Selection process for the new Editor-in-Chief of the International Brazilian Journal of Urology

Vol. 45 N. 03, 2019

Vol. 45 N. 03, 2019

Int Braz J Urol. Vol. 45 N. 03 – 2019 Download the PDF file . EDITORIAL IN THIS ISSUE 422 | The multiparametric prostate resonance imaging with the prostate imaging-reporting and data system (PI-RADS): the state of art of prostate cancer diagnosis Luciano Alves Favorito [view article] DIFFERENCE OF OPINION 424 | Radical prostatectomy for high-risk prostate cancer | Opinion: YES Leonardo O. Reis, Rodrigo Montenegro, Quoc-Dien Trinh [view article] 428 | Radical prostatectomy for high-risk prostate cancer | Opinion: NO Saum Ghodoussipour, Giovanni Enrico Cacciamani, Andre Luis de Castro Abreu [view article] REVIEW ARTICLE 435 | Identifying quality of life indicators to improve outpatient pharmacy services for prostate cancer patients: a comparison between Brazilian and British experiences Harindra Patel, Patricia Melo Aguiar, Adalberto Pessoa Jr., Silvia Storpirtis, Paul F. Long [view article]  ORIGINAL ARTICLE  449 | Second brazilian consensus on the treatment of advanced prostate cancer: a SBOC-SBU-SBRT panel review Andre Deeke Sasse, Rodolfo Borges dos Reis , Lucas Mendes Nogueira, Fernando Cotait Maluf, Daniel Herchenhorn, Oren Smaletz, Volney Soares Lima, Fabio Schutz, Diogo Bastos, Evanius Garcia Wiermann, Igor Alexandre Protzner Morbeck, Leonardo Fontes Jardim, Vinicius Carrera Souza, Icaro Thiago Carvalho, Elton Trigo Teixeira Leite, Archimedes Nardozza Jr., Antonio Carlos Lima Pompeo, Francisco Bretas, Marcos Lima de Oliveira Leal, Marcus Vinicius Sadi, Jose Ricardo Tuma da Ponte, Gustavo F. Carvalhal [view article] 459 | Enhancing PSMA-uptake with androgen deprivation therapy – a new way to detect prostate cancer metastases? Conrad Leitsmann, Paul Thelen, Marianne Schmid, Johannes Meller, Carsten-Oliver Sahlmann, Birgit Meller, Lutz Trojan, Arne Strauss [view article] 468 | Impact of time from biopsy to surgery on complications, functional and oncologic outcomes following radical prostatectomy Mary E. Westerman, Vidit Sharma, George C. Bailey, Stephen A. Boorjian, Igor Frank, Matthew T. Gettman, R. Houston Thompson, Matthew K. Tollefson, Robert Jeffrey Karnes [view article] 478 | A continuous fall of PSA use for prostate cancer screening among Brazilian doctors since 2001. Good or bad notice? Fernando Antonio Glasner da Rocha Araujo, Nairo Massakazu Sumita, Ubirajara de Oliveira Barroso Jr. [view article] 486 | Impact of PI-RADS v2 on indication of prostate biopsy George de Queiroz Rozas, Lucas Scatigno Saad, Homero Jose de Farias e Melo, Henrique Armando Azevedo Gabrielle, Jacob Szejnfeld [view article] 495 | Role of native Thiol, total Thiol and dynamic Disulphide in diagnosis of patient with prostate cancer and prostatitis Mehmet Solakhan, Hulya Cicek, Nuri Orhan, Mustafa Yildirim [view article] 503 | Limited significance of repeated long-term radiological and hormonal examination in nonfunctioning adrenal incidentalomas Masayuki Tasaki, Takashi Kasahara, Itsuhiro Takizawa, Kazuhide Saito, Tsutomu Nishiyama, Yoshihiko Tomita [view article] 514 | Predictors of complication after adrenalectomy Victor Srougi, João A. B. Barbosa, Isaac Massaud, Isadora P. Cavalcante, Fabio Y. Tanno, Madson Q. Almeida, Miguel Srougi, Maria C. Fragoso, José L. Chambô [view article] 523 | A higher circulating concentration of 25-hydroxyvitamin-D decreases the risk of renal cell carcinoma: a case-control study Fei Li, HongFan Zhao, Lina Hou, Fengsheng Ling, Yue Zhang, WanLong Tan [view article] 531 | Surgical treatment for renal masses in the elderly: analysis of oncological, surgical and functional outcomes Slawomir Poletajew, Piotr Zapała, Bartlomiej Kopczyński, Lukasz Białek, Sylwia Bender, Tomasz Mutrynowski, Mateusz Nowak, Julia Mroz, Grzegorz Pędzisz, Bartosz Dybowski, Piotr Radziszewski [view article] 541 | Prognostic significance of inflammation-based prognostic scoring in patients with...

