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4. Creating respectful workplaces for nurses in regional acute care settings: A quasi-experimental design.

Author

Hawkins, N, Jeong, SY-S, Smith, T, Sim, J, Clapham, M, Hawkins, N, Jeong, SY-S, Smith, T, Sim, J, and Clapham, M

Abstract

AIM: To examine self-reported exposure and experiences of negative workplace behaviour and ways of coping of nursing staff before and after educational workshops. DESIGN: A Quasi-experimental design. METHOD/SETTING/PARTICIPANTS: Data were collected pre- /postworkshops using a structured questionnaire. Nurses (N = 230) from 12 units in four regional acute care hospitals were invited to complete a pre-intervention survey. Educational workshops were then implemented by the organization at two of the hospitals, after which, follow-up surveys were undertaken. RESULTS: There were 74 responses in the pre-intervention and 56 responses in the postintervention time period. There were 111 participants who attended the educational intervention, 20% (n = 22) completed the follow-up survey. Participants were more likely exposed to work-related bullying acts and they used problem-focused coping strategies and sought social support as a way of coping when exposed to the negative behaviours. Overall, there was a decrease in both bullying and incivility experienced by participants; however, our findings were unable to establish that a statistically significant difference was made due to the implementation of the intervention. STUDY REGISTRATION: Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

Published
2023

5. A conflicted tribe under pressure: A qualitative study of negative workplace behaviour in nursing.

Author

Hawkins, N, Jeong, SY-S, Smith, T, Sim, J, Hawkins, N, Jeong, SY-S, Smith, T, and Sim, J

Abstract

AIM: This study explored workplace interactions of Australian nurses in regional acute care hospitals through an examination of nurses' experiences and perceptions of workplace behaviour. DESIGN: This research is informed by Social Worlds Theory and is the qualitative component of an overarching mixed methods sequential explanatory study. METHODS: Between January and March 2019, data were collected from 13 nursing informants from different occupational levels and roles, who engaged in semi-structured, in-depth, face-to-face interviews. Data analysis was guided by Straussian grounded theory to identify the core category and subcategories. RESULTS: Theoretical saturation occurred after 13 interviews. The core category identified is A conflicted tribe under pressure, which is comprised of five interrelated subcategories: Belonging to the tribe; 'It's a living hell'; Zero tolerance-'it's a joke'; Conflicted priorities; Shifting the cultural norm. CONCLUSION: This study provides valuable insight into the nursing social world and the organizational constraints in which nurses work. Although the inclination for an individual to exhibit negative behaviours cannot be dismissed, this behaviour can either be facilitated or impeded by organizational influences. IMPACT: By considering the nurses' experiences of negative workplace behaviour and identifying the symptoms of a struggling system, nurse leaders can work to find and implement strategies to mitigate negative behaviour and create respectful workplace behaviours. PATIENT OR PUBLIC CONTRIBUTION: This study involved registered nurse participants and there was no patient or public contribution. CLINICAL TRIAL REGISTRATION: Study registration Australian New Zealand Clinical Trials Registry (Registration No. ACTRN12618002007213; December 14, 2018).

Published
2023

6. Mapping health service coverage inequalities in Africa: a scoping review protocol

Author

Karamagi, H. C., Ben Charif, A., Afriyie, D. O., Sy, S., Kipruto, H., Oyelade, T., and Droti, B.

Abstract

INTRODUCTION: Addressing inequities in health service coverage is a global priority, especially with the resurgence of interest in universal health coverage. However, in Africa, which has the lowest health service coverage index, there is limited information on the progress of countries in addressing inequalities related to health services. Thus, we seek to map the evidence on inequalities in health service coverage in Africa. METHODS AND ANALYSIS: We will conduct a scoping review following the Joanna Briggs Institute Manual for Evidence Synthesis. We preregistered this protocol with the Open Science Framework on 26 July 2022 (https://osf.io/zd5bt). We will consider any empirical research that assesses inequalities in relation to services for reproductive, maternal, newborn and child health (eg, family planning), infectious diseases (eg, tuberculosis treatment) and non-communicable diseases (eg, cervical cancer screening) in Africa. We will search MEDLINE, Embase, Web of Science, CINAHL, PsycINFO and Cochrane Library from their inception onwards. We will also hand-search Google and Global Index Medicus, and screen reference lists of relevant studies. We will evaluate studies for eligibility and extract data from included studies using pre-piloted and standardised forms. We will further extract a core set of health service coverage indicators, which are disaggregated by place of residence, race/ethnicity/culture, occupation, gender, religion, education, socioeconomic status and social capital plus equity stratifiers. We will summarise data using a narrative approach involving thematic syntheses and descriptive statistics. We will report our findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. ETHICS AND DISSEMINATION: Ethical approval is not required as primary data will not be collected. This work will contribute to identifying knowledge gaps in the evidence of inequalities in health service coverage in Africa, and propose strategies that could help overcome current challenges. We will disseminate our findings to knowledge users through a publication in a peer-reviewed journal and organisation of workshops.

