Construction of Single Stereocenters

2015 ◽  
Author(s):  
Tristan H. Lambert
Keyword(s):  
Medical Center ◽  
Columbia University ◽  
Santa Barbara ◽  
Electrophilic Amination ◽  
Ene Reaction ◽  
University Of Texas ◽  
University Of Wisconsin ◽  
Nucleophilic Displacement ◽  
Institute Of Technology ◽  
The University

James L. Leighton at Columbia University reported (Nature 2012, 487, 86) that the commercially available allylsilane 2 allylated acetoacetone (1) to furnish the enantioenriched tertiary carbinol 3. Alexander T. Radosevich demonstrated (Angew. Chem. Int. Ed. 2012, 51, 10605) that diazaphospholidine 5 induced the formal reductive insertion of 3,5-dinitrobenzoic acid to α-ketoester 4 to generate adduct 6 enantioselectively. Tehshik P. Yoon at the University of Wisconsin at Madison found (J. Am Chem. Soc. 2012, 134, 12370) that aminoalcohol derivative 9 could be prepared via an asymmetric iron-catalyzed oxyamination of diene 7 using oxaziridine 8. A procedure for the desymmetrization of 1,3-difluoropropanol 10 by nucleophilic displacement of an unactivated aliphatic fluoride to generate 11 was reported (Angew. Chem. Int. Ed. 2012, 51, 12275) by Günter Haufe at the University of Münster and Norio Shibata at the Nagoya Institute of Technology. An innovative procedure for the amination of unactivated olefins involving an ene reaction/[ 2,3]-rearrangement sequence (e.g., 12 to 13) was developed (J. Am. Chem. Soc. 2012, 134, 18495) by Uttam K. Tambar at the University of Texas Southwestern Medical Center. James P. Morken at Boston College demonstrated the stereospecific amination of borane 14 with methoxylamine to produce 15. The conversion of β-ketoester 16 to 18 by amination with 17 under oxidative conditions was reported (J. Am. Chem. Soc. 2012, 134, 18948) by Javier Read de Alaniz at the University of California at Santa Barbara. The electrophilic amination of silyl ketene acetal 19 with a functionalized hydroxylamine reagent to produce 20 was disclosed (Angew. Chem. Int. Ed. 2012, 51, 11827) by Koji Hirano and Masahiro Miura at Osaka University. Erick M. Carreira at ETH Zürich developed (Angew. Chem. Int. Ed. 2012, 51, 8652) the enantioconvergent thioetherification of alcohol 21 to produce 23 with high branched to linear selectivity and ee. The asymmetric conjugate addition of 2-aminothiophenol 25 to 24 catalyzed by mesitylcopper in the presence of ligand 26 was developed (Angew. Chem. Int. Ed. 2012, 51, 8551) by Naoya Kumagai and Masakatsu Shibasaki at the Institute of Microbial Chemistry in Tokyo. The enantioselective conversion of aldehyde 28 to α-fluoride 30 under catalysis by NHC 29 was developed (Angew. Chem. Int. Ed. 2012, 51, 10359) by Zhenyang Lin and Jianwei Sun at the Hong Kong University of Science and Technology.

Reactions of Alkenes: The RajanBabu Synthesis of Pseudopterosin G-J Aglycone Dimethyl Ether

2015 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Medical Center ◽  
Selective Reduction ◽  
Oxidative Cleavage ◽  
University Of Texas ◽  
Furman University ◽  
National University ◽  
Institute Of Technology ◽  
Seoul National University ◽  
The University ◽  
Medical University

