Publications by authors named "Peter Filip"

16 Publications

  • Page 1 of 1

Multidisciplinary management of ventilator weaning and tracheostomies for COVID-19 patients at a major NYC public hospital: A blueprint for other institutions.

Laryngoscope Investig Otolaryngol 2021 Mar 1. Epub 2021 Mar 1.

Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA.

At the height of the coronavirus pandemic in New York City, at our hospital (NYC Health/Hospitals-Elmhurst) 95% of inpatients tested positive for COVID-19 and it operated at 500% surge ICU capacity-one of the greatest impacted centers in the nation. In the face of this we established a systematic multidisciplinary approach to manage ventilated ICU patients and select those appropriate for tracheostomy. Members from Pulmonary Critical Care, Anesthesiology, Surgery, Ethics, and Otolaryngology, created a protocolized way to assess all ICU patients in our hospital and, if deemed appropriate, help them towards weaning or tracheostomy and subsequent discharge. Given the climbing COVID numbers throughout the nation, and once again in NY, we believe sharing our protocol and brief outcomes will be very helpful for hospitals who are struggling with what we did, as it may serve as a blueprint for these institutions.
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http://dx.doi.org/10.1002/lio2.537DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013437PMC
March 2021

Letter to the editor: Study Summary - Randomized Control Trial of Omega-3 Fatty Acid Supplementation for the Treatment of COVID-19 Related Olfactory Dysfunction.

Trials 2020 Nov 23;21(1):942. Epub 2020 Nov 23.

Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Objectives: To evaluate a therapeutic role for omega-3 fatty acid supplementation in the treatment of olfactory dysfunction associated with COVID-19 infection TRIAL DESIGN: Randomized, double-blinded, placebo-controlled trial PARTICIPANTS: Eligible patients are adults with self-reported new-onset olfactory dysfunction of any duration associated with laboratory-confirmed or clinically suspected COVID-19 patients. Exclusion criteria include patients with pre-existing olfactory dysfunction, history of chronic rhinosinusitis or history of sinus surgery, current use of nasal steroid sprays or omega-3 supplementation, fish allergy, or inability to provide informed consent for any reason. The trial is conducted at Mount Sinai Hospital INTERVENTION AND COMPARATOR: The intervention group will receive 2000 mg daily of omega-3 supplementation in the form of two "Fish Oil, Ultra Omega-3" capsules (product of Pharmavite®) daily. The comparator group will take 2 placebo capsules of identical size, shape, and odor daily for 6 weeks.

Main Outcomes: Each subject will take a Brief Smell Identification Test at study enrolment and completion after 6 weeks. The primary outcome will be change in Brief Smell Identification Test over the 6-week period.

Randomisation: Patients will be randomized by the Investigational Drug Pharmacy at the Icahn School of Medicine at Sinai via a computer-generated sequence in a 1:1 allocation to treatment or control arms.

Blinding (masking): Both participants and researchers will be blinded.

Numbers To Be Randomised (sample Size): There will be 88 participants randomized to each group. A total of 176 participants will be randomized.

Trial Status: Protocol Version 1, 8/3/2020 Recruitment is ongoing, started 8/5/2020 with estimated completion 11/30/2020.

Trial Registration: The trial is registered on ClinicalTrials.gov with Protocol Identifier: NCT04495816 .

Trial Registration: ClinicalTrials.gov, NCT04495816 . Registered 3 August 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1).
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http://dx.doi.org/10.1186/s13063-020-04905-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681177PMC
November 2020

Nuances in transcanal endoscopic surgical technique for glomus tympanicum tumors.

Am J Otolaryngol 2020 Sep - Oct;41(5):102562. Epub 2020 May 27.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.

Objective: To describe the utility and nuances of transcanal endoscopic surgery (TCES) on glomus tympanicum tumors from a single surgeon's experience.

Patients/intervention: Twelve patients, eight female and four males, diagnosed pre-operatively with glomus tympanicum tumors. They all underwent endoscopic resection by a single surgeon.

Main Outcome Measures: Feasibility of endoscopic resection of glomus tympanicum tumors without conversion to a microscopic approach. Secondary outcomes include tumor stage, pre and post-operative audiometry, vertigo, sensorineural hearing loss (SNHL) and integrity of the facial nerve, ossicles, chorda tympani and tympanic membrane.

Results: Twelve patients underwent TCES, eight patient's pathology results were glomus tympanicum, ranging from Glasscock-Jackson grade I-III. Due to loss in follow up, 6/8 patients had complete audiometric data, which were analyzed. Average pre-operative air-bone-gap (ABG) was 5.41 compared to post-operative ABG of 5.08 (p > 0.89). No patients resulted in any, post-operative vertigo, tinnitus, SNHL, facial nerve injury or chorda tympani nerve injury. Two patients had intentional tympanic membrane perforations secondary to tumor adherence to the membrane. They were repaired with tragal perichondrium graft. No patients have had any recurrences.

