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Zhang W, Chen B, Yoda Y, Shima M, Zhao C, Ji X, Wang J, Liao S, Jiang S, Li L, Chen Y, Guo X, Deng F. Ambient ultrafine particles exacerbate oxygen desaturation during sleep in patients with chronic obstructive pulmonary disease: New insights into the effect spectrum of ultrafine particles on susceptible populations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 947:174519. [PMID: 38972410 DOI: 10.1016/j.scitotenv.2024.174519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/09/2024] [Accepted: 07/03/2024] [Indexed: 07/09/2024]
Abstract
The health effects of ultrafine particles (UFPs) are of growing global concern, but the epidemiological evidence remains limited. Sleep-disordered breathing (SDB) characterized by hypoxemia is a prevalent condition linked to many debilitating chronic diseases. However, the role of UFPs in the development of SDB is lacking. Therefore, this prospective panel study was performed to specifically investigate the association of short-term exposure to UFPs with SDB parameters in patients with chronic obstructive pulmonary disease (COPD). Ninety-one COPD patients completed 226 clinical visits in Beijing, China. Personal exposure to ambient UFPs of 0-7 days was estimated based on infiltration factor and time-activity pattern. Real-time monitoring of sleep oxygen saturation, spirometry, respiratory questionnaires and airway inflammation detection were performed at each clinical visit. Generalized estimating equation was used to estimate the effects of UFPs. Exposure to UFPs was significantly associated with increased oxygen desaturation index (ODI) and percent of the time with oxygen saturation below 90 % (T90), with estimates of 21.50 % (95%CI: 6.38 %, 38.76 %) and 18.75 % (95%CI: 2.83 %, 37.14 %), respectively, per 3442 particles/cm3 increment of UFPs at lag 0-3 h. Particularly, UFPs' exposure within 0-7 days was positively associated with the concentration of alveolar nitric oxide (CaNO), and alveolar eosinophilic inflammation measured by CaNO exceeding 5 ppb was associated with 29.63 % and 33.48 % increases in ODI and T90, respectively. In addition, amplified effects on oxygen desaturation were observed in current smokers. Notably, individuals with better lung function and activity tolerance were more affected by ambient UFPs due to longer time spent outdoors. To our knowledge, this is the first study to link UFPs to hypoxemia during sleep and uncover the key role of alveolar eosinophilic inflammation. Our findings provide new insights into the effect spectrum of UFPs and potential environmental and behavioral intervention strategies to protect susceptible populations.
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Affiliation(s)
- Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yoshiko Yoda
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Chen Zhao
- Community Health Service Center, Huayuan Road, Haidian District, Beijing 100088, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Junyi Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Sha Liao
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Simin Jiang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
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Brems JH, Raju S. An Issue of Caliber: The Airway Tree and Air Pollution Susceptibility. Am J Respir Crit Care Med 2024; 209:1294-1295. [PMID: 38394649 PMCID: PMC11146566 DOI: 10.1164/rccm.202401-0146ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/23/2024] [Indexed: 02/25/2024] Open
Affiliation(s)
- J Henry Brems
- Division of Pulmonary and Critical Care Medicine Johns Hopkins University Baltimore, Maryland
| | - Sarath Raju
- Division of Pulmonary and Critical Care Medicine Johns Hopkins University Baltimore, Maryland
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Maeda T, Dransfield MT. Chronic obstructive pulmonary disease and cardiovascular disease: mechanistic links and implications for practice. Curr Opin Pulm Med 2024; 30:141-149. [PMID: 38085609 PMCID: PMC10948016 DOI: 10.1097/mcp.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are both significant burdens on the healthcare system and often coexist. Mechanistic links between the two conditions and their clinical impact are increasingly understood. RECENT FINDINGS Recent studies demonstrate multiple mechanisms by which the pathobiology of COPD may have negative effects on the cardiovascular system. These include extrapulmonary consequences of the COPD inflammatory state, cardiac autonomic dysfunction, which has been recently implicated in worsening respiratory symptoms and exacerbation risk, and mechanical effects of lung hyperinflation on left ventricular diastolic function.Clinical studies have consistently shown a high prevalence of CVD in COPD patients and worsened outcomes (and vice versa ). Exacerbations of COPD have also been demonstrated to dramatically increase the risk of cardiovascular events. While some safety concerns exist, medications for COPD and cardiovascular disease should be used in accordance with respective guidelines. However, real-world data show suboptimal management for patients with COPD and CVD. SUMMARY COPD and cardiovascular disease have complicated interrelationships. Further mechanistic studies may lead to defining better targets for interventions. Education for medical professionals and implementation of novel screening protocols should be encouraged to fill in the gaps in clinical care for these patients.
