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  1. Article: Lessons from Polyomavirus Immunofluorescence Staining of Urinary Decoy Cells.

    Pajenda, Sahra / Hevesi, Zsofia / Eder, Michael / Gerges, Daniela / Aiad, Monika / Koldyka, Oliver / Winnicki, Wolfgang / Wagner, Ludwig / Eskandary, Farsad / Schmidt, Alice

    Life (Basel, Switzerland)

    2023  Volume 13, Issue 7

    Abstract: Decoy cells that can be detected in the urine sediment of immunosuppressed patients are often caused by the uncontrolled replication of polyomaviruses, such as BK-Virus (BKV) and John Cunningham (JC)-Virus (JCV), within the upper urinary tract. Due to ... ...

    Abstract Decoy cells that can be detected in the urine sediment of immunosuppressed patients are often caused by the uncontrolled replication of polyomaviruses, such as BK-Virus (BKV) and John Cunningham (JC)-Virus (JCV), within the upper urinary tract. Due to the wide availability of highly sensitive BKV and JCV PCR, the diagnostic utility of screening for decoy cells in urine as an indicator of polyomavirus-associated nephropathy (PyVAN) has been questioned by some institutions. We hypothesize that specific staining of different infection time-dependent BKV-specific antigens in urine sediment could allow cell-specific mapping of antigen expression during decoy cell development. Urine sediment cells from six kidney transplant recipients (five males, one female) were stained for the presence of the early BKV gene transcript lTag and the major viral capsid protein VP1 using monospecific antibodies, monoclonal antibodies and confocal microscopy. For this purpose, cyto-preparations were prepared and the BK polyoma genotype was determined by sequencing the PCR-amplified coding region of the VP1 protein. lTag staining began at specific sites in the nucleus and spread across the nucleus in a cobweb-like pattern as the size of the nucleus increased. It spread into the cytosol as soon as the nuclear membrane was fragmented or dissolved, as in apoptosis or in the metaphase of the cell cycle. In comparison, we observed that VP1 staining started in the nuclear region and accumulated at the nuclear edge in 6-32% of VP1
    Language English
    Publishing date 2023-07-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life13071526
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Ventilation with the esophageal-tracheal Combitube during general anaesthesia: assessing complications in 540 patients.

    Harrison, Nicole / Pajenda, Sahra / Szarpak, Lukasz / Buschsieweke, Anna-Maria / Somri, Mostafa / Frass, Michael / Panning, Bernhard / Robak, Oliver

    Upsala journal of medical sciences

    2023  Volume 128

    Abstract: Background: The esophageal-tracheal Combitube (ETC) was developed for the management of difficult airways but can also be used for general anaesthesia.: Methods: This clinical study collected data from patients undergoing anaesthesia with the ETC in ... ...

    Abstract Background: The esophageal-tracheal Combitube (ETC) was developed for the management of difficult airways but can also be used for general anaesthesia.
    Methods: This clinical study collected data from patients undergoing anaesthesia with the ETC in order to assess the rate of complications.
    Results: Five hundred forty patients were ventilated with the ETC. In 94.8% (512/540), insertion was performed for the first time by the respective physician. The following minor complications were observed: 38.7% sore throat, 30.9% blood on tube as sign of mucosal lesions and 17.0% cyanotic tongue. Experience decreased the risk of mucosal lesions (odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.5-3.5). A higher than recommended volume of the oropharyngeal cuff was associated with blood on the ETC (OR: 1.5, 95% CI: 1.0-2.3) and tongue cyanosis (OR: 2.3, 95% CI: 1.4-3.7). Ventilation for more than 2 h was associated with tongue cyanosis (OR: 2.2, 95% CI: 1.6-3.1) and tongue protrusion (OR: 1.4, 95% CI: 1.1-1.9).
    Conclusion: We conclude that the Combitube may be used for short procedures requiring general anaesthesia, but the high rate of minor complications limits its value when other alternatives such as a laryngeal mask airway are available. The tested method appears safe regarding major complications, but minor complications are common. Adherence to recommended cuff volumes, experience with the ETC and limiting its use to surgeries lasting less than 2 h might reduce the rate of complications.
    MeSH term(s) Humans ; Intubation, Intratracheal/methods ; Laryngeal Masks/adverse effects ; Respiration ; Anesthesia, General/adverse effects ; Cyanosis/etiology
    Language English
    Publishing date 2023-04-21
    Publishing country Sweden
    Document type Journal Article
    ZDB-ID 183949-4
    ISSN 2000-1967 ; 0300-9734
    ISSN (online) 2000-1967
    ISSN 0300-9734
    DOI 10.48101/ujms.v128.9212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Urinary Collectrin (TMEM27) as Novel Marker for Acute Kidney Injury.

