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[PMID]:29505527
[Au] Autor:Zhong H; Wang X; Yang L; Miao L; Ji G; Fan Z
[Ad] Endereço:The Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University.
[Ti] Título:Modified transprepancreatic septotomy reduces postoperative complications after intractable biliary access.
[So] Source:Medicine (Baltimore);97(1):e9522, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to assess the clinical value of transprepancreatic septotomy indwelling guide wire or pancreatic duct stent in intractable endoscopic retrograde cholangiopancreatography (ERCP) for bile duct cannulation.Of the 2107 patients treated by ERCP, a total of 81 cases with difficult bile duct cannulation underwent transprebiliopancreatic septotomy (referred to as the septotomy group, 37 cases) and transprepancreatic septotomy with pancreatic duct stent (modified septotomy group, 44 cases). Success rates of cannulation and postoperative complications for both methods were compared.Among them, 77 cases were successfully administered bile duct cannulation. The success rates of the septotomy and modified septotomy groups were 91.89% and 97.73%, respectively, with no significant difference (P = .489). Of the 77 patients, 12 cases had complications. The septotomy group included 7 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases; while in the modified septotomy group, there were 1 acute pancreatitis, 1 bleeding, and 1 biliary tract infection cases. The occurrence rate of acute pancreatitis in the modified septotomy group was lower than that of the septotomy group (2.33% vs 20.59%) with a significant difference (P = .026).These findings indicate that transprepancreatic septotomy with pancreatic duct stent seems to be a safe and feasible operation with reducing complication rates.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos do Sistema Biliar/estatística & dados numéricos
Colangiopancreatografia Retrógrada Endoscópica/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Procedimentos Cirúrgicos do Sistema Biliar/efeitos adversos
Procedimentos Cirúrgicos do Sistema Biliar/instrumentação
Cateterismo/estatística & dados numéricos
China/epidemiologia
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos
Colangiopancreatografia Retrógrada Endoscópica/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Stents
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009522


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[PMID]:28470922
[Au] Autor:Sorokin V; MacLaren G; Vidanapathirana PC; Delnoij T; Lorusso R
[Ad] Endereço:Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
[Ti] Título:Choosing the appropriate configuration and cannulation strategies for extracorporeal membrane oxygenation: the potential dynamic process of organ support and importance of hybrid modes.
[So] Source:Eur J Heart Fail;19 Suppl 2:75-83, 2017 May.
[Is] ISSN:1879-0844
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Extracorporeal membrane oxygenation (ECMO) is becoming a common procedure to support patients with severe cardio-circulatory or respiratory failure as well as in case of combined compromise of the two systems. Deciding which ECMO configuration and proceeding with an uneventful implantation, however, may present minor or major shortcomings. Cannulation techniques should be tailored to specific patient conditions to provide sufficient regional and systemic perfusion, both of which must be comprehensively monitored. Changes in the patient's status or suboptimal ECMO-related support, however, may occur and should trigger re-appraisal of the cannulation strategy and circuit configuration. This dynamic management, based around the adequacy of end organ perfusion and patient requirements, may dictate ECMO configuration and cannulation changes. In these circumstances, adjunct of a cannula in the venous or arterial vasculature may represent a mandatory procedure to solve unfavorable hemodynamic status or enhance ECMO efficiency. These type of ECMO configurations, different from basic one, and called hybrid configurations, may represent, therefore, a critical aspect of optimal ECMO management towards optimized and successful temporary support. The aim of this review is to critically appraise and summarize the existing literature on adult ECMO configuration including cannulation strategies and circuit arrangement, and highlighting more complex pattern required in some specific clinical settings.
[Mh] Termos MeSH primário: Cateterismo/normas
Oxigenação por Membrana Extracorpórea/normas
Insuficiência Cardíaca/terapia
Guias de Prática Clínica como Assunto
Insuficiência Respiratória/terapia
[Mh] Termos MeSH secundário: Desenho de Equipamento
Insuficiência Cardíaca/complicações
Seres Humanos
Insuficiência Respiratória/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1002/ejhf.849


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[PMID]:29466161
[Au] Autor:Kim A; Sendlewski G; Zador E; Kalsi M; Zador L; Kurup V
[Ad] Endereço:From the Department of Anesthesiology, Yale University School of Medicine, New Haven, CT. Address reprint requests to Dr. Kim at Brigham and Women's Hospital, Department of Anesthesiology and Perioperative and Pain Medicine, 75 Francis St., Boston, MA 02115, or at akim30@bwh.harvard.edu .
[Ti] Título:Placing a Lumbar Epidural Catheter.
[So] Source:N Engl J Med;378(8):e11, 2018 Feb 22.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Analgesia Epidural/métodos
Cateterismo/métodos
Vértebras Lombares
[Mh] Termos MeSH secundário: Analgesia Epidural/instrumentação
Anestesia Local/instrumentação
Anestesia Local/métodos
Cateterismo/efeitos adversos
Cateterismo/instrumentação
Contraindicações de Procedimentos
Seres Humanos
Vértebras Lombares/anatomia & histologia
Vértebras Lombares/diagnóstico por imagem
Ultrassonografia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMvcm1500438


