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Effects Of Preexisting Psychotropic Medication Use On A Cohort Of Patients With Ischemic Stroke Outcome, Adalia H. Jun-O'Connell, Dilip K. Jayaraman, Nils Henninger, Brian Silver, Majaz Moonis, Anthony J. Rothschild 2020 University of Massachusetts Medical School

Effects Of Preexisting Psychotropic Medication Use On A Cohort Of Patients With Ischemic Stroke Outcome, Adalia H. Jun-O'Connell, Dilip K. Jayaraman, Nils Henninger, Brian Silver, Majaz Moonis, Anthony J. Rothschild

University of Massachusetts Medical School Faculty Publications

Background: Several studies investigated the use of selective serotonin reuptake inhibitors (SSRI) after ischemic stroke to improve motor recovery. However, little is known about the effects of preexisting psychotropic medication use (PPMU), such as antidepressants, on a long-term ischemic stroke functional disability.

Objective: We sought to determine the prevalence of PPMU and whether PPMU relates to the long-term clinical outcome in a cohort of patients presenting with acute ischemic strokes.

Methods: We retrospectively analyzed 323 consecutive patients who presented with an acute ischemic stroke in a single institution between January 2015 and December 2017. Baseline characteristics, functional disability as measured ...


Clinically Meaningful Change In Quality Of Life And Associated Factors Among Older Patients With Atrial Fibrillation, Hawa Ozien Abu, Jane S. Saczynski, Jordy Mehawej, Mayra Tisminetzky, Catarina I. Kiefe, Robert J. Goldberg, David D. McManus 2020 University of Massachusetts Medical School

Clinically Meaningful Change In Quality Of Life And Associated Factors Among Older Patients With Atrial Fibrillation, Hawa Ozien Abu, Jane S. Saczynski, Jordy Mehawej, Mayra Tisminetzky, Catarina I. Kiefe, Robert J. Goldberg, David D. Mcmanus

Open Access Publications by UMMS Authors

Background: Among older patients with atrial fibrillation, there are limited data examining clinically meaningful changes in quality of life (QoL). We examined the extent of, and factors associated with, clinically meaningful change in QoL over 1-year among older adults with atrial fibrillation.

Methods and Results: Patients from cardiology, electrophysiology, and primary care clinics in Massachusetts and Georgia were enrolled in a cohort study (2015-2018). The Atrial Fibrillation Effect on Quality-of-Life questionnaire was used to assess overall QoL and across 3 subscales: symptoms, daily activities, and treatment concern. Clinically meaningful change in QoL (ie, difference between 1-year and baseline QoL score ...


Cardiac Magnetic Resonance Evaluation Of Cardiac Masses In Patients With Suspicion Of Cardiac Masses On Echo Or Computed Tomography, Fateh Ali Tipoo Sultan, Syed Waqar Ahmed 2020 Aga Khan University

Cardiac Magnetic Resonance Evaluation Of Cardiac Masses In Patients With Suspicion Of Cardiac Masses On Echo Or Computed Tomography, Fateh Ali Tipoo Sultan, Syed Waqar Ahmed

Section of Cardiology

Objectives: In recent years, cardiac magnetic resonance (CMR) imaging has emerged as an important tool in the identification and characterization of cardiac masses. No imaging data on cardiac masses are available from Pakistan. We aimed to review the clinical presentation, CMR findings, and outcome of patients referred for CMR due to suspicion of cardiac masses on echocardiogram or computed tomography (CT).
Material and methods: We reviewed all the patients referred for CMR at Aga Khan University Hospital, Karachi, from January 2011 to March 2020, with the suspicion of cardiac mass on echocardiogram and/or CT. Only those with the confirmed ...


