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1. Longitudinal Feasibility of the Montreal Cognitive Assessment (MoCA) in Non-Demented ALS Patients

Author

Aiello, E, Solca, F, Torre, S, Colombo, E, Maranzano, A, De Lorenzo, A, Patisso, V, Treddenti, M, Curti, B, Morelli, C, Doretti, A, Verde, F, Ferrucci, R, Barbieri, S, Ruggiero, F, Priori, A, Silani, V, Ticozzi, N, Poletti, B, Aiello E. N., Solca F., Torre S., Colombo E., Maranzano A., De Lorenzo A., Patisso V., Treddenti M., Curti B., Morelli C., Doretti A., Verde F., Ferrucci R., Barbieri S., Ruggiero F., Priori A., Silani V., Ticozzi N., Poletti B., Aiello, E, Solca, F, Torre, S, Colombo, E, Maranzano, A, De Lorenzo, A, Patisso, V, Treddenti, M, Curti, B, Morelli, C, Doretti, A, Verde, F, Ferrucci, R, Barbieri, S, Ruggiero, F, Priori, A, Silani, V, Ticozzi, N, Poletti, B, Aiello E. N., Solca F., Torre S., Colombo E., Maranzano A., De Lorenzo A., Patisso V., Treddenti M., Curti B., Morelli C., Doretti A., Verde F., Ferrucci R., Barbieri S., Ruggiero F., Priori A., Silani V., Ticozzi N., and Poletti B.

Abstract

Introduction: The present study aimed at testing the longitudinal feasibility of the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented amyotrophic lateral sclerosis (ALS) patients. Methods: N = 39 nondemented ALS patients were followed-up at a 5-to-10-month interval (M = 6.8; SD = 1.4) with the MoCA and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Practice effects, test-retest reliability, and predictive validity (against follow-up ECAS scores) were assessed. Reliable change indices (RCIs) were derived via a regression-based approach by accounting for retest interval and baseline confounders (i.e., demographics, disease duration, and severity and progression rate). Results: At retest, 100% and 69.2% of patients completed the ECAS and the MoCA, respectively. Patients who could not complete the MoCA showed a slightly more severe and fast-progressing disease. The MoCA was not subject to practice effects (t[32] = ?0.80; p = 0.429) and was reliable at retest (intra-class correlation = 0.82). Moreover, baseline MoCA scores predicted the ECAS at retest. RCIs were successfully derived-with baseline MoCA scores being the only significant predictor of retest performances (ps < 0.001). Conclusions: As long as motor disabilities do not undermine its applicability, the MoCA appears to be longitudinally feasible at a 5-to-10-month interval in non-demented ALS patients. However, ALSspecific screeners-such as the ECAS-should be preferred whenever possible.

Published
2024

2. Bulbar involvement and cognitive features in amyotrophic lateral sclerosis: a retrospective study on 347 patients

Author

Aiello, E, Solca, F, Torre, S, Patisso, V, De Lorenzo, A, Treddenti, M, Colombo, E, Maranzano, A, Morelli, C, Doretti, A, Verde, F, Silani, V, Ticozzi, N, Poletti, B, Aiello E. N., Solca F., Torre S., Patisso V., De Lorenzo A., Treddenti M., Colombo E., Maranzano A., Morelli C., Doretti A., Verde F., Silani V., Ticozzi N., Poletti B., Aiello, E, Solca, F, Torre, S, Patisso, V, De Lorenzo, A, Treddenti, M, Colombo, E, Maranzano, A, Morelli, C, Doretti, A, Verde, F, Silani, V, Ticozzi, N, Poletti, B, Aiello E. N., Solca F., Torre S., Patisso V., De Lorenzo A., Treddenti M., Colombo E., Maranzano A., Morelli C., Doretti A., Verde F., Silani V., Ticozzi N., and Poletti B.

