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  1. Article ; Online: Glucagon -like Peptide 1 Receptor Agonist Use and the Effect on Diabetic Retinopathy: An Uncertain Relationship.

    Hui, Benjamin Tk / Yeong, Jian Lee / Peto, Tunde / Willoughby, Colin E

    Peptides

    2024  , Page(s) 171240

    Abstract: Glucagon-like Peptide 1 Receptor Agonists (GLP-1 RAs) are a group of relatively novel medications for the treatment of diabetes mellitus. These medications can mimic the naturally occurring incretins of the body, which promote the release of insulin in ... ...

    Abstract Glucagon-like Peptide 1 Receptor Agonists (GLP-1 RAs) are a group of relatively novel medications for the treatment of diabetes mellitus. These medications can mimic the naturally occurring incretins of the body, which promote the release of insulin in response to hyperglycaemia. The anti-glycaemic effects of these medications can be profound and carry other metabolic benefits such as promoting weight loss. Clinical trials have shown GLP-1 RAs are safe to use from a cardiovascular perspective. However, some trials have suggested a link between GLP-1 RA use and worsening diabetic retinopathy. The conclusions surrounding this link are poorly established as data is drawn primarily from cardiovascular outcome trials. If an association does exist, a possible explanation might be the observed phenomenon of early worsening diabetic retinopathy with rapid correction of hyperglycaemic states. Trials which look at diabetic retinopathy as a primary outcome in relation to use of GLP-1 RAs are sparce and warrant investigation given the growing use of this group of medications. Therefore currently, it is uncertain what effect, beneficial or adverse, GLP-1 RA use has on diabetic retinopathy. This article provides an overview of GLP-1 RA use as a treatment for diabetes mellitus and the current understanding of their relationship with diabetic retinopathy.
    Language English
    Publishing date 2024-05-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 769028-9
    ISSN 1873-5169 ; 0196-9781
    ISSN (online) 1873-5169
    ISSN 0196-9781
    DOI 10.1016/j.peptides.2024.171240
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  2. Article ; Online: A Newly Developed Web-Based Resource on Genetic Eye Disorders for Users With Visual Impairment (Gene.Vision): Usability Study.

    Yeong, Jian Lee / Thomas, Peter / Buller, James / Moosajee, Mariya

    Journal of medical Internet research

    2021  Volume 23, Issue 1, Page(s) e19151

    Language English
    Publishing date 2021-01-20
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1439-4456
    ISSN (online) 1438-8871
    ISSN 1439-4456
    DOI 10.2196/19151
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  3. Article ; Online: Correction: A Newly Developed Web-Based Resource on Genetic Eye Disorders for Users With Visual Impairment (Gene.Vision): Usability Study.

    Yeong, Jian Lee / Thomas, Peter / Buller, James / Moosajee, Mariya

    Journal of medical Internet research

    2021  Volume 23, Issue 1, Page(s) e27330

    Abstract: This corrects the article DOI: 10.2196/19151.]. ...

    Abstract [This corrects the article DOI: 10.2196/19151.].
    Language English
    Publishing date 2021-01-25
    Publishing country Canada
    Document type Published Erratum
    ZDB-ID 2028830-X
    ISSN 1438-8871 ; 1438-8871
    ISSN (online) 1438-8871
    ISSN 1438-8871
    DOI 10.2196/27330
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  4. Article ; Online: Correction

    Yeong, Jian Lee / Thomas, Peter / Buller, James / Moosajee, Mariya

    Journal of Medical Internet Research, Vol 23, Iss 1, p e

    A Newly Developed Web-Based Resource on Genetic Eye Disorders for Users With Visual Impairment (Gene.Vision): Usability Study

    2021  Volume 27330

    Keywords Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: A Newly Developed Web-Based Resource on Genetic Eye Disorders for Users With Visual Impairment (Gene.Vision)

    Yeong, Jian Lee / Thomas, Peter / Buller, James / Moosajee, Mariya

    Journal of Medical Internet Research, Vol 23, Iss 1, p e

    Usability Study

    2021  Volume 19151

    Abstract: BackgroundDespite the introduction of the Web Content Accessibility Guidelines and legislations, many websites remain poorly accessible to users with disability, especially those with visual impairment, as the internet has become a more visually complex ... ...