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Challenging risk factors for right and left laparoscopic adrenalectomy: A single centre experience with 272 cases

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2019.0131 ORIGINAL ARTICLE Kadir Omur Gunseren 1, Mehmet Cagatay Cicek 1, Hakan Vuruskan 1, Yakup Kordan 2, Ismet Yavascaoglu 1 1 Department of Urology, Uludag University, School of Medicine, Nilufer, Bursa, Turkey; 2 Departmet of Urology, Koc University, School of Medicine, Nilufer, Bursa, Turkey ABSTRACT Purpose: This study aimed to compare perioperative and postoperative results of right and left laparoscopic adrenalectomy (LA), and to evaluate the impact of challenging factors on these outcomes. Materials and Methods: A total of 272 patient’s medical records that underwent single side LA between October 2006 and September 2017 were retrospectively reviewed. The patients were divided into 2 groups according to operation side. Moreover, pheochromocytoma, metastatic masses and adrenal lesions >5cm in size were considered to be difficult adrenalectomy cases and the outcomes of these cases were compared between two groups. Results: 135 patients (49.6%) underwent right LA and 137 patients (50.4%) underwent left LA. Operation time, estimated blood loss (EBL) and hospitalization time were similar between the groups (p=0.415, p=0.242, p=0.741, respectively). Although EBL was higher on the right side than the left (p=0.038) in the fi rst 20 cases, after this learning period has been completed, there was no signifi cant difference between the groups. In patients with pheochromocytoma, metastatic mass and a mass >5cm in size, despite bleeding complications were clinically higher on the right side, this difference was not statistically significant. Conclusions: During the learning period of LA, EBL is higher on the right side. Due to the greater risk of bleeding complications on the right side even on the hands of experienced surgeons, extra care and preoperative planning are required in patients with pheochromocytoma, metastatic masses and masses >5cm in size. Keywords: Laparoscopy; Adrenalectomy; Risk Factors [Full...

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Is possible to rule out clinically significant prostate cancer using PI-RADS v2 for the assessment of prostate MRI?

