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Tullo E, Dotchin C, Jaiswal S. 502 OUTCOMES OF HOSPITALISED PATIENTS WITH COVID-19 SIX MONTHS AFTER INDEX ADMISSION. Age Ageing 2021. [DOI: 10.1093/ageing/afab119.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Early outcomes for hospitalised patients with covid-19, including admissions to critical care and mortality have been widely published. Less is known about the longer-term patient outcomes such as readmissions, deaths after discharge and level of care required on discharge.
Methods
Following an audit of 360 consecutive admissions of patients with covid-19 requiring level 1 inpatient care in spring 2020, we collated data about mortality, readmissions, and residential status for the same cohort at six months after index admission.
Results
The cohort had a median age of 78: 70% survived to discharge. Median length of stay was nine days (range 1–90). Of 252 patients discharged, a further 35 (14%) had died by six-month follow-up. 95 patients (38%) required at least one further hospital admission in the following six-month period. 40 (16%) of discharged patient required increased support, defined as new or increased package of care or an alternative interim or permanent change of residence. (Table 1). Table 1 emailed separately as will not transfer into this space Of the 40 patients requiring increased support on discharge, 7 (18%) died, 15 (38%) returned to their preadmission residential status, and 17 (43%) still required increased support.
Conclusions
Covid-19 has a high mortality rate in those admitted to hospital. Patients receiving level 1 care in hospital and surviving to discharge have a high risk of readmission or death in the following six-months. For those requiring increased support on discharge, the majority do not return to their pre-admission residential status.
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Affiliation(s)
- E Tullo
- Northumbria Healthcare NHS Foundation Trust
| | - C Dotchin
- NIHR Newcastle Biomedical Research Centre in Ageing and Longterm Conditions, Newcastle University
| | - S Jaiswal
- School of Population and Health Sciences, Newcastle University; Newcastle University Medical School
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Tullo E, Lerea MJ, González R, Galeano J, Insfrán MD, Muñoz M, Aragón M, Sanhueza A. [Health and social inequalities in maternal and child health in Paraguay]. Rev Panam Salud Publica 2020; 44:e107. [PMID: 32905374 PMCID: PMC7469975 DOI: 10.26633/rpsp.2020.107] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 07/02/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To describe health and social inequalities in maternal and child health indicators defined in Sustainable Development Goal (SDG) 3.1 and SDG 3.2 targets based on administrative data among the departments of Paraguay in 2017. METHODS Quantitative descriptive study with ecological design. Simple gap measures and complex gradient measures based on the adjustment of negative binomial and logistic regression models were used. RESULTS Fifty percent of Paraguay's departments have estimated maternal mortality ratio (MMR) values higher than the national value. The percentage of births attended by a qualified professional in the country is 98.1%, with a range between 82.4% and 99.9%. In 13 of 18 departments, under-five mortality rate (U5MR) is higher than the national average, ranging from 4.2 to 49.2 deaths per 1 000 live births. Neonatal mortality rates (NMR) in the departments vary from 2.6 to 45.1 deaths per 1 000 live births. There are major health and social inequalities in the MMR, U5MR and NMR between the departments. There are no high inequalities in the percentage of births attended by a qualified professional between the departments. CONCLUSIONS Paraguay needs to make significant efforts to reduce the health and social inequalities that exist in the MMR, U5MR and NMR between departments. Numerical targets must be established to improve national values and reduce inequalities in these indicators, which will allow for accountability on the commitment to "leave no one behind" established in the SDG, and will help generate strategies to improve the health of women and children in Paraguay.
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Affiliation(s)
- Edgar Tullo
- Dirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar SocialParaguayDirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.
| | - María Jose Lerea
- Dirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar SocialParaguayDirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.
| | - Rosa González
- Dirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar SocialParaguayDirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.
| | - Julio Galeano
- Dirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar SocialParaguayDirección General de Información Estratégica en Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.
| | - María Delasnieve Insfrán
- Dirección General de Problemas de Salud, Ministerio de Salud Pública y Bienestar SocialParaguayDirección General de Problemas de Salud, Ministerio de Salud Pública y Bienestar Social, Paraguay.
| | - Mara Muñoz
- Organización Panamericana de la SaludAsunciónParaguayOrganización Panamericana de la Salud, Asunción, Paraguay.
| | - Miguel Aragón
- Organización Panamericana de la SaludAsunciónParaguayOrganización Panamericana de la Salud, Asunción, Paraguay.
| | - Antonio Sanhueza
- Organización Panamericana de la SaludWashington D.C.Estados Unidos de AméricaOrganización Panamericana de la Salud, Washington D.C., Estados Unidos de América.
