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Intralesional Therapy in Oncology: A New Vision of a Classic Treatment 肿瘤病灶内治疗:经典治疗的新视角
Pub Date : 2021-01-01 DOI: 10.31038/cst.2021621
M. Sureda, V. Escudero-Ortiz, E. Martínez-Navarro, J. Rebollo
Intralesional therapy has been used in oncology for over a century. The former empirical observations on local control were followed by trials with administration of different substances and/or destructive treatments with the aim of controlling cancer growth. Chemotherapy, molecular target therapy, radiotherapy and other physical therapies were initially viewed as a strategy that mainly affected tumor cells, but accumulating evidence in recent years indicates that can also affect the immune system and the tumor microenvironment to contribute to tumor regression. In the light of the recent and relevant findings in immunotherapy, a new point of view that integrates the current knowledge in the topic is presented, with the aim of stimulating further research that might help to optimize the use of new drugs, making them affordable, more effective and less toxic.
病灶内治疗已经在肿瘤学中使用了一个多世纪。在先前关于局部控制的经验观察之后,进行了旨在控制癌症生长的不同物质和/或破坏性治疗的试验。化疗、分子靶向治疗、放疗等物理治疗最初被认为是主要影响肿瘤细胞的策略,但近年来越来越多的证据表明,它们也可以影响免疫系统和肿瘤微环境,从而促进肿瘤的消退。鉴于最近免疫治疗方面的相关发现,本文提出了一个新的观点,将当前的知识整合到该主题中,旨在促进进一步的研究,这可能有助于优化新药的使用,使它们负担得起,更有效,毒性更小。
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引用次数: 0
Psychological Responses of Patients Receiving a Diagnosis of Adenocarcinoma 确诊腺癌患者的心理反应
Pub Date : 2021-01-01 DOI: 10.31038/cst.2021622
RN RabiaHaddad
In some health organizations, the patients kept ignored in relation to the true nature of their disease, the risks involved, and their prognosis. While in some cases a doctor and a nurse may still withhold information concerning certain details that might threaten the recovery of a patient who is unstable, nervous, or seriously depressed. Nowadays, the sharing of information is governed by the principle of autonomy that is, patients themselves take decisions on everything concerning their disease and must confirm their knowledge and acceptance of any tests or treatments that carry risks by signing an informed consent form Guerra-Tapia [1]. Therefore, before starting to discuss the case of Mr. X and how to inform him with his new diagnosis, more emphasis should be done to understand the definition of what we call it as “bad news”. Buckman (1984) [2], was the first person to define the bad news as “any information likely to alter drastically a patient’s view of his or her future” [3]. Although those information are as it was mentioned in the definition will altered Mr. X expectations for his future, he should be informed about his condition. Delivering unfavorable information is important for many reasons. Giving him the truthful and correct information about his condition can help him make informed choices about his treatment and take responsibility for his care, rise his understanding and awareness of his condition and support him to make appropriate plans for his future. Additionally, this practice will prevent him from undertaking heavy treatment and facilitate end-of-life care planning [4]. Mr. X should know everything he needs in order to participate in diagnostic and therapeutic decisions concerning his own disease. As a long term outcome, Mr. X will perceive the healthcare team as honest; he will experience an increase in his satisfaction, compliance, and coping mechanisms. Moreover, and in general, after a person’s death, memories of care at the end of life will remain with those who grieve the loss and can affect their perception of the facility, healthcare Case Report