Published
2023
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9. Raw and Cooked Vegetable Consumption and Risk of Cardiovascular Disease:a Study of 400,000 Adults in UK Biobank

Author

Feng, Q, Kim, JH, Omiyale, W, Bešević, J, Conroy, M, May, M, Yang, Z, Wong, SY-S, Tsoi, KK-F, Allen, N, and Lacey, B

Subjects
raw vegetable, Nutrition and Dietetics, Endocrinology, Diabetes and Metabolism, cooked vegetable, vegetable intake, UK biobank, Food Science, cardiovascular diseases
Abstract

ObjectivesHigher levels of vegetable consumption have been associated with a lower risk of cardiovascular disease (CVD), but the independent effect of raw and cooked vegetable consumption remains unclear.MethodsFrom the UK Biobank cohort, 399,586 participants without prior CVD were included in the analysis. Raw and cooked vegetable intakes were measured with a validated dietary questionnaire at baseline. Multivariable Cox regression was used to estimate the associations between vegetable intake and CVD incidence and mortality, adjusted for socioeconomic status, health status, and lifestyle factors. The potential effect of residual confounding was assessed by calculating the percentage reduction in the likelihood ratio (LR) statistics after adjustment for the confounders.ResultsThe mean age was 56 years and 55% were women. Mean intakes of raw and cooked vegetables were 2.3 and 2.8 tablespoons/day, respectively. During 12 years of follow-up, 18,052 major CVD events and 4,406 CVD deaths occurred. Raw vegetable intake was inversely associated with both CVD incidence (adjusted hazard ratio (HR) [95% CI] for the highest vs. lowest intake: 0.89 [0.83–0.95]) and CVD mortality (0.85 [0.74–0.97]), while cooked vegetable intake was not (1.00 [0.91–1.09] and 0.96 [0.80–1.13], respectively). Adjustment for potential confounders reduced the LR statistics for the associations of raw vegetables with CVD incidence and mortality by 82 and 87%, respectively.ConclusionsHigher intakes of raw, but not cooked, vegetables were associated with lower CVD risk. Residual confounding is likely to account for much, if not all, of the observed associations. This study suggests the need to reappraise the evidence on the burden of CVD disease attributable to low vegetable intake in the high-income populations.

Published
2022

10. The Burden of Illness in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease in Canada

Author

M Reza Maleki-Yazdi, Suzanne M Kelly, Sy S Lam, Mihaela Marin, Martin Barbeau, and Valery Walker

Subjects
Diseases of the respiratory system, RC705-779
Abstract

INTRODUCTION: No recent Canadian studies with physician- and spirometry-confirmed diagnosis of chronic obstructive pulmonary disease (COPD) that assessed the burden of COPD have been published.

Published
2012
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12. Lithium administered to pregnant, lactating and neonatal rats: entry into developing brain

Author

Chiou, SY-S, Kysenius, K, Huang, Y, Habgood, MD, Koehn, LM, Qiu, F, Crouch, PJ, Varshney, S, Ganio, K, Dziegielewska, KM, Saunders, NR, Chiou, SY-S, Kysenius, K, Huang, Y, Habgood, MD, Koehn, LM, Qiu, F, Crouch, PJ, Varshney, S, Ganio, K, Dziegielewska, KM, and Saunders, NR

Abstract

BACKGROUND: Little is known about the extent of drug entry into developing brain, when administered to pregnant and lactating women. Lithium is commonly prescribed for bipolar disorder. Here we studied transfer of lithium given to dams, into blood, brain and cerebrospinal fluid (CSF) in embryonic and postnatal animals as well as adults. METHODS: Lithium chloride in a clinically relevant dose (3.2 mg/kg body weight) was injected intraperitoneally into pregnant (E15-18) and lactating dams (birth-P16/17) or directly into postnatal pups (P0-P16/17). Acute treatment involved a single injection; long-term treatment involved twice daily injections for the duration of the experiment. Following terminal anaesthesia blood plasma, CSF and brains were collected. Lithium levels and brain distribution were measured using Laser Ablation Inductively Coupled Plasma-Mass Spectrometry and total lithium levels were confirmed by Inductively Coupled Plasma-Mass Spectrometry. RESULTS: Lithium was detected in blood, CSF and brain of all fetal and postnatal pups following lithium treatment of dams. Its concentration in pups' blood was consistently below that in maternal blood (30-35%) indicating significant protection by the placenta and breast tissue. However, much of the lithium that reached the fetus entered its brain. Levels of lithium in plasma fluctuated in different treatment groups but its concentration in CSF was stable at all ages, in agreement with known stable levels of endogenous ions in CSF. There was no significant increase of lithium transfer into CSF following application of Na+/K+ ATPase inhibitor (digoxin) in vivo, indicating that lithium transfer across choroid plexus epithelium is not likely to be via the Na+/K+ ATPase mechanism, at least early in development. Comparison with passive permeability markers suggested that in acute experiments lithium permeability was less than expected for diffusion but similar in long-term experiments at P2. CONCLUSIONS: Information obtai

Published
2021

14. The Impact of Different Screening Model Structures on Cervical Cancer Incidence and Mortality Predictions: The Maximum Clinical Incidence Reduction (MCLIR) Methodology

Author

Kok, I.M.C.M. (Inge) de, Burger, E.A. (Emily A.), Naber, S.K. (Steffie), Canfell, K. (Karen), Killen, J. (James), Simms, K. (Kate), Kulasingam, S. (Shalini), Groene, E. (Emily), Sy, S., Kim, J.J. (Jane J.), Ballegooijen, M. (Marjolein) van, Kok, I.M.C.M. (Inge) de, Burger, E.A. (Emily A.), Naber, S.K. (Steffie), Canfell, K. (Karen), Killen, J. (James), Simms, K. (Kate), Kulasingam, S. (Shalini), Groene, E. (Emily), Sy, S., Kim, J.J. (Jane J.), and Ballegooijen, M. (Marjolein) van

Abstract

Background. To interpret cervical cancer screening model results, we need to understand the influence of model structure and assumptions on cancer incidence and mortality predictions. Cervical cancer cases and deaths following screening can be attributed to 1) (precancerous or cancerous) disease that occurred after screening, 2) disease that was present but not screen detected, or 3) disease that was screen detected but not successfully treated. We examined the relative contributions of each of these using 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models. Methods. The maximum clinical incidence reduction (MCLIR) method compares changes in the number of clinically detected cervical cancers and mortality among 4 scenarios: 1) no screening, 2) one-time perfect screening at age 45 that detects all existing disease and delivers perfect (i.e., 100% effective) treatment of all screen-detected disease, 3) one-time realistic-sensitivity cytological screening and perfect treatment of all screen-detected disease, and 4) one-time realistic-sensitivity cytological screening and realistic-effectiveness treatment of all screen-detected disease. Results. Predicted incidence reductions ranged from 55% to 74%, and mortality reduction ranged from 56% to 62% within 15 years of follow-up for scenario 4 across models. The proportion of deaths due to disease not detected by screening differed across the models (21%–35%), as did the failure of treatment (8%–16%) and disease occurring after screening (from 1%–6%). Conclusions. The MCLIR approach aids in the interpretation of variability across model results. We showed that the reasons why screening failed to prevent cancers and deaths differed between the models. This likely reflects uncertainty about unobservable model inputs and structures; the impact of this uncertainty on policy conclusions should be examined via comparing findings from different well-calibrated and validated model platforms.

