Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial.
Identifieur interne : 000434 ( Main/Exploration ); précédent : 000433; suivant : 000435Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial.
Auteurs : Martha A Q. Curley [États-Unis] ; Patricia L. Hibberd ; Lori D. Fineman ; David Wypij ; Mei-Chiung Shih ; John E. Thompson ; Mary Jo C. Grant ; Frederick E. Barr ; Natalie Z. Cvijanovich ; Lauren Sorce ; Peter M. Luckett ; Michael A. Matthay ; John H. ArnoldSource :
- JAMA [ 1538-3598 ] ; 2005.
Descripteurs français
- KwdFr :
- Adolescent (MeSH), Décubitus dorsal (MeSH), Décubitus ventral (MeSH), Enfant (MeSH), Enfant d'âge préscolaire (MeSH), Femelle (MeSH), Humains (MeSH), Mâle (MeSH), Nourrisson (MeSH), Nouveau-né (MeSH), Syndrome de détresse respiratoire de l'adulte (thérapie), Syndrome de détresse respiratoire du nouveau-né (thérapie), Unités de soins intensifs pédiatriques (MeSH), Ventilation artificielle (MeSH).
- MESH :
- thérapie : Syndrome de détresse respiratoire de l'adulte, Syndrome de détresse respiratoire du nouveau-né.
- Adolescent, Décubitus dorsal, Décubitus ventral, Enfant, Enfant d'âge préscolaire, Femelle, Humains, Mâle, Nourrisson, Nouveau-né, Unités de soins intensifs pédiatriques, Ventilation artificielle.
English descriptors
- KwdEn :
- Adolescent (MeSH), Child (MeSH), Child, Preschool (MeSH), Female (MeSH), Humans (MeSH), Infant (MeSH), Infant, Newborn (MeSH), Intensive Care Units, Pediatric (MeSH), Male (MeSH), Prone Position (MeSH), Respiration, Artificial (MeSH), Respiratory Distress Syndrome, Adult (therapy), Respiratory Distress Syndrome, Newborn (therapy), Supine Position (MeSH).
- MESH :
Abstract
CONTEXT
In uncontrolled clinical studies, prone positioning appeared to be safe and to improve oxygenation in pediatric patients with acute lung injury. However, the effect of prone positioning on clinical outcomes in children is not known.
OBJECTIVE
To test the hypothesis that at the end of 28 days infants and children with acute lung injury treated with prone positioning would have more ventilator-free days than those treated with supine positioning.
DESIGN, SETTING, AND PATIENTS
Multicenter, randomized, controlled clinical trial conducted from August 28, 2001, to April 23, 2004, of 102 pediatric patients from 7 US pediatric intensive care units aged 2 weeks to 18 years who were treated with supine vs prone positioning. Randomization was concealed and group assignment was not blinded.
INTERVENTION
Patients were randomized to either supine or prone positioning within 48 hours of meeting acute lung injury criteria, with those patients in the prone group being positioned within 4 hours of randomization and remaining prone for 20 hours each day during the acute phase of their illness for a maximum of 7 days, after which they were positioned supine. Both groups were treated using lung protective ventilator and sedation protocols, extubation readiness testing, and hemodynamic, nutrition, and skin care guidelines.
MAIN OUTCOME MEASURE
Ventilator-free days to day 28.
RESULTS
The trial was stopped at the planned interim analysis on the basis of the prespecified futility stopping rule. There were no differences in the number of ventilator-free days between the 2 groups (mean [SD], 15.8 [8.5] supine vs 15.6 [8.6] prone; mean difference, -0.2 days; 95% CI, -3.6 to 3.2; P = .91). After controlling for age, Pediatric Risk of Mortality III score, direct vs indirect acute lung injury, and mode of mechanical ventilation at enrollment, the adjusted difference in ventilator-free days was 0.3 days (95% CI, -3.0 to 3.5; P = .87). There were no differences in the secondary end points, including proportion alive and ventilator-free on day 28 (P = .45), mortality from all causes (P>.99), the time to recovery of lung injury (P = .78), organ-failure-free days (P = .88), and cognitive impairment (P = .16) or overall functional health (P = .12) at hospital discharge or on day 28.