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0382 ORIGINAL ARTICLE Publio Cesar Cavalcanti Viana 1, Natally Horvat 1, Valter Ribeiro dos Santos Júnior 1, Thais Carneiro Lima 1, Davi dos Santos Romão 1, Luciana Mendes de Oliveira Cerri 1, Marilia Germanos de Castro 2, Herbert Alberto Vargas 3, Júlia Azevedo Miranda 1, Claudia da Costa Leite 1, Giovanni Guido Cerri 1 1 Departamento de Radiologia do Hospital Sírio-Libanês, São Paulo, SP, Brasil; 2 Departamento de Patologia do Hospital Sírio-Libanês, São Paulo, SP, Brasil; 3 Departamento de Radiologia, Memorial Sloan Kettering Cancer Center, Nova York, NY, EUA ABSTRACT Objectives: To evaluate the diagnostic performance and interobserver agreement of PI-RADS v2. Materials and Methods: In this Institutional Review Board approved single-center retrospective study, 98 patients with clinically suspected PCa who underwent 3-T multiparametric MRI followed by MRI/TRUS fusion-guided prostate biopsy were included from June 2013 to February 2015. Two radiologists (R1 and R2) with 8 and 1 years of experience in abdominal radiology reviewed the MRI scans and assigned PI-RADS v2 scores in all prostate zones. PI-RADS v2 were compared to MRI/TRUS fusion-guided biopsy results, which were classifi ed as negative, PCa, and significant PCa (sPCa). Results: Sensitivity, specifi city, NPV, PPV and accuracy for PCa was 85.7% (same for all metrics) for R1 and 81.6%, 79.6%, 81.2%, 80.0% and 80.6% for R2. For detecting sPCa, the corresponding values were 95.3%, 85.4%, 95.9%, 83.7% and 89.8% for R1 and 93.0%, 81.8%, 93.7%, 86.7% and 86.7% for R2. There was substantial interobserver agreement in assigning PI-RADS v2 score as negative (1, 2, 3) or positive (4, 5) (Kappa=0.78). On multivariate analysis, PI-RADS v2 (p <0.001) was the only independent predictor of sPCa compared with age, abnormal DRE, prostate volume, PSA and PSA density. Conclusions: Our study population demonstrated that PI-RADS v2 had high diagnostic accuracy, substantial interobserver agreement, and it was the only independent predictor of sPCa. Keywords: Prostate; Magnetic Resonance Imaging; Neoplasms; Prostatic Neoplasms [Full...

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Efficacy and tolerability of mirabegron in female patients with overactive bladder symptoms after surgical treatment for stress urinary incontinence

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0518 ORIGINAL ARTICLE Mete Özkidik 1, Alper Coşkun 1, Mehmet Kazim Asutay 1, Tuncer Bahçeci 1, Nurullah Hamidi 2 1 Clinic of Urology, Şanliurfa Research and Training Hospital, Şanliurfa, Turkey; 2 Department of Urology, Ankara Atatürk Training and Research Hospital, Ankara, Turkey ABSTRACT Purpose: To evaluate the effi cacy and tolerability of mirabegron in females with overactive bladder (OAB) symptoms after surgical treatment for stress urinary incontinence (SUI). Materials and Methods: The study was conducted with a prospective, randomized and double-blinded design. 62 patients over the age of 40 who met the inclusion-exclusion criterias of the study were enrolled and randomly divided into two groups as Group A (mirabegron 50mg) and B (solifenacin 5mg). Patients were compared based on efficacy of treatment [Patient Perception of Bladder Condition (PPBC) scale and micturition diaries], safety of treatment (heart rate, systolic and diastolic blood pressure, adverse events), number of micturitions per day, patient’s satisfaction status after treatment [Visual Analog Scale(VAS)] and quality of life. Results: The mean age of the population was 48.2±3.8 years and the duration of OAB symptoms was 5.9±2.9 months. Baseline values for the mean number of micturitions, volume voided in each micturition, nocturia episodes, urgency and urgency incontinence episodes were 15.3±0.34, 128±3.88mL, 3.96±1.67, 5.72±1.35 and 4.22±0.69, respectively. After treatment, values for these parameters were 11.7±0.29, 164.7±2.9mL, 2.25±0.6, 3.38±0.71, 2.31±0.49 respectively. Quality of life score, symptom bother score, VAS for treatment satisfaction score, PPBC score after treatment were 66.1±0.85, 43.7±0.77, 4.78±0.14, 4.78±0.14, respectively. There were no signifi cant differences between two groups on any parameter. However, mirabegron showed better tolerability than solifenacin, particularly after 6 months. Conclusion: Mirabegron is safe, effective and tolerable in the long-term treatment of females with OAB symptoms after surgery for stress urinary incontinence. Keywords: mirabegron [Supplementary Concept]; Urinary Bladder, Overactive; Solifenacin Succinate; Urinary Incontinence, Stress [Full...