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Affiliation(s)
- Tetsuro Maeda
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Qi W, Liu L, Zeng Q, Zhou Z, Chen D, He B, Gong S, Gao L, Wang X, Xiong J, Cai D, Yu S, Zhao L. Contribution of cuproptosis and Cu metabolism-associated genes to chronic obstructive pulmonary disease. J Cell Mol Med 2023; 27:4034-4044. [PMID: 37801050 PMCID: PMC10747414 DOI: 10.1111/jcmm.17985] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023] Open
Abstract
Airway epithelial cell injury plays a crucial role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, a novel form of Cu-induced programmed cell death known as cuproptosis has not yet been thoroughly investigated in the context of COPD. Clinical reports have suggested that high copper exposure may increase the risk of COPD. In this study, we aimed to determine the expression and potential functions of cuproptosis-related genes and genes associated with copper metabolism in COPD. We initially identified 52 copper metabolism-related genes based on a review of the literature. Subsequently, we calculated the expression levels of these genes using data from four GEO datasets. To gain insights into the activated signalling pathways and underlying mechanisms in COPD patients, we conducted Gene Ontology (GO) and KEGG pathway analyses, examined protein-protein interactions, and performed weighted correlation network analysis. Our findings revealed that 18 key copper metabolism-related genes, including 5 cuproptosis-related genes, were significantly enriched in signalling pathways and biological processes associated with the development of COPD. Further analysis of clinical data and animal experiments confirmed the high expression of certain cuproptosis key regulators, such as DLD and CDKN2A, in both healthy smokers and COPD smokers. Additionally, these regulators exhibited abnormal expression in a COPD rat model. Notably, copper content was found to be elevated in the lung tissues of COPD rats, suggesting its potential involvement in cuproptosis. These findings provide an experimental foundation for further research into the role of cuproptosis in COPD. Targeting copper metabolism-related genes may represent an effective approach for the treatment of COPD.
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Affiliation(s)
- Wenchuan Qi
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture & Chronobiology Key Laboratory of Sichuan ProvinceChengduSichuanChina
| | - Lu Liu
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Qian Zeng
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Ziyang Zhou
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Daohong Chen
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Bin He
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Siyao Gong
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Lei Gao
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Xiao Wang
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture & Chronobiology Key Laboratory of Sichuan ProvinceChengduSichuanChina
| | - Jian Xiong
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
| | - Dingjun Cai
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture & Chronobiology Key Laboratory of Sichuan ProvinceChengduSichuanChina
| | - Shuguang Yu
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture & Chronobiology Key Laboratory of Sichuan ProvinceChengduSichuanChina
| | - Ling Zhao
- Acupuncture and Tuina SchoolChengdu University of Traditional Chinese MedicineChengduSichuanChina
- Acupuncture & Chronobiology Key Laboratory of Sichuan ProvinceChengduSichuanChina
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Walker ES, Stewart T, Jones D. Fine particulate matter infiltration at Western Montana residences during wildfire season. