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Profile of Patients with Isolated Distal Deep Vein Thrombosis versus Proximal Deep Vein Thrombosis or Pulmonary Embolism: RE-COVERY DVT/PE Study.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

Isolated distal deep vein thrombosis (IDDVT) is presumed to be more benign than proximal DVT (PDVT) or pulmonary embolism (PE), suggesting a need for different management approaches. This subgroup analysis of the RE-COVERY DVT/PE global, observational study investigated patient characteristics, hospitalization details, and anticoagulant therapy in patients with IDDVT in real-world settings in 34 countries enrolled from January 2016 to May 2017. Data were analyzed descriptively according to the type and location of the index venous thromboembolism (VTE): IDDVT, PDVT ± distal DVT (DDVT), and PE ± DVT. Read More

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Arterial Thrombosis in Patients with Antiphospholipid Syndrome: A Review and Meta-Analysis.

Semin Thromb Hemost 2021 May 10. Epub 2021 May 10.

Department of Medicine, Thrombosis and Atherosclerosis Research Institute, McMaster University, Hamilton, Ontario, Canada.

There is a scarcity of high-quality randomized controlled trials (RCTs) comparing antithrombotic regimens for secondary prevention of arterial thrombosis (AT) in antiphospholipid syndrome (APS). We reviewed different antithrombotic regimens used for this purpose. We searched for studies on management of AT in APS on PubMed and Web of Science. Read More

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Identification of multiple RNAs using feature fusion.

Brief Bioinform 2021 May 10. Epub 2021 May 10.

National Agri-Food Biotechnology Institute, Sector 81, SAS Nagar, 140306, Punjab, India.

Detection of novel transcripts with deep sequencing has increased the demand for computational algorithms as their identification and validation using in vivo techniques is time-consuming, costly and unreliable. Most of these discovered transcripts belong to non-coding RNAs, a large group known for their diverse functional roles but lacks the common taxonomy. Thus, upon the identification of the absence of coding potential in them, it is crucial to recognize their prime functional category. Read More

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Survival Outcomes of Hemoperfusion and Hemodialysis versus Hemodialysis in Patients with End-Stage Renal Disease: A Systematic Review and Meta-Analysis.

Blood Purif 2021 May 10:1-13. Epub 2021 May 10.

Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute (IRRIV), San Bortolo Hospital, Vicenza, Italy.

Background: The maintenance treatment of ESRD puts a great burden on individual patients, society, and the country of China as a whole. Hemoperfusion plus hemodialysis (HP + HD) in ESRD patients can yield modified outcomes such as prolonged life expectancy and improved dialysis quality and quality of life. This study aimed to systematically analyze the effect of HP + HD on the overall survival (OS) rates of ESRD patients and to provide support for clinical decision-making. Read More

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Dietary protein source contributes to the risk of developing maternal syndrome in the Dahl salt-sensitive rat.

Pregnancy Hypertens 2021 May 5;24:126-134. Epub 2021 May 5.

Department of Physiology, Augusta University, United States.

Preeclampsia (PE) is a disorder of pregnancy, which is categorized by hypertension and proteinuria or signs of end-organ damage. Though PE is the leading cause of maternal and fetal morbidity and mortality, the mechanisms leading to PE remain unclear. The present study examined the contribution of dietary protein source (casein versus wheat gluten) to the risk of developing maternal syndrome utilizing two colonies of Dahl salt-sensitive (SS/JrHsdMcwi) rats. Read More

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Detection of anticancer drugs in wastewater effluents: Grab versus passive sampling.

Sci Total Environ 2021 Apr 30;786:147477. Epub 2021 Apr 30.

iBET - Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal; Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Oeiras, Portugal. Electronic address:

The occurrence of six anticancer drugs was evaluated in wastewater effluents. Several grab samples from wastewater effluent were collected throughout a year. Capecitabine, cyclophosphamide and ifosfamide were detected at concentrations ranging from 8 to 46 ng·L. Read More

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[Impact of the eConsultation on the primary care agenda].

Aten Primaria 2021 May 7;53(8):102070. Epub 2021 May 7.

Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAP JGol), Mataró, Barcelona, España.

Objective: A «before and after» type observational study was carried out to assess the impact of the virtual consultation (eConsulta) on the frequency with which the patient visits their primary care center once they have had their first virtual consultation.

