77 research outputs found
FIRST experiment: Fragmentation of Ions Relevant for Space and Therapy
Nuclear fragmentation processes are relevant in different fields of basic research and applied physics and are of particular interest for tumor therapy and for space radiation protection applications. The FIRST (Fragmentation of Ions Relevant for Space and Therapy) experiment at SIS accelerator of GSI laboratory in Darmstadt, has been designed for the measurement of different ions fragmentation cross sections at different energies between 100 and 1000 MeV/nucleon. The experiment is performed by an international collaboration made of institutions from Germany, France, Italy and Spain. The experimental apparatus is partly based on an already existing setup made of the ALADIN magnet, the MUSIC IV TPC, the LAND2 neutron detector and the TOFWALL scintillator TOF system, integrated with newly designed detectors in the interaction Region (IR) around the carbon removable target: a scintillator Start Counter, a Beam Monitor drift chamber, a silicon Vertex Detector and a Proton Tagger for detection of light fragments emitted at large angles (KENTROS). The scientific program of the FIRST experiment started on summer 2011 with the study of the 400 MeV/nucleon 12C beam fragmentation on thin (8mm) carbon targe
Quasi-elastic processes of the 48Ca + 120Sn system and the 48Ca nuclear matter density
Under the terms of the Creative Commons Attribution License 3.0 (CC-BY).-- et al.We present the results of a high-precision quasi-elastic excitation function measurement for the 48Ca + 120Sn system at ΞLAB = 160 at near-barrier energies in steps of 1.0 MeV. The corresponding quasi-elastic barrier distribution is derived. A large-scale coupled-channel calculation was performed to investigate the role of several reaction channels in the reaction mechanism. An excellent agreement between theory and data was obtained for the barrier distribution. The first quadrupole vibrations of the 48Ca and 120Sn, the 2n, and the 4He transfers have a strong influence on the reaction mechanism and are responsible for the good agreement achieved. The 1n transfer has a minor importance in the result when compared with the 2n transfer, which suggests that the pairing correlation might play an important role in the 2n-neutron transfer process. However, if the octupole vibration of the projectile is included in the coupling scheme, the agreement with the data gets worse. The