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Rocha JLFDN, Leão CCA, Canedo LR, Macedo LFRD, Rosa SC, Macedo JLSD. Epidemiological Profile of Victim Patients of Facial Canine and Human Bites in a Public Hospital. J Craniofac Surg 2023:00001665-990000000-01181. [PMID: 37948634 DOI: 10.1097/scs.0000000000009818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/26/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Bites are among the most common types of trauma to which humans are exposed. The possibility of disfiguring lesions and the transmission of infectious diseases with high morbidity make this trauma a public health problem. METHOD This was a retrospective, descriptive study that analyzed the medical records of patients treated at the Emergency Unit of the Plastic Surgery Service of the Asa Norte Regional Hospital from March 2019 to March 2020. The variables analyzed included age, sex, origin, time interval from aggression to hospital care, aggressor agent, wound site, lesion characteristics, and treatment. RESULTS A total of 103 patients with a mean age of 25 years were evaluated. Most patients were male (57.3%), and 73.8% were from the Federal District. The most common type of treatment was direct suturing in 77.7% of cases, followed by local flaps (15.5%) or grafts (4.9%). There were no deaths or infections reported. CONCLUSION The predominant profile of a facial bite victim is a young male adult living in the Federal District, bitten by a canine and treated with direct sutures. Adequate treatment for animal bites should include prevention of infection, such as rabies and tetanus, as well as primary wound closure for achieving a better prognosis and satisfactory esthetics for the patient.
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Affiliation(s)
| | | | - Lucas Ribeiro Canedo
- Asa Norte Regional Hospital, Plastic Surgery Service
- Graduate Program in Health Sciences, Foundation for Teaching and Research in Health Sciences
| | | | - Simone Corrêa Rosa
- Asa Norte Regional Hospital, Plastic Surgery Service
- Medical School of the Catholic University of Brasília, Brasília, DF, Brazil
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Giovannini E, Roccaro M, Peli A, Bianchini S, Bini C, Pelotti S, Fais P. Medico-legal implications of dog bite injuries: A systematic review. Forensic Sci Int 2023; 352:111849. [PMID: 37783138 DOI: 10.1016/j.forsciint.2023.111849] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/13/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
Dog bites pose a significant global public health issue and are the most common type of injury caused by animals. While most dog bites result in minor harm, they can also lead to severe or even fatal consequences. In cases involving serious injury or death, forensic pathologists investigate various aspects, including the crime scene, the injuries sustained by the victim, and the characteristics of the dog suspected to have caused the bite. The aim of this study is to provide a systematic review of the literature on the medical-legal implications of dog bites in forensic practice, in order to recognize the dog bite victim features, the injuries and their consequences related to, and to identify the offending dogs. The literature search was performed using PubMed, Scopus and Web of Science from January 1980 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about dog bites to humans. A total of 116 studies met the inclusion criteria and were included in the review and they were organized and discussed by issue of interest (biting dog features, dog bite victim features, anatomical distribution of dog bites, injuries related to dog bites, cause of death, bite features, dog identification and post-mortem dog depredation). The findings of this systematic review highlight the importance of bite mark analysis in reconstructing the events leading to the attack and identifying the dog responsible. In medical forensic evaluations of dog bite cases, a multidisciplinary approach is crucial. This approach involves thorough analysis of the crime scene, identification of risk factors, examination of dog characteristics, and assessment of the victim's injuries. By combining expertise from both human and veterinary forensic fields, a comprehensive understanding can be achieved in dog bite cases.
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Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Mariana Roccaro
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolaradi Sopra, 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
| | - Angelo Peli
- Department of Veterinary Medical Sciences, University of Bologna, Via Tolaradi Sopra, 50, Ozzano dell'Emilia, 40064 Bologna, Italy.
| | - Simone Bianchini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Carla Bini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Susi Pelotti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, 40126 Bologna, Italy.