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[PMID]:29384560
[Au] Autor:Avila A; Liu J; Kohen MC
[Ti] Título:Horner Syndrome After Epidural Catheter Placement in a 4-Month-Old Child.
[So] Source:J Pediatr Ophthalmol Strabismus;55:e1-e3, 2018 Jan 31.
[Is] ISSN:1938-2405
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although there are reports of iatrogenic Horner syndrome in the adult population, pediatric cases are rare. The current report presents a case of acquired Horner syndrome that occurred after an epidural catheter was placed for pain control. Horner syndrome completely resolved after removing the catheter and no imaging or further work-up was necessary. [J Pediatr Ophthalmol Strabismus. 2018;55:e1-e3.].
[Mh] Termos MeSH primário: Anestesia Epidural/efeitos adversos
Cateterismo/efeitos adversos
Cateteres/efeitos adversos
Síndrome de Horner/etiologia
Pneumotórax/terapia
[Mh] Termos MeSH secundário: Anestesia Epidural/instrumentação
Pré-Escolar
Remoção de Dispositivo
Feminino
Síndrome de Horner/diagnóstico
Síndrome de Horner/terapia
Seres Humanos
Doença Iatrogênica
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.3928/01913913-20170907-02


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[PMID]:29465580
[Au] Autor:Höhne S; Hesse V
[Ti] Título:Standard values for gas-perfusion manometry of the esophagus.
[So] Source:Medicine (Baltimore);97(8):e9910, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The manometry with water-perfused or solid-state catheters is the predominant diagnostic procedure to detect motility disorders of the esophagus. Another method is the manometry using gas-perfused catheters. Although the high-resolution manometry is the method of first choice, the conventional manometry with helium has some advantages: the simple and hygienically unproblematic use and the absence of any artefacts by the perfusion medium compared with water-perfusion, and the considerably lower costs compared with the solid-state catheters. Every method has own normal values because of the specific pressure transmission and the design of the catheter probes. To our knowledge, normal values for gas-perfusion manometry of the esophagus have not yet been published.The esophageal manometry with helium-perfused catheters was performed in 30 healthy volunteers. The main parameters of the esophageal motility and the lower esophageal sphincter were analyzed by liquid and bolus-like swallows and compared with the previous published values in other manometric procedures.The values of the motility in the distal esophagus are consistent; the pressure of the lower esophageal sphincter is generally lower than with other methods. The distal wave amplitude and the propagation velocity are significant higher in the distal esophagus than in the middle. The perfusion medium is well tolerated by the investigated volunteers.
[Mh] Termos MeSH primário: Esôfago/fisiologia
Manometria/métodos
[Mh] Termos MeSH secundário: Adulto
Cateterismo/métodos
Esfíncter Esofágico Inferior/fisiologia
Feminino
Hélio
Seres Humanos
Masculino
Satisfação do Paciente
Perfusão
Pressão
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
206GF3GB41 (Helium)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009910