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 896:165238. [PMID: 37392877 PMCID: PMC10529724 DOI: 10.1016/j.scitotenv.2023.165238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND/AIMS Wildfire air pollution is a growing public health concern as wildfires increase in size, intensity, and duration in the United States. The public is often encouraged to stay indoors during wildfire smoke events to reduce exposure. However, there is limited information on how much wildfire smoke infiltrates indoors at residences and what household/behavioral characteristics contribute to higher infiltration. We assessed fine particulate matter (PM2.5) infiltration into Western Montana residences during wildfire season. METHODS We measured continuous outdoor and indoor PM2.5 concentrations from July-October 2022 at 20 residences in Western Montana during wildfire season using low-cost PM2.5 sensors. We used paired outdoor/indoor PM2.5 data from each household to calculate infiltration efficiency (Finf; range 0-1; higher values indicate more outdoor PM2.5 infiltration to the indoor environment) using previously validated methods. Analyses were conducted for all households combined and for various household subgroups. RESULTS Median (25th percentile, 75th percentile) daily outdoor PM2.5 at the households was 3.7 μg/m3 (2.1, 7.1) during the entire study period and 29.0 μg/m3 (19.0, 49.4) during a 2-week period in September impacted by wildfire smoke. Median daily indoor PM2.5 at the households was 2.5 μg/m3 (1.3, 5.5) overall and 10.4 μg/m3 (5.6, 21.0) during the wildfire period. Overall Finf was 0.34 (95 % Confidence Interval [95%CI]: 0.33, 0.35) with lower values during the wildfire period (0.32; 95%CI: 0.28, 0.36) versus non-wildfire period (0.39; 95%CI: 0.37, 0.42). Indoor PM2.5 concentrations and Finf varied substantially across household subgroups such as household income, age of the home, presence of air conditioning units, and use of portable air cleaners. CONCLUSIONS Indoor PM2.5 was substantially higher during wildfire-impacted periods versus the rest of the study. Indoor PM2.5 and Finf were highly variable across households. Our results highlight potentially modifiable behaviors and characteristics that can be used in targeted intervention strategies.
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Affiliation(s)
- Ethan S Walker
- Center for Population Health Research, University of Montana, Missoula, MT, USA.
| | - Taylor Stewart
- Center for Population Health Research, University of Montana, Missoula, MT, USA
| | - Dave Jones
- Center for Population Health Research, University of Montana, Missoula, MT, USA
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Balogun AO, Weigel MM, Estévez E, Armijos RX. Chronic Occupational Exposure to Traffic Pollution Is Associated with Increased Carotid Intima-Media Thickness in Healthy Urban Traffic Control Police. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6701. [PMID: 37681841 PMCID: PMC10487607 DOI: 10.3390/ijerph20176701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
Urban traffic officers in many low- and middle-income countries are exposed to high levels of traffic-related air pollutants (TRAP) while working vehicle control on heavily congested streets. The impact of chronic TRAP exposure on the cardiovascular health, including the carotid intima-media thickness (CIMT), of this outdoor occupational group remains unclear. This cross-sectional study compared the average mean and maximum CIMT measurements of two groups of relatively young, healthy traffic police (32 ± 7 years; 77% male) in Quito, Ecuador, who were without clinical evidence of serious cardiovascular or other disease. Previously published background data on PM10 (a TRAP surrogate) indicated that street levels of the pollutant were several orders of magnitude higher at the street intersections worked by traffic police compared to those working only in an office. Accordingly, officers permanently assigned to daily traffic control duties requiring them to stand 0-3 m from heavily trafficked street intersections were assigned to the high exposure group (n = 61). The control group (n = 54) consisted of officers from the same organization who were permanently assigned to office duties inside an administration building. Mean and maximum CIMT were measured with ultrasound. General linear models were used to compare the CIMT measurements of the high exposure and control groups, adjusting for covariates. The adjusted average mean and maximum CIMT measures of the high exposure group were increased by 11.5% and 10.3%, respectively, compared to the control group (p = 0.0001). These findings suggest that chronic occupational exposure to TRAP is associated with increased CIMT in traffic police. This is important since even small increases in arterial thickening over time may promote earlier progression to clinical disease and increased premature mortality risk.