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Baslington-Davies A, Howell H, Hogue TE, Mills DS. An Assessment of Scientific Evidence Relating to the Effect of Early Experience on the Risk of Human-Directed Aggression by Adult Dogs. Animals (Basel) 2023; 13:2329. [PMID: 37508106 PMCID: PMC10376210 DOI: 10.3390/ani13142329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
Human-directed aggression by domestic dogs is a major worldwide public health problem. The causes of aggression are complex, and research in this area often has to balance ecological validity with pragmatic controls; accordingly, it often does not meet the thresholds for quality typically used in reviews applying a classical "evidence-based" approach. Here, we propose a method of literature assessment that makes the "best use" of available evidence to identify and synthesise evidence relating to the most likely risk factors reported in the scientific literature. We used a systematic review process to initially identify relevant literature relating to potential early life experience (i.e., in the first six months of life) risk factors in the dog for human-directed aggression in the adult animal. Fourteen papers met our initial screening process and were subsequently analysed in detail, with data extracted and effect sizes calculated where possible. This highlighted the potential importance of the source of the animal, the age at which it was rehomed, the reason for the acquisition, the experience level of the owner, the animal's socialisation experiences, the consistent husbandry and management practices, the training, the sex ratio of the litter and the history of dogs that display aggression in the pedigree as risk factors. Taken together, it seems that early experiences which limit the ability to develop effective coping strategies and routines may be particularly important. We provide guidance for the future standardised reporting of risk related to human-directed aggression by dogs to allow greater synthesis of the literature in the future.
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Affiliation(s)
| | - Helen Howell
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
| | - Todd E Hogue
- School of Psychology, University of Lincoln, Lincoln LN6 7TS, UK
| | - Daniel S Mills
- Department of Life Sciences, University of Lincoln, Lincoln LN6 7DL, UK
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Mendpara V, Sahu S, Madhu K, Tarannum Shaik S, Maram MR, Natarajan B, Movva S, Sayed Mushir Ali A, Chauhan DR. Cranioplasty for a Growing Fracture of the Skull: A Case Report. Cureus 2022; 14:e30271. [PMID: 36381935 PMCID: PMC9653207 DOI: 10.7759/cureus.30271] [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] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Pediatric growing skull fractures are complications that usually occur due to delays in management. In this report, we present the case of a three-year-old girl who was brought to the outpatient department with a complaint of swelling in her scalp. The patient had a history of swelling after suffering a head injury at the age of six months. There was no history of specific neurological impairments or seizures, despite the swelling being reported to have grown gradually in size. The current case is being reported since early evaluation of pediatric patients with a head injury, regardless of any neurological shortfalls, should be thoroughly worked up to prevent any progressively growing cranial defects. The subtlety of these pediatric head injury cases tends to cause misdiagnosis, which can delay management and can cause complications, as with this patient. Extended observation, intensive supportive care, and neurosurgery are considered when dealing with these seemingly innocuous cases.
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Chen T, Karim M, Grace ZT, Magdich AR, Carniol EC, Benson BE, Svider PF. Surgical management of facial dog bite trauma: A contemporary perspective and review. World J Otorhinolaryngol Head Neck Surg 2022. [DOI: 10.1002/wjo2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Tiffany Chen
- Hackensack Meridian School of Medicine Nutley New Jersey USA
| | - Maria Karim
- Hackensack Meridian School of Medicine Nutley New Jersey USA
| | | | | | | | - Brian E. Benson
- Hackensack Meridian School of Medicine Nutley New Jersey USA
- Hackensack Meridian Health Hackensack University Medical Center Hackensack New Jersey USA
| | - Peter F. Svider
- Hackensack Meridian Health Hackensack University Medical Center Hackensack New Jersey USA
- Bergen Medical Associates Emerson New Jersey USA
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Borg BA, Kato PJ, Donoghue L, Shanti CM. Utilization of Imaging in the Management of Pediatric Dog Bites. Pediatr Emerg Care 2022; 38:e431-e435. [PMID: 34986595 DOI: 10.1097/pec.0000000000002317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We hypothesized that imaging is overused in the initial workup of dog bite patients. To reduce radiation exposure, we aim to determine which circumstances surrounding dog bites, patient population, and injury patterns would necessitate imaging studies for management. METHODS A retrospective review was performed on all patients presenting with dog bites to our level I pediatric trauma center between 2013 and 2015. Data collected included: circumstances surrounding the injury, patient demographics, injuries, and imaging studies performed. Our analysis focused on maxillofacial and head CT scans, and plain radiographic studies of the limbs, hands, and feet. Imaging studies were considered positive if there was evidence of bony injury. RESULTS We identified 615 patients with dog bites, with 114 patients having had at least one imaging study performed (a total of 145 imaging studies to analyze). Only 13 (11%) patients had a positive study. In the CT scan group, 6 (22.2%) of 27 studies were positive. In the plain radiographic group, 7 (5.9%) of 118 studies were positive. CONCLUSIONS Our review indicates that imaging studies are overused in the initial workup of these patients, and the majority of these studies are negative. This study confirms that it is feasible to institute guidelines for ordering imaging studies in dog bite patients. This will ultimately reduce radiation exposure and the cost of care for these injuries.