Xiangge Zhou of Sichuan University showed (Tetrahedron Lett. 2011, 52, 318) that even the monosubstituted alkene 1 was smoothly converted to the methyl ether 2 by catalytic FeCl3. Brian C. Goess of Furman University protected (J. Org. Chem. 2011, 76, 4132) the more reactive alkene of 3 as the 9-BBN adduct, allowing selective reduction of the less reactive alkene to give, after reoxidation, the monoreduced 4. Nobukazu Taniguchi of the Fukushima Medical University added (Synlett 2011, 1308) Na p-toluenesulfinate oxidatively to 1 to give the sulfone 5. Krishnacharya G. Akamanchi of the Indian Institute of Chemical Technology, Mumbai oxidized (Synlett 2011, 81) 1 directly to the bromo ketone 6. Osmium is used catalytically both to effect dihydroxylation, to prepare 8, and to mediate oxidative cleavage, as in the conversion of 7 to the dialdehyde 9. Ken-ichi Fujita of AIST Tsukuba devised (Tetrahedron Lett. 2011, 52, 3137) magnetically retrievable osmium nanoparticles that can be reused repeatedly for the dihydroxylation. B. Moon Kim of Seoul National University established (Tetrahedron Lett. 2011, 52, 1363) an extraction scheme that allowed the catalytic Os to be reused repeatedly for the oxidative cleavage. Maurizio Taddei of the Università di Siena showed (Synlett 2011, 199) that aqueous formaldehyde could be used in place of Co/H2 (syngas) for the formylation of 1 to 10. Hirohisa Ohmiya and Masaya Sawamura of Hokkaido University prepared (Org. Lett. 2011, 13, 1086) carboxylic acids (not illustrated) from alkenes using CO2. Joseph M. Ready of the University of Texas Southwestern Medical Center selectively arylated (Angew. Chem. Int. Ed. 2011, 50, 2111) the homoallylic alcohol 11 to give 12. Many reactions of alkenes are initiated by hydroboration, then conversion of the resulting alkyl borane. Hiroyuki Kusama of the Tokyo Institute of Technology photolyzed (J. Am. Chem. Soc. 2011, 133, 3716) 14 with 13 to give the ketone 15. William G. Ogilvie of the University of Ottawa added (Synlett 2011, 1113) the 9-BBN adduct from 1 to 16 to give 17. Professors Ohmiya and Sawamura effected (Org. Lett. 2011, 13, 482) a similar conjugate addition, not illustrated, of 9-BBN adducts to α,β-unsaturated acyl imidazoles.

C–H Functionalization

2015 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Medical Center ◽  
Columbia University ◽  
Manganese Porphyrin ◽  
University Of Houston ◽  
Princeton University ◽  
Direct Fluorination ◽  
Ether Oxygen ◽  
Hydride Abstraction ◽  
Institute Of Technology ◽  
The University

Konstantin P. Bryliakov of the Boreskov Institute of Catalysis devised (Org. Lett. 2012, 14, 4310) a manganese catalyst for the selective tertiary hydroxylation of 1 to give 2. Note that the electron-withdrawing Br deactivates the alternative methine H. Bhisma K. Patel of the Indian Institute of Technology, Guwahati selectively oxidized (Org. Lett. 2012, 14, 3982) a benzylic C–H of 3 to give the corresponding benzoate 4. Dalibor Sames of Columbia University cyclized (J. Org. Chem. 2012, 77, 6689) 5 to 6 by intramolecular hydride abstraction followed by recombination. Thomas Lectka of Johns Hopkins University showed (Angew. Chem. Int. Ed. 2012, 51, 10580) that direct C–H fluorination of 7 occurred predominantly at carbons 3 and 5. John T. Groves of Princeton University reported (Science 2012, 337, 1322) an alternative manganese porphyrin catalyst (not illustrated) for direct fluorination. C–H functionalization can also be mediated by a proximal functional group. John F. Hartwig of the University of California, Berkeley effected (J. Am. Chem. Soc. 2012, 134, 12422) Ir-mediated borylation of an ether 9 in the position β to the oxygen to give 10. Uttam K. Tambar of the UT Southwestern Medical Center devised (J. Am. Chem. Soc. 2012, 134, 18495) a protocol for the net enantioselective amination of 11 to give 12. Conversion of a C–H bond to a C–C bond can be carried out in an intramolecular or an intermolecular sense. Kilian Muñiz of the Catalan Institution for Research and Advanced Studies cyclized (J. Am. Chem. Soc. 2012, 134, 15505) the terminal alkene 13 directly to the cyclopentene 15. Olivier Baudoin of Université Claude Bernard Lyon 1 closed (Angew. Chem. Int. Ed. 2012, 51, 10399) the pyrrolidine ring of 17 by selective activation of a methyl C–H of 16. Jeremy A. May of the University of Houston found (J. Am. Chem. Soc. 2012, 134, 17877) that the Rh carbene derived from 18 inserted into the distal alkyne to give a new Rh carbene 19, which in turn inserted into a C–H bond adjacent to the ether oxygen to give 20.

