Eleanor Molloy

Eleanor Molloy

Professor of Paediatrics & Child Health, TCD

Eleanor Molloy is the Professor and Chair of Paediatrics at Trinity College Dublin and a Consultant Neonatologist & Paediatrician at the Coombe Women and Infant’s University Hospital, the National Children’s Hospital, Tallaght, and Children’s Health Ireland at Crumlin.

Prof. Molloy’s research group aims to delineate perinatal and early neonatal inflammatory responses in health and disease. They have established longitudinal cohorts of infants with neonatal encephalopathy and preterm infants as well as neonatal controls in order to explore the role of early inflammatory changes and developmental outcomes.

Eleanor Molloy

Professor of Paediatrics & Child Health, TCD

Dr. Lynne Kelly
Position: Research Fellow

Post doctoral researcher in GEMINI and research coordinator of the Paediatrics research lab in TTMI, St James’ Hospital.

Dr. Mary O’ Dea
Position: PhD Researcher

PhD in the Underlying mechanisms in Neonatal Immune metabolic dysregulation and brain Injury.

Dr. Emer Ryan
Position: PhD Researcher

PhD in Paediatric Outcomes and Serum biomarker Panel in acute traumatic brain injury /concussion to severe traumatic brain injury .

Dr. Dean Huggard
Position: PhD Researcher

PhD in Down Syndrome Inflammation and Systemic Multiorgan Outcomes

Dr. Matthew McGovern
Position: PhD Researcher

PhD in Gender and Neonatal Inflammation in preterm outcomes.

Dr. Tim Hurley
Position: PhD Researcher

PhD in Circadian Rhythm Alterations and outcome in neonatal Encephalopathy.

Dr. Saima Aslam
Position: PhD Researcher

PhD in Understanding systemic Inflammation& immunomodulation in neontatal brain injury .

Dr. Murwan Omer
Position: PhD Researcher

PhD in Preterm Infection and Systemic inflammation and neonatal outcomes.

Dr. Niamh Lagan
Position: PhD Researcher

PhD in Down syndrome, neurodevelopment and multiorgan outcomes.

Dr. John Allen
Position: PhD Researcher

PhD in Severe Neurological Impairment and children with medical complexity.

NIMBUS: Neonatal Inflammation and Multiorgan dysfunction and Brain injUry reSearch group

Neonatal brain injury (NBI) has a heterogenous aetiology with a high economic and social burden. Neonatal encephalopathy describes the babies who require resuscitation at birth and have an abnormal neurological examination. It remains difficult to predict their developmental outcome. Enhanced inflammatory responses are seen in affected infants and correlate with outcomes. Multiorgan dysfunction is common with renal, hepatic, cardiac and haematological abnormalities.We aim to correlate these inflammatory responses with clinical, neurodevelopmental and MRI outcomes to establish biomarkers of brain injury in neonates. This research may allow early recognition of brain injury prior to MRI (Day 5-7) so that new therapies as adjuvants to therapeutic hypothermia can be initiated as soon as possible after birth.

UNICORN: Underlying mechanisms in Neonatal Immune metaboliC dysregulatiOn and bRain Injury.

: Persistent systemic inflammation has been implicated in neonatal brain injury and identifying novel inflammatory biomarker combinations will help to determine the aetiology of NE and develop new adjunctive therapies. We have shown that immune cell ROS are produced at abnormally high levels in infants with severe NE and increase over the first week of life despite therapeutic hypothermia (TH) therapy. Babies with NE and age-matched controls will have inflammatory phenotyping in terms of immune cell activation and cytokine production to assess t immune dysregulation. Detailed neuroimaging using MRI/MRS (1.5T & 3.0T) and neurological outcome will be correlated with these results in order to assist with improved prognostic biomarker development. We will examine cellular metabolism and mitochondrial function in samples from infants with NE in comparison to healthy neonates with a view to identifying altered pathways that could be targeted by potential adjunctive therapies.

