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Outcomes of a Single Isocenter Brain Multi-Metastases Linear Accelerator Delivered Stereotactic Radiosurgery (SRS). Int J Radiat Oncol Biol Phys 2023; 117:e135. [PMID: 37784700 DOI: 10.1016/j.ijrobp.2023.06.940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The management of brain metastases has evolved from using 2D whole brain radiotherapy (WBRT) to more complex techniques like stereotactic radiosurgery (SRS) for patients with limited disease. Long-term control of lesions is challenging with WBRT techniques but treating multiple lesions with traditional SRS, where each lesion is treated on its own isocenter, can be time-consuming and difficult on patients, especially those with claustrophobia. Single Isocenter Multiple Metastases (SIMM) SRS has emerged as an option to deliver ablative SRS doses simultaneously to multiple brain metastases using a single isocenter, thereby limiting the duration of treatments for patients. Though appealing, SIMM SRS adds technical complexity and could potentially lead to worse outcomes or more complications relative to traditional SRS treatments. Given the current paucity of clinical evidence supporting SIMM SRS, we sought to retrospectively review our institution's outcomes and complications for patients treated with SIMM SRS to determine the efficacy and safety of this approach in our hands. MATERIALS/METHODS Patients treated at our institution with SIMM SRS with at least one post-treatment brain MRI were identified. Date on patient clinical characteristics, planning, and treatment characteristics, and outcomes were retrospectively collected. Post-treatment tumor control was evaluated with follow-up MRI imaging based on RANO criteria. Correlation between tumor control and toxicity was done by assessing radiation doses, PTV coverage, and normal brain V12 constraints. RESULTS A total of 27 patients received SIMM SRS from January 2015 to February 2022. The median age at first SIMM SRS was 61 (range: 38-87). The most common disease sites were lung (63.0%), breast (18.5%), and GI (7.4%). The 27 patients had 47 SIMM SRS treatments of 163 lesions total. The median number of lesions treated per isocenter was 3 (range: 2-9). 5 patients had 2 SIMM SRS isocenters treated on the same day, treating clusters of lesions (ranging from 5-11 lesions treated on that day). The most common locations involved were frontal, cerebellar, and parietal lobes (32.52%, 21.47%, and 15.34%). The modal dose was 22 Gy (range: 18-24 Gy). Median OS from initial primary diagnosis was 23.23 months, and 9.92 months after the first SIMM SRS treatment. The median imaging follow-up was 9.8 months per lesion, and the local control rate was 95.03%. 2 lesions (1.23%) developed radiation necrosis and the median time to RT necrosis among those lesions was 5.7 months after treatment. CONCLUSION The utilization of SIMM SRS demonstrates acceptable efficacy and safety as it has been implemented at our institution. Further studies to evaluate this planning modality are warranted to establish suitable candidates for SIMM SRS as well as evaluate the long-term outcomes for these patients.
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Racial disparities in future development of lethal prostate cancer based on PSA levels in midlife. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01236-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Survey utilization to identify the unmet needs of adolescent and young adult oncology patients. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00665-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Lumps and bumps: superficial findings with a deeper diagnosis. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00058-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Baseline PSA levels in midlife & future development of lethal prostate cancer: A diverse North American cohort analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00307-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Evaluating the role of lymphvascular invasion as an indicator for adverse outcomes for patients with upper tract urothelial carcinoma and its histological subtypes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00960-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Testing the external validity of the pout III trial (adjuvant platnium-based chemotherapy in upper tract urothelial carcinoma) in a North American cohort. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Technology Usage and Impacts by COVID-19 among Patients in a Radiation Oncology Clinic. Int J Radiat Oncol Biol Phys 2022. [PMCID: PMC9595464 DOI: 10.1016/j.ijrobp.2022.07.919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Purpose/Objective(s) Mobile devices provide platforms for consistent and real time symptom tracking for cancer patients, allowing for better symptom reporting and more timely interventions. There is limited research investigating barriers to adoption within the oncology setting and COVID-19 impacts on patent willingness to use health technology. Understanding these issues is key to successful development and implementation. We designed a survey to assess patient willingness and barriers to using mobile devices to report/track symptoms (e-report). Materials/Methods Two cohorts of adult patients completed a 21-question anonymized survey. The survey was administered to clinic patients before (PRE) and 18mo after (POST) the start of the COVID pandemic. Three additional questions were added to POST survey to investigate impacts from COVID. Demographics, technology usage, willingness to report data, barriers to utilization, and changes due to COVID were evaluated using descriptive statistics. Predictors of willingness to e-report, barriers to use, and changes due to the COVID-19 pandemic were analyzed using univariate and multivariate logistic regression (MVA). Results 318 patients completed the survey (PRE= 144 patients; POST= 174 patients) with mean age 65y, 75% Caucasian, 55% male. Altogether, 75% used a smart phone (PRE=66.7%; POST=81.3%; p 0.003), 90% reported home internet access (PRE=87.5%; POST=91.4%; p 0.259), 86% used a computer (PRE=79.2%; POST=90.8%; p 0.004), and 26% used a wearable health tracker (PRE 25.7%; POST 26.4%; p 0.881). On MVA, age>65 (OR 0.32; p 0.001), annual income>50K (OR 2.16; p 0.032), smart phone ownership (OR 4.07; p 0.000), and new/current patient status (OR 2.15; p 0.020) were all significant factors impacting willingness to e- report. Limited tech literacy (p 0.024) and time commitment (p 0.048) were the only significant barriers. Privacy as a barrier was greater in PRE vs POST cohort (OR 2.3 vs OR 1.1) trending toward significance. Nearly all modes of tech usage were greater in POST vs PRE cohort. POST cohort was significantly more willing to e- report (81.1% vs 69.1%; OR 1.91; p 0.016). This remained significant on MVA after adjusting for age, concern for privacy, tech literacy, and patient status (OR 1.88; p 0.026). Furthermore, 51% of POST cohort reported the pandemic directly influenced their willingness to e-report (40% more, 11% less). Conclusion Radiation oncology patients are willing to use mobile technology to report symptoms. Willingness increases with decreasing age, increasing annual income, smartphone ownership, and new/current patient status. Significant barriers include tech literacy and time commitment. Post-pandemic patients are more willing to e-report and list fewer barriers. The COVID-19 pandemic appears to have had a positive impact on technology usage by patients. Efforts to develop and test mobile applications for this population are justified.
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A collaboration on teaching communication by text. CLINICAL TEACHER 2022; 19:294-298. [PMID: 35508599 PMCID: PMC9541018 DOI: 10.1111/tct.13498] [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: 07/21/2021] [Revised: 04/07/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022]
Abstract
Background Since the start of the pandemic, text‐based communication with patients has become increasingly common. Leicester Medical School introduced experiential teaching in this field in 2014 but identified a need to develop teaching on the key skills required for effective consultations. Shout 85258 offers a text messaging support service for anyone who is struggling with their mental health. They have developed an evidence‐based training programme enabling volunteers to deliver quality crisis support via the medium of text messaging. Approach Leicester Medical School and Shout 85258 collaborated, developing a small group teaching session for delivery to second‐year medical students. The training programme and framework developed by Shout 85258 was used as the basis for a 1.5‐hour session with didactic teaching and experiential role play. It was hoped that the collaboration would raise the profile of Shout 85258 in the student body. Evaluation The students enjoyed the mixture of didactic teaching and role play. They saw the relevance of the topic and recognised the key difficulties of text‐based consultations such as in rapport building. Tutors valued the structure of the session and the framework provided. The session raised the profile of Shout 85258 amongst students and tutors. Further evaluation is needed to measure changes in the use of the service or volunteering by students following the session. Implications Text‐based consultation is an increasingly important area of communication in health care. Collaborating with a charitable organisation allowed sharing of established best practice in this area and raised the profile of the charity within the student body.