CONCLUSION
Prone positioning does not significantly reduce ventilator-free days or improve other clinical outcomes in pediatric patients with acute lung injury.
DOI: 10.1001/jama.294.2.229
PubMed: 16014597
PubMed Central: PMC1237036
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Barr</name></author><author><name sortKey="Cvijanovich, Natalie Z" sort="Cvijanovich, Natalie Z" uniqKey="Cvijanovich N" first="Natalie Z" last="Cvijanovich">Natalie Z. Cvijanovich</name></author><author><name sortKey="Sorce, Lauren" sort="Sorce, Lauren" uniqKey="Sorce L" first="Lauren" last="Sorce">Lauren Sorce</name></author><author><name sortKey="Luckett, Peter M" sort="Luckett, Peter M" uniqKey="Luckett P" first="Peter M" last="Luckett">Peter M. Luckett</name></author><author><name sortKey="Matthay, Michael A" sort="Matthay, Michael A" uniqKey="Matthay M" first="Michael A" last="Matthay">Michael A. Matthay</name></author><author><name sortKey="Arnold, John H" sort="Arnold, John H" uniqKey="Arnold J" first="John H" last="Arnold">John H. 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Curley</name><affiliation wicri:level="2"><nlm:affiliation>Children's Hospital Boston, Medical-Surgical Intensive Care Unit, 300 Longwood Ave, Boston, MA 02115, USA. martha.curley@childrens.harvard.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Children's Hospital Boston, Medical-Surgical Intensive Care Unit, 300 Longwood Ave, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Hibberd, Patricia L" sort="Hibberd, Patricia L" uniqKey="Hibberd P" first="Patricia L" last="Hibberd">Patricia L. Hibberd</name></author><author><name sortKey="Fineman, Lori D" sort="Fineman, Lori D" uniqKey="Fineman L" first="Lori D" last="Fineman">Lori D. Fineman</name></author><author><name sortKey="Wypij, David" sort="Wypij, David" uniqKey="Wypij D" first="David" last="Wypij">David Wypij</name></author><author><name sortKey="Shih, Mei Chiung" sort="Shih, Mei Chiung" uniqKey="Shih M" first="Mei-Chiung" last="Shih">Mei-Chiung Shih</name></author><author><name sortKey="Thompson, John E" sort="Thompson, John E" uniqKey="Thompson J" first="John E" last="Thompson">John E. Thompson</name></author><author><name sortKey="Grant, Mary Jo C" sort="Grant, Mary Jo C" uniqKey="Grant M" first="Mary Jo C" last="Grant">Mary Jo C. Grant</name></author><author><name sortKey="Barr, Frederick E" sort="Barr, Frederick E" uniqKey="Barr F" first="Frederick E" last="Barr">Frederick E. Barr</name></author><author><name sortKey="Cvijanovich, Natalie Z" sort="Cvijanovich, Natalie Z" uniqKey="Cvijanovich N" first="Natalie Z" last="Cvijanovich">Natalie Z. Cvijanovich</name></author><author><name sortKey="Sorce, Lauren" sort="Sorce, Lauren" uniqKey="Sorce L" first="Lauren" last="Sorce">Lauren Sorce</name></author><author><name sortKey="Luckett, Peter M" sort="Luckett, Peter M" uniqKey="Luckett P" first="Peter M" last="Luckett">Peter M. Luckett</name></author><author><name sortKey="Matthay, Michael A" sort="Matthay, Michael A" uniqKey="Matthay M" first="Michael A" last="Matthay">Michael A. Matthay</name></author><author><name sortKey="Arnold, John H" sort="Arnold, John H" uniqKey="Arnold J" first="John H" last="Arnold">John H. Arnold</name></author></analytic><series><title level="j">JAMA</title><idno type="eISSN">1538-3598</idno><imprint><date when="2005" type="published">2005</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent (MeSH)</term><term>Child (MeSH)</term><term>Child, Preschool (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Infant (MeSH)</term><term>Infant, Newborn (MeSH)</term><term>Intensive Care Units, Pediatric (MeSH)</term><term>Male (MeSH)</term><term>Prone Position (MeSH)</term><term>Respiration, Artificial (MeSH)</term><term>Respiratory Distress Syndrome, Adult (therapy)</term><term>Respiratory Distress Syndrome, Newborn (therapy)</term><term>Supine Position (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent (MeSH)</term><term>Décubitus dorsal (MeSH)</term><term>Décubitus ventral (MeSH)</term><term>Enfant (MeSH)</term><term>Enfant d'âge préscolaire (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Mâle (MeSH)</term><term>Nourrisson (MeSH)</term><term>Nouveau-né (MeSH)</term><term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term><term>Syndrome de détresse respiratoire du nouveau-né (thérapie)</term><term>Unités de soins intensifs pédiatriques (MeSH)</term><term>Ventilation artificielle (MeSH)</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Respiratory Distress Syndrome, Adult</term><term>Respiratory Distress Syndrome, Newborn</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Syndrome de détresse respiratoire de l'adulte</term><term>Syndrome de détresse respiratoire du nouveau-né</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Infant</term><term>Infant, Newborn</term><term>Intensive Care Units, Pediatric</term><term>Male</term><term>Prone Position</term><term>Respiration, Artificial</term><term>Supine Position</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Décubitus dorsal</term><term>Décubitus ventral</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Nourrisson</term><term>Nouveau-né</term><term>Unités de soins intensifs pédiatriques</term><term>Ventilation artificielle</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>CONTEXT</b></p><p>In uncontrolled clinical studies, prone positioning appeared to be safe and to improve oxygenation in pediatric patients with acute lung injury. However, the effect of prone positioning on clinical outcomes in children is not known.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>To test the hypothesis that at the end of 28 days infants and children with acute lung injury treated with prone positioning would have more ventilator-free days than those treated with supine positioning.</p></div><div type="abstract" xml:lang="en"><p><b>DESIGN, SETTING, AND PATIENTS</b></p><p>Multicenter, randomized, controlled clinical trial conducted from August 28, 2001, to April 23, 2004, of 102 pediatric patients from 7 US pediatric intensive care units aged 2 weeks to 18 years who were treated with supine vs prone positioning. Randomization was concealed and group assignment was not blinded.</p></div><div type="abstract" xml:lang="en"><p><b>INTERVENTION</b></p><p>Patients were randomized to either supine or prone positioning within 48 hours of meeting acute lung injury criteria, with those patients in the prone group being positioned within 4 hours of randomization and remaining prone for 20 hours each day during the acute phase of their illness for a maximum of 7 days, after which they were positioned supine. Both groups were treated using lung protective ventilator and sedation protocols, extubation readiness testing, and hemodynamic, nutrition, and skin care guidelines.</p></div><div type="abstract" xml:lang="en"><p><b>MAIN OUTCOME MEASURE</b></p><p>Ventilator-free days to day 28.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The trial was stopped at the planned interim analysis on the basis of the prespecified futility stopping rule. There were no differences in the number of ventilator-free days between the 2 groups (mean [SD], 15.8 [8.5] supine vs 15.6 [8.6] prone; mean difference, -0.2 days; 95% CI, -3.6 to 3.2; P = .91). After controlling for age, Pediatric Risk of Mortality III score, direct vs indirect acute lung injury, and mode of mechanical ventilation at enrollment, the adjusted difference in ventilator-free days was 0.3 days (95% CI, -3.0 to 3.5; P = .87). There were no differences in the secondary end points, including proportion alive and ventilator-free on day 28 (P = .45), mortality from all causes (P>.99), the time to recovery of lung injury (P = .78), organ-failure-free days (P = .88), and cognitive impairment (P = .16) or overall functional health (P = .12) at hospital discharge or on day 28.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Prone positioning does not significantly reduce ventilator-free days or improve other clinical outcomes in pediatric patients with acute lung injury.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">16014597</PMID><DateCompleted><Year>2005</Year><Month>07</Month><Day>21</Day></DateCompleted><DateRevised><Year>2018</Year><Month>11</Month><Day>13</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1538-3598</ISSN><JournalIssue CitedMedium="Internet"><Volume>294</Volume><Issue>2</Issue><PubDate><Year>2005</Year><Month>Jul</Month><Day>13</Day></PubDate></JournalIssue><Title>JAMA</Title></Journal><ArticleTitle>Effect of prone positioning on clinical outcomes in children with acute lung injury: a randomized controlled trial.