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Mass drug administration: the importance of synchrony 大规模药物管理:同步性的重要性。
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw005
Daozhou Gao;Thomas M. Lietman;Chao-Ping Dong;Travis C. Porco
Mass drug administration, a strategy in which all individuals in a population are subject to treatment without individual diagnosis, has been recommended by the World Health Organization for controlling and eliminating several neglected tropical diseases, including trachoma and soil-transmitted helminths. In this article, we derive effective reproduction numbers and average post-treatment disease prevalences of a simple susceptible–infectious–susceptible epidemic model with constant, impulsive synchronized and non-synchronized drug administration strategies. In the non-synchronized model, the individuals in the population are treated at most once per period and their treatment times are uniformly distributed. Mathematically, the set of pulses for the non-synchronized model has the cardinality of the continuum. We show that synchronized and constant strategies are, respectively, the most and least effective treatments in disease control. Elimination through synchronized treatment is always possible when adequate drug efficacy and coverage are fulfilled and sustained. For a strategy with multiple rounds of synchronized treatment per period, the average post-treatment prevalence is irrelevant what the time differences between treatments are, as long as there are the same number of treatments per period.
世界卫生组织建议,大规模药物管理是一种在没有个人诊断的情况下对人群中的所有人进行治疗的策略,用于控制和消除几种被忽视的热带疾病,包括沙眼和土壤传播的蠕虫。在本文中,我们推导了一个具有恒定、脉冲同步和非同步给药策略的简单易感感染易感流行病模型的有效繁殖数和平均治疗后疾病流行率。在非同步模型中,群体中的个体每个时期最多接受一次治疗,并且他们的治疗时间是均匀分布的。在数学上,非同步模型的脉冲集具有连续体的基数。我们表明,同步策略和持续策略分别是疾病控制中最有效和最不有效的治疗方法。当充分的药物疗效和覆盖范围得到满足和持续时,通过同步治疗消除总是可能的。对于每个周期有多轮同步治疗的策略,只要每个周期有相同数量的治疗,平均治疗后患病率与治疗之间的时间差异无关。
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引用次数: 9
A model of the effects of cancer cell motility and cellular adhesion properties on tumour-immune dynamics 癌细胞运动和细胞粘附特性对肿瘤免疫动力学影响的模型
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw004
Federico Frascoli;Emelie Flood;Peter S. Kim
We present a three-dimensional model simulating the dynamics of an anti-cancer T-cell response against a small, avascular, early-stage tumour. Interactions at the tumour site are accounted for using an agent-based model (ABM), while immune cell dynamics in the lymph node are modelled as a system of delay differential equations (DDEs). We combine these separate approaches into a two-compartment hybrid ABM-DDE system to capture the T-cell response against the tumour. In the ABM at the tumour site, movement of tumour cells is modelled using effective physical forces with a specific focus on cell-to-cell adhesion properties and varying levels of tumour cell motility, thus taking into account the ability of cancer cells to spread and form clusters. We consider the effectiveness of the immune response over a range of parameters pertaining to tumour cell motility, cell-to-cell adhesion strength and growth rate. We also investigate the dependence of outcomes on the distribution of tumour cells. Low tumour cell motility is generally a good indicator for successful tumour eradication before relapse, while high motility leads, almost invariably, to relapse and tumour escape. In general, the effect of cell-to-cell adhesion on prognosis is dependent on the level of tumour cell motility, with an often unpredictable cross influence between adhesion and motility, which can lead to counterintuitive effects. In terms of overall tumour shape and structure, the spatial distribution of cancer cells in clusters of various sizes has shown to be strongly related to the likelihood of extinction.