comparison of the coupled-channel calculations with experimental data leads to the conclusion that the nuclear matter diffuseness of the 48Ca nucleus is 0.56 fm in agreement with most of the double-magic nuclei. © 2013 American Physical Society.The authors acknowledge the financial support of Fundaçùo de Amparo Ă Pesquisa do Estado de SĂąo Paulo (FAPESPBrazil), Fundaçùo de Amparo Ă Pesquisa do Estado do Rio de Janeiro (FAPERJ-Brazil), Conselho Nacional de Desenvolvimento CientĂfico e TecnolĂłgico (CNPq-Brazil), The Pronex (Brazil), and the European Community FP7âCapacities-Integrated Infrastructure InitiativeâContract No. ENSAR 262010.Peer Reviewe
Performance of upstream interaction region detectors for the FIRST experiment at GSI
The FIRST (Fragmentation of Ions Relevant for Space and Therapy) experiment at GSI has been designed to study carbon fragmentation, measuring 12C double differential cross sections (â2Ï/ âΞâE) for different beam energies between 100 and 1000 MeV/u. The experimental setup integrates newly designed detectors in the, so called, Interaction Region around the graphite target. The Interaction Region upstream detectors are a 250 ÎŒm thick scintillator and a drift chamber optimized for a precise measurement of the ions interaction time and position on the target. In this article we review the design of the upstream detectors along with the preliminary results of the data taking performed on August 2011 with 400 MeV/u fully stripped carbon ion beam at GSI. Detectors performances will be reviewed and compared to those obtained during preliminary tests, performed with 500 MeV electrons (at the BTF facility in the INFN Frascati Laboratories) and 80 MeV/u protons and carbon ions (at the INFN LNS Laboratories in Catania)
Measurement of fragmentation cross sections of 12C ions on a thin gold target with the FIRST apparatus
A detailed knowledge of the light ions interaction processes with matter is of great interest in basic and
applied physics. As an example, particle therapy and space radioprotection require highly accurate fragmentation
cross-section measurements to develop shielding materials and estimate acute and late health risks for manned
missions in space and for treatment planning in particle therapy. The Fragmentation of Ions Relevant for Space
and Therapy experiment at the Helmholtz Center for Heavy Ion research (GSI) was designed and built by
an international collaboration from France, Germany, Italy, and Spain for studying the collisions of a 12C ion