    Pajenda, Sahra / Wagner, Ludwig / Gerges, Daniela / Herkner, Harald / Tevdoradze, Tamar / Mechtler, Karl / Schmidt, Alice / Winnicki, Wolfgang

    Life (Basel, Switzerland)

    2022  Volume 12, Issue 9

    Abstract: Acute kidney injury (AKI) is a leading complication in hospitalized patients of different disciplines due to various aetiologies and is associated with the risk of chronic kidney disease, the need for dialysis and death. Since nephrons are not supplied ... ...

    Abstract Acute kidney injury (AKI) is a leading complication in hospitalized patients of different disciplines due to various aetiologies and is associated with the risk of chronic kidney disease, the need for dialysis and death. Since nephrons are not supplied with pain signals, kidney injury is mostly diagnosed by serum creatinine with a time delay. Recent work has shown that certain urinary biomarkers are available for early detection of AKI. In total, 155 subjects, including 102 patients with AKI at various stages and 53 subjects without AKI, were enrolled, and their course and laboratory data were recorded. Urinary collectrin (TMEM27) was measured by a commercially available ELISA assay. Changes in serum creatinine were used to determine AKI stage. Patients with AKI presented with significantly lower levels of urinary collectrin compared to patients without AKI (1597 ± 1827 pg/mL vs. 2855 ± 2073;
    Language English
    Publishing date 2022-09-06
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662250-6
    ISSN 2075-1729
    ISSN 2075-1729
    DOI 10.3390/life12091391
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Tubular epithelial progenitors are excreted in urine during recovery from severe acute kidney injury and are able to expand and differentiate

    Gerges, Daniela / Hevesi, Zsofia / Schmidt, Sophie H / Kapps, Sebastian / Pajenda, Sahra / Geist, Barbara / Schmidt, Alice / Wagner, Ludwig / Winnicki, Wolfgang

    PeerJ

    2022  Volume 10, Page(s) e14110

    Abstract: Background: Acute kidney injury (AKI) is a serious condition associated with chronic kidney disease, dialysis requirement and a high risk of death. However, there are specialized repair mechanisms for the nephron, and migrated committed progenitor cells ...

    Abstract Background: Acute kidney injury (AKI) is a serious condition associated with chronic kidney disease, dialysis requirement and a high risk of death. However, there are specialized repair mechanisms for the nephron, and migrated committed progenitor cells are the key players. Previous work has described a positive association between renal recovery and the excretion of tubular progenitor cells in the urine of kidney transplant recipients. The aim of this work was to describe such structures in non-transplanted AKI patients and to focus on their differentiation.
    Methods: Morning urine was obtained from four patients with AKI stage 3 and need for RRT on a consecutive basis. Urine sediment gene expression was performed to assess which part of the tubular or glomerular segment was affected by injury, along with measurement of neprilysin. Urine output and sediment morphology were monitored, viable hyperplastic tubular epithelial clusters were isolated and characterized by antibody or cultured
    Results: Urinary neprilysin decreased rapidly with increasing urinary volume in ischemic, toxic, nephritic, and infection-associated AKI, whereas the decrease in sCr required at least 2 weeks. While urine output increased, dead cells were present in the sediment along with debris followed by hyperplastic agglomerates. Monitoring of urine sediment for tubular cell-specific gene transcript levels NPHS2 (podocyte), AQP1 and AQP6 (proximal tubule), and SLC12A1 (distal tubule) by qPCR revealed different components depending on the cause of AKI. Confocal immunofluorescence staining confirmed the presence of intact nephron-specific epithelial cells, some of which appeared in clusters expressing AQP1 and PAX8 and were 53% positive for the stem cell marker PROM1. Isolated tubule epithelial progenitor cells were grown
    Conclusion: During renal recovery, a high replicatory potential of tubular epithelial progenitor cells is found in urine.
    MeSH term(s) Humans ; Neprilysin/metabolism ; Acute Kidney Injury/metabolism ; Kidney ; Kidney Tubules, Proximal/metabolism ; Ischemia/metabolism
    Chemical Substances Neprilysin (EC 3.4.24.11)
    Language English
    Publishing date 2022-10-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2703241-3
    ISSN 2167-8359
    ISSN 2167-8359
    DOI 10.7717/peerj.14110
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Acute Kidney Injury and BK Polyomavirus in Urine Sediment Cells.

