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Abushanab D, Nasr ZG, Al-Badriyeh D. Efficacy and Safety of Colistin versus Tigecycline for Multi-Drug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens-A Meta-Analysis. Antibiotics (Basel) 2022; 11:antibiotics11111630. [PMID: 36421274 PMCID: PMC9686723 DOI: 10.3390/antibiotics11111630] [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: 08/15/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background: We intended to compare the efficacy and safety outcomes of colistin versus tigecycline as monotherapy or combination therapy against multi-drug resistant (MDR) and extensively drug-resistant (XDR) pathogens. Methods: A search was conducted in PubMed, Cochrane CENTRAL, EMBASE, and in the grey literature (i.e., ClinicalTrials.gov and Google Scholar) up to May 2021. Outcomes were clinical response, mortality, infection recurrence, and renal and hepatic toxicity. We pooled odd ratios (OR) using heterogeneity-guided random or fixed models at a statistical significance of p < 0.05. Results: Fourteen observational studies involving 1163 MDR/XDR pathogens, receiving tigecycline versus colistin monotherapy or combination, were included. Base-case analyses revealed insignificant differences in the clinical response, reinfection, and hepatic impairment. The 30-day mortality was significantly relatively reduced with tigecycline monotherapy (OR = 0.35, 95% CI 0.16−0.75, p = 0.007). The colistin monotherapy significantly relatively reduced in-hospital mortality (OR = 2.27, 95%CI 1.24−4.16, p = 0.008). Renal impairment rates were lower with tigecycline monotherapy or in combination, and were lower with monotherapy versus colistin-tigecycline combination. Low-risk of bias and moderate/high evidence quality were associated with all studies. Conclusions: Within the limitations of this study, it can be concluded that there were no statistically significant differences in main efficacy outcomes between colistin and tigecycline monotherapies or combinations against MDR/XDR infections, except for lower rates of 30-day mortality with tigecycline and in-hospital mortality with colistin. Tigecycline was associated with favourable renal toxicity outcomes.
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Affiliation(s)
- Dina Abushanab
- Department of Pharmacy, Hamad Medical Corporation, Doha 3050, Qatar
| | - Ziad G. Nasr
- College of Pharmacy, QU Health, Qatar University, Doha 2713, Qatar
| | - Daoud Al-Badriyeh
- College of Pharmacy, QU Health, Qatar University, Doha 2713, Qatar
- Correspondence: ; Tel.: +974-4403-5591; Fax: +974-4403-5551
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Almulla H, Hassouneh D. Home-Based Palliative Care and Home Health Care in Saudi Arabia: An Integrative Literature Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223221085684] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Aging populations and a rising disease burden have increased the need for palliative care (PC). Despite the growing demand for PC, only 14% of patients worldwide receive this service. Home-based PC is necessary because many people prefer to receive care and die at home. Nurses are well equipped to address diverse health care needs in the community and are critical to successful delivery of home-based PC. The purpose of this review is to synthesize and analyze literature relevant to home-based PC in Saudi Arabia with an emphasis on nursing. This purpose required us to examine literature in two areas: PC and home health care (HHC). We identified studies through database searches. We found 24 studies published between 2005 and 2021 that met quality and inclusion criteria. Although PC and HHC are associated with positive outcomes, lack of nurses’ knowledge and awareness of PC and the underdevelopment of HHC in Saudi Arabia have contributed to underuse of these services. Nurses are vital to the functioning of interdisciplinary teams and effective interfacing with patients, caregivers, and families. Education and training of nurses in Saudi Arabia is essential to promoting access to PC and HHC and the development of home-based PC in the kingdom.
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Affiliation(s)
- Halah Almulla
- Oregon Health & Science University, Portland, OR, USA
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Zhao J, Xu L, Dong Z, Zhang Y, Cao J, Yao J, Xing J. The LncRNA DUXAP10 Could Function as a Promising Oncogene in Human Cancer. Front Cell Dev Biol 2022; 10:832388. [PMID: 35186937 PMCID: PMC8850700 DOI: 10.3389/fcell.2022.832388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Cancer is one of the most prevalent and deadliest diseases globally, with an increasing morbidity of approximately 14 million new cancer cases per year. Identifying novel diagnostic and prognostic biomarkers for cancers is important for developing cancer therapeutic strategies and lowering mortality rates. Long noncoding RNAs (lncRNAs) represent a group of noncoding RNAs of more than 200 nucleotides that have been shown to participate in the development of human cancers. The novel lncRNA DUXAP10 was newly reported to be abnormally overexpressed in several cancers and positively correlated with poor clinical characteristics of cancer patients. Multiple studies have found that DUXAP10 widely regulates vital biological functions related to the development and progression of cancers, including cell proliferation, apoptosis, invasion, migration, and stemness, through different molecular mechanisms. The aim of this review was to recapitulate current findings regarding the roles of DUXAP10 in cancers and evaluate the potential of DUXAP10 as a novel biomarker for cancer diagnosis, treatment, and prognostic assessment.