Abstract

Background: This study aimed at clarifying the role of bulbar involvement (BI) as a risk factor for cognitive impairment (CI) in non-demented amyotrophic lateral sclerosis (ALS) patients. Methods: Data on N = 347 patients were retrospectively collected. Cognition was assessed via the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). On the basis of clinical records and ALS Functional Rating Scale-Revised (ALSFRS-R) scores, BI was characterized as follows: (1) BI at onset—from medical history; (2) BI at testing (an ALSFRS-R-Bulbar score ≤11); (3) dysarthria (a score ≤3 on item 1 of the ALSFRS-R); (4) severity of BI (the total score on the ALSFRS-R-Bulbar); and (5) progression rate of BI (computed as 12-ALSFRS-R-Bulbar/disease duration in months). Logistic regressions were run to predict a below- vs. above-cutoff performance on each ECAS measure based on BI-related features while accounting for sex, disease duration, severity and progression rate of respiratory and spinal involvement and ECAS response modality. Results: No predictors yielded significance either on the ECAS-Total and -ALS-non-specific or on ECAS-Language/-Fluency or -Visuospatial subscales. BI at testing predicted a higher probability of an abnormal performance on the ECAS-ALS-specific (p = 0.035) and ECAS-Executive Functioning (p = 0.018). Lower ALSFRS-R-Bulbar scores were associated with a defective performance on the ECAS-Memory (p = 0.025). No other BI-related features affected other ECAS performances. Discussion: In ALS, the occurrence of BI itself, while neither its specific features nor its presence at onset, might selectively represent a risk factor for executive impairment, whilst its severity might be associated with memory deficits.

Published
2023

3. COVID-19-associated Guillain-Barré syndrome in the early pandemic experience in Lombardia (Italy)

Author

Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., Salmaggi A., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., and Salmaggi A.

Abstract

Objective: To estimate the incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients (COVID19-GBS) in one of the most hit regions during the first pandemic wave, Lombardia. Methods: Adult patients admitted to 20 Neurological Units between 1/3–30/4/2020 with COVID19-GBS were included as part of a multi-center study organized by the Italian society of Hospital Neuroscience (SNO). Results: Thirty-eight COVID19-GBS patients had a mean age of 60.7 years and male frequency of 86.8%. CSF albuminocytological dissociation was detected in 71.4%, and PCR for SARS-CoV-2 was negative in 19 tested patients. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP, 12.1% of AMSAN, and 6.1% of AMAN. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.2% worsened, of which 3 died. The estimated occurrence rate in Lombardia ranges from 0.5 to 0.05 GBS cases per 1000 COVID-19 infections depending on whether you consider positive cases or estimated seropositive cases. When we compared GBS cases with the pre-pandemic period, we found a reduction of cases from 165 to 135 cases in the 2-month study period in Lombardia. Conclusions: We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients and a reduction of GBS events during the pandemic period possibly due to a lower spread of more common respiratory infectious diseases determined by an increased use of preventive measures.

Published
2023

4. Correction to: COVID‐19‐associated Guillain‐Barré syndrome in the early pandemic experience in Lombardia (Italy) (Neurological Sciences, (2023), 44, 2, (437-446), 10.1007/s10072-022-06429-6)

Author

Martinelli-Boneschi F., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., Salmaggi A., Martinelli-Boneschi F., Martinelli-Boneschi, F, Colombo, A, Bresolin, N, Sessa, M, Bassi, P, Grampa, G, Magni, E, Versino, M, Ferrarese, C, Zarcone, D, Albanese, A, Micieli, G, Zanferrari, C, Cagnana, A, Ferrante, C, Zilioli, A, Locatelli, D, Calloni, M, Delodovici, M, Pozzato, M, Patisso, V, Bortolan, F, Foresti, C, Frigeni, B, Canella, S, Xhani, R, Crabbio, M, Clemenzi, A, Mauri, M, Beretta, S, La Spina, I, Bernasconi, S, De Santis, T, Cavallini, A, Ranieri, M, D'Adda, E, Fruguglietti, M, Peverelli, L, Agosti, E, Leoni, O, Rigamonti, A, Salmaggi, A, Martinelli-Boneschi F., Colombo A., Bresolin N., Sessa M., Bassi P., Grampa G., Magni E., Versino M., Ferrarese C., Zarcone D., Albanese A., Micieli G., Zanferrari C., Cagnana A., Ferrante C., Zilioli A., Locatelli D., Calloni M. V., Delodovici M. L., Pozzato M., Patisso V., Bortolan F., Foresti C., Frigeni B., Canella S., Xhani R., Crabbio M., Clemenzi A., Mauri M., Beretta S., La Spina I., Bernasconi S., De Santis T., Cavallini A., Ranieri M., D'Adda E., Fruguglietti M. E., Peverelli L., Agosti E., Leoni O., Rigamonti A., and Salmaggi A.

