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1.
BMC Genomics ; 25(1): 431, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38693480

RESUMEN

Ophthalmic manifestations have recently been observed in acute and post-acute complications of COVID-19 caused by SARS-CoV-2 infection. Our precious study has shown that host RNA editing is linked to RNA viral infection, yet ocular adenosine to inosine (A-to-I) RNA editing during SARS-CoV-2 infection remains uninvestigated in COVID-19. Herein we used an epitranscriptomic pipeline to analyze 37 samples and investigate A-to-I editing associated with SARS-CoV-2 infection, in five ocular tissue types including the conjunctiva, limbus, cornea, sclera, and retinal organoids. Our results revealed dramatically altered A-to-I RNA editing across the five ocular tissues. Notably, the transcriptome-wide average level of RNA editing was increased in the cornea but generally decreased in the other four ocular tissues. Functional enrichment analysis showed that differential RNA editing (DRE) was mainly in genes related to ubiquitin-dependent protein catabolic process, transcriptional regulation, and RNA splicing. In addition to tissue-specific RNA editing found in each tissue, common RNA editing was observed across different tissues, especially in the innate antiviral immune gene MAVS and the E3 ubiquitin-protein ligase MDM2. Analysis in retinal organoids further revealed highly dynamic RNA editing alterations over time during SARS-CoV-2 infection. Our study thus suggested the potential role played by RNA editing in ophthalmic manifestations of COVID-19, and highlighted its potential transcriptome impact, especially on innate immunity.


Asunto(s)
COVID-19 , Edición de ARN , SARS-CoV-2 , Humanos , COVID-19/genética , COVID-19/virología , SARS-CoV-2/genética , Adenosina/metabolismo , Inosina/metabolismo , Inosina/genética , Transcriptoma , Ojo/metabolismo , Ojo/virología
2.
J Youth Adolesc ; 51(10): 1873-1885, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-35789320

RESUMEN

Reflection on prosocial experiences may be helpful for adolescents highly attentive to their internal states (i.e., high private self-consciousness) to gain prosocial self-knowledge, yet adolescents with low private self-consciousness may not benefit from it. The current study proposed and examined that engaging in helping behavior would be beneficial for those with low private self-consciousness in self-understanding. Two experimental studies using immersive virtual environment technology were conducted to simulate helping situations. A total of 140 middle school students (n = 59, 47.5% female, Mage = 13.98, SD = 0.89, in Study 1; n = 81, 44.4% female, Mage = 15.31, SD = 1.18, in Study 2) completed the experiments. In both studies, adolescents engaging in helping behaviors identified themselves as more prosocial than those who did not engage in helping behaviors. In Study 2, adolescents' positive prosocial self-concept would increase more through engaging in prosocial behavior than by reflecting on past prosocial experiences. Furthermore, adolescents with high private self-consciousness can gain self-understanding both from self-reflection and engaging in prosocial behavior, whereas adolescents with low private self-consciousness benefit only from engaging in prosocial behavior. The findings suggest the need to consider individual differences and adopt appropriate ways of self-understanding when assisting adolescents' prosocial self-formation.


Asunto(s)
Conducta del Adolescente , Realidad Virtual , Adolescente , Femenino , Conducta de Ayuda , Humanos , Masculino , Solución de Problemas , Autoimagen , Conducta Social
3.
BMC Public Health ; 21(1): 1034, 2021 06 02.
Artículo en Inglés | MEDLINE | ID: mdl-34078353