Setting: Assigned population of the primary care center of Masnou-Alella and Ocata-Teià, Catalan Health Institute.

Participants: A random sampling was performed and 329 patients who engaged in eConsulta were compared with 329 statistically similar patients in age, sex and medical complexity who did not engage in eConsulta. Read More

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Natural antioxidants enhance the power of physical and mental activities versus risk factors inducing progression of Alzheimer's disease in rats.

Int Immunopharmacol 2021 May 7;96:107729. Epub 2021 May 7.

Pharmacology and Toxicology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt. Electronic address:

Background: Alzheimer's disease (AD) is a progressive neurodegenerative disease that is exacerbated by social isolation (SI) and protein malnutrition (PM). Antioxidants, physical and mental activities (Ph&M) can maintain cognitive functions and protect against dementia.

Objective: To investigate the impact of Epigallocatechin-3-gallate (EGCG), Vitamin E (VE), Vitamin C (VC), and Selenium (Se), in enhancing the potential effect of Ph&M versus SI&PM as risk factors in the progression of AD in rats. Read More

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Associations of accumulated selected persistent organic pollutants in adipose tissue with insulin sensitivity and risk of incident type-2 diabetes.

Environ Int 2021 May 7;155:106607. Epub 2021 May 7.

Universidad de Granada. Departamento de Medicina Preventiva y Salud Pública, Granada, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain. Electronic address:

Continuous exposure to low doses of persistent organic pollutant (POPs), such as those occurring in the general population, might contribute to the burden of type 2 diabetes mellitus (T2DM). However, evidences from longitudinal studies are scarce. We aimed to explore the associations of accumulated POP exposure with the development of T2DM by means of 1) longitudinal associations with the 16-year incidence of the disease, and 2) complementary cross-sectional analyses with markers of glucose homeostasis at recruitment. Read More

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Non-parameningeal head and neck rhabdomyosarcoma in children, adolescents, and young adults: Experience of the European paediatric Soft tissue sarcoma Study Group (EpSSG) - RMS2005 study.

Eur J Cancer 2021 May 7;151:84-93. Epub 2021 May 7.

SIREDO Oncology Center, Institute Curie, PSL University, Paris, France.

Background/objectives: The primary aim of this study was to analyse and evaluate the impact of different local treatments on the pattern of relapse in children with primary head and neck non-parameningeal (HNnPM) rhabdomyosarcoma (RMS), treated in the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 study. The secondary aim was to assess whether current risk stratification is valid for this specific site.

Design/methods: This study includes all patients with localised HNnPM RMS enrolled in the RMS2005 study between 2005 and 2016. Read More

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Circulating extracellular vesicles are endowed with enhanced procoagulant activity in SARS-CoV-2 infection.

EBioMedicine 2021 May 7;67:103369. Epub 2021 May 7.

Laboratory for Cardiovascular Theranostics, Istituto Cardiocentro Ticino, Ente Ospedaliero Cantonale Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland; Institute of Life Science, Scuola Superiore Sant'Anna, Pisa, Italy. Electronic address:

Background: Coronavirus-2 (SARS-CoV-2) infection causes an acute respiratory syndrome accompanied by multi-organ damage that implicates a prothrombotic state leading to widespread microvascular clots. The causes of such coagulation abnormalities are unknown. The receptor tissue factor, also known as CD142, is often associated with cell-released extracellular vesicles (EV). Read More

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Healthcare utilization and cost outcomes for a multicenter first seizure and new onset epilepsy clinic.

Epilepsy Behav 2021 May 7;120:107972. Epub 2021 May 7.

Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Northwest, 200 Mullins Dr, Lebanon, OR 97355, United States; Providence Brain and Spine Institute, 9135 SW Barnes Rd., Suite 363, Portland, OR 97225, United States.

Rationale: A First Seizure/New Onset Epilepsy (FS/NOE) protocol was implemented to ensure proper evaluation by an epileptologist and improve overall care for patients. We compared healthcare utilization and cost incurred by patients pre and post protocol implementation.

Methods: Clinical data were retrospectively collected from the EMR and cost data from the financial database. Read More

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Nitrous oxide for pain management of first-trimester instrumental termination of pregnancy under local anaesthesia and/or minimal sedation: A systematic review and meta-analysis.