在一些卫生组织中,患者在其疾病的真实性质、所涉及的风险及其预后方面一直被忽视。而在某些情况下,医生和护士可能仍然会隐瞒某些细节信息,这些细节可能会威胁到不稳定、紧张或严重抑郁的患者的康复。如今,信息共享受自主原则的支配,即患者自己对有关其疾病的一切作出决定,必须通过签署一份知情同意书,确认他们了解并接受任何有风险的检测或治疗。因此,在开始讨论X先生的病例以及如何告知他他的新诊断之前,更应该强调的是理解我们所说的“坏消息”的定义。巴克曼(1984)是第一个将坏消息定义为“任何可能彻底改变病人对自己未来看法的信息”的人。虽然这些信息正如定义中提到的那样会改变X先生对未来的期望,但他应该被告知他的情况。传递不利信息很重要,原因有很多。向他提供有关他的病情的真实和正确的信息,可以帮助他对治疗作出知情的选择,并对自己的护理负责,提高他对自己病情的了解和认识,并支持他为自己的未来制定适当的计划。此外,这种做法将防止他承担繁重的治疗和促进临终关怀计划bbb。X先生应该知道他所需要的一切,以便参与有关他自己疾病的诊断和治疗决定。长期来看,X先生会认为医疗团队是诚实的;他将体验到满意度、依从性和应对机制的提高。此外,一般来说,在一个人死后,临终关怀的记忆将留在那些悲伤的人身上,并可能影响他们对设施的看法,医疗案例报告
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引用次数: 2
A Comment on Nuclear Safety and Radiation Protection from a Historian of Science 一位科学史家评核安全和辐射防护
Pub Date : 2021-01-01 DOI: 10.31038/cst.2021614
Maria Rentetzi
Cancer Stud Ther J, Volume 6(1): 1–2, 2021 In 1985 Hans Blix, the then IAEA Director General, called for the creation of an advisory committee in the area of nuclear safety. As a result, IAEA’s International Nuclear Safety Advisory Group (INSAG) was formed with the main objective to offer advice on matters of nuclear safety, produce safety standards, and identify nuclear safety issues of international significance [1]. Only a year later the newly created Advisory Group was faced with one of the most terrifying nuclear accidents in history: Chernobyl. The concept of ‘safety culture’ was first introduced in the report that the Advisory Group issued a few months after the accident. Product of a crisis in the nuclear industry, the concept of safety culture was defined and analyzed as “assembly of characteristics and attitudes in organizations and individuals, which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance.” Obviously, the emphasis was on organizational policies and managerial actions while individuals were seen as having “personal attitudes and habits of thought” linked to safety [2]. The aim was to strengthen the safety of nuclear power plants and avoid Chernobyl-type accidents in the future. Nevertheless, in a IAEA 2007 updated definition of culture, “nuclear power plant safety issues” (1986 definition) has been simply replaced by “protection and safety issues” [3] to mark a wider concern about safety culture in other “safety conscious industries” [4]. Evidently, since 1986 nuclear safety culture has been closely and primarily connected to organizational and technical issues within nuclear industrial settings leaving the medical sector largely unaffected. In this sense, culture is identified with learned behavior, a whole body of attitudes, habits, and practices passed on from one generation of nuclear operators to the next and related to the style of organizations and their culture. This understanding of safety culture is linked to earlier conceptualizations of culture—as static, shared, and uniform—that have prevailed in anthropology in the early part of the 20th century. The culture concept in use comes actually to mean the cultivation of people—in this case nuclear operators—through special technical education. Based on this perspective, individuals have been seen as complacent or in a position that is opposed to and thus outside culture [5-7].
