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SARS-CoV-2 viral load
REGRESSION
Overall, at baseline mean (SD) and median (min–max) logBox plot presenting mean (cross within the box), median (horizontal line within the box), interquartile range, minimum and maximum logFigure LogMean logAvailable at The results of the random effects analysis showed that on a logRandom effects analysis of mean log* ...
PMC10403620
Discussion
infection, critically ill, illness, respiratory and cardiovascular disease
VIRUS, CRITICALLY ILL, DISEASE, INFECTION, OF DISEASE TRANSMISSION, CORONAVIRUS, ORAL INFECTION
This pilot study provided important information on the impact of three different mouthwashes containing 0.2% Chlorhexidine digluconate (CHX), 1.5% Hydroxide peroxide (HTo the best of authors’ knowledge this is the first clinical study to investigate the efficacy of different mouthwashes in reducing viral load in the sa...
PMC10403620
Conclusion
DISEASE TRANSMISSION
Taking into consideration the findings and limitations of the present pilot study, it may be concluded that:The mouthwashes containing 0.2% CHX, 1.5% HThe marginally significant reduction in the average viral load observed in all study groups both at 2 and 3 h compared to baseline, may suggest a mechanical effect/actio...
PMC10403620
Supplementary Information
The online version contains supplementary material available at 10.1038/s41598-023-39308-x.
PMC10403620
Acknowledgements
RECRUITMENT
We acknowledge the contribution of all patients and study team members at each recruitment site. Most particularly, the research nurses Lisa Groarke and Bessie Cipriano. We also extend our thanks to the team members of the Centre for Oral Clinical Research (COCR) and Joint Research Management Office (JRMO) for Barts He...
PMC10403620
Author contributions
RECRUITMENT
N.D. was responsible for the concept of the study. J.P., N.G., M.T., and N.D. designed the trial and study protocol. J.P. was responsible for the site work including the recruitment, study visits and data collection. S.T. facilitated recruitment. S.T. and M.C.M. provided relevant medical advice and information. M.T. pe...
PMC10403620
Funding
GSK Consumer Healthcare (GSKCH) provided funding for this study as part of the
PMC10403620
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
PMC10403620
Competing interests
N.D. had an advisory role at GlaxoSmithKline (GSK) and was awarded a GSK Consumer Healthcare (GSKCH) research grant, which provided funding for this study. ND has also lectured for Oral-B. S.T. is a GSK Global Health Consultant. J.P., N.G., A.P., M.T. and M.C.M. do not report any competing interest.
PMC10403620
References
PMC10403620
1. Introduction
non-communicable chronic diseases, Diabetes, T2DM, diabetes
DYSLIPIDEMIA, INSULIN RESISTANCE, DIABETES, TYPE 2 DIABETES, TYPE 2 DIABETES MELLITUS, DIABETES
These authors contributed equally to this work.(1) Background: We investigated the effects of a 12-week exercise intervention with or without vitamin D supplementation on insulin resistance and the plasma lipidome of participants with type 2 diabetes. We further explored whether the effects of the intervention on glyce...
PMC10346630
2. Methods
PMC10346630
2.1. Study Design and Population
fracture, T2DM, hypoglycemic
ACUTE INFECTION, OSTEOPOROSIS, RENAL INSUFFICIENCY
The study was a randomized controlled trial with a 12-week intervention and additional 12-week follow-up period assessing the impact of vitamin D and exercise intervention on glycemic improvement in participants diagnosed with T2DM without insulin treatment in Xi’an, China (34° N latitude). Participants were excluded i...
PMC10346630
2.2. Intervention
PMC10346630
2.2.1. Vitamin D Intervention
Participants in the EX + VD and VD groups took a daily vitamin D
PMC10346630
2.2.2. Exercise Intervention
Participants in the EX and EX + VD groups participated in a supervised 1-h progressively increasing endurance cycling exercise at 65–80% of maximal heart rate (HRmax), 2 to 3 times/week, for 12 weeks at a gym. HRmax was predicted using the following formula: HRmax = (220 − age) [Flow diagram of participants (
PMC10346630
2.3. Data Collection
PMC10346630
2.3.1. Anthropometric Measurements and Questionnaires
Body mass index (BMI) was calculated as body mass in kilograms divided by height in meters squared (kg/mPhysical activity information was obtained using the long form of the International Physical Activity Questionnaire (IPAQ), except for when participants were attending the exercise program. Metabolic equivalent task ...
