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  1. Article: Systematic Review and Meta-Analysis of the Usefulness of Epicardial Fat Thickness as a Non-Invasive Marker of the Presence and Severity of Nonalcoholic Fatty Liver Disease.

    Orci, Lorenzo A / Jornayvaz, François R / Toso, Christian / Gariani, Karim

    Biomedicines

    2022  Volume 10, Issue 9

    Abstract: We performed a systematic review and meta-analysis to assess the association between epicardial fat thickness (EFT) and nonalcoholic fatty liver disease (NAFLD). This systematic review was conducted in accordance with the Preferred Reporting Items for ... ...

    Abstract We performed a systematic review and meta-analysis to assess the association between epicardial fat thickness (EFT) and nonalcoholic fatty liver disease (NAFLD). This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) and was based on a registered protocol (CRD 4201809 5493). We searched Medline and Embase until December 2021 for studies reporting on the association between EFT and NAFLD. Qualitative reviews, meta-analyses and meta-regressions were performed to explore this association. Effect sizes are reported as standardized mean differences. We included 12 studies, comprising 3610 individuals. EFT was evaluated with trans-thoracic echocardiography in nine studies, two studies using cardiac computed tomography and one study using magnetic resonance imaging (MRI). The presence of NAFLD was evaluated using transabdominal liver ultrasound in nine studies. Other studies used histology, magnetic resonance spectroscopy and MRI-derived proton density fat fraction. Liver biopsy was performed to assess the severity of NAFLD in four studies. The random-effects meta-analysis indicated that, as compared to control patients with lean livers, patients with NAFLD displayed significantly higher EFT (standardized mean difference 0.61, 95% confidence interval: 0.47−0.75, p < 0.0001, I2 = 72%). EFT was further significantly higher in patients with severe liver steatosis versus patients with mild−moderate liver steatosis (standardized mean difference 1.21 95% confidence interval: 0.26−2.16, p < 0.001, I2 S = 96%). Through the meta-regression analysis, we found that patients with increasingly higher blood levels of aspartate aminotransferase displayed an increasingly higher depth of association. The current meta-analysis suggests that EFT may represent a useful surrogate for assessing the presence and severity of NAFLD in a non-invasive manner.
    Language English
    Publishing date 2022-09-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines10092204
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Shorter Survival after Liver Pedicle Clamping in Patients Undergoing Liver Resection for Hepatocellular Carcinoma Revealed by a Systematic Review and Meta-Analysis.

    Wassmer, Charles-Henri / Moeckli, Beat / Berney, Thierry / Toso, Christian / Orci, Lorenzo A

    Cancers

    2021  Volume 13, Issue 4

    Abstract: Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma ( ... ...

    Abstract Liver pedicle clamping minimizes surgical bleeding during hepatectomy. However, by inducing ischemia-reperfusion injury to the remnant liver, pedicle clamping may be associated with tumor recurrence in the regenerating liver. Hepatocellular carcinoma (HCC) having a high rate of recurrence, evidences demonstrating an eventual association with pedicle clamping is strongly needed. We did a systematic review of the literature until April 2020, looking at studies reporting the impact of liver pedicle clamping on long-term outcomes in patients undergoing liver resection for HCC. Primary and secondary outcomes were overall survival (OS) and disease-free survival, respectively. Results were obtained by random-effect meta-analysis and expressed as standardized mean difference (SMD). Eleven studies were included, accounting for 8087 patients. Results of seven studies were pooled in a meta-analysis. Findings indicated that, as compared to control patients who did not receive liver pedicle clamping, those who did had a significantly shorter OS (SMD = -0.172, 95%CI: -0.298 to -0.047,
    Language English
    Publishing date 2021-02-05
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13040637
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Liver Transplantation Selection and Allocation Criteria for Hepatocellular Carcinoma: A European Perspective.

    Moeckli, Beat / Majno, Pietro / Orci, Lorenzo A / Peloso, Andrea / Toso, Christian

    Seminars in liver disease

    2021  Volume 41, Issue 2, Page(s) 172–181

    Abstract: For patients with early-stage hepatocellular carcinoma (HCC), liver transplantation offers the best chance of cure. Over the past two decades, selection criteria to determine eligibility for liver transplantation have been constantly refined but a fair ... ...

