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1.
ACS Omega ; 7(20): 17492-17500, 2022 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-35647440

RESUMO

Core-shell colloids make attractive feedstocks for three-dimensional (3D) printing mixed oxide glass materials because they enable synthetic control of precursor dimensions and compositions, improving glass fabrication precision. Toward that end, we report the design and use of core-shell germania-silica (GeO2-SiO2) colloids and their use as precursors to fabricate GeO2-SiO2 glass monoliths by direct ink write (DIW) 3D printing. By this method, GeO2 colloids were prepared in solution using sol-gel chemistry and formed oblong, raspberry-like agglomerates with ∼15 nm diameter primary particles that were predominantly amorphous but contained polycrystalline domains. An ∼15 nm encapsulating SiO2 shell layer was formed directly on the GeO2 core agglomerates to form core-shell GeO2-SiO2 colloids. For glass 3D printing, GeO2-SiO2 colloidal sols were formulated into a viscous ink by solvent exchange, printed into monoliths by DIW additive manufacturing, and sintered to transparent glasses. Characterization of the glass components demonstrates that the core-shell GeO2-SiO2 presents a feasible route to prepare quality, optically transparent low wt % GeO2-SiO2 glasses by DIW printing. Additionally, the results offer a novel, hybrid colloid approach to fabricating 3D-printed Ge-doped silica glass.

3.
Hum Resour Health ; 20(1): 35, 2022 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-35525924

RESUMO

BACKGROUND: In April 2020, the World Health Organization (WHO) Information Network for Epidemics produced an agenda for managing the COVID-19 infodemic. "Infodemic" refers to the overabundance of information-including mis- and disinformation. In this agenda it was pointed out the need to create a competency framework for infodemic management (IM). This framework was released by WHO on 20th September 2021. This paper presents the WHO framework for IM by highlighting the different investigative steps behind its development. METHODS: The framework was built through three steps. Step 1 included the preparatory work following the guidelines in the Guide to writing Competency Framework for WHO Academy courses. Step 2 was based on a qualitative study with participants (N = 25), identified worldwide on the basis of their academic background in relevant fields of IM or of their professional experience in IM activities at the institutional level. The interviews were conducted online between December 2020 and January 2021, they were video-recorded and analyzed using thematic analysis. In Step 3, two stakeholder panels were conducted to revise the framework. RESULTS: The competency framework contains four primary domains, each of which comprised main activities, related tasks, and knowledge and skills. It identifies competencies to manage and monitor infodemics, to design, conduct and evaluate appropriate interventions, as well as to strengthen health systems. Its main purpose is to assist institutions in reinforcing their IM capacities and implementing effective IM processes and actions according to their individual contexts and resources. CONCLUSION: The competency framework is not intended to be a regulatory document nor a training curriculum. As a WHO initiative, it serves as a reference tool to be applied according to local priorities and needs within the different countries. This framework can assist institutions in strengthening IM capacity by hiring, staff development, and human resources planning.


Assuntos
COVID-19 , Infodemia , COVID-19/epidemiologia , Currículo , Humanos , Desenvolvimento de Pessoal , Organização Mundial da Saúde
4.
Cell ; 184(25): 6010-6014, 2021 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-34890548

RESUMO

The COVID-19 information epidemic, or "infodemic," demonstrates how unlimited access to information may confuse and influence behaviors during a health emergency. However, the study of infodemics is relatively new, and little is known about their relationship with epidemics management. Here, we discuss unresolved issues and propose research directions to enhance preparedness for future health crises.