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Detection of clinically signifi cant prostate cancer with PIRADS v2 scores, PSA density, and ADC values in regions with and without mpMRI visible lesions

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0768 ORIGINAL ARTICLE Antonio C. Westphalen 1, 2, 3, Farhad Fazel 1, Hao Nguyen 2, 3, Miguel Cabarrus 1, Katryana Hanley- Knutson 1, Katsuto Shinohara 2, 3, Peter R. Carroll 2, 3 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA; 2 Department of Urology, University of California, San Francisco, CA, USA; 3 Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA ABSTRACT Purpose: To determine if PSAD, PSADtz, and ADC values improve the accuracy of PI-RADS v2 and identify men whose concurrent systematic biopsy detects clinically signifi cant cancer on areas without mpMRI visible lesions. Materials and methods: Single reference-center, cross-sectional, retrospective study of consecutive men with suspected or known low to intermediate-risk prostate cancer who underwent 3T mpMRI and TRUS-MRI fusion biopsy from 07/15/2014 to 02/17/2018. Cluster-corrected logistic regression analyses were utilized to predict clinically signifi cant prostate cancer (Gleason score ≥3+4) at targeted mpMRI lesions and on systematic biopsy. Results: 538 men (median age=66 years, median PSA=7.0ng/mL) with 780mpMRI lesions were included. Clinically signifi cant disease was diagnosed in 371 men. PI-RADS v2 scores of 3, 4, and 5 were clinically signifi cant cancer in 8.0% (16/201), 22.8% (90/395), and 59.2% (109/184). ADC values, PSAD, and PI-RADS v2 scores were independent predictors of clinically signifi cant cancer in targeted lesions (OR 2.25-8.78; P values <0.05; AUROC 0.84, 95% CI 0.81-0.87). Increases in PSAD were also associated with upgrade on systematic biopsy (OR 2.39-2.48; P values <0.05; AUROC 0.69, 95% CI 0.64-0.73). Conclusions: ADC values and PSAD improve characterization of PI-RADS v2 score 4 or 5 lesions. Upgraded on systematic biopsy is slightly more likely with PSAD ≥0.15 and multiple small PI-RADS v2 score 3 or 4 lesions. Keywords: Radiology; Prostate; Magnetic Resonance Imaging [Full...

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External validation of nomogram to predict inguinal lymph node metastasis in patients with penile cancer and clinically negative lymph nodes

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0756 ORIGINAL ARTICLE Carlos Vaz de Melo Maciel 1, Roberto Dias Machado 1, Mariana Andozia Morini 1, Pablo Aloisio Lima Mattos 2, Ricardo dos Reis 1, Rodolfo Borges dos Reis 1, Gustavo Cardoso Guimarães 3, Isabela Werneck da Cunha 3, Eliney Ferreira Faria 1 1 Departamento de Urologia, Hospital do Câncer de Barretos, Barretos, SP, Brasil; 2 Associação Piauiense de Combate ao Câncer, Teresina, PI. Brasil; 3 Fundação Antonio Prudente, A. C. Camargo Cancer Center, São Paulo, SP, Brasil ABSTRACT Introduction: Penile cancer (PC) occurs less frequently in Europe and in the United States than in South America and parts of Africa. Lymph node (LN) involvement is the most important prognostic factor, and inguinal LN (ILN) dissection can be curative; however, ILN dissection has high morbidity. A nomogram was previously developed based on clinicopathological features of PC to predict ILN metastases. Our objective was to conduct an external validation of the previously developed nomogram based on our population. Materials and methods: We included men with cN0 ILNs who underwent ILN dissection for penile carcinoma between 2000 and 2014. We performed external validation of the nomogram considering three different external validation methods: k-fold, leave-oneout, and bootstrap. We also analyzed prognostic variables. Performance was quantified in terms of calibration and discrimination (receiver operator characteristic curve). A logistic regression model for positive ILNs was developed based on clinicopathological features of PC. Results: We analyzed 65 men who underwent ILN dissection (cN0). The mean age was 56.8 years. Of 65 men, 24 (36.9%) presented with positive LNs. A median 21 ILNs were removed. Considering the three different methods used, we concluded that the previously developed nomogram was not suitable for our sample. Conclusions: In our study, the previously developed nomogram that was applied to our population had low accuracy and low precision for correctly identifying patients with PC who have positive ILNs. Keywords: Nomograms; Lymph; Lymphatic Metastasis; Penile Neoplasms [Full...