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Affiliation(s)
- Junjie Zhao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lixia Xu
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zihui Dong
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yize Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junhua Cao
- Department of Plastic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jie Yao
- Department of Ultrasound, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiyuan Xing
- Department of Infectious Diseases, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Jiyuan Xing,
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Yamout R, Hanna J, El Asmar R, Beydoun H, Rahm M, Osman H. Preferred place of death for patients with terminal illness: A literature review. PROGRESS IN PALLIATIVE CARE 2021. [DOI: 10.1080/09699260.2021.1961985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Rana Yamout
- Department of Anesthesia and Pain Management, Palliative and Supportive Care Program, NKBCI, AUBMC, Beirut, Lebanon
| | - Janane Hanna
- Department of Anesthesia and Pain Management, AUBMC, Beirut, Lebanon
| | | | - Hanadi Beydoun
- Department of Anesthesia and Pain Management, Palliative and Supportive Care Program, NKBCI, AUBMC, Beirut, Lebanon
| | - Mira Rahm
- Department of Anesthesia and Pain Management, Palliative and Supportive Care Program, NKBCI, AUBMC, Beirut, Lebanon
| | - Hibah Osman
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
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Sadler K, Abudari G, Aljawi D, Snelling D. Deaths in the Emergency Department: An Assessment of Patient's End-of-Life Trajectory and Quality of Care. Indian J Palliat Care 2020; 26:352-357. [PMID: 33311879 PMCID: PMC7725167 DOI: 10.4103/ijpc.ijpc_206_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 03/26/2020] [Accepted: 03/31/2020] [Indexed: 11/24/2022] Open
Abstract
Background: A considerable proportion of deaths occur in the emergency department (ED), and yet a palliative care approach is not well integrated. End-of-life patients often either receive invasive care, or their care is neglected due to being perceived as not being “acutely” ill. While a small proportion of these deaths are of an unpredictable nature, most have identifiable dying trajectories: (a) advanced cancer, (b) organ failure, (c) chronic frailty, and (d) sudden death. Aims: This study aims (1) to determine the incidence, nature and illness trajectory of deaths in the ED; (2) to examine to which extent end of life discussions took place; (3) to analyze the aggressiveness of the care; and (4) to determine if palliative care services were being consulted. Methods: This retrospective study was conducted in a large tertiary hospital and cancer center in Saudi Arabia over a 1 year period. Data collection included demographics, clinical presentation, end-of-life care, and palliative care involvement. Results: Our study included 103 patients. Cancer was the main diagnosis (45.7%). Deaths were related to advanced cancer (45.6%), followed by organ failure (29.1%), sudden death (13.6%), and chronic frailty (11.7%,). 35.9% had a documented Do-Not-Attempt-Resuscitation (DNAR) status prior to admission. 51.5% received aggressive treatments. Palliative care was consulted for 19.4% of patients, among which 50% of referrals occurred 1 day prior to death. Conclusions: End-of-life care discussions tend to occur late in the disease trajectory; a number of patients are subjected to aggressive treatments, and palliative care services remain underutilized. An early, integrated and collaborative approach is warranted to address the challenges of end of life care.
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Affiliation(s)
- Kim Sadler
- Department of Oncology and Liver Transplant, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Gassan Abudari
- Department of Oncology and Liver Transplant, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Deena Aljawi
- Department of Oncology and Liver Transplant, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - David Snelling
- Adult Emergency Department, Penn State Health Milton S Hershey Medical Center, Pennsylvania, USA
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Sun Z, Guerriere DN, de Oliveira C, Coyte PC. Temporal trends in place of death for end-of-life patients: Evidence from Toronto, Canada. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1807-1816. [PMID: 32364288 DOI: 10.1111/hsc.13007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 06/11/2023]
Abstract
Understanding the temporal trends in the place of death among patients in receipt of home-based palliative care can help direct health policies and planning of health resources. This paper aims to assess the temporal trends in place of death and its determinants over the past decade for patients receiving home-based palliative care. This paper also examines the impact of early referral to home-based palliative care services on patient's place of death. Survey data collected in a home-based end-of-life care program in Toronto, Canada from 2005 to 2015 were analysed using a multivariate logistic model. The results suggest that the place of death for patients in receipt of home-based palliative care has changed over time, with more patients dying at home over 2006-2015 when compared to 2005. Also, early referral to home-based palliative care services may not increase a patient's likelihood of home death. Understanding the temporal shifts of place of death and the associated factors is essential for effective improvements in home-based palliative care programs and the development of end-of-life care policies.