</ArticleTitle><Pagination><MedlinePgn>229-37</MedlinePgn></Pagination><Abstract><AbstractText Label="CONTEXT" NlmCategory="BACKGROUND">In uncontrolled clinical studies, prone positioning appeared to be safe and to improve oxygenation in pediatric patients with acute lung injury. However, the effect of prone positioning on clinical outcomes in children is not known.</AbstractText><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To test the hypothesis that at the end of 28 days infants and children with acute lung injury treated with prone positioning would have more ventilator-free days than those treated with supine positioning.</AbstractText><AbstractText Label="DESIGN, SETTING, AND PATIENTS" NlmCategory="METHODS">Multicenter, randomized, controlled clinical trial conducted from August 28, 2001, to April 23, 2004, of 102 pediatric patients from 7 US pediatric intensive care units aged 2 weeks to 18 years who were treated with supine vs prone positioning. Randomization was concealed and group assignment was not blinded.</AbstractText><AbstractText Label="INTERVENTION" NlmCategory="METHODS">Patients were randomized to either supine or prone positioning within 48 hours of meeting acute lung injury criteria, with those patients in the prone group being positioned within 4 hours of randomization and remaining prone for 20 hours each day during the acute phase of their illness for a maximum of 7 days, after which they were positioned supine. Both groups were treated using lung protective ventilator and sedation protocols, extubation readiness testing, and hemodynamic, nutrition, and skin care guidelines.</AbstractText><AbstractText Label="MAIN OUTCOME MEASURE" NlmCategory="METHODS">Ventilator-free days to day 28.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The trial was stopped at the planned interim analysis on the basis of the prespecified futility stopping rule. There were no differences in the number of ventilator-free days between the 2 groups (mean [SD], 15.8 [8.5] supine vs 15.6 [8.6] prone; mean difference, -0.2 days; 95% CI, -3.6 to 3.2; P = .91). After controlling for age, Pediatric Risk of Mortality III score, direct vs indirect acute lung injury, and mode of mechanical ventilation at enrollment, the adjusted difference in ventilator-free days was 0.3 days (95% CI, -3.0 to 3.5; P = .87). There were no differences in the secondary end points, including proportion alive and ventilator-free on day 28 (P = .45), mortality from all causes (P>.99), the time to recovery of lung injury (P = .78), organ-failure-free days (P = .88), and cognitive impairment (P = .16) or overall functional health (P = .12) at hospital discharge or on day 28.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Prone positioning does not significantly reduce ventilator-free days or improve other clinical outcomes in pediatric patients with acute lung injury.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Curley</LastName><ForeName>Martha A Q</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Children's Hospital Boston, Medical-Surgical Intensive Care Unit, 300 Longwood Ave, Boston, MA 02115, USA. martha.curley@childrens.harvard.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hibberd</LastName><ForeName>Patricia L</ForeName><Initials>PL</Initials></Author><Author ValidYN="Y"><LastName>Fineman</LastName><ForeName>Lori D</ForeName><Initials>LD</Initials></Author><Author ValidYN="Y"><LastName>Wypij</LastName><ForeName>David</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Shih</LastName><ForeName>Mei-Chiung</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Thompson</LastName><ForeName>John E</ForeName><Initials>JE</Initials></Author><Author ValidYN="Y"><LastName>Grant</LastName><ForeName>Mary Jo C</ForeName><Initials>MJ</Initials></Author><Author ValidYN="Y"><LastName>Barr</LastName><ForeName>Frederick E</ForeName><Initials>FE</Initials></Author><Author