1985年,时任国际原子能机构总干事汉斯·布利克斯(Hans Blix)呼吁在核安全领域成立一个咨询委员会。为此,国际原子能机构成立了国际核安全咨询小组(INSAG),其主要目的是就核安全问题提供咨询意见,制定安全标准,识别具有国际意义的核安全问题[1]。仅仅一年后,新成立的咨询小组就面临着历史上最可怕的核事故之一:切尔诺贝利。“安全文化”的概念是在事故发生几个月后谘询小组发表的报告中首次提出的。作为核工业危机的产物,安全文化的概念被定义和分析为“组织和个人的特征和态度的集合,它确立了作为压倒一切的优先事项,核电站安全问题受到其重要性所保证的关注。”显然,重点是组织政策和管理行动,而个人则被视为与安全有关的“个人态度和思维习惯”[2]。其目的是加强核电站的安全,避免今后发生切尔诺贝利式的事故。然而,在国际原子能机构2007年更新的文化定义中,“核电站安全问题”(1986年定义)被简单地替换为“保护和安全问题”[3],以标志着其他“安全意识行业”对安全文化的更广泛关注[4]。显然,自1986年以来,核安全文化主要与核工业环境中的组织和技术问题密切相关,而医疗部门基本上不受影响。从这个意义上说,文化等同于后天习得的行为,是一代又一代核操作员传承下来的一整套态度、习惯和实践,与组织风格及其文化有关。这种对安全文化的理解与20世纪早期人类学中流行的静态、共享和统一的文化概念有关。这里使用的文化概念实际上是指通过特殊的技术教育来培养人——在这个例子中是指核操作员。基于这一观点,个人被视为自满或处于反对文化的位置,因此处于文化之外[5-7]。
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引用次数: 0
Smaller and Small: Strategies to Iterate to Knowledge about the Granular Aspects of Donations 更小和更小:关于捐赠细节方面的知识迭代策略
Pub Date : 2020-12-18 DOI: 10.31038/cst.2020543
Hollis Belger, Ariola Harizi, S. Davidov, Pnina Deitel
rigorously uncover the nature of the for a specific end recipient, that recipient being Center (name disguised to preserve confidentiality). The is to children with cancer by addressing their medical, social, and psychological needs, as well as their family’s The is to discover what type of messages are likely to drive a person to donate. The problem is a practical one with a limited scope, specifically Children’s Cancer Center’s donations, but the learning which emerges from the study is relevant to an understanding of other communications driving support for a given charity. The empirical part of this paper shows the two steps followed to discover what to say to potential donors about Children’s Cancer Center. The combination of the two studies may be viewed as a discussion of ‘method,’ so-called methodological research. The specific findings of the second study, which is larger, but still small in terms of general practice, show what can be discovered for practical use. Abstract The paper presents the use of an emerging science, Mind Genomics, to understand a practical aspect of daily life: what motivates a person to donate to a specific charity. Beyond the knowledge of specific messages which are deemed to be potentially effective as a stimulus to donation, the paper shows how knowledge of a specific end-use can inform us about the mind of a person for a more general problem—how understanding the messages for donation drives a deeper understanding of human motivation. The paper moves from inexpensive pilot tests, through an affordable experiment, and onto the creation of a
严格地揭示特定最终收件人的性质,该收件人是中心(名称伪装以保护机密性)。目的是通过解决癌症儿童的医疗、社会和心理需求,以及他们的家人的需求,发现什么样的信息可能会促使一个人捐赠。这个问题是一个实际的问题,范围有限,特别是儿童癌症中心的捐赠,但从研究中获得的知识与理解其他推动支持特定慈善机构的沟通是相关的。本文的实证部分显示了发现对儿童癌症中心的潜在捐赠者说什么所遵循的两个步骤。这两项研究的结合可以被看作是对“方法”的讨论,即所谓的方法论研究。第二项研究的具体发现更大,但就一般实践而言仍然很小,它显示了可以用于实际用途的发现。本文介绍了一门新兴的科学,心灵基因组学,来理解日常生活的一个实际方面:是什么促使一个人捐赠给特定的慈善机构。除了被认为可能有效刺激捐赠的特定信息的知识之外,该论文还展示了特定最终用途的知识如何告诉我们一个人的思想,以解决一个更普遍的问题——如何理解捐赠信息推动对人类动机的更深入理解。论文从廉价的试点测试,通过一个负担得起的实验,到创建一个
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引用次数: 0
Current Utility of Chimeric Antigen Receptor T-Cell Therapy in Non-Small Cell Lung Cancer 嵌合抗原受体t细胞治疗非小细胞肺癌的现状
Pub Date : 2020-11-28 DOI: 10.31038/cst.2020542
M. Jaradeh, B. Curran, W. Vigneswaran
this study paved Abstract Although the utilization of chimeric antigen receptor (CAR) T-cells for the treatment of non-small cell lung cancer (NSCLC) has traditionally been severely limited, numerous recent technological advancements have allowed for rapid progression of the field in various forms. With the maturation of techniques such as genotyping, immunohistochemistry, large-scale antibody production, and ultra-high throughput screening among many others, the production of novel NSCLC-focused CAR T-cells encompassing a wide array of structural designs and functions has yet to undergo a transition comparable to that of the previous decade. Indeed, the number and quality of modern antigens, antibodies, short-chain variable fragment (scFv) sequences, ligands, and inhibitors available for designing and bioengineering CARs have allowed for a markedly increased understanding of the mechanisms and processes necessary for the successful production of a CAR T-cell line. Most notably, advances in antigen understanding, targeting, and manipulation, CAR module integration, interaction, and compatibility, and immune cell modulation are three approaches currently at the focal point of NSCLC-focused CAR T-cell production. Herein, we briefly discuss the current status of each of these three strategies; novel targeting of NSCLC tumor-specific antigens, bispecific and physiological CAR T-cells, and inhibitory CAR T-cells, in the ongoing development of viable NSCLC management options.