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Peripheral parenteral nutrition in adult acute care- Evaluation of a midline catheter service. Clin Nutr ESPEN 2022. [DOI: 10.1016/j.clnesp.2022.02.099] [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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215: Mucus hyperconcentration initiates bowel obstruction in the distal ileum of CF mice. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01640-4] [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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179: Modulator therapy reverses aberrant mucus properties in vitro via hydration. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01604-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Optical Coherence Tomography Doppler Vibrometry Measurement of Stapes Vibration in Patients With Stapes Fixation and Normal Controls. Otol Neurotol 2019; 40:e349-e355. [DOI: 10.1097/mao.0000000000002193] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Nutrition in the real world – patient outcomes from a multidisciplinary nutrition clinic in a large district general hospital (non-intestinal failure) setting in the UK. Clin Nutr ESPEN 2019. [DOI: 10.1016/j.clnesp.2018.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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15
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Working Memory Event-Related Potentials in Monolinguals and Bilinguals. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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The Influence of Emotions on Long Term Working Memory: An ERP study. Int J Psychophysiol 2018. [DOI: 10.1016/j.ijpsycho.2018.07.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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The effect of ovarian follicle size on the formation of good quality blastocysts. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Blastocyst aneuploidy as a function of the diameter of the originating ovarian follicle. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.1185] [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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Insights into the tumor microenvironment and human TRBV gene polymorphism revealed by long-amplicon immune repertoire sequencing. Eur J Cancer 2018. [DOI: 10.1016/j.ejca.2018.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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MA 11.06 Retrospective Analysis of NSCLC Testing in Low Tumor Content Samples: Single-Gene Tests, NGS, & the Oncomine™ Dx Target Test. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mobilan: a recombinant adenovirus carrying Toll-like receptor 5 self-activating cassette for cancer immunotherapy. Oncogene 2017; 37:439-449. [PMID: 28967901 PMCID: PMC5799711 DOI: 10.1038/onc.2017.346] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/23/2017] [Accepted: 08/07/2017] [Indexed: 12/14/2022]
Abstract
Toll-like receptor 5 (TLR5) is considered an attractive target for anticancer immunotherapy. TLR5 agonists, bacterial flagellin and engineered flagellin derivatives, have been shown to have potent antitumor and metastasis-suppressive effects in multiple animal models and to be safe in both animals and humans. Anticancer efficacy of TLR5 agonists stems from TLR5-dependent activation of nuclear factor-κB (NF-κB) that mediates innate and adaptive antitumor immune responses. To extend application of TLR5-targeted anticancer immunotherapy to tumors that do not naturally express TLR5, we created an adenovirus-based vector for intratumor delivery, named Mobilan that drives expression of self-activating TLR5 signaling cassette comprising of human TLR5 and a secreted derivative of Salmonella flagellin structurally analogous to a clinical stage TLR5 agonist, entolimod. Co-expression of TLR5 receptor and agonist in Mobilan-infected cells established an autocrine/paracrine TLR5 signaling loop resulting in constitutive activation of NF-κB both in vitro and in vivo. Injection of Mobilan into primary tumors of the prostate cancer-prone transgenic adenocarcinoma of the mouse prostate (TRAMP) mice resulted in a strong induction of multiple genes involved in inflammatory responses and mobilization of innate immune cells into the tumors including neutrophils and NK cells and suppressed tumor progression. Intratumoral injection of Mobilan into subcutaneously growing syngeneic prostate tumors in immunocompetent hosts improved animal survival after surgical resection of the tumors, by suppression of tumor metastasis. In addition, vaccination of mice with irradiated Mobilan-transduced prostate tumor cells protected mice against subsequent tumor challenge. These results provide proof-of-concept for Mobilan as a tool for antitumor vaccination that directs TLR5-mediated immune response toward cancer cells and does not require identification of tumor antigens.