scholarly journals An Interesting and Productive Research and Clinical Career

2020 ◽  
Vol 39 (3) ◽  
pp. 182-188
Author(s):  
Samuel M. Cohen
Keyword(s):  
High School ◽  
Clinical Medicine ◽  
Medical Center ◽  
Basic Research ◽  
Nebraska Medical ◽  
Good Fortune ◽  
University Of Wisconsin ◽  
Productive Research ◽  
The University

To begin, I wish to thank the Academy of Toxicological Sciences for bestowing this honor on me. I have had a rewarding career in basic research and clinical medicine, beginning with research in high school and always planning on becoming a physician. I have had the good fortune of having outstanding mentors, wonderful parents, and a supportive and intuitive wife and family. This article provides a brief overview of some of the events of my career and individuals who have played a major role, beginning with the M.D./Ph.D. program at the University of Wisconsin, pathology residency and faculty at St. Vincent Hospital, Worcester, Massachusetts, a year as visiting professor at Nagoya City University, and my career at the University of Nebraska Medical Center since 1981. This could not have happened without the strong input and support from these individuals, the numerous students, residents and fellows with whom I have learned so much, and the more than 500 terrific collaborators.

Other Methods for Carbocyclic Construction: The Porco Synthesis of (-)-Hyperibone K

2013 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Oxidative Cyclization ◽  
Florida State University ◽  
State University ◽  
Colorado State University ◽  
Intramolecular Alkylation ◽  
University Of Wisconsin ◽  
Tokyo Institute ◽  
Institute Of Technology ◽  
University Of Bristol ◽  
The University

Varinder K. Aggarwal of the University of Bristol described (Angew. Chem. Int. Ed. 2010, 49, 6673) the conversion of the Sharpless-derived epoxide 1 into the cyclopropane 2. Christopher D. Bray of Queen Mary University of London established (Chem. Commun. 2010, 46, 5867) that the related conversion of 3 to 5 proceeded with high diastereocontrol. Javier Read de Alaniz of the University of California, Santa Barbara, extended (Angew. Chem. Int. Ed. 2010, 49, 9484) the Piancatelli rearrangement of a furyl carbinol 6 to allow inclusion of an amine 7, to give 8. Issa Yavari of Tarbiat Modares University described (Synlett 2010, 2293) the dimerization of 9 with an amine to give 10. Jeremy E. Wulff of the University of Victoria condensed (J. Org. Chem. 2010, 75, 6312) the dienone 11 with the commercial butadiene sulfone 12 to give the highly substituted cyclopentane 13. Robert M. Williams of Colorado State University showed (Tetrahedron Lett. 2010, 51, 6557) that the condensation of 14 with formaldehyde delivered the cyclopentanone 15 with high diastereocontrol. D. Srinivasa Reddy of Advinus Therapeutics devised (Tetrahedron Lett. 2010, 51, 5291) conditions for the tandem conjugate addition/intramolecular alkylation conversion of 16 to 17. Marie E. Krafft of Florida State University reported (Synlett 2010, 2583) a related intramolecular alkylation protocol. Takao Ikariya of the Tokyo Institute of Technology effected (J. Am. Chem. Soc. 2010, 132, 11414) the enantioselective Ru-mediated hydrogenation of bicyclic imides such as 18. This transformation worked equally well for three-, four-, five-, six-, and seven-membered rings. Stefan France of the Georgia Institute of Technology developed (Org. Lett. 2010, 12, 5684) a catalytic protocol for the homo-Nazarov rearrangement of the doubly activated cyclopropane 20 to the cyclohexanone 21. Richard P. Hsung of the University of Wisconsin effected (Org. Lett. 2010, 12, 5768) the highly diastereoselective rearrangement of the triene 22 to the cyclohexadiene 23. Strategies for polycyclic construction are also important. Sylvain Canesi of the Université de Québec devised (Org. Lett. 2010, 12, 4368) the oxidative cyclization of 24 to 25.

