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Partitioning of phytocannabinoids between faeces and water - Implications for wastewater-based epidemiology.

Sci Total Environ 2021 Sep 14;805:150269. Epub 2021 Sep 14.

University of South Australia, Clinical and Health Sciences (CHS), Health and Biomedical Innovation, South Australia 5000, Australia. Electronic address:

Evaluating consumption estimates for lipophilic drugs in wastewater has proven to be a challenge. A common feature for these compounds is that they are excreted in faeces and in conjugated form in urine. Limited research with no obvious experimental evidence has been conducted to investigate the degree to which faecal-bound chemical markers contribute towards mass loads in wastewater. Read More

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September 2021

Predictors of Infarction in Tuberculous Meningitis in Indian Patients.

J Stroke Cerebrovasc Dis 2021 Sep 15;30(11):106088. Epub 2021 Sep 15.

Department OF Neurology, AIIMS, New Delhi. Electronic address:

Background: Stroke is a devastating complication of tuberculous meningitis (TBM) and is an important determinant of its outcome. We propose a model which would help to predict development of infarction or cerebrovascular events in patients of TBM.

Methods: A prospective study with n=129 patients of TBM were evaluated for predictors and outcomes of stroke. Read More

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September 2021

Utility and usability of an automated COVID-19 symptom monitoring system (CoSMoS) in primary care during COVID-19 pandemic: A qualitative feasibility study.

Int J Med Inform 2021 Sep 6;155:104567. Epub 2021 Sep 6.

University of Malaya eHealth Unit, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia; Department of Artificial Intelligence, Faculty of Computer Science & Information Technology, University of Malaya, 50603 Kuala Lumpur, Malaysia.

Background: COVID-19 telemonitoring applications have been developed and used in primary care to monitor patients quarantined at home. There is a lack of evidence on the utility and usability of telemonitoring applications from end-users' perspective.

Objectives: This study aimed to evaluate the feasibility of a COVID-19 symptom monitoring system (CoSMoS) by exploring its utility and usability with end-users. Read More

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September 2021

Disturbance of functional and effective connectivity of the salience network involved in attention deficits in right temporal lobe epilepsy.

Epilepsy Behav 2021 Sep 15;124:108308. Epub 2021 Sep 15.

Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China. Electronic address:

The salience network (SN) acts as a switch that generates transient control signals to regulate the executive control network (ECN) and the default mode network (DMN) and has been implicated in cognitive processes. Temporal lobe epilepsy (TLE) is usually accompanied by different types of cognitive deficits, but whether it is associated with dysfunctional connectivity of the SN remains unknown. To address this, thirty-six patients with right TLE (rTLE) and thirty-six healthy controls (HCs) were recruited for the present study. Read More

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September 2021

Clinical perception and management of Parkinson's disease during the COVID-19 pandemic: A Canadian experience.

Parkinsonism Relat Disord 2021 Sep 1;91:66-76. Epub 2021 Sep 1.

Centre de Recherche du CHU de Québec - Université Laval, Axe Neurosciences, Québec, QC, Canada; Département de Psychiatrie & Neurosciences, Université Laval, Québec, QC, Canada. Electronic address:

Background: The COVID-19 pandemic has necessitated the social isolation of the population and the rapid implementation of remote care for patients with neurodegenerative diseases. The objective of this study was to explore the perceived impact of confinement in patients with Parkinson's disease and document the effects of gender and living environment.

Methods: We recruited two cohorts from the Canadian provinces of Québec and Alberta, which differed in the dynamics of COVID-19 spreading at the time of the study, and administered a questionnaire on the perceived effects of confinement on daily living and disease management. Read More

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September 2021

A comparison of young children's spatiotemporal gait measures in three common types of footwear with different sole hardness.

Gait Posture 2021 Sep 6;90:276-282. Epub 2021 Sep 6.

Department of Physiotherapy, Monash University, Melbourne, Australia; Peninsula Health, Melbourne, Victoria, Australia.

Background: It is unknown what the impact of sole hardness is on young children's gait. Yet, this feature is commonly marketed as having differing benefits for young children's walking and development.

Research Question: What are the differences in spatiotemporal measures of gait during walking and running in three common types of young children's footwear with a soft sole, compared to a hard sole?