Abstract

The above article was published with error. The affiliation address of the authors Alberto Albanese and Tiziana De Santis has been modified to: “U.O. Neurologia, IRCCS Istituto Clinico Humanitas, Milan, Italy”.The Original article has been corrected.

Published
2023

5. Longitudinal Feasibility of the Montreal Cognitive Assessment (MoCA) in Non-Demented ALS Patients.

Author

Aiello EN, Solca F, Torre S, Colombo E, Maranzano A, De Lorenzo A, Patisso V, Treddenti M, Curti B, Morelli C, Doretti A, Verde F, Ferrucci R, Barbieri S, Ruggiero F, Priori A, Silani V, Ticozzi N, and Poletti B

Subjects
Humans, Male, Female, Middle Aged, Aged, Longitudinal Studies, Reproducibility of Results, Cognitive Dysfunction etiology, Cognitive Dysfunction diagnosis, Disease Progression, Italy, Neuropsychological Tests standards, Amyotrophic Lateral Sclerosis complications, Feasibility Studies, Mental Status and Dementia Tests standards
Abstract

Introduction: The present study aimed at testing the longitudinal feasibility of the Montreal Cognitive Assessment (MoCA) in an Italian cohort of non-demented amyotrophic lateral sclerosis (ALS) patients., Methods: N = 39 non-demented ALS patients were followed-up at a 5-to-10-month interval (M = 6.8; SD = 1.4) with the MoCA and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). Practice effects, test-retest reliability, and predictive validity (against follow-up ECAS scores) were assessed. Reliable change indices (RCIs) were derived via a regression-based approach by accounting for retest interval and baseline confounders (i.e., demographics, disease duration, and severity and progression rate)., Results: At retest, 100% and 69.2% of patients completed the ECAS and the MoCA, respectively. Patients who could not complete the MoCA showed a slightly more severe and fast-progressing disease. The MoCA was not subject to practice effects (t[32] = -0.80; p = 0.429) and was reliable at retest (intra-class correlation = 0.82). Moreover, baseline MoCA scores predicted the ECAS at retest. RCIs were successfully derived - with baseline MoCA scores being the only significant predictor of retest performances (ps &lt; 0.001)., Conclusions: As long as motor disabilities do not undermine its applicability, the MoCA appears to be longitudinally feasible at a 5-to-10-month interval in non-demented ALS patients. However, ALS-specific screeners - such as the ECAS - should be preferred whenever possible., (© 2024 S. Karger AG, Basel.)

Published
2024
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6. Bulbar involvement and cognitive features in amyotrophic lateral sclerosis: a retrospective study on 347 patients.

Author

Aiello EN, Solca F, Torre S, Patisso V, De Lorenzo A, Treddenti M, Colombo E, Maranzano A, Morelli C, Doretti A, Verde F, Silani V, Ticozzi N, and Poletti B