Multimorbidity, Physical Frailty, And Self-Rated Health In Older Patients With Atrial Fibrillation, Hawa Ozien Abu, Jane Saczynski, Jordy Mehawej, Tenes Paul, Hamza Awad, Benita A. Bamgbade, Isabelle C. Pierre-Louis, Mayra Tisminetzky, Catarina I. Kiefe, Robert J. Goldberg, David D. McManus 2020 University of Massachusetts Medical School

Multimorbidity, Physical Frailty, And Self-Rated Health In Older Patients With Atrial Fibrillation, Hawa Ozien Abu, Jane Saczynski, Jordy Mehawej, Tenes Paul, Hamza Awad, Benita A. Bamgbade, Isabelle C. Pierre-Louis, Mayra Tisminetzky, Catarina I. Kiefe, Robert J. Goldberg, David D. Mcmanus

Open Access Publications by UMMS Authors

BACKGROUND: Holistic care models emphasize management of comorbid conditions to improve patient-reported outcomes in treatment of atrial fibrillation (AF). We investigated relations between multimorbidity, physical frailty, and self-rated health (SRH) among older adults with AF.

METHODS: Patients (n = 1235) with AF aged 65 years and older were recruited from five medical centers in Massachusetts and Georgia between 2015 and 2018. Ten previously diagnosed cardiometabolic and 8 non-cardiometabolic conditions were assessed from medical records. Physical Frailty was assessed with the Cardiovascular Health Study frailty scale. SRH was categorized as either "excellent/very good", "good", and "fair/poor". Separate multivariable ordinal logistic ...


Flash Pulmonary Edema: A Case And Review Of Left Ventricular Non-Compaction Cardiomyopathy, Paula J. Watts, Oliver S. Garbo, Wendy Barrett, Michael Kopstein, Ryan Maybrook, Dmitriy Scherbak 2020 HCA Health One - Sky Ridge Medical Center

Flash Pulmonary Edema: A Case And Review Of Left Ventricular Non-Compaction Cardiomyopathy, Paula J. Watts, Oliver S. Garbo, Wendy Barrett, Michael Kopstein, Ryan Maybrook, Dmitriy Scherbak

HCA Healthcare Journal of Medicine

Left ventricular non-compaction cardiomyopathy is an uncommon type of cardiomyopathy caused by malformation of the myocardium during embryogenesis. This results in trabeculations within the ventricular wall that can affect the left and, less commonly, right ventricles. Presentation ranges from clinically asymptomatic to life-threatening arrhythmias. It is a rare and relatively unknown form of cardiomyopathy, though thought to be underdiagnosed. Prevalence is increasing due to improvements in imaging and awareness. Management is similar to that of other cardiomyopathies including angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers, beta-blockers, diuretics, automatic implantable cardioverter defibrillator placement and cardiac transplantation. We present a case of a ...


Machine Learning Model Based On Transthoracic Bioimpedance And Heart Rate Variability For Lung Fluid Accumulation Detection: Prospective Clinical Study, Natasa Reljin, Hugo F. Posada-Quintero, Caitlin Eaton-Robb, Sophia Binici, Emily Ensom, Eric Y. Ding, Anna Hayes, Jarno Riistama, Chad E. Darling, David D. McManus, Ki H. Chon 2020 University of Connecticut

Machine Learning Model Based On Transthoracic Bioimpedance And Heart Rate Variability For Lung Fluid Accumulation Detection: Prospective Clinical Study, Natasa Reljin, Hugo F. Posada-Quintero, Caitlin Eaton-Robb, Sophia Binici, Emily Ensom, Eric Y. Ding, Anna Hayes, Jarno Riistama, Chad E. Darling, David D. Mcmanus, Ki H. Chon

Open Access Publications by UMMS Authors

BACKGROUND: Accumulation of excess body fluid and autonomic dysregulation are clinically important characteristics of acute decompensated heart failure. We hypothesized that transthoracic bioimpedance, a noninvasive, simple method for measuring fluid retention in lungs, and heart rate variability, an assessment of autonomic function, can be used for detection of fluid accumulation in patients with acute decompensated heart failure.

OBJECTIVE: We aimed to evaluate the performance of transthoracic bioimpedance and heart rate variability parameters obtained using a fluid accumulation vest with carbon black-polydimethylsiloxane dry electrodes in a prospective clinical study (System for Heart Failure Identification Using an External Lung Fluid Device; SHIELD ...


Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman 2020 University of Maine

Health Insurance Plan Design And Chronic Disease Management, Daniel E. Feldman

Electronic Theses and Dissertations

Each year, Americans spend more money on health care than any other industrialized nation, despite comparable mortality rates for people with risk factors for heart disease. The reasons for this lack of health care value in the US are numerous and complex – including market distortions like supplier-inflated pricing and regulatory structures that enable consumers to utilize ubiquitous, high-cost medical technologies that yield uncertain benefits. Health insurance, once thought to be an insignificant contributor to rising health spending, has changed considerably in the past few decades in ways that make it more accessible and more generous in coverage. Health insurance design ...


Bilateral Basal Ganglia Hemorrhage In A Patient With Confirmed Covid-19, Rrita Daci, Megan Kennelly, Annie Ferris, Muhammad U. Azeem, Mark D. Johnson, Farid Hamzei-Sichani, Adalia H. Jun-O'Connell, Sabareesh K. Natarajan 2020 University of Massachusetts Medical School

Bilateral Basal Ganglia Hemorrhage In A Patient With Confirmed Covid-19, Rrita Daci, Megan Kennelly, Annie Ferris, Muhammad U. Azeem, Mark D. Johnson, Farid Hamzei-Sichani, Adalia H. Jun-O'Connell, Sabareesh K. Natarajan

COVID-19 Publications by UMMS Authors

Bilateral basal ganglia hemorrhage is exceedingly rare. To our knowledge, our patient is the first reported case of a confirmed coronavirus disease 2019 (COVID-19) patient who had bilateral basal ganglia hemorrhage. In the absence of other risk factors for bilateral deep cerebral involvement, we suspect that COVID-19 may be contributing to these rare pathologies. Most published data represent a correlation between COVID-19 and neurologic complications, and more research is still needed to prove causation.


Incidental Discovery Of Anomalous Left Coronary Artery Arising From The Pulmonary Artery In A Coronavirus Disease-2019 Patient: A Blessing In Disguise, Masood Ghori, Rizwan Ahmed 2020 Sheikh Khalifa Medical City ,Abu Dhabi,United Arab Emirates

Incidental Discovery Of Anomalous Left Coronary Artery Arising From The Pulmonary Artery In A Coronavirus Disease-2019 Patient: A Blessing In Disguise, Masood Ghori, Rizwan Ahmed

Journal of the Saudi Heart Association

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a serious congenital malformation. Reports about asymptomatic, incidentally discovered ALCAPA in adults are scarce. We describe a patient with no known pre-existing cardiac condition admitted to our hospital with coronavirus disease 2019 (COVID-19) and was incidentally found to have ALCAPA. To the best of our knowledge, this is the first reported case of incidentally discovered ALCAPA in a COVID-19 patient and highlights the importance of appropriate investigation of the coronary status by Multidetector Cardiac Computed Tomographic Angiography (MDCCTA) in individuals with asymptomatic left ventricular dysfunction. The presentation ...


Relations Between Plasma Micrornas, Echocardiographic Markers Of Atrial Remodeling, And Atrial Fibrillation: Data From The Framingham Offspring Study, Aditya Vaze, Khanh-Van T. Tran, Kahraman Tanriverdi, Mayank Sardana, Darleen M. Lessard, J. Kevin Donahue, Bruce A. Barton, Gerard P. Aurigemma, Amiya Mandapati, Jane E. Freedman, David D. McManus 2020 University of Massachusetts Medical School

Relations Between Plasma Micrornas, Echocardiographic Markers Of Atrial Remodeling, And Atrial Fibrillation: Data From The Framingham Offspring Study, Aditya Vaze, Khanh-Van T. Tran, Kahraman Tanriverdi, Mayank Sardana, Darleen M. Lessard, J. Kevin Donahue, Bruce A. Barton, Gerard P. Aurigemma, Amiya Mandapati, Jane E. Freedman, David D. Mcmanus

Open Access Publications by UMMS Authors

BACKGROUND: Circulating microRNAs may reflect or influence pathological cardiac remodeling and contribute to atrial fibrillation (AF).

OBJECTIVE: The purpose of this study was to identify candidate plasma microRNAs that are associated with echocardiographic phenotypes of atrial remodeling, and incident and prevalent AF in a community-based cohort.

METHODS: We analyzed left atrial function index (LAFI) of 1788 Framingham Offspring 8 participants. We quantified expression of 339 plasma microRNAs. We examined associations between microRNA levels with LAFI and prevalent and incident AF. We constructed pathway analysis of microRNAs' predicted gene targets to identify molecular processes involved in adverse atrial remodeling in AF ...


