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Serum adiponectin, body adiposity and metabolic parameters in obese Egyptian children with Down syndrome.

J Pediatr Endocrinol Metab 2021 Aug 4. Epub 2021 Aug 4.

Department of Pediatrics, Endocrinology Unit, Faculty of Medicine, Mansoura, Egypt.

Objectives: Children with Down syndrome (DS) have a higher risk for obesity. Adiponectin plays a crucial role in obesity-related cardiometabolic comorbidities. The study aimed to explore whether body adiposity indicators, the frequency of metabolic syndrome (MetS) and its components, serum adiponectin and insulin resistance indices as well as the validity of serum adiponectin as a biomarker for MetS are different in prepubertal obese-DS children compared to matched obese-controls. Read More

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Morning report goes virtual: learner experiences in a virtual, case-based diagnostic reasoning conference.

Diagnosis (Berl) 2021 Aug 4. Epub 2021 Aug 4.

Department of Medicine, Division of Infectious Diseases, Johns Hopkins Hospital, Baltimore, MD, USA.

Objectives: Participation in case-based diagnostic reasoning (DR) conferences has previously been limited to those who can attend in-person. Technological advances have enabled these conferences to migrate to virtual platforms, creating an opportunity to improve access and promote learner participation. We describe the design and evaluation of virtual morning report (VMR), a novel case-based DR conference that aimed to expand access to these conferences, leverage a virtual platform to create new opportunities for learner participation, and improve learner confidence in performing DR. Read More

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The COVID trap: pediatric diagnostic errors in a pandemic world.

Diagnosis (Berl) 2021 Aug 4. Epub 2021 Aug 4.

Department of Pediatrics, Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Objectives: The COVID-19 pandemic has introduced strains in the diagnostic process through uncertainty in diagnosis, changes to usual clinical processes, and introduction of a unique social context of altered health care delivery and fear of the medical environment. These challenges created a context ripe for diagnostic error involving both systems and cognitive factors.

Case Presentation: We present a series of three pediatric cases presenting to care during the early phases of the COVID-19 pandemic that highlight the heightened potential for diagnostic errors in the pandemic context with particular focus on the interplay of systems and cognitive factors leading to delayed and missed diagnoses. Read More

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Availability of interventional-radiological revascularization procedures in Germany - an analysis of the DeGIR Registry Data 2018/19.

Rofo 2021 Aug 4. Epub 2021 Aug 4.

Sektion für Interventionelle Radiologie, Klinikum rechts der Isar der Technischen Universität München, Germany.

Purpose:  Peripheral artery disease (PAD) is a common condition with high socio-economic relevance. Therefore, qualified nationwide provision of interventional treatments of PAD is important for maintaining a high quality medical service in Germany.

Materials And Methods:  All data on revascularization procedures from the quality management system of the German interventional radiological society (DeGIR) for the years 2018 and 2019 were retrospectively analysed. Read More

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Family Caregiver and Provider Perspectives on Inclusive Care: Aligning Needs and Expectations.

Med Care 2021 Aug 4. Epub 2021 Aug 4.

Duke University Department of Population Health Sciences Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham Veterans Affairs Health Care System Duke-Margolis Center for Health Policy Sanford School of Public Policy, Duke University Duke University School of Medicine, Center for the Study of Aging and Human Development, Durham, NC General and Hospital Medicine Division, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX Campaign for Inclusive Care, Elizabeth Dole Foundation National Caregiver Support Program, Department of Veterans Affairs, Washington, DC.

Background: Home-based and community-based health care for individuals with complex medical conditions is often provided by family caregivers. Yet caregivers often are not meaningfully included in interactions with clinical health care teams. Inclusive care means inviting the caregiver to participate in shared decision-making and treatment planning. Read More

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Validity Evidence Supporting the Comunicación y Habilidades Interpersonales (CAI) Scale for Medical Spanish Communication and Interpersonal Skills Assessment.

Acad Med 2021 Aug 3. Epub 2021 Aug 3.