PMC10346630
2.3.2. Glycemic Control Indicators
AutoSep, Venous fasting blood samples, high-density lipoprotein cholesterol
Venous fasting blood samples were collected at baseline (t1), 12 weeks (t2), and the 12-week follow-up (t3) after a 12-h overnight fast in Venoject-II AutoSep tubes with serum or NaF for plasma. Tubes with EDTA were used to determine blood glycosylated hemoglobin (HbA1c). Serum and plasma samples were transferred to se...
PMC10346630
2.3.3. Plasma Lipidomic Profiling
COLD
Venous plasma samples collected at three time points (t1–t3) were used for lipidomics analysis using ultra-high-performance liquid chromatography–mass spectrometry (UPLC-MS/MS). The order of the plasma samples was randomized prior to extraction and instrumental analyses to minimize the influence of signal fluctuations....
PMC10346630
2.4. Statistical Analysis
All statistical analyses were conducted using R 4.0.4 or SPSS 24.0. Descriptive statistics were calculated using mean ± standard deviation for continuous variables, Comprehensive changes in lipid profiles in response to different interventions were captured using the fuzzy c-means clustering algorithm (R package “Mfuzz...
PMC10346630
3. Results
PMC10346630
3.1. Baseline Characteristics of Participants
One participant in the VD group and another in the EX + VD group withdrew from the study due to personal reasons during the intervention. Additionally, 11 participants were lost to follow-up at t3. See more details in
PMC10346630
3.2. Effects of Exercise and Vitamin D on Serum 25(OH)D Concentrations and Glycemic Control Indicators
Serum 25(OH)D concentrations were significantly increased in the EX + VD and VD groups, but they were not altered in the EX and Con groups (During the OGTT, compared with basal values, the levels of fasting glucose were relatively lower at five time points after EX + VD, VD, and EX interventions for 12 weeks. Opposite ...
PMC10346630
3.3. Effects of Exercise and Vitamin D on Plasma Lipidome
INSULIN RESISTANCE
A total of 1774 lipid features were identified and quantified, among which 1315 were annotated, including TGs (Among the lipid features, levels of 21 were increased by both VD and EX + VD interventions, while those of 7 were decreased (Mean ± standard deviation (SD) of blood parameters from baseline (0-week) for each g...
PMC10346630
3.4. Individual Responses to Interventions Improving Glycemic Control and Baseline Prediction
T2DM
There was high inter-individual variability in multiple glycemic parameters in response to the interventions, which might have contributed to the lack of benefit of the VD and EX interventions and their combination on glycemic control, i.e., HOMA-IR in participants with T2DM (We conducted comprehensive machine learning...
PMC10346630
4. Discussion
T2DM
ADVERSE EVENTS, HYPERGLYCEMIA, DISEASE, DIABETIC COMPLICATIONS
In this randomized placebo-controlled trial, the overall beneficial effects of a 12-week endurance exercise training program with and without VD intervention on fasting glucose in participants with T2DM were observed, accompanied by notable alterations in the plasma lipidome. Although VD intervention failed to provide ...
PMC10346630
5. Conclusions
T2DM
Although vitamin D supplementation failed to provide an additive effect beyond exercise on glucose homeostasis, we observed a regulatory effect of exercise combined with vitamin D intervention on the plasma lipidome. Such effects lasted until the 12-week follow-up in the EX + VD group, but this was not the case for the...
PMC10346630
Supplementary Materials
The following supporting information can be downloaded at: Click here for additional data file.
PMC10346630
Author Contributions
Research concept and design was created by X.S., L.S. and Y.W. Data screening and analysis were conducted by T.Y., Z.L. and S.Z. The manuscript was drafted and revised by X.S., L.S. and T.Y., and was critically revised by W.P., W.C., J.X. and Z.-B.C. Y.W. secured administration and financial support for the study. All ...
