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  1. Article ; Online: Contributions of Real-World Evidence and Real-World Data to Decision-Making in the Management of Soft Tissue Sarcomas.

    Demetri, George D / Stacchiotti, Silvia

    Oncology

    2021  Volume 99 Suppl 1, Page(s) 3–7

    Abstract: ... claims through to electronic surveillance data (e.g., activity trackers). Real-world data derive ...

    Abstract Real-world data are defined as data relating to any aspect of a patient's health status collected in the context of routine health surveillance and medical care delivery. Sources range from insurance billing claims through to electronic surveillance data (e.g., activity trackers). Real-world data derive from large populations in diverse clinical settings and thus can be extrapolated more readily than clinical trial data to patients in different clinical settings or with a variety of comorbidities. Real-world data are used to generate real-world evidence, which might be regarded as a "meta-analysis" of accumulated real-world data. Increasingly, regulatory authorities are recognizing the value of real-world data and real-world evidence, especially for rare diseases where it may be practically unfeasible to conduct randomized controlled trials. However, the quality of real-world evidence depends on the quality of the data collected which, in turn, depends on a correct pathological diagnosis and the homogeneous behaviour of a reliably defined and consistent disease entity. As each of the more than 80 varieties of soft tissue sarcoma (STS) types represents a distinct disease entity, the situation is exceedingly complicated. Discordant diagnoses, which affect data quality, present a major challenge for use of real-world data. As real-world data are difficult to collect, collaboration across sarcoma reference institutions and sophisticated information technology solutions are required before the potential of real-world evidence to inform decision-making in the management of STS can be fully exploited.
    MeSH term(s) Clinical Trials as Topic ; Data Collection ; Decision Making ; Humans ; Information Technology ; Sarcoma/therapy
    Language English
    Publishing date 2021-04-14
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 250101-6
    ISSN 1423-0232 ; 0030-2414
    ISSN (online) 1423-0232
    ISSN 0030-2414
    DOI 10.1159/000515266
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Incorporating a Three-Dimensional Printed Airway into a Pediatric Flexible Bronchoscopy Curriculum.

    Painter, Natalia / Monovoukas, Demetri / Delecaris, Angela O / Coverstone, Andrea M / Zopf, David A / Saba, Thomas G

    ATS scholar

    2024  Volume 5, Issue 1, Page(s) 142–153

    Abstract: Background: Although hands-on simulation plays a valuable role in procedural training, there are limited tools available to teach pediatric flexible bronchoscopy (PFB). Fellowship programs rely on patient encounters, with inherent risk, or high-cost ... ...

    Abstract Background: Although hands-on simulation plays a valuable role in procedural training, there are limited tools available to teach pediatric flexible bronchoscopy (PFB). Fellowship programs rely on patient encounters, with inherent risk, or high-cost virtual reality simulators that may not be widely available and create education inequalities.
    Objective: Our objective was to study the educational value and transferability of a novel, low-cost, three-dimensional-printed pediatric airway model (3D-AM) for PFB training. Our central hypothesis was that the 3D-AM would have high educational value and would be easily transferrable to learners at different teaching hospitals.
    Methods: The 3D-AM was designed to teach technical bronchoscopy skills, airway anatomy, airway pathology, and bronchoalveolar lavage (BAL). The curriculum was offered to incoming fellows in pediatric pulmonology, pediatric surgery, and pediatric critical care across three different teaching institutions. After course completion, each participant assessed the simulation model(s) with a 5-point Likert scale across six domains: physical attributes, realism of experience, ability to perform tasks, value, relevance, and global impression. The expert instructors assessed the learners' competency using a modified version of the Bronchoscopy Skills and Tasks Assessment Tool.
    Results: A total of 14 incoming fellows participated in the course. The mean scores for the 3D-AM across all six domains and across the three institutions was between 4 and 5, suggesting that learners generally had a favorable impression and a similar experience across different institutions. All learners "agreed" or "strongly agreed" that the course was a valuable use of their time, helped teach technical skills and airway anatomy, and would be useful for extra training during fellowship. Most of the learners correctly identified anatomy, bronchomalacia, and performed a BAL. Wall trauma was observed in 36% of learners.
    Conclusion: The utility, low cost, and transferability of this model may create opportunities for PFB training across different institutions despite resource limitations in the United States and abroad.
    Language English
    Publishing date 2024-01-30
    Publishing country United States
    Document type Journal Article
    ISSN 2690-7097
    ISSN (online) 2690-7097
    DOI 10.34197/ats-scholar.2023-0078OC
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Photonic waveguide bundles using 3D laser writing and deep neural network image reconstruction.