    Abstract For patients with early-stage hepatocellular carcinoma (HCC), liver transplantation offers the best chance of cure. Over the past two decades, selection criteria to determine eligibility for liver transplantation have been constantly refined but a fair allocation strategy of liver grafts to HCC patients remains challenging. In Europe, over a dozen transplantation networks apply different liver transplantation criteria for HCC patients. In this review, we explore and compare candidate selection and liver graft allocation strategies for patients with HCC with a European perspective and discuss the ethical and technical challenges involved. In addition, we suggest possible paths for future improvement such as transitioning from fixed selection and allocation criteria to a more flexible model of benefit, which includes criteria concerning the graft, response to treatment, the biology of the tumor, and other relevant recipient factors.
    MeSH term(s) Carcinoma, Hepatocellular/surgery ; Humans ; Liver Neoplasms/surgery ; Liver Transplantation/adverse effects ; Patient Selection
    Language English
    Publishing date 2021-05-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0041-1723032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Incidence of Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review, Meta-analysis, and Meta-regression.

    Orci, Lorenzo A / Sanduzzi-Zamparelli, Marco / Caballol, Berta / Sapena, Victor / Colucci, Nicola / Torres, Ferran / Bruix, Jordi / Reig, María / Toso, Christian

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2021  Volume 20, Issue 2, Page(s) 283–292.e10

    Abstract: Background & aims: Nonalcoholic fatty liver disease (NAFLD) may be a risk factor for hepatocellular carcinoma (HCC), but the extent of this association still needs to be addressed. Pooled incidence rates of HCC across the disease spectrum of NAFLD have ... ...

    Abstract Background & aims: Nonalcoholic fatty liver disease (NAFLD) may be a risk factor for hepatocellular carcinoma (HCC), but the extent of this association still needs to be addressed. Pooled incidence rates of HCC across the disease spectrum of NAFLD have never been estimated by meta-analysis.
    Methods: In this systematic review, we searched Web of Science, Embase, PubMed, and the Cochrane Library from January 1, 1950 through July 30, 2020. We included studies reporting on HCC incidence in patients with NAFLD. The main outcomes were pooled HCC incidences in patients with NAFLD at distinct severity stages. Summary estimates were calculated with random-effects models. Sensitivity analyses and meta-regression analyses were carried out to address heterogeneity.
    Results: We included 18 studies involving 470,404 patients. In patients with NAFLD at a stage earlier than cirrhosis, the incidence rate of HCC was 0.03 per 100 person-years (95% confidence interval [CI], 0.01-0.07; I
    Conclusions: Patients with NAFLD-related cirrhosis have a risk of developing HCC similar to that reported for patients with cirrhosis from other etiologies. Evidence documenting the risk in patients with nonalcoholic steatohepatitis or simple steatosis is limited, but the incidence of HCC in these populations may lie below thresholds used to recommend a screening. Well-designed prospective studies in these subpopulations are needed. The protocol for this systematic review is registered in the Prospero database (registration number CRD42018092861).
    MeSH term(s) Carcinoma, Hepatocellular/diagnosis ; Humans ; Incidence ; Liver Neoplasms/diagnosis ; Non-alcoholic Fatty Liver Disease/complications ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Prospective Studies ; Risk Factors
    Language English
    Publishing date 2021-05-28
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2021.05.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Predicting recurrence of hepatocellular carcinoma after liver transplantation using a novel model that incorporates tumor and donor-related factors.

    Orci, Lorenzo A / Combescure, Christophe / Fink, Michael / Oldani, Graziano / Compagnon, Philippe / Andres, Axel / Berney, Thierry / Toso, Christian

    Transplant international : official journal of the European Society for Organ Transplantation

    2021  Volume 34, Issue 12, Page(s) 2875–2886

    Abstract: Evidence suggests that liver graft quality impacts on posttransplant recurrence of hepatocellular carcinoma (HCC). As of today, selection criteria only use variables related to tumor characteristics. Within the Scientific Registry of Transplant ... ...