    Abstract BackgroundDespite the introduction of the Web Content Accessibility Guidelines and legislations, many websites remain poorly accessible to users with disability, especially those with visual impairment, as the internet has become a more visually complex environment. With increasing reliance on the internet and almost 2 million people in the United Kingdom being affected by vision loss, it is important that they are not overlooked when developing web-based materials. A significant proportion of those affected have irreversible vision loss due to rare genetic eye disorders, and many of them use the internet as a primary source of information for their conditions. However, access to high-quality web-based health information with an inclusive design remains a challenge for many. We have developed a new web-based resource for genetic eye disorders called Gene.Vision that aims to provide a holistic guide for patients, relatives, and health care professionals. ObjectiveThrough a usability testing session of our website prototype, this study aims to identify key web-based accessibility features for internet users with vision impairment and to explore whether the contents provided in Gene.Vision are relevant and comprehensible. MethodsA face-to-face testing session with 8 participants (5 patients, 2 family members, and 1 member of the public) and 8 facilitators was conducted on a prototype website. Remote testing was performed with another patient due to COVID-19 restrictions. Home page design, navigation, content layout and quality, language, and readability were explored through direct observation and task completion using the think-aloud method. A patient focus group was organized to elicit further feedback. Qualitative data were gathered and analyzed to identify core themes through open and axial coding. ResultsAll participants had good computer literacy; 6 patients with visual impairment used visual aid software including iOS VoiceOver and Speak Screen, iOS Classic Invert, ZoomText 2020, Job Access With Speech, and ...
    Keywords Computer applications to medicine. Medical informatics ; R858-859.7 ; Public aspects of medicine ; RA1-1270
    Subject code 302
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher JMIR Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Esotropia Outcomes and the Influence of Delay to Wearing Full Hypermetropic Correction.

    Brennan, Rosie / McCance, Patrick / Yeong, Jian Lee / Adamson, Gary / Mallett, John

    Journal of pediatric ophthalmology and strabismus

    2020  Volume 57, Issue 2, Page(s) 85–89

    Abstract: Purpose: To assess whether delay to full hypermetropic correction wear in children might influence the outcome of a diagnosis of full versus partially accommodative esotropia.: Methods: All children younger than 7 years who were referred with ... ...

    Abstract Purpose: To assess whether delay to full hypermetropic correction wear in children might influence the outcome of a diagnosis of full versus partially accommodative esotropia.
    Methods: All children younger than 7 years who were referred with possible strabismus over a 1-year period were assessed. A standard set of details were documented: age at which esotropia was first noticed, age at which esotropia was confirmed by an orthoptist, age at which glasses were prescribed, and age at which full refractive error was constantly worn. When full-time hypermetropic correction was worn, the type of esotropia was determined.
    Results: There were 430 children referred. Of these, 117 had a concomitant esotropia (62 males and 55 females). Esotropia was confirmed at 35.47 ± 16.67 months of age (range: 4 to 78 months). There were 51 children (43.6%) with full accommodative esotropia, 57 (48.7%) with partially accommodative esotropia, and 9 (7.7%) with nonaccommodative esotropia. Longer delays between the time at which esotropia was identified and the time at which glasses were prescribed were associated with a reduced likelihood of an outcome of full versus partially accommodative esotropia (odds ratio [OR] = 0.73, 95% confidence interval [CI] = 0.58 to 0.93). Delay to glasses wear for full and partially accommodative esotropia was 1.94 ± 6.4 and 6.24 ± 8.36 months, respectively. Higher average spherical correction scores were associated with a higher likelihood of being in the full accommodative esotropia group (OR = 1.35, 95% CI = 1.07 to 1.69).
    Conclusions: A child with recent onset concomitant esotropia is more likely to achieve full versus partially accommodative esotropia if the delay to full hypermetropic corrective glasses wear is minimized. [J Pediatr Ophthalmol Strabismus. 2020;57(2):85-89.].
    MeSH term(s) Accommodation, Ocular/physiology ; Child ; Child, Preschool ; Esotropia/diagnosis ; Esotropia/physiopathology ; Esotropia/therapy ; Eyeglasses ; Female ; Humans ; Infant ; Male ; Prospective Studies ; Refraction, Ocular/physiology ; Surveys and Questionnaires ; Time-to-Treatment ; Visual Acuity/physiology
    Language English
    Publishing date 2020-03-13
    Publishing country United States
    Document type Journal Article
    ZDB-ID 800921-1
    ISSN 1938-2405 ; 0191-3913
    ISSN (online) 1938-2405
    ISSN 0191-3913
    DOI 10.3928/01913913-20200117-01
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 333: Show issues Location:
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  7. Article ; Online: Visual cycle modulators versus placebo or observation for the prevention and treatment of geographic atrophy due to age-related macular degeneration.