PROSPER: PaediatRic Outcomes and Serum biomarker Panel in acutE traumatic bRain injury /concussion to severe traumatic brain injury

Traumatic brain injury (TBI) is more common in childhood and adolescence than at any other time of life and is one of the most common causesof neurological morbidity and includes concussion. Post concussion syndrome (PCS) combines clinical, cognitive and behavioral symptoms and occurs in one in sevenschool children sustaining an TBI for three months or longerand is associated with persistent inflammation. At present there are no evidence-based clinical guidelines or accurate early tests to predict PCS in children. We aim to prospectively evaluate novel clinical and biochemical markers neurocognitive function at presentation inthe Emergency department and at 6 weeks in children presenting with TBI.

DISCO: Down syndrome Inflammation and Systemic multiorgan outCOmes

Down syndrome is associated with increased incidence of infections in childhood and other inflammatory conditions such as rheumatoid arthritis and Alzheimers disease have an earlier onset. Modulation of inflammatory signalling during infection may improve developmental outcomes. We will evaluate detailed clinical multiorgan outcomes and correlate with detailed developmental outcomes including audiology, Bayley’s developmental scales (BSID III) and WIPPSI and explore the effects of organ dysfunction on outcome. We will examine pro and anti-inflammatory cytokine responses and evaluate the innate inflammatory cell phenotype and activation of the inflammasome. This research will improve the understanding of the systemic inflammatory response in children with Down Syndrome and the potential for newer adjunctive therapies. In addition these immune markers may assist in prognosis of multi-organ outcomes in children with DS.

CRADLE: Circadian Rhythm Alterations anD outcome in neonatal Encephalopathy

Changes in circadian rhythm are common in many illnesses including neonatal brain injury and neonatal encephalopathy (NE). NE is associated with persistent abnormal systemic inflammatory responses that may be amenable to immunomodulation as an adjunct to therapeutic hypothermia. Alterations in circadian rhythm affect immune function and are associated with changes in melatonin, which has anti-inflammatory properties. Understanding the role of the circadian rhythm in neonatal brain injury and inflammation may lead to simple therapeutic measures such as decreasing the duration duration of light exposure to increase endogenous melatonin production. Therefore, we wish to investigate whether alteration of the circadian rhythm in babies with NE decrease inflammation and improve outcome?

GENIE: GEnder and neonatal Inflammation in prEterm outcomes

From infancy to old age,males have poorer disease outcomes compared to females.Preterm infants display a marked gender dimorphism as regards outcome and mortality especially at the borders of viability.We will explore the role of infection and gender in preterm infants in a large prospective cohort examining sex steroid hormones, infection, inflammation and neonatal multiorgan outcomes including brain injury. We will also translate the immune results to include possible new immunomodulatory therapies exploring the roles of estradiol, testoterone and glucocorticoids.

NEBULA: Understanding systemic InfLAmmation & immunomodulation

Neonatal brain injury has multifactorial etiology and causes significant neurological morbidity such as cerebral palsy. Therapeutic hypothermia is the only treatment available in term infants with neonatal encephalopathy (altered neurological function). Activated leucocytes, infection and persistent inflammation have been implicated in the pathogenesis of brain injury and cerebral palsy. Circadian rhythm plays a key role in innate immune responses and melatonin is an essential regulator. Melatonin has been shown to improve outcomes in combination with hypothermia in animal models of neonatal brain injury. Hypoxia-inducible factor (HIF) 1 alpha is a key transcriptional factor in the hypoxic response and is associated with persistent inflammation.We will examine circadian Rhythm and HIF-1alpha in neonatal NE and Control samples. This research will improve the understanding of the systemic inflammatory response in infants with brain injury and the potential for therapies such asmelatonin in addition to hypothermia.

PRISM: PReterm Infection and SysteMic inflammation and neonatal outcomes

Despite rapid progress in neonatal intensive care over the past decades, neonatal mortality from sepsis remains unacceptably highand morbidity includes brain injury and developmental delay. Systemic inflammation related to sepsis has been implicated in many common neonatal complications such as brain, lung, or gastrointestinal injuryespecially in preterm infants. Modulation of inflammatory signalling during sepsis may improve survival in preterm infants and prevent related neurodevelopmental complications. This research will improve the understanding of the systemic inflammatory response in preterm infants and the potential for newer adjunctive therapies. In addition these immune markers will assist in prognosis of multi-organ outcomes in preterm infants.