RESUMEN

BACKGROUND: The World Health Organization has recognized that people with disability are among the most marginalized in the world. This study's objective was to investigate the differences in the probability of colorectal cancer (CRC) screening with faecal immunochemical testing (FIT) between people with disability and without disability in Taiwan. METHODS: The study participants included people with and without disability from the Disability Registration Database (2012) and the National Health Insurance Research Database (2009-2012). The study included 50- to 69-year-olds with and without disability who were screened from 2011 to 2012 and were alive in 2012. There were 16 categories of disability. After propensity score matching (PSM) between the two groups, conditional logistic regression analysis with control variables was used to investigate the odds ratio (OR) that people with or without disability would undergo CRC screening. RESULTS: The percentage of people with disability receiving CRC screening was 21.84%, and the highest rate of those receiving CRC screening (38.72%) was found in people with intractable epilepsy, whose OR was 1.47 times that of people with moving functional limitation (95% confidence interval (CI) = 1.17-1.85). The results showed that the probability of CRC screening in people with disability was lower than that in people without disability (OR = 0.88, 95%CI = 0.87-0.89). The probability of receiving CRC screening differed between people with different categories of disability. CONCLUSIONS: Although the probability of CRC screening in the four categories of disability was higher than that in the general population, overall, people with disability were less likely than people without disability to undergo CRC screening. Health inequalities still exist under National Health Insurance in Taiwan.


Asunto(s)
Neoplasias Colorrectales , Personas con Discapacidad , Estudios de Cohortes , Neoplasias Colorrectales/diagnóstico , Neoplasias Colorrectales/epidemiología , Detección Precoz del Cáncer , Humanos , Tamizaje Masivo , Sangre Oculta , Taiwán/epidemiología
4.
Opt Express ; 26(5): 6202-6213, 2018 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-29529812

RESUMEN

The optomechanical interaction between a plasmonic nanocavity and a gold nanorod through optical forces is demonstrated. It is revealed that strong localized plasmon resonance mode hybridization induced by a gold nanorod results in the resonance mode of the nanocavity splitting into two different plasmon resonance modes (bonding plasmon resonance mode and antibonding plasmon resonance mode). When the whole system (gold nanorod and gold nanocavity) is excited at the antibonding plasmon mode, the gold nanorod can receive an optical pushing force and be pushed away from the gold nanocavity. On the other hand, an optical pulling force acts on the gold nanorod and the gold nanorod can be trapped by the gold nanocavity when the plasmonic tweezers work at the bonding mode. The optical pulling force acting on the gold nanorod can be enhanced by two orders of magnitude larger than that of the same sized dielectric nanorod, which benefits from the strong resonant nearfield interaction between the gold nanorod and the gold nanocavity. More importantly, the shape and the position of the optical potential can be tuned by tailoring the wavelength of the laser used in the optical trapping, which can be used to manipulate the gold nanorod within a nanoscale region. Our findings have important implications for optical trapping, manipulation, sorting, and sieving of plasmonic nanoparticles with plasmonic tweezers.

5.
Int Psychogeriatr ; 30(7): 957-965, 2018 07.
Artículo en Inglés | MEDLINE | ID: mdl-29559028

RESUMEN

ABSTRACTBackground:Sedative-hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan. METHODS: A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative-hypnotic use and demographic and health status. RESULTS: Among the 3,978 participants aged 65 years and over, the rate of sedative-hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative-hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative-hypnotic use. CONCLUSIONS: This study is one of the largest pioneer studies to date to survey sedatives-hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative-hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative-hypnotic use in geriatric patients.


Asunto(s)
Cognición/efectos de los fármacos , Hipnóticos y Sedantes , Vida Independiente , Competencia Mental , Trastornos del Inicio y del Mantenimiento del Sueño , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Evaluación Geriátrica/métodos , Evaluación Geriátrica/estadística & datos numéricos , Disparidades en el Estado de Salud , Humanos , Hipnóticos y Sedantes/efectos adversos , Hipnóticos y Sedantes/uso terapéutico , Vida Independiente/psicología , Vida Independiente/estadística & datos numéricos , Masculino , Ajuste de Riesgo , Factores de Riesgo , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Trastornos del Inicio y del Mantenimiento del Sueño/epidemiología , Trastornos del Inicio y del Mantenimiento del Sueño/psicología , Factores Socioeconómicos , Taiwán/epidemiología
6.
Front Psychiatry ; 13: 826673, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35370817