    Panusa, Giulia / Dinc, Niyazi Ulas / Psaltis, Demetri

    Optics express

    2022  Volume 30, Issue 2, Page(s) 2564–2577

    Abstract: In recent years, three-dimensional (3D) printing with multi-photon laser writing has become an essential tool for the manufacturing of three-dimensional optical elements. Single-mode optical waveguides are one of the fundamental photonic components, and ... ...

    Abstract In recent years, three-dimensional (3D) printing with multi-photon laser writing has become an essential tool for the manufacturing of three-dimensional optical elements. Single-mode optical waveguides are one of the fundamental photonic components, and are the building block for compact multicore fiber bundles, where thousands of single-mode elements are closely packed, acting as individual pixels and delivering the local information to a sensor. In this work, we present the fabrication of polymer rectangular step-index (STIN) optical waveguide bundles in the IP-Dip photoresist, using a commercial 3D printer. Moreover, we reduce the core-to-core spacing of the imaging bundles by means of a deep neural network (DNN) which has been trained with a large synthetic dataset, demonstrating that the scrambling of information due to diffraction and cross-talk between fiber cores can be undone. The DNN-based approach can be adopted in applications such as on-chip platforms and microfluidic systems where accurate imaging from in-situ printed fiber bundles suffer cross-talk. In this respect, we provide a design and fabrication guideline for such scenarios by employing the DNN not only as a post-processing technique but also as a design optimization tool.
    Language English
    Publishing date 2022-02-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1491859-6
    ISSN 1094-4087 ; 1094-4087
    ISSN (online) 1094-4087
    ISSN 1094-4087
    DOI 10.1364/OE.446775
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Self-organisation of fullerene-containing conical supermesogens.

    Peroukidis, Stavros D / Vanakaras, Alexandros G / Photinos, Demetri J

    Soft matter

    2020  Volume 4, Issue 3, Page(s) 493–499

    Abstract: A molecular model of cubic building blocks is used to describe the mesomorphism of conical fullerenomesogens. Calculations based on density functional molecular theory and on Monte Carlo computer simulations give qualitatively similar results that are ... ...

    Abstract A molecular model of cubic building blocks is used to describe the mesomorphism of conical fullerenomesogens. Calculations based on density functional molecular theory and on Monte Carlo computer simulations give qualitatively similar results that are also in good agreement with the experimentally observed mesomorphic behaviour. The columnar and lamellar mesophases obtained are non-polar, and their relative stability is controlled by a single model parameter representing the softness of the repulsive interactions among the building blocks of the conical molecules.
    Language English
    Publishing date 2020-09-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 2191476-X
    ISSN 1744-6848 ; 1744-683X
    ISSN (online) 1744-6848
    ISSN 1744-683X
    DOI 10.1039/b714506c
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Advances and controversies in the management of soft tissue sarcomas.

    Demetri, George D / Blay, Jean-Yves / Casali, Paolo G

    Future oncology (London, England)

    2017  Volume 13, Issue 1s, Page(s) 3–11

    Abstract: Intensive clinical research in the sarcoma field has provided insight into the histopathological diversity of soft tissue sarcomas (STS) and led to the introduction of many new agents that promise to play an important role in the management of patients ... ...

    Abstract Intensive clinical research in the sarcoma field has provided insight into the histopathological diversity of soft tissue sarcomas (STS) and led to the introduction of many new agents that promise to play an important role in the management of patients with STS. While an increasing body of scientific data has advanced our knowledge of this complex family of mesenchymal diseases, several controversies remain to be resolved: Is doxorubicin-based therapy still the definitive standard first-line treatment for all patients with unresectable and/or metastatic STS of all subtypes? Is histology-driven therapy beyond gastrointestinal stromal tumors a reality or are we pursuing an unachievable objective? Are we making practical headway in the establishment of sarcoma reference centers? Is it clearly established which is the best parameter to evaluate the efficacy of a new agent in STS?
    MeSH term(s) Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Clinical Trials as Topic ; Disease Management ; Humans ; Molecular Targeted Therapy ; Neoplasm Staging ; Sarcoma/diagnosis ; Sarcoma/drug therapy ; Sarcoma/mortality ; Treatment Outcome
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2017-01
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2184533-5
    ISSN 1744-8301 ; 1479-6694
    ISSN (online) 1744-8301
    ISSN 1479-6694
    DOI 10.2217/fon-2016-0498
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Urine-Derived Renal Epithelial Cells (URECs) from Transplanted Kidneys as a Promising Immunomodulatory Cell Population.