我们提出了一个三维模型,模拟抗癌t细胞对一个小的,无血管的,早期肿瘤的反应动力学。肿瘤部位的相互作用使用基于agent的模型(ABM)来解释,而淋巴结中的免疫细胞动力学被建模为延迟微分方程(DDEs)系统。我们将这些单独的方法结合成一个双室混合ABM-DDE系统,以捕获t细胞对肿瘤的反应。在肿瘤部位的ABM中,肿瘤细胞的运动是用有效的物理力来模拟的,特别关注细胞间的粘附特性和不同水平的肿瘤细胞运动,从而考虑到癌细胞扩散和形成簇的能力。我们考虑免疫反应的有效性在一系列参数有关肿瘤细胞运动,细胞间的粘附强度和生长速度。我们还研究了结果对肿瘤细胞分布的依赖性。低肿瘤细胞运动性通常是肿瘤复发前成功根除的良好指标,而高运动性几乎总是导致复发和肿瘤逃逸。一般来说,细胞间黏附对预后的影响取决于肿瘤细胞的运动水平,黏附和运动之间往往存在不可预测的交叉影响,这可能导致违反直觉的效果。就整体肿瘤的形状和结构而言,不同大小的癌细胞簇的空间分布已被证明与灭绝的可能性密切相关。
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引用次数: 10
Mathematical modelling of cardiovascular response to the Valsalva manoeuvre 瓦尔萨尔瓦演习心血管反应的数学模型
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw008
Leszek Pstras;Karl Thomaseth;Jacek Waniewski;Italo Balzani;Federico Bellavere
The Valsalva manoeuvre (VM) used for clinical autonomic testing results in a complex cardiovascular response with a concomitant action of several regulatory mechanisms whose nonlinear interactions are difficult to analyse without the aid of a mathematical model. The article presents a new non-pulsatile compartmental model of the human cardiovascular system with a variable intrathoracic pressure enabling the simulation of the haemodynamic response to the VM. The model is based on physiological data and includes three baroreflex mechanisms acting on heart rate, systemic resistance and venous unstressed volume. New nonlinear functions have been proposed to model cardiac output dependence on preload and afterload. Following the individual fitting of some parameters with a clear physiological meaning, the model is able to fit clinical data from patients with both typical and abnormal haemodynamic response to the VM. The sensitivity analysis showed that the model is most sensitive to the parameters describing the vascular pressure–volume relationships (the maximal volume of systemic veins and the relative level of vascular compliance). The use of nonlinear pressure–volume relationships for systemic veins proved crucial for the accurate modelling of the VM. On the contrary, the introduction of aroreflex time delays did not change significantly the haemodynamic response to the manoeuvre. The model can be a useful tool for aiding the interpretation of patient's response to the VM and provides a framework for analysing the interactions between the cardiovascular system and autonomic regulatory mechanisms.
用于临床自主神经测试的Valsalva操作(VM)结果是复杂的心血管反应,伴有几种调节机制的共同作用,如果没有数学模型的帮助,这些机制的非线性相互作用很难分析。本文提出了一种新的无搏动性的人心血管系统室室模型,该模型具有可变的胸内压,可以模拟对虚拟机的血流动力学反应。该模型基于生理数据,包括三种作用于心率、全身阻力和静脉非应激容量的压力反射机制。提出了新的非线性函数来模拟心输出量对前负荷和后负荷的依赖。在对一些具有明确生理意义的参数进行个体拟合后,该模型能够拟合典型和异常患者对VM血流动力学反应的临床数据。敏感性分析表明,该模型对描述血管压力-容积关系的参数(全身静脉的最大容积和血管顺应性的相对水平)最为敏感。系统静脉的非线性压力-体积关系的使用证明对VM的准确建模至关重要。相反,引入反射时间延迟并没有显著改变对动作的血流动力学反应。该模型有助于解释患者对VM的反应,并为分析心血管系统和自主调节机制之间的相互作用提供了一个框架。
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引用次数: 15
Spatial modelling of tumour drug resistance: the case of GIST liver metastases 肿瘤耐药的空间模拟:GIST肝转移病例
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw002
Guillaume Lefebvre;Francois Cornelis;Patricio Cumsille;Thierry Colin;Clair Poignard;Olivier Saut
This work is devoted to modelling gastrointestinal stromal tumour metastases to the liver, their growth and resistance to therapies. More precisely, resistance to two standard treatments based on tyrosine kinase inhibitors (imatinib and sunitinib) is observed clinically. Using observations from medical images (CT scans), we build a spatial model consisting in a set of non-linear partial differential equations. After calibration of its parameters with clinical data, this model reproduces qualitatively and quantitatively the spatial tumour evolution of one specific patient. Important features of the growth such as the appearance of spatial heterogeneities and the therapeutical failures may be explained by our model. We then investigate numerically the possibility of optimizing the treatment in terms of progression-free survival time and minimum tumour size reachable by varying the dose of the first treatment. We find that according to our model, the progression-free survival time reaches a plateau with respect to this dose. We also demonstrate numerically that the spatial structure of the tumour may provide much more insights on the cancer cell activities than the standard RECIST criteria, which only consists in the measurement of the tumour diameter. Finally, we discuss on the non-predictivity of the model using only CT scans, in the sense that the early behaviour of the lesion is not sufficient to predict the response to the treatment.
