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Article ; Online: Frequency-Following Responses in Sensorineural Hearing Loss: A Systematic Review.

Jacxsens, Laura / Biot, Lana / Escera, Carles / Gilles, Annick / Cardon, Emilie / Van Rompaey, Vincent / De Hertogh, Willem / Lammers, Marc J W

Journal of the Association for Research in Otolaryngology : JARO

2024 Volume 25, Issue 2, Page(s) 131–147

Abstract: Purpose: This systematic review aims to assess the impact of sensorineural hearing loss (SNHL) on various frequency-following response (FFR) parameters.: Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, Web of ... ...

Abstract	Purpose: This systematic review aims to assess the impact of sensorineural hearing loss (SNHL) on various frequency-following response (FFR) parameters. Methods: Following PRISMA guidelines, a systematic review was conducted using PubMed, Web of Science, and Scopus databases up to January 2023. Studies evaluating FFRs in patients with SNHL and normal hearing controls were included. Results: Sixteen case-control studies were included, revealing variability in acquisition parameters. In the time domain, patients with SNHL exhibited prolonged latencies. The specific waves that were prolonged differed across studies. There was no consensus regarding wave amplitude in the time domain. In the frequency domain, focusing on studies that elicited FFRs with stimuli of 170 ms or longer, participants with SNHL displayed a significantly smaller fundamental frequency (F Conclusion: Patients with SNHL may require more time for processing (speech) stimuli, reflected in prolonged latencies. However, the exact timing of this delay remains unclear. Additionally, when presenting longer stimuli (≥ 170 ms), patients with SNHL show difficulties tracking the F
MeSH term(s)	Humans ; Speech Perception/physiology ; Hearing Loss, Sensorineural ; Case-Control Studies ; Speech
Language	English
Publishing date	2024-02-09
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2021417-0
ISSN	1438-7573 ; 1525-3961
ISSN (online)	1438-7573
ISSN	1525-3961
DOI	10.1007/s10162-024-00932-7
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Article ; Online: Guidance for otolaryngology health care workers performing aerosol generating medical procedures during the COVID-19 pandemic.

Lammers, Marc J W / Lea, Jane / Westerberg, Brian D

Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

2020 Volume 49, Issue 1, Page(s) 36

Abstract: Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health ... ...

Abstract	Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and surgeries are Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers of becoming infected with SARS-CoV-2 while providing clinical care. Recommendations: During the COVID-19 pandemic all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. For non-AGMPs in all patients, even COVID-19 positive patients Level 1 PPE (surgical mask, gown, gloves and face shield or goggles) is sufficient. If local prevalence is favourable and patients are asymptomatic and test negative for SARS-CoV-2, Level 1 PPE can be used during short duration AGMPs, with limited risk of infected aerosol spread. For AGMPs in patients who test positive for SARS-CoV-2 a minimum of Level 2 PPE, with adequate protection of mucosal surfaces, is recommended (N95/FFP2 respirator, gown, double gloves, goggles or face shield and head cover). For long duration AGMPs that are deemed high-risk in COVID-19 positive patients, Level 3 PPE can provide a higher level of protection and be more comfortable during long duration surgeries if surgical hoods or PAPRs are used. It is recommended that these procedures are performed in negative pressure rooms, if available. It is essential to follow strict donning and doffing protocols to minimize the risk of contamination. Conclusions: By following strict infection prevention recommendations, the risk of HCWs becoming infected with SARS-CoV-2 while treating patients can be minimized. As the COVID-19 pandemic evolves rapidly, these recommendations should serve as guidance and need to be interpreted based on local factors and availability of healthcare resources.
MeSH term(s)	Aerosols/adverse effects ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Health Personnel/standards ; Humans ; Infection Control/standards ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Otolaryngology/organization & administration ; Otolaryngology/standards ; Otorhinolaryngologic Diseases/diagnosis ; Otorhinolaryngologic Diseases/therapy ; Otorhinolaryngologic Surgical Procedures/standards ; Pandemics/prevention & control ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; Practice Guidelines as Topic ; Protective Devices/standards ; SARS-CoV-2
Chemical Substances	Aerosols
Keywords	covid19
Language	English
Publishing date	2020-06-03
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2434004-2
ISSN	1916-0216 ; 1916-0208 ; 0381-6605
ISSN (online)	1916-0216
ISSN	1916-0208 ; 0381-6605
DOI	10.1186/s40463-020-00429-2
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Article: Listening effort and fatigue among cochlear implant users: a scoping review.