PMC10346630
Institutional Review Board Statement
All of the procedures were reviewed and approved by the Ethics Committee of Xi’an Jiaotong University Health Science Center. The study was conducted in accordance with the Declaration of Helsinki and registered in the Chinese Clinical Trial System (No. ChiCTR1800015383).
PMC10346630
Informed Consent Statement
Not applicable.
PMC10346630
Data Availability Statement
The data used in this study are not publicly available due to ethical reasons; the corresponding author can provide further information on these data upon reasonable request.
PMC10346630
Conflicts of Interest
The authors declare that they have no competing interests.
PMC10346630
References
PMC10346630
Background
PJIs
Edited by: Marie Hallin, Université libre de Bruxelles, BelgiumReviewed by: Youliang Ren, University of Rochester Medical Center, United StatesChaitanya Tellapragada, Karolinska Institutet (KI), Sweden†These authors have contributed equally to this workMetagenomic next-generation sequencing (mNGS) is a culture-independ...
PMC10808557
Methods
PJI
JOINT INFECTION
We performed a prospective trial among patients who undergone hip or knee surgery due to periprosthetic joint infection (PJI) to compare the positivity rate of culture and mNGS between cases with and without previous antimicrobial therapy, and the positivity rates between cases with different antimicrobial-free interva...
PMC10808557
Results
PJIs
Among 131 included PJIs, 91 (69.5%) had positive cultures and 115 (87.8%) had positive mNGS results. There was no significant difference in the positivity rate of deep-tissue culture and synovial fluid mNGS between cases with and without previous antimicrobial therapy. The positivity rate of synovial fluid culture was ...
PMC10808557
Conclusion
PJIs
mNGS is more advantageous than culture with a higher pathogen detection rate. However, our data suggested that antimicrobial agents may need to be discontinued more than 3 days before sampling to further increase the positivity rate of mNGS for PJIs.
PMC10808557
Introduction
Periprosthetic joint infection, PJI, TJA
COMPLICATIONS
Periprosthetic joint infection (PJI) is one of the most serious complications following total joint arthroplasty (TJA) (Metagenomic next-generation sequencing (mNGS) is a culture-independent, massively parallel DNA sequencing technology that has been widely used for rapid aetiological diagnosis with significantly high ...
PMC10808557
Materials and methods
PMC10808557
Study population
infection, PJI, Musculoskeletal Infection
INFECTION
The present study was a prospective, single-centre clinical trial conducted in accordance with the World Medical Association Declaration of Helsinki and approved by the Ethics Committee of Honghui Hospital Affiliated to Xi’an Jiao Tong University. Written informed consent was obtained from all subjects. Patients with s...
PMC10808557
Sampling
STERILE
Synovial fluid and deep tissue were obtained at the time of surgery. Synovial fluid was collected in a sterile manner using an 18-gauge needle prior to arthrotomy, and samples were immediately divided into aerobic and anaerobic blood culture bottles (BACTEC 9240 system; BD Diagnostic Systems) for microbiology, a steril...
PMC10808557
Culture
ADVERSE EFFECT, POSITIVE
Deep tissue samples were homogenised and routine cultures, including aerobic and anaerobic bacterial cultures, fungal cultures and acid-fast bacilli cultures, were performed simultaneously. For synovial fluid culture, blood culture bottles were incubated on the BD-BACTEC-9240 instrument (BD Diagnostic Systems) for a to...
PMC10808557
mNGS detection
The workflow for mNGS in synovial fluid included sample preparation, nucleic acid extraction, DNA library construction, metagenomic sequencing and bioinformatic analysis. Full details are available in
PMC10808557
Data and statistical analysis
infection, PJI
CHRONIC INFECTIONS, INFECTION, POSITIVE
Patients with PJI were divided into acute and chronic infections according to the duration of infection, as described by To assess the concordance of microbiological results between positive culture and positive mNGS, categorisation was determined as follows: (i) complete concordance: identical organism detected, (ii) ...
PMC10808557
Results
PMC10808557
General characteristics
aseptic failure, PJIs, PJI, Periprosthetic joint infection
Of the 167 screened cases with suspected hip or knee PJI, 36 cases were excluded due to aseptic failure (n=14), no culture or mNGS testing of synovial fluid (n=10), cement spacers in place at the time of sampling (n=6), unknown antimicrobial-free interval (n=5), and contamination in the operating room (n=1). The remain...