这项工作致力于模拟胃肠道间质瘤转移到肝脏、其生长和对治疗的耐药性。更确切地说,临床上观察到对基于酪氨酸激酶抑制剂的两种标准治疗方法(伊马替尼和舒尼替尼)的耐药性。利用医学图像(CT扫描)的观察结果,我们建立了一个由一组非线性偏微分方程组成的空间模型。在用临床数据校准其参数后,该模型定性和定量地再现了一个特定患者的肿瘤空间演变。生长的重要特征,如空间异质性的出现和治疗失败,可以用我们的模型来解释。然后,我们从数字上研究了通过改变第一次治疗的剂量,在无进展生存时间和可达到的最小肿瘤大小方面优化治疗的可能性。我们发现,根据我们的模型,相对于该剂量,无进展生存时间达到平稳期。我们还从数字上证明,肿瘤的空间结构可能比仅包括肿瘤直径测量的标准RECIST标准提供更多关于癌症细胞活性的见解。最后,我们讨论了仅使用CT扫描的模型的非预测性,因为病变的早期行为不足以预测对治疗的反应。
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引用次数: 12
Three-factor models versus time series models: quantifying time-dependencies of interactions between stimuli in cell biology and psychobiology for short longitudinal data 三因素模型与时间序列模型:量化细胞生物学和心理生物学短纵向数据刺激之间相互作用的时间依赖性
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw001
Till D. Frank;Anatoly Kiyatkin;Alex Cheong;Boris N. Kholodenko
Signal integration determines cell fate on the cellular level, affects cognitive processes and affective responses on the behavioural level, and is likely to be involved in psychoneurobiological processes underlying mood disorders. Interactions between stimuli may subjected to time effects. Time-dependencies of interactions between stimuli typically lead to complex cell responses and complex responses on the behavioural level. We show that both three-factor models and time series models can be used to uncover such time-dependencies. However, we argue that for short longitudinal data the three factor modelling approach is more suitable. In order to illustrate both approaches, we re-analysed previously published short longitudinal data sets. We found that in human embryonic kidney 293 cells cells the interaction effect in the regulation of extracellular signal-regulated kinase (ERK) 1 signalling activation by insulin and epidermal growth factor is subjected to a time effect and dramatically decays at peak values of ERK activation. In contrast, we found that the interaction effect induced by hypoxia and tumour necrosis factor-alpha for the transcriptional activity of the human cyclo-oxygenase-2 promoter in HEK293 cells is time invariant at least in the first 12-h time window after stimulation. Furthermore, we applied the three-factor model to previously reported animal studies. In these studies, memory storage was found to be subjected to an interaction effect of the beta-adrenoceptor agonist clenbuterol and certain antagonists acting on the alpha-1-adrenoceptor / glucocorticoid-receptor system. Our model-based analysis suggests that only if the antagonist drug is administer in a critical time window, then the interaction effect is relevant.