SERENITY: SEveRE Neurological Impairment and children with medical complexiTY

Severe Neurological Impairment (SNI) is a term that has been used to describe a global impairment of the nervous system. This group of children, who have unique challenges, could be considered a sub-group of those with more general medical complexity. However, there is no internationally agreed definition of severe neurological impairment and, therefore, a paucity of literature on its prevalence and medical and social consequences. This information is vital for future resource planning so we can provide the very best care for this vulnerable group of individuals. Objectives 1.To create a consensus definition of SNI 2.To quantify medical complexity in this group 3.To assess wellbeing in the families of children with SNI

The list of publications below is automatically derived from MEDLINE/PubMed. As a result, there may be incorrect or missing publications.

Lavizzari A, Klingenberg C, Profit J, Zupancic JAF, Davis AS, Mosca F, Molloy EJ, Roehr CC, International Neonatal COVID-19 Consortium., 2020 Jun 15, International comparison of guidelines for managing neonates at the early phase of the SARS-CoV-2 pandemic. Pediatr Res, DOI: 10.1038/s41390-020-0976-5
O'Dea M, Sweetman D, Bonifacio SL, El-Dib M, Austin T, Molloy EJ, 2020, Management of Multi Organ Dysfunction in Neonatal Encephalopathy. Front Pediatr, DOI: 10.3389/fped.2020.00239
Molloy EJ, Bearer CF, 2020 May 26, When research goes wrong: the importance of clinical trials methodology. Pediatr Res, DOI: 10.1038/s41390-020-0984-5
Camden VJ, Molloy EJ, Bearer CF, 2020 May 25, Our new feature: Narrative Medicine. Pediatr Res, DOI: 10.1038/s41390-020-0983-6
Molloy EJ, 2020 Apr 28, The Doctor's Dilemma: lessons from GB Shaw in a modern pandemic COVID-19. Pediatr Res, DOI: 10.1038/s41390-020-0927-1
Sweetman DU, Kelly L, Hurley T, Onwuneme C, Watson RWG, Murphy JFA, Slevin M, Molloy EJ, 2020 Apr 13, Troponin T correlates with MRI results in neonatal encephalopathy. Acta Paediatr, DOI: 10.1111/apa.15255
Molloy EJ, Murphy N, 2020 Apr 3, Vitamin D, Covid-19 and Children. Ir Med J, DOI: 10.1111/apa.15255
Molloy EJ, Bearer CF, 2020 Apr 3, COVID-19 in children and altered inflammatory responses. Pediatr Res, DOI: 10.1038/s41390-020-0881-y
Zareen Z, Strickland T, Eneaney VM, Kelly LA, McDonald D, Sweetman D, Molloy EJ, 2020 Mar 30, Cytokine dysregulation persists in childhood post Neonatal Encephalopathy. BMC Neurol, DOI: 10.1186/s12883-020-01656-w
Molloy EJ, Wynn JL, Bliss J, Koenig JM, Keij FM, McGovern M, Kuester H, Turner MA, Giannoni E, Mazela J, Degtyaeva M, Strunk T, Simons SHP, Janota J, Plotz FB, van den Hoogen A, de Boode W, Schlapbach LJ, Reiss IKM, on behalf of the Infection, Inflammation, Immunology and Immunisation (I4) section of the ESPR., 2020 Jul, Neonatal sepsis: need for consensus definition, collaboration and core outcomes. Pediatr Res, DOI: 10.1038/s41390-020-0850-5
Huggard D, Doherty DG, Molloy EJ, 2020, Immune Dysregulation in Children With Down Syndrome. Front Pediatr, DOI: 10.3389/fped.2020.00073
McGovern M, Giannoni E, Kuester H, Turner MA, van den Hoogen A, Bliss JM, Koenig JM, Keij FM, Mazela J, Finnegan R, Degtyareva M, Simons SHP, de Boode WP, Strunk T, Reiss IKM, Wynn JL, Molloy EJ, Infection, Inflammation, Immunology and Immunisation (I4) section of the ESPR., 2020 Jul, Challenges in developing a consensus definition of neonatal sepsis. Pediatr Res, DOI: 10.1038/s41390-020-0785-x