PMC10808557
Diagnostic performance of non- and microbiologic tests
PJIs
The positivity rates of all non-microbiological and microbiological diagnostic tests are shown in Positivity rates of non- and microbiologic tests.The results are shown as numbers of cases (percentages). CRP, C-reactive protein; ESR, Erythrocyte sedimentation rate; PMN, Polymorphonuclear neutrophil. SF, Synovial fluid;...
PMC10808557
Influence of previous antimicrobial therapy on microbial results
acute infection, PJIs, chronic infection (N=75).In, infection
ACUTE INFECTIONS, INFECTION, CHRONIC INFECTIONS, ACUTE INFECTION
In the group with prior antimicrobial therapy, the positivity rate of mNGS was 88.2% (67 of 76), which was significantly higher than that of all cultures in all courses (synovial fluid and deep tissue) (58 of 76 [76.3%], p=0.004). In the group without prior antimicrobial therapy, the positivity rate of mNGS was 87.3% (...
PMC10808557
Influence of different antimicrobial-free intervals on microbial results
Comparison of the positivity rate of deep tissue culture (≥1 positive culture), synovial fluid culture and mNGS during different antimicrobial-free intervals is shown in Positivity rate of microbiologic tests according to no. of days before surgery when antimicrobial therapy was discontinued. SF, Synovial fluid; DT, De...
PMC10808557
Concordance of microbial results
PJIs, PJI
JOINT INFECTION
The pathogens based on their frequency of isolation by culture and detection by mNGS are shown in Correspondence between culture growth and the pathogen detected by mNGS.*The values are given as the detected frequency of a corresponding pathogen in all specimens. mNGS, Metagenomic next-generation sequencing.Including I...
PMC10808557
Comparison of the cost and turnaround time between culture and mNGS
±
From sampling to reporting, the average days required for mNGS were 1.2 ± 0.4 and the average cost was 3234.6 ± 9.8 CNY. Meanwhile, the average turnaround time for culture results was 5.1 ± 2.6 days and the average cost was 696.8 ± 87.3 CNY. The turnaround time for obtaining the results of mNGS was significantly shorte...
PMC10808557
Discussion
PJIs, PJI, infections
INFECTIONS, COMPLICATION
PJI is a catastrophic complication following knee or hip arthroplasty, and microbial culture is considered the gold standard for pathogen identification and diagnosis. However, due to preoperative antimicrobial therapy, the presence of biofilms and fastidious bacteria, the positivity rate has been low (A total of 131 P...
PMC10808557
Conclusion
PJI
In conclusion, mNGS had a significantly higher positivity rate than culture in detecting PJI, suggesting that mNGS may be a promising tool for rapid aetiological diagnosis of PJI, especially in PJI patients with a negative culture result or history of antibiotic administration. However, our data suggest that antimicrob...
PMC10808557
Data availability statement
The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below:
PMC10808557
Ethics statement
The studies involving humans were approved by the Ethics Committee of Honghui Hospital Affiliated to Xi’an Jiao Tong University. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.
PMC10808557
Author contributions
HL
LH: Data curation, Funding acquisition, Project administration, Writing – original draft, Writing – review & editing. WB: Writing – review & editing. ZQ: Writing – review & editing. TM: Writing – review & editing. PX: Project administration, Supervision, Writing – review & editing. HL: Project administration, Supervisi...
PMC10808557
Conflict of interest
The 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.
PMC10808557
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or ...
PMC10808557
Supplementary material
The Supplementary Material for this article can be found online at: Click here for additional data file.Click here for additional data file.Click here for additional data file.
PMC10808557
References
PMC10808557
Background
Academic Editor: Adam Kern This study explored the efficacy of the “
PMC10049845
Methods and Results
Of 99 patients with true bifurcation lesions, 38 patients underwent the “
PMC10049845
Conclusions
The “
PMC10049845
1. Introduction
Coronary bifurcation lesions
Coronary bifurcation lesions account for about 15%–20% of total PCI [
PMC10049845
2. Methods
PMC10049845
2.1. Study Population
This study complied with the Helsinki Declaration and was approved by the institutional ethics committee of Fuwai Central China Cardiovascular Hospital, Zhengzhou University (Zhengzhou, China). All participants in the study provided written informed consent. This trial has been registered on the ClinicalTrials website ...
