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  1. Article ; Online: Facilitating rapid access to addiction treatment

    Anita Srivastava / Sarah Clarke / Kate Hardy / Meldon Kahan

    Addiction Science & Clinical Practice, Vol 16, Iss 1, Pp 1-

    a randomized controlled trial

    2021  Volume 6

    Abstract: Abstract Background Obtaining timely access to addiction medicine treatment for patients with substance use disorders is challenging and patients often have to navigate complex referral pathways. This randomized controlled trial examines the effect of ... ...

    Abstract Abstract Background Obtaining timely access to addiction medicine treatment for patients with substance use disorders is challenging and patients often have to navigate complex referral pathways. This randomized controlled trial examines the effect of providing an expedited pathway to addiction medicine treatment on initial treatment engagement and health care utilization. Methods Individuals with possible alcohol or opioid use disorder were recruited from three residential withdrawal management services (WMS). Subjects randomized to the Delayed Intervention (DI) group were given contact information for a nearby addiction medicine clinic; those randomized to the Rapid Intervention (RI) group were given an appointment at the clinic within 2 days and were accompanied to their first appointment. Results Of the 174 individuals who were screened, 106 were randomized to either the DI or RI group. The two groups were similar in demographics, housing status, and substance use in the last 30 days. In the 6-month period following randomization, 85% of the RI group attended at least one clinic appointment, compared to only 29% in the DI group (p < 0.0001). The RI group had a mean of 6.39 ED visits per subject in the 12 months after randomization, while the DI group had a mean of 13.02 ED visits per subject in the same 12-month period (p = 0.0469). Other health utilization measures did not differ between the two groups. Conclusion Providing immediate facilitated access to an addiction medicine service resulted in greater initial engagement and reduced emergency department visits at 6 months. Trial registration This trial is registered at the National Institutes of Health (ClinicalTrials.gov) under identifier #NCT01934751.
    Keywords Treatment access ; Alcohol use disorder ; Opioid use disorder ; ED visits ; Medicine (General) ; R5-920 ; Social pathology. Social and public welfare. Criminology ; HV1-9960
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Impact of malnutrition management e-learning module on GPs’ knowledge

    Aisling A Geraghty / Patricia Dominguez Castro / Ciara ME Reynolds / Sarah Browne / Frank Bourke / Catriona Bradley / Karen Finnigan / Sarah Clarke / Barbara Clyne / Gerard Bury / Carla Perrotta / Sharon Kennelly / Clare A Corish

    BJGP Open, Vol 7, Iss

    a pilot study

    2023  Volume 1

    Abstract: Background: Malnutrition is underdiagnosed in primary care. GPs are key healthcare contacts for older adults at risk of protein-energy malnutrition; however, lack of knowledge and confidence in its diagnosis and treatment is often reported. Aim: To ... ...

    Abstract Background: Malnutrition is underdiagnosed in primary care. GPs are key healthcare contacts for older adults at risk of protein-energy malnutrition; however, lack of knowledge and confidence in its diagnosis and treatment is often reported. Aim: To evaluate the impact of a bespoke online education module on GP malnutrition knowledge and management. Design & setting: A prospective pre—post pilot study with 23 GPs and eight GP trainees in the Republic of Ireland. Method: The module included units on the following: ‘malnutrition definition, prevalence, and latest evidence’; ‘identifying malnutrition in clinical practice’; ‘food-first advice’; ‘reviewing malnutrition’; and ‘oral nutritional supplements’. Participant knowledge was measured using a multiple choice questionnaire (MCQ) before and after the module (n = 31), and 6 weeks following completion (n = 11). Case studies assessing identification and management of malnutrition were evaluated by a clinical specialist dietitian with expertise in managing malnutrition. Changes in assessment performance were calculated using paired t-tests. Acceptability was evaluated using a questionnaire. Results: Post-training, 97% of GPs increased MCQ scores from baseline (+25%, P<0.001), with the greatest improvement in ‘identifying malnutrition in clinical practice’ (mean increase 47%, P<0.001). Eleven GPs completed the 6-week MCQ with scores remaining significantly higher than baseline (mean increase 15%, P = 0.005); ‘identifying malnutrition in clinical practice’ remained the most highly scored (mean increase 40%, P<0.001). Seventeen GPs completed the case studies; 76% at baseline and 88% post-module correctly calculated malnutrition risk scores. Appropriate malnutrition management improved for 47% of GPs after module completion. Conclusion: This e-learning module improved malnutrition knowledge, with good short-term retention in a small cohort. Development of online evidence-based nutrition education may improve GP nutrition care.
    Keywords malnutrition ; education ; medical ; continuing ; oral nutritional supplements ; general practice ; primary healthcare ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Royal College of General Practitioners
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: La plainte de discrimination devant le Tribunal canadien des droits de la personne portant sur les services d’aide à l’enfance aux enfants des Premières Nations et le Principe de Jordan