    Pizzuti, Valeria / Donadei, Chiara / Balducelli, Emma / Conte, Diletta / Gessaroli, Elisa / Paris, Francesca / Bini, Claudia / Demetri, Marcello / Di Nunzio, Miriam / Corradetti, Valeria / Alviano, Francesco / La Manna, Gaetano / Comai, Giorgia

    Cells

    2023  Volume 12, Issue 12

    Abstract: Kidney transplantation is a lifesaving procedure for patients with end-stage kidney disease (ESKD). Organs derived from donation after cardiac death (DCD) are constantly increasing; however, DCD often leads to ischaemia-reperfusion (IR) and Acute Kidney ... ...

    Abstract Kidney transplantation is a lifesaving procedure for patients with end-stage kidney disease (ESKD). Organs derived from donation after cardiac death (DCD) are constantly increasing; however, DCD often leads to ischaemia-reperfusion (IR) and Acute Kidney Injury (AKI) events. These phenomena increase kidney cell turnover to replace damaged cells, which are voided in urine. Urine-derived renal epithelial cells (URECs) are rarely present in the urine of healthy subjects, and their loss has been associated with several kidney disorders. The present study aimed to characterize the phenotype and potential applications of URECs voided after transplant. The results indicate that URECs are highly proliferating cells, expressing several kidney markers, including markers of kidney epithelial progenitor cells. Since the regulation of the immune response is crucial in organ transplantation and new immunoregulatory strategies are needed, UREC immunomodulatory properties were investigated. Co-culture with peripheral blood mononuclear cells (PBMCs) revealed that URECs reduced PBMC apoptosis, inhibited lymphocyte proliferation, increased T regulatory (Treg) cells and reduced T helper 1 (Th1) cells. URECs from transplanted patients represent a promising cell source for the investigation of regenerative processes occurring in kidneys, and for cell-therapy applications based on the regulation of the immune response.
    MeSH term(s) Humans ; Leukocytes, Mononuclear/metabolism ; Kidney/metabolism ; Acute Kidney Injury/metabolism ; Biomarkers/metabolism ; Immunity ; Epithelial Cells/metabolism
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-06-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2661518-6
    ISSN 2073-4409 ; 2073-4409
    ISSN (online) 2073-4409
    ISSN 2073-4409
    DOI 10.3390/cells12121630
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Real-world survival outcomes in patients with locally advanced or metastatic NTRK fusion-positive solid tumors receiving standard-of-care therapies other than targeted TRK inhibitors.

    Hibar, Derrek P / Demetri, George D / Peters, Solange / Davies, Jessica / Humblet, Olivier / Maund, Sophia L / Perez, Laura

    PloS one

    2022  Volume 17, Issue 8, Page(s) e0270571

    Abstract: ... g., entrectinib or larotrectinib) during their patient journey. The unselected NTRK-population ...

    Abstract The clinical profiles and outcomes of patients with neurotrophic tropomyosin receptor kinase fusion-positive (NTRK+) solid tumors receiving standard of care other than tropomyosin receptor kinase inhibitor (TRKi) targeted therapy have not been well documented. Here, we describe the clinical characteristics of patients with NTRK+ tumors treated in clinical practice using information from a United States electronic health record-derived clinicogenomic database. We also compared survival outcomes in NTRK+ patients and matched NTRK fusion-negative (NTRK-) patients and investigated the clinical prognostic value of NTRK fusions. NTRK positivity was defined by the presence of a fusion or rearrangement involving NTRK1/2/3, determined using NGS (Foundation Medicine, Inc.). NTRK+ patients (n = 28) were diagnosed with locally advanced/metastatic solid tumors between January 1, 2011 and December 31, 2019 and had received no TRKis (e.g., entrectinib or larotrectinib) during their patient journey. The unselected NTRK-population comprised 24,903 patients, and the matched NTRK-cohort included 280 patients. NTRK+ patients tended to be younger, were more commonly not smokers, and had a shorter time from advanced diagnosis to first NGS report, compared with unselected NTRK-patients; however, these differences were not significant. Median overall survival (OS) from advanced/metastatic diagnosis was 10.2 months (95% CI, 7.2-14.1) for the NTRK+ cohort versus 10.4 months (95% CI, 6.7-14.3) for the matched NTRK-cohort; hazard ratio for death in NTRK+ versus matched NTRK-patients was 1.6 (95% CI, 1.0-2.5; P = 0.05). Genomic co-alterations were rare in the NTRK+ cohort (only two of 28 patients had a co-alteration). Overall, while hazard ratios suggest NTRK fusions may be a negative prognostic factor of survival, there are no significant indications of any favorable impact of NTRK fusions on patient outcomes. TRKis, with their high response rate and good tolerability, are likely to improve outcomes for patients compared with existing standard-of-care treatments.
    MeSH term(s) Gene Fusion ; Humans ; Neoplasms/drug therapy ; Neoplasms/genetics ; Neoplasms/pathology ; Neoplasms, Second Primary/drug therapy ; Oncogene Proteins, Fusion/genetics ; Protein Kinase Inhibitors/therapeutic use ; Receptor, trkA/genetics ; Tropomyosin/genetics
    Chemical Substances Oncogene Proteins, Fusion ; Protein Kinase Inhibitors ; Tropomyosin ; Receptor, trkA (EC 2.7.10.1)
    Language English
    Publishing date 2022-08-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2267670-3
    ISSN 1932-6203 ; 1932-6203
    ISSN (online) 1932-6203
    ISSN 1932-6203
    DOI 10.1371/journal.pone.0270571
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Dysfunctional lactate metabolism in human alveolar type II cells from idiopathic pulmonary fibrosis lung explant tissue.

