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Sovaila S, Purcarea A, Neculau A. Chronic pain, a narrative review for the internist in 2024. ROMANIAN JOURNAL OF INTERNAL MEDICINE = REVUE ROUMAINE DE MEDECINE INTERNE 2024; 62:124-137. [PMID: 38153854 DOI: 10.2478/rjim-2023-0035] [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: 12/07/2023] [Indexed: 12/30/2023]
Abstract
Chronic pain is a complex and pervasive condition that profoundly affects individuals physically, emotionally, and socially. This narrative review aims to provide internists and healthcare professionals with a comprehensive overview of chronic pain, its various types, pathophysiology, epidemiology, clinical presentation, evaluation tools, and the burden it imposes on patients. We discuss the importance of recognizing chronic pain as a legitimate condition and the need for a compassionate, individualized approach to management. The review highlights the role of both pharmacological and non-pharmacological interventions in treating chronic pain, emphasizing the value of reducing pain, improving function, enhancing quality of life, and minimizing medication dependence. Additionally, we touch upon the promising future of pain treatment, including advancements in technology and personalized medicine. While not a comprehensive systematic review, this article serves as a valuable resource for healthcare providers seeking to understand, manage, and treat chronic pain effectively in their daily practice.
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Affiliation(s)
- Silvia Sovaila
- 1Department of Internal Medicine, Faculty of Medicine, "Transilvania" University Braşov, Romania
- 3Internist.ro Clinic, Braşov, Romania
| | - Adrian Purcarea
- 2Department of Fundamental, Prophylactic and Clinical Sciences, Faculty of Medicine, "Transilvania" University Braşov; Romania
- 3Internist.ro Clinic, Braşov, Romania
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De-Diego-Cordero R, Velasco-Domínguez C, Aranda-Jerez A, Vega-Escaño J. The Spiritual Aspect of Pain: An Integrative Review. JOURNAL OF RELIGION AND HEALTH 2024; 63:159-184. [PMID: 37573533 PMCID: PMC10861647 DOI: 10.1007/s10943-023-01890-9] [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] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Pain is an unpleasant sensory and emotional experience that affects individuals in various ways involving biological, psychological, social, and spiritual aspects. There is currently no comprehensive treatment that effectively addresses all aspects of pain. This integrative review aimed to analyze the spiritual aspect of pain relief. Following the specified methodological criteria, a total of 20 articles were selected. There evidenced a lack of spiritual care provided by healthcare professionals, even though its correlation with pain and its potential benefits have been widely demonstrated in the literature. Fortunately, some patients put into practice existential and religious tools to self-control and cope with their pain, although not always with a successful response.
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Affiliation(s)
- Rocío De-Diego-Cordero
- Research Group PAIDI-CTS 969 Innovation in HealthCare and Social Determinants of Health, Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009, Seville, Spain
| | | | - Alicia Aranda-Jerez
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009, Seville, Spain
| | - Juan Vega-Escaño
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, C/ Avenzoar 6, 41009, Seville, Spain.
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Zhu GC, Chen KM, Belcastro F. Effects of Different Mind-body Exercises in Managing Chronic Pain of Older Adults: A Network Meta-analysis of Randomized Trials. Geriatr Nurs 2024; 55:183-190. [PMID: 38007907 DOI: 10.1016/j.gerinurse.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/13/2023] [Accepted: 11/14/2023] [Indexed: 11/28/2023]
Abstract
INTRODUCTION Mind-body exercises (MBEs) were shown to be effective in managing chronic pain among older adults in several recent studies. However, the differences in the effects of different MBEs remained unclear. OBJECTIVE To compare the effects of different MBEs in managing chronic pain in older adults. METHODS Eight databases were searched for studies published between 2012 and 2023, and 14 studies were included in this systematic review and network meta-analysis (NMA). The NMA was performed using R and Metainsight. RESULTS Results showed that tai chi and yoga were effective in alleviating chronic pain, but their effects were not superior to traditional physical exercises and other MBEs. In addition, none of the MBEs were shown to be effective in mitigating chronic pain-related disabilities. CONCLUSION Tai chi and yoga can be used for relieving chronic pain in older adults; however, MBE programs alone were not sufficient to mitigate chronic pain-related disabilities.
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Affiliation(s)
- Guan-Cheng Zhu
- PhD, Postdoctoral Fellow; Center for Long-Term Care Research, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan 80708; Tel: 886-7-3121101.
| | - Kuei-Min Chen
- PhD, RN, FAAN, Professor; College of Nursing, Kaohsiung Medical University; 100 Shih-Chuan 1st Rd., Sanmin District, Kaohsiung, Taiwan 80708; Center for Long-Term Care Research, Kaohsiung Medical University; Department of Medical Research, Kaohsiung Medical University Hospital.
| | - Frank Belcastro
- PhD, Professor; Department of Education and Psychology, University of Dubuque; 2000 University Ave., Dubuque, Iowa 52001, USA.
