Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.
Identifieur interne : 001E18 ( Main/Exploration ); précédent : 001E17; suivant : 001E19Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.
Auteurs : David L. Tucker [Royaume-Uni] ; Mark Rockett [Royaume-Uni] ; Mehedi Hasan [Royaume-Uni] ; Sarah Poplar [Royaume-Uni] ; Simon A. Rule [Royaume-Uni]Source :
- Journal of clinical pathology [ 1472-4146 ] ; 2015.
Descripteurs français
- KwdFr :
- Douleur (prévention et contrôle), Femelle (MeSH), Humains (MeSH), Manipulation d'échantillons (effets indésirables), Mesure de la douleur (MeSH), Moelle osseuse (MeSH), Myélogramme (effets indésirables), Mâle (MeSH), Méthode en double aveugle (MeSH), Neurostimulation électrique transcutanée (méthodes), Prélèvement d'organes et de tissus (effets indésirables), Sujet âgé (MeSH).
- MESH :
- effets indésirables : Manipulation d'échantillons, Myélogramme, Prélèvement d'organes et de tissus.
- méthodes : Neurostimulation électrique transcutanée.
- prévention et contrôle : Douleur.
- Femelle, Humains, Mesure de la douleur, Moelle osseuse, Mâle, Méthode en double aveugle, Sujet âgé.
English descriptors
- KwdEn :
- Aged (MeSH), Bone Marrow (MeSH), Bone Marrow Examination (adverse effects), Double-Blind Method (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Pain (prevention & control), Pain Measurement (MeSH), Specimen Handling (adverse effects), Tissue and Organ Harvesting (adverse effects), Transcutaneous Electric Nerve Stimulation (methods).
- MESH :
- adverse effects : Bone Marrow Examination, Specimen Handling, Tissue and Organ Harvesting.
- methods : Transcutaneous Electric Nerve Stimulation.
- prevention & control : Pain.
- Aged, Bone Marrow, Double-Blind Method, Female, Humans, Male, Pain Measurement.
Abstract
AIMS
Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS).
METHODS
70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure.
RESULTS
No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated.
CONCLUSIONS
TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study.
CLINICAL REGISTRATION NUMBER
NCT02005354.
DOI: 10.1136/jclinpath-2015-202908
PubMed: 25759407
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Tucker</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Rockett, Mark" sort="Rockett, Mark" uniqKey="Rockett M" first="Mark" last="Rockett">Mark Rockett</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Hasan, Mehedi" sort="Hasan, Mehedi" uniqKey="Hasan M" first="Mehedi" last="Hasan">Mehedi Hasan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Poplar, Sarah" sort="Poplar, Sarah" uniqKey="Poplar S" first="Sarah" last="Poplar">Sarah Poplar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Rule, Simon A" sort="Rule, Simon A" uniqKey="Rule S" first="Simon A" last="Rule">Simon A. Rule</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:25759407</idno><idno type="pmid">25759407</idno><idno type="doi">10.1136/jclinpath-2015-202908</idno><idno type="wicri:Area/Main/Corpus">001D84</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001D84</idno><idno type="wicri:Area/Main/Curation">001D84</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">001D84</idno><idno type="wicri:Area/Main/Exploration">001D84</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.</title><author><name sortKey="Tucker, David L" sort="Tucker, David L" uniqKey="Tucker D" first="David L" last="Tucker">David L. Tucker</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Rockett, Mark" sort="Rockett, Mark" uniqKey="Rockett M" first="Mark" last="Rockett">Mark Rockett</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Hasan, Mehedi" sort="Hasan, Mehedi" uniqKey="Hasan M" first="Mehedi" last="Hasan">Mehedi Hasan</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Poplar, Sarah" sort="Poplar, Sarah" uniqKey="Poplar S" first="Sarah" last="Poplar">Sarah Poplar</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author><author><name sortKey="Rule, Simon A" sort="Rule, Simon A" uniqKey="Rule S" first="Simon A" last="Rule">Simon A. Rule</name><affiliation wicri:level="1"><nlm:affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth</wicri:regionArea><wicri:noRegion>Plymouth</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of clinical pathology</title><idno type="eISSN">1472-4146</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Bone Marrow (MeSH)</term><term>Bone Marrow Examination (adverse effects)</term><term>Double-Blind Method (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Pain (prevention & control)</term><term>Pain Measurement (MeSH)</term><term>Specimen Handling (adverse effects)</term><term>Tissue and Organ Harvesting (adverse effects)</term><term>Transcutaneous Electric Nerve Stimulation (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Douleur (prévention et contrôle)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Manipulation d'échantillons (effets indésirables)</term><term>Mesure de la douleur (MeSH)</term><term>Moelle osseuse (MeSH)</term><term>Myélogramme (effets indésirables)</term><term>Mâle (MeSH)</term><term>Méthode en double aveugle (MeSH)</term><term>Neurostimulation électrique transcutanée (méthodes)</term><term>Prélèvement d'organes et de tissus (effets indésirables)</term><term>Sujet âgé (MeSH)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Bone Marrow Examination</term><term>Specimen Handling</term><term>Tissue and Organ Harvesting</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Manipulation d'échantillons</term><term>Myélogramme</term><term>Prélèvement d'organes et de tissus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Transcutaneous Electric Nerve Stimulation</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Neurostimulation électrique transcutanée</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Pain</term></keywords><keywords scheme="MESH" qualifier="prévention et contrôle" xml:lang="fr"><term>Douleur</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Bone Marrow</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Pain Measurement</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Femelle</term><term>Humains</term><term>Mesure de la douleur</term><term>Moelle osseuse</term><term>Mâle</term><term>Méthode en double aveugle</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>AIMS</b></p><p>Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS).</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study.</p></div><div type="abstract" xml:lang="en"><p><b>CLINICAL REGISTRATION NUMBER</b></p><p>NCT02005354.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25759407</PMID><DateCompleted><Year>2015</Year><Month>07</Month><Day>27</Day></DateCompleted><DateRevised><Year>2015</Year><Month>05</Month><Day>19</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1472-4146</ISSN><JournalIssue CitedMedium="Internet"><Volume>68</Volume><Issue>6</Issue><PubDate><Year>2015</Year><Month>Jun</Month></PubDate></JournalIssue><Title>Journal of clinical pathology</Title><ISOAbbreviation>J Clin Pathol</ISOAbbreviation></Journal><ArticleTitle>Does transcutaneous electrical nerve stimulation (TENS) alleviate the pain experienced during bone marrow sampling in addition to standard techniques? A randomised, double-blinded, controlled trial.</ArticleTitle><Pagination><MedlinePgn>479-83</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/jclinpath-2015-202908</ELocationID><Abstract><AbstractText Label="AIMS" NlmCategory="OBJECTIVE">Bone marrow aspiration and trephine (BMAT) biopsies remain important tests in haematology. However, the procedures can be moderately to severely painful despite standard methods of pain relief. To test the efficacy of transcutaneous electrical nerve stimulation (TENS) in alleviating the pain from BMAT in addition to standard analgesia using a numerical pain rating scale (NRS).</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">70 patients requiring BMAT were randomised (1:1) in a double-blind, placebo-controlled trial. -35 patients received TENS impulses at a strong but comfortable amplitude (intervention group) and 35 patients received TENS impulses just above the sensory threshold (control group) (median pulse amplitude 20 and 7 mA, respectively). Patients and operators were blinded to group allocation. Pain assessments were made using a numerical pain scale completed after the procedure.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">No significant difference in NRS pain recalled after the procedure was detected (median pain score 5.7 (95% CI 4.8 to 6.6) in control vs 5.6 (95% CI 4.8 to 6.4) in the intervention group). However, 100% of patients who had previous experience of BMAT and >94% of participants overall felt they benefited from using TENS and would recommend it to others for this procedure. There were no side effects from the TENS device, and it was well tolerated.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">TENS is a safe, non-invasive adjunct to analgesia for reducing pain during bone marrow biopsy and provides a subjective benefit to most users; however, no objective difference in pain scores was detected when using TENS in this randomised controlled study.</AbstractText><AbstractText Label="CLINICAL REGISTRATION NUMBER" NlmCategory="UNASSIGNED">NCT02005354.</AbstractText><CopyrightInformation>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tucker</LastName><ForeName>David L</ForeName><Initials>DL</Initials><AffiliationInfo><Affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rockett</LastName><ForeName>Mark</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Anaesthesia, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hasan</LastName><ForeName>Mehedi</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Poplar</LastName><ForeName>Sarah</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rule</LastName><ForeName>Simon A</ForeName><Initials>SA</Initials><AffiliationInfo><Affiliation>Department of Haematology, Plymouth Hospitals NHS Trust, Plymouth, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><DataBankList CompleteYN="Y"><DataBank><DataBankName>ClinicalTrials.gov</DataBankName><AccessionNumberList><AccessionNumber>NCT02005354</AccessionNumber></AccessionNumberList></DataBank></DataBankList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>03</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Clin Pathol</MedlineTA><NlmUniqueID>0376601</NlmUniqueID><ISSNLinking>0021-9746</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001853" MajorTopicYN="Y">Bone Marrow</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001856" MajorTopicYN="N">Bone Marrow Examination</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004311" MajorTopicYN="N">Double-Blind Method</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010146" MajorTopicYN="N">Pain</DescriptorName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010147" MajorTopicYN="N">Pain Measurement</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013048" MajorTopicYN="N">Specimen Handling</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020858" MajorTopicYN="N">Tissue and Organ Harvesting</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004561" MajorTopicYN="N">Transcutaneous Electric Nerve Stimulation</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">BONE MARROW TREPHINES</Keyword><Keyword MajorTopicYN="N">EVALUATING INSTRUMEN</Keyword><Keyword MajorTopicYN="N">LABORATORY TESTS</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2015</Year><Month>01</Month><Day>31</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>02</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>3</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>3</Month><Day>12</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2015</Year><Month>7</Month><Day>28</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25759407</ArticleId><ArticleId IdType="pii">jclinpath-2015-202908</ArticleId><ArticleId IdType="doi">10.1136/jclinpath-2015-202908</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Royaume-Uni</li></country></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Tucker, David L" sort="Tucker, David L" uniqKey="Tucker D" first="David L" last="Tucker">David L. Tucker</name></noRegion><name sortKey="Hasan, Mehedi" sort="Hasan, Mehedi" uniqKey="Hasan M" first="Mehedi" last="Hasan">Mehedi Hasan</name><name sortKey="Poplar, Sarah" sort="Poplar, Sarah" uniqKey="Poplar S" first="Sarah" last="Poplar">Sarah Poplar</name><name sortKey="Rockett, Mark" sort="Rockett, Mark" uniqKey="Rockett M" first="Mark" last="Rockett">Mark Rockett</name><name sortKey="Rule, Simon A" sort="Rule, Simon A" uniqKey="Rule S" first="Simon A" last="Rule">Simon A. Rule</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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