Understanding Of Metals Dysregulation In Patients With Systolic And Diastolic Dysfunction In Ischemic Heart Disease, Noman Khan, Satwat Hashmi, Amna Jabbar Siddiqui, Sabiha Farooq, Shahid Ahmed Sami, Nageeb Basir, Syeda Saira Bokhari, Hasanat Sharif, Sanaullah Junejo, Hesham R. El-Seedi, Syed Ghulam Musharraf 2020 University of Karachi, Karachi, Pakistan

Understanding Of Metals Dysregulation In Patients With Systolic And Diastolic Dysfunction In Ischemic Heart Disease, Noman Khan, Satwat Hashmi, Amna Jabbar Siddiqui, Sabiha Farooq, Shahid Ahmed Sami, Nageeb Basir, Syeda Saira Bokhari, Hasanat Sharif, Sanaullah Junejo, Hesham R. El-Seedi, Syed Ghulam Musharraf

Department of Biological & Biomedical Sciences

Ischemic heart disease (IHD) is the leading cause of death and chronic disability in the world. IHD affects both the systolic and diastolic function of the heart which progressively leads to heart failure; a structural and functional impairment of filling or ejection of blood from the heart. In this study, the progression of systolic and diastolic dysfunction characterized according to their echocardiographic parameters including left ventricular ejection fraction (EF), grades of diastolic dysfunction and ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e'), were correlated with differential regulation of various metals in patients sera samples ...


Optimism And Risk Of Incident Hypertension: A Target For Primordial Prevention, Laura D. Kubzansky, Julia K. Boehm, Andrew R. Allen, Loryana L. Vie, Tiffany E. Ho, Claudia Trudel-Fitzgerald, Hayami K. Koga, Lawrence M. Scheier, Martin E. P. Seligman 2020 Harvard School of Public Health

Optimism And Risk Of Incident Hypertension: A Target For Primordial Prevention, Laura D. Kubzansky, Julia K. Boehm, Andrew R. Allen, Loryana L. Vie, Tiffany E. Ho, Claudia Trudel-Fitzgerald, Hayami K. Koga, Lawrence M. Scheier, Martin E. P. Seligman

Psychology Faculty Articles and Research

Aims

Optimism is associated with reduced cardiovascular disease risk; however, few prospective studies have considered optimism in relation to hypertension risk specifically. We investigated whether optimism was associated with a lower risk of developing hypertension in U.S. service members, who are more likely to develop high blood pressure early in life. We also evaluated race/ethnicity, sex and age as potential effect modifiers of these associations.

Methods

Participants were 103 486 hypertension-free U.S. Army active-duty soldiers (mean age 28.96 years, 61.76% White, 20.04% Black, 11.01% Hispanic, 4.09% Asian, and 3.10% others). We ...


Efficacy And Safety Of Bempedoic Acid For Prevention Of Cardiovascular Events And Diabetes: A Systematic Review And Meta-Analysis., Xing Wang, Yu Zhang, Huiwen Tan, Peng Wang, Xi Zha, Weelic Chong, Liangxue Zhou, Fang Fang 2020 West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan, 610041, China

Efficacy And Safety Of Bempedoic Acid For Prevention Of Cardiovascular Events And Diabetes: A Systematic Review And Meta-Analysis., Xing Wang, Yu Zhang, Huiwen Tan, Peng Wang, Xi Zha, Weelic Chong, Liangxue Zhou, Fang Fang

Department of Medicine Faculty Papers

BACKGROUND: Bempedoic acid is an oral, once-daily, first-in-class drug being developed for the treatment of hyperlipidemia. However, evidence of bempedoic acid use for the prevention of cardiovascular events and diabetes is lacking. Thus, we aim to evaluate the benefit and safety of bempedoic acid use for the prevention of cardiovascular events and diabetes.

METHODS: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials with no language restriction from inception until March 3, 2020. Pairs of reviewers independently identified randomized controlled trials comparing the use of bempedoic acid with placebo or no treatment for primary prevention of cardiovascular ...