Published
2020
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15. The Impact of Different Screening Model Structures on Cervical Cancer Incidence and Mortality Predictions: The Maximum Clinical Incidence Reduction (MCLIR) Methodology

Author

Driesprong - de Kok, Inge, Burger, EA, Naber, Steffie, Canfell, K, Killen, J, Simms, K, Kulasingam, S, Groene, E, Sy, S, Kim, JJ, Ballegooijen, Marjolein, Driesprong - de Kok, Inge, Burger, EA, Naber, Steffie, Canfell, K, Killen, J, Simms, K, Kulasingam, S, Groene, E, Sy, S, Kim, JJ, and Ballegooijen, Marjolein

Published
2020

24. The Periodontal Condition of Chronic Hemodialysis Patients in the Nephrology and Hemodialysis Department of the Mali-Gavardo Hospital in Bamako

Author

Diawara, O, primary, Coulibaly, M., additional, Kone, M., additional, Lawrence, EE Belinga, additional, Niang, A, additional, Samake, M., additional, Konare, S., additional, Sy, S., additional, Nimaga, A, additional, Djiguiba, K., additional, Yattara, H., additional, Ba, M., additional, Diallo, D., additional, Ba, B., additional, and Fongoro, S., additional

Published
2020
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29. Use of Modified Clostridium perfringens Enterotoxin Fragments for Claudin Targeting in Liver and Skin Cells

Author

Beier, L, Rossa, J, Woodhouse, S, Bergmann, S, Kramer, H, Protze, J, Eichner, M, Piontek, A, Vidal-Y-Sy, S, Brandner, J, Krause, G, Zitzmann, N, and Piontek, J

Subjects
Clostridium perfringens enterotoxin, Hepatitis C Virus, epidermal barrier, Clostridiumperfringens enterotoxin, digestive system diseases, lcsh:Chemistry, lcsh:Biology (General), lcsh:QD1-999, reconstructed human epidermis, claudin-1, viral entry, lcsh:QH301-705.5, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit, claudin targeting
Abstract

Claudins regulate paracellular permeability in different tissues. The claudin-binding domain of Clostridium perfringens enterotoxin (cCPE) is a known modulator of a claudin subset. However, it does not efficiently bind to claudin-1 (Cldn1). Cldn1 is a pharmacological target since it is (i) an essential co-receptor for hepatitis C virus (HCV) infections and (ii) a key element of the epidermal barrier limiting drug delivery. In this study, we investigated the potential of a Cldn1-binding cCPE mutant (i) to inhibit HCV entry into hepatocytes and (ii) to open the epidermal barrier. Inhibition of HCV infection by blocking of Cldn1 with cCPE variants was analyzed in the Huh7.5 hepatoma cell line. A model of reconstructed human epidermis was used to investigate modulation of the epidermal barrier by cCPE variants. In contrast to cCPEwt, the Cldn1-binding cCPE-S305P/S307R/S313H inhibited infection of Huh7.5 cells with HCV in a dose-dependent manner. In addition, TJ modulation by cCPE variant-mediated targeting of Cldn1 and Cldn4 opened the epidermal barrier in reconstructed human epidermis. cCPE variants are potent claudin modulators. They can be applied for mechanistic in vitro studies and might also be used as biologics for therapeutic claudin targeting including HCV treatment (host-targeting antivirals) and improvement of drug delivery.

Published
2019
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30. Modeling the cost effectiveness and budgetary impact of Polypills for secondary prevention of cardiovascular disease in the United States

Author

Gaziano, TA, Pandya, A, Sy, S, Jardim, TV, Ogden, JM, Rodgers, A, Weinstein, MC, Gaziano, TA, Pandya, A, Sy, S, Jardim, TV, Ogden, JM, Rodgers, A, and Weinstein, MC

Abstract

Background: There is underutilization of appropriate medications for secondary prevention of cardiovascular disease (CVD). Methods: Usual care (UC) was compared to polypill-based care with 3 versions using a validated micro-simulation model in the NHANES population with prior CVD. UC included individual prescription of up to 4 drug classes (antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone inhibitors and statins). The polypills modeled were aspirin 81 mg, atenolol 50 mg, ramipril 5 mg, and either simvastatin 40 mg (Polypill I), atorvastatin 80 mg (Polypill II), or rosuvastatin 40 mg (Polypill III). Baseline medication use and adherence came from United Healthcare claims data. Results: When compared to UC, there were annual reductions of 130,000 to 178,000 myocardial infarctions and 54,000 to 74,000 strokes using Polypill I and II, respectively. From a health sector perspective, in incremental analysis the ICERs for Polypill I and II were $20,073/QALY and $21,818/QALY respectively; Polypill III was dominated but had a similar cost-effectiveness ratio to Polypill II when compared directly to usual care. From a societal perspective, Polypill II was cost-saving and dominated all strategies. Over a 5-year period, those taking Polypill I and II compared to UC saved approximately $12 and $6 per-patient-per-year alive, respectively. Polypill II was the preferred strategy in 98% of runs at a willingness to pay of $50,000 in the probability sensitivity analysis. Conclusions: Use of a polypill has a favorable cost profile for secondary CVD prevention in the United States. Reductions in CVD-related healthcare costs outweighed medication cost increases on a per-patient-per-year basis, suggesting that a polypill would be economically advantageous to both patients and payers.

