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[PMID]: 25796021
[Au] Autor:Espahbodi E; Sanatkar M; Sadrossadat H; Darabi Vafsi ME; Azarshahin M; Shoroughi M
[Ad] Address:Department of Anesthesiology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Anesthesiology, Farabi Hospital, Tehran University of Medical Sciences, Tehran, Iran. eespahbodi@yahoo.com....
[Ti] Title:Ketamine or Atropine: Which One Better Prevents Oculocardiac Reflex during Eye Surgery? a Prospective Randomized Clinical Trial.
[So] Source:Acta Med Iran;53(3):158-61, 2015 Mar.
[Is] ISSN:1735-9694
[Cp] Country of publication:Iran
[La] Language:eng
[Ab] Abstract:Profound bradycardia during eye surgery is a potentially serious event. In clinical practice oculo-cardiac reflex (OCR) is most often encountered during squint surgery. The objective of this study was to assess the occurrence of OCR and prove the effect of ketamine as an induction drug and anticholinergic premedication (atropine) to prevent OCR. This study comprised 90 patients (aged 4-10 years) operated for squint surgery under general anesthesia. Patients were divided into three groups. Using block randomization, each patient enrolled in one of the three groups based on organized random table prepared by statistician. Group K received ketamine as an induction drug, Group A was premedicated with intravenous injection of atropine and Group C did not receive any premedication. Patients were monitored during operation for any bradycardia or dysrhythmias. The observed data showed occurrence of 63% OCR in Group C as compared to 43% in group A and only 20% in Group K. Current study showed that induction with ketamine in the patients of squint surgery under general anesthesia definitely obtunds OCR and prevents any untoward effects of dysrhythmias during eye surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 1442187 MEDLINE  
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[PMID]: 25796020
[Au] Autor:Farsi L; Naghib Zadeh M; Afshari K; Norouzi-Javidan A; Ghajarzadeh M; Naghshband Z; Keshavarz M
[Ad] Address:Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. lfarsi@razi.tums.ac.ir....
[Ti] Title:Effects of combining methylprednisolone with magnesium sulfate on neuropathic pain and functional recovery following spinal cord injury in male rats.
[So] Source:Acta Med Iran;53(3):149-57, 2015 Mar.
[Is] ISSN:1735-9694
[Cp] Country of publication:Iran
[La] Language:eng
[Ab] Abstract:Methylprednisolone (MP) has been widely used as a standard therapeutic agent for the treatment of spinal cord injury (SCI). Because of its controversial useful effects, the combination of MP and other pharmacological agents to enhance neuroprotective effects is desirable. Magnesium sulfate (MgSO4) has been shown to have neuroprotective and antihyperalgesic effects. In the present study, we sought to determine the effect of combining MP and MgSO4, on neuropathic pain and functional recovery following spinal cord injury (SCI) in male rats. A total of 48 adult male rats (weight 300-350 g) were used. After laminectomy, complete SCI was achieved by compression of the spinal cord for one minute with aneurysm clips. Single doses of Magnesium sulfate (MgSO4), (600 mg/kg), Methylprednisolone (MP), (30 mg/kg) or combining MgSO4 and MP were injected intraperitoneally. Prior to surgery and during four weeks of study Tail flick latency (TFL) and BBB (Basso-Beattie-Bresnahan) score and the acetone drop test were evaluated. In mean values of BBB score, a significant difference was observed in SCI+veh compared with other groups (P<0.05). Mean TFL also was significantly higher in SCI+veh compared with other groups (P<0.05). Mean acetone drop test score and weight were significantly different in MgSO4, MP and combining MgSO4 and MP  treated groups compared with SCI+veh group (P<0.05). These findings revealed that MP, MgSO4 and combining MgSO4 and MP treatment can attenuate neuropathic pains following SCI in rats include: thermal hyperalgesia and cold allodynia. They also can yield better improvement in motor function and decrease weight loss after SCI in rats compared with the control group.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 1442187 MEDLINE  
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[PMID]: 25704423
[Au] Autor:Ralls MW; Demehri FR; Feng Y; Woods Ignatoski KM; Teitelbaum DH
[Ad] Address:Section of Pediatric Surgery, Department of Surgery, University of Michigan, Ann Arbor, MI....
