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  1. Article ; Online: Emphysematous cystitis with extraperitoneal gas: new insights into pathogenesis via novel CT findings.

    Wojack, Paul R / Goldman, Inessa A

    Clinical imaging

    2020  Volume 65, Page(s) 1–4

    Abstract: Emphysematous cystitis is a relatively rare disease entity characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging. Its disease mechanism is not well understood. A case of a diabetic patient with emphysematous ...

    Abstract Emphysematous cystitis is a relatively rare disease entity characterized by intramural and/or intraluminal bladder gas best depicted by cross-sectional imaging. Its disease mechanism is not well understood. A case of a diabetic patient with emphysematous cystitis is presented and is notable for the rare finding of extraperitoneal gas in the pelvis based on a review of 114 case reports. Herein we propose a distension-based mechanism with intramural bacterial seeding as the pathogenesis of emphysematous cystitis based on the patient's imaging and the disease's established associations with diabetes and E. coli. The ability to recognize extraperitoneal pelvic gas as a feature of emphysematous cystitis allowed prompt diagnosis. This facilitated early commencement of successful treatment in a diabetic patient in whom the diagnosis was not suspected clinically.
    MeSH term(s) Cystitis/complications ; Cystitis/diagnostic imaging ; Cystitis/microbiology ; Emphysema/diagnostic imaging ; Escherichia coli ; Female ; Humans ; Rare Diseases/complications ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-04-13
    Publishing country United States
    Document type Case Reports
    ZDB-ID 1028123-x
    ISSN 1873-4499 ; 0899-7071
    ISSN (online) 1873-4499
    ISSN 0899-7071
    DOI 10.1016/j.clinimag.2020.04.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Imaging of Lumen-Apposing Metal Stents in Abdominopelvic Applications.

    Goldman, Inessa A / Yang, Julie / Scheinfeld, Meir H

    AJR. American journal of roentgenology

    2019  Volume 213, Issue 3, Page(s) 602–609

    Abstract: OBJECTIVE. ...

    Abstract OBJECTIVE.
    MeSH term(s) Drainage/instrumentation ; Humans ; Metals ; Pancreatic Diseases/diagnostic imaging ; Pancreatic Diseases/surgery ; Postoperative Complications/diagnostic imaging ; Stents
    Chemical Substances Metals
    Language English
    Publishing date 2019-06-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 82076-3
    ISSN 1546-3141 ; 0361-803X ; 0092-5381
    ISSN (online) 1546-3141
    ISSN 0361-803X ; 0092-5381
    DOI 10.2214/AJR.19.21310
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Lower-extremity Arterial Thrombosis Associated with COVID-19 Is Characterized by Greater Thrombus Burden and Increased Rate of Amputation and Death.

    Goldman, Inessa A / Ye, Kenny / Scheinfeld, Meir H

    Radiology

    2020  Volume 297, Issue 2, Page(s) E263–E269

    Abstract: Background During the peak of the coronavirus disease 2019 (COVID-19) pandemic, the authors noted an increase in positive lower-extremity CT angiography examinations in patients who presented with leg ischemia. The goal of this study was to determine ... ...

    Abstract Background During the peak of the coronavirus disease 2019 (COVID-19) pandemic, the authors noted an increase in positive lower-extremity CT angiography examinations in patients who presented with leg ischemia. The goal of this study was to determine whether lower-extremity arterial thrombosis was associated with COVID-19 and whether it was characterized by greater severity in these patients. Materials and Methods In this retrospective propensity score-matched study approved by the institutional review board, 16 patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who underwent CT angiography of the lower extremities and 32 patients who tested negative for SARS-CoV-2 observed from January to April 2018, January to April 2019, and January to April 2020 were compared using three scoring systems: two systems including all vessels, with weighting in one system given to more proximal vessels and with weighting in the other system given to more distal vessels, and a third system in which only the common iliac through popliteal arteries were considered. Correlation with presenting symptoms and outcomes was computed. Fisher exact tests were used to compare patients who tested positive for COVID-19 with patients who tested negative for COVID-19 regarding the presence of clots and presenting symptoms. A Mantel-Haenszel test was used to associate outcome of death and/or amputation with COVID-19 adjusted according to history of peripheral vascular disease (PVD). Results Sixteen patients with confirmed COVID-19 (70 years ± 14 [standard deviation]; seven women) who underwent CT angiography and 32 propensity score-matched control patients (71 years ± 15; 16 women) were included. All patients with COVID-19 (100%, 95% confidence interval [CI]: 79%, 100%) had at least one thrombus, and only 69% of control patients (95% CI: 50%, 84%) had thrombi (
    MeSH term(s) Aged ; Amputation, Surgical/statistics & numerical data ; Betacoronavirus ; COVID-19 ; Causality ; Cohort Studies ; Comorbidity ; Coronavirus Infections/epidemiology ; Coronavirus Infections/mortality ; Female ; Humans ; Lower Extremity/blood supply ; Male ; New York City/epidemiology ; Pandemics ; Peripheral Vascular Diseases/epidemiology ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/mortality ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Thrombosis/epidemiology
    Keywords covid19
    Language English
    Publishing date 2020-07-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80324-8
    ISSN 1527-1315 ; 0033-8419
    ISSN (online) 1527-1315
    ISSN 0033-8419
    DOI 10.1148/radiol.2020202348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: New CT-based diagnoses of torso cancer is low in the emergency department setting.