Published
2019

31. Effect of time to diagnostic testing for breast, cervical, and colorectal cancer screening abnormalities on screening efficacy: A modeling study

Author

Rutter, C.M. (Carolyn), Kim, J.J. (Jane J.), Meester, R.G.S. (Reinier), Sprague, B.L. (Brian), Burger, E.A. (Emily A.), Zauber, A.G. (Ann), Ergun, M.A. (Mehmet Ali), Campos, N.G. (Nicole G.), Doubeni, C.A. (Chyke A.), Trentham-Dietz, A. (Amy), Sy, S., Alagoz, O. (Oguzhan), Stout, N.K. (Natasha), Lansdorp-Vogelaar, I. (Iris), Corley, D.A. (Douglas), Tosteson, A.N.A. (Anna), Rutter, C.M. (Carolyn), Kim, J.J. (Jane J.), Meester, R.G.S. (Reinier), Sprague, B.L. (Brian), Burger, E.A. (Emily A.), Zauber, A.G. (Ann), Ergun, M.A. (Mehmet Ali), Campos, N.G. (Nicole G.), Doubeni, C.A. (Chyke A.), Trentham-Dietz, A. (Amy), Sy, S., Alagoz, O. (Oguzhan), Stout, N.K. (Natasha), Lansdorp-Vogelaar, I. (Iris), Corley, D.A. (Douglas), and Tosteson, A.N.A. (Anna)

Abstract

Background: Patients who receive an abnormal cancer screening result require follow-up for diagnostic testing, but the time to follow-up varies across patients and practices. Methods: We used a simulation study to estimate the change in lifetime screening benefits when time to follow-up for breast, cervical, and colorectal cancers was increased. Estimates were based on four independently developed microsimulation models that each simulated the life course of adults eligible for breast (women ages 50–74 years), cervical (women ages 21–65 years), or colorectal (adults ages 50–75 years) cancer screening. We assumed screening based on biennial mammography for breast cancer, triennial Papanicolaou testing for cervical cancer, and annual fecal immunochemical testing for colorectal cancer. For each cancer type, we simulated diagnostic testing immediately and at 3, 6, and 12 months after an abnormal screening exam. Results: We found declines in screening benefit with longer times to diagnostic testing, particularly for breast cancer screening. Compared to immediate diagnostic testing, testing at 3 months resulted in reduced screening benefit, with fewer undiscounted life years gained per 1,000 screened (breast: 17.3%, cervical: 0.8%, colorectal: 2.0% and 2.7%, from two colorectal cancer models), fewer cancers prevented (cervical: 1.4% fewer, colorectal: 0.5% and 1.7% fewer, respectively), and, for breast and colorectal cancer, a less favorable stage distribution. Conclusions: Longer times to diagnostic testing after an abnormal screening test can decrease screening effectiveness, but the impact varies substantially by cancer type. Impact: Understanding the impact of time to diagnostic testing on screening effectiveness can help inform quality improvement efforts. Cancer Epidemiol Biomarkers Prev; 27(2); 158–64. 2017 AACR.

Published
2018
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32. Effect of Time to Diagnostic Testing for Breast, Cervical, and Colorectal Cancer Screening Abnormalities on Screening Efficacy: A Modeling Study

Author

Rutter, CM, Kim, JJ, Meester, Reinier, Sprague, BL, Burger, EA, Zauber, AG, Ergun, MA, Campos, NG, Doubeni, CA, Trentham-Dietz, A, Sy, S, Alagoz, O, Stout, N, Lansdorp - Vogelaar, Iris, Corley, DA, Tosteson, ANA, Rutter, CM, Kim, JJ, Meester, Reinier, Sprague, BL, Burger, EA, Zauber, AG, Ergun, MA, Campos, NG, Doubeni, CA, Trentham-Dietz, A, Sy, S, Alagoz, O, Stout, N, Lansdorp - Vogelaar, Iris, Corley, DA, and Tosteson, ANA