RESUMEN

Objective: Maternal mental health disorders are a leading complication of childbirth. While few systems are adequately able to identify and treat depression, people experiencing perinatal depression may benefit from the intervention of home visiting. The intent of home visiting interventions is to alleviate stressors of parenthood for people facing additional risk factors. The aim of this scoping review is to investigate the effect of home visiting on perinatal depression grounded in published studies. Methods: We conducted a scoping review of the existing literature of studies relevant to perinatal depression and home visiting. We entered keywords in five search databases: MEDLINE, PsycInfo, CINAHL, Social Work Abstracts, and Google Scholar. All relevant literature published between January 1999-December 2019 was reviewed. Duplicates, books, and errata were excluded from the study. As a scoping review, we included all studies published in English describing the inclusion of maternal depression in home visits. We hypothesize birthing people with perinatal depression will benefit from home visiting interventions. Results: The results from the scoping review and describe the use of home visiting to improve perinatal mental health. An initial 12,652 records were identified in the search. After duplicates were removed, the titles of 2,140 articles were assessed for applicability, however 29 identified for full-text eligibility and were included in this analysis. The majority of the studies included in this review were quantitative (n = 23), followed by qualitative (n = 3), and mixed methods (n = 3). Nearly all studies (n = 28) using validated instruments such as the Edinburgh Postnatal Depression Scale to determine depressive symptoms. Discussion: This review offers preliminary qualitative insights on the efficacy of home visiting for administrating perinatal depression care. Studies show that home visiting programs can provide treatment for perinatal depression and reduce the effects of depression for birthing people. Our review suggests that the efficacy of home visiting programs beginning in the postpartum period are less predictable than prenatal home visiting intervention among various populations, including people experiencing both high-risk and low-risk situations.

7.
Front Health Serv ; 2: 845441, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36925830

RESUMEN

Background: Perinatal (during pregnancy and up until one year after birth) depression is one of the most common medical complications of pregnancy and is a major public health issue. The common early detection method to identify depression is to systematically administer depression screens to patients during their usual care clinic encounters. This study investigates how prenatal patients perceive depression screening and how screening informs their treatment to meet the specific needs of different racial and ethnic groups within both community and health care settings. Methods: Between June 2019 and August 2019, semi-structured in-depth interviews were conducted to explore participants' experiences of depression screening with the Edinburgh Postnatal Depression Scale (EPDS). Perinatal women (N = 29) consented to participate in-depth, one-on-one qualitative interviews. Trained patient-researchers (n = 6), women who had previously experienced a perinatal mental health problem, were trained as research team members and facilitated the interviews alongside a research assistant. All interviews were recorded and transcribed verbatim. Data was analyzed with the use of Nvivo12. Thematic network analysis was used to analyze the data. Results: Through the in-depth patient engaged qualitative interviews this study uncovered several specific motivators and behaviors related to perinatal depression screening. Using directed content analysis, several themes within a COM-B frame emerged and could be reduced to themes and further divided into two different stages: the depression screening stage and the post-screening stage. Conclusions: The results of this qualitative study provide information for health care providers to improve, adjust, and assess the process of conducting perinatal depression screening among women. The data also provide information for health care facilities to identify a better screening tool and develop and measure their screening process. These findings are essential to design comprehensive patient-centered screening protocols given the increase in state and federal policies urging universal depression screening.