    Yeong, Jian Lee / Loveman, Emma / Colquitt, Jill L / Royle, Pamela / Waugh, Norman / Lois, Noemi

    The Cochrane database of systematic reviews

    2020  Volume 12, Page(s) CD013154

    Abstract: Background: Age-related macular degeneration (AMD) is a highly prevalent condition in an ever-increasing elderly population. Although insidious in the early stages, advanced AMD (neovascular and atrophic forms) can cause significant visual disability ... ...

    Abstract Background: Age-related macular degeneration (AMD) is a highly prevalent condition in an ever-increasing elderly population. Although insidious in the early stages, advanced AMD (neovascular and atrophic forms) can cause significant visual disability and economic burden on health systems worldwide. The most common form, geographic atrophy, has no effective treatment to date, whereas neovascular AMD can be treated with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. Geographic atrophy has a slow disease progression and patients tend to have preserved central vision until the final stages. This tendency, coupled with the use of modern imaging modalities, provides a large window of opportunity to intervene with validated methods to assess treatment efficacy. As geographic atrophy is an increasingly common condition with no effective intervention, many treatments are under investigation, one of which is visual cycle modulators. These medications have been shown to reduce lipofuscin accumulation in pre-clinical studies that have led to several clinical trials, reviewed herein.
    Objectives: To assess the efficacy and safety of visual cycle modulators for the prevention and treatment of geographic atrophy secondary to AMD.
    Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2020, Issue 1); MEDLINE Ovid; Embase Ovid; Web of Science Core Collection; Scopus; Association for Research in Vision and Ophthalmology (ARVO) website; ClinicalTrials.gov and the WHO ICTRP to 11 January 2020 with no language restrictions. We also searched using the reference lists of reviews and existing studies and the Cited Reference Search function in Web of Science to identify further relevant studies.
    Selection criteria: We included randomised controlled trials (RCTs) and quasi-randomised clinical studies (if available) that compared visual cycle modulators to placebo or no treatment (observation) in people diagnosed with AMD (early, intermediate or geographic atrophy).
    Data collection and analysis: Two authors independently assessed risk of bias in the included studies and extracted data. Both authors entered data into RevMan 5. We resolved discrepancies through discussion. We graded the certainty of the evidence using the GRADE approach.
    Main results: We included three RCTs from the USA; one of these had clinical sites in Germany. Two studies compared emixustat to placebo while the other compared fenretinide to placebo. All assigned one study eye per participant and, combined, have a total of 821 participants with a majority white ethnicity (97.6%). All participants were diagnosed with geographic atrophy due to AMD based on validated imaging modalities. All three studies have high risk of attrition bias mainly due to ocular adverse effects of emixustat and fenretinide. We considered only one study to be adequately conducted and reported with high risk of bias in only one domain (attrition bias). We considered the other two studies to be poorly reported and to have high risk of attrition bias and reporting bias. People with geographic atrophy treated with emixustat may not experience a clinically important change in best-corrected visual acuity (BCVA) between baseline and 24 months compared to people treated with placebo (mean difference (MD) 1.9 Early Treatment Diabetic Retinopathy Study (ETDRS) letters, 95% confidence interval (CI) -2.34 to 6.14, low-certainty evidence). Emixustat may also result in little or no difference in loss of 15 ETDRS letters or more of BCVA compared with placebo at 24 months (16.4% versus 18%) (risk ratio (RR) 0.91, 95% CI 0.59 to 1.4, low-certainty evidence). In terms of disease progression, emixustat may result in little or no difference in the annual growth rate of geographic atrophy compared with placebo (mean difference MD 0.09 mm
    Authors' conclusions: There is limited evidence to support the use of visual cycle modulators (emixustat and fenretinide) for the treatment of established geographic atrophy due to AMD. The possible reduction in the incidence of CNV observed with fenretinide, and to a lesser extent, emixustat, requires formal assessment in focused studies.
    MeSH term(s) Aged ; Aged, 80 and over ; Choroidal Neovascularization/epidemiology ; Clinical Trials, Phase II as Topic ; Disease Progression ; Fenretinide/adverse effects ; Fenretinide/therapeutic use ; Geographic Atrophy/drug therapy ; Geographic Atrophy/etiology ; Geographic Atrophy/prevention & control ; Humans ; Incidence ; Macular Degeneration/complications ; Phenyl Ethers/adverse effects ; Phenyl Ethers/therapeutic use ; Placebos/therapeutic use ; Propanolamines/adverse effects ; Propanolamines/therapeutic use ; Randomized Controlled Trials as Topic ; Visual Acuity/drug effects ; Watchful Waiting
    Chemical Substances Phenyl Ethers ; Placebos ; Propanolamines ; emixustat (02DZ1HBF0M) ; Fenretinide (187EJ7QEXL)
    Language English
    Publishing date 2020-12-17
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
    ISSN 1469-493X
    ISSN (online) 1469-493X
    DOI 10.1002/14651858.CD013154.pub2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: PRAGMATISM OF RANDOMIZED CLINICAL TRIALS ON RANIBIZUMAB FOR THE TREATMENT OF DIABETIC MACULAR EDEMA: Impact on Clinical Outcomes.