Abstract

Background: This study aimed at clarifying the role of bulbar involvement (BI) as a risk factor for cognitive impairment (CI) in non-demented amyotrophic lateral sclerosis (ALS) patients., Methods: Data on N = 347 patients were retrospectively collected. Cognition was assessed via the Edinburgh Cognitive and Behavioral ALS Screen (ECAS). On the basis of clinical records and ALS Functional Rating Scale-Revised (ALSFRS-R) scores, BI was characterized as follows: (1) BI at onset-from medical history; (2) BI at testing (an ALSFRS-R-Bulbar score ≤11); (3) dysarthria (a score ≤3 on item 1 of the ALSFRS-R); (4) severity of BI (the total score on the ALSFRS-R-Bulbar); and (5) progression rate of BI (computed as 12-ALSFRS-R-Bulbar/disease duration in months). Logistic regressions were run to predict a below- vs. above-cutoff performance on each ECAS measure based on BI-related features while accounting for sex, disease duration, severity and progression rate of respiratory and spinal involvement and ECAS response modality., Results: No predictors yielded significance either on the ECAS-Total and -ALS-non-specific or on ECAS-Language/-Fluency or -Visuospatial subscales. BI at testing predicted a higher probability of an abnormal performance on the ECAS-ALS-specific ( p = 0.035) and ECAS-Executive Functioning ( p = 0.018). Lower ALSFRS-R-Bulbar scores were associated with a defective performance on the ECAS-Memory ( p = 0.025). No other BI-related features affected other ECAS performances., Discussion: In ALS, the occurrence of BI itself, while neither its specific features nor its presence at onset, might selectively represent a risk factor for executive impairment, whilst its severity might be associated with memory deficits., Competing Interests: VS received compensation for consulting services and/or speaking activities from AveXis, Cytokinetics, Italfarmaco, Liquidweb S.r.l., Novartis Pharma AG, and Zambon, receives or has received research supports from the Italian Ministry of Health, AriSLA, and E-Rare Joint Transnational Call. He is in the Editorial Board of Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, European Neurology, American Journal of Neurodegenerative Diseases, Frontiers in Neurology and Exploration of Neuroprotective Therapy. BP received compensation for consulting services and/or speaking activities from Liquidweb S.r.l. She is Associate Editor for Frontiers in Neuroscience. NT received compensation for consulting services from Amylyx Pharmaceuticals and Zambon Biotech SA. He is Associate Editor for Frontiers in Aging Neuroscience. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Aiello, Solca, Torre, Patisso, De Lorenzo, Treddenti, Colombo, Maranzano, Morelli, Doretti, Verde, Silani, Ticozzi and Poletti.)

Published
2023
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7. Correction to: COVID‑19‑associated Guillain‑Barré syndrome in the early pandemic experience in Lombardia (Italy).

Author

Martinelli-Boneschi F, Colombo A, Bresolin N, Sessa M, Bassi P, Grampa G, Magni E, Versino M, Ferrarese C, Zarcone D, Albanese A, Micieli G, Zanferrari C, Cagnana A, Ferrante C, Zilioli A, Locatelli D, Calloni MV, Delodovici ML, Pozzato M, Patisso V, Bortolan F, Foresti C, Frigeni B, Canella S, Xhani R, Crabbio M, Clemenzi A, Mauri M, Beretta S, La Spina I, Bernasconi S, De Santis T, Cavallini A, Ranieri M, D'Adda E, Fruguglietti ME, Peverelli L, Agosti E, Leoni O, Rigamonti A, and Salmaggi A

Published
2023
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8. COVID-19-associated Guillain-Barré syndrome in the early pandemic experience in Lombardia (Italy).

Author

Martinelli-Boneschi F, Colombo A, Bresolin N, Sessa M, Bassi P, Grampa G, Magni E, Versino M, Ferrarese C, Zarcone D, Albanese A, Micieli G, Zanferrari C, Cagnana A, Ferrante C, Zilioli A, Locatelli D, Calloni MV, Delodovici ML, Pozzato M, Patisso V, Bortolan F, Foresti C, Frigeni B, Canella S, Xhani R, Crabbio M, Clemenzi A, Mauri M, Beretta S, La Spina I, Bernasconi S, De Santis T, Cavallini A, Ranieri M, D'Adda E, Fruguglietti ME, Peverelli L, Agosti E, Leoni O, Rigamonti A, and Salmaggi A

