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  1. Article ; Online: Predictive and prognostic value of inflammatory markers in locally advanced rectal cancer (PILLAR) – A multicentric analysis by the Italian Association of Radiotherapy and Clinical Oncology (AIRO) Gastrointestinal Study Group

    Giuditta Chiloiro / Angela Romano / Silvia Mariani / Gabriella Macchia / Diana Giannarelli / Luciana Caravatta / Pierfrancesco Franco / Luca Boldrini / Alessandra Arcelli / Almalina Bacigalupo / Liliana Belgioia / Antonella Fontana / Elisa Meldolesi / Giampaolo Montesi / Rita Marina Niespolo / Elisa Palazzari / Cristina Piva / Vincenzo Valentini / Maria Antonietta Gambacorta

    Clinical and Translational Radiation Oncology, Vol 39, Iss , Pp 100579- (2023)

    2023  

    Abstract: Background: Patients (pts) affected with locally advanced rectal cancer (LARC) may respond differently to neoadjuvant chemoradiotherapy (nCRT). The identification of reliable biomarkers able to predict oncological outcomes could help in the development ... ...

    Abstract Background: Patients (pts) affected with locally advanced rectal cancer (LARC) may respond differently to neoadjuvant chemoradiotherapy (nCRT). The identification of reliable biomarkers able to predict oncological outcomes could help in the development of risk-adapted treatment strategies. It has been suggested that inflammation parameters may have a role in predicting tumor response to nCRT and survival outcomes and in rectal cancer, but no definitive conclusion can be drawn at present. The aim of the current study is to evaluate the role of baseline inflammatory markers as prognostic and predictive factors in a large multicentric Italian cohort of LARC pts. Methods: Patients diagnosed with LARC from January 2002 to December 2019 in 9 Italian centers were retrospectively collected. Patients underwent long-course RT with chemotherapy based on fluoropyrimidine ± oxaliplatin followed by surgery. Inflammatory markers were retrieved based on a pre-treatment blood sample including HEI (hemo-eosinophils inflammation index), SII (systemic index of inflammation), NLR (neutrophil-to-lymphocyte ratio), PLR (platelet-to-lymphocyte ratio) and MLR (monocyte-to-lymphocyte ratio). Outcomes of interest were pathological complete response (pCR), disease-free survival (DFS), and overall survival (OS). Results: 808 pts were analyzed. pCR rate was 22 %, 5yOS and 5yDFS were 84.0% and 63.1% respectively. Multivariate analysis identified that a NLR cut-off value >1.2 and SII cut-off value >500 could predict pCR (p = 0.05 and 0.009 respectively). In addition to age, extramesorectal nodes and RT dose, MLR >0.18 (p = 0.03) and HEI = 3 (p = 0.05) were independent prognostic factors for DFS. Finally, age, RT dose, MLR with a cut-off >0.35 (p = 0.028) and HEI = 3 (p = 0.045) were independent predictors of OS. Conclusions: Higher values of baseline composite inflammatory markers can serve as predictors of lower pCR rates and worse survival outcomes in LARC patients undergoing nCRT. More reliable data from prospective studies ...
    Keywords Rectal cancer ; Neoadjuvant radiotherapy ; Inflammatory markers ; Prognostic factors ; Predictive factors ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The Italian version of the Pediatric Quality of Life Inventory™ (PEDSQL™) 3.0 healthcare satisfaction hematology/oncology module

    Elisa Marconi / Francesco Beghella Bartoli / Elisa Meldolesi / Silvia Mariani / Giulia Panza / Alessia Nardangeli / Loredana Dinapoli / Teresa Carmen Lees / Antonella Guido / Angela Mastronuzzi / Antonio Ruggiero / Maria Antonietta Gambacorta / Vincenzo Valentini / Mario Balducci / Daniela Pia Rosaria Chieffo / Silvia Chiesa

    Health and Quality of Life Outcomes, Vol 21, Iss 1, Pp 1-

    reliability and validity in radiation oncology

    2023  Volume 8

    Abstract: Abstract Background Health-related quality of life (HRQOL) measurement has become an important health care outcome even in oncological pediatric scenario. During radiation therapy care path, pediatric patients and their relatives may suffer from ... ...