Lagan N, Huggard D, Mc Grane F, Leahy TR, Franklin O, Roche E, Webb D, O' Marcaigh A, Cox D, El-Khuffash A, Greally P, Balfe J, Molloy EJ, 2020 Jun, Multiorgan involvement and management in children with Down syndrome. Acta Paediatr, DOI: 10.1111/apa.15153
Dibble M, O'Dea MI, Hurley T, Byrne A, Colleran G, Molloy EJ, Bokde ALW, 2019 Dec 10, Diffusion tensor imaging in neonatal encephalopathy: a systematic review. Arch Dis Child Fetal Neonatal Ed, DOI: 10.1136/archdischild-2019-318025
Huggard D, Kelly L, Ryan E, McGrane F, Lagan N, Roche E, Balfe J, Leahy TR, Franklin O, Doherty DG, Molloy EJ, 2020 Mar, Increased systemic inflammation in children with Down syndrome. Cytokine, DOI: 10.1016/j.cyto.2019.154938
Ui Mhaonaigh A, Coughlan AM, Dwivedi A, Hartnett J, Cabral J, Moran B, Brennan K, Doyle SL, Hughes K, Lucey R, Floudas A, Fearon U, McGrath S, Cormican S, De Bhailis A, Molloy EJ, Brady G, Little MA, 2019, Low Density Granulocytes in ANCA Vasculitis Are Heterogenous and Hypo-Responsive to Anti-Myeloperoxidase Antibodies. Front Immunol, DOI: 10.3389/fimmu.2019.02603
Sweetman D, Kelly LA, Zareen Z, Nolan B, Murphy J, Boylan G, Donoghue V, Molloy EJ, 2019, Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy. Front Pediatr, DOI: 10.3389/fped.2019.00399
Eliwan HO, Watson WRG, Regan I, Philbin B, O'Hare FM, Strickland T, O'Neill A, O'Rourke M, Blanco A, Healy M, Nolan B, Smith O, Molloy EJ, 2019, Pediatric Intensive Care: Immunomodulation With Activated Protein C ex vivo. Front Pediatr, DOI: 10.3389/fped.2019.00386
Huggard D, Koay WJ, Kelly L, McGrane F, Ryan E, Lagan N, Roche E, Balfe J, Leahy TR, Franklin O, Moreno-Oliveira A, Melo AM, Doherty DG, Molloy EJ, 2019, Altered Toll-Like Receptor Signalling in Children with Down Syndrome. Mediators Inflamm, DOI: 10.1155/2019/4068734
Ryan E, Eves D, Menon PJ, Alnafisee S, Mooney EE, Downey P, Culliton M, Murphy JFA, Vavasseur C, Molloy EJ, 2020 Apr, Histological chorioamnionitis is predicted by early infant C-reactive protein in preterm infants and correlates with neonatal outcomes. Acta Paediatr, DOI: 10.1111/apa.15038
Bearer CF, Chalak L, Fuentes-Afflick E, Molloy EJ, 2020 Jan, The rewards of peer-reviewing. Pediatr Res, DOI: 10.1038/s41390-019-0573-7
Molloy EJ, 2019 Dec, Dr Janusz Korczak: paediatrician, children's advocate and hero. Pediatr Res, DOI: 10.1038/s41390-019-0495-4
O'Leary N, Jairaj C, Molloy EJ, McAuliffe FM, Nixon E, O'Keane V, 2019 Jul, Antenatal depression and the impact on infant cognitive, language and motor development at six and twelve months postpartum. Early Hum Dev, DOI: 10.1016/j.earlhumdev.2019.05.021
Aslam S, Strickland T, Molloy EJ, 2019, Neonatal Encephalopathy: Need for Recognition of Multiple Etiologies for Optimal Management. Front Pediatr, DOI: 10.3389/fped.2019.00142
Molloy EJ, Bearer CF, 2019 Aug, Insights in Pediatric Research. Pediatr Res, DOI: 10.1038/s41390-019-0394-8
Brennan K, O'Leary BD, Mc Laughlin D, Kinlen D, Molloy EJ, Cody D, Paran S, McAuliffe FM, Hogan AE, Doyle SL, 2019 Jul, Nucleic acid cytokine responses in obese children and infants of obese mothers. Cytokine, DOI: 10.1016/j.cyto.2019.03.015