    Stewart, Stephen / Yeong, Jian Lee / Virgili, Gianni / Azuara-Blanco, Augusto / Lois, Noemi

    Retina (Philadelphia, Pa.)

    2019  Volume 40, Issue 5, Page(s) 919–927

    Abstract: Purpose: To evaluate the pragmatism and generalizability of randomized clinical trials (RCTs) on ranibizumab for diabetic macular edema and determine whether clinical outcomes would differ based on whether or not patients fulfill the eligibility ... ...

    Abstract Purpose: To evaluate the pragmatism and generalizability of randomized clinical trials (RCTs) on ranibizumab for diabetic macular edema and determine whether clinical outcomes would differ based on whether or not patients fulfill the eligibility criteria of these RCTs.
    Methods: Pragmatism and generalizability of three RCTs on ranibizumab for diabetic macular edema (DRCRnet Protocols I and T, and RESTORE) were rated using the PRECIS-2 tool. A cohort of consecutive patients with diabetic macular edema was assessed to determine whether clinical outcomes differed based on whether or not patients met the RCT eligibility criteria. Univariable and multivariable regression analyses, adjusted for baseline best-corrected visual acuity, central retinal thickness and number of injections received, were used.
    Results: All RCTs were rated as being more pragmatic than explanatory, with DRCRnet trials being the most pragmatic. Of the 216 eyes (176 patients) included in the cohort, 63% would have met eligibility criteria for Protocol T, 61% for Protocol I, and 56% for RESTORE. When adjusted for best-corrected visual acuity, central retinal thickness, and number of ranibizumab injections received, there were no statistically significant differences in best-corrected visual acuity or central retinal thickness found between "eligible" and "ineligible" patients.
    Conclusion: Randomized clinical trials evaluating ranibizumab for diabetic macular edema were more pragmatic than explanatory. "Ineligible" patients still benefited from ranibizumab therapy.
    MeSH term(s) Aged ; Angiogenesis Inhibitors/administration & dosage ; Diabetic Retinopathy/complications ; Diabetic Retinopathy/diagnosis ; Diabetic Retinopathy/drug therapy ; Female ; Humans ; Intravitreal Injections ; Macula Lutea/pathology ; Macular Edema/diagnosis ; Macular Edema/drug therapy ; Macular Edema/etiology ; Male ; Middle Aged ; Randomized Controlled Trials as Topic/methods ; Ranibizumab/administration & dosage ; Tomography, Optical Coherence/methods ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity
    Chemical Substances Angiogenesis Inhibitors ; Vascular Endothelial Growth Factor A ; Ranibizumab (ZL1R02VT79)
    Language English
    Publishing date 2019-02-26
    Publishing country United States
    Document type Journal Article ; Multicenter Study
    ZDB-ID 603192-4
    ISSN 1539-2864 ; 0275-004X
    ISSN (online) 1539-2864
    ISSN 0275-004X
    DOI 10.1097/IAE.0000000000002476
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    Zs.A 1724: Show issues Location:
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  9. Article ; Online: Treatments for dry age-related macular degeneration and Stargardt disease: a systematic review.