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[PMID]:29419660
[Au] Autor:Kim JE; Lee MK; Lee DK; Choi SS; Park JS
[Ad] Endereço:Department of Anesthesiology and Pain medicine, Korea University, Guro Hospital, Seoul, Republic of Korea.
[Ti] Título:Continuous cervical epidural block: Treatment for intractable hiccups.
[So] Source:Medicine (Baltimore);97(6):e9444, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Intractable hiccups, although rare, may result in severe morbidity, including sleep deprivation, poor food intake, respiratory muscle fatigue, aspiration pneumonia, and death. Despite these potentially fatal complications, the etiology of intractable hiccups and definitive treatment are unknown. This study aimed to evaluate the effectiveness of continuous cervical epidural block in the treatment of intractable hiccups.Records from 28 patients with a history of unsuccessful medical and invasive treatments for hiccups were evaluated. Continuous cervical epidural block was performed with a midline approach at the C7-T1 or T1-T2 intervertebral space with the patient in the prone position. The epidural catheter was advanced through the needle in a cephalad direction to the C3-C5 level. Catheter placement was confirmed using contrast radiography. A 6-mL bolus of 0.25% ropivacaine was injected, and a continuous infusion of 4 mL/h of ropivacaine was administered through the epidural catheter using an infuser containing 0.75% ropivacaine (45 mL ropivacaine and 230 mL normal saline). When the hiccups stopped and did not recur for 48 hours, the catheter was removed.Cumulative complete remission rates were 60.71% after the first cervical epidural block, 92.86% after the second, and 100% after the third. One patient complained of dizziness that subsided. No other adverse effects were reported.Continuous C3-C5 level cervical epidural block has a successful remission rate. We suggest that continuous cervical epidural block is an effective treatment for intractable hiccups.
[Mh] Termos MeSH primário: Amidas/administração & dosagem
Bloqueio Nervoso Autônomo
Soluço
Injeções Epidurais/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestésicos Locais/administração & dosagem
Bloqueio Nervoso Autônomo/efeitos adversos
Bloqueio Nervoso Autônomo/métodos
Cateterismo/métodos
Medula Cervical/efeitos dos fármacos
Medula Cervical/fisiopatologia
Tontura/etiologia
Feminino
Soluço/diagnóstico
Soluço/fisiopatologia
Soluço/terapia
Seres Humanos
Masculino
Meia-Idade
Recidiva
Indução de Remissão/métodos
República da Coreia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amides); 0 (Anesthetics, Local); 7IO5LYA57N (ropivacaine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180209
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009444


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[PMID]:29176359
[Au] Autor:Günay Ismailoglu E; Zaybak A
[Ad] Endereço:Author Affiliation: Ege University, zmir, Turkey.
[Ti] Título:Comparison of the Effectiveness of a Virtual Simulator With a Plastic Arm Model in Teaching Intravenous Catheter Insertion Skills.
[So] Source:Comput Inform Nurs;36(2):98-105, 2018 Feb.
[Is] ISSN:1538-9774
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The objective of this study was to compare the effectiveness of a virtual intravenous simulator with a plastic arm model in teaching intravenous catheter insertion skills to nursing students. We used a randomized controlled quasi-experimental trial design and recruited 65 students who were assigned to the experimental (n = 33) and control (n = 32) groups using the simple random sampling method. The experimental group received intravenous catheterization skills training on the virtual intravenous simulator, and the control group received the same training on a plastic model of a human arm. Data were collected using the personal information form, intravenous catheterization knowledge assessment form, Intravenous Catheterization Skill Test, Self-Confidence and Satisfaction Scale, and Fear Symptoms Scale. In the study, the mean scores in the control group were 20.44 for psychomotor skills, 15.62 for clinical psychomotor skills, 31.78 for self-confidence, and 21.77 for satisfaction. The mean scores in the experimental group were 45.18 for psychomotor skills, 16.28 for clinical psychomotor skills, 34.18 for self-confidence, and 43.89 for satisfaction. The results indicated that psychomotor skills and satisfaction scores were higher in the experimental group, while the clinical psychomotor skills and self-confidence scores were similar in both groups. More students in the control group reported experiencing symptoms such as cold and sweaty hands, significant restlessness, and tense muscles than those in the experimental group.
[Mh] Termos MeSH primário: Cateterismo
Educação em Enfermagem/métodos
Modelos Anatômicos
Treinamento por Simulação/métodos
Realidade Virtual
[Mh] Termos MeSH secundário: Competência Clínica
Seres Humanos
Pesquisa em Educação de Enfermagem
Pesquisa em Avaliação de Enfermagem
Pesquisa Metodológica em Enfermagem
Estudantes de Enfermagem/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1097/CIN.0000000000000405


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[PMID]:29241850
[Au] Autor:Adler DG
[Ad] Endereço:Department of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
[Ti] Título:Guidewire cannulation in ERCP: from zero to hero!
[So] Source:Gastrointest Endosc;87(1):202-204, 2018 01.
[Is] ISSN:1097-6779
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Cateterismo
Colangiopancreatografia Retrógrada Endoscópica
[Mh] Termos MeSH secundário: Seres Humanos
Pancreatite
Esfinterotomia Endoscópica
[Pt] Tipo de publicação:EDITORIAL; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