[Ti] Title:Enteral nutrient deprivation in patients leads to a loss of intestinal epithelial barrier function.
[So] Source:Surgery;157(4):732-42, 2015 Apr.
[Is] ISSN:1532-7361
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To investigate the effect of nutrient withdrawal on human intestinal epithelial barrier function (EBF). We hypothesized that unfed mucosa results in decreased EBF. This was tested in a series of surgical small intestinal resection specimens. DESIGN: Small bowel specifically excluding inflamed tissue, was obtained from pediatric patients (aged 2 days to 19 years) undergoing intestinal resection. EBF was assessed in Ussing chambers for transepithelial resistance (TER) and passage of fluorescein isothiocyanate (FITC)-dextran (4 kD). Tight junction and adherence junction proteins were imaged with immunofluorescence staining. Expression of Toll-like receptors (TLR) and inflammatory cytokines were measured in loop ileostomy takedowns in a second group of patients. RESULTS: Because TER increased with patient age (P < .01), results were stratified into infant versus teenage groups. Fed bowel had significantly greater TER versus unfed bowel (P < .05) in both age populations. Loss of EBF was also observed by an increase in FITC-dextran permeation in enteral nutrient-deprived segments (P < .05). Immunofluorescence staining showed marked declines in intensity of ZO-1, occludin, E-cadherin, and claudin-4 in unfed intestinal segments, as well as a loss of structural formation of tight junctions. Analysis of cytokine and TLR expression showed significant increases in tumor necrosis factor (TNF)-α and TLR4 in unfed segments of bowel compared with fed segments from the same individual. CONCLUSION: EBF declined in unfed segments of human small bowel. This work represents the first direct examination of EBF from small bowel derived from nutrient-deprived humans and may explain the increased incidence of infectious complications seen in patients not receiving enteral feeds.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review

  4 / 1442187 MEDLINE  
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[PMID]: 25661502
[Au] Autor:Elsalanty ME; Malavia V; Zakhary I; Mulone T; Kontogiorgos ED; Dechow PC; Opperman LA
[Ad] Address:Associate Professor, Department of Oral Biology and Oral and Maxillofacial Surgery, College of Dental Medicine, Georgia Regents University, Augusta, GA. Electronic address: melsalanty@gru.edu....
[Ti] Title:Dentate transport discs can be used to reconstruct large segmental mandibular defects.
[So] Source:J Oral Maxillofac Surg;73(4):745-58, 2015 Apr.
[Is] ISSN:1531-5053
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: This study tested the use of a dentate transport segment for the reconstruction of a large U-shaped defect in the anterior segment of the canine mandible using a novel curved reconstruction plate. The quality and quantity of bone regenerate formed by dentate versus edentulous transport segments were compared. MATERIALS AND METHODS: In 5 adult foxhound dogs, a defect of 70 to 75 mm was created in the canine mandible by excising the mandible anterior to the right and left fourth premolars. Reconstruction was performed by trifocal distraction osteogenesis using a bone transport reconstruction plate (BTRP-02), with 2 transport units being activated simultaneously, one on either side of the defect, 1 dentate and 1 edentulous. Bilateral distraction proceeded at a rate of 1 mm/day until the segments docked against each other in the midline. After 39 to 44 days of consolidation, the animals were euthanized. The quantity and quality of bone regeneration on the 2 sides were compared using micro-computed tomography. RESULTS: The defect reconstruction was successful. The amount and quality of bone formed by the transport segments were similar on the 2 sides. There were no major differences in the bone volume fraction and density of the regenerate bone formed by the 2 transport segments. The bone volume fraction and density of the regenerate bone were considerably lower than those of the host bone in the distal segments, likely owing to the short consolidation period. CONCLUSIONS: Bone transport remains a viable option in reconstructing anterior segmental defects in the mandible. The use of dentate or edentulous transport segments for reconstruction provides options for the surgeon in often highly compromised patients requiring these surgeries.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:AIM; D; IM
[St] Status:In-Data-Review

  5 / 1442187 MEDLINE  
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[PMID]: 25790453
[Au] Autor:Tighe PJ; Le-Wendling LT; Patel A; Zou B; Fillingim RB
[Ad] Address:aDepartment of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA bUniversity of Florida College of Medicine, Gainesville, FL, USA cDepartment of Biostatistics, University of Florida College of Medicine, Gainesville, FL, USA dDepartment of Community Dentistry and Behavioral Science, University of Florida College of Dentistry, Gainesville, FL, USA.