8.
Front Neurosci ; 16: 895602, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36061611

RESUMEN

Objective: The aim of this study was to determine whether auricular acupuncture has neuromodulatory effects on the motor cortex of healthy adults. Methods: Fourteen healthy subjects received a real auricular acupuncture stimulation (SF1) session and a sham acupuncture stimulation session. The interval between the two types of stimulation was more than 24 h. A finger dexterity test (taping score and taping speed by using ipad) was assessed, and motor-evoked potentials (MEP) were assessed before and after each stimulation. Results: Before the treatment, there were no significant differences in MEP amplitude, tapping score, or tapping speed (P > 0.05) between the real and sham stimulation conditions. After the treatment, the MEP amplitude, tapping score, and tapping speed in the real stimulation condition increased significantly compared to the pre-stimulation measurements and were significantly higher than those in the sham stimulation condition (P < 0.01). In the sham stimulation condition, the MEP amplitude, tapping score, and tapping speed decreased significantly compared to the pre-stimulation measurements (P < 0.05). Conclusion: Acupuncture of auricular points can modulate the excitability of the motor cortex area of controlling the upper limbs. Clinical trial registration: [http://www.chictr.org.cn/index.aspx], identifier [ChiCTR2100051608].

9.
Front Neurol ; 12: 641023, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34113305

RESUMEN

Objective: This study aims to evaluate the efficacy of music-supported therapy for stroke patients' hand function. Methods: The databases used included Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PubMed, Embase, Music Index, and Google Scholar. Studies published between January 2010 and August 2020 were included. The searching key terms included "music-supported therapy," "music therapy," "hand function," "hand dysfunction," "stroke," "ischemic," and "hemorrhagic." Randomized controlled trials or controlled trials involving adults who have hand function problems caused by stroke are included in this study. The methodological quality and risk of bias of the included studies were rated by two independent assessors under the guidance of Cochrane collaboration's risk of bias tool. Results: Twelve studies that met the inclusion criteria were included in this study. Totally, the data included 598 stroke patients (345 male, 253 female) with recruited time from 1.7 months to 3 years, and the mean age of the participants were 61.09 years old. Based on the Cochrane risk of bias tool, study quality ranged from three to seven out of seven points. Compared with the control group, outcomes including hand strength, range of joint motion, dexterity of hands, arm function, and quality of life were significantly superior with music-supported therapy. Five studies reported improved dexterity of hands, and one study reported the improvement of range of motion and strength of patients' hands, which supported the therapy has positive effects on patients' hand function and improving their quality of life after the therapy. The therapy ranged over a period of 4-8 weeks, with an average duration of 30 min/session and an average of three times per week. Conclusion: Based on the results, music-supported therapy could be a useful treatment for improving hand function and activities of daily living in patients with stroke, especially for patients within 6 months after stroke. However, the low certainty of evidence downgrades our confidence to practice in hospital. More and more randomized controlled trials and larger sample sizes are required for a deeper review.

10.
Prev Med Rep ; 23: 101432, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34150482

RESUMEN

Despite the increasing health burden of chronic hepatitis B (CHB) in aging populations, little is known about the course of health-related quality of life (HRQoL) changes. We aimed to assess individual-level longitudinal HRQoL changes in elderly patients with CHB and to examine their correlates. A prospective 5.1 years-cohort study was conducted in community-dwelling adults aged 55 years with hepatitis B surface antigen-positive. Participants underwent serial measurement of HRQoL using the short-form (12) health survey version 2. Of 503 participants, 82.7% remained in good physical health throughout the study period, whereas 9.1% had declining physical health and 8.2% were in poor physical health. We likewise identified three trajectories of mental health changes ("good mental health" [86.9%], "declining mental health" [6.8%], and "poor mental health" [6.4%]). Three baseline characteristics were independently associated with a lower likelihood of remaining physically or mentally healthy: sarcopenic obesity (odds ratio [OR] with 95% confidence interval [95% CI] of 7.5 [2.8-20.5] for poor physical health, 3.1 [1.1-8.4] for declining physical health, 4.3 [1.4-13.0] for poor mental health), a higher number of metabolic abnormalities (OR [95% CI] of 3.6 [1.6-8.0] for poor physical health) and depressed mood (OR [95% CI] of 21.7 [5.8-81.0] for poor physical health, 5.3 [1.4-19.9] for declining physical health, 83.1 [19.7-350.2] for poor mental health, 13.6 [2.9-64.8] for declining mental health). In conclusion, in a cohort of elderly patients with CHB, we demonstrated the heterogeneity and nonlinearity of HRQoL changes and their associations with variations in specific extrahepatic organs/systems.