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[PMID]:28743506
[Au] Autor:Miwa Y; Yamagishi Y; Konuma T; Sato T; Narita H; Kobayashi K; Takahashi S; Tojo A
[Ad] Endereço:Department of Nursing, Research Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
[Ti] Título:Risk factors and characteristics of falls among hospitalized adult patients with hematologic diseases.
[So] Source:J Geriatr Oncol;8(5):363-367, 2017 Sep.
[Is] ISSN:1879-4076
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Falls and fall-related injuries are major problems in hospitals. In hematologic patients, both disease and its treatment, including chemotherapy and allogeneic hematopoietic cell transplantation (allo-HCT), can cause anemia, febrile neutropenia, and bleeding tendency, which may result in falls and fall-related injuries. MATERIALS AND METHODS: We retrospectively analyzed 397 consecutive admissions to the hematology unit at our institute which included 201 adult patients with hematologic disease. RESULTS AND CONCLUSIONS: A total of 56 fall events were observed in 43 patients, and the incidence of falls was 2.49 per 1000 person-days. The median hemoglobin, platelet, and serum albumin levels prior to fall events were 8.65g/dl (range, 6.3-12.7), 38×10 /l (range, 7-454), and 2.85g/dl (range, 1.6-4.3), respectively. Despite the presence of thrombocytopenia among the majority of patients who fell, no serious injury was observed. Multiple variable logistic regression analysis demonstrated that age older than 65years (hazard ratio [HR], 2.86; 95% confidence interval [CI], 1.17-6.99, P=0.02), admission for allo-HCT (HR, 9.48; 95% CI, 3.35-26.80, P<0.001), hypnotic medication (HR, 3.57; 95% CI, 1.56-8.20, P=0.002), urinary or intravenous catheter placement (HR, 2.34; 95% CI, 1.08-5.09, P=0.03), and hypoalbuminemia (HR, 2.30; 95% CI, 1.07-4.96, P=0.03) were significantly associated with increased fall risk. These findings indicated that special attention should be paid to patients with such risk factors during their treatment.
[Mh] Termos MeSH primário: Acidentes por Quedas/estatística & dados numéricos
Doenças Hematológicas/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Cateterismo/estatística & dados numéricos
Feminino
Transplante de Células-Tronco Hematopoéticas/estatística & dados numéricos
Hemoglobinas/metabolismo
Seres Humanos
Hipnóticos e Sedativos/efeitos adversos
Hipoalbuminemia/etiologia
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Estudos Retrospectivos
Fatores de Risco
Fatores de Tempo
Ferimentos e Lesões/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hemoglobins); 0 (Hypnotics and Sedatives)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE


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[PMID]:29272277
[Au] Autor:Shindo R; Aoki S; Yonemoto N; Yamamoto Y; Kasai J; Kasai M; Miyagi E
[Ad] Endereço:Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center, Yokohama, Japan.
[Ti] Título:Hygroscopic dilators vs balloon catheter ripening of the cervix for induction of labor in nulliparous women at term: Retrospective study.
[So] Source:PLoS One;12(12):e0189665, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the efficacy and safety of hygroscopic dilators and balloon catheters for ripening of the cervix in induction of labor. STUDY DESIGN: This retrospective, observational study used data from the Successive Pregnancy Birth Registry System of the Japan Society of Obstetrics and Gynecology from 2012 to 2014. Nulliparous women in whom labor was induced by mechanical methods of cervical ripening at term were enrolled. The eligible women were divided into dilator, balloon <40 mL, balloon ≧40 mL, and overlapping groups. RESULTS: The groups included 4645, 4100, 6615, and 1992 women, respectively. In the overlapping group, which included the women in whom delivery was most difficult, the vaginal delivery rate was lower and the intrauterine infection and neonatal mortality rates were higher than those in the dilator group. No difference in the vaginal delivery rate was observed among the dilator, balloon <40 mL, and balloon ≧40 mL groups (74.6%, 72.3%, and 73.8%, respectively; p>0.05). The vaginal instrumental delivery rate was higher in the two-balloon groups than in the dilator group. The volume of intrapartum hemorrhage was lowest in the dilator group. No significant difference in the frequencies of uterine rupture and intrauterine infection were observed among the dilator and two-balloon groups. With regard to neonatal outcomes, the frequency of a low Apgar score was statistically significantly lower in the dilator group than in the two-balloon groups. Moreover, the frequency of neonatal death tended to be lower in the dilator group than in the two-balloon groups. CONCLUSION: With regard to cervical ripening for labor induction in nulliparous women at term, the vaginal delivery rate on using a dilator and on using a balloon seems to be equivalent. Concerning maternal complications and neonatal outcomes, cervical ripening with hygroscopic dilators in labor induction might be safer.
[Mh] Termos MeSH primário: Cateterismo/métodos
Maturidade Cervical
Dilatação/métodos
Trabalho de Parto Induzido
Paridade
[Mh] Termos MeSH secundário: Adulto
Parto Obstétrico/métodos
Feminino
Seres Humanos
Japão
Gravidez
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171223
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189665



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