Methods: The study used a quasi-experimental design, with the condition order randomised using a Latin square sequence. Read More

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September 2021

A SMART approach to optimizing delivery of an mHealth intervention among cancer survivors with posttraumatic stress symptoms.

Contemp Clin Trials 2021 Sep 15:106569. Epub 2021 Sep 15.

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America; Department of Psychology in Psychiatry, Weill Cornell Medicine, New York, NY, United States of America.

Background/aims: Many cancer survivors who received intensive treatment such as hematopoietic stem cell transplantation (HCT) experience posttraumatic stress disorder (PTSD) symptoms. PTSD is associated with lower quality of life and other symptoms that require clinical treatment. The iterative treatment decisions that happen in clinical practice are not adequately represented in traditional randomized controlled trials (RCT) of PTSD treatments. Read More

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September 2021

Exosome-mediated circ_0001846 participates in IL-1β-induced chondrocyte cell damage by miR-149-5p-dependent regulation of WNT5B.

Clin Immunol 2021 Sep 15:108856. Epub 2021 Sep 15.

Trauma Center, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu, China. Electronic address:

Aims: Osteoarthritis (OA) is the leading cause of physical disability in middle-aged and elderly people globally. Previous studies have revealed that circular RNA (circRNA) is involved in the pathogenesis of OA. In this study, we studied the role of circ_0001846 in interleukin-1β (IL-1β)-induced OA progression. Read More

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September 2021

Plasmacytoid dendritic cells recruited by HIF-1α/eADO/ADORA1 signaling induce immunosuppression in hepatocellular carcinoma.

Cancer Lett 2021 Sep 15. Epub 2021 Sep 15.

Department of Surgery, Faculty of Medicine and HKU-SZH, The University of Hong Kong, Hong Kong, China. Electronic address:

Plasmacytoid dendritic cells (pDCs) play immunosuppressive roles in the tumor microenvironment. However, the molecular mechanisms underlying the recruitment and dysfunction of pDCs in the tumor microenvironment remain largely elusive, especially in hepatocellular carcinoma (HCC). In this study, we observed that pDCs accumulated in the blood, tumor tissue, and ascitic fluid of HCC patients. Read More

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September 2021

Associations among maternal perfluoroalkyl substance levels, fetal sex-hormone enzymatic gene polymorphisms, and fetal sex hormone levels in the Hokkaido study.

Reprod Toxicol 2021 Sep 15. Epub 2021 Sep 15.

Center for Environmental and Health Sciences, Hokkaido University, North-12, West-7, Kita-ku, Sapporo, 060-0812, Japan. Electronic address:

Prenatal sex hormones affect fetal growth; for example, prenatal exposure to low levels of androgen accelerates female puberty onset. We assessed the association of perfluoroalkyl substances (PFASs) in maternal sera and infant genotypes of genes encoding enzymes involved in sex steroid hormone biosynthesis on cord sera sex hormone levels in a prospective birth cohort study of healthy pregnant Japanese women (n = 224) recruited in Sapporo between July 2002 and October 2005. We analyzed PFAS and five sex hormone levels using liquid chromatography-tandem mass spectrometry. Read More

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September 2021

The Attitudes of European Medical Students towards the Clinical Importance of Neuroanatomy.

Ann Anat 2021 Sep 15:151832. Epub 2021 Sep 15.

Department of Morphological Sciences, Division of Anatomy, Faculty of Medicine, C. Davila University, Bucharest, Romania.

The attitudes of medical students towards the clinical importance of neuroanatomy have been little studied. Because it has been reported that medical students find neuroanatomy difficult and can have 'neurophobia', here we test the hypothesis that early-stage medical students across Europe have a low regard for neuroanatomy's clinical relevance. The work was conducted under the auspices of the Trans-European Pedagogic Research Group (TEPARG), with just over 1,500 students from 12 European medical schools providing responses to a survey (52% response rate) that assessed their attitudes using Thurstone and Chave methodologies. Read More

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September 2021

Immunological memory to SARS-CoV-2 in convalescent COVID-19 patients at one-year post-infection.

J Allergy Clin Immunol 2021 Sep 15. Epub 2021 Sep 15.

Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Background: Understanding the complexities of immune memory to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is key to gain insights into the durability of protective immunity against reinfection.