    Abstract Abstract Background Health-related quality of life (HRQOL) measurement has become an important health care outcome even in oncological pediatric scenario. During radiation therapy care path, pediatric patients and their relatives may suffer from emotional and psychosocial distress not only related to cancer diagnosis, but also due to the procedure and the required daily routine. Despite the high prevalence of psychosocial consequences in this setting, instruments that inquire pediatric HRQOL and healthcare satisfaction have rarely been studied in Italy. Purpose of this study was to investigate reliability and linguistic validation of the PedsQL™ healthcare satisfaction Hematology/Oncology module from its original English version to Italian language. Methods Three phases standard procedure of cross-culture adaptation were used to create Italian version of PedsQL™ healthcare satisfaction Hematology/Oncology module. Forward translations and backward translations were performed. Finally, a pilot-testing for understandability of the ‘pre-final’ version was conducted with parents of children attending our Radiotherapy Center using two methodologies of Cognitive Interviewing (“Think-aloud Interviews” and “Respondent Debriefing”), in order to obtain the final Italian version of the PedsQL™ healthcare satisfaction Hematology/Oncology module. Results Twenty-five parents (2 father, 23 mothers) were recruited during their children’s radiotherapy treatment and the grammatically and conceptually acceptable pre-final version of the PedsQL™ Healthcare Satisfaction Hematology/Oncology Module was administered. The questionnaire was well understood reflecting its linguistic adaptation. Compliance with questionnaire administration was optimal. All subjects stated that the questions were interesting to express their opinion, most of them reported that all the questions of each section were clearly comprehensible and easy to understand, suggesting minimal changes that were double-checked with back translation. Furthermore, six of ...
    Keywords Pediatric Quality of Life ; Health-related quality of life ; Healthcare satisfaction ; Psychometric properties ; Translation ; Pediatric Radiotherapy ; Computer applications to medicine. Medical informatics ; R858-859.7
    Subject code 027
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Interventional Radiotherapy (Brachytherapy) for Nasal Vestibule

    Bruno Fionda / Francesco Bussu / Elisa Placidi / Enrico Rosa / Valentina Lancellotta / Claudio Parrilla / Tiziano Zinicola / Martina De Angeli / Francesca Greco / Mario Rigante / Mariangela Massaccesi / Maria Antonietta Gambacorta / Luca Indovina / Marco De Spirito / Luca Tagliaferri

    Journal of Clinical Medicine, Vol 12, Iss 6154, p

    Novel Strategies to Prevent Side Effects

    2023  Volume 6154

    Abstract: Interventional radiotherapy (brachytherapy) has become the new therapeutic standard in the management of early stages nasal vestibule tumors; in fact it allows for high local control rates and low toxicity profiles. However, since more and more patients ... ...

    Abstract Interventional radiotherapy (brachytherapy) has become the new therapeutic standard in the management of early stages nasal vestibule tumors; in fact it allows for high local control rates and low toxicity profiles. However, since more and more patients will receive interventional radiotherapy (brachytherapy) as primary treatment, it is desirable to implement novel strategies to reduce the dose to organs at risk with the future aim to result in further lowering long-term side effects. Materials and methods: We were able to identify two different strategies to reduce dose to the treatment volume, including the implantation technique (the implant can be interstitial, endocavitary or mixed and the catheters may be placed either using the Paris system rules or the anatomical approach) and the dose distribution within the implant (the most commonly used parameter to consider is the dose non-uniformity ratio). We subsequently propose two novel strategies to reduce dose to organs at risk, including the use of metal shields for fixed organs as in the case of the eyes and the use of a mouth swab to push away mobile organs, such in the case of the mandible. We used two different algorithms to verify the values namely the TG-43 and the TG-186. Results: We provided an accurate literature review regarding strategies to reduce toxicity to the treatment volume, underlining the pros and cons of all implantation techniques and about the use dose non-uniformity ratio. Regarding the innovative strategies to reduce the dose to organs at risk, we investigated the use of eye shielding and the use of swabs to push away the mandible by performing an innovative calculation using two different algorithms in a series of three consecutive patients. Our results show that the dose reduction, both in the case of the mandible and in the case of eye shielding, was statistically significant. Conclusion: Proper knowledge of the best implantation technique and dose non-uniformity ratio as highlighted by existing literature is mandatory in order to ...
    Keywords nose vestibule ; nasal vestibule ; interventional radiotherapy ; brachytherapy ; radiotherapy ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2023-09-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: KIT 1 (Keep in Touch) Project—Televisits for Cancer Patients during Italian Lockdown for COVID-19 Pandemic