A Questionnaire Survey For Improving Awareness Of Rheumatic Heart Disease Among School-Aged Children In India, Madhab Ray, Santanu Guha, Meghna Ray, Avik Karak, Basabendra Choudhury, Bipasha Ray, Prakash C. Hazra, Harry P. Selker, Robert J. Goldberg, Deepak L. Bhatt 2020 Tufts University

A Questionnaire Survey For Improving Awareness Of Rheumatic Heart Disease Among School-Aged Children In India, Madhab Ray, Santanu Guha, Meghna Ray, Avik Karak, Basabendra Choudhury, Bipasha Ray, Prakash C. Hazra, Harry P. Selker, Robert J. Goldberg, Deepak L. Bhatt

Population and Quantitative Health Sciences Publications

OBJECTIVES: We examined the level of awareness about Rheumatic Heart Disease (RHD) among school-aged children in a rural district of India and evaluated the effects of a questionnaire-based survey in improving the level of awareness.

METHODS: The study involved 8,646 students aged 10-16 years from 20 schools in West Midnapore, India which was conducted in August 2017. We examined changes in the level of awareness of RHD using a 29-point scoring system in seven domains. The baseline questionnaire survey assessed students' knowledge and was followed by a multimedia presentation about RHD and a post-intervention survey using the same questionnaire ...


Insights From Individuals With Chronic Conditions In The Context Of Covid-19, B. Stephen Burton, Jonathan Patterson, Mackenzie Robinson, Dhiren Patel, Matt Allison, Kelly J. Brassil 2020 Pack Health

Insights From Individuals With Chronic Conditions In The Context Of Covid-19, B. Stephen Burton, Jonathan Patterson, Mackenzie Robinson, Dhiren Patel, Matt Allison, Kelly J. Brassil

Patient Experience Journal

The objective of this prospective survey series was to evaluate knowledge and concerns related to the COVID-19 pandemic among individuals with one or more chronic conditions, including cardiometabolic, autoimmune, respiratory and cancer diagnoses. Two surveys were distributed consisting of up to 55 items (March; n=1069) and up to 71 items (April, n=1126), with 24 items repeated from the first survey. Questions focused on healthcare access, barriers and concerns related to the COVID-19 virus. Descriptive analysis evaluated central tendencies, spread, and frequencies of the demographic data, disease states, and survey results within and between the two survey timepoints. Results ...


Evaluation Of Aspirin And Statin Therapy Use And Adherence In Patients With Premature Atherosclerotic Cardiovascular Disease, Dhruv Mahtta, David J. Ramsey, Mahmoud Al Rifai, Khurram Nasir, Zainab Samad, David Aguilar, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani 2020 Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas

Evaluation Of Aspirin And Statin Therapy Use And Adherence In Patients With Premature Atherosclerotic Cardiovascular Disease, Dhruv Mahtta, David J. Ramsey, Mahmoud Al Rifai, Khurram Nasir, Zainab Samad, David Aguilar, Hani Jneid, Christie M. Ballantyne, Laura A. Petersen, Salim S. Virani

Section of Cardiology

Importance: Studies on the use of and adherence to secondary prevention therapies in patients with premature and extremely premature atherosclerotic cardiovascular disease (ASCVD) are lacking.
Objective: To evaluate and compare aspirin use, any statin use, high-intensity statin use, and statin adherence among patients with premature or extremely premature ASCVD compared with patients with nonpremature ASCVD.
Design, setting, and participants: This multicenter cross-sectional study used the clinical and administrative data sets of the US Department of Veterans Affairs (VA) to identify adult patients with at least 1 primary care visit in the VA health care system between October 1, 2014, and ...


Loss Of Supervillin Causes Myopathy With Myofibrillar Disorganization And Autophagic Vacuoles, Carola Hedberg-Oldfors, Elizabeth J. Luna, Anders Oldfors, Cordula Knopp 2020 University of Gothenburg

Loss Of Supervillin Causes Myopathy With Myofibrillar Disorganization And Autophagic Vacuoles, Carola Hedberg-Oldfors, Elizabeth J. Luna, Anders Oldfors, Cordula Knopp

Open Access Publications by UMMS Authors

The muscle specific isoform of the supervillin protein (SV2), encoded by the SVIL gene, is a large sarcolemmal myosin II- and F-actin-binding protein. Supervillin (SV2) binds and co-localizes with costameric dystrophin and binds nebulin, potentially attaching the sarcolemma to myofibrillar Z-lines. Despite its important role in muscle cell physiology suggested by various in vitro studies, there are so far no reports of any human disease caused by SVIL mutations. We here report four patients from two unrelated, consanguineous families with a childhood/adolescence onset of a myopathy associated with homozygous loss-of-function mutations in SVIL. Wide neck, anteverted shoulders and prominent ...