Assuntos
COVID-19/psicologia , Infodemia , Disseminação de Informação/ética , COVID-19/epidemiologia , Epidemias/psicologia , Humanos , Disseminação de Informação/métodos , Saúde Pública , Pesquisa/tendências , SARS-CoV-2
5.
JMIR Infodemiology ; 1(1): e30971, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34447926

RESUMO

BACKGROUND: The COVID-19 pandemic has been accompanied by an infodemic: excess information, including false or misleading information, in digital and physical environments during an acute public health event. This infodemic is leading to confusion and risk-taking behaviors that can be harmful to health, as well as to mistrust in health authorities and public health responses. The World Health Organization (WHO) is working to develop tools to provide an evidence-based response to the infodemic, enabling prioritization of health response activities. OBJECTIVE: In this work, we aimed to develop a practical, structured approach to identify narratives in public online conversations on social media platforms where concerns or confusion exist or where narratives are gaining traction, thus providing actionable data to help the WHO prioritize its response efforts to address the COVID-19 infodemic. METHODS: We developed a taxonomy to filter global public conversations in English and French related to COVID-19 on social media into 5 categories with 35 subcategories. The taxonomy and its implementation were validated for retrieval precision and recall, and they were reviewed and adapted as language about the pandemic in online conversations changed over time. The aggregated data for each subcategory were analyzed on a weekly basis by volume, velocity, and presence of questions to detect signals of information voids with potential for confusion or where mis- or disinformation may thrive. A human analyst reviewed and identified potential information voids and sources of confusion, and quantitative data were used to provide insights on emerging narratives, influencers, and public reactions to COVID-19-related topics. RESULTS: A COVID-19 public health social listening taxonomy was developed, validated, and applied to filter relevant content for more focused analysis. A weekly analysis of public online conversations since March 23, 2020, enabled quantification of shifting interests in public health-related topics concerning the pandemic, and the analysis demonstrated recurring voids of verified health information. This approach therefore focuses on the detection of infodemic signals to generate actionable insights to rapidly inform decision-making for a more targeted and adaptive response, including risk communication. CONCLUSIONS: This approach has been successfully applied to identify and analyze infodemic signals, particularly information voids, to inform the COVID-19 pandemic response. More broadly, the results have demonstrated the importance of ongoing monitoring and analysis of public online conversations, as information voids frequently recur and narratives shift over time. The approach is being piloted in individual countries and WHO regions to generate localized insights and actions; meanwhile, a pilot of an artificial intelligence-based social listening platform is using this taxonomy to aggregate and compare online conversations across 20 countries. Beyond the COVID-19 pandemic, the taxonomy and methodology may be adapted for fast deployment in future public health events, and they could form the basis of a routine social listening program for health preparedness and response planning.

6.
Stud Health Technol Inform ; 281: 989-993, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042821

RESUMO

The COVID-19 pandemic is the first to unfold in the highly digitalized society of the 21st century and is therefore the first pandemic to benefit from and be threatened by a thriving real-time digital information ecosystem. For this reason, the response to the infodemic required development of a public health social listening taxonomy, a structure that can simplify the chaotic information ecosystem to enable an adaptable monitoring infrastructure that detects signals of fertile ground for misinformation and guides trusted sources of verified information to fill in information voids in a timely manner. A weekly analysis of public online conversations since 23 March 2020 has enabled the quantification of running shifts of public interest in public health-related topics concerning the pandemic and has demonstrated the frequent resumption of information voids relevant for public health interventions and risk communication in an emergency response setting.


Assuntos
COVID-19 , Mídias Sociais , Comunicação , Ecossistema , Humanos , Inteligência , Pandemias , SARS-CoV-2 , Organização Mundial da Saúde
7.
Stud Health Technol Inform ; 281: 1009-1010, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042825

RESUMO

As the COVID-19 pandemic evolves, the accompanying infodemic is being amplified through social media and has challenged effective response. The WHO Early AI-supported Response with Social Listening (EARS) is a platform that summarizes real-time information about how people are talking about COVID-19 in public spaces online in 20 pilot countries and in four languages. The aim of the platform is to better integrate social listening with other data sources and analyses that can inform infodemic response.