    Calogero Casà / Barbara Corvari / Francesco Cellini / Patrizia Cornacchione / Andrea D’Aviero / Sara Reina / Silvia Di Franco / Alessandra Salvati / Giuseppe Ferdinando Colloca / Alfredo Cesario / Stefano Patarnello / Mario Balducci / Alessio Giuseppe Morganti / Vincenzo Valentini / Maria Antonietta Gambacorta / Luca Tagliaferri

    Healthcare, Vol 11, Iss 1950, p

    The Real-World Experience of Establishing a Telemedicine System

    2023  Volume 1950

    Abstract: To evaluate the adoption of an integrated eHealth platform for televisit/monitoring/consultation during the COVID-19 pandemic. Methods: During the lockdown imposed by the Italian government during the COVID19 pandemic spread, a dedicated multi- ... ...

    Abstract To evaluate the adoption of an integrated eHealth platform for televisit/monitoring/consultation during the COVID-19 pandemic. Methods: During the lockdown imposed by the Italian government during the COVID19 pandemic spread, a dedicated multi-professional working group was set up in the Radiation Oncology Department with the primary aim of reducing patients’ exposure to COVID-19 by adopting de-centralized/remote consultation methodologies. Each patient’s clinical history was screened before the visit to assess if a traditional clinical visit would be recommended or if a remote evaluation was to be preferred. Real world data (RWD) in the form of patient-reported outcomes (PROMs) and patient reported experiences (PREMs) were collected from patients who underwent televisit/teleconsultation through the eHealth platform. Results: During the lockdown period (from 8 March to 4 May 2020) a total of 1956 visits were managed. A total of 983 (50.26%) of these visits were performed via email (to apply for and to upload of documents) and phone call management; 31 visits (1.58%) were performed using the eHealth system. Substantially, all patients found the eHealth platform useful and user-friendly, consistently indicating that this type of service would also be useful after the pandemic. Conclusions: The rapid implementation of an eHealth system was feasible and well-accepted by the patients during the pandemic. However, we believe that further evidence is to be generated to further support large-scale adoption.
    Keywords telemedicine ; digital health ; radiation oncology ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: An IT Platform Supporting Rectal Cancer Tumor Board Activities

    Maria Lucia Specchia / Andrea Di Pilla / Maria Antonietta Gambacorta / Alessandro Filippella / Flavia Beccia / Sara Farina / Elisa Meldolesi / Chiara Lanza / Rocco Domenico Alfonso Bellantone / Vincenzo Valentini / Giampaolo Tortora

    International Journal of Environmental Research and Public Health, Vol 19, Iss 15808, p

    Implementation Process and Impact Analysis

    2022  Volume 15808

    Abstract: Colorectal cancer (RC) is the third most common cancer, with an increasing incidence in recent years. Digital health solutions supporting multidisciplinary tumor boards (MTBs) could improve positive outcomes for RC patients. This paper describes the ... ...

    Abstract Colorectal cancer (RC) is the third most common cancer, with an increasing incidence in recent years. Digital health solutions supporting multidisciplinary tumor boards (MTBs) could improve positive outcomes for RC patients. This paper describes the implementation process of a digital solution within the RC-MTB and its impact analysis in the context of the Fondazione Policlinico ‘A. Gemelli’ in Italy. Adopting a two-phase methodological approach, the first phase qualitatively describes each phase of the implementation of the IT platform, while the second phase quantitatively describes the analysis of the impact of the IT platform. Descriptive and inferential analyses were performed for all variables, with a p -value < 0.05 being considered statistically significant. The implementation of the platform allowed more healthcare professionals to attend meetings and resulted in a decrease in patients sent to the RC-MTB for re-staging and further diagnostic investigations and an increase in patients sent to the RC-MTB for treatment strategies. The results could be attributed to the facilitated access to the platform remotely for specialists, partly compensating for the restrictions imposed by the COVID-19 pandemic, as well as to the integration of the platform into the hospital’s IT system. Furthermore, the early involvement of healthcare professionals in the process of customizing the platform to the specific needs of the RC-MTB may have facilitated its use and contributed to the encouraging quantitative results.
    Keywords rectal cancer ; multidisciplinary tumor boards ; IT platform ; implementation ; impact analysis ; digital health ; Medicine ; R
    Subject code 020
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Multidisciplinary Tumor Board Smart Virtual Assistant in Locally Advanced Cervical Cancer