[Ti] Title:Clinically derived early postoperative pain trajectories differ by age, sex, and type of surgery.
[So] Source:Pain;156(4):609-17, 2015 Apr.
[Is] ISSN:1872-6623
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The objective of this study was to determine the effects of age, sex, and type of surgery on postoperative pain trajectories derived in a clinical setting from pain assessments in the first 24 hours after surgery. This study is a retrospective cohort study using a large electronic medical records system to collect and analyze surgical case data. The sample population included adult patients undergoing nonambulatory nonobstetric surgery in a single institution over a 1-year period. Analyses of postoperative pain trajectories were performed using a linear mixed-effects model. Pain score observations (91,708) from 7293 patients were included in the statistical analysis. On average, the pain score decreased about 0.042 (95% confidence interval [CI]: -0.044 to -0.040) points on the numerical rating scale (NRS) per hour after surgery for the first 24 postoperative hours. The pain score reported by male patients was approximately 0.27 (95% CI: -0.380 to -0.168) NRS points lower than that reported by females. Pain scores significantly decreased over time in all age groups, with a slightly more rapid decrease for younger patients. Pain trajectories differed by anatomic location of surgery, ranging from -0.054 (95% CI: -0.062 to -0.046) NRS units per hour for integumentary and nervous surgery to -0.104 (95% CI: -0.110 to -0.098) NRS units per hour for digestive surgery, and a positive trajectory (0.02 [95% CI: 0.016 to 0.024] NRS units per hour) for musculoskeletal surgery. Our data support the important role of time after surgery in considering the influence of biopsychosocial and clinical factors on acute postoperative pain.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/01.j.pain.0000460352.07836.0d

  6 / 1442187 MEDLINE  
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[PMID]: 25590605
[Au] Autor:Zhang J; Gold KA; Lin HY; Swisher SG; Xing Y; Lee JJ; Kim ES; William WN
[Ad] Address:*Department of Thoracic/Head & Neck Medical Oncology, †Department of Genomic Medicine, ‡Department of Biostatistics, §Department of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, The University of Texas, Houston TX; ‖Department of Medicine, Harvard Medical School, Mount Auburn Hospital, Cambridge, MA; and ¶Levine Cancer Institute, Carolina HealthCare System, Charlotte, NC.
[Ti] Title:Relationship Between Tumor Size and Survival in Non-Small-Cell Lung Cancer (NSCLC): An Analysis of the Surveillance, Epidemiology, and End Results (SEER) Registry.
[So] Source:J Thorac Oncol;10(4):682-90, 2015 Apr.
[Is] ISSN:1556-1380
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: Tumor size is a known prognostic factor for early stage non-small-cell lung cancer (NSCLC), but its significance in node-positive and locally invasive NSCLC has not been extensively characterized. We queried the Surveillance, Epidemiology, and End Results database to evaluate the prognostic value of tumor size for early stage and node-positive and locally invasive NSCLC. METHODS: Patients in Surveillance, Epidemiology, and End Results registry with NSCLC diagnosed between 1998 and 2003 were analyzed. Tumor size was analyzed as a continuous variable. Other demographic variables included age, gender, race, histology, primary tumor extension, node status, and primary treatment modality (surgery vs. radiation). The Kaplan-Meier method was used to estimate overall survival (OS). Cox proportional hazard model was used to evaluate whether tumor size was an independent prognostic factor. RESULTS: In all, 52,287 eligible patients were subgrouped based on tumor extension and node status. Tumor size had a significant effect on OS in all subgroups defined by tumor extension or node status. In addition, tumor size also had statistically significant effect on OS in 15 of 16 subgroups defined by tumor extension and nodal status after adjustment for other clinical variables. Our model incorporating tumor size had significantly better predictive accuracy than our alternative model without tumor size. CONCLUSIONS: Tumor size is an independent prognostic factor, for early stage and node-positive and locally invasive disease. Prediction tools, such as nomograms, incorporating more detailed information not captured in detail by the routine tumor, node, metastasis classification, may improve prediction accuracy of OS in NSCLC.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:IM
[St] Status:In-Data-Review
[do] DOI:10.1097/JTO.0000000000000456

  7 / 1442187 MEDLINE  
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SciELO Brazil full text

[PMID]: 25789521
[Au] Autor:Hou T; Zhou Q; Dai F; Luo F; He Q; Zhang J; Xu J
[Ad] Address:National & Regional United Engineering Lab of Tissue Engineering, Department of Orthopaedics, Southwest Hospital, the Third Military, Medical University, Chongqing, China....