    Anne Levesque / Sarah Clarke / Cindy Blackstock

    Enfances, Familles, Générations, Vol

    2016  Volume 25

    Abstract: More First Nations children today are being placed in foster care than the number of students who ever attended residential schools. It is becoming increasingly clear that this problem is caused by inequitable and insufficient federal government funding ... ...

    Abstract More First Nations children today are being placed in foster care than the number of students who ever attended residential schools. It is becoming increasingly clear that this problem is caused by inequitable and insufficient federal government funding for child welfare services. In 2007, the First Nations Child & Family Caring Society of Canada (the Caring Society) and the Assembly of First Nations filed a complaint concerning two allegations of discrimination. The first allegation concerned a conflict of jurisdiction between the federal and provincial governments that resulted in First Nations children often having to wait to receive vital services or even refused services provided to other children. The second allegation of discrimination concerned the unfair treatment of 163,000 First Nations children in the child welfare system provided on reserves. In both cases, it was alleged that these treatments constituted discriminatory acts prohibited under the Canada Human Rights Act. Over the next six years, the Canadian government spent millions of dollars on numerous unsuccessful attempts to derail the case. The case was nevertheless brought before the Human Rights Tribunal in February 2013; for the first time in Canadian history, the federal government’s liability regarding allegations of discrimination toward First Nations children was examined by a body that could make legally binding decisions and remedial orders. Over the year that followed, the Tribunal heard from over 25 witnesses and examined over 500 evidentiary documents. Internal federal documents that were submitted revealed consistent and systematic discrimination against First Nations children, along with a failure to resolve the problem, even with known solutions at hand. Even while the case was still before the Tribunal, a number of academics and members of First Nations began making parallels between the federal government’s reaction in this case and other cases of discrimination in access to services such as education, policing, health, ...
    Keywords First Nations ; children ; discrimination ; human rights ; Ethnology. Social and cultural anthropology ; GN301-674 ; The family. Marriage. Woman ; HQ1-2044
    Subject code 320
    Language English
    Publishing date 2016-10-01T00:00:00Z
    Publisher Centre Urbanisation Culture Société (UCS) de l'INRS
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Correction

    Sarah Clarke / Emma Wallace / Andrew Murphy / Paul Gallagher / Karen Cardwell / Laura McCullagh / Ciara Kirke / Michael Barry / Karen Finnigan / Maria Daly / Catriona Bradley / Edel Murphy / Patrick Byrne / Aisling Croke / Oscar James

    BMJ Open, Vol 10, Iss

    Health-related quality of Life in patients with advanced soft TIssue sarcomas treated with Chemotherapy (The HOLISTIC study): protocol for an international observational cohort study

    2020  Volume 6

    Keywords Medicine ; R
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Evaluation of the General Practice Pharmacist (GPP) intervention to optimise prescribing in Irish primary care

    Sarah Clarke / Emma Wallace / Andrew Murphy / Paul Gallagher / Karen Cardwell / Laura McCullagh / Ciara Kirke / Michael Barry / Karen Finnigan / Maria Daly / Catriona Bradley / Edel Murphy / Patrick Byrne / Aisling Croke / Oscar James

    BMJ Open, Vol 10, Iss

    a non-randomised pilot study

    2020  Volume 6

    Abstract: Objective Limited evidence suggests integration of pharmacists into the general practice team could improve medicines management for patients, particularly those with multimorbidity and polypharmacy. This study aimed to develop and assess the feasibility ...