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190 Antibiotic allergy testing in adult patients with cystic fibrosis: a single-centre experience. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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99SARCOPENIA AND VASCULAR RISK IN A HEALTHY ELDERLY UK POPULATION (BRAVES STUDY). Age Ageing 2017. [DOI: 10.1093/ageing/afx059.99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Corrigendum to "The vapor-phase multi-stage CMD test for characterizing contaminant mass discharge associated with VOC sources in the vadose zone: Application to three sites in different lifecycle stages of SVE operations" [J. Contam. Hydrol. 179 (2015) 55-64]. JOURNAL OF CONTAMINANT HYDROLOGY 2017; 196:62. [PMID: 27986308 DOI: 10.1016/j.jconhyd.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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ISQUA16-3180THE IMPACT OF AN INNOVATIVE PATIENT-CENTERED CARE MODEL ON PATIENT AND FAMILY EXPERIENCE IN ACUTE CARE. Int J Qual Health Care 2016. [DOI: 10.1093/intqhc/mzw104.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Neoadjuvant Chemoradiation With Ifosfamide and Etoposide in the Management of Soft Tissue Sarcomas: A Single-Institution Review. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Clinical assessments of MELK immunohistochemical expression in uterine cancer patients: A Gynecologic Cancer Center of Excellence study. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.400] [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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12.11 SARCOPENIA AND VASCULAR RISK IN A HEALTHY ELDERLY UK POPULATION (BRAVES STUDY). Artery Res 2016. [DOI: 10.1016/j.artres.2016.10.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Fistulizing Epstein-Barr virus-positive plasmablastic lymphoma in an HIV-positive man. Br J Dermatol 2015; 174:398-401. [PMID: 26286218 DOI: 10.1111/bjd.14089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2015] [Indexed: 11/30/2022]
Abstract
Plasmablastic lymphoma (PBL) is an unusual subtype of non-Hodgkin lymphoma recently classified as a diffuse immunoblastic lymphoma with a plasma-cell immunophenotype. Originally described in the oral cavity of HIV-positive patients, it has also been recognized to occur rarely at other sites. We describe a previously unreported fistulizing presentation of Epstein-Barr virus (EBV)-positive PBL, reviewing its association with HIV-1 infection and its importance as an AIDS-defining malignancy.
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C-96Is Scoring the Rey Any Better Than Just Looking at it: Preliminary Findings. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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The vapor-phase multi-stage CMD test for characterizing contaminant mass discharge associated with VOC sources in the vadose zone: Application to three sites in different lifecycle stages of SVE operations. JOURNAL OF CONTAMINANT HYDROLOGY 2015; 179:55-64. [PMID: 26047819 PMCID: PMC4520789 DOI: 10.1016/j.jconhyd.2015.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 04/10/2015] [Accepted: 05/17/2015] [Indexed: 06/01/2023]
Abstract
Vapor-phase multi-stage contaminant mass discharge (CMD) tests were conducted at three field sites to measure mass discharge associated with contaminant sources located in the vadose zone. The three sites represent the three primary stages of the soil vapor extraction (SVE) operations lifecycle-pre/initial-SVE, mid-lifecycle, and near-closure. A CMD of 32g/d was obtained for a site at which soil vapor SVE has been in operation for approximately 6years, and for which mass removal is currently in the asymptotic stage. The contaminant removal behavior exhibited for the vapor extractions conducted at this site suggests that there is unlikely to be a significant mass of non-vapor-phase contaminant (e.g., DNAPL, sorbed phase) remaining in the advective domains, and that most remaining mass is likely located in poorly accessible domains. Given the conditions for this site, this remaining mass is hypothesized to be associated with the low-permeability (and higher water saturation) region in the vicinity of the saturated zone and capillary fringe. A CMD of 25g/d was obtained for a site wherein SVE has been in operation for several years but concentrations and mass-removal rates are still relatively high. A CMD of 270g/d was obtained for a site for which there were no prior SVE operations. The behavior exhibited for the vapor extractions conducted at this site suggest that non-vapor-phase contaminant mass (e.g., DNAPL) may be present in the advective domains. Hence, the asymptotic conditions observed for this site most likely derive from a combination of rate-limited mass transfer from DNAPL (and sorbed) phases present in the advective domain as well as mass residing in lower-permeability ("non-advective") regions. The CMD values obtained from the tests were used in conjunction with a recently developed vapor-discharge tool to evaluate the impact of the measured CMDs on groundwater quality.