Published
2018

33. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016

Author

Vos T., A, Abajobir A. A., D, Abbafati C., H, Abbas K. M., I, Abate, K, Abd-Allah F., J, Abdulle A. M., K, Abebo T. A., L, Abera S. F., M, R, A, V., S, L. J., T, I. N., U, A. A., X, O., Z, M., C, Afshin A., A, Agarwal, S. K., A, Aggarwal, R., A, Agrawal, A., A, Ad, A, S., A, Ahmad, K, Ahmadieh, H., A, Am, A, M. B., A, Aichour, A. N., A, I., A, M. T. E., A, Aiyar S., A, Akinyemi, R. O., A, At, A, N., A, Av, Al, L, F. H., A, Alahdab, F., A, Ba, A, Z., B, Alam, K., B, Bg, B, N., B, Alam T., A, Alasfoor, D., B, Alene, K. A., B, Bo, A, R., B, Alizadeh-Navaei, Alkerwi, A., B, Alla, F., B, Allebeck, P., D, Allen C., A, Al-Maskari, F., C, Al-Raddadi, R., C, Alsharif, U., C, Alsowaidi, S., C, Altirkawi, K. A., C, Amare, A. T., C, Ch, A, E., C, Ck, A, W., C, Amoako, Y. A., D, Andersen, H. H., D, Antonio, C. A. T., D, Anwari, Ärnlöv, J., D, Dj, A, A., D, Aryal, K. K., D, Dm, A, H., D, Asgedom S. W., Q, Assadi, R., D, Atey T. M., Q, Atnafu, N. T., D, Atre, S. R., D, Ds, A, L., D, Avokpaho, E. F. G. A., D, Dv, A, Ayala, Q, B. P., D, Dy, Ba, S, H. O., D, Bacha, U., E, Badawi, Eb, B, K., E, Banerjee, A., E, Bannick M. S., A, Barac, Barber R. M., A, Barker-Collo, S. L., E, Bärnighausen, T., E, El, E, Barquera, S., D, Barregard, L., E, Barrero, L. H., E, Basu, S., E, Battista, B., E, Battle, K. E., B, Baune, B. T., C, Bazargan-Hejazi, Es, B, J., E, Bedi, N., E, Beghi, E., E, Béjot, Y., E, Bekele, B. B., B, Ex, B, M. L., E, Bennett, D. A., B, Bensenor, I. M., F, Benson J., A, Berhane, A., F, Berhe D. F., N, Fe, B, E., F, Betsu B. D., Q, Beuran, M., F, Fk, B, A. S., F, Bhala, N., F, Fo, B, Bhatt, S., F, Bhutta, Z. A., A, Fu, B, Bienhoff K., A, Bikbov, B., F, Birungi, C., E, Biryukov S., A, Bisanzio, Bizuayehu, H. M., F, Boneya, D. J., F, Boufous, Bourne, R. R. A., G, Brazinova, A., G, Brugha, T. S., G, Buchbinder R., U, Gg, B, L. N. B., F, Bumgarner B. R., A, Butt, Z. A., G, Cahuana-Hurtado, Cameron, E., B, Car, Gi, C, H., G, Carapetis, J. R., G, Cárdenas, R., G, Carpenter, D. O., G, Carrero, J. J., D, Carter A., A, Carvalho, F., G, Casey D. C., A, Caso, V., G, Castañeda-Orjuela, C. A., G, Gt, C, C. D., A, Gv, C, H. -Y., G, Gx, C, J. -C., G, Charlson F. J., A, D, G, Chen, H., H, Chibalabala, M., H, Chibueze, C. E., H, Chisumpa, V. H., H, He, C, A. A., H, Christopher, D. J., H, Ciobanu, L. G., C, Cirillo, Colombara D., A, Cooper, C., B, Hi, H, Cortesi, P. A., H, Criqui, M. H., H, Crump, J. A., H, Dadi, A. F., B, Hp, D, K., H, Dandona L., A, Ag, D, Das, N, J., G, Davitoiu, D. V., F, De, C, B., W, De, L, D., H, Degenhardt L., A, Ga, D, R. P., H, Deribe, Hu, Des, J, D. C., H, Hx, D, Dharmaratne, S. D., H, Dhillon, P. K., A, Dicker D., A, Ding, E. L., E, Djalalinia, S., H, Do, H. P., I, Dorsey, E. R., I, Dos, S, K. P. B., I, Douwes-Schultz D., A, Doyle, Id, D, T. R., B, Dubey, M., I, Duncan, B. B., I, Ig, E, Z. Z., D, Ih, E, A., I, Endries, A. Y., I, Ermakov, S. P., I, Il, E, H. E., A, Gz, E, B., I, In, E, S., I, Esteghamati, A., C, Estep K., A, Fanuel, F. B. B., I, Iq, F, C. S. E. S., I, Is, F, Farzadfar, Fazeli, M. S., E, Feigin, V. L., I, Fereshtehnejad, S. -M., D, Fernandes, J. C., I, Ferrari A. J., A, Feyissa, T. R., I, Filip, I., I, Fischer, F., I, Fitzmaurice C., A, B, I, Flaxman A. D., A, Flor, L. S., J, Jb, F, N., J, Foreman K. J., A, Franklin, R. C., J, Fullman N., A, Fürst, T., F, Je, J, Furtado, J. M., J, Futran N. D., C, Gakidou E., A, Ganji, Garcia-Basteiro, A. L., J, Jj, G, T., J, Gebrehiwot, T. T., A, Geleto, Jl, G, B. L., J, Gesesew, H. A., A, Hp, G, P. W., B, Ghajar, Gibney, K. B., J, Gill, P. S., J, Gillum, R. F., J, Ginawi, I. A. M., J, Giref, A. Z., H, Gishu, M. D., F, Jr, G, G., E, Godwin W. W., A, Gold A. L., A, Goldberg E. M., A, Gona, P. N., J, Goodridge, A., J, Gopalani, S. V., J, Goto, Goulart, A. C., E, Jw, G, M., A, H. C., J, Gupta, R., J, T., K, Kb, G, V., K, Hafezi-Nejad, N., C, Hailu, A. D., H, Kf, H, G. B., Q, Hamadeh, R. R., K, Hamidi, S., K, Handal, A. J., K, Hankey, G. J., K, Kl, K, Hao, Y., K, Harb, H. 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K. dl, dm Asayesh, H. dn, Asgedom S. W. q, R. do, Atey T. M. q, N. T. dp, S. R. dq, ds Avila-Burgos, L. dt, E. F. G. A. du, dv Awasthi, A. dw, Ayala Quintanilla, B. P. dx, dy, Ba Saleem, H. O. dz, U. ea, A. aw, eb Balakrishnan, K. ec, A. ed, Bannick M. S. a, A. eg, Barber R. M. a, S. L. ei, T. ej, el em, S. dt, L. en, L. H. eo, S. ep, B. eq, K. E. bq, B. T. cf, S. er, es Beardsley, J. et, N. eu, E. ev, Y. ew, B. B. bm, ex Bell, M. L. ey, D. A. bs, I. M. fb, Benson J. a, A. fc, Berhe D. F. n, fe Bernabé, E. fi, Betsu B. D. q, M. fj, fk Beyene, A. S. fl, N. fn, fo Bhansali, A. fp, S. fq, Z. A. au, fu Biadgilign, S. fv, Bienhoff K. a, B. fw, C. ef, Biryukov S. a, D. bt, H. M. fy, D. J. fx, S. fz, R. R. A. gd, A. ge, T. S. gf, Buchbinder R. u, gg Bulto, L. N. B. fm, Bumgarner B. R. a, Z. A. gh, E. br, M. ft, gi Carabin, H. gj, J. R. gk, R. gl, D. O. gm, J. J. dg, Carter A. a, F. gn, Casey D. C. a, V. gr, C. A. gs, gt Castle, C. 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S. ja, jb Foigt, N. jc, Foreman K. J. a, R. C. jd, Fullman N. a, T. fq, je jg, J. M. jh, Futran N. D. c, Gakidou E. a, M. cy, A. L. ji, jj Gebre, T. jk, T. T. ao, A. fm, jl Gemechu, B. L. jm, H. A. ao, hp Gething, P. W. bv, A. cm, K. B. jn, P. S. jo, R. F. jp, I. A. M. jq, A. Z. hv, M. D. fm, jr Giussani, G. ev, Godwin W. W. a, Gold A. L. a, Goldberg E. M. a, P. N. js, A. jt, S. V. ju, A. jv, A. C. ez, jw Griswold, M. a Gugnani, H. C. jx, R. jy, R. jz, T. ka, kb Gupta, V. kc, N. cl, A. D. hu, kf Hailu, G. B. q kg, R. R. kh, S. ki, A. J. kj, G. J. kk, kl km, Y. kn, H. L. cz, H. A. hv, J. M. ko, Harvey J. a, M. S. cn, R. di, Hawley C. a, R. J. br, fi kp, Hay S. I. a, Henry N. J. a, I. B. dt, P. co, H. W. ff, kq Hoffman, H. J. ks, N. ku, H. D. kb, S. fj, P. J. kv, D. G. kw, A. S. dm, kx Hu, G. ky, H. kz, Huynh C. a, K. M. lb, E. U. lc, ld Ikeda, C. a Irvine, C. M. S. a Jacobsen, K. H. le, N. ak, Jakovljevic M. B. a, lf Jassal, S. K. hl, M. lg, S. P. lh, P. af, li Jensen, P. 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Abstract