虽然利用嵌合抗原受体(CAR) t细胞治疗非小细胞肺癌(NSCLC)传统上受到严重限制,但最近的许多技术进步使得该领域以各种形式快速发展。随着基因分型、免疫组织化学、大规模抗体生产和超高通量筛选等技术的成熟,新型非小细胞肺癌CAR - t细胞的生产包含了广泛的结构设计和功能,尚未经历与前十年相当的过渡。事实上,用于设计和生物工程CAR的现代抗原、抗体、短链可变片段(scFv)序列、配体和抑制剂的数量和质量,使得人们对成功生产CAR - t细胞系所需的机制和过程的理解显著增加。最值得注意的是,抗原理解、靶向和操作、CAR模块整合、相互作用和兼容性以及免疫细胞调节方面的进展是目前以非小细胞肺癌为重点的CAR - t细胞生产的三种方法。在此,我们简要讨论了这三种策略的现状;新的靶向非小细胞肺癌肿瘤特异性抗原,双特异性和生理性CAR - t细胞,以及抑制性CAR - t细胞,正在开发可行的非小细胞肺癌治疗方案。
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引用次数: 0
https://researchopenworld.com/dosimetric-comparison-and-clinical-toxicity-in-cervical-cancer-patients-treated-with-intensity-modulated-and-three-dimensional-conformal-radiotherapy-real-world-data/# https://researchopenworld.com/dosimetric-comparison-and-clinical-toxicity-in-cervical-cancer-patients-treated-with-intensity-modulated-and-three-dimensional-conformal-radiotherapy-real-world-data/#
Pub Date : 2020-11-18 DOI: 10.31038/cst.2020535
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引用次数: 0
https://researchopenworld.com/car-t-neurotoxicity-causing-severe-brain-oedema-and-tonsillar-herniation-in-a-young-child-with-relapse-all-a-case-report/# https://researchopenworld.com/car-t-neurotoxicity-causing-severe-brain-oedema-and-tonsillar-herniation-in-a-young-child-with-relapse-all-a-case-report/#
Pub Date : 2020-10-27 DOI: 10.31038/cst.2020534
R. Lerner, E. Jacoby, G. Paret
Background: Cellular immunotherapy with autologous T cells genetically engineered to express chimeric antigen receptors is emerging as a promising new class of immunotherapeutic agents, however may cause unique symptoms of neuro-toxicity, such as toxic encephalopathic state with symptoms of confusion and delirium, and occasionally seizures and cerebral oedema. presentation : Hereby, we report a case of a 4-year-old boy, with B-cell precursor acute lymphoblastic leukemia and refractory CNS involvement, which was treated with CAR T-cells. The patient developed severe encephalopathy, high fever and seizures, and was treated with steroids and anticonvulsants. Nevertheless, the patient rapidly deteriorated and developed diffused brain oedema and herniation of cerebellar tonsils. the patient showed no neurological improvement and suffered brain death. Conclusion: Neurotoxicity is an important and common complication of CAR-T cell therapies. Usually, severe neurological symptoms are manageable in most patients, which respond to standard interventions. Early detection of neurological deterioration is of paramount importance, and pediatric intensivists should consider pre-emptive management for brain oedema, even prior to radiological evidence. Randomized prospective studies of treatment algorithms are urgently needed to improve patient monitoring and management.