Bearer CF, Molloy EJ, 2019 Jul, Gender bias at Pediatric Research? Pediatr Res, DOI: 10.1038/s41390-018-0246-y
Molloy EJ, Mader S, Modi N, Gale C, 2019 Jan, Parent, child and public involvement in child health research: core value not just an optional extra. Pediatr Res, DOI: 10.1038/s41390-018-0245-z
Geraghty AA, O'Brien EC, Alberdi G, Horan MK, Donnelly J, Larkin E, Segurado R, Mehegan J, Molloy EJ, McAuliffe FM, 2018 Dec, Maternal protein intake during pregnancy is associated with child growth up to 5 years of age, but not through insulin-like growth factor-1: findings from the ROLO study. Br J Nutr, DOI: 10.1017/S0007114518002611
Huggard D, McGrane F, Lagan N, Roche E, Balfe J, Leahy TR, Franklin O, Moreno A, Melo AM, Doherty DG, Molloy EJ, 2018 Nov 3, Altered endotoxin responsiveness in healthy children with Down syndrome. BMC Immunol, DOI: 10.1186/s12865-018-0270-z
McGovern M, Flynn L, Coyne S, Molloy EJ, 2019 Jan, Question 2: Does coagulase negative staphylococcal sepsis cause neurodevelopmental delay in preterm infants? Arch Dis Child, DOI: 10.1136/archdischild-2018-316004
Huggard D, Molloy EJ, 2019 Jan, Question 1: Palivizumab for all children with Down syndrome? Arch Dis Child, DOI: 10.1136/archdischild-2018-316140
Donnelly JM, Lindsay K, Walsh JM, Horan MK, O'Shea D, Molloy EJ, McAuliffe FM, 2020 Apr, Perinatal inflammation and childhood adiposity - a gender effect? J Matern Fetal Neonatal Med, DOI: 10.1080/14767058.2018.1517315
Molloy EJ, Bearer C, 2018 Nov, Neonatal encephalopathy versus Hypoxic-Ischemic Encephalopathy. Pediatr Res, DOI: 10.1038/s41390-018-0169-7
Huggard D, Molloy EJ, 2018 Nov, Question 1: Do children with Down syndrome benefit from extra vaccinations? Arch Dis Child, DOI: 10.1136/archdischild-2018-315541
Bearer CF, Molloy EJ, 2018 Jul, Pediatric research: brief update on key objectives. Pediatr Res, DOI: 10.1038/s41390-018-0087-8
Molloy EJ, Gale C, Marsh M, Bearer CF, Devane D, Modi N, 2018 Sep, Developing core outcome set for women's, newborn, and child health: the CROWN Initiative. Pediatr Res, DOI: 10.1038/s41390-018-0041-9
Brennan K, O'Leary BD, Mc Laughlin D, Breen EP, Connolly E, Ali N, O'Driscoll DN, Ozaki E, Mahony R, Mulfaul K, Ryan AM, Ni Chianain A, McHugh A, Molloy EJ, Hogan AE, Paran S, McAuliffe FM, Doyle SL, 2018 Aug 15, Type 1 IFN Induction by Cytosolic Nucleic Acid Is Intact in Neonatal Mononuclear Cells, Contrasting Starkly with Neonatal Hyporesponsiveness to TLR Ligation Due to Independence from Endosome-Mediated IRF3 Activation. J Immunol, DOI: 10.4049/jimmunol.1700956
Quinlan SMM, Rodriguez-Alvarez N, Molloy EJ, Madden SF, Boylan GB, Henshall DC, Jimenez-Mateos EM, 2018 Jul 3, Complex spectrum of phenobarbital effects in a mouse model of neonatal hypoxia-induced seizures. Sci Rep, DOI: 10.1038/s41598-018-28044-2
Onwuneme C, Molloy EJ, 2018 Aug, Question 2: Vitamin D intake for preterm infants: how much do they really need? Arch Dis Child, DOI: 10.1136/archdischild-2018-315363
O'Driscoll DN, McGovern M, Greene CM, Molloy EJ, 2018 May 11, Gender disparities in preterm neonatal outcomes. Acta Paediatr, DOI: 10.1111/apa.14390
O'Driscoll DN, Greene CM, Molloy EJ, 2017 Nov, Immune function? A missing link in the gender disparity in preterm neonatal outcomes. Expert Rev Clin Immunol, DOI: 10.1080/1744666X.2017.1386555