P. Ortega is clinical assistant professor, Departments of Medical Education and Emergency Medicine, University of Illinois College of Medicine, Chicago, Illinois; ORCID: http://orcid.org/0000-0002-5136-1805. N.R. Moxon is a medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois. A.K. Chokshi is a medical student, Northwestern University Feinberg School of Medicine, Chicago, Illinois. C. Pérez-Cordón is a language specialist, Language and Communication Training Unit, United Nations Headquarters, New York, New York. Y.S. Park is associate professor, Harvard Medical School, and director of health professions education research, Massachusetts General Hospital, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-8583-4335.

Purpose: While many schools teach medical Spanish to improve communication with the growing Spanish-speaking population, a standardized assessment methodology is lacking. This study evaluates validity evidence for a newly developed Spanish Communication and Interpersonal Skills (CIS) scale.

Method: The authors developed the Comunicación y Habilidades Interpersonales (CAI, pronounced /kī/) scale by culturally and linguistically adapting a 14-item validated English CIS scale. Read More

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A Meaningful and Actionable Professionalism Assessment: Validity Evidence for the Professionalism Mini-Evaluation Exercise (P-MEX) Across 8 Years.

Acad Med 2021 Aug 3. Epub 2021 Aug 3.

N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, and faculty member, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0002-1445-4594. M.R. Nendaz is professor and director, Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, and attending physician, Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland; ORCID: http://orcid.org/0000-0003-3795-3254. K.M. Posfay-Barbe is professor and chairperson, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, Geneva, Switzerland; ORCID: https://orcid.org/0000-0001-9464-5704. R. Yudkowsky is professor, Department of Medical Education, College of Medicine at the University of Illinois at Chicago, Chicago, Illinois; ORCID: https://orcid.org/0000-0002-2145-7582. Y.S. Park is associate professor, Harvard Medical School, and director of health professions education research, Massachusetts General Hospital, Boston, Massachusetts; ORCID: http://orcid.org/0000-0001-8583-4335.

Purpose: With the growing importance of professionalism in medical education, it is imperative to develop professionalism assessments that demonstrate robust validity evidence. The Professionalism Mini-Evaluation Exercise (P-MEX) is an assessment that has demonstrated validity evidence in the authentic clinical setting. Identifying the factorial structure of professionalism assessments determines professionalism constructs that can be used to provide diagnostic and actionable feedback. Read More

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What management for epidermal growth factor receptor-mutated non-small-cell lung cancer, with squamous cell transformation and T790M-acquired resistance mechanisms? A Case report and review of literature.

Anticancer Drugs 2021 Aug 3. Epub 2021 Aug 3.

Clinical Research Unit, Begin Military Hospital, Saint-Mandé Department of Pathology, Henri Mondor Hospital, Créteil Department of Anatomical pathology, Begin Military Hospital Department of Radiology, Begin Military Hospital, Saint-Mandé, France.

Histological transformation into squamous cell carcinoma (SCC) is a rare mechanism of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors. Its pathophysiology remains unclear and its management is particularly challenging. We report on tumor progression with SCC histological transformation associated with the T790M mutation in a patient with stage IV bronchial adenocarcinoma with an L858R mutation of the EGFR gene and treated with gefitinib. Read More

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Pharmacologic therapies for neuropathic pain: an assessment of reporting biases in randomized controlled trials.

Pain 2021 Aug 3. Epub 2021 Aug 3.

Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

Abstract: Several different reporting biases cited in scientific literature have raised concerns about the overestimation of effects and the subsequent potential impact on the practice of evidence-based medicine and human health. Up to 7-8% of the population experiences neuropathic pain, and established treatment guidelines are based predominately on published, clinical trial results. Therefore, we examined published randomized controlled trials (RCTs) of first-line drugs for neuropathic pain and assessed the relative proportions with statistically significant (i. Read More

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Association between Vitamin D Level and Acne, and Correlation with Disease Severity: A Meta-Analysis.

Dermatology 2021 Aug 4:1-8. Epub 2021 Aug 4.

Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand.