Assuntos
COVID-19 , Mídias Sociais , Inteligência Artificial , Humanos , Pandemias , SARS-CoV-2 , Organização Mundial da Saúde
8.
Cancers (Basel) ; 13(7)2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33915952

RESUMO

Tyrosine kinase inhibitors (TKIs) are the frontline therapy for BCR-ABL (Ph+) chronic myeloid leukemia (CML). A systematic meta-analysis of 43 peer-reviewed studies with 10,769 CML patients compared the incidence of gastrointestinal adverse events (GI AEs) in a large heterogeneous CML population as a function of TKI type. Incidence and severity of nausea, vomiting, and diarrhea were assessed for imatinib, dasatinib, bosutinib, and nilotinib. Examination of combined TKI average GI AE incidence found diarrhea most prevalent (22.5%), followed by nausea (20.6%), and vomiting (12.9%). Other TKI GI AEs included constipation (9.2%), abdominal pain (7.6%), gastrointestinal hemorrhage (3.5%), and pancreatitis (2.2%). Mean GI AE incidence was significantly different between TKIs (p < 0.001): bosutinib (52.9%), imatinib (24.2%), dasatinib (20.4%), and nilotinib (9.1%). Diarrhea was the most prevalent GI AE with bosutinib (79.2%) and dasatinib (28.1%), whereas nausea was most prevalent with imatinib (33.0%) and nilotinib (13.2%). Incidence of grade 3 or 4 severe GI AEs was ≤3% except severe diarrhea with bosutinib (9.5%). Unsupervised clustering revealed treatment efficacy measured by the complete cytogenetic response, major molecular response, and overall survival is driven most by disease severity, not TKI type. For patients with chronic phase CML without resistance, optimal TKI selection should consider TKI AE profile, comorbidities, and lifestyle.

10.
Vaccine ; 39(2): 364-371, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33293160

RESUMO

Successful emergency vaccination campaigns rely on effective deployment and vaccination plans. This applies to localised outbreaks as well as for pandemics. In the wake of the 2009 H1N1 influenza pandemic, analysis of the global Vaccine Deployment Initiative, through which the World Health Organization (WHO) donated pandemic influenza vaccines to countries in need, revealed that an absence of vaccine deployment plans in many countries significantly hindered vaccine deployment. Through the Pandemic Influenza Preparedness Framework adopted by the World Health Assembly in 2011, WHO is engaging in several capacity building activities to improve pandemic influenza preparedness and response and make provisions for access to vaccines and sharing of other benefits. The Framework calls for the development and exercise of operational plans for deployment of influenza vaccines to enhance pandemic preparedness. To this end, WHO has supported the development of PIPDeploy, an interactive, in-person table top simulation exercise to facilitate learning for emergency preparedness. It employs various game design elements including a game board, time pressure, leaderboards and teams to enhance participants' motivation. PIPDeploy formed part of five WHO Pandemic Influenza Vaccine Deployment Workshops attended by national-level managers responsible for pandemic influenza vaccine response predominantly in non-producing countries. The purpose of this study was to describe the features and application of PIPDeploy, and present findings of the evaluation of participants' experiences during the simulation involving a "hot wash" discussion and collection of quantitative data. The simulation's instructional approach was widely accepted by participants, who reported that the format was novel and engaging. They reflected on its utility for identifying gaps in their own vaccine deployment plans and regulatory frameworks for importation of vaccine products. All participants found the simulation relevant to their professional objectives. A range of other potential applications were suggested, including PIPDeploy's adaptation to sub-national contexts and to other epidemic diseases.


Assuntos
Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Humanos , Programas de Imunização , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinação
12.
JMIR Infodemiology ; 1(1): e30979, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604708