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Affiliation(s)
- Breanna A Borg
- From the Department of Surgery, Wayne State University School of Medicine
| | - Patrick J Kato
- From the Department of Surgery, Wayne State University School of Medicine
| | - Lydia Donoghue
- Department of Pediatric Surgery, Children's Hospital of Michigan, Detroit, MI
| | - Christina M Shanti
- Department of Pediatric Surgery, Children's Hospital of Michigan, Detroit, MI
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Microbiological Characteristics and Surgical Management of Animal-Bite-Related Oral & Maxillofacial Injuries: A Single Center's Experience. Antibiotics (Basel) 2021; 10:antibiotics10080998. [PMID: 34439048 PMCID: PMC8388934 DOI: 10.3390/antibiotics10080998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/11/2021] [Accepted: 08/16/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of the current study is to retrospectively evaluate animal-bite injuries and to gain insight into the epidemiology, accident consequences and treatment concept of these accidents in oral and maxillofacial surgery. Data of patients, who were admitted January 2015 and April 2021, were retrospectively evaluated regarding the patients’ characteristics (age, gender), facial distribution of substance defects/partial amputations, duration of hospitalization, operation treatments and antibiotic treatments. Data of 75 patients were included. Patients were bitten by dogs (n = 69.92%), cats (n = 4) and horses (n = 2). Lower eyelid/cheek complex was the most affected region (n = 37, 32.74%). Most of the patients between 0 and 3 years had to be operated on under general anesthesia (p = 0.011), while most of the adults could be operated on under local anesthesia (p = 0.007). In the age group 0–12 years, 30 patients (68%) were operated on under general anesthesia. Ampicillin/Sulbactam (48%) was the antibiotic most used. Antibiotics were adjusted after wound swabs in case of wound infections or critical wound conditions. This means that resistant antibiotics were stopped, and sensitive antibiotics were used. Structured surgical and antibiotic management of animal-bite wounds in the maxillofacial region is the most important factor for medical care to avoid long-term aesthetic consequences. Public health actions and policies under the leadership of an interdisciplinary committee could improve primary wound management, healing outcome and information status in the general population.
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Niño-Taravilla C, García-Salido A, Leoz-Gordillo I, García-Campos MT, Márquez-Pérez TM, Rozas-Gómez I, Serrano-González A. Intracranial Injury after a Dog Attack in a Neonate. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0039-1697923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractDog bites are a common event, especially in the pediatric population. Common anatomic site of dog bites is the head. Despite this, intracranial injuries due to dog bites are reported anecdotally, especially in neonates. In this article, we reported a 7-day-old female neonate attacked in the head by the family dog. She presented penetrating bilateral intracranial injuries that required urgent surgery and pediatric intensive care unit (PICU) admission. She received rabies and tetanus prophylaxis, wide-spectrum antibiotic, and anticonvulsive prophylaxis. She was hospitalized in PICU for 9 days, developing intracranial hypertension. One year after the dog bite, she showed moderate psychomotor retardation and focal epilepsy.
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Affiliation(s)
- Carmen Niño-Taravilla
- Pediatric Critical Care Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Alberto García-Salido
- Pediatric Critical Care Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Inés Leoz-Gordillo
- Pediatric Critical Care Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | | | | | - Isabel Rozas-Gómez
- Pediatric Radiology Service, Niño Jesús University Children's Hospital, Madrid, Spain
| | - Ana Serrano-González
- Pediatric Critical Care Service, Niño Jesús University Children's Hospital, Madrid, Spain
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Stanton AN, Toms J, Ritter A. Attacked and Shaken by a Dog: A Cause of Traumatic Brain and Carotid Injury in an Infant. Pediatr Neurosurg 2021; 56:140-145. [PMID: 33647903 DOI: 10.1159/000511089] [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] [Received: 07/02/2020] [Accepted: 08/24/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Posttraumatic carotid artery dissection (PTCAD) is a common injury in motor vehicle accidents and other extension and rotation injuries, but rarely developed from being shaken vigorously. CASE DESCRIPTION A 7-day-old infant presented to our facility after being attacked by a large dog. Initial examination revealed multiple puncture wounds and lacerations with visible dura. Head CT demonstrated subarachnoid, intraparenchymal, and epidural hemorrhages as well as left hemispheric loss of gray-white differentiation. Thus, the patient presented similarly to shaken baby syndrome (SBS). The patient was taken emergently to the operating room for hematoma evacuation and dural repair. Postoperatively, worsened left hemispheric ischemia was noted and an MRA demonstrated a Grade IV left ICA dissection. No intervention, including anticoagulation, was sought as the stroke was determined to be complete with irreversible damage. Hospital course was complicated by worsening exam, seizures, and a retinal hemorrhage. At 2 years follow-up, the patient still has notable delays but is progressing slowly through milestones. CONCLUSION Large animal attacks are a rare cause of PTCAD but may be due to the mechanism of shaking during the attack. We propose either CTA or MRA be considered as part of the initial workup in cases where an infant is attacked by a dog or other large animals, preventing delay of treatment.