背景:自体T细胞基因工程表达嵌合抗原受体的细胞免疫治疗正在成为一种有前途的新型免疫治疗药物,然而可能引起独特的神经毒性症状,如中毒性脑病状态,症状为精神错乱和谵妄,偶尔发作和脑水肿。在此,我们报告一例4岁男孩,患有b细胞前体急性淋巴细胞白血病和难治性中枢神经系统受累,用CAR - t细胞治疗。患者出现严重的脑病、高烧和癫痫,并给予类固醇和抗惊厥药治疗。然而,患者病情迅速恶化,发展为弥漫性脑水肿和小脑扁桃体突出。患者神经系统无改善,脑死亡。结论:神经毒性是CAR-T细胞治疗的重要且常见的并发症。通常,大多数患者的严重神经症状是可控的,对标准干预有反应。早期发现神经系统恶化是至关重要的,儿科重症医师应该考虑对脑水肿进行先发制人的治疗,甚至在有放射证据之前。迫切需要对治疗算法进行随机前瞻性研究,以改善患者的监测和管理。
{"title":"https://researchopenworld.com/car-t-neurotoxicity-causing-severe-brain-oedema-and-tonsillar-herniation-in-a-young-child-with-relapse-all-a-case-report/#","authors":"R. Lerner, E. Jacoby, G. Paret","doi":"10.31038/cst.2020534","DOIUrl":"https://doi.org/10.31038/cst.2020534","url":null,"abstract":"Background: Cellular immunotherapy with autologous T cells genetically engineered to express chimeric antigen receptors is emerging as a promising new class of immunotherapeutic agents, however may cause unique symptoms of neuro-toxicity, such as toxic encephalopathic state with symptoms of confusion and delirium, and occasionally seizures and cerebral oedema. presentation : Hereby, we report a case of a 4-year-old boy, with B-cell precursor acute lymphoblastic leukemia and refractory CNS involvement, which was treated with CAR T-cells. The patient developed severe encephalopathy, high fever and seizures, and was treated with steroids and anticonvulsants. Nevertheless, the patient rapidly deteriorated and developed diffused brain oedema and herniation of cerebellar tonsils. the patient showed no neurological improvement and suffered brain death. Conclusion: Neurotoxicity is an important and common complication of CAR-T cell therapies. Usually, severe neurological symptoms are manageable in most patients, which respond to standard interventions. Early detection of neurological deterioration is of paramount importance, and pediatric intensivists should consider pre-emptive management for brain oedema, even prior to radiological evidence. Randomized prospective studies of treatment algorithms are urgently needed to improve patient monitoring and management.","PeriodicalId":72517,"journal":{"name":"Cancer studies and therapeutics","volume":"722 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88641629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
https://researchopenworld.com/convalescent-plasma-therapy-for-covid-19/# https://researchopenworld.com/convalescent-plasma-therapy-for-covid-19/#
Pub Date : 2020-08-07 DOI: 10.31038/cst.2020532
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引用次数: 1
https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/# https://researchopenworld.com/management-of-cancer-patients-undergoing-radiation-therapy-during-the-novel-coronavirus-disease-2019-covid-19-pandemic-a-review-of-the-literature/#
Pub Date : 2020-07-24 DOI: 10.31038/cst.2020531
A. Krauze
Cancer patients are more vulnerable to acquiring COVID 19 infection and may also experience higher morbidity and mortality. In the context of cancer patients may be affected through delayed diagnosis and have significant impact on management in resource strained settings. Cancer treatment typically involves a possible combination of surgical resection, chemotherapy and radiation therapy (RT). RT delivery requires often daily attendance to a cancer center, is complex and poses potentially additional risks for infection as well as treatment related complications. Optimization of infection control measures and RT treatment schedules is paramount to minimize the impact of the pandemic on patients and optimize outcomes. This review