Background: Vitamin D deficiency is frequently associated with several medical conditions. However, a comprehensive meta-analysis assessing the association between vitamin D level and acne is lacking.

Objective: To determine the relationship between vitamin D level and acne, and to assess the association between vitamin D level and acne severity. Read More

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Snakebite-Associated Kidney Injury.

Contrib Nephrol 2021 Aug 4;199:1-8. Epub 2021 Aug 4.

Poison Control Center, Instituto Doutor Jose Frota Hospital, Fortaleza, Brazil.

Snakebite-related acute kidney injury (AKI) is mainly caused by bites from the Viperidae family which are common snakes worldwide. It is a frequent and potentially fatal clinical complication. Coagulation abnormalities are usually present and are most likely to contribute to AKI development. Read More

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Tobacco Use and the Kidney: A Review of Public Policies and Studies on Kidney Disease Progression.

Contrib Nephrol 2021 Aug 4;199:1-13. Epub 2021 Aug 4.

Centro de Nefrología/Universidad de la República/Hospital de Clínicas "Dr Manuel Quintela", Montevideo, Uruguay.

Clinical Background: Cigarette smoking is one of the leading causes of preventable deaths, including cardiovascular diseases and cancer. However, the effects of tobacco use on chronic kidney disease (CKD) are less widespread. Epidemiology: Smoking tobacco is associated with proteinuria and attenuation of glomerular filtration rate in the general population of different ethnicities. Read More

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The Role of Perfluorinated Compound Pollution in the Development of Acute and Chronic Kidney Disease.

Contrib Nephrol 2021 Aug 4;199:1-12. Epub 2021 Aug 4.

International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy.

Clinical Background: Poly- and perfluorinated compound (PFCS) pollution has been found to be the driver of different diseases, including glucose intolerance, hyperlipidemia, thyroid diseases, gestational diabetes mellitus and hypertension, testicular and genitourinary cancer, as well as impaired kidney function. This review focuses on the renal effects of PFCS, intending to clarify their occurrence and pathogenetic mechanisms. Epidemiology: Between October 31st, 2017, and March 31st, 2020, most frequently analyzed PFCS were perfluorooctane sulfonate, perfluorooctanoic acid, sodium perfluoro-1-hexanesulfonate, perfluoro-n-nonanoic acid, and perfluoro-n-decanoic acid. Read More

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Clinical Characteristics and Outcomes of Oral Mucositis Associated With Immune Checkpoint Inhibitors in Patients With Cancer.

J Natl Compr Canc Netw 2021 Aug 4. Epub 2021 Aug 4.

3Department of Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Background: Immune checkpoint inhibitor (ICI) therapy predisposes patients to immune-related adverse events (irAEs). Data are limited regarding the incidence, management, and outcomes of one such irAE: mucositis. In this study, we evaluated the clinical characteristics, disease course, treatment, and outcomes of ICI-mediated mucositis. Read More

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Self-reported neurocognitive symptoms during COVID-19 lockdown and its associated factors in a sample of psychiatric patients. Results from the BRIS-MHC study.

Eur Neuropsychopharmacol 2021 Jul 20;53:7-18. Epub 2021 Jul 20.

Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, c/Villarroel, 170, 12-0, 08036 Barcelona, Catalonia, Spain; Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona, Neuroscience Institute, IDIBAPS, CIBERSAM, Barcelona, Spain.

Lockdown caused by COVID-19 pandemic has a negative impact on mental health. The aim was to assess self-reported neurocognitive symptoms during the lockdown and identify associated vulnerable and protective factors in a sample of psychiatric patients in a Spanish population. These results are part of the Barcelona ResIlience Survey for Mental Health COVID-19 (BRIS-MHC) project. Read More

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Defining the prodromal phase of multiple sclerosis based on healthcare access in a Portuguese population - ProdMS study.

Mult Scler Relat Disord 2021 Jul 19;55:103154. Epub 2021 Jul 19.

Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Background: Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system. Prodromal symptoms and higher healthcare use have been suggested in patients who later develop MS.