Background As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-c, Background As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and incidence for 328 diseases and injuries and 2982 sequelae, their non-fatal consequences. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between incidence, prevalence, remission, and cause of death rates for each condition. For some causes, we used alternative modelling strategies if incidence or prevalence needed to be derived from other data. YLDs were estimated as the product of prevalence and a disability weight for all mutually exclusive sequelae, corrected for comorbidity and aggregated to cause level. We updated the Socio-demographic Index (SDI), a summary indicator of income per capita, years of schooling, and total fertility rate. GBD 2016 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, low back pain, migraine, age-related and other hearing loss, iron-deficiency anaemia, and major depressive disorder were the five leading causes of YLDs in 2016, contributing 57·6 million (95% uncertainty interval [UI] 40·8-75·9 million [7·2%, 6·0-8·3]), 45·1 million (29·0-62·8 million [5·6%, 4·0-7·2]), 36·3 million (25·3-50·9 million [4·5%, 3·8-5·3]), 34·7 million (23·0-49·6 million [4·3%, 3·5-5·2]), and 34·1 million (23·5-46·0 million [4·2%, 3·2-5·3]) of total YLDs, respectively. Age-standardised rates of YLDs for all causes combined decreased between 1990 and 2016 by 2·7% (95% UI 2·3-3·1). Despite mostly stagnant age-standardised rates, the absolute number of YLDs from non-c

Published
2017

34. GROSSESSE AU COURS DE L'HEMODIALYSE CHRONIQUE : A PROPOS D'UN CAS.

Author

Yattara H., Samaké M., Sy S., Diallo D., Coulibaly N., Djiguiba K., Fofana A. S., Coulibaly S., Touré A., Coulibaly M., DIALLO O., Fongoro S., and Diouf B.

Abstract

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2019

35. Selenium Decreases Thyroglobulin Concentrations But Does Not Affect the Increased Thyroxine-to-Triiodothyronine Ratio in Children with Congenital Hypothyroidism1

Author

Jean-Baptiste Vanderpas, Pierre Bourdoux, Sy S. Wu, Jean Neve, and Jean-Pierre Chanoine

Subjects
endocrine system, medicine.medical_specialty, endocrine system diseases, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Clinical Biochemistry, chemistry.chemical_element, Biochemistry, Endocrinology, Selenium deficiency, Internal medicine, medicine, Euthyroid, chemistry.chemical_classification, Triiodothyronine, business.industry, Glutathione peroxidase, Biochemistry (medical), Thyroid, medicine.disease, Congenital hypothyroidism, medicine.anatomical_structure, chemistry, Thyroglobulin, business, hormones, hormone substitutes, and hormone antagonists, Selenium
Abstract

Compared with euthyroid controls, patients with congenital hypothyroidism (CH) who are receiving L-T(4) treatment show elevated serum TSH relative to serum T(4) concentrations and increased T(4)/T(3) ratio. These abnormalities could be the consequence of impaired activity of the selenoenzymes deiodinases on which patients with CH rely to convert the ingested L-T(4) into active T(3). Eighteen patients (0.5-15.4 yr), diagnosed with CH in infancy, received selenomethionine (SeM, 20-60 microg selenium/day) for 3 months. The study took place in Belgium, a country where selenium intake is borderline. Compared with the values observed in age- and sex-matched euthyroid controls, patients with CH had decreased selenium, thyroglobulin and T(3) concentrations and increased TSH, reverse T(3), and T(4) concentrations and T(4)/T(3) ratio at baseline. Selenium supplementation caused a 74% increase in plasma selenium values but did not affect the activity of the selenoenzyme glutathione peroxidase used as a marker of selenium status. SeM abolished the TSH difference observed between CH patients and euthyroid controls at baseline and caused a significant decrease in thyroglobulin values. Thyroid hormone concentrations were not affected by SeM. In conclusion, our data suggest that selenium is not a limiting factor for peripheral T(4)-to-T(3) conversion in CH patients. In contrast, we find indirect evidence that SeM improves thyroid hormones feedback at the hypothalamo-pituitary level and decreases stimulation of the residual thyroid tissue, possibly suggesting greater intracellular T(4)-to-T(3) conversion.