ValidYN="Y"><LastName>Cvijanovich</LastName><ForeName>Natalie Z</ForeName><Initials>NZ</Initials></Author><Author ValidYN="Y"><LastName>Sorce</LastName><ForeName>Lauren</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Luckett</LastName><ForeName>Peter M</ForeName><Initials>PM</Initials></Author><Author ValidYN="Y"><LastName>Matthay</LastName><ForeName>Michael A</ForeName><Initials>MA</Initials></Author><Author ValidYN="Y"><LastName>Arnold</LastName><ForeName>John H</ForeName><Initials>JH</Initials></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>R01NR05336</GrantID><Acronym>NR</Acronym><Agency>NINR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>M01 RR000054</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>RR00064</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>R01 NR005336</GrantID><Acronym>NR</Acronym><Agency>NINR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>M01 RR000064</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>RR00054</GrantID><Acronym>RR</Acronym><Agency>NCRR NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013487">Research Support, U.S. Gov't, P.H.S.</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>JAMA</MedlineTA><NlmUniqueID>7501160</NlmUniqueID><ISSNLinking>0098-7484</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>JAMA. 2005 Jul 13;294(2):248-50</RefSource><PMID Version="1">16014601</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>JAMA. 2005 Nov 9;294(18):2297; author reply 2297-8</RefSource><PMID Version="1">16278352</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002675" MajorTopicYN="N">Child, Preschool</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007223" MajorTopicYN="N">Infant</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007231" MajorTopicYN="N">Infant, Newborn</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D015278" MajorTopicYN="N">Intensive Care Units, Pediatric</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016684" MajorTopicYN="Y">Prone Position</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012121" MajorTopicYN="Y">Respiration, Artificial</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012128" MajorTopicYN="N">Respiratory Distress Syndrome, Adult</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012127" MajorTopicYN="N">Respiratory Distress Syndrome, Newborn</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016683" MajorTopicYN="N">Supine 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Arnold</name><name sortKey="Barr, Frederick E" sort="Barr, Frederick E" uniqKey="Barr F" first="Frederick E" last="Barr">Frederick E. Barr</name><name sortKey="Cvijanovich, Natalie Z" sort="Cvijanovich, Natalie Z" uniqKey="Cvijanovich N" first="Natalie Z" last="Cvijanovich">Natalie Z. Cvijanovich</name><name sortKey="Fineman, Lori D" sort="Fineman, Lori D" uniqKey="Fineman L" first="Lori D" last="Fineman">Lori D. Fineman</name><name sortKey="Grant, Mary Jo C" sort="Grant, Mary Jo C" uniqKey="Grant M" first="Mary Jo C" last="Grant">Mary Jo C. Grant</name><name sortKey="Hibberd, Patricia L" sort="Hibberd, Patricia L" uniqKey="Hibberd P" first="Patricia L" last="Hibberd">Patricia L. Hibberd</name><name sortKey="Luckett, Peter M" sort="Luckett, Peter M" uniqKey="Luckett P" first="Peter M" last="Luckett">Peter M. Luckett</name><name sortKey="Matthay, Michael A" sort="Matthay, Michael A" uniqKey="Matthay M" first="Michael A" last="Matthay">Michael A. Matthay</name><name sortKey="Shih, Mei Chiung" sort="Shih, Mei Chiung" uniqKey="Shih M" first="Mei-Chiung" last="Shih">Mei-Chiung Shih</name><name sortKey="Sorce, Lauren" sort="Sorce, Lauren" uniqKey="Sorce L" first="Lauren" last="Sorce">Lauren Sorce</name><name sortKey="Thompson, John E" sort="Thompson, John E" uniqKey="Thompson J" first="John E" last="Thompson">John E. Thompson</name><name sortKey="Wypij, David" sort="Wypij, David" uniqKey="Wypij D" first="David" last="Wypij">David Wypij</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Curley, Martha A Q" sort="Curley, Martha A Q" uniqKey="Curley M" first="Martha A Q" last="Curley">Martha A Q. Curley</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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