    Abstract Objective Limited evidence suggests integration of pharmacists into the general practice team could improve medicines management for patients, particularly those with multimorbidity and polypharmacy. This study aimed to develop and assess the feasibility of an intervention involving pharmacists, working within general practices, to optimise prescribing in Ireland.Design Non-randomised pilot study.Setting Primary care in Ireland.Participants Four general practices, purposively sampled and recruited to reflect a range of practice sizes and demographic profiles.Intervention A pharmacist joined the practice team for 6 months (10 hours/week) and undertook medication reviews (face to face or chart based) for adult patients, provided prescribing advice, supported clinical audits and facilitated practice-based education.Outcome measures Anonymised practice-level medication (eg, medication changes) and cost data were collected. Patient-reported outcome measure (PROM) data were collected on a subset of older adults (aged ≥65 years) with polypharmacy using patient questionnaires, before and 6 weeks after medication review by the pharmacist.Results Across four practices, 786 patients were identified as having 1521 prescribing issues by the pharmacists. Issues relating to deprescribing medications were addressed most often by the prescriber (59.8%), compared with cost-related issues (5.8%). Medication changes made during the study equated to approximately €57 000 in cost savings assuming they persisted for 12 months. Ninety-six patients aged ≥65 years with polypharmacy were recruited from the four practices for PROM data collection and 64 (66.7%) were followed up. There were no changes in patients’ treatment burden or attitudes to deprescribing following medication review, and there were conflicting changes in patients’ self-reported quality of life.Conclusions This non-randomised pilot study demonstrated that an intervention involving pharmacists, working within general practices is feasible to implement and has potential ...
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2020-06-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: A Comparison of Stride Length and Lower Extremity Kinematics during Barefoot and Shod Running in Well Trained Distance Runners

    Peter Francis, James Ledingham, Sarah Clarke, DJ Collins, Philip Jakeman

    Journal of Sports Science and Medicine, Vol 15, Iss 3, Pp 417-

    2016  Volume 423

    Abstract: Stride length, hip, knee and ankle angles were compared during barefoot and shod running on a treadmill at two speeds. Nine well-trained (1500m time: 3min:59.80s ± 14.7 s) male (22 ±3 years; 73 ±9 kg; 1.79 ±0.4 m) middle distance (800 m – 5,000 m) ... ...

    Abstract Stride length, hip, knee and ankle angles were compared during barefoot and shod running on a treadmill at two speeds. Nine well-trained (1500m time: 3min:59.80s ± 14.7 s) male (22 ±3 years; 73 ±9 kg; 1.79 ±0.4 m) middle distance (800 m – 5,000 m) runners performed 2 minutes of running at 3.05 m·s-1 and 4.72 m·s-1 on an treadmill. This approach allowed continuous measurement of lower extremity kinematic data and calculation of stride length. Statistical analysis using a 2X2 factorial ANOVA revealed speed to have a main effect on stride length and hip angle and footwear to have a main effect on hip angle. There was a significant speed*footwear interaction for knee and ankle angles. Compared to shod running at the lower speed (3.05 m·s-1), well trained runners have greater hip, knee and ankle angles when running barefoot. Runners undertake a high volume (~75%) of training at lower intensities and therefore knowledge of how barefoot running alters running kinematics at low and high speeds may be useful to the runner.
    Keywords Running mechanics ; endurance ; hip ; knee ; ankle ; Sports ; GV557-1198.995 ; Sports medicine ; RC1200-1245
    Subject code 796
    Language English
    Publishing date 2016-09-01T00:00:00Z
    Publisher University of Uludag
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Towards stratified treatment of JIA