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Tullo E, Smith A, Ridden J, Ross R, Curless R, Doshi M. 38 Improving Access to Outpatient Services for Older People Using A Clinical Microsystems Approach. Age Ageing 2020. [DOI: 10.1093/ageing/afz185.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Northumbria Healthcare NHS Foundation Trust provides services to more than 500,000 residents in the North-East of England across multiple sites.
Local problem
Outpatient services for older people across Northumbria include specialist (eg falls) and generic clinics with differing referral routes, demands and waiting times. Referrals derive from primary care, emergency services and elsewhere; some are complex patients requiring a comprehensive geriatric assessment (CGA). Existing pathways led to variable waits for clinics, duplication and delays.
Aim was to improve the timeliness, efficiency and access to appropriate assessment first time.
Methods
We adopted a Clinical Microsystems approach (Sheffield Microsystems Coaching Academy) for improvement. Main components were team coaching, weekly “Big Room” meeting of involved staff to share understanding of current process, agree change ideas, and test these with multiple plan, do, study, act (PDSA) cycles. Impacts of each PDSA cycle were discussed in Big Room, leading to refinement of the pathway.
Interventions
Results: PDSA interventions were tested over 6 months: Development of a single triage systemCGA clinic for frail older patients.Development of shared documentation for CGA.Improved cycle and lead times for assessment
Conclusions
Our quality improvement work supported the development and implementation of a new referral triage process with CGA assessment for complex frail patients. The change has reduced patient wait times, provided early intervention and reduced duplication. Work is ongoing to determine impact on patient satisfaction and time to discharge from clinic. The approach taken by this project could be applied elsewhere to improve outpatient referral processes.
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Affiliation(s)
- E Tullo
- Northumbria Healthcare NHS Foundation Trust
| | - A Smith
- Northumbria Healthcare NHS Foundation Trust
| | - J Ridden
- Northumbria Healthcare NHS Foundation Trust
| | - R Ross
- Northumbria Healthcare NHS Foundation Trust
| | - R Curless
- Northumbria Healthcare NHS Foundation Trust
| | - M Doshi
- Northumbria Healthcare NHS Foundation Trust
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Tullo E, Young T, Smith D, Goodson M. A COMPARISON OF MEDICAL STUDENTS’ ATTITUDES TOWARD PEOPLE WITH DEMENTIA ACROSS THREE INTERNATIONAL LOCATIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - D Smith
- Newcastle University Medicine Malaysia
| | - M Goodson
- Newcastle University Medicine Malaysia
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Tullo E, Fontana I, Peña Fernandez A, Vranken E, Norton T, Berckmans D, Guarino M. Association between environmental predisposing risk factors and leg disorders in broiler chickens. J Anim Sci 2017; 95:1512-1520. [PMID: 28464112 DOI: 10.2527/jas.2016.1257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Footpad dermatitis and lameness are a major welfare concern in broiler chicken farming. In general, footpad lesions are linked to poor environmental conditions. Ulcers that arise from advanced lesions can negatively affect the gait of the birds, with effects on the animal welfare, including, in the worst cases, inability to reach the feed or water. In this study, the degree of footpad dermatitis and lameness was manually scored on 4 broiler farms across Europe, as part of an EU-wide welfare assessment program. The welfare of the chickens was assessed 3 times per production cycle (at wk 3, 4, and 5), scoring footpad dermatitis, lameness, and litter quality. In the same broiler farms, variables such as air temperature and relative humidity were automatically measured over the same period. These variables were combined into a widely accepted thermal comfort index and associated to upper and lower thresholds, which made it possible to quantify the percentage of time the birds spent out of the thermal comfort zone (POOC). The data was analyzed by combining data from the welfare assessments with environmental data collected by the automated monitoring systems. Considering the comparison between POOC classes, the highest probabilities of footpad dermatitis and lameness were obtained when POOC values exceeded the 70% threshold. Therefore, the analysis showed that footpad dermatitis and lameness were more frequent when the flock was exposed to poor environmental conditions for prolonged periods ( < 0.001). Since environmental conditions can be continuously measured, and the risk factor for footpad dermatitis and lameness increases with poor environmental conditions, there is the possibility to develop a detection and control system of severe lesions.