Eur J Obstet Gynecol Reprod Biol 2021 Apr 25;261:193-199. Epub 2021 Apr 25.

Division of Gynecology, Obstetrics, and Reproduction, Gynepôle, Hôpital de la Conception, Marseille, France. Electronic address:

Background: Inhalation of nitrous oxide and oxygen (NO/O) is used to reduce pain that is spontaneous or induced by procedures. NO/O could be useful in the treatment of the pain in first-trimester termination of pregnancy performed under local anaesthesia and/or minimal sedation (FTOPL).

Objective: To evaluate the usefulness of NO/O to reduce pain in FTOPL. Read More

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Bone density and quality in patients treated with direct-acting oral anticoagulants versus warfarin.

Bone 2021 May 7:116000. Epub 2021 May 7.

Endocrine Division, Hospital de Clínicas, Universidade Federal do Paraná (SEMPR), Avenida Agostinho Leão Júnior, 285, Alto da Glória, Curitiba, PR, Brazil. Electronic address:

Introduction: Direct-acting oral anticoagulants (DOACs) are therapeutic alternatives to warfarin that act independently of vitamin K, thus not affecting bone matrix formation. The aim of this study was to compare bone mineral density (BMD) and microarchitecture in patients treated with DOACs versus warfarin.

Methods: Cross-sectional, observational study in patients using oral anticoagulants for >1 year and a paired control group (CG). Read More

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eGFR Variability in Patients with Heart Failure and Chronic Kidney Disease.

J Card Fail 2021 May 7. Epub 2021 May 7.

Department of Medicine, Duke University School of Medicine, Durham, NC; Duke Clinical Research Institute, Durham, NC. Electronic address:

Background: Greater variability in estimated glomerular filtration rate (eGFR) is associated with higher mortality in patients with chronic kidney disease (CKD). Heart failure (HF) is common in CKD and may increase variability through changes in hemodynamic and volume regulation. We sought to determine if patients with versus without HF have higher kidney function variability in CKD, and to define the association with mortality. Read More

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Association between ß-Blockers and Outcomes in HFpEF - Current Insights from the SwedeHF Registry.

J Card Fail 2021 May 7. Epub 2021 May 7.

Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Swede; Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.

Background: ß-blockers have an uncertain effect in heart failure with a preserved ejection fraction of 50% or higher (HFpEF).

Methods: We included patients with HFpEF from the Swedish Heart Failure Registry (SwedeHF) enrolled from 2011 through 2018. In a 2:1 propensity-score matched analysis (β-blocker use versus no-use), we assessed the primary outcome first HF hospitalization, the co-primary outcome cardiovascular (CV) death, and the secondary outcomes all-cause hospitalization and all-cause death. Read More

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Effects of moderate to vigorous intensity cycling on appetite, ad libitum energy intake and appetite-related hormones in healthy South Asian and white European men.

Appetite 2021 May 7:105282. Epub 2021 May 7.

Applied & Human Sciences, School of Life Sciences, Pharmacy & Chemistry, Kingston University London, Kingston Upon Thames KT1 2EE, United Kingdom. Electronic address:

Compensatory changes in appetite and energy intake do not appear to occur in the short-term after acute exercise; however, responses have not been compared in South Asians, a group at high risk of central obesity and type 2 diabetes, with white Europeans. This study examined appetite perceptions, energy intake and appetite-related hormones after moderate-to-vigorous intensity cycling in South Asian versus white European men. Fifteen South Asians (mean(SD) 29(8) years; 25. Read More

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Catheter directed haemorrhoidal de-arterialization technique for the management of haemorrhoids: a meta-analysis of the clinical evidence.

J Vasc Interv Radiol 2021 May 7. Epub 2021 May 7.

Vascular and oncologic Interventional Radiology Department at the Hôpital Européen Georges Pompidou, France.

Purpose: To assess the efficacy and safety of catheter directed hemorrhoidal de-arterialization (CDHD) technique for the management of hemorrhoidal bleeding METHODS: A systematic review and meta-analysis of the Pubmed, Cochrane and Scopus databases was conducted according to the PRISMA guidelines. Clinical studies reporting on CDHD for rectal bleeding were analyzed.