Conclusions: Endoscopic resection of glomus tympanicum tumors is a feasible and effective, alternative visualization modality for the neurotologist. Surgical pearls are described herein.
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http://dx.doi.org/10.1016/j.amjoto.2020.102562DOI Listing
November 2020

COVID-19 sampling from the middle ear and mastoid: A case report.

Am J Otolaryngol 2020 Sep - Oct;41(5):102577. Epub 2020 Jun 2.

Icahn School of Medicine at Mount Sinai, Department of Otolaryngology-Head and Neck Surgery, United States of America; New York Eye and Ear Infirmary of Mount Sinai, Department of Otolaryngology-Head and Neck Surgery, United States of America.

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http://dx.doi.org/10.1016/j.amjoto.2020.102577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264918PMC
September 2020

Endoscopic Skull Base Surgery Protocol From the Frontlines: Transnasal Surgery During the COVID-19 Pandemic.

Otolaryngol Head Neck Surg 2020 09 26;163(3):482-490. Epub 2020 May 26.

Department of Neurosurgery, The Mount Sinai Hospital/Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Objective: The coronavirus disease 2019 (COVID-19) pandemic disrupted the standard management paradigms for care of patients with sinus and skull base presentations due to concern for patient and health care provider safety, given the high aerosol-generating potential of endonasal procedures.

Data Sources: We reviewed the relevant literature complied from available sources, including PubMed, Google Scholar, and otolaryngology journals providing electronic manuscripts ahead of indexing or publication.

Review Methods: Incorporating available evidence and the projected infection control and resource limitations at our institution, we collectively authored a dynamic set of protocols guiding (1) case stratification, (2) preoperative assessment, (3) operative setup, and (4) postoperative care of patients with sinus or skull base presentations. Due to the rapidly evolving nature of COVID-19 publications, lack of rigorous data, and urgent necessity of standardized protocols, strict inclusion and exclusion criteria were not employed.

Conclusions: As scarce hospital resources are diverted to COVID-19 care and staff are redeployed to forward-facing roles, endonasal procedures have largely ceased, leaving patients with ongoing sinonasal and skull base complaints untreated. Skull base teams now weigh the urgency of surgery in this population with the regional availability of resources.

Implications For Practice: The COVID-19 pandemic will have an enduring and unpredictable impact on hospital operations and surgical skull base practices and will require a dynamic set of management protocols responsive to new evidence and changing resources. In the current resource-limited environment, clinicians may utilize these protocols to assist with stratifying patients by acuity, performing preoperative assessment, and guiding peri- and postoperative care.
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http://dx.doi.org/10.1177/0194599820931836DOI Listing
September 2020

The role of the otolaryngologist in the evaluation and management of headaches.

Am J Otolaryngol 2019 Jan - Feb;40(1):115-120. Epub 2018 Jul 7.

Department of Otolaryngology, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States.

Background: Headaches are commonly evaluated in otolaryngology and often represent a diagnostic dilemma. This review addresses rhinogenic headache as well as trigeminal neuralgia and migraine, both of which can masquerade as sinus headache and whose management increasingly involves otolaryngology intervention. Discussion considers diagnostic criteria and novel therapies and derives an algorithm for clinical decision-making.

Data Sources: OVID MEDLINE, Cochrane Library, and Google Scholar databases.

Methods: A literature search was performed to identify relevant articles published in the past 10 years addressing the diagnosis and management of rhinogenic headache, trigeminal neuralgia and/or migraine.

Findings: Rhinogenic headache: Identification of the specific cause must be achieved before treatment. No studies have mentioned the effect of certain therapies on the amelioration of headache. New techniques of balloon dilation for sinusitis are controversial, and their use remains contingent on surgeon preference. Removal of mucosal contact points has been shown to benefit quality of life in patients with contact point headache. Trigeminal neuralgia: Microvascular decompression is considered the gold standard for treatment, but percutaneous therapies can be effective for achieving pain control. Migraine: Patients who report amelioration of symptoms after targeted botulinum toxin injection may benefit from definitive decompression or nerve avulsion. Patients with mucosal contact points may have less favorable outcomes with migraine surgery if they are not simultaneously addressed.

