressure less regularly. The educational intervention performed by nurses is relevant for the mental adjustment of hypertensive patients, contributing to increased knowledge, as well as improvement in preventive and self-care practices, facilitating the experience of the health/disease transition process.
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Affiliation(s)
- Ana Margarida Alves
- Inpatient Service of Surgical Specialties, Centro Hospitalar do Baixo Vouga E.P.E., 3810-164 Aveiro, Portugal;
| | - Alexandre Rodrigues
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Center for Health Studies and Research, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Pedro Sa-Couto
- Centre for Research and Development in Mathematics and Applications (CIDMA), Department of Mathematics (DMAT), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - João Lindo Simões
- School of Health Sciences (ESSUA), University of Aveiro, 3810-193 Aveiro, Portugal;
- Institute of Biomedicine (iBiMED), University of Aveiro, 3810-193 Aveiro, Portugal
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Effect of a repeated educational intervention versus an initial intervention on blood pressure control in hypertensive patients. Med Clin (Barc) 2021; 158:406-412. [PMID: 34373072 DOI: 10.1016/j.medcli.2021.04.032] [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: 01/08/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND OBJECTIVES Hypertension is one of the main cardiovascular risk factors. An educational intervention, aimed at increasing or reinforcing the patient's knowledge, can contribute to better control of their blood pressure. Our goal was to evaluate the efficacy of a continuing therapeutic education versus an initial intervention in hypertensive patients. METHODS Experimental study of multicenter community intervention, through the application of a therapeutic education program in hypertension. RESULTS 980 patients on antihypertensive treatment were included, 490 in each group, with a mean age of 65 years, and 50% women, baseline mean SBP in both groups was136 mmHg. Regarding knowledge about hypertension, although a similar initial improvement was observed in both groups, at the end of the study, in the continuous intervention group (CIG) an average of 23.06 correct answers was observed, while in the Initial intervention group (IIG) the mean was 20.91, being the difference statistically significant (p < 0.001). At the end of the study, the mean SBP was 127.5 mmHg in the CIG and 136.57 mmHg in the IIG group. Likewise, a lower percentage of patients with a BMI ≥25 was observed in the CIG (78.2%) than in the IIG 82.6%, this difference being statistically significant (p < 0.001). This same effect was observed on the abdominal perimeter, observing an increased abdominal perimeter in 46.3% of the CIG compared to 68.8% in the IIG (p < 0.001). CONCLUSIóN: A continuous educational intervention increases the degree of knowledge about hypertension compared to an initial intervention. Likewise, this intervention is associated with an improvement in blood pressure, weight, body mass index and abdominal girth figures.
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Estrada D, Sierra C, Soriano RM, Jordán AI, Plaza N, Fernández C. Grado de conocimiento de la hipertensión en pacientes hipertensos. ENFERMERIA CLINICA 2020; 30:99-107. [DOI: 10.1016/j.enfcli.2018.11.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 11/28/2018] [Indexed: 01/07/2023]
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The Effect of Training on Knowledge, Attitude, and Practice in Patients with Hypertension; The Application of the Expanded Chronic Care Model: A Clinical Trial Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2018. [DOI: 10.5812/ircmj.61693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Tarverdizade Asl P, Lakdizaji S, Ghahramanian A, Seyedrasooli A, Ghavipanjeh Rezaiy S. Effectiveness of Text Messaging and Face to Face Training on Improving Knowledge and Quality of Life of Patients undergoing Hemodialysis: a Randomized Clinical Trial. J Caring Sci 2018; 7:95-100. [PMID: 29977880 PMCID: PMC6029648 DOI: 10.15171/jcs.2018.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 02/03/2017] [Indexed: 01/22/2023] Open
Abstract
Background: The quality of life of patients undergoing hemodialysis is lower; to improve their living conditions, patients need further training. This study conducted to compare the effectiveness of two methods of text messaging and face to face education on knowledge and quality of life of patients under hemodialysis.