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Using vapor phase tomography to measure the spatial distribution of vapor concentrations and flux for vadose-zone VOC sources. JOURNAL OF CONTAMINANT HYDROLOGY 2015; 177-178:54-63. [PMID: 25835545 PMCID: PMC4456264 DOI: 10.1016/j.jconhyd.2015.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 02/26/2015] [Accepted: 03/08/2015] [Indexed: 05/11/2023]
Abstract
A test was conducted at a chlorinated-solvent contaminated site in Tucson, AZ, to evaluate the effectiveness of vapor-phase tomography (VPT) for characterizing the distribution of volatile organic contaminants (VOC) in the vadose zone. A soil vapor extraction (SVE) system has been in operation at the site since 2007. Vapor concentration and vacuum pressure were measured at four different depths in each of the four monitoring wells surrounding the extraction well. The test provided a 3D characterization of local vapor concentrations under induced-gradient conditions. Permeability data obtained from analysis of borehole logs were used along with pressure and the vapor-concentration data to determine VOC mass flux within the test domain. A region of higher mass flux was identified in the deepest interval of the S-SW section of the domain, indicating the possible location of a zone with greater contaminant mass. These results are consistent with the TCE-concentration distribution obtained from sediment coring conducted at the site. In contrast, the results of a standard soil gas survey did not indicate the presence of a zone with greater contaminant mass. These results indicate that the VPT test provided a robust characterization of VOC concentration and flux distribution at the site.
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Weak antilocalization of high mobility holes in a strained germanium quantum well heterostructure. JOURNAL OF PHYSICS. CONDENSED MATTER : AN INSTITUTE OF PHYSICS JOURNAL 2015; 27:022201. [PMID: 25469938 DOI: 10.1088/0953-8984/27/2/022201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We present the observation of weak antilocalization due to the Rashba spin-orbit interaction, through magnetoresistance measurements performed at low temperatures and low magnetic fields on a high mobility (777,000 cm(2) V(-1) s(-1)) p-Ge/SiGe quantum well heterostructure. The measured magnetoresistance over a temperature range of 0.44 to 11.2 K shows an apparent transition from weak localization to weak antilocalization. The temperature dependence of the zero field conductance correction is indicative of weak localization using the simplest model, despite the clear existence of weak antilocalization. The Rashba interaction present in this material, and the absence of the un-tuneable Dresselhaus interaction, indicates that Ge quantum well heterostructures are highly suitable for semiconductor spintronic applications, particularly the proposed spin field effect transistor.
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Evidence for a time-dependent association between FOLR1 expression and survival from ovarian carcinoma: implications for clinical testing. An Ovarian Tumour Tissue Analysis consortium study. Br J Cancer 2014; 111:2297-307. [PMID: 25349970 PMCID: PMC4264456 DOI: 10.1038/bjc.2014.567] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/03/2014] [Accepted: 10/02/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Folate receptor 1 (FOLR1) is expressed in the majority of ovarian carcinomas (OvCa), making it an attractive target for therapy. However, clinical trials testing anti-FOLR1 therapies in OvCa show mixed results and require better understanding of the prognostic relevance of FOLR1 expression. We conducted a large study evaluating FOLR1 expression with survival in different histological types of OvCa. METHODS Tissue microarrays composed of tumour samples from 2801 patients in the Ovarian Tumour Tissue Analysis (OTTA) consortium were assessed for FOLR1 expression by centralised immunohistochemistry. We estimated associations for overall (OS) and progression-free (PFS) survival using adjusted Cox regression models. High-grade serous ovarian carcinomas (HGSC) from The Cancer Genome Atlas (TCGA) were evaluated independently for association between FOLR1 mRNA upregulation and survival. RESULTS FOLR1 expression ranged from 76% in HGSC to 11% in mucinous carcinomas in OTTA. For HGSC, the association between FOLR1 expression and OS changed significantly during the years following diagnosis in OTTA (Pinteraction=0.01, N=1422) and TCGA (Pinteraction=0.01, N=485). In OTTA, particularly for FIGO stage I/II tumours, patients with FOLR1-positive HGSC showed increased OS during the first 2 years only (hazard ratio=0.44, 95% confidence interval=0.20-0.96) and patients with FOLR1-positive clear cell carcinomas (CCC) showed decreased PFS independent of follow-up time (HR=1.89, 95% CI=1.10-3.25, N=259). In TCGA, FOLR1 mRNA upregulation in HGSC was also associated with increased OS during the first 2 years following diagnosis irrespective of tumour stage (HR: 0.48, 95% CI: 0.25-0.94). CONCLUSIONS FOLR1-positive HGSC tumours were associated with an increased OS in the first 2 years following diagnosis. Patients with FOLR1-negative, poor prognosis HGSC would be unlikely to benefit from anti-FOLR1 therapies. In contrast, a decreased PFS interval was observed for FOLR1-positive CCC. The clinical efficacy of FOLR1-targeted interventions should therefore be evaluated according to histology, stage and time following diagnosis.