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Correlation of tools for objective evaluation of infravesical obstruction of men with lower urinary tract symptoms

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0706 ORIGINAL ARTICLE Orestes Mazzariol Jr. 1, Leonardo O. Reis 1, Paulo R. Palma 1 1 Universidade Estadual de Campinas – Unicamp, Campinas, SP, Brasil ABSTRACT Purpose: To identify how the most frequently used parameters in daily clinical practice diagnosing bladder outlet obstruction (BOO) due to benign prostate hyperplasia (BPH) correlate to each other. Materials and methods: The study included 452 patients with lower urinary tract symptoms (LUTS) of the UNICAMP urology outpatient clinic of LUTS. Inclusion criteria: patients with BOO due to BPH who agreed to participate in the study. Exclusion criteria: patients with urinary tract infection, neurological diseases that compromised the lower urinary tract, prior prostatic surgery, radiotherapy or urethral stenosis. Patient assessment: history, international prostate symptoms score (IPSS), nocturnal quality of life score (NQoL) questionnaires, physical and digital rectal examination (DRE), PSA, transabdominal ultrasound with intravesical prostate protrusion (IPP), post-mictional residue and free urofl owmetry. Results: There was no strong Spearman correlation among the studied variables. The only moderate correlations occurred between IPSS and NQoL (p <0001; c=0.56) and between IPP and prostate volume (p <0001; c=0.57). Weak correlations between IPP and post-mictional residue (p <0001; c=0.31) and free urofl owmetry (p <0001; c=-0.26); and between IPSS and free urofl owmetry (p <0001, c=-0.21) were observed. Conclusion: In this study, we found moderate, weak, very weak and absent correlation among the various parameters used in the diagnosis and management of BOO due to BPH. As the value of these tools is variable, the creation of a logical and objective algorithm was not possible and the treatment is based on the interpretation of clinical symptoms.   Keywords: Prostatic Hyperplasia; Prostate; Transurethral Resection of Prostate [Full...

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A prospective study assessing feasibility of performing percutaneous nephrolithotomy in chronic kidney disease patients – What factors affect the outcome?

Vol. 45 (x): 2019 April 4.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0816 ORIGINAL ARTICLE Rohan Patel 1, Samarth Agarwal 1, S. N. Sankhwar 1, Apul Goel 1, B. P. Singh 1, Manoj Kumar 1 1 Department of Urology, King George’s Medical University, Lucknow, India ABSTRACT Objectives: To primarily evaluate the functional outcomes of PCNL for bilateral renal calculi/calculi in solitary functioning kidney with Chronic Kidney Disease(CKD). To identify factors affecting the renal replacement therapy following PCNL. Materials and Methods: Patients with bilateral renal calculi/calculi in solitary kidney and CKD (eGFR<60/s.creatinine>2) and Good Performance Status [Eastern Cooperative Oncology Group (ECOG): 0–2] were included in the study. Results: A total of 60 patients with CKD who had bilateral renal calculi/calculi in solitary functioning kidney underwent PCNL. At 6 months, eGFR improved or stabilized in 45 (75%) patients, while in 15 (25%) patients eGFR deteriorated. A total of 5 (14.28%) and 2 (25%) patients of CKD stage 4 and 5 respectively had improvement in eGFR as well as CKD stage. Fourteen (82.35%), 21 (60%), 3 (37.5%) patients of CKD stage 3, 4, 5 had improvement in eGFR but not signifi cant enough to cause stage migration. Again 3 (17.65%) , 9 ( 40%) and 3 (37.5%) patients of CKD stage 3, 4, 5 had reduction in eGFR but not signifi cant enough to cause stage migration. None of the patients had worsening of CKD stage. Preoperative CKD stage and eGFR were compared with measurements made at the fi nal follow up visit (6 months). Conclusion: Our results indicate that most patients of renal calculi with CKD show improvement or stabilization of renal function with aggressive stone removal. Improvement is more in patients who have mild to moderate CKD. Aggressive management of comorbidities, peri-operative UTI and complications may delay or avoid progression of CKD status in such patients. Keywords: Nephrolithotomy, Percutaneous; Kidney Diseases; Urinary Tract Infections [Full...