Organic Functional Group Conversion

2013 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Hong Kong ◽  
Allylic Alcohol ◽  
Primary Alcohols ◽  
National Chemical Laboratory ◽  
Chemical Laboratory ◽  
University Of Texas ◽  
University Of Wisconsin ◽  
Pan American ◽  
Acetate Formation ◽  
The University

Pradeep Kumar of the National Chemical Laboratory, Pune, developed (Tetrahedron Lett. 2010, 51, 744) a new procedure for the conversion of an alcohol 1 to the inverted chloride 3. Michel Couturier of OmegaChem devised (J. Org. Chem. 2010, 75, 3401) a new reagent for the conversion of an alcohol 4 to the inverted fluoride 6. For both reagents, primary alcohols worked as well. Patrick H. Toy of the University of Hong Kong showed (Synlett 2010, 1115) that diethyl-lazodicarboxylate (DEAD) could be used catalytically in the Mitsunobu coupling of 7. Employment of 8 minimized competing acetate formation. In another application of hyper-valent iodine chemistry, Jaume Vilarrasa of the Universitat de Barcelona observed (Tetrahedron Lett. 2010, 51, 1863) that the Dess-Martin reagent effected the smooth elimination of a pyridyl selenide 10. Ken-ichi Fujita and Ryohei Yamaguchi of Kyoto University extended (Org. Lett. 2010, 12, 1336) the “borrowed hydrogen” approach to effect conversion of an alcohol 12 to the sulfonamide 13. Dan Yang, also of the University of Hong Kong, developed (Org. Lett. 2010, 12, 1068, not illustrated) a protocol for the conversion of an allylic alcohol to the allylically rearranged sulfonamide. Shu-Li You of the Shanghai Institute of Organic Chemistry used (Org. Lett. 2010, 12, 800) an Ir catalyst to effect rearrangement of an allylic sulfinate 14 to the sulfone. Base-mediated conjugation then delivered 15. K. Rama Rao of the Indian Institute of Chemical Technology, Hyderabad, devised (Tetrahedron Lett. 2010, 51, 293) a La catalyst for the conversion of an iodoalkene 16 to the alkenyl sulfide 17. Alkenyl selenides could also be prepared. James M. Cook of the University of Wisconsin, Milwaukee, described (Org. Lett. 2010, 12, 464, not illustrated) a procedure for coupling alkenyl iodides and bromides with N-H heterocycles and phenols. Hansjörg Streicher of the University of Sussex showed (Tetrahedron Lett. 2010, 51, 2717) that under free radical conditions, the carboxylic acid derivative 18 could be decarboxylated to the alkenyl iodide 19. Bimal K. Banik of the University of Texas–Pan American found (Synth. Commun. 2010, 40, 1730) that water was an effective solvent for the microwave-mediated addition of a secondary amine 21 to a Michael acceptor 20.

C–O Natural Products: (–)-Hybridalactone (Fürstner), (+)-Anthecotulide (Hodgson), (–)-Kumausallene (Tang), (±)-Communiol E (Kobayashi), (–)-Exiguolide (Scheidt), Cyanolide A (Rychnovsky)

2015 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Max Planck ◽  
Enantiomerically Pure ◽  
University Of Oxford ◽  
University Of Wisconsin ◽  
Favorskii Rearrangement ◽  
Alternative Approach ◽  
Ether Oxygen ◽  
Institute Of Technology ◽  
The University ◽  
Complementary Strategy