    Gabriella Macchia / Gabriella Ferrandina / Stefano Patarnello / Rosa Autorino / Carlotta Masciocchi / Vincenzo Pisapia / Cristina Calvani / Chiara Iacomini / Alfredo Cesario / Luca Boldrini / Benedetta Gui / Vittoria Rufini / Maria Antonietta Gambacorta / Giovanni Scambia / Vincenzo Valentini

    Frontiers in Oncology, Vol

    A Proof of Concept

    2022  Volume 11

    Abstract: AimThe first prototype of the “Multidisciplinary Tumor Board Smart Virtual Assistant” is presented, aimed to (i) Automated classification of clinical stage starting from different free-text diagnostic reports; (ii) Resolution of inconsistencies by ... ...

    Abstract AimThe first prototype of the “Multidisciplinary Tumor Board Smart Virtual Assistant” is presented, aimed to (i) Automated classification of clinical stage starting from different free-text diagnostic reports; (ii) Resolution of inconsistencies by identifying controversial cases drawing the clinician’s attention to particular cases worthy for multi-disciplinary discussion; (iii) Support environment for education and knowledge transfer to junior staff; (iv) Integrated data-driven decision making and standardized language and interpretation.Patients and MethodData from patients affected by Locally Advanced Cervical Cancer (LACC), FIGO stage IB2-IVa, treated between 2015 and 2018 were extracted. Magnetic Resonance (MR), Gynecologic examination under general anesthesia (EAU), and Positron Emission Tomography–Computed Tomography (PET-CT) performed at the time of diagnosis were the items from the Electronic Health Records (eHRs) considered for analysis. An automated extraction of eHR that capture the patient’s data before the diagnosis and then, through Natural Language Processing (NLP), analysis and categorization of all data to transform source information into structured data has been performed.ResultsIn the first round, the system has been used to retrieve all the eHR for the 96 patients with LACC. The system has been able to classify all patients belonging to the training set and - through the NLP procedures - the clinical features were analyzed and classified for each patient. A second important result was the setup of a predictive model to evaluate the patient’s staging (accuracy of 94%). Lastly, we created a user-oriented operational tool targeting the MTB who are confronted with the challenge of large volumes of patients to be diagnosed in the most accurate way.ConclusionThis is the first proof of concept concerning the possibility of creating a smart virtual assistant for the MTB. A significant benefit could come from the integration of these automated methods in the collaborative, crucial decision stages.
    Keywords locally advanced cervical cancer ; multidisciplinary tumor board smart virtual assistant ; artificial intelligence ; virtual medicine support ; chemoradiation (CRT) ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Frontiers Media S.A.
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Art and digital technologies to support resilience during the oncological journey

    Luca Tagliaferri / Loredana Dinapoli / Calogero Casà / Giuseppe Ferdinando Colloca / Fabio Marazzi / Patrizia Cornacchione / Ciro Mazzarella / Valeria Masiello / Silvia Chiesa / Francesco Beghella Bartoli / Elisa Marconi / Marika D'Oria / Alfredo Cesario / Daniela Pia Rosaria Chieffo / Vincenzo Valentini / Maria Antonietta Gambacorta

    Technical Innovations & Patient Support in Radiation Oncology, Vol 24, Iss , Pp 101-

    The Art4ART project

    2022  Volume 106

    Abstract: Introduction: New digital technologies can become a tool for welcoming the patient through the artistic dimension. Cancer patients, in particular, need support that accompanies and supports them throughout their treatment. Materials and methods: The ... ...

    Abstract Introduction: New digital technologies can become a tool for welcoming the patient through the artistic dimension. Cancer patients, in particular, need support that accompanies and supports them throughout their treatment. Materials and methods: The Art4ART project consist in the structural proposal to cancer patients of a web-based digital platform containing several forms of art as video-entertainments; a multimedia immersive room; an art-based welcoming of the patients with several original paintings; an environment with a peacefulness vertical garden; a reconceptualization of the chemotherapy-infusion seats. Data regarding patients’ preference and choices will be stored and analysed also using artificial intelligence (AI) algorithm to measure and predict impact indicators regarding clinical outcomes (survival and toxicity), psychological indicators. Moreover, the same digital platform will contribute to a better organization of the activities. Discussion: Through the systematic acquisition of patient preferences and through integration with other clinical parameters, it will be possible to measure the clinical, psychological, organisational, and social impact of the newly implemented Art4ART project. The use of digital technology leads us to apply the reversal of viewpoint from therapeutic acts to patient-centred care.
    Keywords Digital health ; Cancer ; Radiotherapy ; Resilience ; Patient-centered care ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Language English
    Publishing date 2022-12-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: A radiotherapy staff experience of gratitude during COVID-19 pandemic