    Newton, Danforth A / Lottes, Robyn G / Ryan, Rita M / Spyropoulos, Demetri D / Baatz, John E

    Respiratory research

    2021  Volume 22, Issue 1, Page(s) 278

    Abstract: Background: Idiopathic Pulmonary Fibrosis (IPF) is the most common and progressive form of the interstitial lung diseases, leading most patients to require lung transplants to survive. Despite the relatively well-defined role of the fibroblast in the ... ...

    Abstract Background: Idiopathic Pulmonary Fibrosis (IPF) is the most common and progressive form of the interstitial lung diseases, leading most patients to require lung transplants to survive. Despite the relatively well-defined role of the fibroblast in the progression of IPF, it is the alveolar type II epithelial cell (AEC2) that is now considered the initiation site of damage, driver of disease, and the most efficacious therapeutic target for long-term resolution. Based on our previous studies, we hypothesize that altered lactate metabolism in AEC2 plays a pivotal role in IPF development and progression, affecting key cellular and molecular interactions within the pulmonary microenvironment.
    Methods: AEC2s isolated from human patient specimens of non-fibrotic and IPF lungs were used for metabolic measurements, lactate dehydrogenase (LDH) analyses and siRNA-mediated knockdown experiments.
    Results: AEC2s isolated from human IPF lung explant tissues had lower rates of oxidative metabolism and were more glycolytic lactate-producing cells than were AEC2 from control, non-fibrotic lung explant tissues. Consistent with this shift in metabolism, patient-derived IPF AEC2s exhibited LDH tetramers that have higher ratios of LDHA:LDHB (i.e., favoring pyruvate to lactate conversion) than control AEC2s. Experimental manipulation of LDHA subunit expression in IPF AEC2s restored the bioenergetic profile characteristic of AEC2 from non-fibrotic lungs.
    Conclusions: These results are consistent with the concept that altered lactate metabolism may be an underlying feature of AEC2 dysfunction in IPF and may be a novel and important target for therapeutic treatment.
    MeSH term(s) A549 Cells ; Alveolar Epithelial Cells/metabolism ; Alveolar Epithelial Cells/pathology ; Case-Control Studies ; Energy Metabolism ; Humans ; Idiopathic Pulmonary Fibrosis/metabolism ; Idiopathic Pulmonary Fibrosis/pathology ; Isoenzymes/genetics ; Isoenzymes/metabolism ; L-Lactate Dehydrogenase/genetics ; L-Lactate Dehydrogenase/metabolism ; Lactic Acid/metabolism
    Chemical Substances Isoenzymes ; Lactic Acid (33X04XA5AT) ; L-Lactate Dehydrogenase (EC 1.1.1.27) ; LDHA protein, human (EC 1.1.1.27) ; lactate dehydrogenase 1 (EC 1.1.1.27.-)
    Language English
    Publishing date 2021-10-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041675-1
    ISSN 1465-993X ; 1465-993X
    ISSN (online) 1465-993X
    ISSN 1465-993X
    DOI 10.1186/s12931-021-01866-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Cerebral hemodynamic effects of head-up CPR in a porcine model.