11.
Ann Transl Med ; 9(3): 213, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33708840

RESUMEN

BACKGROUND: The prognostic role of the interval between disease onset and hospital admission (O-A interval) was undetermined in patients with the coronavirus disease 2019 (COVID-19). METHODS: A total of 205 laboratory-confirmed inpatients admitted to Hankou hospital of Wuhan from January 11 to March 8, 2020 were consecutively included in this retrospective observational study. Demographic data, medical history, laboratory testing results were collected from medical records. Univariate and multivariate logistic regression models were used to evaluate the prognostic effect of the O-A interval (≤7 versus >7 days) on disease progression in mild-to-moderate patients. For severe-to-critical patients, the in-hospital mortality and the length of hospital stay were compared between the O-A interval subgroups using log-rank test and Mann-Whitney U test, respectively. RESULTS: Mild-to-moderate patients with a short O-A interval (≤7 days) are more likely to deteriorate to severe-to-critical stage compared to those with a long O-A interval (>7 days) [unadjusted odds ratio =2.93, 95% confidence interval (CI), 1.32-6.55; adjusted odds ratio =3.44, 95% CI, 1.20-9.83]. No association was identified between the O-A interval and the mortality or the length of hospital stay of severe-to-critical patients. CONCLUSIONS: The O-A interval has predictive values for the disease progression in mild-to-moderate COVID-19 patients. Under circumstances of the specific health system in Wuhan, China, the spontaneous healthcare-seeking behavior is usually determined by patients' own heath conditions. Hence, the O-A interval can be reflective of the natural course of COVID-19 to some extent. However, our findings should be validated further in other cohorts and in other health systems.

12.
J Nutr Educ Behav ; 50(6): 620-625, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29526661

RESUMEN

OBJECTIVE: To identify the availability and quality of apps supporting Dietary Approaches to Stop Hypertension (DASH) education. METHODS: The researchers identified DASH apps over 1 month in the Apple App Store. Five registered dietitians used the App Quality Evaluation (AQEL) to evaluate app quality on 7 domains. Interrater reliability was tested using intraclass correlations. RESULTS: One paid and 3 free DASH apps were evaluated. Interrater reliability (n = 5) was good for 3 apps and fair for 1 app. Only the paid app scored high (>8 of 10) on most AQEL quality domains. CONCLUSIONS AND IMPLICATIONS: Based on lower quality found among the included free apps, further development of free apps is warranted. Whereas the paid app may be useful in supporting DASH education, future research should determine whether improvements in clinical outcomes are found and whether this app should be improved to address AQEL domains better.


Asunto(s)
Enfoques Dietéticos para Detener la Hipertensión/normas , Aplicaciones Móviles/normas , Enfoques Dietéticos para Detener la Hipertensión/métodos , Humanos , Reproducibilidad de los Resultados , Teléfono Inteligente
13.
Phys Rev E Stat Nonlin Soft Matter Phys ; 71(6 Pt 1): 062901, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-16089796

RESUMEN

The radial compression properties of single DNA molecules have been studied using vibrating scanning polarization force microscopy. By imaging DNA molecules at different vibration amplitude set-point values, we obtain the correlations between radially applied force and DNA compression, from which the radial compressive elasticity can be deduced. The estimated elastic modulus is approximately 20-70 MPa under small external forces (<0.4 nN) and increases to approximately 100-200 MPa for large loads.