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Nair PMK, Kriplani S, Kodali PB, Maheshwari A, Bhalavat KD, Singh D, Saini S, Yadav D, Keswani J, Silwal K, Sharma H, Tewani GR. Characteristics of patients who use yoga for pain management in Indian yoga and naturopathy settings: a retrospective review of electronic medical records. FRONTIERS IN PAIN RESEARCH 2023; 4:1185280. [PMID: 37396143 PMCID: PMC10308043 DOI: 10.3389/fpain.2023.1185280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Objectives The aim of this study is to identify the characteristics of patients who underwent yoga therapy for pain in yoga and naturopathy clinical settings in India. Methods Electronic medical records of patients who received yoga therapy for pain in three inpatient yoga and naturopathy hospitals were reviewed retrospectively from January 2021 to September 2022. Demographic characteristics and details on pain condition, socioeconomic status, comorbidities, ancillary therapies received, and insurance status were collected. In addition, we prospectively collected data on adherence to yoga practice through a telephonic interview. Results A total of 984 patients were identified from a pool of 3,164 patients who received yoga therapy for pain for an average of 9.48 (1.13) days. Patients aged between 8 and 80 underwent therapy for varying pain conditions and diseases that include pain in the extremities, pain due to infection, trauma, degenerative diseases, autoimmune diseases, and spine and neurological diseases. The majority of the patients were females (66.3%), from middle class families (74.8%), and who did not have any insurance coverage (93.8%). Most of the patients were under naturopathy treatment (99.8%), followed by ayurveda (56%), and physiotherapy (49.3%), along with yoga therapy. All patients reported a significant reduction in pain post-integrated yoga therapy (p < 0.001). Adherence to yoga was significantly associated with underlying pain conditions, the presence of comorbidities, the types of therapies used, and socioeconomic status (p < 0.001). Conclusion This study highlights the real-time application of yoga in pain management in Indian yoga and naturopathy settings, as well as implications for future research.
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Affiliation(s)
- Pradeep M. K. Nair
- Department of Research, Sant Hirdaram Medical College of Naturopathy and Yogic Sciences for Women, Bhopal, India
| | - Sucheta Kriplani
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | - Prakash Babu Kodali
- Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, India
| | - Ayush Maheshwari
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | | | - Deepika Singh
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | - Sanjeev Saini
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | - Dinesh Yadav
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | - Jyoti Keswani
- Department of Yoga, Sant Hirdaram Medical College of Naturopathy and Yogic Sciences for Women, Bhopal, India
| | - Karishma Silwal
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
| | - Hemanshu Sharma
- Department of Community Medicine, Sant Hirdaram Medical College of Naturopathy and Yogic Sciences for Women, Bhopal, India
| | - Gulab Rai Tewani
- Department of Yoga and Naturopathy, Sant Hirdaram Yoga and Nature Cure Hospital, Bhopal, India
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Loewenthal J, Innes KE, Mitzner M, Mita C, Orkaby AR. Effect of Yoga on Frailty in Older Adults : A Systematic Review. Ann Intern Med 2023; 176:524-535. [PMID: 36913687 DOI: 10.7326/m22-2553] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
BACKGROUND Yoga, a multicomponent mind-body practice, improves several domains of physical and psychological health and may affect frailty in older adults. PURPOSE To evaluate the available trial evidence on the effect of yoga-based interventions on frailty in older adults. DATA SOURCES MEDLINE, EMBASE, and Cochrane Central from their inception to 12 December 2022. STUDY SELECTION Randomized controlled trials evaluating the effect of yoga-based interventions, including at least 1 session of physical postures, on a validated frailty scale or single-item markers of frailty in adults aged 65 years or older. DATA EXTRACTION Two authors independently screened articles and extracted data; 1 author assessed risk of bias with review from a second author. Disagreements were resolved through consensus and as-needed input from a third author. DATA SYNTHESIS Thirty-three studies (n = 2384 participants) were identified in varied populations, including community dwellers, nursing home residents, and those with chronic disease. Yoga styles were primarily based on Hatha yoga and most often included Iyengar or chair-based methods. Single-item frailty markers included measures of gait speed, handgrip strength, balance, lower-extremity strength and endurance, and multicomponent physical performance measures; no studies included a validated definition of frailty. When compared with education or inactive control, there was moderate-certainty evidence that yoga improved gait speed and lower-extremity strength and endurance, low-certainty evidence for balance and multicomponent physical function measures, and very low-certainty evidence for handgrip strength. LIMITATION Heterogeneity in study design and yoga style, small sample sizes, and reporting deficiencies leading to concerns for selection bias. CONCLUSION Yoga may affect frailty markers that are associated with clinically meaningful outcomes in older adult populations but may not offer benefit over active interventions (for example, exercise). PRIMARY FUNDING SOURCE None. (PROSPERO: CRD42020130303).