RESUMO

BACKGROUND: An infodemic is an overflow of information of varying quality that surges across digital and physical environments during an acute public health event. It leads to confusion, risk-taking, and behaviors that can harm health and lead to erosion of trust in health authorities and public health responses. Owing to the global scale and high stakes of the health emergency, responding to the infodemic related to the pandemic is particularly urgent. Building on diverse research disciplines and expanding the discipline of infodemiology, more evidence-based interventions are needed to design infodemic management interventions and tools and implement them by health emergency responders. OBJECTIVE: The World Health Organization organized the first global infodemiology conference, entirely online, during June and July 2020, with a follow-up process from August to October 2020, to review current multidisciplinary evidence, interventions, and practices that can be applied to the COVID-19 infodemic response. This resulted in the creation of a public health research agenda for managing infodemics. METHODS: As part of the conference, a structured expert judgment synthesis method was used to formulate a public health research agenda. A total of 110 participants represented diverse scientific disciplines from over 35 countries and global public health implementing partners. The conference used a laddered discussion sprint methodology by rotating participant teams, and a managed follow-up process was used to assemble a research agenda based on the discussion and structured expert feedback. This resulted in a five-workstream frame of the research agenda for infodemic management and 166 suggested research questions. The participants then ranked the questions for feasibility and expected public health impact. The expert consensus was summarized in a public health research agenda that included a list of priority research questions. RESULTS: The public health research agenda for infodemic management has five workstreams: (1) measuring and continuously monitoring the impact of infodemics during health emergencies; (2) detecting signals and understanding the spread and risk of infodemics; (3) responding and deploying interventions that mitigate and protect against infodemics and their harmful effects; (4) evaluating infodemic interventions and strengthening the resilience of individuals and communities to infodemics; and (5) promoting the development, adaptation, and application of interventions and toolkits for infodemic management. Each workstream identifies research questions and highlights 49 high priority research questions. CONCLUSIONS: Public health authorities need to develop, validate, implement, and adapt tools and interventions for managing infodemics in acute public health events in ways that are appropriate for their countries and contexts. Infodemiology provides a scientific foundation to make this possible. This research agenda proposes a structured framework for targeted investment for the scientific community, policy makers, implementing organizations, and other stakeholders to consider.

14.
J Med Internet Res ; 22(6): e19659, 2020 06 26.
Artigo em Inglês | MEDLINE | ID: mdl-32558655

RESUMO

BACKGROUND: An infodemic is an overabundance of information-some accurate and some not-that occurs during an epidemic. In a similar manner to an epidemic, it spreads between humans via digital and physical information systems. It makes it hard for people to find trustworthy sources and reliable guidance when they need it. OBJECTIVE: A World Health Organization (WHO) technical consultation on responding to the infodemic related to the coronavirus disease (COVID-19) pandemic was held, entirely online, to crowdsource suggested actions for a framework for infodemic management. METHODS: A group of policy makers, public health professionals, researchers, students, and other concerned stakeholders was joined by representatives of the media, social media platforms, various private sector organizations, and civil society to suggest and discuss actions for all parts of society, and multiple related professional and scientific disciplines, methods, and technologies. A total of 594 ideas for actions were crowdsourced online during the discussions and consolidated into suggestions for an infodemic management framework. RESULTS: The analysis team distilled the suggestions into a set of 50 proposed actions for a framework for managing infodemics in health emergencies. The consultation revealed six policy implications to consider. First, interventions and messages must be based on science and evidence, and must reach citizens and enable them to make informed decisions on how to protect themselves and their communities in a health emergency. Second, knowledge should be translated into actionable behavior-change messages, presented in ways that are understood by and accessible to all individuals in all parts of all societies. Third, governments should reach out to key communities to ensure their concerns and information needs are understood, tailoring advice and messages to address the audiences they represent. Fourth, to strengthen the analysis and amplification of information impact, strategic partnerships should be formed across all sectors, including but not limited to the social media and technology sectors, academia, and civil society. Fifth, health authorities should ensure that these actions are informed by reliable information that helps them understand the circulating narratives and changes in the flow of information, questions, and misinformation in communities. Sixth, following experiences to date in responding to the COVID-19 infodemic and the lessons from other disease outbreaks, infodemic management approaches should be further developed to support preparedness and response, and to inform risk mitigation, and be enhanced through data science and sociobehavioral and other research. CONCLUSIONS: The first version of this framework proposes five action areas in which WHO Member States and actors within society can apply, according to their mandate, an infodemic management approach adapted to national contexts and practices. Responses to the COVID-19 pandemic and the related infodemic require swift, regular, systematic, and coordinated action from multiple sectors of society and government. It remains crucial that we promote trusted information and fight misinformation, thereby helping save lives.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Crowdsourcing , Educação em Saúde/métodos , Educação em Saúde/normas , Pandemias , Pneumonia Viral , Mídias Sociais/organização & administração , Mídias Sociais/normas , Organização Mundial da Saúde , Betacoronavirus/patogenicidade , COVID-19 , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Surtos de Doenças , Educação em Saúde/organização & administração , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Saúde Pública/métodos , Saúde Pública/normas , SARS-CoV-2 , Mídias Sociais/provisão & distribuição
15.
Arch Biochem Biophys ; 616: 47-58, 2017 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-28153386