Asunto(s)
ADN/química , ADN/ultraestructura , Micromanipulación/métodos , Microscopía de Fuerza Atómica/métodos , Microscopía de Polarización/métodos , Modelos Químicos , Modelos Moleculares , Fuerza Compresiva , Simulación por Computador , ADN/análisis , Elasticidad , Interpretación de Imagen Asistida por Computador/métodos , Conformación de Ácido Nucleico , Estrés Mecánico , Vibración
14.
J Telemed Telecare ; 21(5): 243-53, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25680388

RESUMEN

We conducted a systematic review to determine if the use of nutrition apps resulted in improved outcomes, including knowledge and behavior, among healthy adults. Using app(s), cellular phone, iPads, mobile phone, mobile telephone, smart phone, mobile and mHealth as search terms with diet, food and nutrition as qualifiers we searched PubMed, CINAHL (January 2008-October 2013) and Web of Science (January 2008-January 2014). Inclusion criteria were peer-reviewed randomized controlled trials, non-controlled trials, and cohort studies published in English that used apps to increase nutrition knowledge or improve behavior related to nutrition. Studies that were descriptive, did not include apps, focused on app development, app satisfaction app feasibility, text messaging, or digital photography were excluded. We evaluated article quality using the Academy of Nutrition and Dietetics Evidence Analysis Manual. Data was extracted for knowledge, behavior and weight change. Our initial search identified 12,010 titles from PubMed, 260 from CINAHL and 4762 from Web of Science; of these, only four articles met all search criteria. Positive quality ratings were given to three articles; only one reported knowledge outcomes (non-significant). All four articles evaluated weight loss and suggested an advantage to using nutrition apps. Behavioral changes in reviewed studies included increased adherence to diet monitoring (p < 0.001) and decreased effort to continue diet without app (p = 0.024). Few studies, however, have explored the use of nutrition apps as supportive educational interventions. Most apps focus on weight loss with inconsistent outcomes. We conclude that using apps for education needs additional research which includes behavior theory within the app and improved study design.


Asunto(s)
Dieta , Conductas Relacionadas con la Salud , Educación en Salud/métodos , Conocimientos, Actitudes y Práctica en Salud , Aplicaciones Móviles , Ensayos Clínicos como Asunto , Humanos
16.
Chem Asian J ; 4(5): 668-80, 2009 May 04.
Artículo en Inglés | MEDLINE | ID: mdl-19338012

RESUMEN

The synthesis, structure, and single- and two-photon spectroscopic properties of a series of pyrimidine-based (bent-shaped) molecules are reported. All these stable heterocyclic compounds are fully characterized, and exhibit intense single- and two-photon excited fluorescence (SPEF and TPEF) over a wide spectral range from blue to red, with the spectral peak position of the SPEF being basically the same as that of the TPEF. The well-conjugated pi-systems, observed from the crystal structure, indicate the charge transfer feature of the ground state. Meanwhile, the theoretical and experimental studies indicate that the charge transfer from donor to acceptor is greatly enhanced in the excited states and the different substituted donor groups on the pyrimidine have a large effect on the optical and electrochemical properties. Based on typical structure data and comprehensive spectral data, the following structure-property relationships can be determined: for such bent-shaped chromophores, the absorption and the fluorescence wavelength maximum of the SPEF and TPEF, and two-photon absorption cross sections show a similar trend with increasing electron-donating strength of the corresponding terminal group and the number of branches, while the average bond lengths of the pi-linkage and HOMO-LUMO energy levels show an inverse trend. Experimental data and theoretical calculation provide a coherent picture. With these findings, bent-shaped quadrupolar chromophores combining peak TPA cross sections (up to 2280 GM), broad TPA bands throughout the whole 700-900 nm range, and high fluorescence quantum yields could, thus, be obtained. Such compounds are of particular interest for TPEF microscopy, as well as optical data storage in the visible and NIR regions. A data recording experiment proved the potential application of these materials.


Asunto(s)
Colorantes Fluorescentes/síntesis química , Pirimidinas/síntesis química , Absorción , Algoritmos , Colorantes Fluorescentes/química , Conformación Molecular , Fotoquímica , Pirimidinas/química , Espectrometría de Fluorescencia , Termodinámica , Difracción de Rayos X
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