    Pajenda, Sahra / Gerges, Daniela Anna / Freire, Raimundo / Wagner, Ludwig / Hevesi, Zsofia / Aiad, Monika / Eder, Michael / Schmidt, Alice / Winnicki, Wolfgang / Eskandary, Farsad Alexander

    International journal of molecular sciences

    2023  Volume 24, Issue 24

    Abstract: Polyomaviruses are widespread, with BK viruses being most common in humans who require immunosuppression due to allotransplantation. Infection with BK polyomavirus (BKV) may manifest as BK virus-associated nephropathy and hemorrhagic cystitis. ... ...

    Abstract Polyomaviruses are widespread, with BK viruses being most common in humans who require immunosuppression due to allotransplantation. Infection with BK polyomavirus (BKV) may manifest as BK virus-associated nephropathy and hemorrhagic cystitis. Established diagnostic methods include the detection of polyomavirus in urine and blood by PCR and in tissue biopsies via immunohistochemistry. In this study, 79 patients with pathological renal retention parameters and acute kidney injury (AKI) were screened for BK polyomavirus replication by RNA extraction, reverse transcription, and virus-specific qPCR in urine sediment cells. A short fragment of the VP2 coding region was the target of qPCR amplification; patients with (n = 31) and without (n = 48) a history of renal transplantation were included. Urine sediment cell immunofluorescence staining for VP1 BK polyomavirus protein was performed using confocal microscopy. In 22 patients with acute renal injury, urinary sediment cells from 11 participants with kidney transplantation (KTX) and from 11 non-kidney transplanted patients (nonKTX) were positive for BK virus replication. BK virus copies were found more frequently in patients with AKI stage III (n = 14). Higher copy numbers were detected in KTX patients having experienced BK polyoma-nephropathy (BKPyVAN) in the past or diagnosed recently by histology (5.6 × 10
    MeSH term(s) Humans ; BK Virus/genetics ; Viremia/diagnosis ; Viremia/etiology ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Kidney/pathology ; Polyomavirus ; Polyomavirus Infections ; Acute Kidney Injury/etiology
    Language English
    Publishing date 2023-12-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms242417511
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  6. Article: Urinary Collectrin as Promising Biomarker for Acute Kidney Injury in Patients Undergoing Cardiac Surgery.

    Tichy, Johanna / Pajenda, Sahra / Bernardi, Martin H / Wagner, Ludwig / Ryz, Sylvia / Aiad, Monika / Gerges, Daniela / Schmidt, Alice / Lassnigg, Andrea / Herkner, Harald / Winnicki, Wolfgang

    Biomedicines

    2023  Volume 11, Issue 12

    Abstract: Background: Early detection of acute kidney injury (AKI) is crucial for timely intervention and improved patient outcomes after cardiac surgery. This study aimed to evaluate the potential of urinary collectrin as a novel biomarker for AKI in this ... ...

    Abstract Background: Early detection of acute kidney injury (AKI) is crucial for timely intervention and improved patient outcomes after cardiac surgery. This study aimed to evaluate the potential of urinary collectrin as a novel biomarker for AKI in this patient population.
    Methods: In this prospective, observational cohort study, 63 patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB) were studied at the Medical University of Vienna between 2016 and 2018. We collected urine samples prospectively at four perioperative time points, and urinary collectrin was measured using an enzyme-linked immunosorbent assay. Patients were divided into two groups, AKI and non-AKI, defined by Kidney Disease: Improving Global Outcomes Guidelines, and differences between groups were analyzed.
    Results: Postoperative AKI was found in 19 (30%) patients. Urine sample analysis revealed an inverse correlation between urinary collectrin and creatinine and AKI stages, as well as significant changes in collectrin levels during the perioperative course. Baseline collectrin levels were 5050 ± 3294 pg/mL, decreased after the start of CPB, reached their nadir at the end of surgery, and began to recover slightly on postoperative day (POD) 1. The most effective timepoint for distinguishing between AKI and non-AKI patients based on collectrin levels was POD 1, with collectrin levels of 2190 ± 3728 pg/mL in AKI patients and 3768 ± 3435 pg/mL in non-AKI patients (
    Conclusions: Urinary collectrin shows promise as a novel biomarker for the early detection of AKI in patients undergoing cardiac surgery on CPB. Its dynamic changes throughout the perioperative period, especially on POD 1, provide valuable insights for timely diagnosis and intervention. Further research and validation studies are needed to confirm its clinical usefulness and potential impact on patient outcomes.
    Language English
    Publishing date 2023-12-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines11123244
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Heparin-binding protein as a novel biomarker for sepsis-related acute kidney injury.