Control of the absolute configuration of adjacent alkylated stereogenic centers is a classic challenge in organic synthesis. In the course of the synthesis of (–)-hybridalactone 4, Alois Fürstner of the Max-Planck-Institut Mülheim effected (J. Am. Chem. Soc. 2011, 133, 13471) catalytic enantioselective conjugate addition to the simple acceptor 1. The initial adduct, formed in 80% ee, could readily be recrystallized to high ee. In an alternative approach to high ee 2,3-dialkyl γ-lactones, David M. Hodgson of the University of Oxford cyclized (Org. Lett. 2011, 13, 5751) the alkyne 5 to an aldehyde, which was condensed with 6 to give 7. Coupling with 8 then delivered (+)-anthecotulide 9. The enantiomerically pure diol 10 is readily available from acetylacetone. Weiping Tang of the University of Wisconsin dissolved (Org. Lett. 2011, 13, 3664) the symmetry of 10 by Pd-mediated cyclocarbonylation. The conversion of the lactone 11 to (–)-kumausallene 12 was enabled by an elegant intramolecular bromoetherification. Shoji Kobayshi of the Osaka Institute of Technology developed (J. Org. Chem. 2011, 76, 7096) a powerful oxy-Favorskii rearrangement that enabled the preparation of both four-and five-membered rings with good diastereocontrol, as exemplified by the conversion of 13 to 14. With the electron-withdrawing ether oxygen adjacent to the ester carbonyl, Dibal reduction of 14 proceeded cleanly to the aldehyde. Addition of ethyl lithium followed by deprotection completed the synthesis of (±)-communiol E. En route to (–)-exiguolide 18, Karl A. Scheidt of Northwestern University showed (Angew. Chem. Int. Ed. 2011, 50, 9112) that 16 could be cyclized efficiently to 17. The cyclization may be assisted by a scaffolding effect from the dioxinone ring. Dimeric macrolides such as cyanolide A 21 are usually prepared by lactonization of the corresponding hydroxy acid. Scott D. Rychnovsky of the University of California Irvine devised (J. Am. Chem. Soc. 2011, 133, 9727) a complementary strategy, the double Sakurai dimerization of the silyl acetal 19 to 20.

Functional Group Transformations

2015 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Gold Catalyst ◽  
Sulfonyl Chloride ◽  
Allylic Alcohol ◽  
West Virginia University ◽  
Israel Institute ◽  
University Of Texas ◽  
Amino Amide ◽  
Cu Catalyst ◽  
Institute Of Technology ◽  
The University

Mark Gandelman of the Technion–Israel Institute of Technology devised (Adv. Synth. Catal. 2011, 353, 1438) a protocol for the decarboxylative conversion of an acid 1 to the iodide 3. Doug E. Frantz of the University of Texas, San Antonio effected (Angew. Chem. Int. Ed. 2011, 50, 6128) conversion of a β-keto ester 4 to the diene 5 by way of the vinyl triflate. Pei Nian Liu of the East China University of Science and Technology and Chak Po Lau of the Hong Kong Polytechnic University (Adv. Synth. Catal. 2011, 353, 275) and Robert G. Bergman and Kenneth N. Raymond of the University of California, Berkeley (J. Am. Chem. Soc. 2011, 133, 11964) described new Ru catalysts for the isomerization of an allylic alcohol 6 to the ketone 7. Xiaodong Shi of West Virginia University optimized (Adv. Synth. Catal. 2011, 353, 2584) a gold catalyst for the rearrangement of a propargylic ester 8 to the enone 9. Xue-Yuan Liu of Lanzhou University used (Adv. Synth. Catal. 2011, 353, 3157) a Cu catalyst to add the chloramine 11 to the alkyne 10 to give 12. Kasi Pitchumani of Madurai Kamaraj University converted (Org. Lett. 2011, 13, 5728) the alkyne 13 into the α-amino amide 15 by reaction with the nitrone 14. Katsuhiko Tomooka of Kyushu University effected (J. Am. Chem. Soc. 2011, 133, 20712) hydrosilylation of the propargylic ether 16 to the alcohol 17. Matthew J. Cook of Queen’s University Belfast (Chem. Commun. 2011, 47, 11104) and Anna M. Costa and Jaume Vilarrasa of the Universitat de Barcelona (Org. Lett. 2011, 13, 4934) improved the conversion of an alkenyl silane 18 to the iodide 19. Vinay Girijavallabhan of Merck/Kenilworth developed (J. Org. Chem. 2011, 76, 6442) a Co catalyst for the Markovnikov addition of sulfide to an alkene 20. Hojat Veisi of Payame Noor University oxidized (Synlett 2011, 2315) the thiol 22 directly to the sulfonyl chloride 23. Nicholas M. Leonard of Abbott Laboratories prepared (J. Org. Chem. 2011, 76, 9169) the chromatography-stable O-Su ester 25 from the corresponding acid 24.