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Nilsen C, Tullo E, Van Regenmortel S. FROM ISSA STUDENT TO ALUMNI: LEARNING OUTCOMES AND EXPERIENCES OF PARTICIPANTS. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C. Nilsen
- Aging Research Center - Karolinska Institutet & Stockholm University, Stockholm, Sweden,
| | - E. Tullo
- Newcastle University, Newcastle upon Tyne, United Kingdom,
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Hutchinson A, Tiplady S, Tullo E. THE VALUE OF INTERPROFESSIONAL FEEDBACK AS PART OF A PRE-REGISTRATION MODULE IN GERIATRIC NURSING. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.5059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - S. Tiplady
- Northumbria University, Newcastle, United Kingdom,
| | - E. Tullo
- University of Newcastle, Newcastle, United Kingdom
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Tullo E, Fontana I, Peña Fernandez A, Vranken E, Norton T, Berckmans D, Guarino M. Association between environmental predisposing risk factors and leg disorders in broiler chickens. J Anim Sci 2017. [DOI: 10.2527/jas2016.1257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tullo E, Fontana I, Gottardo D, Sloth K, Guarino M. Technical note: Validation of a commercial system for the continuous and automated monitoring of dairy cow activity. J Dairy Sci 2016; 99:7489-7494. [DOI: 10.3168/jds.2016-11014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/20/2016] [Indexed: 11/19/2022]
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Vandermeulen J, Bahr C, Tullo E, Fontana I, Ott S, Kashiha M, Guarino M, Moons CPH, Tuyttens FAM, Niewold TA, Berckmans D. Discerning pig screams in production environments. PLoS One 2015; 10:e0123111. [PMID: 25923725 PMCID: PMC4414550 DOI: 10.1371/journal.pone.0123111] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 02/27/2015] [Indexed: 11/19/2022] Open
Abstract
Pig vocalisations convey information about their current state of health and welfare. Continuously monitoring these vocalisations can provide useful information for the farmer. For instance, pig screams can indicate stressful situations. When monitoring screams, other sounds can interfere with scream detection. Therefore, identifying screams from other sounds is essential. The objective of this study was to understand which sound features define a scream. Therefore, a method to detect screams based on sound features with physical meaning and explicit rules was developed. To achieve this, 7 hours of labelled data from 24 pigs was used. The developed detection method attained 72% sensitivity, 91% specificity and 83% precision. As a result, the detection method showed that screams contain the following features discerning them from other sounds: a formant structure, adequate power, high frequency content, sufficient variability and duration.
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Affiliation(s)
- J. Vandermeulen
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - C. Bahr
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - E. Tullo
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - I. Fontana
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - S. Ott
- Livestock-Nutrition-Quality, KU Leuven, Leuven, Belgium
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
| | - M. Kashiha
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
| | - M. Guarino
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - C. P. H. Moons
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
| | - F. A. M. Tuyttens
- Departement of Animal Nutrition, Genetics and Ethology, Laboratory for Ethology, Ghent university, Merelbeke, Belgium
- Institute for Agricultural and Fisheries Research (ILVO), Animal Sciences Unit, Melle, Belgium
| | - T. A. Niewold
- Livestock-Nutrition-Quality, KU Leuven, Leuven, Belgium
| | - D. Berckmans
- M3-BIORES—Measure, Model & Manage Bioresponses, KU Leuven, Leuven, Belgium
- * E-mail:
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Tullo E, Robinson L, Newton J. 106 * COMPARATIVE PERCEPTIONS OF ACADEMICS AND MEMBERS OF THE PUBLIC ABOUT PUBLIC AND PATIENT INVOLVEMENT (PPI) IN AGEING RESEARCH. Age Ageing 2014. [DOI: 10.1093/ageing/afu044.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abdullah A, Omar AN, Mulcahy R, Clapp A, Tullo E, Carrick-Sen D, Newton J, Hirst B, Krishnaswami V, Foster A, Vahidassr D, Chavan T, Matthew A, Trolan CP, Steel C, Ellis G, Ahearn DJ, Lotha K, Shukla P, Bourne DR, Mathur A, Musarrat K, Patel A, Nicholson G, Nelson E, McNicholl S, McKee H, Cuthbertson J, Nelson E, Nicholson G, McNicholl S, McKee H, Cuthbertson J, Lunt E, Lee S, Okeke J, Daniel J, Naseem A, Ramakrishna S, Singh I, Barker JR, Weatherburn AJ, Thornton L, Daniel J, Okeke J, Holly C, Jones J, Varanasi A, Verma A, Singh I, Foster JAH, Carmichael C, Cawston C, Homewood S, Leitch M, Martin J, McDicken J, Lonnen J, Bishop-Miller J, Beishon LC, Harrison JK, Conroy SP, Gladman JRF, Sim J, Byrne F, Currie J, Ollman S, Brown S, Wilkinson M, Manoj A, Hussain F, Druhan A, Thompson M, Tsang J, Soh J, Offiah C, Coughlan T, O'Brien P, McCabe DJH, Murphy S, McManus J, O'Neill D, Collins DR, Warburton K, Maini N, Cunnington AL, Mathew P, Hoyles K, Lythgoe M, Brewer H, Western-Price J, Colquhoun K, Ramdoo K, Bowen J, Dale OT, Corbridge R, Chatterjee A, Gosney MA, Richardson L, Daunt L, Ali A, Harwood R, Beveridge LA, Harper J, Williamson LD, Bowen JST, Gosney MA, Wentworth L, Wardle K, Ruddlesdin J, Baht S, Roberts N, Corrado O, Morell J, Baker P, Whiller N, Wilkinson I, Barber M, Maclean A, Frieslick J, Reoch A, Thompson M, Tsang J, McSorley A, Crawford A, Sarup S, Niruban A, Edwards JD, Bailey SJ, May HM, Mathieson P, Jones H, Ray R, Prettyman R, Gibson R, Heaney A, Hull K, Manku B, Bellary S, Ninan S, Chhokar G, Sweeney D, Nivatongs W, Wong SY, Aung T, Kalsi T, Babic-Illman G, Harari D, Aljaizani M, Pattison AT, Pattison AT, Aljaizani M, Fox J, Reilly S, Chauhan V, Azad M, Youde J, Lagan J, Cooper H, Komrower D, Price V, von Stempel CB, Gilbert B, Bouwmeester N, Jones HW, Win T, Weekes C, Hodgkinson R, Walker S, Le Ball K, Muir ZN. Clinical effectiveness. Age Ageing 2013. [DOI: 10.1093/ageing/aft096] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Atkinson JM, Tullo E, Mitchison H, Pearce MS, Kumar N. Improving the efficiency of selection to Core Medical Training: a study of the use of multiple assessment stations. J R Coll Physicians Edinb 2012; 42:101-5. [DOI: 10.4997/jrcpe.2012.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Rizzi R, Tullo E, Cito AM, Caroli A, Pieragostini E. Monitoring of genetic diversity in the endangered Martina Franca donkey population1. J Anim Sci 2011; 89:1304-11. [DOI: 10.2527/jas.2010-3379] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tullo E. Trepanation and Roman medicine: a comparison of osteoarchaeological remains, material culture and written texts. J R Coll Physicians Edinb 2010; 40:165-71. [PMID: 20695173 DOI: 10.4997/jrcpe.2010.215] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Evidence for prehistoric trepanation is limited to preserved osteoarchaeological material, namely human skulls, and the occasional discovery of surgical instruments. However, the Roman empire gave rise to an abundant and diverse range of source types, including skeletal remains, material culture and detailed medical texts, each of which harbours the potential to contribute to our understanding of trepanation during this historical period. This paper highlights the advantages and inherent biases of each of these source types, and proposes that the simultaneous analysis and integration of different types of historical evidence is essential for the study of trepanation as a surgical procedure.
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Affiliation(s)
- E Tullo
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.
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Ishida K, Stupp P, Serbanescu F, Tullo E. Perinatal risk for common mental disorders and suicidal ideation among women in Paraguay. Int J Gynaecol Obstet 2010; 110:235-40. [DOI: 10.1016/j.ijgo.2010.03.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Revised: 03/26/2010] [Accepted: 03/26/2010] [Indexed: 10/19/2022]
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