Philips, Cato / Jacquemin, Laure / Lammers, Marc J W / Mertens, Griet / Gilles, Annick / Vanderveken, Olivier M / Van Rompaey, Vincent

Frontiers in neurology

2023 Volume 14, Page(s) 1278508

Abstract: Introduction: In challenging listening situations, speech perception with a cochlear implant (CI) remains demanding and requires high levels of listening effort, which can lead to increased levels of listening-related fatigue. The body of literature on ... ...

Abstract	Introduction: In challenging listening situations, speech perception with a cochlear implant (CI) remains demanding and requires high levels of listening effort, which can lead to increased levels of listening-related fatigue. The body of literature on these topics increases as the number of CI users rises. This scoping review aims to provide an overview of the existing literature on listening effort, fatigue, and listening-related fatigue among CI users and the measurement techniques to evaluate them. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements were used to conduct the scoping review. The search was performed on PubMed, Scopus, and Web of Science to identify all relevant studies. Results: In total, 24 studies were included and suggests that CI users experience higher levels of listening effort when compared to normal hearing controls using scales, questionnaires and electroencephalogram measurements. However, executing dual-task paradigms did not reveal any difference in listening effort between both groups. Uncertainty exists regarding the difference in listening effort between unilateral, bilateral, and bimodal CI users with bilateral hearing loss due to ambiguous results. Only five studies were eligible for the research on fatigue and listening-related fatigue. Additionally, studies using objective measurement methods were lacking. Discussion: This scoping review highlights the necessity for additional research on these topics. Moreover, there is a need for guidelines on how listening effort, fatigue, and listening-related fatigue should be measured to allow for study results that are comparable and support optimal rehabilitation strategies.
Language	English
Publishing date	2023-11-03
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1278508
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Article ; Online: Interaural and sex differences in the natural evolution of hearing levels in pre-symptomatic and symptomatic carriers of the p.Pro51Ser variant in the COCH gene.

Moyaert, Julie / Gilles, Annick / Mertens, Griet / Lammers, Marc J W / Gommeren, Hanne / Janssens de Varebeke, Sebastien / Fransen, Erik / Verhaert, Nicolas / Denys, Sam / van de Berg, Raymond / Pennings, Ronald / Vanderveken, Olivier / Van Rompaey, Vincent

Scientific reports

2024 Volume 14, Issue 1, Page(s) 184

Abstract: Hearing impairment constitutes a significant health problem in developed countries. If hearing loss is slowly progressive, the first signs may not be noticed in time, or remain untreated until the moment the auditory dysfunction becomes more apparent. ... ...

Abstract	Hearing impairment constitutes a significant health problem in developed countries. If hearing loss is slowly progressive, the first signs may not be noticed in time, or remain untreated until the moment the auditory dysfunction becomes more apparent. The present study will focus on DFNA9, an autosomal dominant disorder caused by pathogenic variants in the COCH gene. Although several cross-sectional studies on this topic have been conducted, a crucial need for longitudinal research has been reported by many authors. Longitudinal trajectories of individual hearing thresholds were established as function of age and superimposed lowess curves were generated for 101 female and male carriers of the p.Pro51Ser variant. The average number of times patients have been tested was 2.49 years with a minimum of 1 year and a maximum of 4 years. In addition, interaural and sex differences were studied, as they could modify the natural evolution of the hearing function. The current study demonstrates that, both in female carriers and male carriers, the first signs of hearing decline, i.e. hearing thresholds of 20 dB HL, become apparent as early as the 3rd decade in the highest frequencies. In addition, a rapid progression of SNHL occurs between 40 and 50 years of age. Differences between male and female carriers in the progression of hearing loss are most obvious between the age of 50 and 65 years. Furthermore, interaural discrepancies also manifest from the age of 50 years onwards. High-quality prospective data on the long-term natural evolution of hearing levels offer the opportunity to identify different disease stages in each cochlea and different types of evolution. This will provide more insights in the window of opportunity for future therapeutic intervention trials.
MeSH term(s)	Humans ; Male ; Female ; Middle Aged ; Aged ; Cross-Sectional Studies ; Prospective Studies ; Sex Characteristics ; Hearing Loss, Sensorineural/genetics ; Deafness/genetics ; Hearing Loss/genetics ; Hearing/genetics ; Extracellular Matrix Proteins/genetics
Chemical Substances	Extracellular Matrix Proteins ; COCH protein, human
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-50583-6
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Article ; Online: Validation of the acoustic change complex (ACC) prediction model to predict speech perception in noise in adult patients with hearing loss: a study protocol.