Direct True Lumen Versus Conventional Cannulation For Acute Type-A Aortic Dissection, Asra Wahid, Syed Shahabuddin, Muhammad Muneer Amanullah, Shiraz Hashmi, Shahid Ahmed Sami 2020 Aga Khan University

Direct True Lumen Versus Conventional Cannulation For Acute Type-A Aortic Dissection, Asra Wahid, Syed Shahabuddin, Muhammad Muneer Amanullah, Shiraz Hashmi, Shahid Ahmed Sami

Medical College Documents

Acute type-A aortic dissection is a surgical emergency and has a high rate of short-term mortality. Aortic dissection is highly under-reported in Pakistan. With the technological developments in its management, arterial cannulation technique of direct true lumen cannulation has emerged with improved outcomes. We aimed to compare the mortality and morbidity outcomes between direct true lumen and conventional cannulation techniques for arterial access in patients with acute type- A aortic dissection under a single-centre retrospective review from 2007 to 2017. Mean age of the participants was 43.3±11.6 vs 45±12.4 years with males being dominant in ...


A Neurovascular High-Frequency Optical Coherence Tomography System Enables In Situ Cerebrovascular Volumetric Microscopy, Giovanni J. Ughi, Miklos G. Marosfoi, Robert M. King, Jildaz Caroff, Lindsy M. Peterson, Benjamin H. Duncan, Erin T. Langan, Amanda J. Collins, Anita M. Leporati, Serge Rousselle, Demetrius K. Lopes, Matthew J. Gounis, Ajit S. Puri 2020 University of Massachusetts Medical School

A Neurovascular High-Frequency Optical Coherence Tomography System Enables In Situ Cerebrovascular Volumetric Microscopy, Giovanni J. Ughi, Miklos G. Marosfoi, Robert M. King, Jildaz Caroff, Lindsy M. Peterson, Benjamin H. Duncan, Erin T. Langan, Amanda J. Collins, Anita M. Leporati, Serge Rousselle, Demetrius K. Lopes, Matthew J. Gounis, Ajit S. Puri

Radiology Publications

Intravascular imaging has emerged as a valuable tool for the treatment of coronary and peripheral artery disease; however, no solution is available for safe and reliable use in the tortuous vascular anatomy of the brain. Endovascular treatment of stroke is delivered under image guidance with insufficient resolution to adequately assess underlying arterial pathology and therapeutic devices. High-resolution imaging, enabling surgeons to visualize cerebral arteries' microstructure and micron-level features of neurovascular devices, would have a profound impact in the research, diagnosis, and treatment of cerebrovascular diseases. Here, we present a neurovascular high-frequency optical coherence tomography (HF-OCT) system, including an imaging console ...


Prospects For Rnai Therapy Of Covid-19, Hasan Uludağ, Kylie Parent, Hamidreza Montazeri Aliabadi, Azita Haddadi 2020 University of Alberta

Prospects For Rnai Therapy Of Covid-19, Hasan Uludağ, Kylie Parent, Hamidreza Montazeri Aliabadi, Azita Haddadi

Pharmacy Faculty Articles and Research

COVID-19 caused by the SARS-CoV-2 virus is a fast emerging disease with deadly consequences. The pulmonary system and lungs in particular are most prone to damage caused by the SARS-CoV-2 infection, which leaves a destructive footprint in the lung tissue, making it incapable of conducting its respiratory functions and resulting in severe acute respiratory disease and loss of life. There were no drug treatments or vaccines approved for SARS-CoV-2 at the onset of pandemic, necessitating an urgent need to develop effective therapeutics. To this end, the innate RNA interference (RNAi) mechanism can be employed to develop front line therapies against ...


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