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Affiliation(s)
- Amanda N Stanton
- School of Medicine, Virginia Commonwealth University SOM, Richmond, Virginia, USA, .,Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA,
| | - Jamie Toms
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ann Ritter
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia, USA
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Variable Mechanisms of Dog-Related Deaths. Am J Forensic Med Pathol 2020; 41:287-290. [DOI: 10.1097/paf.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Mkony D, Magogo Mzimbiri J, Leidinger A, Bonfield CM, Zuckerman SL, Härtl R. Delayed death after hyena bite in a 3-year-old Tanzanian boy: the unique reality of neurosurgery in a resource-limited setting. J Neurosurg Pediatr 2020; 25:659-662. [PMID: 32109867 DOI: 10.3171/2019.12.peds19495] [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] [Received: 09/15/2019] [Accepted: 12/30/2019] [Indexed: 11/06/2022]
Abstract
A 3-year-old boy presented after a hyena bite to the skull in Tanzania. A large degloving wound with herniating cerebrum was seen in the right parietotemporal region. A CT scan confirmed a large 8-cm skull defect. The patient was taken for irrigation and debridement, but due to significant tissue loss, the skin could not be closed. CSF leaked from the wound, and two additional operations for attempted closure were undertaken but failed. The plastic surgery team was consulted, but no closure was done because of the procedure's complexity, lack of resources, and cost. CSF diversion could not be performed due to no available lumbar catheter or external ventricular drain. Meningitis developed, leading to severe hyponatremia and death. The current case highlights both the unique mechanism of a hyena bite requiring neurosurgical intervention and the realities of practicing neurosurgery in a low-resource setting.
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Affiliation(s)
- Denis Mkony
- 1Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania
| | | | | | - Christopher M Bonfield
- 3Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee; and
| | - Scott L Zuckerman
- 3Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee; and
- 4Weill Cornell Brain and Spine Center, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
| | - Roger Härtl
- 4Weill Cornell Brain and Spine Center, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York
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Marusinec LE. An Excellent Addition to Recent Studies in the US From Various Disciplines and Locations That Show Similar Results. J Orthop Trauma 2019; 33:e37. [PMID: 30562262 DOI: 10.1097/bot.0000000000001385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Laura E Marusinec
- AAP Council on Injury, Violence, and Poison Prevention, Urgent Care Pediatrician, Milwaukee, WI
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Cheyuo C, Singh R, Lucke-Wold B, Serrano C. Growing Skull Fracture: Case Report after Rottweiler Bite and Review of the Literature. JOURNAL OF NEUROLOGY & NEUROPHYSIOLOGY 2018; 9. [PMID: 29888100 DOI: 10.4172/2155-9562.1000461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Growing skull fracture remains a rare but clinically significant complication of traumatic skull fractures in children less than 3 years of age. Dog attacks on children commonly cause head and neck injuries. We report the first case of growing skull fracture caused by a Rottweiler bite in a 21 days old neonate. Early diagnosis and surgical repair resulted in excellent outcome.
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Affiliation(s)
- Cletus Cheyuo
- Department of Neurosurgery, Ruby Memorial Hospital, West Virginia University, USA
| | - Rahul Singh
- Department of Neurosurgery, Ruby Memorial Hospital, West Virginia University, USA
| | | | - Cesar Serrano
- Department of Neurosurgery, Ruby Memorial Hospital, West Virginia University, USA
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Byard RW. Letter to the Editor. Medicolegal aspects of craniocentric dog attacks. J Neurosurg Pediatr 2017; 20:109. [PMID: 28430030 DOI: 10.3171/2017.1.peds174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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