    Jaeger, Deborah / Kosmopoulos, Marinos / Voicu, Sebastian / Kalra, Rajat / Gaisendrees, Christopher / Schlartenberger, Georg / Bartos, Jason A / Yannopoulos, Demetri

    Resuscitation

    2023  Volume 193, Page(s) 110039

    Abstract: Aim: To assess the hemodynamic effects of head elevation on cerebral perfusion during cardiopulmonary resuscitation (CPR) in a porcine model of cardiac arrest.: Methods: VF was induced in eight 65 kg pigs that were treated with CPR after five minutes ...

    Abstract Aim: To assess the hemodynamic effects of head elevation on cerebral perfusion during cardiopulmonary resuscitation (CPR) in a porcine model of cardiac arrest.
    Methods: VF was induced in eight 65 kg pigs that were treated with CPR after five minutes of no flow. Mean arterial pressure (MAP) was measured at the descending thoracic aorta. Internal carotid artery blood flow (CBF) was measured with an ultrasound probe. Cerebral perfusion pressure (CerPP) was calculated in two ways (CerPP
    Results: MAP and coronary perfusion pressure measurements were similar in both CPR positions (p = 0.36 and p = 0.1, respectively). ICP was significantly lower in the HUP CPR group (14.7 ± 1 mm Hg vs 26.9 ± 1 mm Hg, p < 0.001) as was ICAP (30.1 ± 2 mm Hg vs 42.6 ± 1 mmHg, p < 0.001). The proportional decrease in ICP and ICAP resulted in similar CerPP
    Conclusion: HUP did not affect cerebral perfusion pressure and it significantly decreased internal carotid blood flow.
    MeSH term(s) Animals ; Swine ; Cardiopulmonary Resuscitation/methods ; Heart Arrest/therapy ; Hemodynamics/physiology ; Arterial Pressure ; Cerebrovascular Circulation/physiology
    Language English
    Publishing date 2023-11-05
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2023.110039
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Association between cardiopulmonary resuscitation duration and survival after out-of-hospital cardiac arrest according: a first nationwide study in France.

    Jaeger, Deborah / Lafrance, Martin / Canon, Valentine / Kosmopoulos, Marinos / Gaisendrees, Christopher / Debaty, Guillaume / Yannopoulos, Demetri / Hubert, Hervé / Chouihed, Tahar

    Internal and emergency medicine

    2023  Volume 19, Issue 2, Page(s) 547–556

    Abstract: Objective: Determining whether to pursue or terminate resuscitation efforts remains one of the biggest challenges of cardiopulmonary resuscitation (CPR). No ideal cut-off duration has been recommended and the association between CPR duration and ... ...

    Abstract Objective: Determining whether to pursue or terminate resuscitation efforts remains one of the biggest challenges of cardiopulmonary resuscitation (CPR). No ideal cut-off duration has been recommended and the association between CPR duration and survival is still unclear for out-of-hospital cardiac arrest (OHCA). The aim of this study was to assess the association between CPR duration and 30-day survival after OHCA with favorable neurological outcomes according to initial rhythm.
    Methods: This was an observational, retrospective analysis of the French national multicentric registry on cardiac arrest, RéAC. The primary endpoint was neurologically intact 30-day survival according to initial rhythm.
    Results: 20,628 patients were included. For non-shockable rhythms, the dynamic probability of 30-day survival with a Cerebral Performance Category (CPC) of 1 or 2 was less than 1% after 25 min of CPR. CPR duration over 10 min was not associated with 30-day survival with CPC of 1 or 2 (adjusted OR: 1.67; CI 95% 0.95-2.94). For shockable rhythms, the dynamic probability of 30-day survival with a CPC score of 1 or 2, was less than 1% after 54 min of CPR. CPR duration of 21-25 min was still associated with 30-day survival and 30-day survival with a CPC of 1 or 2 (adjusted OR: 2.77; CI 95% 2.16-3.57 and adjusted OR: 1.82; CI 95% 1.06-3.13, respectively).
    Conclusions: Survival decreased rapidly with increasing CPR duration, especially for non-shockable rhythms. Pursuing CPR after 25 min may be futile for patients presenting a non-shockable rhythm. On the other hand, shockable rhythms might benefit from prolonged CPR.
    MeSH term(s) Humans ; Cardiopulmonary Resuscitation ; Retrospective Studies ; Out-of-Hospital Cardiac Arrest/therapy ; Emergency Medical Services ; Registries ; France/epidemiology
    Language English
    Publishing date 2023-10-29
    Publishing country Italy
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2454173-4
    ISSN 1970-9366 ; 1828-0447
    ISSN (online) 1970-9366
    ISSN 1828-0447
    DOI 10.1007/s11739-023-03449-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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