[Ti] Title:Repeated microendoscopic discectomy for recurrent lumbar disk herniation.
[So] Source:Clinics (Sao Paulo);70(2):120-5, 2015 Feb.
[Is] ISSN:1980-5322
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To explore the microendoscopic discectomy technique and inclusion criteria for the treatment of recurrent lumbar disc herniation and to supply feasible criteria and technical notes to avoid complications and to increase the therapeutic effect. METHODS: A consecutive series of 25 patients who underwent posterior microendoscopic discectomy for recurrent lumbar disc herniation were included. The inclusion criteria were as follows: no severe pain in the lumbar region, no lumbar instability observed by flexion-extension radiography and no intervertebral discitis or endplate damage observed by magnetic resonance imaging. All patients were diagnosed by clinical manifestations and imaging examinations. RESULTS: Follow-up visits were carried out in all cases. Complications, such as nerve injuries, were not observed. The follow-up outcomes were graded using the MacNab criteria. A grade of excellent was given to 12 patients, good to 12 patients and fair to 1 patient. A grade of excellent or good occurred in 96% of cases. One patient relapsed 3 months after surgery and then underwent lumbar interbody fusion and inner fixation. The numerical rating scale of preoperative leg pain was 7.4± 1.5, whereas it decreased to 2.1±0.8 at 7 days after surgery. The preoperative Oswestry disability index of lumbar function was 57.5±10.0, whereas it was 26.0±8.5 at 7 days after surgery. CONCLUSION: In these cases, microendoscopic discectomy was able to achieve satisfactory clinical results. Furthermore, it has advantages over other methods because of its smaller incision, reduced bleeding and more efficient recovery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 1442187 MEDLINE  
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[PMID]: 25789520
[Au] Autor:Dai F; Liu Y; Zhang F; Sun D; Luo F; Zhang Z; Xu J
[Ad] Address:Southwest Hospital, National & Regional United Engineering Laboratory of Tissue Engineering, Department of Orthopaedics, The Third Military Medical University, Chongqing, China....
[Ti] Title:Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients.
[So] Source:Clinics (Sao Paulo);70(2):114-9, 2015 Feb.
[Is] ISSN:1980-5322
[Cp] Country of publication:Brazil
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5) underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months). The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018) and an improvement in lower extremity function (p = 0.025) in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:IM
[St] Status:In-Data-Review

  9 / 1442187 MEDLINE  
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[PMID]: 25130936
[Au] Autor:Yadav S; Dave M; Edakkanambeth Varayil J; Harmsen WS; Tremaine WJ; Zinsmeister AR; Sweetser SR; Melton LJ; Sandborn WJ; Loftus EV
[Ad] Address:Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota....
[Ti] Title:A Population-based Study of Incidence, Risk Factors, Clinical Spectrum, and Outcomes of Ischemic Colitis.
[So] Source:Clin Gastroenterol Hepatol;13(4):731-738.e6, 2015 Apr.