Biot, Lana / Jacxsens, Laura / Cardon, Emilie / Versnel, Huib / Rhebergen, Koenraad S / Boerboom, Ralf A / Gilles, Annick / Van Rompaey, Vincent / Lammers, Marc J W

Diagnostic and prognostic research

2024 Volume 8, Issue 1, Page(s) 1

Abstract: Background: Speech perception tests are essential to measure the functional use of hearing and to determine the effectiveness of hearing aids and implantable auditory devices. However, these language-based tests require active participation and are ... ...

Abstract	Background: Speech perception tests are essential to measure the functional use of hearing and to determine the effectiveness of hearing aids and implantable auditory devices. However, these language-based tests require active participation and are influenced by linguistic and neurocognitive skills limiting their use in patients with insufficient language proficiency, cognitive impairment, or in children. We recently developed a non-attentive and objective speech perception prediction model: the Acoustic Change Complex (ACC) prediction model. The ACC prediction model uses electroencephalography to measure alterations in cortical auditory activity caused by frequency changes. The aim is to validate this model in a large-scale external validation study in adult patients with varying degrees of sensorineural hearing loss (SNHL) to confirm the high predictive value of the ACC model and to assess its test-retest reliability. Methods: A total of 80 participants, aged 18-65 years, will be enrolled in the study. The categories of severity of hearing loss will be used as a blocking factor to establish an equal distribution of patients with various degrees of sensorineural hearing loss. During the first visit, pure tone audiometry, speech in noise tests, a phoneme discrimination test, and the first ACC measurement will be performed. During the second visit (after 1-4 weeks), the same ACC measurement will be performed to assess the test-retest reliability. The acoustic change stimuli for ACC measurements consist of a reference tone with a base frequency of 1000, 2000, or 4000 Hz with a duration of 3000 ms, gliding to a 300-ms target tone with a frequency that is 12% higher than the base frequency. The primary outcome measures are (1) the level of agreement between the predicted speech reception threshold (SRT) and the behavioral SRT, and (2) the level of agreement between the SRT calculated by the first ACC measurement and the SRT of the second ACC measurement. Level of agreement will be assessed with Bland-Altman plots. Discussion: Previous studies by our group have shown the high predictive value of the ACC model. The successful validation of this model as an effective and reliable biomarker of speech perception will directly benefit the general population, as it will increase the accuracy of hearing evaluations and improve access to adequate hearing rehabilitation.
Language	English
Publishing date	2024-01-23
Publishing country	England
Document type	Journal Article
ISSN	2397-7523
ISSN (online)	2397-7523
DOI	10.1186/s41512-024-00164-6
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Article ; Online: Risk of Stroke and Myocardial Infarction After Sudden Sensorineural Hearing Loss: A Meta-Analysis.

Lammers, Marc J W / Young, Emily / Westerberg, Brian D / Lea, Jane

The Laryngoscope

2020 Volume 131, Issue 6, Page(s) 1369–1377

Abstract: Objectives/hypothesis: The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown, but labyrinthine artery infarction has been proposed. The objective of this study was to perform a systematic review and conduct a meta- ...

Abstract	Objectives/hypothesis: The pathophysiology of idiopathic sudden sensorineural hearing loss (ISSNHL) is still unknown, but labyrinthine artery infarction has been proposed. The objective of this study was to perform a systematic review and conduct a meta-analysis assessing the risk of developing stroke and myocardial infarction after presentation with ISSNHL. Methods: A systematic literature review was conducted using Pubmed, Embase, Web of Science, and Cochrane Libraries. All studies investigating an association between ISSNHL and stroke and/or myocardial infarction (MI) were included. Adhering to the MOOSE guideline, two independent reviewers extracted data, assessed risk of bias, and evaluated the relevance and quality of evidence. Results: Three observational studies evaluating the risk of stroke in ISSNHL were included (n = 6,521 patients). All individual study results indicated an increased relative risk of stroke after ISSNHL (unadjusted relative risk range 1.21-1.63). Pooled adjusted hazard ratios revealed a 1.42-fold increased risk of stroke after ISSNHL (hazard ratio [HR] 1.42; 95% confidence interval [CI] 1.15-1.75, I Conclusion: ISSNHL may be an independent risk factor for the subsequent development of stroke especially in a subgroup of elderly patients. More studies are needed to confirm this association and to assess whether such patients would benefit from cardiovascular risk assessment and management to prevent future strokes. Laryngoscope, 131:1369-1377, 2021.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Ear, Inner/blood supply ; Female ; Hearing Loss, Sensorineural/complications ; Hearing Loss, Sudden/complications ; Heart Disease Risk Factors ; Humans ; Male ; Middle Aged ; Myocardial Infarction/etiology ; Observational Studies as Topic ; Proportional Hazards Models ; Stroke/etiology
Language	English
Publishing date	2020-11-06
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.29237
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Article ; Online: Guidance for otolaryngology health care workers performing aerosol generating medical procedures during the COVID-19 pandemic