Results: 14 studies (N=362) were identified. Read More

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Histogram parameters derived from T1 and T2 weighted images correlate with tumor infiltrating lymphocytes and tumor-stroma ratio in head and neck squamous cell cancer.

Magn Reson Imaging 2021 May 7. Epub 2021 May 7.

Department of Diagnostic and Interventional Radiology, University of Magdeburg, Germany.

Purpose: The present study used histogram analysis values derived from T1- and T2- weighted (w) images to elucidate possible associations with Tumor-infiltrating lymphocytes (TIL) and Vimentin expression in head and neck squamous cell cancer (HNSCC).

Materials And Methods: Overall, 28 patients (n = 8 female patient, 28.6%) with primary HNSCC of different localizations were involved in the study. Read More

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Comparison of corticospinal tract integrity measures extracted from standard versus native space in chronic stroke.

J Neurosci Methods 2021 May 7:109216. Epub 2021 May 7.

Department of Exercise Science, University of South Carolina, Columbia, SC, 29201, USA. Electronic address:

Background: Fractional anisotropy (FA) and mean diffusivity (MD) are measures derived from diffusion-weighted imaging that represent the integrity of the corticospinal tract (CST) after stroke. Some studies of the motor system after stroke extract FA and MD from native space while others extract from standard space making comparison across studies challenging.

New Method: The purpose was to compare CST integrity measures extracted from standard versus native space in individuals with chronic stroke. Read More

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Post-surgical complications after bladder outlet reducing surgery: an analysis of the FDA Manufacturer and User Facility Device Experience (MAUDE) database.

Urology 2021 May 7. Epub 2021 May 7.

Department of Urology, Oregon Health & Science University. Electronic address:

Objective: To examine voluntary reports in the Food & Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database, categorize complications and assign device-related causality with transurethral resection of the prostate (TURP), prostatic urethral lift (PUL), and transurethral water vapor therapy (TWVT).

Methods: A review was performed using the terms "Urolift," "Rezum," and "transurethral resection of the prostate" between 01/01/2015 and 12/31/2019. Duplicate and incomplete reports were excluded. Read More

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Extrapleural Pneumonectomy versus Pleurectomy/Decortication for Malignant Pleural Mesothelioma.

Ann Thorac Surg 2021 May 7. Epub 2021 May 7.

Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address:

Background: Whether extrapleural pneumonectomy (EPP) or extended pleurectomy/decortication (P/D) is the optimal resection for malignant pleural mesothelioma (MPM) remains controversial. We therefore compared perioperative outcomes and long-term survival of patients who underwent EPP vs P/D.

Methods: Patients with the diagnosis of MPM who underwent either EPP or P/D from 2000 to 2019 were identified from our departmental database. Read More

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Sex Differences in Ascending Aortic and Arch Surgery: A Propensity-matched Comparison of 1153 Pairs.

Ann Thorac Surg 2021 May 7. Epub 2021 May 7.

Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine; Section of Adult Cardiac Surgery, Department of Cardiovascular Surgery, Texas Heart Institute; Department of Cardiovascular Surgery, CHI St Luke's Health-Baylor St Luke's Medical Center; Cardiovascular Research Institute, Baylor College of Medicine, Houston, Texas.

Background: We investigated the relationship of sex with clinical outcomes after proximal aortic (ascending and arch) operations, and whether sex-specific preoperative factors are associated with mortality.

Methods: Of 3745 patients who underwent elective, urgent, and emergency proximal aortic operations over a 20-year period, 1153 pairs of men and women were propensity-matched, and their early and long-term outcomes were compared. Kaplan-Meier survival analysis was used to estimate late survival. Read More

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The inflammatory profile of exacerbations in patients with severe refractory eosinophilic asthma receiving mepolizumab (the MEX study): a prospective observational study.

Lancet Respir Med 2021 May 7. Epub 2021 May 7.