    Abstract Evidence suggests that liver graft quality impacts on posttransplant recurrence of hepatocellular carcinoma (HCC). As of today, selection criteria only use variables related to tumor characteristics. Within the Scientific Registry of Transplant Recipients, we identified patients with HCC who underwent liver transplantation between 2004 and 2016 (development cohort, n = 10 887). Based on tumor recurrence rates, we fitted a competing-risk regression incorporating tumor- and donor-related factors, and we developed a prognostic score. Results were validated both internally and externally in the Australia and New Zealand Liver Transplant Registry. Total tumor diameter (subhazard ratio [sub-HR] 1.52 [1.28-1.81]), alpha-feto protein (sub-HR 1.27 [1.23-1.32], recipient male gender (sub-HR 1.43 [1.18-1.74]), elevated donor body mass index (sub-HR 1.26 [1.01-1.58]), and shared graft allocation policy (sub-HR 1.20 [1.01-1.43]) were independently associated with tumor recurrence. We next developed the Darlica score (sub-HR 2.72 [2.41-3.08] P < 0.001) that allows identifying risky combinations between a given donor and a given recipient. Results were validated internally (n = 3 629) and externally in the Australia and New Zealand Liver Transplant Registry (n = 370). The current score is based on variables that are readily available at the time of graft offer. It allows identifying hazardous donor-recipient combinations in terms of risk of tumor recurrence and overall survival.
    MeSH term(s) Carcinoma, Hepatocellular/surgery ; Humans ; Liver Neoplasms/surgery ; Liver Transplantation ; Living Donors ; Male ; Neoplasm Recurrence, Local ; Retrospective Studies ; Risk Factors
    Language English
    Publishing date 2021-12-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.1111/tri.14161
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Liver Transplantation Selection and Allocation Criteria for Hepatocellular Carcinoma: A European Perspective

    Moeckli, Beat / Majno, Pietro / Orci, Lorenzo A. / Peloso, Andrea / Toso, Christian

    Seminars in Liver Disease

    2021  Volume 41, Issue 02, Page(s) 172–181

    Abstract: For patients with early-stage hepatocellular carcinoma (HCC), liver transplantation offers the best chance of cure. Over the past two decades, selection criteria to determine eligibility for liver transplantation have been constantly refined but a fair ... ...

    Abstract For patients with early-stage hepatocellular carcinoma (HCC), liver transplantation offers the best chance of cure. Over the past two decades, selection criteria to determine eligibility for liver transplantation have been constantly refined but a fair allocation strategy of liver grafts to HCC patients remains challenging. In Europe, over a dozen transplantation networks apply different liver transplantation criteria for HCC patients. In this review, we explore and compare candidate selection and liver graft allocation strategies for patients with HCC with a European perspective and discuss the ethical and technical challenges involved. In addition, we suggest possible paths for future improvement such as transitioning from fixed selection and allocation criteria to a more flexible model of benefit, which includes criteria concerning the graft, response to treatment, the biology of the tumor, and other relevant recipient factors.
    Keywords liver transplantation ; HCC ; allocation ; transplant benefit ; selection
    Language English
    Publishing date 2021-05-01
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 603177-8
    ISSN 1098-8971 ; 0272-8087
    ISSN (online) 1098-8971
    ISSN 0272-8087
    DOI 10.1055/s-0041-1723032
    Database Thieme publisher's database

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  7. Article ; Online: The Swiss approach to the COVID-19 outbreak.

    Moeckli, Beat / Peloso, Andrea / Oldani, Graziano / Orci, Lorenzo A / Banz, Vanessa / Dutkowski, Philipp / Toso, Christian / Berney, Thierry

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2020  Volume 20, Issue 7, Page(s) 1935–1936

    MeSH term(s) Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/diagnosis ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Disease Outbreaks ; Humans ; Living Donors ; Organ Transplantation/standards ; Organ Transplantation/trends ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2 ; Switzerland/epidemiology ; Tissue Donors ; Tissue and Organ Procurement/standards ; Tissue and Organ Procurement/trends
    Keywords covid19
    Language English
    Publishing date 2020-06-23
    Publishing country United States
    Document type Letter
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15939
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Effects of liver transplantation on endocrine function: a systematic review.