Conclusions: A comprehensive understanding of the diagnostic workup and therapeutic options available for common headache etiologies is key to the management of a patient presenting with headache attributed to a rhinogenic cause.
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http://dx.doi.org/10.1016/j.amjoto.2018.07.002DOI Listing
April 2019

Fungal granulomatous disease of the nasal cavity: A case report of a rare entity.

Am J Otolaryngol 2017 Sep - Oct;38(5):642-644. Epub 2017 May 8.

Department of Otolaryngology/Head and Neck Surgery, Westchester Medical Center, ENT Faculty Practice, 100 Woods Rd., Valhalla, NY 10595, United States.

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http://dx.doi.org/10.1016/j.amjoto.2017.05.005DOI Listing
July 2018

Treatment of locally advanced parotid malignancies with parotidectomy and temporal bone resection.

Am J Otolaryngol 2017 Jul - Aug;38(4):380-382. Epub 2017 Mar 31.

Loyola University Medical Center, Department of Otolaryngology-Head and Neck Surgery, 2160 South First Avenue, Maywood, IL 60153, United States.

Purpose: In this study we review our institution's experience and outcomes with temporal bone resection and parotidectomy in the treatment of advanced parotid malignancies.

Methods: Patients undergoing lateral temporal bone resection and parotidectomy from 2007-2013 were identified in the EPIC electronic medical record. Primary tumor location, staging, surgical procedure, and patient demographic and outcome data were collected retrospectively.

Results: Fifteen patients underwent combined temporal bone resection and parotidectomy for parotid malignancy. Carcinoma ex-pleomorphic and squamous cell carcinoma were the most common pathologies. Two year disease free survival was 40%. Distant metastases were the most common site of disease recurrence. Only nodal disease was predictive of reduced disease free survival, though pre-operative facial paralysis showed a trend towards significance. Margin status and operating for recurrent tumor did not influence outcome in our series.

Conclusion: Local and regional tumor controls are attainable with combined skull base approaches to advanced parotid malignancies. Unfortunately these cases have a high rate of distant recurrence despite negative margins and local control.
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http://dx.doi.org/10.1016/j.amjoto.2017.03.005DOI Listing
May 2018

Bilateral sinonasal extramedulary plasmacytoma treated with radiotherapy and a medial maxillectomy with a Denker's procedure.

Am J Otolaryngol 2017 May - Jun;38(3):360-362. Epub 2017 Feb 15.

Department of Otolaryngology/Head and Neck Surgery, New York Eye and Ear Infirmary- Mount Sinai Health System, 310 E. 14(th) St., 6(th) Floor, New York, NY 10003, United States.

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http://dx.doi.org/10.1016/j.amjoto.2017.02.003DOI Listing
June 2018

Toxicity and mutagenicity of low-metallic automotive brake pad materials.

Ecotoxicol Environ Saf 2016 Sep 13;131:37-44. Epub 2016 May 13.

VŠB - Technical University of Ostrava, Nanotechnology Centre, 17. listopadu 15, 708 33 Ostrava, Czech Republic; Southern Illinois University Carbondale, Department of Mechanical Engineering and Energy Processes, Carbondale, IL 62901-4343, USA.

Organic friction materials are standardly used in brakes of small planes, railroad vehicles, trucks and passenger cars. The growing transportation sector requires a better understanding of the negative impact related to the release of potentially hazardous materials into the environment. This includes brakes which can release enormous quantities of wear particulates. This paper addresses in vitro detection of toxic and mutagenic potency of one model and two commercially available low-metallic automotive brake pads used in passenger cars sold in the EU market. The model pad made in the laboratory was also subjected to a standardized brake dynamometer test and the generated non-airborne wear particles were also investigated. Qualitative "organic composition" was determined by GC/MS screening of dichloromethane extracts. Acute toxicity and mutagenicity of four investigated sample types were assessed in vitro by bioluminescence assay using marine bacteria Vibrio fischeri and by two bacterial bioassays i) Ames test on Salmonella typhimurium His(-) and ii) SOS Chromotest using Escherichia coli PQ37 strain. Screening of organic composition revealed a high variety of organic compounds present in the initial brake pads and also in the generated non-airborne wear debris. Several detected compounds are classified by IARC as possibly carcinogenic to humans, e. g. benzene derivatives. Acute toxicity bioassay revealed a response of bacterial cells after exposure to all samples used. Phenolic resin and wear debris were found to be acutely toxic; however in term of mutagenicity the response was negative. All non-friction exposed brake pad samples (a model pad and two commercial pad samples) were mutagenic with metabolic activation in vitro.
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http://dx.doi.org/10.1016/j.ecoenv.2016.05.003DOI Listing
September 2016

Automotive airborne brake wear debris nanoparticles and cytokinesis-block micronucleus assay in peripheral blood lymphocytes: A pilot study.