    Pajenda, Sahra / Figurek, Andreja / Wagner, Ludwig / Gerges, Daniela / Schmidt, Alice / Herkner, Harald / Winnicki, Wolfgang

    PeerJ

    2020  Volume 8, Page(s) e10122

    Abstract: Background: Sepsis-related acute kidney injury (AKI) is associated with high morbidity and mortality among patients. Underlying pathomechanisms include capillary leakage and fluid loss into the interstitial tissue and constant exposure to pathogens ... ...

    Abstract Background: Sepsis-related acute kidney injury (AKI) is associated with high morbidity and mortality among patients. Underlying pathomechanisms include capillary leakage and fluid loss into the interstitial tissue and constant exposure to pathogens results in activation of inflammatory cascades, organ dysfunction and subsequently organ damage.
    Methods: To identify novel factors that trigger sepsis-related acute kidney injury, plasma levels of Granzyme A, as representative of a lymphocyte-derived protease, and heparin-binding protein as indicator for neutrophil-derived mediators, were investigated retrospectively in 60 sepsis patients.
    Results: While no association was found between plasma levels of lymphocyte-derived Granzyme A and the incidence of sepsis-related AKI, sepsis patients with AKI had significantly higher plasma levels of heparin-binding protein compared to those without AKI. This applies both to heparin-binding protein peak values (43.30 ±  23.34 vs. 30.25 ±  15.63 pg/mL;
    Conclusion: This study identifies the neutrophil-derived heparin-binding protein as a valuable new biomarker for AKI in sepsis. Beyond the diagnostic perspective, this offers prospect for further research on pathogenesis of AKI and novel therapeutic approaches.
    Language English
    Publishing date 2020-10-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2703241-3
    ISSN 2167-8359
    ISSN 2167-8359
    DOI 10.7717/peerj.10122
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Dynamic 2-deoxy-2[18F] fluoro-D-glucose PET/MRI in human renal allotransplant patients undergoing acute kidney injury.

    Pajenda, Sahra / Rasul, Sazan / Hacker, Marcus / Wagner, Ludwig / Geist, Barbara Katharina

    Scientific reports

    2020  Volume 10, Issue 1, Page(s) 8270

    Abstract: Patients after solid organ kidney transplantation (KTX) often suffer from acute kidney injury (AKI). Parameters as serum creatinine indicate a loss of kidney function, although no distinction of the cause and prognosis can be made. Imaging tools ... ...

    Abstract Patients after solid organ kidney transplantation (KTX) often suffer from acute kidney injury (AKI). Parameters as serum creatinine indicate a loss of kidney function, although no distinction of the cause and prognosis can be made. Imaging tools measuring kidney function have not been widely in clinical use. In this observational study we evaluated 2-deoxy-2[18F] fluoro-D-glucose (FDG) PET/MRI in thirteen patients after KTX with AKI as a functional assessment of the graft. Twenty-four healthy volunteers served as control. General kidney performance (GKP), initial flow (IF) and renal response function (RF) were calculated by standardized uptake values (SUV) and time activity curves (TAC). The GKP measured for the total kidney and medulla was significantly higher in healthy patients compared to patients after KTX (p = 0.0002 and p = 0.0004, respectively), but no difference was found for the GKP of the cortex (p = 0.59). The IF in KTX patients correlated with renal recovery, defined as change in serum creatinine 10 days after PET/MRI (r = 0.80, p = 0.001). With regard to the RF, a negative correlation for tubular damage was found (r = -0.74, p = 0.004). In conclusion, parameters obtained from FDG PET/MRI showed a possible predictive feature for renal recovery in KTX patients undergoing AKI.
    MeSH term(s) Acute Kidney Injury/blood ; Acute Kidney Injury/diagnostic imaging ; Acute Kidney Injury/etiology ; Adult ; Aged ; Case-Control Studies ; Creatinine/blood ; Female ; Fluorodeoxyglucose F18/administration & dosage ; Humans ; Kidney Transplantation/adverse effects ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Multimodal Imaging ; Positron-Emission Tomography/methods ; Prospective Studies ; Transplantation, Homologous ; Young Adult
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D) ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2020-05-19
    Publishing country England
    Document type Journal Article ; Observational Study
    ZDB-ID 2615211-3
    ISSN 2045-2322 ; 2045-2322
    ISSN (online) 2045-2322
    ISSN 2045-2322
    DOI 10.1038/s41598-020-65267-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Tubular epithelial progenitors are excreted in urine during recovery from severe acute kidney injury and are able to expand and differentiate in vitro