    Goldman, Inessa A / Cunqueiro, Alain / Scheinfeld, Meir H

    Emergency radiology

    2019  Volume 26, Issue 6, Page(s) 633–638

    Abstract: Purpose: The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types of new CT-based torso ... ...

    Abstract Purpose: The incidence of new CT-based torso cancer diagnoses and the most commonly diagnosed cancer types in the emergency department (ED) setting are unknown. The purpose of our study was to determine the incidence and types of new CT-based torso cancer diagnoses in the ED.
    Methods: A total of 19,496 CT reports including all or parts of the torso from 2017 were searched for the keywords: "mass", "tumor", "neoplasm", "malignancy", or "cancer". Each report and corresponding medical record was evaluated for presence of a new cancer. Cases were scored as no cancer, subcentimeter lung nodule, known cancer, new cancer, or suspicious, but unconfirmed for new cancer. Each mass was characterized as symptom-related or incidental.
    Results: At least one keyword was found in 2086 reports. Of these 706, 126 and 905 were known cancer cases, subcentimeter lung nodules, and non-cancerous cases, respectively. There were 251 confirmed new cancers and 98 suspicious cases which lacked adequate diagnostic workup. Depending on whether only definite or definite and suspicious cases were included together, the number of new cancer cases per 100 torso CT exams was 1.3 or 1.8, respectively. Gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers were most common. Only 58 of the confirmed cases (23%) were deemed as incidental findings.
    Conclusion: CT-diagnosis of new torso cancers was uncommon in our setting. Still, while extensive knowledge of cancer staging may not be necessary for ED radiologists, knowledge of the most common types of cancer including gastrointestinal, lung, pancreaticobiliary, urinary, and gynecologic cancers may improve sensitivity for these diagnoses and may expedite appropriate referrals for the newly diagnosed patients.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Incidental Findings ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Neoplasms/diagnostic imaging ; Thoracic Neoplasms/epidemiology ; Tomography, X-Ray Computed
    Language English
    Publishing date 2019-08-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1425144-9
    ISSN 1438-1435 ; 1070-3004
    ISSN (online) 1438-1435
    ISSN 1070-3004
    DOI 10.1007/s10140-019-01715-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Non-traumatic hemoperitoneum in the ED setting: causes, characteristics, prevalence and sex differences.

    Scheinfeld, Meir H / Schwartz, Carly / Jain, Vineet R / Goldman, Inessa A

    Abdominal radiology (New York)

    2020  Volume 46, Issue 2, Page(s) 441–448

    Abstract: Purpose: Prevalence and sex differences of non-traumatic hemoperitoneum in the Emergency Department has not been studied in the literature.: Methods: Following IRB approval, multiple keyword searches were used to identify all cases of hemoperitoneum ... ...