Methods: Undergoing in a clinical trial study, 60 patients undergoing hemodialysis in Sina-teaching hospital of Tabriz, Iran were selected by convenience sampling and randomly allocated into three groups: two intervention groups: text massaging (P=20), face to face group (n=20) and one control group (n=20). Their knowledge and quality of life were assessed and compared by Chronic Hemodialysis Knowledge Survey (CHeKS) and Kidney Disease Quality of Life-short form (KDQOL-SF) questionnaires. Data were analyzed by SPSS version 13.
Results: After intervention, the knowledge of text messaging and face to face groups were significantly more than the control group, but the quality of life scores after intervention had not any significant difference among the three groups. Intra-group comparisons showed that quality of life in face to face group have been significantly increased.
Conclusion: Text messaging and face to face teaching were effective on improving knowledge of patients undergoing hemodialysis. However, the effectiveness of these methods on quality of life needs further evaluations in different setting for longer times in hemodialysis patients.
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Affiliation(s)
- Pouya Tarverdizade Asl
- Department of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Science, Tabriz, Iran
| | - Sima Lakdizaji
- Department of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Science, Tabriz, Iran
| | - Akram Ghahramanian
- Department of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Science, Hematology and Oncology Research Center, Tabriz, Iran
| | - Alehe Seyedrasooli
- Department of Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Science, Tabriz, Iran
| | - Somayeh Ghavipanjeh Rezaiy
- Department of Nursing, Nursing and Midwifery Faculty, Maragheh University of Medical Sciences, Maragheh, Iran
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Tinsel I, Siegel A, Schmoor C, Buchholz A, Niebling W. DECADE-pilot: decision aid, action planning, and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases-a protocol of a randomized controlled pilot trial. Pilot Feasibility Stud 2017; 3:32. [PMID: 28808581 PMCID: PMC5549435 DOI: 10.1186/s40814-017-0172-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 07/06/2017] [Indexed: 11/21/2022] Open
Abstract
Background A healthy lifestyle can reduce cardiovascular risk (CVR) and prevent premature death. Usually most patients at increased CVR have difficulties implementing the necessary health behavior changes, such as smoking cessation, increasing of physical activity, healthy diet, stress reduction, etc. In this pilot study, a new intervention (DECADE) that includes a cardiovascular risk calculation, evidence-based decision aids, action planning, and follow-up support for patients to reduce their 10-year risk of cardiovascular diseases will be tested in primary care. The objectives of this trial are to test (1) the feasibility of the study design in preparation for the main trail including (2) the usability and acceptance of DECADE, and (3) initial data to ascertain that changes can be observed in these patients. Methods This randomized controlled pilot trial will generate initial data on the potential effects of DECADE on patients’ self-evaluated activity and behavior change as well as on clinical outcomes such as blood pressure, cholesterol, body mass index (BMI), HbA1C, and CVR score. In the qualitative part of the study, we will analyze data collected in semi-structured interviews with participating general practitioners (GP) and in patient questionnaires. Discussion The outcomes of this pilot study will indicate whether DECADE is a promising intervention in the domain of patient-centered prevention of cardiovascular diseases (CVD) and whether a larger multi-center randomized controlled trial is feasible. Trial registration German Clinical Trials Register (DRKS), DRKS00010584 Electronic supplementary material The online version of this article (doi:10.1186/s40814-017-0172-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Iris Tinsel
- Division of General Practice, Medical Center-University of Freiburg, Faculty of Medicine, Elsässerstr. 2m, 79110 Freiburg, Germany
| | - Achim Siegel
- Division of General Practice, Medical Center-University of Freiburg, Faculty of Medicine, Elsässerstr. 2m, 79110 Freiburg, Germany
| | - Claudia Schmoor
- Clinical Trials Unit, Faculty of Medicine, Medical Center-University of Freiburg, Elsässerstr. 2, 79110 Freiburg, Germany
| | - Anika Buchholz
- Clinical Trials Unit, Faculty of Medicine, Medical Center-University of Freiburg, Elsässerstr. 2, 79110 Freiburg, Germany.,Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Wilhelm Niebling
- Division of General Practice, Medical Center-University of Freiburg, Faculty of Medicine, Elsässerstr. 2m, 79110 Freiburg, Germany
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