癌症患者更容易感染COVID - 19,发病率和死亡率也可能更高。在癌症患者的背景下,可能会受到影响,通过延迟诊断,并对资源紧张环境的管理产生重大影响。癌症治疗通常包括手术切除、化疗和放射治疗(RT)的可能组合。放疗通常需要每天到癌症中心进行治疗,这很复杂,并且可能会带来感染和治疗相关并发症的额外风险。优化感染控制措施和RT治疗计划对于最大限度地减少大流行对患者的影响和优化结果至关重要。这篇评论
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引用次数: 0
Towards COVID-19 Prophylaxis: An AIDS Preclinical Research Perspective. 面向COVID-19预防:艾滋病临床前研究视角
Pub Date : 2020-07-01
Michele Di Mascio

The success of an antiviral drug depends on its potency to neutralize the virus in vitro and its ability after administration in vivo to reach the anatomic compartments that fuel viral dissemination in the body. For instance, remdesivir, a potent SARS-CoV-2 antiviral drug based on studies in vitro, if administered orally would be poorly effective because low drug levels would reach the lungs due to its high first pass destruction in the liver. This is the reason remdesivir can only be administered intravenously, a requirement that clearly limits its use as a prophylactic agent for COVID-19, although novel formulations for its easier administration are under development. Whether an antiviral prophylaxis could further control or even stop the COVID-19 epidemic in synergy with other non-pharmacological based mitigation strategies is today unknown. Since the mid-1960s, pharmacologists have investigated the use of lipid-based nanoparticles for efficient delivery of antivirals to tissues, for example by transforming the route of administration from intravenous to oral, subcutaneous or aerosol administrations. These novel encapsulation strategies have also the potential to maintain high levels of the antiviral drugs in tissues, with reduced dose frequency compared to the non-encapsulated drug. Several lipid-based nanoparticles are today approved by the US Food and Drug Administration or being tested in clinical studies with favorable toxicity profiles. Nonhuman primate models of coronavirus infection offer unique platforms to accelerate the search for SARS-CoV-2 antiviral prophylaxis. Paradigms, to corroborate this claim, are borrowed from nonhuman primate research studies, some of which had a profound impact on global public health in the specific setting of the AIDS pandemic. Sharing information from nonhuman primate research programs, invoking principles of scientific transparency and bioethics similar to those universally agreed for human studies, would also likely significantly help our collective fight (as the human species) against this public health emergency.

抗病毒药物的成功取决于其在体外中和病毒的效力,以及在体内给药后到达促进病毒在体内传播的解剖腔室的能力。例如,瑞德西韦(remdesivir)是一种基于体外研究的强效SARS-CoV-2抗病毒药物,如果口服,效果会很差,因为低水平的药物会到达肺部,因为它在肝脏中的首次破坏程度很高。这就是瑞德西韦只能静脉注射的原因,这一要求显然限制了它作为COVID-19预防药物的使用,尽管正在开发更容易给药的新配方。目前尚不清楚抗病毒预防是否能与其他非药物缓解策略协同作用,进一步控制甚至阻止COVID-19的流行。自20世纪60年代中期以来,药理学家一直在研究利用脂质纳米颗粒将抗病毒药物有效地输送到组织中,例如将给药途径从静脉注射转变为口服、皮下或气雾剂给药。这些新的包封策略也有可能在组织中保持高水平的抗病毒药物,与非包封药物相比,其剂量频率降低。目前,美国食品和药物管理局批准了几种基于脂质的纳米颗粒,或正在临床研究中进行测试,具有良好的毒性。冠状病毒感染的非人灵长类动物模型为加速寻找SARS-CoV-2抗病毒预防方法提供了独特的平台。为了证实这一说法,从非人类灵长类动物研究中借鉴了一些范例,其中一些范例在艾滋病大流行的特定背景下对全球公共卫生产生了深远影响。分享来自非人类灵长类动物研究项目的信息,援引类似于人类研究普遍认可的科学透明度和生物伦理原则,也可能极大地帮助我们(作为人类物种)共同对抗这场公共卫生紧急事件。
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引用次数: 0
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Cancer studies and therapeutics
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