信号整合在细胞水平上决定细胞命运,在行为水平上影响认知过程和情感反应,并可能参与情绪障碍背后的心理神经生物学过程。刺激之间的相互作用可能受到时间效应的影响。刺激之间相互作用的时间依赖性通常导致复杂的细胞反应和行为水平上的复杂反应。我们表明,三因素模型和时间序列模型都可以用来揭示这种时间依赖性。然而,我们认为,对于短纵向数据三因素建模方法是更合适的。为了说明这两种方法,我们重新分析了以前发表的短纵向数据集。我们发现,在人胚胎肾293细胞中,胰岛素和表皮生长因子对细胞外信号调节激酶(ERK) 1信号激活的相互作用受时间效应的影响,并在ERK激活的峰值时急剧衰减。相反,我们发现缺氧和肿瘤坏死因子- α诱导的HEK293细胞中人环氧化酶-2启动子转录活性的相互作用至少在刺激后的第一个12小时时间窗内是时不变的。此外,我们将三因素模型应用于先前报道的动物研究。在这些研究中,记忆储存被发现受到-肾上腺素能受体激动剂克伦特罗和某些拮抗剂作用于-1-肾上腺素能受体/糖皮质激素受体系统的相互作用的影响。我们基于模型的分析表明,只有拮抗剂药物在一个关键的时间窗口内使用,那么相互作用效应是相关的。
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引用次数: 0
Alzheimer's disease: a mathematical model for onset and progression 阿尔茨海默病:发病和发展的数学模型
Pub Date : 2017-06-01 DOI: 10.1093/imammb/dqw003
Michiel Bertsch;Bruno Franchi;Norina Marcello;Maria Carla Tesi;Andrea Tosin
In this article we propose a mathematical model for the onset and progression of Alzheimer's disease based on transport and diffusion equations. We regard brain neurons as a continuous medium and structure them by their degree of malfunctioning. Two different mechanisms are assumed to be relevant for the temporal evolution of the disease: i) diffusion and agglomeration of soluble polymers of amyloid, produced by damaged neurons and ii) neuron-to-neuron prion-like transmission. We model these two processes by a system of Smoluchowski equations for the amyloid concentration, coupled to a kinetic-type transport equation for the distribution function of the degree of malfunctioning of neurons. The second equation contains an integral term describing the random onset of the disease as a jump process localized in particularly sensitive areas of the brain. Our numerical simulations are in good qualitative agreement with clinical images of the disease distribution in the brain which vary from early to advanced stages.
在本文中,我们提出了一个基于传输和扩散方程的阿尔茨海默病发生和发展的数学模型。我们把大脑神经元看作是一个连续的介质,并根据它们的故障程度来构造它们。两种不同的机制被认为与该疾病的时间演变有关:i)受损神经元产生的可溶性淀粉样聚合物的扩散和团聚;ii)神经元到神经元的朊病毒样传播。我们通过淀粉样蛋白浓度的Smoluchowski方程系统和神经元功能失调程度分布函数的动力学型传输方程来模拟这两个过程。第二个方程包含一个积分项,描述了这种疾病的随机发病,作为一个局限于大脑特别敏感区域的跳跃过程。我们的数值模拟在定性上很好地符合临床图像的疾病分布在大脑从早期到晚期的变化。
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引用次数: 79
A syringe-sharing model for the spread of HIV: application to Omsk, Western Siberia 艾滋病毒传播的注射器共用模式:在西伯利亚西部鄂木斯克的应用
Pub Date : 2017-03-01 DOI: 10.1093/imammb/dqv036
Marc Artzrouni;Vasiliy N. Leonenko;Thierry A. Mara
A system of two differential equations is used to model the transmission dynamics of human immunodeficiency virus between ‘persons who inject drugs’ (PWIDs) and their syringes. Our vector-borne disease model hinges on a metaphorical urn from which PWIDs draw syringes at random which may or may not be infected and may or may not result in one of the two agents becoming infected. The model's parameters are estimated with data mostly from the city of Omsk in Western Siberia. A linear trend in PWID prevalence in Omsk could only be fitted by considering a time-dependent version of the model captured through a secular decrease in the probability that PWIDs decide to share a syringe. A global sensitivity analysis is performed with 14 parameters considered random variables in order to assess their impact on average numbers infected over a 50-year projection. With obvious intervention implications the drug injection rate and the probability of syringe-cleansing are the only parameters whose coefficients of correlations with numbers of infected PWIDs and infected syringes have an absolute value close to or larger than 0.40.