Objective: To evaluate the immune memory to SARS-CoV-2 in convalescent patients with longer follow-up time.

Methods: SARS-CoV-2-specific humoral and cellular responses were assessed in convalescent coronavirus disease 2019 (COVID-19) patients at one-year post-infection. Read More

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September 2021

Informed Consent Challenges and Strategies: A Qualitative Study of the Orthodontists' Perspective.

Orthod Craniofac Res 2021 Sep 18. Epub 2021 Sep 18.

Faculty of Medicine & Dentistry, University of Alberta, Alberta, Canada.

Objective: To identify the barriers and strategies perceived by orthodontists when obtaining consent from their adult patients concerning patients' comprehension or recollection of treatment information. Settings and Sample Population The sample comprised 12 orthodontists working in 8 different cities in Alberta, Canada.

Methods: An exploratory investigation using qualitative inquiry was conducted. Read More

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September 2021

Utility of Smartphone-based real-time report (Ecological Momentary Assessment) in the assessment and monitoring of awake bruxism. A multiple-week interval study in a Portuguese population of university students.

J Oral Rehabil 2021 Sep 18. Epub 2021 Sep 18.

School of Dentistry, University of Siena, Siena, Italy.

Purpose: The Ecological Momentary Assessment (EMA) concept was the basis for developing a smartphone application for the on-time report of awake bruxism (AB) activities. This study aims to monitor AB report over time in a population of healthy young adults.

Methods: A population of young adults recruited among dental students in good general health was recruited. Read More

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September 2021

Leg Movements during Sleep in Children Treated with Serotonergic Antidepressants.

Sleep 2021 Sep 18. Epub 2021 Sep 18.

Seattle Children's Hospital and University of Washington, Seattle, WA, USA.

Study Objectives: To evaluate leg movements during sleep (LMS) in children taking serotonergic antidepressants, compared to those of children with restless legs syndrome (RLS) and controls, and to assess the time structure of intermovement intervals (IMI).

Methods: Twenty-three children (12 girls, mean age 14.1 years) on antidepressants and with a total LMS index ≥15/hour, 21 drug-naïve RLS children (11 girls, mean age 13. Read More

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September 2021

Validity of resting strain/strain rate in prediction of myocardial viability.

Int J Cardiovasc Imaging 2021 Sep 18. Epub 2021 Sep 18.

Cardiovascular Department, Kafrelsheikh University, Kafrelsheikh, Egypt.

To evaluate the validity of the resting strain/strain rate measurements in predicting myocardial viability taking delayed enhancement cardiac magnetic resonance imaging as the gold standard. A cohort of 60 patients at three months followed up after acute myocardial infarction were recruited for this study. Resting echocardiography with offline analysis of deformation indices and gadolinium contrast enhanced cardiac magnetic resonance imaging were applied for all patients. Read More

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September 2021

Saliva secretion is reduced in mild reflux esophagitis patients.

Esophagus 2021 Sep 18. Epub 2021 Sep 18.

Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

Background: Salivary secretion in patients with mild reflux esophagitis has not been examined. In this study, saliva secretion and salivary epidermal growth factor (EGF) in patients with mild reflux esophagitis were investigated.

Methods: Thirty-eight mild reflux esophagitis patients and 38 control subjects were recruited for this case-control study. Read More

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September 2021

Sustained social withdrawal behavior and 'difficult' temperament among infants, in relation to maternal affectivity in a low-income area of Kinshasa, Democratic Republic of Congo.

Eur Child Adolesc Psychiatry 2021 Sep 18. Epub 2021 Sep 18.

Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen, Bergen, Norway.

Little is known about the relationship between maternal affectivity, social withdrawal and temperament in infants in low-income countries. The goal of the study was to assess the prevalence of social withdrawal behavior in infants aged 8 ± 2.3 months and to explore associations between maternal affectivity during pregnancy and postpartum, infant social withdrawal (as a sign of stress) and 'difficult' temperament as assessed by the mothers. Read More

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September 2021

Association of dietary fat intake and hepatocellular carcinoma among US adults.

Cancer Med 2021 Sep 18. Epub 2021 Sep 18.

Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Background And Aims: The role of dietary fat consumption in the etiology of hepatocellular carcinoma (HCC) remains unclear. We investigated the associations of total fat and fatty acids with risk of HCC among US adults in a hospital-based case-control study.