    Stephanie J.W. Shoop-Worrall / Saskia Lawson-Tovey / Lucy R. Wedderburn / Kimme L. Hyrich / Nophar Geifman / Aline Kimonyo / Alyssia McNeece / Andrew Dick / Andrew Morris / Annie Yarwood / Athimalaipet Ramanan / Bethany R. Jebson / Chris Wallace / Daniela Dastros-Pitei / Damian Tarasek / Elizabeth Ralph / Emil Carlsson / Emily Robinson / Emma Sumner /
    Fatema Merali / Fatjon Dekaj / Helen Neale / Hussein Al-Mossawi / Jacqui Roberts / Jenna F. Gritzfeld / Joanna Fairlie / John Bowes / John Ioannou / Melissa Kartawinata / Melissa Tordoff / Michael Barnes / Michael W. Beresford / Michael Stadler / Paul Martin / Rami Kallala / Sandra Ng / Samantha Smith / Sarah Clarke / Soumya Raychaudhuri / Stephen Eyre / Sumanta Mukherjee / Teresa Duerr / Thierry Sornasse / Vasiliki Alexiou / Victoria J. Burton / Wei-Yu Lin / Wendy Thomson / Zoe Wanstall

    EBioMedicine, Vol 100, Iss , Pp 104946- (2024)

    machine learning identifies subtypes in response to methotrexate from four UK cohortsResearch in context

    2024  

    Abstract: Summary: Background: Methotrexate (MTX) is the gold-standard first-line disease-modifying anti-rheumatic drug for juvenile idiopathic arthritis (JIA), despite only being either effective or tolerated in half of children and young people (CYP). To ... ...

    Abstract Summary: Background: Methotrexate (MTX) is the gold-standard first-line disease-modifying anti-rheumatic drug for juvenile idiopathic arthritis (JIA), despite only being either effective or tolerated in half of children and young people (CYP). To facilitate stratified treatment of early JIA, novel methods in machine learning were used to i) identify clusters with distinct disease patterns following MTX initiation; ii) predict cluster membership; and iii) compare clusters to existing treatment response measures. Methods: Discovery and verification cohorts included CYP who first initiated MTX before January 2018 in one of four UK multicentre prospective cohorts of JIA within the CLUSTER consortium. JADAS components (active joint count, physician (PGA) and parental (PGE) global assessments, ESR) were recorded at MTX start and over the following year.Clusters of MTX ‘response’ were uncovered using multivariate group-based trajectory modelling separately in discovery and verification cohorts. Clusters were compared descriptively to ACR Pedi 30/90 scores, and multivariate logistic regression models predicted cluster-group assignment. Findings: The discovery cohorts included 657 CYP and verification cohorts 1241 CYP. Six clusters were identified: Fast improvers (11%), Slow Improvers (16%), Improve-Relapse (7%), Persistent Disease (44%), Persistent PGA (8%) and Persistent PGE (13%), the latter two characterised by improvement in all features except one. Factors associated with clusters included ethnicity, ILAR category, age, PGE, and ESR scores at MTX start, with predictive model area under the curve values of 0.65–0.71. Singular ACR Pedi 30/90 scores at 6 and 12 months could not capture speeds of improvement, relapsing courses or diverging disease patterns. Interpretation: Six distinct patterns following initiation of MTX have been identified using methods in artificial intelligence. These clusters demonstrate the limitations in traditional yes/no treatment response assessment (e.g., ACRPedi30) and can form the basis ...
    Keywords Juvenile idiopathic arthritis ; Machine learning ; Treatment outcome ; Epidemiology ; Methotrexate ; Medicine ; R ; Medicine (General) ; R5-920
    Subject code 310
    Language English
    Publishing date 2024-02-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article: OBSERVATIONS ON THE LOCAL DISTRIBUTION, BIOLOGY AND ECOLOGY OF PALOURDE <i>TAPES DECUSSATUS</i> (L.) OF RELEVANCE TO ITS EXPLOITATION IN THE REPUBLIC OF IRELAND