Lammers, Marc J. W. / Lea, Jane / Westerberg, Brian D.

Journal of Otolaryngology - Head & Neck Surgery

2020 Volume 49, Issue 1

Keywords	Surgery ; Otorhinolaryngology ; covid19
Language	English
Publisher	Springer Science and Business Media LLC
Publishing country	us
Document type	Article ; Online
ZDB-ID	2434004-2
ISSN	1916-0216 ; 1916-0208 ; 0381-6605
ISSN (online)	1916-0216
ISSN	1916-0208 ; 0381-6605
DOI	10.1186/s40463-020-00429-2
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Article ; Online: The Acoustic Change Complex Compared to Hearing Performance in Unilaterally and Bilaterally Deaf Cochlear Implant Users.

van Heteren, Jan A A / Vonck, Bernard M D / Stokroos, Robert J / Versnel, Huib / Lammers, Marc J W

Ear and hearing

2022 Volume 43, Issue 6, Page(s) 1783–1799

Abstract: Objectives: Clinical measures evaluating hearing performance in cochlear implant (CI) users depend on attention and linguistic skills, which limits the evaluation of auditory perception in some patients. The acoustic change complex (ACC), a cortical ... ...

Abstract	Objectives: Clinical measures evaluating hearing performance in cochlear implant (CI) users depend on attention and linguistic skills, which limits the evaluation of auditory perception in some patients. The acoustic change complex (ACC), a cortical auditory evoked potential to a sound change, might yield useful objective measures to assess hearing performance and could provide insight in cortical auditory processing. The aim of this study is to examine the ACC in response to frequency changes as an objective measure for hearing performance in CI users. Design: Thirteen bilaterally deaf and six single-sided deaf subjects were included, all having used a unilateral CI for at least 1 year. Speech perception was tested with a consonant-vowel-consonant test (+10 dB signal-to-noise ratio) and a digits-in-noise test. Frequency discrimination thresholds were measured at two reference frequencies, using a 3-interval, 2-alternative forced-choice, adaptive staircase procedure. The two reference frequencies were selected using each participant's frequency allocation table and were centered in the frequency band of an electrode that included 500 or 2000 Hz, corresponding to the apical electrode or the middle electrode, respectively. The ACC was evoked with pure tones of the same two reference frequencies with varying frequency increases: within the frequency band of the middle or the apical electrode (+0.25 electrode step), and steps to the center frequency of the first (+1), second (+2), and third (+3) adjacent electrodes. Results: Reproducible ACCs were recorded in 17 out of 19 subjects. Most successful recordings were obtained with the largest frequency change (+3 electrode step). Larger frequency changes resulted in shorter N1 latencies and larger N1-P2 amplitudes. In both unilaterally and bilaterally deaf subjects, the N1 latency and N1-P2 amplitude of the CI ears correlated to speech perception as well as frequency discrimination, that is, short latencies and large amplitudes were indicative of better speech perception and better frequency discrimination. No significant differences in ACC latencies or amplitudes were found between the CI ears of the unilaterally and bilaterally deaf subjects, but the CI ears of the unilaterally deaf subjects showed substantially longer latencies and smaller amplitudes than their contralateral normal-hearing ears. Conclusions: The ACC latency and amplitude evoked by tone frequency changes correlate well to frequency discrimination and speech perception capabilities of CI users. For patients unable to reliably perform behavioral tasks, the ACC could be of added value in assessing hearing performance.
MeSH term(s)	Humans ; Cochlear Implants ; Cochlear Implantation ; Hearing ; Speech Perception/physiology ; Evoked Potentials, Auditory/physiology ; Acoustics ; Acoustic Stimulation
Language	English
Publishing date	2022-10-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	603093-2
ISSN	1538-4667 ; 0196-0202
ISSN (online)	1538-4667
ISSN	0196-0202
DOI	10.1097/AUD.0000000000001248
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Article ; Online: Prevalence of tinnitus and hyperacusis in 9-12-year-old children.

