JNCI Cancer Spectrum最新文献

{"title":"Outpatient palliative care and end-of-life care intensity: linking Massachusetts Cancer Registry with All-Payer Claims Database.","authors":"Nancy L Keating, Joel S Weissman, Alexi A Wright, Robert Wolf, Susan Gershman, Richard Knowlton, John Z Ayanian","doi":"10.1093/jncics/pkaf010","DOIUrl":"10.1093/jncics/pkaf010","url":null,"abstract":"<p><strong>Background: </strong>Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across 8 provider networks in Massachusetts.</p><p><strong>Methods: </strong>We linked Massachusetts Cancer Registry and the All-Payer Claims Database for individuals with commercial insurance, Medicaid, or Medicare Advantage diagnosed with colorectal, lung, prostate, and breast cancers from 2010 to 2013 who died by December 31, 2014. We characterized outpatient palliative care visits in the 6 months before death and identified end-of-life hospitalizations, emergency department visits, intensive care unit admissions, chemotherapy, no/late hospice enrollment, and in-hospital deaths. We used logistic regression to assess factors associated with outpatient palliative care and ordinal logistic regression with provider network fixed effects to assess the association of palliative care with a composite measure summing individual end-of-life intensity measures.</p><p><strong>Results: </strong>Among 6279 decedents, 11.3% had at least 1 outpatient palliative care visit. Palliative care use varied across provider networks from 6.0% to 19.3%. In adjusted analyses, younger age, longer duration from diagnosis to death, death in 2012-2014 vs 2010, and provider network were associated with palliative care visits (all P values less than .05). End-of-life care intensity varied across provider networks. Patients with palliative care visits had lower adjusted odds of receiving intensive end-of-life care (adjusted odds ratio = 0.62 per additional measure of end-of-life intensity, 95% CI = 0.53 to 0.72).</p><p><strong>Conclusions: </strong>Outpatient palliative care use varied substantially among regional provider networks and was associated with less intensive end-of-life care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11847477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopausal hormone therapy: assessing associations with breast and colorectal cancers by familial risk.","authors":"Robert J MacInnis, Mark A Jenkins, Roger L Milne, Esther M John, Mary B Daly, Irene L Andrulis, Sarah V Colonna, Kelly-Anne Phillips, Loic Le Marchand, Polly A Newcomb, Amanda I Phipps, Stephanie L Schmit, Finlay A Macrae, Daniel D Buchanan, Steven Gallinger, Rish K Pai, Niloy J Samadder, Graham G Giles, Melissa C Southey, John L Hopper, Mary Beth Terry","doi":"10.1093/jncics/pkae121","DOIUrl":"10.1093/jncics/pkae121","url":null,"abstract":"<p><p>Menopausal users of hormone replacement therapy (HRT) are at increased breast cancer risk and decreased colorectal cancer (CRC) risk compared with individuals who have never used HRT, but these opposing associations may differ by familial risk of breast cancer and CRC. We harmonized data from 3 cohorts and generated separate breast cancer and CRC familial risk scores based on cancer family history. We defined moderate or strong family history as a risk score of 0.4 or higher, where 0.4 was equivalent to a 50-year-old woman with 1 parent diagnosed with either breast cancer or CRC at 55 years of age. Of 24 486 women assessed, 1243 and 405 were diagnosed with incident breast cancer and CRC, respectively. For breast cancer, menopausal HRT ever use versus never use hazard ratios were 1.27 (95% CI = 1.11 to 1.45) for a breast cancer familial risk score below 0.4 and 1.01 (95% CI = 0.82 to 1.25) for a breast cancer familial risk score of 0.4 or higher (Pdifference = .08). For CRC, menopausal HRT hazard ratios were 0.63 (95% CI = 0.50 to 0.78) for a CRC familial risk score below 0.4 and 1.21 (95% CI = 0.73 to 2.00) for a CRC familial risk score of 0.4 or higher (Pdifference = .03). Associations with menopausal HRT use that apply to the general population may not hold for women at moderate or strong familial risk of these cancers.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of undifferentiated carcinomas of the pancreas with and without osteoclast-like giant cells.","authors":"Jamie N Mills, Valerie Gunchick, Jake McGue, Zhaoping Qin, Chandan Kumar-Sinha, Filip Bednar, Noah Brown, Jiaqi Shi, Aaron M Udager, Timothy Frankel, Mark M Zalupski, Vaibhav Sahai","doi":"10.1093/jncics/pkae097","DOIUrl":"10.1093/jncics/pkae097","url":null,"abstract":"<p><strong>Background: </strong>Undifferentiated carcinoma (UC) is a rare subtype of pancreatic cancer distinguished from UC with osteoclast-like giant cells (UC-OGC) in 2019, affecting interpretation of literature that does not distinguish these subtypes. We sought to identify translationally relevant differences between these 2 variants and compared with pancreatic ductal adenocarcinoma.</p><p><strong>Methods: </strong>We characterized clinical and multiomic differences between UC (n = 32) and UC-OGC (n = 15) using DNA sequencing, RNA sequencing, and multiplex immunofluorescence and compared these findings with pancreatic ductal adenocarcinoma.