RESUMO

Phenylacetaldehyde dehydrogenase catalyzes the NAD+-dependent oxidation of phenylactealdehyde to phenylacetic acid in the styrene catabolic and detoxification pathway of Pseudomonas putida (S12). Here we report the structure and mechanistic properties of the N-terminally histidine-tagged enzyme, NPADH. The 2.83 Å X-ray crystal structure is similar in fold to sheep liver cytosolic aldehyde dehydrogenase (ALDH1), but has unique set of intersubunit interactions and active site tunnel for substrate entrance. In solution, NPADH occurs as 227 kDa homotetramer. It follows a sequential reaction mechanism in which NAD+ serves as both the leading substrate and homotropic allosteric activator. In the absence of styrene monooxygenase reductase, which regenerates NAD+ from NADH in the first step of styrene catabolism, NPADH is inhibited by a ternary complex involving NADH, product, and phenylacetaldehyde, substrate. Each oligomerization domain of NPADH contains a six-residue insertion that extends this loop over the substrate entrance tunnel of a neighboring subunit, thereby obstructing the active site of the adjacent subunit. This feature could be an important factor in the homotropic activation and product inhibition mechanisms. Compared to ALDH1, the substrate channel of NPADH is narrower and lined with more aromatic residues, suggesting a means for enhancing substrate specificity.


Assuntos
Aldeído Oxirredutases/química , Proteínas de Bactérias/química , Proteínas de Escherichia coli/química , Pseudomonas putida/enzimologia , Aldeídos/química , Sítio Alostérico , Animais , Catálise , Domínio Catalítico , Bovinos , Clonagem Molecular , Cristalografia por Raios X , Cinética , Conformação Molecular , NAD/química , Domínios Proteicos , Pseudomonas , Ovinos , Espectrometria de Fluorescência , Estireno/química , Especificidade por Substrato , Temperatura
16.
Cureus ; 7(1): e238, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26180662

RESUMO

PURPOSE: In the setting of biochemical failure (BCF) following primary treatment for prostate cancer, additional discrimination between clinically significant and non-clinically significant biochemical recurrence is critical in defining robust surrogate endpoints for prostate cancer and guiding salvage management decisions. We reviewed the literature to determine which prognostic factors are most significant for predicting prostate cancer-specific survival (PCSS), metastases-free survival (MFS), and/or overall survival (OS) after BCF. MATERIALS AND METHODS: A search of PubMed from 1980 to 2013 yielded 999 studies that examined prognostic factors predictive for PCSS, MFS, and/or OS in prostate cancer patients with BCF following primary treatment. Eligibility criteria for inclusion were: 1) examined a prostate cancer population in the setting of BCF without overt clinical relapse following primary treatment with radical prostatectomy or radiotherapy; 2) based analyses on patient parameters obtained prior to the initiation of salvage therapies; and 3) determined clinical prognostic factors that were significant prognostic measures for at least one of three clinically relevant endpoints: OS, PCS, or MFS. RESULTS: Nineteen eligible studies reported on 8,040 patients that experienced BCF from 1981-2013. The initial primary therapy was variable: radical prostatectomy alone (n=8), radiotherapy alone (n=4), radiotherapy/radical prostatectomy ± adjuvant therapy (n=5), and multiple treatment arms (n=2). There was also heterogeneity in which outcomes were assessed: PCSS (n=14), MFS (n=7), and OS (n=5). The prognostic factors most commonly found to be significant on multivariate analyses were PSA doubling time (PSADT), time to biochemical failure (TTBF), pathological Gleason score (pGS), and age.   CONCLUSIONS: Risk stratification in prostate cancer post-BCF is challenging because of limited predictive modeling that can determine which patients will optimally benefit from salvage therapy. Our systematic literature review has identified PSADT, TTBF, pGS, and age as the leading prognostic factors for the prediction of PCSS, MFS, and OS after BCF. We plan to leverage the Canadian ProCaRS database to perform predictive modeling using the putative findings in the present study in order to propose potential evidence-based surrogate endpoints for prostate cancer in the setting of BCF.