Subjects
Adult, Humans, Male, Middle Aged, SARS-CoV-2, Pandemics, Italy epidemiology, COVID-19 complications, COVID-19 epidemiology, Guillain-Barre Syndrome diagnosis
Abstract

Objective: To estimate the incidence and describe clinical characteristics and outcome of GBS in COVID-19 patients (COVID19-GBS) in one of the most hit regions during the first pandemic wave, Lombardia., Methods: Adult patients admitted to 20 Neurological Units between 1/3-30/4/2020 with COVID19-GBS were included as part of a multi-center study organized by the Italian society of Hospital Neuroscience (SNO)., Results: Thirty-eight COVID19-GBS patients had a mean age of 60.7 years and male frequency of 86.8%. CSF albuminocytological dissociation was detected in 71.4%, and PCR for SARS-CoV-2 was negative in 19 tested patients. Based on neurophysiology, 81.8% of patients had a diagnosis of AIDP, 12.1% of AMSAN, and 6.1% of AMAN. The course was favorable in 76.3% of patients, stable in 10.5%, while 13.2% worsened, of which 3 died. The estimated occurrence rate in Lombardia ranges from 0.5 to 0.05 GBS cases per 1000 COVID-19 infections depending on whether you consider positive cases or estimated seropositive cases. When we compared GBS cases with the pre-pandemic period, we found a reduction of cases from 165 to 135 cases in the 2-month study period in Lombardia., Conclusions: We detected an increased incidence of GBS in COVID-19 patients which can reflect a higher risk of GBS in COVID-19 patients and a reduction of GBS events during the pandemic period possibly due to a lower spread of more common respiratory infectious diseases determined by an increased use of preventive measures., (© 2022. The Author(s).)

Published
2023
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9. Ecological Validity of the Montreal Cognitive Assessment in Non-Demented Parkinson's Disease Patients.

Author

Aiello EN, D'Iorio A, Solca F, Torre S, Colombo E, Maranzano A, De Lorenzo A, Patisso V, Treddenti M, Morelli C, Doretti A, Maderna L, Verde F, Ferrucci R, Barbieri S, Ruggiero F, Priori A, Silani V, Ticozzi N, Santangelo G, Ciammola A, and Poletti B

Abstract

Background: The ecological validity of performance-based cognitive screeners needs to be tested in order for them to be fully recommended for use within clinical practice and research., Objectives: The objective of this study was to examine, within an Italian cohort of non-demented Parkinson's disease (PD) patients, the ecological validity of the Montreal Cognitive Assessment (MoCA) by assessing its association with (1) functional independence (FI), (2) quality of life (QoL), and (3) behavioural-psychological (BP) outcomes., Methods: Seventy-four non-demented PD patients were administered the MoCA and underwent motor functional - i.e., Unified Parkinson's Disease Rating Scale (UPDRS), Modified Hoehn-Yahr Scale (HY), and Schwab and England Scale (SES) -, behavioural and psychological - i.e., State- and Trait-Anxiety Inventory-Form Y (STAI-Y1/-Y2), Beck Depression Inventory (BDI), and Dimensional Apathy Scale (DAS) - and QoL evaluations - i.e., MOS 36-Item Short Form Health Survey (SF-36). Associations of interest against FI, QoL, and BP outcomes were tested via Bonferroni-corrected Pearson's/Spearman's correlations while covarying for demographics, disease duration as well as UPDRS-III, UPDRS-IV, and HY scores. Intake of psychotropic drugs was also covaried when assessing the association between the MoCA and BP/QoL measures., Results: MoCA scores were significantly associated with the SES (rs(73) = 0.34; p = 0.005) and the DAS-Executive (r(67) = -0.47; p &lt; 0.001), while not to other FI/BP outcomes and QoL measures., Conclusions: The MoCA is a valid estimate of daily life functional autonomy in non-demented PD patients, also reflecting apathetic features of a dysexecutive nature., (© 2023 S. Karger AG, Basel.)

Published
2022
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