    Abstract Purpose: Prevalence and sex differences of non-traumatic hemoperitoneum in the Emergency Department has not been studied in the literature.
    Methods: Following IRB approval, multiple keyword searches were used to identify all cases of hemoperitoneum over a 55-month period. Cases were reviewed to confirm and quantify the hemoperitoneum. Maximum attenuation was used to grade blood density. Medical records were reviewed to determine cause, interventions and outcomes in each patient.
    Results: Of the 171 verified cases of non-traumatic hemoperitoneum, 76% of cases were in women. CT exams in women were positive for hemoperitoneum 0.25% of the time, while 0.13% were positive in men. Regarding size, 25.7% were large, 24.5% were moderate and 49.7% were small. Contrast-enhanced studies had HU values of 103 ± 19 (range 47-146) which were significantly higher than for non-enhanced studies with values of 82 ± 19 (range 43-121, p < 0.001). The most common cause of non-traumatic hemoperitoneum was ruptured ovarian cyst which was found in 58% of women (76 cases). Of these, 69 patients received observation, 6 patients underwent surgery and 1 patient received Vitamin K. For the 95 non-ovarian cyst cases, 65% patients were admitted and then discharged, 22% were discharged from the ED, 12% expired and 1% were transferred to a different hospital. Post-procedure hemorrhage was the second to most common cause in women (24/130 = 18%) and the most common etiology in men (14/41 = 34%).
    Conclusions: In women, ovarian cyst rupture was the most common etiology of hemoperitoneum. Post-procedure hemorrhage was second in women and the most common etiology in men. Although unusual causes of hemoperitoneum will be encountered, understanding the most common causes of hemoperitoneum can provide a reasonable starting point when attempting to determine the most likely etiology of hemoperitoneum in any individual patient.
    MeSH term(s) Female ; Hemoperitoneum/diagnostic imaging ; Hemoperitoneum/epidemiology ; Humans ; Male ; Ovarian Cysts ; Prevalence ; Rupture, Spontaneous ; Sex Characteristics
    Language English
    Publishing date 2020-08-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2839786-1
    ISSN 2366-0058 ; 2366-004X
    ISSN (online) 2366-0058
    ISSN 2366-004X
    DOI 10.1007/s00261-020-02699-w
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The Emergency Radiology Dashboard: Facilitating Workflow With Realtime Data.

    Scheinfeld, Meir H / Feltus, Whitney / DiMarco, Philip / Rooney, Kathleen / Goldman, Inessa A

    Current problems in diagnostic radiology

    2020  Volume 49, Issue 4, Page(s) 231–233

    Abstract: Emergency radiology imaging volume varies widely due to predictable (eg, day of the week) and unpredictable factors. This can lead to inefficient or insufficient staffing of radiologists, suboptimal workflow and poor trainee education. In collaboration ... ...

    Abstract Emergency radiology imaging volume varies widely due to predictable (eg, day of the week) and unpredictable factors. This can lead to inefficient or insufficient staffing of radiologists, suboptimal workflow and poor trainee education. In collaboration with the radiology IT division we created and implemented a 2-tiered real-time dashboard to facilitate operational workflow. This allowed us to track overall emergency department patient census, ordered but not yet performed imaging studies, and performed but unread imaging studies. The capability of clicking to obtain information on specific studies was also incorporated. We describe our experience of how this information has improved our workflow, staffing, and trainee education.
    MeSH term(s) Data Display ; Efficiency, Organizational ; Emergency Service, Hospital/organization & administration ; Humans ; Information Storage and Retrieval ; Personnel Staffing and Scheduling ; Radiology/education ; Radiology Information Systems ; User-Computer Interface ; Workflow
    Language English
    Publishing date 2020-04-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 198954-6
    ISSN 1535-6302 ; 0363-0188
    ISSN (online) 1535-6302
    ISSN 0363-0188
    DOI 10.1067/j.cpradiol.2020.02.013
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  7. Article ; Online: Induction Chemotherapy With FOLFIRINOX Followed by Chemoradiation With Gemcitabine in Patients With Borderline-Resectable Pancreatic Ductal Adenocarcinoma.

    Acuna-Villaorduna, Ana / Shankar, Viswanathan / Wysota, Michael / Jirgal, Amanda / Kabarriti, Rafi / Bellemare, Sarah / Goldman, Inessa / Kaubisch, Andreas / Aparo, Santiago / Goel, Sanjay / Chuy, Jennifer

    Cancer control : journal of the Moffitt Cancer Center

    2022  Volume 29, Page(s) 10732748221134411

    Abstract: Introduction: Perioperative therapy is standard for patients with borderline-resectable pancreatic ductal adenocarcinoma (BR-PDAC); however, an optimal neoadjuvant regimen is lacking. We assessed the efficacy of FOLFIRINOX chemotherapy followed by ... ...