Published
2001

37. Abstract P1-13-02: Early change in topoisomerase 1 (Top1) positive circulating tumor cells (CTCs) is associated with overall survival (OS) in patients with advanced breast cancer after treatment with etirinotecan pegol

Author

Rugo, HS, primary, Cortes, J, additional, Awada, A, additional, O'Shaughnessy, J, additional, Twelves, C, additional, Im, S-A, additional, Hannah, AL, additional, Lu, L, additional, Sy, S, additional, Caygill, K, additional, Zajchowski, D, additional, Davis, DW, additional, Hoch, U, additional, and Perez, EA, additional

Published
2016
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39. New Century, Old Disparities

Author

A S Diakité, Kim Jj, Mills E, Nesbitt-Ahmed Z, Mackieu Td, Bai M, I Sissoko, Yuki T, Byiringiro F, Diggins J, Earp Bd, Ogawa K, H J G Berthé, D Sangaré, Sharma M, M L Diakité, Sy S, Sakai M, Ñopo H, Mizuno K, and Ouattara Az

Subjects
education.field_of_study, Economic growth, Human rights, Linguistic rights, media_common.quotation_subject, Population, Right to property, Convention on the Elimination of All Forms of Discrimination Against Women, Convention, International human rights law, Law, Political science, education, media_common, Convention on the Rights of the Child
Abstract

The United Nations (UN) Convention on the Elimination of All Forms of Discrimination Against Women and the Convention on the Rights of the Child provide a sound legal foundation for advocacy of the rights of women and female children. Throughout the world girl children are the most vulnerable members of the community. Both conventions mandate that young girls receive protection from discrimination in access to health care nutrition education and other opportunities. The childrens rights convention establishes the childs right to life and the states obligation to ensure child survival. The womens rights convention calls for the full and equal participation of women in all spheres of social and economic development.

Published
2012

40. The burden of illness in patients with moderate to severe chronic obstructive pulmonary disease in Canada

Author

M. Reza Maleki-Yazdi, Sy S. Lam, Martin Barbeau, Mihaela Marin, S. Kelly, and Valery Walker

Subjects
Pulmonary and Respiratory Medicine, Moderate to severe, Male, medicine.medical_specialty, Canada, Pulmonary disease, Comorbidity, Diseases of the respiratory system, Pulmonary Disease, Chronic Obstructive, Cost of Illness, medicine, Cost of illness, Humans, In patient, Intensive care medicine, Aged, Retrospective Studies, COPD, RC705-779, business.industry, Smoking, Retrospective cohort study, medicine.disease, respiratory tract diseases, Respiratory Function Tests, Smoking epidemiology, Original Article, Female, business
Abstract

INTRODUCTION: No recent Canadian studies with physician- and spirometry-confirmed diagnosis of chronic obstructive pulmonary disease (COPD) that assessed the burden of COPD have been published.OBJECTIVE: To assess the costs associated with maintenance therapy and treatment for acute exacerbations of COPD (AECOPD) over a one-year period.METHODS: Respirologists, internists and family practitioners from across Canada enrolled patients with an established diagnosis of moderate to severe COPD (Global initiative for chonic Obstructive Lung Disease stages 2 and 3) confirmed by postbronchodilator spirometry. Patient information and health care resources related to COPD maintenance and physician-documented AECOPD over the previous year were obtained by chart review and patient survey.RESULTS: A total of 285 patients (59.3% male; mean age 70.4 years; mean pack years smoked 45.6; mean duration of COPD 8.2 years; mean postbronchodilator forced expiratory volume in 1 s 58.0% predicted) were enrolled at 23 sites across Canada. The average annual COPD-related cost per patient was $4,147. Across all 285 patients, maintenance costs were $2,475 per patient, of which medications accounted for 71%. AECOPD treatment costs were $1,673 per patient, of which hospitalizations accounted for 82%. Ninety-eight patients (34%) experienced a total of 157 AECOPD. Treatment of these AECOPD included medications and outpatient care, 19 emergency room visits and 40 hospitalizations (mean length of stay 8.9 days). The mean cost per AECOPD was $3,036.DISCUSSION: The current costs associated with moderate and severe COPD are considerable and will increase in the future. Appropriate use of medications and strategies to prevent hospitalizations for AECOPD may reduce COPD-related costs because these were the major cost drivers.

Published
2012

42. Orexin/Hypocretin Based Pharmacotherapies for the Treatment of Addiction: DORA or SORA?

Author

Khoo, SY-S, Brown, RM, Khoo, SY-S, and Brown, RM

Abstract

Addiction is a chronic relapsing disorder which presents a significant global health burden and unmet medical need. The orexin/hypocretin system is an attractive potential therapeutic target as demonstrated by the successful clinical trials of antagonist medications like Suvorexant for insomnia. It is composed of two neuropeptides, orexin-A and orexin-B and two excitatory and promiscuous G-protein coupled receptors, OX1 and OX2. Orexins are known to have a variety of functions, most notably in regulating arousal, appetite and reward. The orexins have been shown to have a role in mediating the effects of several drugs of abuse, such as cocaine, morphine and alcohol via projections to key brain regions such as the ventral tegmental area, nucleus accumbens and prefrontal cortex. However, it has not yet been demonstrated whether the dual orexin receptor antagonists (DORAs) under development for insomnia are ideal drugs for the treatment of addiction. The question of whether to use a DORA or single orexin receptor antagonist (SORA) for the treatment of addiction is a key question that will need to be answered in order to maximize the clinical utility of orexin receptor antagonists. This review will examine the role of the orexin/hypocretin system in addiction, orexin-based pharmacotherapies under development and factors affecting the selection of one or both orexin receptors as drug targets for the treatment of addiction.