Centre for Experimental Medicine, School of Medicine, Dentistry, and Biological Sciences, Queen's University, Belfast, UK. Electronic address:

Background: Clinical trials with mepolizumab, a humanised monoclonal antibody against interleukin-5, show a 50% reduction in severe asthma exacerbations in people with severe eosinophilic asthma. Exacerbations in patients treated with mepolizumab seem to be different to exacerbations in those given placebo, as patients treated with mepolizumab report fewer symptoms, have a lower sputum eosinophil count, and smaller fall in peak expiratory flow. We aimed to investigate the inflammatory phenotype and physiological characteristics of exacerbation events in patients with severe eosinophilic asthma who were treated with mepolizumab. Read More

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Efficacy and safety of voclosporin versus placebo for lupus nephritis (AURORA 1): a double-blind, randomised, multicentre, placebo-controlled, phase 3 trial.

Lancet 2021 May 7. Epub 2021 May 7.

Research, Aurinia Pharmaceuticals, Victoria, BC, Canada. Electronic address:

Background: Voclosporin, a novel calcineurin inhibitor approved for the treatment of adults with lupus nephritis, improved complete renal response rates in patients with lupus nephritis in a phase 2 trial. This study aimed to evaluate the efficacy and safety of voclosporin for the treatment of lupus nephritis.

Methods: This multicentre, double-blind, randomised phase 3 trial was done in 142 hospitals and clinics across 27 countries. Read More

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F-fluciclovine-PET/CT imaging versus conventional imaging alone to guide postprostatectomy salvage radiotherapy for prostate cancer (EMPIRE-1): a single centre, open-label, phase 2/3 randomised controlled trial.

Lancet 2021 May 7. Epub 2021 May 7.

Department of Radiology and Imaging Sciences, Emory University, Atlanta GA, USA.

Background: Molecular imaging is increasingly used to guide treatment decisions and planning in prostate cancer. We aimed to evaluate the role of F-fluciclovine-PET/CT in improving cancer control compared with conventional imaging (bone scan and either CT or MRI) alone for salvage postprostatectomy radiotherapy.

Methods: In EMPIRE-1, a single-centre, open-label, phase 2/3 randomised controlled trial, patients with prostate cancer with detectable PSA after prostatectomy and negative conventional imaging (no extrapelvic or bone findings) were randomly assigned in a 1:1 ratio to radiotherapy directed by conventional imaging alone or to conventional imaging plus F-fluciclovine-PET/CT. Read More

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Controllable multi-phase protein release from in-situ hydrolyzable hydrogel.

J Control Release 2021 May 7. Epub 2021 May 7.

Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Hong Kong, China; The Hong Kong University of Science and Technology Shenzhen Research Institute, Shenzhen, China. Electronic address:

Using hydrogels to control the long-term release of protein remains challenging, especially for in-situ forming formulations. The uncontrollable burst release in the initial phase, the halted release in the subsequent phase, and the undesired drug dumping at the late stage are some obstacles hydrogel-based depots commonly encounter. In this study, we report hydrolyzable dextran-based hydrogels crosslinked by Michael addition to demonstrate a systematic solution to solve these problems. Read More

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Making the invisible visible: developing and evaluating an intervention to raise awareness and reduce lead exposure among children and their caregivers in rural Bangladesh.

Environ Res 2021 May 7:111292. Epub 2021 May 7.

Stanford University, Stanford, California, USA. Electronic address:

Lead exposure is harmful at any time in life, but pre-natal and early childhood exposures are particularly detrimental to cognitive development. In Bangladesh, multiple household-level lead exposures pose risks, including turmeric adulterated with lead chromate and food storage in lead-soldered cans. We developed and evaluated an intervention to reduce lead exposure among children and their caregivers in rural Bangladesh. Read More

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Annals Graphic Medicine - Intern Year 2020: Expectations Versus Reality.

Diana Zychowski

Ann Intern Med 2021 May 11. Epub 2021 May 11.

University of Minnesota, Minneapolis, Minnesota (D.Z.).

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Effectiveness of orthodontic toothbrush versus conventional toothbrush on plaque and gingival index reduction: a systematic review and meta-analysis.

Int J Dent Hyg 2021 May 10. Epub 2021 May 10.

Department of Dentistry, Centro Universitário Christus, Fortaleza, Ceará, Brazil.

Objective: In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O-TB) versus conventional toothbrush (C-TB) on plaque and gingival index reduction in randomized and nonrandomized controlled clinical trials?

Methods: Electronic database search was performed on: PubMed, ClinicalTrials.gov, Cochrane Library, and Google Scholar. Database research, study selection, data extraction and ROBINS-I and Risk of Bias Tool 2. Read More

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