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Affiliation(s)
- Zhuolu Sun
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Denise N Guerriere
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Canadian Center for Health Economics, Toronto, ON, Canada
| | - Claire de Oliveira
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Canadian Center for Health Economics, Toronto, ON, Canada
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Narayan AK, Al-Naemi H, Aly A, Kharita MH, Khera RD, Hajaj M, Rehani MM. Breast Cancer Detection in Qatar: Evaluation of Mammography Image Quality Using A Standardized Assessment Tool. Eur J Breast Health 2020; 16:124-128. [PMID: 32285034 DOI: 10.5152/ejbh.2020.5115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/01/2020] [Indexed: 11/22/2022]
Abstract
Objective Compared with other countries in the Middle East, Qatar has one of the highest breast cancer incidence and mortality rates. Poor quality mammography images may be associated with advanced stage breast cancer, however there is limited information about the quality of breast imaging in Qatar. Our purpose was to evaluate the clinical image quality of mammography examinations performed at a tertiary care center in Doha, Qatar using a standardized assessment tool. Materials and Methods Bilateral mammograms from consecutive patients from a tertiary care cancer center in Doha, Qatar were obtained. Proportions of examinations deemed adequate for interpretation were estimated. Standardized clinical image quality assessment form was utilized to evaluate image quality components. For each image, image quality components were given grades on a 1-5 scale (5-excellent, 4-good, 3-average, 2-fair, 1-poor). Mean scores with 95% confidence intervals were estimated for each component. Results Consecutive sample of 132 patients was obtained representing 528 mammographic images. Overall, 99.2% of patients underwent examinations rated as acceptable for interpretation. Mean scores for each image quality component ranged from 4.045 to 5.000 (lowest score for inframammary fold). Image quality component scores were 93.0% excellent, 5.2% good, 1.1% average, 0.6% fair, and 0.1% poor. Conclusion Overall image quality at a tertiary care center in Doha, Qatar was acceptable for interpretation with minimal areas identified for improvement.
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Affiliation(s)
| | | | - Antar Aly
- Hamad Medical Corporation, Doha, Qatar
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Alsirafy SA, Hammad AM, Ibrahim NY, Farag DE, Zaki O. Preferred Place of Death for Patients With Incurable Cancer and Their Family Caregivers in Egypt. Am J Hosp Palliat Care 2018; 36:423-428. [PMID: 30477314 DOI: 10.1177/1049909118813990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Little is known about the place of death of patients with cancer in Eastern Mediterranean countries including Egypt, where palliative care is underdeveloped. Identifying the preferred place of death (PPoD) is important for the development of appropriate palliative care models in these countries. OBJECTIVES: To know the PPoD of Egyptian patients with incurable cancer and their family caregivers (FCGs) and to determine the factors that may impact their preferences. METHODS: An observational cross-sectional study that included 301 dyads of patients with incurable cancer and one of their FCGs. A questionnaire was designed to collect data about the characteristics of patients and FCGs as well as their preferences. RESULTS: The majority of dyads (272/301, 90.4%) answered the PPoD question. Home was the PPoD in 93% of patients and 90.1% of FCGs ( P = .218). The congruence between patients' and FCGs' PPoD was 92.7% (κ = 0.526). In multivariate analysis, poorer performance status (Eastern Cooperative Oncology Group 3 or 4) and full employment of FCGs associated significantly with patients' preference to die in hospital (odds ratio [OR] = 3.015 [95% confidence interval [CI]: 1.004-9.054], P = .049 and OR = 4.402 [95% CI: 1.561-12.417], P = .005, respectively), while poorer performance status and nonreferral to the palliative medicine unit were associated with FCGs' preference of hospital death (OR = 2.705 [95% CI: 1.105-6.626], P = .029 and OR = 2.537 [95% CI: 1.082-5.948], P = .032, respectively). CONCLUSIONS: The results of the current study suggest that home is the PPoD for the vast majority of Egyptian patients with incurable cancer and their FCGs. Palliative care interventions that promote home death of patients with incurable cancer are needed in Egypt.