Alkaloid Synthesis: (−)-L-Batzellaside A (Toyooka), Limazepine A (Zemribo), (+)-Febrifugine (Pansare), Amathaspiramide F (Tambar), Allomatrine (Brown), Lyconadine C (Waters), Tabersonine (Andrade)

2017 ◽  
Author(s):  
Douglass F. Taber
Keyword(s):  
Absolute Configuration ◽  
Claisen Rearrangement ◽  
Medical Center ◽  
University Of Texas ◽  
Temple University ◽  
Lycopodium Alkaloid ◽  
Alkaloid Synthesis ◽  
The University ◽  
Acyl Azide ◽  
Stereogenic Center

Naoki Toyooka of the University of Toyama prepared (Eur. J. Org. Chem. 2013, 2841) the lactam 1 from commercial tri-O-benzyl-D-glucal. Reduction with Dibal followed by coupling of the intermediate with allyltrimethylsilane delivered the piper­idine 2, that was carried on to (−)-L-batzellaside A 3. Ronalds Zemribo of the Latvian Institute of Organic Synthesis effected (Org. Lett. 2013, 15, 4406) Ireland–Claisen rearrangement of the lactone 4 to give the pyrroli­dine 5 with high geometric control. This was readily converted to limazepine E 6. Sunil V. Pansare of Memorial University used (Synthesis 2013, 45, 1863) an organo­catalyst to set the relative and absolute configuration in the addition of 7 to 8 to give 9. The acyclic stereogenic center of 9 was inverted twice en route to (+)-febrifugine 10. Uttam K. Tambar of the University of Texas Southwestern Medical Center combined (Org. Lett. 2013, 15, 5138) 11 with 12 under Pd catalysis to set the rel­ative configuration of 13. Late-stage bromination completed the synthesis of amathaspiramide F 14. Richard C. D. Brown of the University of Southampton used (Org. Lett. 2013, 15, 4596) the sulfinylimine of 15 to direct the stereochemical sense of the addition of 16. The product 17 was carried over several steps to the tetracyclic alkaloid allomatrine 18. Stephen P. Waters of the University of Vermont devised (Org. Lett. 2013, 15, 4226) what appears to be a general route to pyridones. On warming, the acyl azide derived from the acid 19 rearranged to the isocyanate, that cyclized to the pyridone 20. Deprotection led to the Lycopodium alkaloid lyconadin C 21. Among the several creative routes to indole alkaloids that have been put forward in recent months, the synthesis of tabersonine 25 (J. Am. Chem. Soc. 2013, 135, 13334) by Rodrigo B. Andrade of Temple University stands out. Deprotonation of 22 led to an anion that was condensed with 23 to give 24, with the relative and absolute configuration directed by the pendant sulfinylimine. In addition to tabersonine, the intermediate 24 was carried on to vincadifformine and to aspidospermidine.

Healthcare Epidemiology Practicum Rotation for Postgraduate Physician Trainees in Medicine–Infectious Diseases

2013 ◽  
Vol 34 (10) ◽  
pp. 1114-1116
Author(s):  
Pranavi Sreeramoju ◽  
Maria Eva Fernandez-Rojas
Keyword(s):  
Infectious Diseases ◽  
Infection Control ◽  
Medical Center ◽  
Common Trunk ◽  
University Hospitals ◽  
Hospital System ◽  
University Of Texas ◽  
Core Rotation ◽  
The University ◽  
Healthcare Epidemiology

Practicum education in healthcare epidemiology and infection control (HEIC) for postgraduate physician trainees in infectious diseases is necessary to prepare them to be future participants and leaders in patient safety. Voss et al suggested that training in HEIC should be offered as a “common trunk” for physicians being trained in clinical microbiology or infectious diseases. A 1-month rotation has been recommended previously. A survey by Joiner et al indicated that only 50% of infectious diseases fellows found the infection control training adequate. The objective of this article is to report our 2-year experience with a 1-month practicum rotation we designed and implemented at our institution.The setting is the Adult Infectious Diseases fellowship program at the University of Texas Southwestern Medical Center (UTSW), Dallas, Texas. The fellows have clinical rotations at the Parkland Health and Hospital System, UTSW University hospitals, North Texas Veterans Affairs Health Care System, and Children's Medical Center Dallas. The 2-year program recruits 7 fellows every 2 years. The 1-month core rotation was established in July 2011 and is ongoing. Fellows who completed the rotation during the period July 2011 to April 2013 are included in this study.

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