    Abstract Introduction: Perioperative therapy is standard for patients with borderline-resectable pancreatic ductal adenocarcinoma (BR-PDAC); however, an optimal neoadjuvant regimen is lacking. We assessed the efficacy of FOLFIRINOX chemotherapy followed by gemcitabine-based chemoradiation as preoperative therapy.
    Methods: Patients received 4 cycles of FOLFIRINOX, followed by 6-weekly gemcitabine with concomitant intensity-modulated radiation. The primary endpoint was the R0 resection rate. Secondary outcomes included resection rate, overall-response, overall survival (OS), progression-free survival (PFS), and tolerability. The trial was terminated early due to slow accrual. A Simon's optimal two-stage phase II trial single arm design was used. The primary hypothesis of treatment efficacy was tested using a multistage group sequential inference procedure. The secondary failure time analysis endpoints were assessed using the Kaplan-Meier procedure and the Cox regression model.
    Results: A total of 22 patients enrolled in the study, 18 (81.8%) completed neoadjuvant treatment. The bias corrected R0 rate was 55.6% (90% CI: 33.3, 68.3;
    Conclusion: An R0 resection rate of 55.6% is favorable. Neoadjuvant FOLFIRINOX followed by concomitant Gemcitabine with radiation was well-tolerated. NCT01897454.
    MeSH term(s) Adenocarcinoma/pathology ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Deoxycytidine/analogs & derivatives ; Fluorouracil ; Humans ; Induction Chemotherapy ; Irinotecan ; Leucovorin ; Neoadjuvant Therapy/methods ; Oxaliplatin ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/pathology ; Gemcitabine ; Pancreatic Neoplasms
    Chemical Substances folfirinox ; Oxaliplatin (04ZR38536J) ; Deoxycytidine (0W860991D6) ; Irinotecan (7673326042) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT) ; Gemcitabine
    Language English
    Publishing date 2022-10-21
    Publishing country United States
    Document type Clinical Trial, Phase II ; Journal Article
    ZDB-ID 1328503-8
    ISSN 1526-2359 ; 1073-2748
    ISSN (online) 1526-2359
    ISSN 1073-2748
    DOI 10.1177/10732748221134411
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Utility of Apical Lung Assessment on Computed Tomography Angiography as a COVID-19 Screen in Acute Stroke.

    Esenwa, Charles / Lee, Ji-Ae / Nisar, Taha / Shmukler, Anna / Goldman, Inessa / Zampolin, Richard / Hsu, Kevin / Labovitz, Daniel / Altschul, David / Haramati, Linda B

    Stroke

    2020  Volume 51, Issue 12, Page(s) 3765–3769

    Abstract: Background and purpose: Evaluation of the lung apices using computed tomography angiography of the head and neck during acute ischemic stroke (AIS) can provide the first objective opportunity to screen for coronavirus disease 2019 (COVID-19).: Methods! ...

    Abstract Background and purpose: Evaluation of the lung apices using computed tomography angiography of the head and neck during acute ischemic stroke (AIS) can provide the first objective opportunity to screen for coronavirus disease 2019 (COVID-19).
    Methods: We performed an analysis assessing the utility of apical lung exam on computed tomography angiography for COVID-19-specific lung findings in 57 patients presenting with AIS. We measured the diagnostic accuracy of apical lung assessment alone and in combination with patient-reported symptoms and incorporate both to propose a COVID-19 era AIS algorithm.
    Results: Apical lung assessment when used in isolation, yielded a sensitivity of 0.67, specificity of 0.93, positive predictive value of 0.19, negative predictive value of 0.99, and accuracy of 0.92 for the diagnosis of COVID-19, in patients presenting to the hospital for AIS. When combined with self-reported clinical symptoms of cough or shortness of breath, sensitivity of apical lung assessment improved to 0.83.
    Conclusions: Apical lung assessment on computed tomography angiography is an accurate screening tool for COVID-19 and can serve as part of a combined screening approach in AIS.
    MeSH term(s) Aged ; COVID-19/complications ; COVID-19/diagnosis ; COVID-19/diagnostic imaging ; COVID-19/physiopathology ; COVID-19 Nucleic Acid Testing ; Cerebral Angiography/methods ; Computed Tomography Angiography/methods ; Cough/physiopathology ; Dyspnea/physiopathology ; Female ; Humans ; Ischemic Stroke/complications ; Ischemic Stroke/diagnostic imaging ; Lung/diagnostic imaging ; Male ; Mass Screening ; Middle Aged ; Sensitivity and Specificity ; Tomography, X-Ray Computed
    Keywords covid19
    Language English
    Publishing date 2020-10-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.120.030959
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Biomarkers of Coagulation and Inflammation in COVID-19-Associated Ischemic Stroke.