Objectives: Assess the healthcare utilization pattern of relapsing-remitting MS (RRMS) patients in the five years prior to MS diagnosis. Read More

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Prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era of COVID-19 in China.

Psychiatry Res 2021 Jul 20;304:114132. Epub 2021 Jul 20.

The Third People's Hospital of Zhongshan, Zhongshan, Guangdong, China. Electronic address:

Few people have paid attention to community epidemic prevention workers in the postpandemic era of COVID-19. This study aimed to explore the prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era. Mental health status was evaluated by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Chinese Perceived Stress Scale, Insomnia Severity Index, and Maslach Burnout Inventory-General Survey. Read More

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Analysis of eight bile acids in urine of gastric cancer patients based on covalent organic framework enrichment coupled with liquid chromatography-tandem mass spectrometry.

J Chromatogr A 2021 Jul 22;1653:462422. Epub 2021 Jul 22.

Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China. Electronic address:

Gastric carcinoma is one of the most common and deadly forms of cancer. Early detection is critical for successful treatment of gastric cancer, and examination of BAs in urine may provide a critical diagnostic tool for identifying gastric cancer at stages when it can still be cured. Bile acids (BAs) are a crucial toxic factor correlated with the injury of gastric mucosa and as such, quantifying the amount of BA in patient's urine could provide a new means to quickly and non-invasively identify the presence of gastric cancer in the early stages. Read More

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Modular pharmacology-based approach to identify hub genes and kernel pathways of taodan granules treated psoriasis.

J Ethnopharmacol 2021 Aug 1:114485. Epub 2021 Aug 1.

Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, China; Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, 200443, China; Department of Dermatology, Shanxi TCM Hospital, Xian, 710003, China. Electronic address:

Ethnopharmacological Relevance: Taodan granules (TDG) have been observed to decrease interleukins, or psoriasis area and severity index (PASI) score for psoriasis vulgaris, without significant adverse events. However, the regulatory network remains elucidated.

Aim Of The Study: The objective is to identify critical genes and kernel pathways of TDG treated psoriasis. Read More

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STAT3 mediated upregulation of C-MET signaling acts as a compensatory survival mechanism upon EGFR family inhibition in chemoresistant breast cancer cells.

Cancer Lett 2021 Aug 1. Epub 2021 Aug 1.

Public Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, 300060, China; Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China; Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China; Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China. Electronic address:

Chemotherapy remains the most common treatment for all types of breast cancer. Chemoresistance in tumors is still a major obstacle for treating late-stage breast cancer. In the process of acquiring resistance, tumor cells dynamically evolve to adapt to the challenge of anti-cancer drugs. Read More

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Manifesto for an ECNP Neuromodulation Thematic Working Group (TWG): Non-invasive brain stimulation as a new Super-subspecialty.

Eur Neuropsychopharmacol 2021 Aug 1;52:72-83. Epub 2021 Aug 1.

Sheba Medical Center at Tel Hashomer, Israel, Sackler Faculty of Medicine, Tel Aviv.

Non-Invasive Brain Stimulation (NIBS) techniques and in particular, repetitive Transcranial Magnetic Stimulation (rTMS), are developing beyond mere clinical application. Although originally purposed for the treatment of resistant neuropsychiatric disorders, NIBS is also contributing to a deeper understanding of psychiatric disorders. rTMS is also changing the model of the disorder itself, from "mental" to one of neural connectivity. Read More

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Squamousness gain defines pancreatic ductal adenocarcinoma hepatic metastases phenotype, and gemcitabine response.

Eur J Cancer 2021 Aug 1;155:42-53. Epub 2021 Aug 1.

Centre de Recherche en Cancérologie de Marseille (CRCM), INSERM U1068, CNRS UMR 7258, Aix-Marseille Université and Institut Paoli-Calmettes, Parc Scientifique et Technologique de Luminy, Marseille, France. Electronic address:

Background: Pancreatic ductal adenocarcinoma (PDAC) is a dismal disease with a survival rate of less than 7%, mainly due to the hepatic metastatic spread. Despite the importance of understanding PDAC metastases, central questions remain concerning their biology and chemosensitivity. Moreover, the transcriptomic divergence between primary tumor (PT) and hepatic metastases (HM) has been poorly studied and without a clear dissection of the confounding tumoral-surrounding tissue. Read More

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Establishing cost-effective allocation of proton therapy for patients with mediastinal Hodgkin lymphoma.