Methods: We analyzed data from 641 cases and 1034 controls recruited at MD Anderson Cancer Center during 2001-2018. Read More

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September 2021

Compound heterozygous KCNV2 variants contribute to cone dystrophy with supernormal rod responses in a Chinese family.

Mol Genet Genomic Med 2021 Sep 18:e1795. Epub 2021 Sep 18.

Department of Medical Genetics, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.

Background: Cone dystrophy with supernormal rod response (CDSRR) is an autosomal recessive retinal disorder characterized by myopia, dyschromatopsia, nyctalopia, photophobia, and nystagmus. CDSRR is caused by mutations in KCNV2, the gene encoding for an electrically silent Kv subunit (Kvs) named Kv8.2. Read More

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September 2021

The clinical relevance of formal thought disorder in the early stages of psychosis: results from the PRONIA study.

Eur Arch Psychiatry Clin Neurosci 2021 Sep 17. Epub 2021 Sep 17.

Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Nussbaumstr. 7, 80336, Munich, Germany.

Background: Formal thought disorder (FTD) has been associated with more severe illness courses and functional deficits in patients with psychotic disorders. However, it remains unclear whether the presence of FTD characterises a specific subgroup of patients showing more prominent illness severity, neurocognitive and functional impairments. This study aimed to identify stable and generalizable FTD-subgroups of patients with recent-onset psychosis (ROP) by applying a comprehensive data-driven clustering approach and to test the validity of these subgroups by assessing associations between this FTD-related stratification, social and occupational functioning, and neurocognition. Read More

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September 2021

Peripheral inflammation is associated with micro-structural and functional connectivity changes in depression-related brain networks.

Mol Psychiatry 2021 Sep 17. Epub 2021 Sep 17.

University of Sussex, Brighton and Sussex Medical School, Clinical Imaging Sciences Centre, Brighton, UK.

Inflammation is associated with depressive symptoms and innate immune mechanisms are likely causal in some cases of major depression. Systemic inflammation also perturbs brain function and microstructure, though how these are related remains unclear. We recruited N = 46 healthy controls, and N = 83 depressed cases stratified by CRP (> 3 mg/L: N = 33; < 3 mg/L: N = 50). Read More

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September 2021

The Effectiveness of Stroke Riskometer™ in Improving Stroke Risk Awareness in Malaysia: A Study Protocol of a Cluster-Randomized Controlled Trial.

Neuroepidemiology 2021 Sep 15:1-11. Epub 2021 Sep 15.

National Institute for Stroke and Applied Neurosciences, Auckland University of Technology (AUT), Auckland City, New Zealand.

Background: Stroke is considered the second leading cause of mortality and disability worldwide. The increasing burden of stroke is strong evidence that currently used primary prevention strategies are not sufficiently effective. The Stroke Riskometer™ application (app) represents a new stroke prevention strategy distinctly different from the conventional high-cardiovascular disease risk approach. Read More

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September 2021

Coronary Inflammation Assessed by Perivascular Fat Attenuation Index in Patients with Psoriasis: A Propensity Score-Matched Study.

Dermatology 2021 Sep 15:1-9. Epub 2021 Sep 15.

Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Objectives: This study aimed to evaluate coronary inflammation by measuring the perivascular fat attenuation index (FAI) and quantify the atherosclerosis burden in patients with psoriasis and control individuals without psoriasis based on coronary computed tomography angiography (CCTA) images.

Methods: A total of 98 consecutive patients with psoriasis (76 male [77.6%], aged 56. Read More

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September 2021

Benefit of an Internet-Based Management System among Hemodialysis Patients at the Risk of Intradialytic Hypotension and Muscle Cramps: A Controlled before and after Study.

Blood Purif 2021 Sep 15:1-8. Epub 2021 Sep 15.

Department of Nephrology, Hebei Key Laboratory of Vascular Calcification in Kidney Disease, Hebei Clinical Research Center for Chronic Kidney Disease, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

Background: The purpose of this study was to observe the impact of an internet-based management system on the incidence of intradialytic hypotension (IDH) and muscle cramps in hemodialysis patients.