17.
Eur J Epidemiol ; 30(2): 115-29, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25385677

RESUMO

Testing for hepatitis C virus (HCV) infection may reduce the risk of liver-related morbidity, by facilitating earlier access to treatment and care. This review investigated the effectiveness of targeted testing interventions on HCV case detection, treatment uptake, and prevention of liver-related morbidity. A literature search identified studies published up to 2013 that compared a targeted HCV testing intervention (targeting individuals or groups at increased risk of HCV) with no targeted intervention, and results were synthesised using meta-analysis. Exposure to a targeted testing intervention, compared to no targeted intervention, was associated with increased cases detected [number of studies (n) = 14; pooled relative risk (RR) 1.7, 95% CI 1.3, 2.2] and patients commencing therapy (n = 4; RR 3.3, 95% CI 1.1, 10.0). Practitioner-based interventions increased test uptake and cases detected (n = 12; RR 3.5, 95% CI 2.5, 4.8; and n = 10; RR 2.2, 95% CI 1.4, 3.5, respectively), whereas media/information-based interventions were less effective (n = 4; RR 1.5, 95% CI 0.7, 3.0; and n = 4; RR 1.3, 95% CI 1.0, 1.6, respectively). This meta-analysis provides for the first time a quantitative assessment of targeted HCV testing interventions, demonstrating that these strategies were effective in diagnosing cases and increasing treatment uptake. Strategies involving practitioner-based interventions yielded the most favourable outcomes. It is recommended that testing should be targeted at and offered to individuals who are part of a population with high HCV prevalence, or who have a history of HCV risk behaviour.


Assuntos
Hepacivirus , Hepatite C/diagnóstico , Programas de Rastreamento/métodos , Humanos , Populações Vulneráveis
18.
Vaccine ; 32(46): 6067-74, 2014 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-25236586

RESUMO

BACKGROUND: Few country-level estimates for hepatitis A virus (HAV) seroprevlance are available for the 23 countries in the Eastern Mediterranean region (EMRO) of the World Health Organization. METHODS: We used a three-stage approach to assign an HAV endemicity level to each country in North Africa and the Middle East based on the age at midpoint of population immunity. First, we conducted a systematic review to identify all age-seroprevalence studies conducted within the past 10 years. Second, for countries without first-stage evidence we searched for incidence data and older seroprevalence data. Third, for countries with no hepatitis A data, we estimated HAV endemicity based on socioeconomic and water indicators. RESULTS: This three-stage method allowed us to estimate country-specific endemicity levels for every country in EMRO even though first-stage evidence was only available for nine countries and for three countries only third-stage evidence was available. The region has a heterogeneous hepatitis A risk profile, with 13 countries having very high endemicity (an age at midpoint of population immunity in early childhood), three having high endemicity (late childhood), and seven having intermediate endemicity (early adulthood). CONCLUSIONS: The three-stage estimation approach enables the creation of a complete country-level map of HAV risk in EMRO. Given the heterogeneity of HAV endemicity levels in the region and the likelihood of transitions to lower incidence rates and greater adult susceptibility in the near future, enhanced surveillance for hepatitis A would strengthen decisions about vaccination policy in the region.


Assuntos
Anticorpos Anti-Hepatite A/sangue , Hepatite A/epidemiologia , Adolescente , Adulto , África do Norte/epidemiologia , Idoso , Criança , Pré-Escolar , Vírus da Hepatite A , Humanos , Lactente , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Projetos de Pesquisa , Estudos Soroepidemiológicos , Adulto Jovem
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