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Factors affecting urinary continence and sexual potency recovery after robotic-assisted radical prostatectomy

Vol. 45 (x): 2019 May 5.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0704 ORIGINAL ARTICLE Mark Fernando Neumaier 1, Carlos Henrique Segall Júnior 1, Marcelo Hisano 2, Flávio Eduardo Trigo Rocha 1, 2, Sami Arap 1, 2, Marco A. Arap 1, 2 1 Hospital Sírio-Libanês, São Paulo, SP. Brasil; 2 Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil ABSTRACT Introduction: Robot-assisted radical prostatectomy (RARP) is the most recent surgical technique for localized prostate cancer. The Da Vinci (Intuitive Surgical, Sunnyvale, CA) system was fi rst introduced in Brazil in 2008, with a fast growing number of surgeries performed each year. Objective: Our primary endpoint is to analyze possible predictors of functional outcomes, related to patient and tumor features. As secondary endpoint, describe functional outcomes (urinary continence and sexual potency) from RARP performed in the Sírio-Libanês Hospital (SLH), a private institution, in São Paulo, from April 2008 to December 2015. Materials and Method: Data from 104 consecutive patients operated by two surgeons from the SLH (MA and SA) between 2008 and 2015, with a minimum 12 months follow-up, were collected. Patient features (age, body mass index – BMI, PSA, date of surgery and sexual function), tumor features (tumor stage, Gleason and surgical margins) and followup data (time to reach urinary continence and sexual potency) were the variables collected at 1, 3, 6 and 12 month and every 6 months thereafter. Continence was defi ned as the use of no pad on medical interview and sexual potency defi ned as the capability for vaginal penetration with or without fosphodiesterase type 5 inhibitors. Results: Mean age was 60 years old and mean BMI was 28.45 kg/m2. BMI >30kg/m2 (p<0.001) and age (p=0.011) were signifi cant predictors for worse sexual potency after surgery. After 1, 3, 6 and 12 months, 20.7%, 45.7%, 60.9% and 71.8% from patients were potent, respectively. The urinary continence was reached in 36.5%, 80.3%, 88.6% and 92.8% after 1, 3, 6 and 12 months, respectively. Until the end of the study, only one patient was incontinent and 20.7% were impotent. Conclusion: Age was a predictor of urinary and erectile function recovery in 12 months. BMI was signifi cant factor for potency recovery. We obtained in a private hospital good functional results after 12 months of follow-up. Keywords: Prostatic Neoplasms; Adenocarcinoma; Urinary Incontinence [Full...

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Laparoscopic nephroureterectomy as treatment in obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome

Laparoscopic nephroureterectomy as treatment in obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome

Vol. 45 (x): 2019 March 3.[Ahead of print] doi: 10.1590/S1677-5538.IBJU.2018.0430 VIDEO SECTION María Medina-González 1, Jorge Panach-Navarrete 1, Lorena Valls-González 1, Ana Castelló-Porcar 1, Jose María Martínez-Jabaloyas 1 1 Department of Urology. University Clinic Hospital of Valencia, Facultat de Medicina i Odontologia, Universitat de València, Spain https://www.intbrazjurol.com.br/videos/20180430_Medina-Gonzalez_et_al.mp4 [Full...

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