Environ Res 2016 07 29;148:443-449. Epub 2016 Apr 29.

Health Effects Laboratory, Department of Environmental Chemistry, NILU-Norwegian Institute for Air Research, Instituttveien 18, 2007 Kjeller, Norway.

Motor vehicle exhaust and non-exhaust processes play a significant role in environmental pollution, as they are a source of the finest particulate matter. Emissions from non-exhaust processes include wear-products of brakes, tires, automotive hardware, road surface, and traffic signs, but still are paid little attention to. Automotive friction composites for brake pads are composite materials which may consist of potentially hazardous materials and there is a lack of information regarding the potential influence of the brake wear debris (BWD) on the environment, especially on human health. Thus, we focused our study on the genotoxicity of the airborne fraction of BWD using a brake pad model representing an average low-metallic formulation available in the EU market. BWD was generated in the laboratory by a full-scale brake dynamometer and characterized by Raman microspectroscopy, scanning electron microscopy, and transmission electron microscopy showing that it contains nano-sized crystalline metal-based particles. Genotoxicity tested in human lymphocytes in different testing conditions showed an increase in frequencies of micronucleated binucleated cells (MNBNCs) exposed for 48h to BWD nanoparticles (NPs) (with 10% of foetal calf serum in culture medium) compared with lymphocytes exposed to medium alone, statistically significant only at the concentration 3µg/cm(2) (p=0.032).
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http://dx.doi.org/10.1016/j.envres.2016.04.022DOI Listing
July 2016

Alteration of root growth by lettuce, wheat, and soybean in response to wear debris from automotive brake pads.

Arch Environ Contam Toxicol 2014 Nov 24;67(4):557-64. Epub 2014 Jun 24.

Department of Plant Biology and Center for Ecology, Southern Illinois University Carbondale, Carbondale, IL, 62901, USA.

Brakes from motor vehicles release brake pad wear debris (BPWD) with increased concentrations of heavy metals. Germination and root-elongation assays with lettuce, wheat, and soybean were used to provide an initial evaluation of the phytotoxicity of either a water extract of BPWD or BPWD particulates. In terms of germination, the only effect observed was that lettuce germination decreased significantly in the BPWD particulate treatment. Lettuce and wheat showed decreased root length and root-elongation rate in the presence of the BPWD particulates, whereas lettuce produced a significantly greater number of lateral roots in response to BPWD extract. There was no significant effect of either BPWD treatment on soybean root elongation or lateral roots. Treatment with BPWD extracts or particulates caused significant alterations in the bending pattern of the plant roots. These initial results suggest that BPWD may have effects on the early growth and development of plants.
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http://dx.doi.org/10.1007/s00244-014-0053-3DOI Listing
November 2014

Single walled carbon nanotube composites for bone tissue engineering.

J Orthop Res 2013 Sep 29;31(9):1374-81. Epub 2013 Apr 29.

Department of Medical Microbiology, Immunology & Cell Biology, Southern Illinois University, School of Medicine, PO Box 19679, 701 North First Street, Springfield, Illinois, 62794-9679, USA.

The purpose of this study was to develop single walled carbon nanotubes (SWCNT) and poly lactic-co-glycolic acid (PLAGA) composites for orthopedic applications and to evaluate the interaction of human stem cells (hBMSCs) and osteoblasts (MC3T3-E1 cells) via cell growth, proliferation, gene expression, extracellular matrix production and mineralization. PLAGA and SWCNT/PLAGA composites were fabricated with various amounts of SWCNT (5, 10, 20, 40, and 100 mg), characterized and degradation studies were performed. Cells were seeded and cell adhesion/morphology, growth/survival, proliferation and gene expression analysis were performed to evaluate biocompatibility. Imaging studies demonstrated uniform incorporation of SWCNT into the PLAGA matrix and addition of SWCNT did not affect the degradation rate. Imaging studies revealed that MC3T3-E1 and hBMSCs cells exhibited normal, non-stressed morphology on the composites and all were biocompatible. Composites with 10 mg SWCNT resulted in highest rate of cell proliferation (p < 0.05) among all composites. Gene expression of alkaline phosphatase, collagen I, osteocalcin, osteopontin, Runx-2, and Bone Sialoprotein was observed on all composites. In conclusion, SWCNT/PLAGA composites imparted beneficial cellular growth capabilities and gene expression, and mineralization abilities were well established. These results demonstrate the potential of SWCNT/PLAGA composites for musculoskeletal regeneration and bone tissue engineering (BTE) and are promising for orthopedic applications.
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http://dx.doi.org/10.1002/jor.22379DOI Listing
September 2013

Dissolution of copper and iron from automotive brake pad wear debris enhances growth and accumulation by the invasive macrophyte Salvinia molesta Mitchell.