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Affiliation(s)
- Julia Loewenthal
- Division of Aging, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (J.L.)
| | - Kim E Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, West Virginia (K.E.I.)
| | - Margalit Mitzner
- Renaissance School of Medicine at Stony Brook University, Stony Brook, New York (M.M.)
| | - Carol Mita
- Countway Library, Harvard Medical School, Boston, Massachusetts (C.M.)
| | - Ariela R Orkaby
- Division of Aging, Brigham and Women's Hospital, Harvard Medical School, and New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts (A.R.O.)
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Wu YC, Shen SF, Lee SY, Chen LK, Tung HH. The effectiveness of mind-body approaches for enhancing resilience in older adults: A systematic review and network meta-analysis. Arch Gerontol Geriatr 2023; 109:104949. [PMID: 36796181 DOI: 10.1016/j.archger.2023.104949] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/16/2023] [Accepted: 01/27/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Resilience in older adults is associated with good well-being and resilience training has been shown to be beneficial. Mind-body approaches (MBAs) combine physical and psychological training in age-appropriate exercise programs.This study aims to evaluate the comparative effectiveness of different modes of MBAs in enhancing resilience in older adults. METHOD Electronic databases and a manual search were searched to identify randomized controlled trials of different MBA modes. Data from the included studies were extracted for fixed-effect pairwise meta-analyses. Quality and risk were assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) and Cochrane's Risk of Bias tool, respectively. Pooled effect sizes with a standardized mean difference (SMD) and a 95% confidence interval (CI) were used to quantify the impact of MBAs in enhancing resilience in older adults. Network meta-analysis was employed to evaluate the comparative effectiveness of different interventions. The study was registered in PROSPERO (Registration No. CRD42022352269). RESULTS Nine studies were included in our analysis. Pairwise comparisons indicated that MBAs, regardless of whether they were related to yoga, could significantly enhancing resilience in older adults (SMD: 0.26, 95% CI 0.09-0.44). With strong consistency, a network meta-analysis showed that physical and psychological programs and yoga-related programs were associated with resilience improvement (SMD: 0.44, 95% CI 0.01-0.88 and SMD: 0.42, 95% CI 0.06-0.79, respectively). CONCLUSION High quality evidence demonstrates that two MBA modes-physical and psychological programs and yoga-related programs-enhance resilience in older adults. However, long-term clinical verification is required to confirm our results.
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Affiliation(s)
- Yi-Chen Wu
- Doctoral Program, Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan, R.O.C; Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan, R.O.C
| | - Shu-Fen Shen
- Department of Nursing, National Yang Ming Chiao Tung University, Taipei 112, Taiwan, R.O.C; Department of Nursing, Anjia home care, New Taipei City, Taiwan, ROC
| | - Szu-Ying Lee
- Assistant Professor, Department of Nursing, Mackay Medical College, New Taipei City 25245, Taiwan, R.O.C
| | | | - Heng-Hsin Tung
- Department of Nursing, National Yang Ming Chiao Tung University, Consultant, Tungs' Taichung MetroHarbor Hospital, Taipei 112, Taiwan, R.O.C.
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Sadacharan CM. Research study on the effects of multi-component exercise on older adults with chronic conditions. J Sports Med Phys Fitness 2023; 63:144-154. [PMID: 35333032 DOI: 10.23736/s0022-4707.22.13697-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Multicomponent exercises involving eccentric contraction (ECC) exercise, chair yoga (CY) and tai chi (TC) are practiced extensively to treat older adults with chronic conditions. The study investigated the effect of CY and TC performance after various intensity of ECC exercise induced muscle pain, delayed onset of muscle sores (DOMS), and strength in sedentary older adults. METHODS Nine sedentary older adults with chronic condition(s) aged between 60 and 90 performed CY and TC after ECC exercise protocol for 9 weeks. The medical preprotocol, ECC exercise, CY, and TC performance, subjective (health activities of daily living [ADL] difficulty scale; Visual Analog Scale [VAS], and DOMS), objective (pressure pain threshold [PPT]), and medical postprotocol assessments were carried out and compared the physical status before and after the protocol. RESULTS Our results show that functional limitations, DOMS, VAS, and PPT levels were improved in the CY and TC performed weeks 3, 4, 7, and 8 compared to ECC exercise weeks 2 and 6. The manual muscle testing (MMT), active range of motion (AROM), and maximal voluntary isometric contraction (MVIC) were improved and showed significant differences on the weak muscle groups. The mean Tinetti balance and gait score, and general endurance showed significant difference. CONCLUSIONS Our findings have important implications for clinical exercise prescription as low perceived CY and TC, and ECC exercise might suit well for older adults with chronic conditions. Performing multicomponent exercises can help to reduce the risk of injury from falls and prevent age-related mobility, balance, and physical function decline in older adults.