    Fahy, Edward / Jim Carroll / John Rafferty / Vincent Roantree / Conor Reid / Mark Norman / Sarah Clarke

    Biology and environment. 2010 Jan. 1, v. 110, no. 2

    2010  

    Abstract: ... This is an account of the changing status of palourde ... Tapes decussatus ... , which occurs in patches associated with a distinctive granulometry that are isolated along the Irish littoral. The species briefly entered the official marine landings ... ...

    Abstract

    This is an account of the changing status of palourde Tapes decussatus, which occurs in patches associated with a distinctive granulometry that are isolated along the Irish littoral. The species briefly entered the official marine landings statistics in 1975 in anticipation of a high harvest value to coastal communities. The 'clam boom', which peaked in 1975–1976 was, however, quickly followed by collapse. Later capture statistics were confused with those of a cultured species, the Manila clam Tapes semidecussatus, and these statistics are elucidated. T. decussatus is near the limit of its north–south range in Ireland, where the species is in retreat. This paper investigates nine beds in Counties Donegal, Galway and Kerry. Some had been examined thirty years previously. The density, year class frequency and growth rates of the species were measured in each to ascertain the reasons for its brief commercial performance and to assess its current status. The age of individuals ranged from 0 to 16+ years. Clam beds had a density of 17–116g m<sup>-2</sup>; age at full recruitment was seven years in commercial samples. T. decussatus has a eulittoral range on the sea shore and is associated with sheltered coastal topography. The species lives within a poorly sorted mixed granulometry of mud, sand and gravel, which is described in quantitative terms from some sample locations and compared with two other common inshore facies: Spisula sand and fine sand associated with Ensis siliqua. T. decussatus was often found in close proximity to fresh water inflows and it can survive eutrophic conditions and toxic algal blooms. Despite its low densities, T. decussatus was the quantitatively dominant bivalve wherever it occurred. The species responds to favourable growing conditions, but throughout Ireland site-specific growth rates were very similar. There was no evidence of exceptional annual spatfalls having contributed to the populations that were examined. It is proposed that the population structures described are of a k-selected species that is long lived and replicates by low but regular annual recruitments. The majority of the biomass resides in the older age classes and these are targeted for harvest; once they have been intensively exploited, T. decussatus populations are very slow to recover.


    Keywords Ruditapes philippinarum ; Spisula ; age structure ; algal blooms ; biomass ; clams ; eutrophication ; freshwater ; gravel ; internal transcribed spacers ; littoral zone ; sand ; statistics ; topography ; toxicity ; Irish Republic
    Language English
    Dates of publication 2010-0101
    Size p. 95-108.
    Publishing place The Royal Irish Academy
    Document type Article
    ZDB-ID 1169496-8
    ISSN 2009-003X ; 0791-7945
    ISSN (online) 2009-003X
    ISSN 0791-7945
    DOI 10.3318%2FBIOE.2010.110.2.95
    Database NAL-Catalogue (AGRICOLA)

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  9. Article: IRELAND'S VELVET CRAB (<i>NECORA PUBER</i> (L.)) POT FISHERY

    Fahy, Edward / Jim Carroll / Aisling Smith / Sinead Murphy / Sarah Clarke

    Biology and environment. 2008 Jan. 1, v. 108, no. 3

    2008  

    Abstract: ... Velvet crabs ( ... Necora puber ... (L.)) are taken mainly as a by-catch in the pot fishery for large crustaceans. ... N. puber ... is negatively associated with spider crabs ( ... Maja brachydactyla ... Balss) and positively associated with brown crabs (< ... ...