Published
2014

43. Central orexin (hypocretin) 2 receptor antagonism reduces ethanol self-administration, but not cue-conditioned ethanol-seeking, in ethanol-preferring rats

Author

Brown, RM, Khoo, SY-S, Lawrence, AJ, Brown, RM, Khoo, SY-S, and Lawrence, AJ

Abstract

Orexins are hypothalamic neuropeptides which bind to two G-protein-coupled receptors, orexin-1 (OX(1)R) and orexin-2 (OX(2)R) receptor. While a role for OX(1)R has been established in both ethanol reinforcement and ethanol-seeking behaviour, the role of OX(2)R in these behaviours is relatively less-studied. The aim of this study was to determine the role of central OX(2)R in ethanol-taking and ethanol-seeking behaviour. Indiana ethanol-preferring rats were trained to self-administer ethanol (10% w/v) or sucrose (0.7–1% w/v) in the presence of reward-associated cues before being implanted with indwelling guide cannulae. The selective OX(2)R antagonist TCS-OX2-29 was administered i.c.v. to assess its effect on operant self-administration and cue-induced reinstatement following extinction. Following i.c.v. injection TCS-OX2-29 reduced self-administration of ethanol, but not sucrose. Despite reducing ethanol self-administration, TCS-OX2-29 had no impact on cue-induced reinstatement of ethanol seeking. To determine where in the brain OX(2)R were acting to modulate ethanol self-administration, TCS-OX2-29 was microinjected into either the shell or core of the nucleus accumbens (NAc). Intra-NAc core, but not shell, infusions of TCS-OX2-29 decreased responding for ethanol. Importantly, the doses of TCS-OX2-029 used were non-sedating. Collectively, these findings implicate OX(2)R in the NAc in mediating the reinforcing effects of ethanol. This effect appears to be drug-specific as antagonism of central OX(2)R had no impact on sucrose self-administration. Thus, OX(2)R in addition to OX(1)R may represent a potential therapeutic target for the treatment of ethanol-use disorders. However, unlike OX(1)R, no impact of OX(2)R antagonism was observed on cue-induced reinstatement, suggesting a more prominent role for OX(2)R in ethanol self-administration compared to cue-conditioned ethanol-seeking.

Published
2013

44. Population pharmacokinetic modeling of tramadol and its O-desmethyl metabolite in plasma and breast milk

Author

Salman, S., Sy, S., Ilett, K., Page-Sharp, Madhu, Paech, M., Salman, S., Sy, S., Ilett, K., Page-Sharp, Madhu, and Paech, M.

Abstract

Purpose: The aim of this investigation was to demonstrate that nonlinear mixed-effects population pharmacokinetic (PK) modeling can be used to evaluate data from studies of drug transport/excretion into human milk and hence to estimate infant exposure. Methods: A sparse dataset from a previously published study of the use of oral tramadol for post-cesarean pain management in 75 lactating women was used. Milk and plasma samples were collected during days 2–4 of lactation, and tramadol and O-desmethyltramadol (ODT) concentration measurements in these samples were available. Absolute infant dose was obtained from the concentration measurements and estimated milk volume ingested, and expressed in micrograms per kilogram per day. Relative infant dose was calculated as a percentage of the absolute infant dose divided by the maternal dose (μg/kg/day). Nonlinear mixed-effects modeling was used to fit a population PK model to the data. Results: The disposition of tramadol and ODT in plasma and the transition of these substances into milk were characterized by a five-compartment population PK mixture model with first-order absorption. The polymorphic ODT formation clearance in the plasma compartment was able to be characterized in both CYP2D6-poor and -extensive metabolizers. Milk creamatocrit was a significant covariate in ODT transfer between the plasma and milk compartments. The estimated relative infant doses in extensive and poor metabolizers, respectively, were 2.16±0.57 and 2.60±0.57% for tramadol, and 0.93 ± .20 and 0.47±0.10% for ODT. Conclusions: This study demonstrates that a population PK approach with sparse sampling of analytes in milk and plasma can yield quality information about the transfer process and that it also can be used to estimate the extent of infant exposure to maternal drugs via milk.

Published
2011

45. Terahertz spectroscopy of liver cirrhosis: Investigating the origin of contrast

Author

Sy, S., Huang, S., Wang, Y.X.J., Yu, J., Ahuja, A.T., Zhang, Y.T., Pickwell-MacPherson, Emma, Sy, S., Huang, S., Wang, Y.X.J., Yu, J., Ahuja, A.T., Zhang, Y.T., and Pickwell-MacPherson, Emma

Abstract

We have previously demonstrated that terahertz pulsed imaging is able to distinguish between rat tissues from different healthy organs. In this paper we report our measurements of healthy and cirrhotic liver tissues using terahertz reflection spectroscopy. The water content of the fresh tissue samples was also measured in order to investigate the correlations between the terahertz properties, water content, structural changes and cirrhosis. Finally, the samples were fixed in formalin to determine whether water was the sole source of image contrast in this study. We found that the cirrhotic tissue had a higher water content and absorption coefficient than the normal tissue and that even after formalin fixing there were significant differences between the normal and cirrhotic tissues' terahertz properties. Our results show that terahertz pulsed imaging can distinguish between healthy and diseased tissue due to differences in absorption originating from both water content and tissue structure. © 2010 Institute of Physics and Engineering in Medicine.

Published
2010

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