PMC10049845
2.2. PCI Procedure
stenosis
STENOSIS
A radial artery approach was used in all patients. All stents were second-generationdrug-eluting stents and all the DCBs were SeQuent® Please (B. Braun, Melsungen, Germany). The size of semicompliant balloon, noncompliant (NC) balloon, cutting balloon, DCB, and stent was determined by the operator. The DCB was inflated...
PMC10049845
2.3. Technical Details
In group In group In group After percutaneous coronary intervention (PCI), all patients received dual antiplatelet therapy (DAPT) for at least 6 months. Secondary prevention medications were prescribed according to current guidelines and patient tolerance.
PMC10049845
2.4. Followup
Clinical followup was performed by office visit or telephone at 30 days and every 3 months after discharge. Patients were advised to return for coronary angiography at 6 months ± 14 days.
PMC10049845
2.5. Study Outcomes
acute gain, restenosis, MLD
ACUTE MYOCARDIAL INFARCTION, CARDIAC DEATH, SECONDARY, MLD, CARDIAC EVENTS, RESTENOSIS
The primary outcome was late lumen loss (LLL) of the MV and SB. The secondary outcomes were minimum lumen diameter (MLD) and acute gain and restenosis. In this study, we divided the SB into two parts for separate analysis. These parts were the “ostium,” which is about 3–5 mm from the beginning of the SB and the “shaft,...
PMC10049845
2.6. Quantitative Coronary Analysis (QCA)
restenosis, stenosis
RESTENOSIS, STENOSIS
QCA was analyzed using Cardiovascular Angiographic Analysis System (CAAS) II software version 5.0 (Pie Medical Imaging, Maastricht, the Netherlands). Analysis was performed by two cardiologists separately. At followup, restenosis was defined as a QCA diameter stenosis ≥50%. The analysis was performed independently by t...
PMC10049845
2.7. Statistical Analysis
Baseline characteristics are reported as counts and percentages or mean ± standard deviation (SD). The chi-square test was used to compare categorical variables. Comparison of means between multiple groups was performed using analysis of variance (one-way ANOVA) followed by Bonferroni's posthoc tests. All statistical a...
PMC10049845
3. Results
PMC10049845
3.1. Baseline and Procedural Characteristics
A total of 99 patients were recruited and randomized, resulting in 33 in group Procedural characteristics are shown in
PMC10049845
3.2. Clinical Outcomes
Two patients in group
PMC10049845
3.3. Angiography Followup
Followup angiography after 6 months was performed in 82.83% (82/99) of patients (
PMC10049845
4. Discussion
stenosis
STENOSIS, PLAQUE
This study evaluated the clinical and angiographic outcomes of a new strategy we proposed to deal with the true coronary bifurcation lesions. The major findings were: (1) the “Mainstream strategies have their pros and cons. The two-stent strategy can solve the stenosis of the SB ostium caused by plaque shift and carina...
PMC10049845
4.1. Study Limitations
This study was a single-center study with a small sample size, which reduces the generalizability of the results. The next step is to perform a multi-center randomized controlled study to provide more evidence of the feasibility of this technique. Intracoronary imaging (intravascular ultrasound or optical coherence tom...
PMC10049845
5. Conclusion
The “
PMC10049845
Acknowledgments
The authors thanked Editage for language correction support. This work was supported by the Natural Science Foundation of Henan Province (Grant no. 202300410465), 23456 Talent Project of Henan Provincial People's Hospital (Grant no. ZC23456132), and Henan Province Medical Science and Technology Research, Provincial and...
PMC10049845
Data Availability
The data used to support the findings of this study are available from the corresponding author upon request.
PMC10049845
Ethical Approval
This study was approved by the institutional ethics committee of Fuwai Central China Cardiovascular Hospital, Zhengzhou University (Zhengzhou, China) (No. 2021 [08]).
PMC10049845
Conflicts of Interest
The authors declare that they have no conflicts of interest.