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Affiliation(s)
- Chakravarthy M Sadacharan
- Department of Biomedical Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA -
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Research on the Protection of Extensor and Flexor Muscles in the Waist and Back of Competitive Athletes. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7378953. [PMID: 35832853 PMCID: PMC9273441 DOI: 10.1155/2022/7378953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/09/2022] [Accepted: 06/23/2022] [Indexed: 01/01/2023]
Abstract
In the past, in the study of special sports quality of heavy antagonistic sports events, the study of strength quality training was emphasized. The transformation of athletes' strength quality to special strength was highlighted, and the special exercises which tended to be consistent with the characteristics of wrestling events were added. However, in competition and training, athletes' spine bears a heavy load. Long-term static contraction of lumbar muscles can lead to excessive local load and injury of lumbar muscles. In this paper, the test results of athletes' joints are analyzed, and the waist protection scheme for athletes' strength training is obtained. First of all, solve the problem of athletes' action mode and improve athletes' muscle endurance. All special sports quality evaluation can reach a good level. Then, enhance athletes' explosive power. Thus, all special sports quality evaluations can reach an excellent level. It is concluded that the waist and back are the key parts to support their participation in various sports, maintain body balance, and realize power transmission. Through the study, it is found that there are significant differences in the muscle strength indexes of the maximum strength of the waist and back of athletes of different levels, which fully proves the characteristics of the maximum strength of the waist and back. Through the test, we can understand the flexion and extension strength, range, speed, force, and flexion and extension ratio of athletes' joints and take timely optimization measures according to the test results to avoid sports injuries in training. It has a key guiding significance for the measurement, analysis, and evaluation of athletes' joint muscle strength, as well as rehabilitation training after injury and prevention of reinjury.
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Dutta A, Aruchunan M, Mukherjee A, Metri KG, Ghosh K, Basu-Ray I. A Comprehensive Review of Yoga Research in 2020. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:114-123. [PMID: 35099279 DOI: 10.1089/jicm.2021.0420] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Objectives: Accumulated evidence garnered in the last few decades has highlighted the role of yoga in health and disease. The overwhelming mortality and morbidity mediated by noncommunicable epidemics such as heart disease and cancer have fostered a search for mechanisms to attenuate them. Despite overwhelming success in acute care, the efficacy of modern medicines has been limited on this front. Yoga is one of the integrative therapies that has come to light as having a substantial role in preventing and mitigating such disorders. It thus seems trite to analyze and discuss the research advancements in yoga for 2020. The present review attempts to distill recent research highlights from voluminous literature generated in 2020. Methods: This review was conducted on the articles published or assigned to an issue in 2020. The authors searched the PubMed database for clinical studies published in the English language, using yoga (including meditation) as the intervention, and having an adequate description of the intervention. Then, they extracted data from each study into a standardized Google sheet. Results: A total of 1149 citations were retrieved in the initial search. Of these, 46 studies met eligibility criteria and were finally included. The studies were predominantly on mental health and neuropsychology, addressing various issues such as anxiety, postural balance, migraine, academic performance, and childhood neglect. Anxiety, stress, and depression were other common denominators. Eight studies were on cardiorespiratory systems, including exercise capacity, cardiac rehabilitation, myocardial infarction, and hypertension. Three studies were on diabetes, evaluating the effect of yoga. Five studies focused on cognition, health status, and autonomic regulation and few others included cancers, infertility, ulcerative colitis, urinary incontinence, restless leg syndrome, rheumatoid arthritis, chronic pain, and metabolic syndrome. Finally, most studies were on noncommunicable diseases with one exception, human immunodeficiency virus; two randomized controlled trials were dedicated to it. Conclusions: Yoga has been studied under a wide variety of clinicopathological conditions in the year 2020. This landscape review intends to provide an idea of the role of yoga in various clinical conditions and its future therapeutic implications.
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Affiliation(s)
- Abhijit Dutta
- Advanced Yoga Research Council, AAYM, Germantown, TN, USA
| | - Mooventhan Aruchunan
- Department of Research, Government Yoga and Naturopathy Medical College, Chennai, India
| | | | | | - Kuntal Ghosh
- Department of Yoga, Manipur University, Imphal, India
| | - Indranill Basu-Ray
- Department of Cardiology, Memphis VA Medical Center, Memphis, TN, USA
- School of Public Health, The University of Memphis, Memphis, TN, USA
- Integrative Cardiology, All India Institute of Medical Sciences, Rishikesh, India
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Maza AR, Pionke JJ, Gothe NP. Mind-body interventions involving a home-based component to improve functional fitness outcomes in adults: A scoping review. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2021.102095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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