    Waugh, Norman / Loveman, Emma / Colquitt, Jill / Royle, Pamela / Yeong, Jian Lee / Hoad, Geraldine / Lois, Noemi

    Health technology assessment (Winchester, England)

    2018  Volume 22, Issue 27, Page(s) 1–168

    Abstract: Background: Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy.: ...

    Abstract Background: Age-related macular degeneration (AMD) is the leading cause of visual loss in older people. Advanced AMD takes two forms, neovascular (wet) and atrophic (dry). Stargardt disease (STGD) is the commonest form of inherited macular dystrophy.
    Objective: To carry out a systematic review of treatments for dry AMD and STGD, and to identify emerging treatments where future NIHR research might be commissioned.
    Design: Systematic review.
    Methods: We searched MEDLINE, EMBASE, Web of Science and The Cochrane Library from 2005 to 13 July 2017 for reviews, journal articles and meeting abstracts. We looked for studies of interventions that aim to preserve or restore vision in people with dry AMD or STGD. The most important outcomes are those that matter to patients: visual acuity (VA), contrast sensitivity, reading speed, ability to drive, adverse effects of treatment, quality of life, progression of disease and patient preference. However, visual loss is a late event and intermediate predictors of future decline were accepted if there was good evidence that they are strong predictors of subsequent visual outcomes. These include changes detectable by investigation, but not necessarily noticed by people with AMD or STGD. ClinicalTrials.gov, the World Health Organization search portal and the UK Clinical Trials gateway were searched for ongoing and recently completed clinical trials.
    Results: The titles and abstracts of 7948 articles were screened for inclusion. The full text of 398 articles were obtained for further screening and checking of references and 112 articles were included in the final report. Overall, there were disappointingly few good-quality studies (including of sufficient size and duration) reporting useful outcomes, particularly in STGD. However we did identify a number of promising research topics, including drug treatments, stem cells, new forms of laser treatment, and implantable intraocular lens telescopes. In many cases, research is already under way, funded by industry or governments.
    Limitations: In AMD, the main limitation came from the poor quality of much of the evidence. Many studies used VA as their main outcome despite not having sufficient duration to observe changes. The evidence on treatments for STGD is sparse. Most studies tested interventions with no comparison group, were far too short term, and the quality of some studies was poor.
    Future work: We think that the topics on which the Health Technology Assessment (HTA) and Efficacy Mechanism and Evaluation (EME) programmes might consider commissioning primary research are in STGD, a HTA trial of fenretinide (ReVision Therapeutics, San Diego, CA, USA), a visual cycle inhibitor, and EME research into the value of lutein and zeaxanthin supplements, using short-term measures of retinal function. In AMD, we suggest trials of fenretinide and of a potent statin. There is epidemiological evidence from the USA that the drug, levodopa, used for treating Parkinson's disease, may reduce the incidence of AMD. We suggest that similar research should be carried out using the large general practice databases in the UK. Ideally, future research should be at earlier stages in both diseases, before vision is impaired, using sensitive measures of macular function. This may require early detection of AMD by screening.
    Study registration: This study is registered as PROSPERO CRD42016038708.
    Funding: The National Institute for Health Research HTA programme.
    MeSH term(s) Automobile Driving ; Cell Transplantation/methods ; Complementary Therapies/methods ; Dietary Supplements ; Disease Progression ; Humans ; Laser Therapy/methods ; Lenses, Intraocular ; Macular Degeneration/congenital ; Macular Degeneration/drug therapy ; Macular Degeneration/therapy ; Patient Preference ; Quality of Life ; Reading ; Stargardt Disease ; Visual Acuity
    Language English
    Publishing date 2018-07-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
    ZDB-ID 2006765-3
    ISSN 2046-4924 ; 1366-5278
    ISSN (online) 2046-4924
    ISSN 1366-5278
    DOI 10.3310/hta22270
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