PMC10049845
Supplementary Materials
SD
AMI, ACUTE MYOCARDIAL INFARCTION
Supplementary Figure 1: step-by-step diagram of the “Click here for additional data file.Research flow chart diagram.Panel (a) is a pattern diagram of a true bifurcation lesion, with measurement points marked. Panel (b) represents the “Statistically significant compared to the “Clinical baseline characteristics of grou...
PMC10049845
Abstract
PMC9939163
Background
esophageal cancer
ESOPHAGEAL CANCER, OESOPHAGEAL CANCER
The treatment of most esophageal cancer patients includes chemo(radio)therapy and extensive surgery, causing physical decline with loss of muscles. This trial aimed to test the hypothesis that a tailored home‐based physical activity (PA) intervention improves muscle strength and mass in patients having undergone curati...
PMC9939163
Methods
esophageal cancer, muscle mass
OESOPHAGEAL CANCER
Patients operated for esophageal cancer 1 year earlier were included in a nationwide randomized controlled trial in Sweden in 2016–2020. The intervention group was randomized to a 12‐week home‐based exercise program, while the control group was encouraged to maintain routine daily PA. The primary outcomes were changes ...
PMC9939163
Results
Among 161 randomized patients, 134 completed the study, 64 in the intervention group and 70 in the control group. Compared with the control group (MD 2.73; 95% CI 1.75–3.71), patients in the intervention group (MD 4.48; 95% CI 3.18–5.80) had statistically significantly (
PMC9939163
Conclusion
esophageal cancer, lower extremity muscle, lower extremity muscle strength
OESOPHAGEAL CANCER
A home‐based PA intervention 1 year after surgery for esophageal cancer improves lower extremity muscle strength.Patients operated for esophageal cancer 12 months earlier benefited from a home‐based physical activity exercise program. The 12‐week, home‐based exercise program with resistance training showed an improveme...
PMC9939163
INTRODUCTION
Esophageal cancer
ESOPHAGEAL CANCER, DISEASE
Esophageal cancer is a debilitating disease with poor overall survival.
PMC9939163
METHODS
PMC9939163
Study design and participants
Cancer
CANCER
The Physical Activity (PA) study was a Swedish nationwide, two‐armed, multi‐centre randomized controlled trial (RCT) with 1:1 allocation during the study period 2016–2020. Ethical approval was obtained from the Regional Ethical Review Board in Stockholm, Sweden (Dnrs:2015/2142–32; 2016/1696–32/1; 2018/1447–32) and the ...
PMC9939163
Randomization
All patients were provided oral and written information about the study at a visit by a research nurse and those who agreed to participate provided consent. The randomization procedure (block randomization) was conducted by an external organization outside the research group (Karolinska Trial Alliance, KTA) to avoid se...
PMC9939163
Intervention versus standard care
esophageal cancer
OESOPHAGEAL CANCER
The intervention consisted of a 12‐week, home‐based exercise training based on previous data.Tailored home‐based strength training for long‐term survivors of esophageal cancer who underwent surgical resection
PMC9939163
Compliance
The intervention group were followed up weekly by telephone by the research dietician/nurse to encourage adherence to the intervention. They were asked to report if during the past week they had performed the exercises as per the instructions received from the research nurse with the alternatives: (1) Yes, completely (...
PMC9939163
Measurements
muscle mass, hand dynamometer
SECONDARY
All measures of muscle strength and muscle mass were assessed objectively by the research dietician/nurse during the home visit both before randomization (baseline) and approximately 12 weeks after randomization.Muscle strength was assessed using two separate tests, one for hand grip strength and another for lower extr...
PMC9939163
Clinical data
tumor
TUMOR
For all included patients, copies of relevant medical records were retrieved from the hospitals, that is, predominantly from the seven university hospitals to provide additional clinical details about the tumor and treatment. These records were assessed according to a detailed predefined study protocol to ensure unifor...
PMC9939163
Sample size
muscle mass
The sample size was determined by the power calculations for the muscle strength and mass. Using one‐sided test and alpha at 0.05, sampling ratio 1, superiority margin of 0.001, to test the superiority of the intervention, 160 patients (80 patients per group after adjusting for 5% drop‐outs) were required for 80% power...
PMC9939163