[Is] ISSN:1542-7714
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND & AIMS: Little is known about progression of ischemic colitis (IC) among unselected patients. We aimed to estimate the incidence, risk factors, and natural history of IC in a population-based cohort in Olmsted County, Minnesota. METHODS: We performed a retrospective population-based cohort and nested case-control study of IC. Each IC case was matched to 2 controls from the same population on the basis of sex, age, and closest registration number. Conditional logistic regression, the Kaplan-Meier method, and proportional hazards regression were used to assess comorbidities, estimate survival, and identify characteristics associated with survival, respectively. RESULTS: Four hundred forty-five county residents (median age, 71.6 years; 67% female) were diagnosed with IC from 1976 through 2009 and were matched with 890 controls. The age-adjusted and sex-adjusted incidence rates of IC nearly quadrupled from 6.1 cases/100,000 person-years in 1976-1980 to 22.9/100,000 in 2005-2009. The odds for IC were significantly higher among subjects with atherosclerotic diseases; odds ratios ranged from 2.6 for individuals with coronary disease to 7.9 for individuals with peripheral vascular disease. Of IC cases, 59% survived for 5 years (95% confidence interval, 54%-64%), compared with 90% of controls (95% confidence interval, 88%-92%). Age >40 years, male sex, right-sided colon involvement, concomitant small bowel involvement, and chronic obstructive pulmonary disease were all independently associated with mortality (P < .05). CONCLUSIONS: The incidence of IC increased during the past 3 decades in a population-based cohort in Minnesota. IC typically presents in older patients with multiple comorbidities and is associated with high in-hospital mortality (11.5%) and rates of surgery (17%).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:IM
[St] Status:In-Data-Review

  10 / 1442187 MEDLINE  
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[PMID]: 25790213
[Au] Autor:Fortier MA; Bunzli E; Walthall J; Olshansky E; Saadat H; Santistevan R; Mayes L; Kain ZN
[Ad] Address:From the *Department of Anesthesiology and Perioperative Care, University of California, Irvine School of Medicine, Irvine, California; †UCI Center on Stress & Health, Irvine, California; ‡Department of Anesthesiology, Yale School of Medicine, New Haven, Connecticut; §School of Nursing Science, University of California, Irvine, Irvine, California; ∥Child Life Department, Children's Hospital of Orange County, Orange, California; ¶Child Study Center, Yale University, New Haven, Connecticut.
[Ti] Title:Web-Based Tailored Intervention for Preparation of Parents and Children for Outpatient Surgery (WebTIPS): Formative Evaluation and Randomized Controlled Trial.
[So] Source:Anesth Analg;120(4):915-22, 2015 Apr.
[Is] ISSN:1526-7598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The purpose of this 2-phase project was to conduct a formative evaluation and to test the preliminary efficacy of a newly developed Web-based Tailored Intervention for Preparation of parents and children undergoing Surgery (WebTIPS). METHODS: Phase 1 enrolled 13 children 2 to 7 years of age undergoing outpatient elective surgery and their parents for formative evaluation of WebTIPS. Parent participation focus groups are common in qualitative research and are a method of asking research participants about their perceptions and attitudes regarding a product or concept. In phase 2, children 2 to 7 years of age in 2 medical centers were assigned randomly to receive the WebTIPS program (n = 38) compared with children receiving the standard of care (n = 44). The primary outcome of phase II was child and parent preoperative anxiety. RESULTS: In phase 2, parents reported WebTIPS to be both helpful (P < 0.001) and easy to use (P < 0.001). In phase 2, children in the WebTIPS group (36.2 ± 14.1) were less anxious than children in the standard of care group (46.0 ± 19.0) at entrance to the operating room (P = 0.02; Cohen d = 0.59) and introduction of the anesthesia mask (43.5 ± 21.7 vs 57.0 ± 21.2, respectively, P = 0.01; Cohen d = 0.63). Parents in the WebTIPS group (32.1 ± 7.4) also experienced less anxiety compared with parents in the control group (36.8 ± 7.1) in the preoperative holding area (P = 0.004; Cohen d = 0.65). CONCLUSIONS: WebTIPS was well received by parents and children and led to reductions in preoperative anxiety.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1503
[Cu] Class update date: 150321
[Lr] Last revision date:150321
[Js] Journal subset:AIM; IM
[St] Status:In-Data-Review
[do] DOI:10.1213/ANE.0000000000000632


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