beam with thin targets. The collaborationâs main purpose is to provide the double-differential cross-section
measurement of carbon-ion fragmentation at energies that are relevant for both tumor therapy and space radiation
protection applications. Fragmentation cross sections of light ions impinging on a wide range of thin targets are
also essential to validate the nuclear models implemented inMC simulations that, in such an energy range, fail to
reproduce the data with the required accuracy. This paper presents the single differential carbon-ion fragmentation
cross sections on a thin gold target, measured as a function of the fragment angle and kinetic energy in the forward angular region (Ξ 6âŠ), aiming to provide useful data for the benchmarking of the simulation softwares used in
light ions fragmentation applications. The 12C ions used in the measurement were accelerated at the energy of
400 MeV/nucleon by the SIS (heavy ion synchrotron) GSI facility.Comunidad Europea FP7 PITNGA-2008-215840-PARTNERJunta de AndalucĂa y Ministerio de Ciencia e InnovaciĂłn P07-FQM-02894 FIS2008-04189 FPA2008- 04972-C0
Precise measurement of near-barrier He 8 + Pb 208 elastic scattering: Comparison with He 6
et al.Dramatic differences in the elastic scattering of the neutron rich nuclei He6 and He8 are found when new high quality data for the He8+Pb208 system are compared with previously published He6+Pb208 data at the same laboratory frame incident energy. The new He8 data are of the same level of detail as for stable beams. When comparing them with those previously obtained for He6+Pb208 at the same energy, it is possible to determine from the data alone that He6 has a much longer range absorption than He8. However, both nuclei show significant absorption beyond their strong absorption radii. While it has been known for a long time that elastic scattering at energies around the barrier only determines the optical potential over a small distance in radial space, typically ±0.5 fm or so, both the He6 and the He8 imaginary potentials obtained from various optical model fits to these data are the same over a much wider range of ±1.5 fm. ©2016 American Physical SocietyThis work was supported in part by Grant No. FPA2010-22131-
C02-01 (FINURA) and Grant No. FPA2013-47327-C2-1-R
from the Spanish Ministry of Economy and Competitiveness,