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Affiliation(s)
- Samy A Alsirafy
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Ahmad M Hammad
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Noha Y Ibrahim
- 2 Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Dina E Farag
- 1 Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Omar Zaki
- 2 Clinical Oncology Department, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
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Futagami M, Yokoyama Y, Sato T, Hirota K, Shimada M, Miyagi E, Suzuki N, Fujimura M. Palliative Care for Patients with Gynecologic Cancer in Japan:
A Japan Society of Gynecologic Palliative Medicine (JSGPM)
Survey. Asian Pac J Cancer Prev 2016; 17:4637-4642. [PMID: 27892676 PMCID: PMC5454609 DOI: 10.22034/apjcp.2016.17.10.4637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Purpose: To evaluate palliative care for patients with gynecologic cancer in Japan. Materials and Method: A questionnaire asking facility characteristics, systems to coordinate palliative care, current status of end-of-life care, provision of symptom relief, palliative radiation therapy and chemotherapy, and cases of death from gynecological cancer, was mailed to facilities treating gynecologic cancer. Results: A total of 115 facilities (29.3% of the total) responded to the questionnaire. Of these, 33.0 (29.0%) had a palliative care ward. End-of-life care was managed by obstetricians and gynecologists in 72.0% of the facilities. The site where end-of-life care was provided was most often a ward in the department where the respondent worked. The waiting period for transfer to a hospice was 2 weeks or more in 52% of facilities. Before the start of primary treatment, pain control was managed by obstetrians and gynecologists in 98.0% of facilities. Palliative radiation therapy or chemotherapy was administered at 93.9% and 92.0% of facilities, respectively. Of the 115 facilities, 34.0 (29.6%) reported cases of death from gynecological cancer. There were 1,134 cases of death. The median time between the last cycle of chemotherapy and death was 85 days for all gynecological cancers. The proportion of patients receiving chemotherapy in the last 30 and 14 days of life were 17.4% and 7.1%, respectively. Conclusions: This large-scale survey showed characteristics of palliative care given to patients with gynecologic cancer in Japan. Assessment of death cases showed that the median time between the last cycle of chemotherapy and death was relatively short.
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Affiliation(s)
- Masayuki Futagami
- Department of Obstetrics and Gynecology and 2Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5-Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
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Hassan AA, Mohsen H, Allam AA, Haddad P. Trends in the Aggressiveness of End-of-Life Cancer Care in the State of Qatar. J Glob Oncol 2016; 2:68-75. [PMID: 28717685 PMCID: PMC5495443 DOI: 10.1200/jgo.2015.000620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Quality of end-of-life (EOL) care is a key component of excellence in cancer care, and monitoring indicators for quality of EOL cancer care is crucial to providing excellent care. The aim of the current study is to describe the relative aggressiveness of EOL cancer care in the state of Qatar and to compare it with international figures. Methods We analyzed all deaths from cancer in Qatar between January 1, 2009 and December 31, 2013. A total of 784 eligible patients were studied to assess aggressiveness of cancer care at EOL. Results The average number of intensive care unit admissions per person decreased from 0.44 to 0.22 (P < .001) over the period of study. In addition, patients spent fewer days in the intensive care unit (2.79 to 1.82 days; P = .006) and made fewer visits to the emergency department (1.00 to 0.52 visits; P < .001) in the last 30 days of life. Fewer patients had at least one aggressive treatment measure at EOL during the 5-year period (82.3% to 71.0%; P = .038). The mean composite score for aggressiveness of EOL care decreased from 2.24 to 1.92 (P < .01). Conclusion The aggressiveness of EOL cancer care has significantly decreased over time in Qatar; however, despite this decrease, the rate is still higher than that reported internationally. The integration of community palliative care services in Qatar may further decrease the aggressiveness of cancer care at EOL.
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Affiliation(s)
- Azza A Hassan
- , , and , Weill Cornell Medical College; and , National Center for Cancer Care and Research, Doha, Qatar; and , Alexandria University, Egypt
| | - Hassan Mohsen
- , , and , Weill Cornell Medical College; and , National Center for Cancer Care and Research, Doha, Qatar; and , Alexandria University, Egypt
| | - Ayman A Allam
- , , and , Weill Cornell Medical College; and , National Center for Cancer Care and Research, Doha, Qatar; and , Alexandria University, Egypt
| | - Pascale Haddad
- , , and , Weill Cornell Medical College; and , National Center for Cancer Care and Research, Doha, Qatar; and , Alexandria University, Egypt
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