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Evidence for a time-dependent association between FOLR1 expression and survival from ovarian carcinoma: implications for clinical testing. An Ovarian Tumour Tissue Analysis consortium study. Br J Cancer 2014. [PMID: 25349970 DOI: 10.1038/bjc.2014.567] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Folate receptor 1 (FOLR1) is expressed in the majority of ovarian carcinomas (OvCa), making it an attractive target for therapy. However, clinical trials testing anti-FOLR1 therapies in OvCa show mixed results and require better understanding of the prognostic relevance of FOLR1 expression. We conducted a large study evaluating FOLR1 expression with survival in different histological types of OvCa. METHODS Tissue microarrays composed of tumour samples from 2801 patients in the Ovarian Tumour Tissue Analysis (OTTA) consortium were assessed for FOLR1 expression by centralised immunohistochemistry. We estimated associations for overall (OS) and progression-free (PFS) survival using adjusted Cox regression models. High-grade serous ovarian carcinomas (HGSC) from The Cancer Genome Atlas (TCGA) were evaluated independently for association between FOLR1 mRNA upregulation and survival. RESULTS FOLR1 expression ranged from 76% in HGSC to 11% in mucinous carcinomas in OTTA. For HGSC, the association between FOLR1 expression and OS changed significantly during the years following diagnosis in OTTA (Pinteraction=0.01, N=1422) and TCGA (Pinteraction=0.01, N=485). In OTTA, particularly for FIGO stage I/II tumours, patients with FOLR1-positive HGSC showed increased OS during the first 2 years only (hazard ratio=0.44, 95% confidence interval=0.20-0.96) and patients with FOLR1-positive clear cell carcinomas (CCC) showed decreased PFS independent of follow-up time (HR=1.89, 95% CI=1.10-3.25, N=259). In TCGA, FOLR1 mRNA upregulation in HGSC was also associated with increased OS during the first 2 years following diagnosis irrespective of tumour stage (HR: 0.48, 95% CI: 0.25-0.94). CONCLUSIONS FOLR1-positive HGSC tumours were associated with an increased OS in the first 2 years following diagnosis. Patients with FOLR1-negative, poor prognosis HGSC would be unlikely to benefit from anti-FOLR1 therapies. In contrast, a decreased PFS interval was observed for FOLR1-positive CCC. The clinical efficacy of FOLR1-targeted interventions should therefore be evaluated according to histology, stage and time following diagnosis.
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Measuring spatial variability of vapor flux to characterize vadose-zone VOC sources: flow-cell experiments. JOURNAL OF CONTAMINANT HYDROLOGY 2014; 167:32-43. [PMID: 25171394 PMCID: PMC4278747 DOI: 10.1016/j.jconhyd.2014.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 07/14/2014] [Accepted: 07/21/2014] [Indexed: 05/11/2023]
Abstract
A method termed vapor-phase tomography has recently been proposed to characterize the distribution of volatile organic contaminant mass in vadose-zone source areas, and to measure associated three-dimensional distributions of local contaminant mass discharge. The method is based on measuring the spatial variability of vapor flux, and thus inherent to its effectiveness is the premise that the magnitudes and temporal variability of vapor concentrations measured at different monitoring points within the interrogated area will be a function of the geospatial positions of the points relative to the source location. A series of flow-cell experiments was conducted to evaluate this premise. A well-defined source zone was created by injection and extraction of a non-reactive gas (SF6). Spatial and temporal concentration distributions obtained from the tests were compared to simulations produced with a mathematical model describing advective and diffusive transport. Tests were conducted to characterize both areal and vertical components of the application. Decreases in concentration over time were observed for monitoring points located on the opposite side of the source zone from the local-extraction point, whereas increases were observed for monitoring points located between the local-extraction point and the source zone. The results illustrate that comparison of temporal concentration profiles obtained at various monitoring points gives a general indication of the source location with respect to the extraction and monitoring points.