    Abstract

    Velvet crabs (Necora puber (L.)) are taken mainly as a by-catch in the pot fishery for large crustaceans. N. puber is negatively associated with spider crabs (Maja brachydactyla Balss) and positively associated with brown crabs (Cancer pagurus L.). In the Irish Sea, which yields small quantities of brown crabs, velvets have greater commercial significance, and they are targeted. Individuals from 28 samples of velvet crabs were described to characterise landings of the species. The female:male ratio was low, as was fecundity, which was typical of the northern European subgrouping of the species. Carapacewidth frequencies of males and females were disaggregated by a Bhattacharya plot into six groups of males and four groups of females. Females have been described as having a lower life expectancy than males in this species. An age of eight to ten years is proposed as the required age to achieve maximum size in the male. Average male and female size and weight within samples correlated highly significantly, and males were used as indicators of population structure as more information was obtained on males. Age at full recruitment of males correlated inversely with landings over a period of ten years; the mortality coefficient (Z) correlated positively with landed weights. There are no conservation measures currently in force in Ireland for this species, but it is difficult to hold in captivity, and most of the trade is live export. Hence this species is landed at 20–34% of potential landing places, only where suitable buyers are available, although the species is believed to occur in all coastal waters. Spatially discontinuous exploitation favours a sustainable velvet fishery.


    Keywords Cancer pagurus ; Maja brachydactyla ; bycatch ; captive animals ; coastal water ; correlation ; crabs ; exports ; fecundity ; females ; longevity ; males ; mortality ; population structure ; Ireland ; Irish Sea
    Language English
    Dates of publication 2008-0101
    Size p. 157-175.
    Publishing place The Royal Irish Academy
    Document type Article
    ZDB-ID 1169496-8
    ISSN 2009-003X ; 0791-7945
    ISSN (online) 2009-003X
    ISSN 0791-7945
    DOI 10.3318%2FBIOE.2008.108.3.157
    Database NAL-Catalogue (AGRICOLA)

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  10. Article ; Online: Quantifying and addressing the prevalence and bias of study designs in the environmental and social sciences

    Alec P. Christie / David Abecasis / Mehdi Adjeroud / Juan C. Alonso / Tatsuya Amano / Alvaro Anton / Barry P. Baldigo / Rafael Barrientos / Jake E. Bicknell / Deborah A. Buhl / Just Cebrian / Ricardo S. Ceia / Luciana Cibils-Martina / Sarah Clarke / Joachim Claudet / Michael D. Craig / Dominique Davoult / Annelies De Backer / Mary K. Donovan /
    Tyler D. Eddy / Filipe M. França / Jonathan P. A. Gardner / Bradley P. Harris / Ari Huusko / Ian L. Jones / Brendan P. Kelaher / Janne S. Kotiaho / Adrià López-Baucells / Heather L. Major / Aki Mäki-Petäys / Beatriz Martín / Carlos A. Martín / Philip A. Martin / Daniel Mateos-Molina / Robert A. McConnaughey / Michele Meroni / Christoph F. J. Meyer / Kade Mills / Monica Montefalcone / Norbertas Noreika / Carlos Palacín / Anjali Pande / C. Roland Pitcher / Carlos Ponce / Matt Rinella / Ricardo Rocha / María C. Ruiz-Delgado / Juan J. Schmitter-Soto / Jill A. Shaffer / Shailesh Sharma

    Nature Communications, Vol 11, Iss 1, Pp 1-

    2020  Volume 11

    Abstract: Randomised controlled experiments are the gold standard for scientific inference, but environmental and social scientists often rely on different study designs. Here the authors analyse the use of six common study designs in the fields of biodiversity ... ...

    Abstract Randomised controlled experiments are the gold standard for scientific inference, but environmental and social scientists often rely on different study designs. Here the authors analyse the use of six common study designs in the fields of biodiversity conservation and social intervention, and quantify the biases in their estimates.
    Keywords Science ; Q
    Language English
    Publishing date 2020-12-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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