UNAM-PAPIIT IA101616 (Mexico), Grant No. N202 033637 from the Ministry of Science and Higher Education of Poland, and Contract No. EUI2009-04163 (EUROGENESIS) from the
European Science Foundation.Peer Reviewe
ĐĐ”ŃĐ°-Đ°ĐœĐ°Đ»ĐžĐ· ĐžŃŃĐ»Đ”ĐŽĐŸĐČĐ°ĐœĐžĐč ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸŃŃĐž ĐŽĐŸĐ±Đ°ĐČĐ»Đ”ĐœĐžŃ Đ°ĐœŃĐž-PD1 Đ°ĐœŃĐžŃДл Đș Ń ĐžĐŒĐžĐŸŃĐ”ŃапОО пДŃĐČĐŸĐč Đ»ĐžĐœĐžĐž ŃĐ°ŃĐżŃĐŸŃŃŃĐ°ĐœŃĐœĐœĐŸĐłĐŸ ŃĐ°ĐșĐ° пОŃĐ”ĐČĐŸĐŽĐ°
Introduction: The results of six randomized control trials have been published by 2022, which evaluated the efficacy of adding PD-1 inhibitors to the first-line chemotherapy in patients with metastatic esophageal cancer. However, it still remains unclear which patients derive the most clinical benefit from combined therapy. Therefore, it is necessary to evaluate the efficacy of the combination of anti-PD1 treatment with chemotherapy in different patient subgroups.Materials and methods: We conducted a meta-analysis of randomized controlled trials in patients with stage IV esophageal cancer who received anti-PD1 drugs with different chemotherapeutic regimens in the first-line setting to select patients who benefit the most from the combined therapy.Results: Six randomized trials were included in the analysis for a total of 3,813 patients. Patients who received combination therapy had significantly longer OS (HR = 0.69, 95% CI: 0.63-0.75; p < 0.001), PFS (HR = 0.62, 95% CI: 0.56-0.69; p < 0.001), and better ORR (OR = 2.12, 95% CI: 1.85-2.42; p < 0.001) than those who received chemotherapy alone. Subgroup analyses showed no benefit of adding PD1-inhibitors to chemotherapy in patients with PD-L1 CPS <1 in terms of OS (HR = 0.58, 95 % CI: 0.31-1.1; p = 0.1) as well as in never-smokers (HR = 0.9, 95% CI: 0.67-1.23; p = 0.52).Conclusions: The addition of PD-1 inhibitors to the first-line chemotherapy in patients with metastatic esophageal cancer significantly improves treatment outcomes. Our results could not strongly suggest the selected patients' cohort which would benefit the most from the combination of PD-1 inhibitors and chemotherapy use.Đ 2022 ĐłĐŸĐŽŃ ĐŸĐżŃблОĐșĐŸĐČĐ°ĐœŃ ŃДзŃĐ»ŃŃĐ°ŃŃ 6 ŃĐ°ĐœĐŽĐŸĐŒĐžĐ·ĐžŃĐŸĐČĐ°ĐœĐœŃŃ
ĐžŃŃĐ»Đ”ĐŽĐŸĐČĐ°ĐœĐžĐč III ŃĐ°Đ·Ń, ĐșĐŸŃĐŸŃŃĐ” ĐżĐŸŃĐČŃŃĐ”ĐœŃ ĐžĐ·ŃŃĐ”ĐœĐžŃ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸŃŃĐž Đ°ĐœŃĐž-PD1 Đ°ĐœŃĐžŃДл ĐżŃĐž ĐŽĐŸĐ±Đ°ĐČĐ»Đ”ĐœĐžĐž Đș Ń
ĐžĐŒĐžĐŸŃĐ”ŃапОО пДŃĐČĐŸĐč Đ»ĐžĐœĐžĐž ĐżŃĐž ŃĐ°ŃĐżŃĐŸŃŃŃĐ°ĐœŃĐœĐœĐŸĐŒ ŃĐ°ĐșĐ” пОŃĐ”ĐČĐŸĐŽĐ°. ĐŃĐž ŃŃĐŸĐŒ ĐŸŃŃŃŃŃŃĐČŃĐ”Ń ŃĐ”ŃĐșĐžĐč ĐżĐŸŃŃŃĐ”Ń ĐżĐ°ŃĐžĐ”ĐœŃĐ°, Ń ĐșĐŸŃĐŸŃĐŸĐłĐŸ Ń