    Gariani, Karim / Toso, Christian / Philippe, Jacques / Orci, Lorenzo A

    Liver international : official journal of the International Association for the Study of the Liver

    2016  Volume 36, Issue 10, Page(s) 1401–1411

    Abstract: Patients with chronic liver disease (CLD) often experience secondary endocrine dysfunction. Therefore, because the liver plays a major role in endocrine function, liver transplantation (LT) may also be beneficial for the restoration of hormonal ... ...

    Abstract Patients with chronic liver disease (CLD) often experience secondary endocrine dysfunction. Therefore, because the liver plays a major role in endocrine function, liver transplantation (LT) may also be beneficial for the restoration of hormonal regulation. This systematic review collects and interprets the available literature on the effect of LT on endocrine and sexual function in adult patients. A systematic review was conducted by searching Pubmed (including Medline) and EMBASE for studies published from database inception until November 2015. We collected all relevant studies that discussed changes in hormonal and sexual function after LT. Studies were included if they assessed the effect of LT on sexual function or one of the following components of the hormone/endocrine axis: the hypothalamus-pituitary-gonadal axis, growth hormone (GH), insulin-like growth factor-1 (IGF-1) or thyroid function. The results are reported according to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Twenty-one studies with a total of 1274 patients were included. The results collected from the included studies suggested that LT improves the hormonal perturbation associated with CLD by restoring physiological levels of circulating GH, IGF-1, testosterone, estradiol, prolactin, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Thyroid function was not affected by LT, and sexual function was partially improved after LT. This systematic review suggests that LT is associated with an improvement in endocrine and sexual function in patients with CLD. This information should encourage clinicians who treat CLD patients to identify endocrine disturbances in this population, inform their patients of the effects of LT and assess post-transplantation improvements.
    MeSH term(s) Endocrine System/physiology ; Estradiol/blood ; Gonadotropins, Pituitary/blood ; Human Growth Hormone/blood ; Humans ; Hypothalamo-Hypophyseal System/physiology ; Insulin-Like Growth Factor I/physiology ; Liver Diseases/surgery ; Liver Transplantation ; Sexuality ; Testosterone/blood
    Chemical Substances Gonadotropins, Pituitary ; Human Growth Hormone (12629-01-5) ; Testosterone (3XMK78S47O) ; Estradiol (4TI98Z838E) ; Insulin-Like Growth Factor I (67763-96-6)
    Language English
    Publishing date 2016-10
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2102783-3
    ISSN 1478-3231 ; 1478-3223
    ISSN (online) 1478-3231
    ISSN 1478-3223
    DOI 10.1111/liv.13158
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Impact of Nonalcoholic Steatohepatitis on the Outcome of Patients Undergoing Roux-en-Y Gastric Bypass Surgery: a Propensity Score-Matched Analysis.

    Abbassi, Ziad / Orci, Lorenzo / Meyer, Jeremy / Sgardello, Sebastian Douglas / Goossens, Nicolas / Rubbia-Brandt, Laura / Spahr, Laurent / Buchs, Nicolas Christian / Mönig, Stefan Paul / Toso, Christian / Hagen, Monika Elisabeth / Jung, Minoa Karin

    Obesity surgery

    2021  Volume 32, Issue 1, Page(s) 74–81

    Abstract: Purpose: It is currently unknown whether NASH (nonalcoholic steatohepatitis), as compared to simple steatosis, is associated with impaired postoperative weight loss and metabolic outcomes after RYGB surgery. To compare the effectiveness of Roux-en-Y ... ...