一个双微分方程系统用于模拟人类免疫缺陷病毒在“注射吸毒者”(PWIDs)和他们的注射器之间的传播动力学。我们的病媒传播疾病模型依赖于一个隐喻性的瓮,PWIDs从中随机抽取注射器,可能感染也可能不感染,也可能不导致两种媒介中的一种被感染。该模型参数的估计数据主要来自西伯利亚西部的鄂木斯克市。在鄂木斯克,PWID患病率的线性趋势只能通过考虑通过PWID决定共用一个注射器的概率的长期下降而获得的模型的时间依赖版本来拟合。对被视为随机变量的14个参数进行了全球敏感性分析,以评估它们对50年预测期间平均感染人数的影响。只有药物注射率和清洗注射器概率与感染PWIDs数和感染注射器数的相关系数绝对值接近或大于0.40的参数具有明显的干预意义。
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引用次数: 3
Insights from mathematical modelling for T cell migration into the central nervous system 从T细胞迁移到中枢神经系统的数学模型的见解
Pub Date : 2017-03-01 DOI: 10.1093/imammb/dqv038
T. Ruck;S. Bittner;S. G. Meuth;M. Herty
The migration of immune cells from peripheral immune organs into the central nervous system (CNS) through the blood–brain barrier (BBB) is a tightly regulated process. The complex interplay between cells of the BBB and immune cells coordinates cell migration as a part of normal immune surveillance while its dysregulation is critically involved in the pathogenesis of various CNS diseases. To develop tools for a deeper understanding of distribution and migratory pattern of immune cells regulated by the BBB, we made use of a mathematical modelling approach derived from Markov chain theory. We present a data-driven model using a derivation of kinetic differential equations from a particle game. According to the theory of gases, these equations allow one to predict the mean behaviour of a large class of cells by modelling cell–cell interactions. We used this model to assess the distribution of naive, central memory and effector memory T lymphocytes in the peripheral blood and cerebrospinal fluid. Our model allows us to evaluate the impact of activation status, migratory capacity and cell death for cell distribution in the peripheral blood and the CNS.
免疫细胞从外周免疫器官通过血脑屏障(BBB)向中枢神经系统(CNS)迁移是一个受到严格调控的过程。血脑屏障细胞与免疫细胞之间的复杂相互作用协调细胞迁移,作为正常免疫监视的一部分,而其失调在各种中枢神经系统疾病的发病机制中至关重要。为了开发更深入了解血脑屏障调节的免疫细胞分布和迁移模式的工具,我们使用了源自马尔可夫链理论的数学建模方法。我们提出了一个数据驱动的模型,使用从粒子游戏的动力学微分方程的推导。根据气体理论,这些方程允许人们通过模拟细胞间的相互作用来预测一大类细胞的平均行为。我们使用该模型来评估外周血和脑脊液中初始、中枢记忆和效应记忆T淋巴细胞的分布。我们的模型使我们能够评估激活状态、迁移能力和细胞死亡对外周血和中枢神经系统细胞分布的影响。
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引用次数: 4
What mechanisms of tau protein transport could be responsible for the inverted tau concentration gradient in degenerating axons? 在退化的轴突中,tau蛋白转运的什么机制可能导致tau蛋白浓度梯度倒置?
Pub Date : 2017-03-01 DOI: 10.1093/imammb/dqv041
I. A. Kuznetsov;A. V. Kuznetsov
In tauopathies, such as Alzheimer's disease (AD), microtubule (MT)-associated protein tau detaches from MTs and aggregates, eventually forming insoluble neurofibrillary tangles. In a healthy axon, the tau concentration increases toward the axon terminal, but in a degenerating axon, the tau concentration gradient is inverted and the highest tau concentration is in the soma. In this article, we developed a mathematical model of tau transport in axons. We calibrated and tested the model by using published distributions of tau concentration and tau average velocity in a healthy axon. According to published research, the inverted tau concentration gradient may be one of the reasons leading to AD. We therefore used the model to investigate what modifications in tau transport can lead to the inverted tau concentration gradient. We investigated whether tau detachment from MTs due to tau hyperphosphorylation can cause the inverted tau concentration gradient. We found that the assumption that most tau molecules are detached from MTs does not consistently predict the inverted tau concentration gradient; the predicted tau distribution becomes more uniform if the axon length is increased. We then hypothesized that in degenerating axons some tau remains bound to MTs and participates in the component ‘a’ of slow axonal transport but that the rate of tau reversals from anterograde to retrograde motion increases. We demonstrated that this hypothesis results in a tau distribution where the tau concentration has its maximum value at the axon hillock and its minimum value at the axon terminal, in agreement with what is observed in AD. Our results thus suggest that defects in active transport of tau may be a contributing factor to the onset of neural degeneration.