Int J Radiat Oncol Biol Phys 2021 Aug 1. Epub 2021 Aug 1.

Department of Radiation Oncology, University of Florida College of Medicine, Gainesville and Jacksonville, FL, USA.

Purpose: For curative treatment of Hodgkin lymphoma, radiotherapy benefit must be weighed against toxicity. Although more costly, proton radiotherapy reduces dose to healthy tissue, potentially improving the therapeutic ratio compared to photons. We sought to determine the cost-effectiveness of proton versus photon therapy for mediastinal Hodgkin lymphoma (MHL) based on reduced heart disease. Read More

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Translation of DNA damage response inhibitors as chemoradiation sensitizers from the laboratory to the clinic.

Int J Radiat Oncol Biol Phys 2021 Aug 1. Epub 2021 Aug 1.

Department of Radiation Oncology, University of Michigan Medical School and Rogel Cancer Center, Ann Arbor, MI, USA. Electronic address:

Combination therapies with agents targeting the DNA damage response (DDR) offer an opportunity to selectively enhance the therapeutic index of chemoradiation or eliminate chemotherapy altogether. The successful translation of DDR inhibitors to clinical use requires investigating both their direct actions as (chemo)radiosensitizers, and their potential to stimulate tumor immunogenicity. Beginning with high-throughput screening using both viability and DNA damage-reporter assays, followed by validation in 'gold standard' radiation colony forming assays and in vitro assessment of mechanistic effects on the DDR we describe proven strategies and methods leading to the clinical development of DDR inhibitors both with radiation alone and in combination with chemoradiation. Read More

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Activation of a hippocampal CREB-pCREB-miRNA-MEF2 axis modulates individual variation of spatial learning and memory capability.

Cell Rep 2021 Aug;36(5):109477

Graduate Institute of Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan; Institute of Molecular Biology, Academia Sinica, Taipei 11529, Taiwan. Electronic address:

Phenotypic variation is a fundamental prerequisite for cell and organism evolution by natural selection. Whereas the role of stochastic gene expression in phenotypic diversity of genetically identical cells is well studied, not much is known regarding the relationship between stochastic gene expression and individual behavioral variation in animals. We demonstrate that a specific miRNA (miR-466f-3p) is upregulated in the hippocampus of a portion of individual inbred mice upon a Morris water maze task. Read More

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Antibody and T cell immune responses following mRNA COVID-19 vaccination in patients with cancer.

Cancer Cell 2021 Jul 27. Epub 2021 Jul 27.

Department of Oncology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Academy of Geriatric Oncology, Odense University Hospital, Odense, Denmark; OPEN-Open Patient data Exploratory Network, Odense University Hospital, Odense, Denmark; Department of Molecular Medicine, University of Southern Denmark, Odense, Denmark. Electronic address:

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Incidence rate and risk factors of central line-associated bloodstream infections among neonates and children admitted to a tertiary care university hospital.

Am J Infect Control 2021 Aug 1. Epub 2021 Aug 1.

Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Clinical and Molecular Epidemiology of Emerging and Re-emerging Infectious Diseases Research Cluster, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. Electronic address:

Central-line associated bloodstream infection(CLABSI) is a common healthcare-associated infection in patients indwelling central venous catheter(CVC). This study examined the incidence rates, risk factors, and clinical outcomes of CLABSI among neonates(aged<1month) and children(aged≥1month) admitted to a tertiary care university hospital. An overall CLABSI incidence rate was 3. Read More

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Post-transplant maintenance therapy for MDS and AML: a bridge too far or the beginning of a new era?

Leuk Lymphoma 2021 Aug 4:1-5. Epub 2021 Aug 4.

Australian Centre for Blood Diseases, Monash University, Melbourne, VIC, Australia.

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