    Abstract Purpose: It is currently unknown whether NASH (nonalcoholic steatohepatitis), as compared to simple steatosis, is associated with impaired postoperative weight loss and metabolic outcomes after RYGB surgery. To compare the effectiveness of Roux-en-Y gastric bypass (RYGB) on patients with NASH versus those with simple nonalcoholic fatty liver (NAFL).
    Materials and methods: We retrospectively retrieved data from 515 patients undergoing RYGB surgery with concomitant liver biopsy. Clinical follow-up and metabolic assessment were performed prior to surgery and 12 months after surgery. We used multivariate analysis of variance (MANOVA) and propensity score matching and we assessed for changes in markers of hepatocellular injury and metabolic outcomes.
    Results: There were 421 patients with simple NAFL, and 94 with NASH. Baseline alanine and aspartate aminotransferases were significantly higher in patients with NASH (p < 0.01). Twelve months after the RYGB surgery, as determined by both MANOVA and propensity score matching, patients with NASH exhibited a significantly greater reduction in alanine aminotransferase (ß-coefficient - 12 iU/l [- 22 to - 1.83], 95% CI, adjusted p = 0.021) compared to their NAFL counterparts (31 matched patients in each group with no loss to follow-up at 12 months). Excess weight loss was similar in both groups (ß-coefficient 4.54% [- 3.12 to 12.21], 95% CI, adjusted p = 0.244). Change in BMI was comparable in both groups (- 14 (- 16.6 to - 12.5) versus - 14.3 (- 17.3 to - 11.9), p = 0.784).
    Conclusion: After RYGB surgery, patients with NASH experience a greater reduction in markers for hepatocellular injury and similar weight loss compared to patients with simple steatosis.
    MeSH term(s) Gastric Bypass ; Humans ; Non-alcoholic Fatty Liver Disease/complications ; Obesity, Morbid/surgery ; Propensity Score ; Retrospective Studies ; Treatment Outcome ; Weight Loss
    Language English
    Publishing date 2021-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1070827-3
    ISSN 1708-0428 ; 0960-8923
    ISSN (online) 1708-0428
    ISSN 0960-8923
    DOI 10.1007/s11695-021-05642-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Exercise-based Interventions for Nonalcoholic Fatty Liver Disease: A Meta-analysis and Meta-regression.

    Orci, Lorenzo A / Gariani, Karim / Oldani, Graziano / Delaune, Vaihere / Morel, Philippe / Toso, Christian

    Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

    2016  Volume 14, Issue 10, Page(s) 1398–1411

    Abstract: Background & aims: The burden of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. We performed a meta-analysis to determine the effectiveness of exercise-based lifestyle interventions on liver-specific end points in populations with ... ...

    Abstract Background & aims: The burden of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. We performed a meta-analysis to determine the effectiveness of exercise-based lifestyle interventions on liver-specific end points in populations with NAFLD and underlying metabolic disorders such as obesity, type 2 diabetes, or metabolic syndrome.
    Methods: We searched PubMed-MEDLINE, Embase, and the Cochrane Central register through October 21, 2015 for randomized trials of exercise-based lifestyle interventions on end points such as intrahepatic lipid content and blood levels of alanine and aspartate aminotransferases. Effect sizes are reported as standardized mean difference and weighted mean difference values. To investigate heterogeneity, we performed sensitivity and meta-regression analyses. Results were reported according to the PRISMA statement.
    Results: We analyzed data from 28 trials. Physical activity, independently from diet change, was associated with a significant reduction in intrahepatic lipid content (standardized mean difference, -0.69; 95% confidence interval [CI], -0.90 to -0.48) and with reductions in alanine aminotransferase (weighted mean difference, -3.30 IU/L; 95% CI, 5.57 to -1.04) and aspartate aminotransferase (weighted mean difference, -4.85 IU/L; 95% CI, -8.68 to -1.02). By meta-regression, we found individuals with increasing body mass index to be increasingly more likely to benefit from the intervention (beta coefficient = -0.10; P = .037). We recorded no effect modification by variables related to the intensity of the intervention.
    Conclusions: In a meta-analysis of randomized trials, we found strong evidence that physical activity reduces intrahepatic lipid content and markers of hepatocellular injury in patients with NAFLD. This effect correlated with baseline body mass index.
    MeSH term(s) Exercise ; Humans ; Life Style ; Non-alcoholic Fatty Liver Disease/pathology ; Non-alcoholic Fatty Liver Disease/prevention & control ; Randomized Controlled Trials as Topic ; Treatment Outcome
    Language English
    Publishing date 2016-05-04
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
    ZDB-ID 2119789-1
    ISSN 1542-7714 ; 1542-3565
    ISSN (online) 1542-7714
    ISSN 1542-3565
    DOI 10.1016/j.cgh.2016.04.036
    Database MEDical Literature Analysis and Retrieval System OnLINE

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