    Elisa Marconi / Silvia Chiesa / Loredana Dinapoli / Elisabetta Lepre / Luca Tagliaferri / Mario Balducci / Vincenzo Frascino / Calogero Casà / Daniela Pia Rosaria Chieffo / Maria Antonietta Gambacorta / Vincenzo Valentini

    Technical Innovations & Patient Support in Radiation Oncology, Vol 18, Iss , Pp 32-

    2021  Volume 34

    Keywords Radiotherapy ; Gratitude ; COVID-19 ; Pandemic ; Healthcare staff ; Teamwork ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Language English
    Publishing date 2021-06-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Could the conservative approach be considered safe in the treatment of locally advanced rectal cancer in case of a clinical near-complete or complete response? A retrospective analysis

    Giuditta Chiloiro / Elisa Meldolesi / Martina Giraffa / Nikola Dino Capocchiano / Brunella Barbaro / Claudio Coco / Barbara Corvari / Paola De Franco / Domenico D'Ugo / Sergio Alfieri / Riccardo Manfredi / Vincenzo Valentini / Maria Antonietta Gambacorta

    Clinical and Translational Radiation Oncology, Vol 28, Iss , Pp 1-

    2021  Volume 9

    Abstract: Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the ... ...

    Abstract Background: Conservative approach has emerged as an option for the management of rectal cancer (RC) patients with a near or complete clinical response after neoadjuvant chemoradiotherapy (nCRT). The aim of this study is to assess the impact of the conservative approach by comparing patients’ survival outcomes and quality of life with those who had surgical resection. Methods: A single-institution and retrospective study including RC patients who reached a near complete or complete clinical response after nCRT from January 2010 to September 2019. Conservative approaches included local excision or watch and wait strategy; surgery approaches included anterior resection or abdominal-perineal resection.Local regrowth (LR), overall survival, disease free survival, metastasis free survival and colostomy free survival were evaluated through Kaplan-Meier curves and compared trough log-rank tests. Quality of life was measured by the following validated questionnaires: EORTC QLC30, EORTC QLQ – CR29 and Fecal Incontinence Quality of Life scale. Results: Overall 157 patients were analyzed: 105 (66,9%) underwent radical surgery and 52 (33,1%) had a conservative approach. With a median follow-up of 51 months, 2 patients in the surgical group had a local recurrence and 8 in the conservative group had a LR, respectively. Distance metastasis occurred in 7 and 1 patients of surgical and conservative group, respectively. No differences were detected in terms of survival outcomes except for colostomy free survival (p: 0,01). The conservative group showed better intestinal (p < 0.01) and sexual (p: 0,04) function and emotional status (p: 0,02). Conclusions: Conservative approach seems to be safe in terms of survival outcomes with a significant advantage on quality of life in RC patients who achieved clinical complete response after nCRT.
    Keywords Rectal cancer ; Chemoradiotherapy ; Watch and Wait ; Clinical near complete response ; Clinical Complete Response ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 610
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: The role of radiation therapy technologist in interventional radiotherapy (brachytherapy) in Italy

    Patrizia Cornacchione / Luca Tagliaferri / Andrea D’Aviero / Antonella Ciabattoni / Carmela Galdieri / Vitaliana De Sanctis / Francesco Fellin / Sergio Gribaudo / Daniele Lambertini / Maria Antonietta Gambacorta / Barbara Jereczek-Fossa / Vittorio Donato / Andrea Vavassori

    Journal of Contemporary Brachytherapy, Vol 13, Iss 6, Pp 599-

    Italian Association of Radiotherapy and Clinical Oncology (AIRO) and Italian Association of Radiation Therapy and Medical Physics Technologists (AITRO) joint project

    2021  Volume 604

    Keywords interventional radiotherapy ; brachytherapy ; rtt ; Medicine ; R
    Language English
    Publishing date 2021-12-01T00:00:00Z
    Publisher Termedia Publishing House
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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