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Affiliation(s)
- Abdulrazak O. Balogun
- Department of Safety and Occupational Health Applied Sciences, Keene State College, Keene, NH 03431, USA;
| | - M. Margaret Weigel
- Department of Environmental & Occupational Health, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47403, USA;
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
- IU Center for Global Health Equity, Indiana University, 702 Rotary Circle, Indianapolis, IN 46202, USA
| | - Edmundo Estévez
- Centro de Biomedicina, Universidad Central del Ecuador, Quito 170129, Ecuador;
- Postgraduate Program in Public Health, Universidad Autónoma Regional de los Andes (UNIANDES), Ambato 180150, Ecuador
| | - Rodrigo X. Armijos
- Department of Environmental & Occupational Health, School of Public Health, Indiana University-Bloomington, 1025 E. 7th Street, Bloomington, IN 47403, USA;
- Global Environmental Health Research Laboratory, Indiana University-Bloomington School of Public Health, Bloomington, IN 47405, USA
- Center for Latin American & Caribbean Studies, Indiana University-Bloomington, Bloomington, IN 47405, USA
- IU Center for Global Health Equity, Indiana University, 702 Rotary Circle, Indianapolis, IN 46202, USA
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Raju S, Woo H, Fawzy A, Putcha N, Balasubramanian A, Mathai SC, Berger RD, Hansel NN, McCormack MC. Decreased Cardiac Autonomic Function is Associated with Higher Exacerbation Risk and Symptom Burden in Chronic Obstructive Pulmonary Disease. CHRONIC OBSTRUCTIVE PULMONARY DISEASES (MIAMI, FLA.) 2023; 10:328-334. [PMID: 37267605 PMCID: PMC10484486 DOI: 10.15326/jcopdf.2023.0410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/04/2023]
Abstract
Current measures of chronic obstructive pulmonary disease (COPD) severity, including lung function, do not fully explain symptom burden, and there is a need to identify predictors of exacerbation risk and morbidity. Autonomic dysfunction may be implicated in both cardiovascular and respiratory morbidity in COPD and convey risk for exacerbations. Heart rate variability (HRV) is a marker of cardiac autonomic function that is predictive of cardiovascular health and has promise as a non-invasive COPD biomarker. The CLEAN AIR Heart study provided an opportunity to investigate the association between HRV and COPD morbidity among former smokers with moderate-severe COPD. Eighty-five participants, contributing 305 HRV measurements, underwent repeated clinical assessments over 4 study periods that included a 24-Holter monitoring assessment of HRV. HRV measures of interest were standard deviation of normal-to-normal intervals, (SDNN) (overall HRV) and root-mean-square of successive differences (RMSSD) (parasympathetic function). Exacerbation risk was assessed using negative binomial models, and mixed-effects models analyzed associations between HRV and symptoms. Decreases in SDNN (incidence rate ratio [IRR]1.40; 95% confidence interval [CI] 1.13 to1.74) and RMSSD (IRR 1.60; 95% CI 1.07 to 2.37) were associated with severe exacerbation risk. Decreases in SDNN were associated with higher St George's Respiratory Questionnaire scores, COPD Assessment Test scores, and chronic bronchitis symptoms. Findings demonstrate that HRV is associated with COPD symptom burden and exacerbation risk. HRV may represent an important biomarker with the potential to identify high-risk COPD populations.
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Affiliation(s)
- Sarath Raju
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Han Woo
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Ashraf Fawzy
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Nirupama Putcha
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Aparna Balasubramanian
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Stephen C. Mathai
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Ronald D. Berger
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
| | - Nadia N. Hansel
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
- Department of Environmental Health Sciences and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Meredith C. McCormack
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
- Department of Environmental Health Sciences and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Zhu Y, Chang D. Interactions between the lung microbiome and host immunity in chronic obstructive pulmonary disease. Chronic Dis Transl Med 2023. [DOI: 10.1002/cdt3.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Affiliation(s)
- Yixing Zhu
- Graduate School of The PLA General Hospital Beijing China
| | - De Chang
- Department of Respiratory and Critical Care Medicine, Eighth Medical Center, Department of Respiratory and Critical Care Seventh Medical Center Chinese PLA General Hospital Beijing China
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Croft DP, Utell MJ, Rich DQ. Can Long-term Residential Air Cleaning Reduce Cardiovascular Morbidity in Patients with Chronic Obstructive Pulmonary Disease? Am J Respir Crit Care Med 2023; 207:651-653. [PMID: 36470239 PMCID: PMC10037481 DOI: 10.1164/rccm.202211-2138ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Daniel P Croft
- Department of Medicine University of Rochester Medical Center Rochester, New York
| | - Mark J Utell
- Department of Medicine and Department of Environmental Medicine University of Rochester Medical Center Rochester, New York
| | - David Q Rich
- Department of Public Health Sciences Department of Medicine and Department of Environmental Medicine University of Rochester Medical Center Rochester, New York
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