在tau病变中,如阿尔茨海默病(AD),微管(MT)相关蛋白tau从MT分离并聚集,最终形成不溶性神经原纤维缠结。在健康的轴突中,tau浓度向轴突末端方向升高,但在退化的轴突中,tau浓度梯度倒置,tau浓度最高的是在体细胞中。在本文中,我们建立了一个tau蛋白在轴突中传递的数学模型。我们使用已发表的健康轴突中tau浓度和tau平均速度的分布来校准和测试模型。根据已发表的研究,倒置的tau浓度梯度可能是导致AD的原因之一。因此,我们使用该模型来研究tau蛋白转运中的哪些变化会导致tau蛋白浓度梯度倒置。我们研究了tau蛋白过度磷酸化是否会导致tau蛋白从MTs中脱离,从而导致tau蛋白浓度梯度倒置。我们发现,大多数tau分子与mt分离的假设并不能一致地预测倒tau浓度梯度;随着轴突长度的增加,预测的tau分布变得更加均匀。然后我们假设,在退化的轴突中,一些tau蛋白仍然与MTs结合,并参与慢轴突运输的组分“a”,但tau蛋白从顺行运动到逆行运动的逆转率增加。我们证明了这一假设导致tau分布,其中tau浓度在轴突丘处具有最大值,在轴突末端具有最小值,与在AD中观察到的结果一致。因此,我们的研究结果表明,tau蛋白主动运输缺陷可能是神经变性发病的一个促成因素。
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引用次数: 7
Sensitivity analysis for dose deposition in radiotherapy via a Fokker–Planck model 利用Fokker-Planck模型分析放射治疗中剂量沉积的敏感性
Pub Date : 2017-03-01 DOI: 10.1093/imammb/dqv039
Richard C. Barnard;Martin Frank;Kai Krycki
In this paper, we study the sensitivities of electron dose calculations with respect to stopping power and transport coefficients. We focus on the application to radiotherapy simulations. We use a Fokker–Planck approximation to the Boltzmann transport equation. Equations for the sensitivities are derived by the adjoint method. The Fokker–Planck equation and its adjoint are solved numerically in slab geometry using the spherical harmonics expansion ($P_N$) and an Harten-Lax-van Leer finite volume method. Our method is verified by comparison to finite difference approximations of the sensitivities. Finally, we present numerical results of the sensitivities for the normalized average dose deposition depth with respect to the stopping power and the transport coefficients, demonstrating the increase in relative sensitivities as beam energy decreases. This in turn gives estimates on the uncertainty in the normalized average deposition depth, which we present.
在本文中,我们研究了电子剂量计算对停止功率和输运系数的敏感性。重点研究了该方法在放射模拟中的应用。我们使用了玻尔兹曼输运方程的福克-普朗克近似。利用伴随法推导了灵敏度方程。采用球面谐波展开(P_N)和Harten-Lax-van Leer有限体积法对平板几何中的Fokker-Planck方程及其伴随方程进行了数值求解。通过与灵敏度的有限差分近似的比较验证了我们的方法。最后,我们给出了归一化平均剂量沉积深度相对于停止功率和输运系数的灵敏度的数值结果,表明相对灵敏度随着束流能量的降低而增加。这反过来又给出了我们提出的标准化平均沉积深度的不确定性的估计。
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引用次数: 2
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Mathematical medicine and biology : a journal of the IMA
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