    Daniela Gerges / Zsofia Hevesi / Sophie H. Schmidt / Sebastian Kapps / Sahra Pajenda / Barbara Geist / Alice Schmidt / Ludwig Wagner / Wolfgang Winnicki

    PeerJ, Vol 10, p e

    2022  Volume 14110

    Abstract: Background Acute kidney injury (AKI) is a serious condition associated with chronic kidney disease, dialysis requirement and a high risk of death. However, there are specialized repair mechanisms for the nephron, and migrated committed progenitor cells ... ...

    Abstract Background Acute kidney injury (AKI) is a serious condition associated with chronic kidney disease, dialysis requirement and a high risk of death. However, there are specialized repair mechanisms for the nephron, and migrated committed progenitor cells are the key players. Previous work has described a positive association between renal recovery and the excretion of tubular progenitor cells in the urine of kidney transplant recipients. The aim of this work was to describe such structures in non-transplanted AKI patients and to focus on their differentiation. Methods Morning urine was obtained from four patients with AKI stage 3 and need for RRT on a consecutive basis. Urine sediment gene expression was performed to assess which part of the tubular or glomerular segment was affected by injury, along with measurement of neprilysin. Urine output and sediment morphology were monitored, viable hyperplastic tubular epithelial clusters were isolated and characterized by antibody or cultured in vitro. These cells were monitored by phase contrast microscopy, gene, and protein expression over 9 days by qPCR and confocal immunofluorescence. Furthermore, UMOD secretion into the supernatant was quantitatively measured. Results Urinary neprilysin decreased rapidly with increasing urinary volume in ischemic, toxic, nephritic, and infection-associated AKI, whereas the decrease in sCr required at least 2 weeks. While urine output increased, dead cells were present in the sediment along with debris followed by hyperplastic agglomerates. Monitoring of urine sediment for tubular cell-specific gene transcript levels NPHS2 (podocyte), AQP1 and AQP6 (proximal tubule), and SLC12A1 (distal tubule) by qPCR revealed different components depending on the cause of AKI. Confocal immunofluorescence staining confirmed the presence of intact nephron-specific epithelial cells, some of which appeared in clusters expressing AQP1 and PAX8 and were 53% positive for the stem cell marker PROM1. Isolated tubule epithelial progenitor cells were grown in ...
    Keywords Acute kidney injury (AKI) ; Tubular regeneration ; Tubular epithelial progenitors ; Nephrosphere ; Gene expression ; Differentiation ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2022-10-01T00:00:00Z
    Publisher PeerJ Inc.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Urinary neprilysin in the critically ill patient.

    Pajenda, Sahra / Mechtler, Karl / Wagner, Ludwig

    BMC nephrology

    2017  Volume 18, Issue 1, Page(s) 172

    Abstract: Background: Critically ill patients in intensive care face hazardous conditions. Among these, acute kidney injury (AKI) is frequently seen as a result of sepsis. Early diagnosis of kidney injury is of the utmost importance in the guidance of ... ...

    Abstract Background: Critically ill patients in intensive care face hazardous conditions. Among these, acute kidney injury (AKI) is frequently seen as a result of sepsis. Early diagnosis of kidney injury is of the utmost importance in the guidance of interventions or avoidance of treatment-induced kidney injury. On these grounds, we searched for markers that could indicate proximal tubular cell injury.
    Methods: Urine samples of 90 patients admitted to the intensive or intermediate care unit were collected over 2 to 5 days. The biomarker neprilysin (NEP) was investigated in urine using several methods such as dot blot, ELISA and immunofluorescence of urinary casts. Fifty-five healthy donors acted as controls.
    Results: NEP was highly significantly elevated in the urine of patients who suffered AKI according to the KDIGO criteria in comparison to healthy controls. It was also found to be elevated in ICU patients without overt signs of AKI according to serum creatinine changes, however they were suffering from potential nephrotoxic insults. According to our findings, urinary NEP is indicative of epithelial cell alterations at the proximal tubule. This was elaborated in ICU patients when ghost fragments and NEP
    Conclusions: NEP, a potential marker for proximal tubular epithelia, can be measured in urine. This does not originate from leakage of elevated serum levels, but indicates proximal tubular cell alterations such as brush border severing, which can heal in most cases.
    Language English
    Publishing date 2017-05-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-017-0587-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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