Jacquemin, Laure / van der Poel, Nicolien / Biot, Lana / Schollaert, Joris / Bonné, Fien / Vanderveken, Olivier M / Lammers, Marc J W / Van Rompaey, Vincent / Gilles, Annick

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery

2023 Volume 280, Issue 11, Page(s) 4819–4825

Abstract: Objectives: To estimate the prevalence of tinnitus and hyperacusis in children aged 9-12 years in Flanders, as well as to explore the associations with hearing abilities and listening behaviours.: Design: A cross-sectional survey was undertaken in ... ...

Abstract	Objectives: To estimate the prevalence of tinnitus and hyperacusis in children aged 9-12 years in Flanders, as well as to explore the associations with hearing abilities and listening behaviours. Design: A cross-sectional survey was undertaken in four different Flemish schools. The questionnaire was distributed among 415 children, with a response rate of 97.3%. Results: The prevalence of permanent tinnitus was 10.5% and of hyperacusis was 3.3%. The hyperacusis prevalence was higher in girls (p < .05). Some children reported effects of tinnitus in terms of anxiety (20.1%), sleep (36.5%), and concentration (24.8%). When listening to personal listening devices, 33.5% of the children reported to listen for at least 1 h at 60% or higher of the volume range. Moreover, 54.9% of children stated to never wear hearing protection. Conclusions: Tinnitus and hyperacusis are prevalent in children aged 9-12 years. Some of these children might be overlooked and, as such, not receiving the required follow-up or counselling. Development of guidelines for the assessment of these auditory symptoms in children would help to determine the prevalence numbers with greater accuracy. Sensibility campaigns for safe listening are warranted, as more than half of the children never use hearing protection.
MeSH term(s)	Female ; Humans ; Child ; Tinnitus/epidemiology ; Tinnitus/diagnosis ; Hyperacusis/epidemiology ; Hyperacusis/diagnosis ; Prevalence ; Cross-Sectional Studies ; Audiometry, Pure-Tone
Language	English
Publishing date	2023-05-03
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1017359-6
ISSN	1434-4726 ; 0937-4477
ISSN (online)	1434-4726
ISSN	0937-4477
DOI	10.1007/s00405-023-07995-x
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Article ; Online: Guidance for otolaryngology health care workers performing aerosol generating medical procedures during the COVID-19 pandemic

Marc J. W. Lammers / Jane Lea / Brian D. Westerberg

Journal of Otolaryngology - Head and Neck Surgery, Vol 49, Iss 1, Pp 1-

2020 Volume 8

Abstract: Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting ... ...

Abstract	Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and surgeries are Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers of becoming infected with SARS-CoV-2 while providing clinical care. Recommendations During the COVID-19 pandemic all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. For non-AGMPs in all patients, even COVID-19 positive patients Level 1 PPE (surgical mask, gown, gloves and face shield or goggles) is sufficient. If local prevalence is favourable and patients are asymptomatic and test negative for SARS-CoV-2, Level 1 PPE can be used during short duration AGMPs, with limited risk of infected aerosol spread. For AGMPs in patients who test positive for SARS-CoV-2 a minimum of Level 2 PPE, with adequate protection of mucosal surfaces, is recommended (N95/FFP2 respirator, gown, double gloves, goggles or face shield and head cover). For long duration AGMPs that are deemed high-risk in COVID-19 positive patients, Level 3 PPE can provide a higher level of protection and be more comfortable during long duration surgeries if surgical hoods or PAPRs are used. It is recommended that these procedures are performed in negative pressure rooms, if available. It is essential to follow strict donning and doffing protocols to minimize the risk of contamination. Conclusions By following strict infection prevention recommendations, the risk of HCWs becoming infected with SARS-CoV-2 while treating patients can be minimized. As the COVID-19 pandemic evolves rapidly, these recommendations should serve as guidance and need to be interpreted based on local factors and availability of healthcare resources.
Keywords	Aerosol ; COVID-19 ; PPE ; PAPR ; Respirator ; Guideline ; Surgery ; RD1-811 ; covid19
Subject code	610
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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