    Esenwa, Charles / Cheng, Natalie T / Luna, Jorge / Willey, Joshua / Boehme, Amelia K / Kirchoff-Torres, Kathryn / Labovitz, Daniel / Liberman, Ava L / Mabie, Peter / Moncrieffe, Khadean / Soetanto, Ainie / Lendaris, Andrea / Seiden, Johanna / Goldman, Inessa / Altschul, David / Holland, Ryan / Benton, Joshua / Dardick, Joseph / Fernandez-Torres, Jenelys /
    Flomenbaum, David / Lu, Jenny / Malaviya, Avinash / Patel, Nikunj / Toma, Aureliana / Lord, Aaron / Ishida, Koto / Torres, Jose / Snyder, Thomas / Frontera, Jennifer / Yaghi, Shadi

    Stroke

    2021  Volume 52, Issue 11, Page(s) e706–e709

    Abstract: Figure: see text]. ...

    Abstract [Figure: see text].
    MeSH term(s) Aged ; Aged, 80 and over ; Blood Sedimentation ; C-Reactive Protein/metabolism ; COVID-19/complications ; COVID-19/metabolism ; Cluster Analysis ; Female ; Ferritins/metabolism ; Fibrin Fibrinogen Degradation Products/metabolism ; Fibrinogen/metabolism ; Hospital Mortality ; Humans ; Inflammation/metabolism ; Interleukin-6/metabolism ; Ischemic Stroke/complications ; Ischemic Stroke/metabolism ; L-Lactate Dehydrogenase/metabolism ; Leukocyte Count ; Logistic Models ; Machine Learning ; Male ; Middle Aged ; Myocardial Infarction/complications ; Myocardial Infarction/metabolism ; Partial Thromboplastin Time ; Pulmonary Embolism/complications ; Pulmonary Embolism/metabolism ; Retrospective Studies ; SARS-CoV-2 ; Severity of Illness Index ; Thrombophilia/metabolism ; Venous Thrombosis/complications ; Venous Thrombosis/metabolism
    Chemical Substances Fibrin Fibrinogen Degradation Products ; IL6 protein, human ; Interleukin-6 ; fibrin fragment D ; Fibrinogen (9001-32-5) ; C-Reactive Protein (9007-41-4) ; Ferritins (9007-73-2) ; L-Lactate Dehydrogenase (EC 1.1.1.27)
    Language English
    Publishing date 2021-08-25
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80381-9
    ISSN 1524-4628 ; 0039-2499 ; 0749-7954
    ISSN (online) 1524-4628
    ISSN 0039-2499 ; 0749-7954
    DOI 10.1161/STROKEAHA.121.035045
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article: Utility of Apical Lung Assessment on Computed Tomography Angiography as a COVID-19 Screen in Acute Stroke

    Esenwa, Charles / Lee, Ji-Ae / Nisar, Taha / Shmukler, Anna / Goldman, Inessa / Zampolin, Richard / Hsu, Kevin / Labovitz, Daniel / Altschul, David / Haramati, Linda B

    Stroke

    Abstract: BACKGROUND AND PURPOSE: Evaluation of the lung apices using computed tomography angiography of the head and neck during acute ischemic stroke (AIS) can provide the first objective opportunity to screen for coronavirus disease 2019 (COVID-19). METHODS: We ...

    Abstract BACKGROUND AND PURPOSE: Evaluation of the lung apices using computed tomography angiography of the head and neck during acute ischemic stroke (AIS) can provide the first objective opportunity to screen for coronavirus disease 2019 (COVID-19). METHODS: We performed an analysis assessing the utility of apical lung exam on computed tomography angiography for COVID-19-specific lung findings in 57 patients presenting with AIS. We measured the diagnostic accuracy of apical lung assessment alone and in combination with patient-reported symptoms and incorporate both to propose a COVID-19 era AIS algorithm. RESULTS: Apical lung assessment when used in isolation, yielded a sensitivity of 0.67, specificity of 0.93, positive predictive value of 0.19, negative predictive value of 0.99, and accuracy of 0.92 for the diagnosis of COVID-19, in patients presenting to the hospital for AIS. When combined with self-reported clinical symptoms of cough or shortness of breath, sensitivity of apical lung assessment improved to 0.83. CONCLUSIONS: Apical lung assessment on computed tomography angiography is an accurate screening tool for COVID-19 and can serve as part of a combined screening approach in AIS.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #894937
    Database COVID19

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