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Subcellular localization of AT-rich interactive domain1A protein expression is associated with survival in epithelial ovarian and peritoneal carcinoma. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.03.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ovarian cancers with nuclear special AT-rich sequence-binding protein 1 and cytoplasmic AT-rich interactive domain-containing protein 1A are rare, drug-resistant, and deadly. Gynecol Oncol 2014. [DOI: 10.1016/j.ygyno.2014.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Undiagnosed intussusception in an adult 'small and large bowel'. CASE REPORTS 2014; 2014:bcr-2013-201981. [DOI: 10.1136/bcr-2013-201981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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P1.002 Development and Persistence of Anti-Chlamydial Antibodies in Women with Incident Chlamydia TrachomatisInfections in Uganda and Zimbabwe. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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TH-A-WAB-05: Selection of Candidate Lesions for Image-Guided Bone Biopsy Using [F-18]NaF PET/CT Response to Therapy. Med Phys 2013. [DOI: 10.1118/1.4815699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Characterizing long-term contaminant mass discharge and the relationship between reductions in discharge and reductions in mass for DNAPL source areas. JOURNAL OF CONTAMINANT HYDROLOGY 2013; 149:1-12. [PMID: 23528743 PMCID: PMC3875322 DOI: 10.1016/j.jconhyd.2013.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 11/09/2012] [Accepted: 02/25/2013] [Indexed: 05/03/2023]
Abstract
The objective of this study was to characterize the temporal behavior of contaminant mass discharge, and the relationship between reductions in contaminant mass discharge and reductions in contaminant mass, for a very heterogeneous, highly contaminated source-zone field site. Trichloroethene is the primary contaminant of concern, and several lines of evidence indicate the presence of organic liquid in the subsurface. The site is undergoing groundwater extraction for source control, and contaminant mass discharge has been monitored since system startup. The results show a significant reduction in contaminant mass discharge with time, decreasing from approximately 1 to 0.15 kg/d over five years. Two methods were used to estimate the mass of contaminant present in the source area at the initiation of the remediation project. One was based on a comparison of two sets of core data, collected 3.5 years apart, which suggests that a significant (~80%) reduction in aggregate sediment-phase TCE concentrations occurred between sampling events. The second method was based on fitting the temporal contaminant mass discharge data with a simple exponential source-depletion function. Relatively similar estimates, 784 and 993 kg, respectively, were obtained with the two methods. These data were used to characterize the relationship between reductions in contaminant mass discharge (CMDR) and reductions in contaminant mass (MR). The observed curvilinear relationship exhibits a reduction in contaminant mass discharge essentially immediately upon the initiation of mass reduction. This behavior is consistent with a system wherein significant quantities of mass are present in hydraulically poorly accessible domains for which mass removal is influenced by rate-limited mass transfer. The results obtained from the present study are compared to those obtained from other field studies to evaluate the impact of system properties and conditions on mass-discharge and mass-removal behavior. The results indicate that factors such as domain scale, hydraulic-gradient status (induced or natural), and flushing-solution composition had insignificant impact on the CMDR-MR profiles and thus on underlying mass-removal behavior. Conversely, source-zone age, through its impact on contaminant distribution and accessibility, was implicated as a critical factor influencing the nature of the CMDR-MR relationship.
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TU-A-WAB-06: Evaluation of Articulated Registration and Application to Metastatic Bone Lesions Identification. Med Phys 2013. [DOI: 10.1118/1.4815340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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History of Injury and Violence as public health problems and emergence of the National Center for Injury Prevention and Control at CDC. JOURNAL OF SAFETY RESEARCH 2012; 43:233-247. [PMID: 23127672 DOI: 10.1016/j.jsr.2012.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 09/17/2012] [Indexed: 06/01/2023]
Abstract
Injuries and violence are among the oldest health problems facing humans. Only within the past 50 years, however, has the problem been addressed with scientific rigor using public health methods. The field of injury control began as early as 1913, but wasn't approached systematically or epidemiologically until the 1940s and 1950s. It accelerated rapidly between 1960 and 1985. Coupled with active federal and state interest in reducing injuries and violence, this period was marked by important medical, scientific, and public health advances. The National Center for Injury Prevention and Control (NCIPC) was an outgrowth of this progress and in 2012 celebrated its 20th anniversary. NCIPC was created in 1992 after a series of government reports identified injury as one of the most important public health problems facing the nation. Congressional action provided the impetus for the creation of NCIPC as the lead federal agency for non-occupational injury and violence prevention. In subsequent years, NCIPC and its partners fostered many advances and built strong capacity. Because of the tragically high burden and cost of injuries and violence in the United States and around the globe, researchers, practitioners, and decision makers will need to redouble prevention efforts in the next 20 years. This article traces the history of injury and violence prevention as a public health priority-- including the evolution and current structure of the CDC's National Center for Injury Prevention and Control.