Chemosphere 2013 Jun 10;92(1):45-51. Epub 2013 Apr 10.

Department of Plant Biology and Center for Ecology, Southern Illinois University, Carbondale, IL 62901, USA.

Automotive vehicles release particulate matter into the environment when their brakes are applied. The environmental effects of this automotive brake pad wear debris (BPWD) on the environment is a matter of growing debate yet the effects on plants have been largely untested. In this study, the effect of BPWD on the growth of the aquatic invasive Salvinia molesta Mitchell was examined. Salvinia molesta, plants were grown hydroponically in distilled water or in a distilled water extract containing BPWD. Growth of floating leaves, submerged leaves, and leaf nodes were measured over 20 d at 4-d intervals. At the conclusion of the study the amount of BPWD present in solutions and plant tissues was quantified using atomic absorption spectrometry (AAS). Cultivation of S. molesta in the water containing BPWD resulted in greater dissolution of Cu and Fe than occurred in the absence of plants. The tissue Cu and Fe concentrations of plants cultivated in the BPWD were significantly higher than plants grown in the absence of BPWD. Growth of S. molesta significantly increased when cultivated in the BPWD solutions in comparison to the distilled water. The results suggest that S. molesta and similar aquatic plants may be capable of increasing the dissolution of metal micronutrients from BPWD and utilizing those micronutrients to increase growth. Such growth responses could indicate that BPWD may interact with invasive floating macrophytes to more rapidly degrade the quality and stability of aquatic communities.
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http://dx.doi.org/10.1016/j.chemosphere.2013.03.002DOI Listing
June 2013

Detection of nano- and micro-sized particles in routine biopsy material - pilot study.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2015 Mar 10;159(1):87-92. Epub 2012 Dec 10.

Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech RepublicbFaculty Hospital Ostrava, 17.listopadu 1790, 708 52 Ostrava cNanotechnology Center, VSB - Technical University Ostrava, 17. listopadu 15, 70833 Ostrava.

Background: Nanotechnology is receiving enormous funding. Very little however is known about the health dangers of this technology so far. Chronic tonsillitis is one of a number of diseases called idiopathic. Among other factors, the tonsils are exposed to suspended particles in inhaled air including nano particles. The objective of this study was to detect and evaluate metallic particles in human tonsil tissue diagnosed with chronic tonsillitis and in amniotic fluid as a comparison.

Methods: . Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) was used for identification of solid particles in a total of 64 samples of routinely analyzed biopsy and cytologic material.

Results: Almost all samples were found to contain solid particles of various metals. The most frequent, regardless of diagnosis, were iron, chromium, nickel and aluminium. The size, determined using SEM, varied from around 500 nm to 25 µm. The majority formed aggregates of several micrometers in size but there were a significant number of smaller (sub-micrometer or nano-sized) particles present. The incidence of metallic particles was similar in child and adult tissues. The difference was in composition: the presence of several metals in adults was due to occupational exposure.

Conclusions: The presence of metallic particles in pathologically altered tissues may signal an alternative causation of some diseases. The ethiopathogenic explanation of these diseases associated with the presence of nano-sized particles in the organism has emerged into a new field of pathology, nanopathology.
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http://dx.doi.org/10.5507/bp.2012.104DOI Listing
March 2015

On airborne nano/micro-sized wear particles released from low-metallic automotive brakes.

Environ Pollut 2011 Apr 17;159(4):998-1006. Epub 2011 Jan 17.

Technical University Ostrava, Nanotechnology Center, Ostrava-Poruba, Czech Republic.

The paper addresses the wear particles released from commercially available "low-metallic" automotive brake pads subjected to brake dynamometer tests. Particle size distribution was measured in situ and the generated particles were collected. The collected fractions and the original bulk material were analyzed using several chemical and microscopic techniques. The experiments demonstrated that airborne wear particles with sizes between 10 nm and 20 μm were released into the air. The numbers of nanoparticles (< 100 nm) were by three orders of magnitude larger when compared to the microparticles. A significant release of nanoparticles was measured when the average temperature of the rotor reached 300°C, the combustion initiation temperature of organics present in brakes. In contrast to particle size distribution data, the microscopic analysis revealed the presence of nanoparticles, mostly in the form of agglomerates, in all captured fractions. The majority of elements present in the bulk material were also detected in the ultra-fine fraction of the wear particles.
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http://dx.doi.org/10.1016/j.envpol.2010.11.036DOI Listing
April 2011