Molloy EJ, Curstedt T, Halliday HL, Hallman M, Saugstad OD, Speer CP, 2017, Sharing Progress in Neonatal (SPIN) Brain, Gut, Heart, and Lung. Neonatology, DOI: 10.1159/000464316
O'Hare FM, Watson RW, O'Neill A, Segurado R, Sweetman D, Downey P, Mooney E, Murphy J, Donoghue V, Molloy EJ, 2017 Apr, Serial cytokine alterations and abnormal neuroimaging in newborn infants with encephalopathy. Acta Paediatr, DOI: 10.1111/apa.13745
O'Driscoll DN, De Santi C, McKiernan PJ, McEneaney V, Molloy EJ, Greene CM, 2017 May, Expression of X-linked Toll-like receptor 4 signaling genes in female vs. male neonates. Pediatr Res, DOI: 10.1038/pr.2017.2
Sweetman DU, Onwuneme C, Watson WR, Murphy JF, Molloy EJ, 2017, Perinatal Asphyxia and Erythropoietin and VEGF: Serial Serum and Cerebrospinal Fluid Responses. Neonatology, DOI: 10.1159/000448702
Molloy EJ, Modi N, Greenough A, Lagercrantz H, Bearer CF, Turner M, 2017 Jan, The future of pediatric research: European perspective. Pediatr Res, DOI: 10.1038/pr.2016.225
Omer M, Molloy EJ, 2017 Jan, QUESTION 2: Is permissive hypercapnia beneficial to preterm infants? Arch Dis Child, DOI: 10.1136/archdischild-2016-312050
Cowman J, Quinn N, Geoghegan S, Müllers S, Oglesby I, Byrne B, Somers M, Ralph A, Voisin B, Ricco AJ, Molloy EJ, Kenny D, 2016 Oct, Dynamic platelet function on von Willebrand factor is different in preterm neonates and full-term neonates: changes in neonatal platelet function. J Thromb Haemost, DOI: 10.1111/jth.13414
Sweetman DU, Onwuneme C, Watson WR, O'Neill A, Murphy JF, Molloy EJ, 2016 Nov, Renal function and novel urinary biomarkers in infants with neonatal encephalopathy. Acta Paediatr, DOI: 10.1111/apa.13555
Cosgrove P, Molloy EJ, 2016 Sep, QUESTION 2: Is frusemide necessary following red cell transfusion in preterm neonates? Arch Dis Child, DOI: 10.1136/archdischild-2016-311620
Onwuneme C, Blanco A, O'Neill A, Watson B, Molloy EJ, 2016 Apr, Vitamin D enhances reactive oxygen intermediates production in phagocytic cells in term and preterm infants. Pediatr Res, DOI: 10.1038/pr.2015.268
Donnelly JM, Lindsay KL, Walsh JM, Horan M, Molloy EJ, McAuliffe FM, 2015 Nov 10, Fetal metabolic influences of neonatal anthropometry and adiposity. BMC Pediatr, DOI: 10.1186/s12887-015-0499-0
Bearer CF, Molloy EJ, 2016 Jan, Expanding research, relevance, and reach. Pediatr Res, DOI: 10.1038/pr.2015.228
Geoghegan S, Nicholson AJ, Molloy EJ, 2015 Jul-Aug, Incorporating Teaching in Global Child Health into Irish Medical School Curriculum. Ir Med J, DOI: 10.1038/pr.2015.228
Onwuneme C, Diya B, Uduma O, McCarthy RA, Murphy N, Kilbane MT, McKenna MJ, Molloy EJ, 2016 Aug, Correction of vitamin D deficiency in a cohort of newborn infants using daily 200 IU vitamin D supplementation. Ir J Med Sci, DOI: 10.1007/s11845-015-1341-2
Onwuneme C, Carroll A, Doherty D, Bruell H, Segurado R, Kilbane M, Murphy N, McKenna MJ, Molloy EJ, 2015 Oct, Inadequate vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care. Acta Paediatr, DOI: 10.1111/apa.13090
O'Hare FM, Watson W, O'Neill A, Grant T, Onwuneme C, Donoghue V, Mooney E, Downey P, Murphy J, Twomey A, Molloy EJ, 2015 Jul, Neutrophil and monocyte toll-like receptor 4, CD11b and reactive oxygen intermediates, and neuroimaging outcomes in preterm infants. Pediatr Res, DOI: 10.1038/pr.2015.66

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