ĐžĐŒĐžĐŸ-ĐžĐŒĐŒŃĐœĐŸŃĐ”ŃĐ°ĐżĐžŃ Đ±ŃĐŽĐ”Ń ĐœĐ°ĐžĐ±ĐŸĐ»Đ”Đ” ŃŃŃĐ”ĐșŃĐžĐČĐœĐ°. Đ ŃĐČŃĐ·Đž Ń ŃŃĐžĐŒ ĐżŃĐŸĐČĐ”ĐŽĐ”ĐœĐžĐ” ĐŒĐ”ŃĐ°-Đ°ĐœĐ°Đ»ĐžĐ·Đ° ĐżĐŸ ОзŃŃĐ”ĐœĐžŃ ŃŃŃĐ”ĐșŃĐžĐČĐœĐŸŃŃĐž ĐșĐŸĐŒĐ±ĐžĐœĐžŃĐŸĐČĐ°ĐœĐœĐŸĐłĐŸ ĐżĐŸĐŽŃ
ĐŸĐŽĐ° ĐČ ĐŸŃЎДлŃĐœŃŃ
ĐżĐŸĐŽĐłŃŃппаŃ
паŃĐžĐ”ĐœŃĐŸĐČ ĐżŃĐž ŃĐŸĐČĐŸĐșŃĐżĐœĐŸĐŒ Đ°ĐœĐ°Đ»ĐžĐ·Đ” ĐœĐ”ŃĐșĐŸĐ»ŃĐșĐžŃ
ĐžŃŃĐ»Đ”ĐŽĐŸĐČĐ°ĐœĐžĐč ĐżĐŸĐŒĐŸĐ¶Đ”Ń ĐžĐ·ĐŒĐ”ĐœĐžŃŃ ĐșĐ»ĐžĐœĐžŃĐ”ŃĐșОД ŃĐ”ĐșĐŸĐŒĐ”ĐœĐŽĐ°ŃОО.ĐĐ°ŃĐ”ŃĐžĐ°Đ»Ń Đž ĐŒĐ”ŃĐŸĐŽŃ: ĐĐ°ĐŒĐž ĐżŃĐŸĐČĐ”ĐŽĐ”Đœ ĐŒĐ”ŃĐ°-Đ°ĐœĐ°Đ»ĐžĐ· ĐžŃŃĐ»Đ”ĐŽĐŸĐČĐ°ĐœĐžĐč ĐșĐŸĐŒĐ±ĐžĐœĐ°ŃĐžĐč ŃазлОŃĐœŃŃ
Đ°ĐœŃĐž-PD1 Đ°ĐœŃĐžŃДл Đž Ń
ĐžĐŒĐžĐŸŃĐ”ŃапДĐČŃĐžŃĐ”ŃĐșĐžŃ
ŃĐ”Đ¶ĐžĐŒĐŸĐČ ĐČ ĐżĐ”ŃĐČĐŸĐč Đ»ĐžĐœĐžĐž Ń Đ±ĐŸĐ»ŃĐœŃŃ
ŃĐ°ŃĐżŃĐŸŃŃŃĐ°ĐœŃĐœĐœŃĐŒ ŃĐ°ĐșĐŸĐŒ пОŃĐ”ĐČĐŸĐŽĐ° Ń ŃДлŃŃ ĐžĐŽĐ”ĐœŃĐžŃĐžĐșĐ°ŃОО ĐŸŃЎДлŃĐœŃŃ
ĐșĐ»ĐžĐœĐžŃĐ”ŃĐșĐžŃ
ĐłŃŃпп Ń ĐŒĐ°ĐșŃĐžĐŒĐ°Đ»ŃĐœŃĐŒ ĐČŃОгŃŃŃĐ”ĐŒ ĐŸŃ ĐżŃĐžĐŒĐ”ĐœĐ”ĐœĐžŃ ĐșĐŸĐŒĐ±ĐžĐœĐ°ŃОО.РДзŃĐ»ŃŃĐ°ŃŃ: Đ ĐŒĐ”ŃĐ°-Đ°ĐœĐ°Đ»ĐžĐ· бŃлО ĐČĐșĐ»ŃŃĐ”ĐœŃ ĐŽĐ°ĐœĐœŃĐ” 6 ŃĐ°ĐœĐŽĐŸĐŒĐžĐ·ĐžŃĐŸĐČĐ°ĐœĐœŃŃ
ĐžŃŃĐ»Đ”ĐŽĐŸĐČĐ°ĐœĐžĐč, ĐČ ĐșĐŸŃĐŸŃŃŃ
ĐżŃĐžĐœŃлО ŃŃĐ°ŃŃОД 3813 паŃĐžĐ”ĐœŃĐŸĐČ. ĐŃŃĐČĐ»Đ”ĐœŃ ĐŽĐŸŃŃĐŸĐČĐ”ŃĐœŃĐ” ŃазлОŃĐžŃ ĐČ ĐŸĐ±ŃĐ”Đč ĐČŃжОĐČĐ°Đ”ĐŒĐŸŃŃĐž ĐČ ĐżĐŸĐ»ŃĐ·Ń Đ°ĐœŃĐž-PD1 Đ°ĐœŃĐžŃДл (ĐĐ 0,69, 95% ĐĐ 0,63-0,75; p < 0,001). ĐĐœĐ°Đ»ĐŸĐłĐžŃĐœĐŸ ĐČĐŸ ĐČŃĐ”Đč ĐłŃŃппД паŃĐžĐ”ĐœŃĐŸĐČ Đ·ĐœĐ°ŃĐžĐŒĐŸ ŃĐ»ŃŃŃалаŃŃ ĐČŃжОĐČĐ°Đ”ĐŒĐŸŃŃŃ Đ±Đ”Đ· ĐżŃĐŸĐłŃĐ”ŃŃĐžŃĐŸĐČĐ°ĐœĐžŃ (ĐĐ 0,62, 95 % ĐĐ 0,56-0,69; p < 0,001) Đž ŃĐČДлОŃĐžĐČĐ°Đ»ŃŃ ŃĐ°ĐœŃ ĐŽĐŸŃŃĐžĐ¶Đ”ĐœĐžŃ ĐŸĐ±ŃĐ”ĐșŃĐžĐČĐœĐŸĐłĐŸ ŃŃŃĐ”ĐșŃĐ° (ĐĐš 2,12, 95% ĐĐ 1,85-2,42; p < 0,001). ĐŃĐž ĐżĐŸĐŽĐłŃŃĐżĐżĐŸĐČŃŃ
Đ°ĐœĐ°Đ»ĐžĐ·Đ°Ń
ĐœĐ” ĐŸŃĐŒĐ”ŃĐ”ĐœĐŸ Đ·ĐœĐ°ŃĐžĐŒĐŸĐłĐŸ ĐČŃОгŃŃŃĐ° ĐČ ĐĐ ĐŸŃ ĐŽĐŸĐ±Đ°ĐČĐ»Đ”ĐœĐžĐž Đ°ĐœŃĐž-PD1 Đ°ĐœŃĐžŃДл Đș Ń
ĐžĐŒĐžĐŸŃĐ”ŃапОО ĐżŃĐž ŃĐșŃĐżŃĐ”ŃŃОО PD-L1 CPS < 1 (ĐĐ 0,58, 95% ĐĐ 0,31-1,1; p = 0,1), ĐżŃĐž ĐŸŃŃŃŃŃŃĐČОО ĐČ Đ°ĐœĐ°ĐŒĐœĐ”Đ·Đ” ŃĐ°ĐșŃĐ° ĐșŃŃĐ”ĐœĐžŃ (ĐĐ 0,9, 95% ĐĐ 0,67-1,23, p = 0,52).ĐŃĐČĐŸĐŽŃ: ĐĐŸĐ±Đ°ĐČĐ»Đ”ĐœĐžĐ” ĐžĐœĐłĐžĐ±ĐžŃĐŸŃĐŸĐČ ĐžĐŒĐŒŃĐœĐœŃŃ
ĐșĐŸĐœŃŃĐŸĐ»ŃĐœŃŃ
ŃĐŸŃĐ”Đș Đș Ń
ĐžĐŒĐžĐŸŃĐ”ŃапОО пДŃĐČĐŸĐč Đ»ĐžĐœĐžĐž Đ±ĐŸĐ»ŃĐœŃŃ
ŃĐ°ŃĐżŃĐŸŃŃŃĐ°ĐœŃĐœĐœŃĐŒ ŃĐ°ĐșĐŸĐŒ пОŃĐ”ĐČĐŸĐŽĐ° Đ·ĐœĐ°ŃĐžĐŒĐŸ ŃĐ»ŃŃŃĐ°Đ”Ń ŃДзŃĐ»ŃŃĐ°ŃŃ Đ»Đ”ŃĐ”ĐœĐžŃ. ĐĐŒĐ”ŃŃОДŃŃ ĐŽĐ°ĐœĐœŃĐ” ĐœĐ” ĐżĐŸĐ·ĐČĐŸĐ»ŃŃŃ ŃĐČĐ”ŃĐ”ĐœĐœĐŸ ĐČŃЎДлОŃŃ ĐżĐŸĐŽĐłŃŃĐżĐżŃ ĐżĐ°ŃĐžĐ”ĐœŃĐŸĐČ, ĐœĐ” ĐČŃОгŃŃĐČĐ°ŃŃŃŃ ĐŸŃ ĐżŃĐžĐŒĐ”ĐœĐ”ĐœĐžŃ Ń
ĐžĐŒĐžĐŸ-ĐžĐŒĐŒŃĐœĐŸŃĐ”ŃапОО.
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-Ï auto-Abs in children
We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2
Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020
- âŠ