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SU-E-J-194: The Impact of Different Imaging Measures on Treatment Response Assessment of Bone Metastases. Med Phys 2012; 39:3697. [DOI: 10.1118/1.4735035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Incidence of major clinical outcomes in a cohort of Ugandan and Zimbabwean women with HIV-1 infection followed from seroconversion. Int J STD AIDS 2012; 23:111-4. [PMID: 22422685 DOI: 10.1258/ijsa.2011.011117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We conducted a prospective cohort study of 306 HIV-1-infected women, followed from seroconversion for median 6.4 years in Uganda (UG) and Zimbabwe (ZM) to describe the incidence of major clinical outcomes (MCOs), defined as World Health Organization stage 4 conditions and any tuberculosis (TB). In Uganda, 19 MCOs occurred in 13 participants at median 4.6 years and a median CD4 count of 213 cells/mm(3). In Zimbabwe, 29 MCOs occurred in 27 participants at median 4.0 years (P < 0.001 versus UG) and median CD4 count of 219 cells/mm(3) (P = 0.83 versus UG). MCO incidence was not statistically different (UG: 2.82 cases/100 person-years versus ZM: 2.45; P = 0.64) except for TB (UG: 0.59 versus ZM: 2.02 cases/100 person-years; P = 0.02). This significant difference in TB incidence is primarily due to a TB screening and isoniazid prevention therapy programme that was implemented in Uganda, but not in Zimbabwe, highlighting the importance of integrated TB screening and treatment within HIV programmes.
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The Trauma Surgeon Satisfaction Gap and its Consequences. J Surg Res 2012. [DOI: 10.1016/j.jss.2011.11.583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Paediatric traumatic out-of-hospital cardiac arrests in Melbourne, Australia. Resuscitation 2011; 83:471-5. [PMID: 22108466 DOI: 10.1016/j.resuscitation.2011.11.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Accepted: 11/08/2011] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Many consider attempted resuscitation for traumatic out-of-hospital cardiac arrest (OHCA) futile. This study aims to describe the characteristics and profile of paediatric traumatic OHCA. METHODS The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all trauma related cases of OHCA in patients aged less than 16 years of age. Cases were linked with their coronial findings. RESULTS Between 2000 and 2009, EMS attended 33,722 OHCAs including 2187 adult traumatic OHCAs. There were 538 (1.6%) OHCAs in children less than 16 years of age of which n=64 were due to trauma. The median age (IQR) of paediatric traumatic OHCA was 7 (4.5-13) years and 44 were male (69%). Bystander CPR was performed in 22 cases (34.4%). The first recorded rhythm by EMS was asystole seen in 42 (66%), PEA in 14 (22%) cases and VF in 2 cases (3%). Cardiac output was present in 7 (11%) cases who subsequently had an EMS witnessed OHCA. EMS attempted resuscitation in 35 (55%) patients of whom 7 (20%) achieved ROSC and were transported, and 1 (3%) survived to hospital discharge with severe neurological sequelae; 14(40%) were transported with CPR of whom none survived. Coronial cause of death was multiple injuries in 35%, head injury in 33%, head and neck injury in 10%, chest injuries in 10% and other causes (12%). CONCLUSIONS Traumatic aetiology of OHCA when compared to the incidence of adult traumatic OHCAs is uncommon. Resuscitation efforts are seldom effective and associated with poor neurological outcome.
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Margin of Error: excision margins and 5 year recurrence after breast conserving surgery. Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.08.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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