Methods: The patients, who underwent maintenance hemodialysis in the center from January 2018 to June 2020, were recruited and divided into the pre-intervention group (before operation of the internet-based hemodialysis management system, from January 2018 to December 2018) and intervention group (after operation of the system, from June 2019 to June 2020). The clinical outcomes were compared between groups. Read More

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September 2021

Rural Adolescent Immunization: Delivery Practices and Barriers to Uptake.

J Am Board Fam Med 2021 Sep-Oct;34(5):937-949

From the ACCORDS, University of Colorado Anschutz Medical Campus, Aurora, CO (JRC, SEB, CP, AF, AN, KS, STO, AFD); Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO (JRC, STO, AFD); Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO (SEB, AN); Department of Biostatistics & Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO (KS); Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (CW).

Background: Rural adolescent vaccination rates lag behind urban. We sought to assess rural-urban differences in barriers to adolescent vaccination, perceived parental vaccine attitudes, and immunization delivery practices among public health nursing (PHN), pediatric (Peds), and family medicine (FM) clinicians.

Methods: Internet and mail survey of Colorado PHN, Peds, and FM clinicians from June-August 2019. Read More

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Predicting pain and function outcomes in people consulting with shoulder pain: the PANDA-S clinical cohort and qualitative study protocol.

BMJ Open 2021 Sep 17;11(9):e052758. Epub 2021 Sep 17.

School of Medicine, Keele University, Keele, UK.

Introduction: People presenting with shoulder pain considered to be of musculoskeletal origin is common in primary care but diagnosing the cause of the pain is contentious, leading to uncertainty in management. To inform optimal primary care for patients with shoulder pain, the study aims to (1) to investigate the short-term and long-term outcomes (overall prognosis) of shoulder pain, (2) estimate costs of care, (3) develop a prognostic model for predicting individuals' level and risk of pain and disability at 6 months and (4) investigate experiences and opinions of patients and healthcare professionals regarding diagnosis, prognosis and management of shoulder pain.

Methods And Analysis: The Prognostic And Diagnostic Assessment of the Shoulder (PANDA-S) study is a longitudinal clinical cohort with linked qualitative study. Read More

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September 2021

Comparison of three different exercise training modalities (aerobic, strength and mixed) in patients with schizophrenia: study protocol for a multicentre randomised wait-list controlled trial.

BMJ Open 2021 Sep 17;11(9):e046216. Epub 2021 Sep 17.

Department of Nursing and Physiotherapy, Faculty of Health Sciences, Universidad Cardenal Herrera-CEU,CEU Universities, Moncada, Valencia, Spain.

Introduction: Numerous studies support the practice of different physical exercise modalities as an effective treatment to address the problems associated with schizophrenia, reporting that they result in improvements in patient symptoms and quality of life. Given the lack of studies comparing different types of training in controlled environments, the aim of this proposed study will be to compare the effects of three physical exercise programmes (strength, aerobic and mixed) on the symptoms, body composition, level of physical activity and health-related quality of life of patients with schizophrenia.

Methods And Analysis: A multicentre, single-blinded (evaluator), randomised, wait-list controlled (ratio 2:2:2:1) trial will be conducted with 105 patients recruited from different psychosocial care centres. Read More

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September 2021

Impact of pulse oximetry on hospital referral acceptance in children under 5 with severe pneumonia in rural Pakistan (district Jamshoro): protocol for a cluster randomised trial.

BMJ Open 2021 Sep 17;11(9):e046158. Epub 2021 Sep 17.

Division of Women and Child Health, Aga Khan University, Karachi, Pakistan.

Background: Pneumonia is a leading cause of death among children under 5 specifically in South Asia and sub-Saharan Africa. Hypoxaemia is a life-threatening complication among children under 5 with pneumonia. Hypoxaemia increases risk of mortality by 4. Read More

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September 2021

Late complication rates after aortic coarctation repair in patients with or without a bicuspid aortic valve.

Heart 2021 Sep 17. Epub 2021 Sep 17.

Central Clinical School, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia.

Objective: Patients with previously repaired aortic coarctation (CoA) are at risk of developing late surgical complications. Many patients with CoA also have a bicuspid aortic valve (BAV). We sought to determine in patients with repaired CoA whether the presence of BAV is associated with more cardiovascular reinterventions during follow-up. Read More

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September 2021