</p><p><strong>Results: </strong>Characteristics at diagnosis were similar between UC and UC-OGC, though the latter was more resectable (P = .009). Across all stages, median overall survival was shorter for UC than for UC-OGC (0.4 years vs 10.8 years, respectively; P = .003). This shorter survival was retained after stratification by resection, albeit without statistical significance (1.8 years vs 11.9 years, respectively; P = .08). In a subset of patients with available tissue, the genomic landscape was similar among UC (n = 9), UC-OGC (n = 5), and pancreatic ductal adenocarcinoma (n = 159). Bulk RNA sequencing was deconvoluted and, along with multiplex immunofluorescence in UC (n = 13), UC-OGC (n = 5), and pancreatic ductal adenocarcinoma (n = 16), demonstrated statistically significantly increased antigen-presenting cells, including M2 macrophages and natural killer cells, and decreased cytotoxic and regulatory T cells in UC and UC-OGC vs pancreatic ductal adenocarcinoma. Findings were similar between UC and UC-OGC , except for decreased regulatory T cells in UC-OGC (P = .04).</p><p><strong>Conclusions: </strong>In this series, UC was more aggressive than UC-OGC, with these variants having more antigen-presenting cells and fewer regulatory T cells than pancreatic ductal adenocarcinoma, suggesting potential for immune-modulating therapies in the treatment of these pancreatic cancer subtypes.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in breast cancer risk associated with benign breast disease from 1967 to 2013.","authors":"Amy C Degnim, Karthik Ghosh, Robert A Vierkant, Stacey J Winham, Tanya L Hoskin, Jodi M Carter, Bryan M McCauley, Matt R Jensen, Teresa Allers, Marlene Frost, Denice L Gehling, Jessica L Fischer, Lisa R Seymour, Laura M Pacheco-Spann, Philip S Rosenberg, Lori A Denison, Celine M Vachon, Lynn C Hartmann, Derek C Radisky, Mark E Sherman","doi":"10.1093/jncics/pkae128","DOIUrl":"10.1093/jncics/pkae128","url":null,"abstract":"<p><strong>Background: </strong>Benign breast disease (BBD) increases breast cancer (BC) risk progressively for women diagnosed with nonproliferative change, proliferative disease without atypia (PDWA), and atypical hyperplasia (AH). Leveraging data from 18 704 women in the Mayo BBD Cohort (1967-2013), we evaluated temporal trends in BBD diagnoses and how they have influenced associated BC risk over 4 decades.</p><p><strong>Methods: </strong>BC risk trends associated with BBD were evaluated using standardized incidence ratios (SIRs) and age-period-cohort modeling across 4 eras-premammogram (1967-1981), precore needle biopsy (CNB) (1982-1992), transition to CNB (1993-2001), and CNB era (2002-2013).</p><p><strong>Results: </strong>With a median follow-up of 15.8 years, 9.9% of women were diagnosed with BC (invasive and/or DCIS). From the premammogram era to the CNB era, we observed a significant increase in BC risk, rising from an SIR of 1.61 to 1.99. The proportion of proliferative BBD diagnoses (PDWA or AH) increased markedly over time (28.1%-49.7%), as did the proportion of DCIS events (11%-28%; χ2  P < .001). Within specific BBD categories, the risk of invasive BC increased modestly.</p><p><strong>Conclusions: </strong>Absolute risk of BC within BBD categories remained stable, but the relative risk of BC after BBD increased over time due to notable increases in higher risk BBD lesions, specifically PDWA and AH. These findings illustrate how evolving screening practices have changed the risk profile of BBD and should inform management strategies for patients with BBD in modern clinical settings.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the intersection of climate vulnerability and cancer burden in North Carolina.","authors":"Joyce Pak, Ngan Le, Eman M Metwally, Jeanny Wang, Arrianna Marie Planey, Amy M Lowman, Bradford E Jackson, Eboneé N Butler, Jennifer L Lund","doi":"10.1093/jncics/pkae124","DOIUrl":"10.1093/jncics/pkae124","url":null,"abstract":"<p><p>Climate-related extreme weather events disrupt health-care systems and exacerbate health disparities, particularly affecting individuals diagnosed with cancer. This study explores the intersection of climate vulnerability and cancer burden in North Carolina (NC). Using county-level data from the US Climate Vulnerability Index (CVI) and the NC Department of Health and Human Services, we analyzed cancer incidence and mortality rates from 2017 to 2021. Our findings reveal a robust correlation between CVI percentiles and cancer mortality (r = 0.72). Counties with high area deprivation like Scotland, Robeson, and Halifax had the highest CVI percentiles of 0.68, 0.67, and 0.66, with respective cancer mortality rates of 193, 195, and 196 per 100 000 person-years. Correlations between CVI and cancer incidence were modest (r = 0.22). These results underscore the need for targeted public health interventions to mitigate climate-related health disparities. Future work could focus on exploring specific climate hazards and cancer outcomes to enhance preparedness and resilience in cancer care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic determinants of cancer screening adherence among cancer survivors: analysis from the 2020 Behavioral Risk Factor Surveillance System.","authors":"Edoardo Beatrici, Zhiyu Qian, Dejan K Filipas, Benjamin V Stone, Filippo Dagnino, Muhieddine Labban, Stuart R Lipsitz, Giovanni Lughezzani, Nicolò M Buffi, Alexander P Cole, Quoc-Dien Trinh","doi":"10.1093/jncics/pkae127","DOIUrl":"10.1093/jncics/pkae127","url":null,"abstract":"<p><strong>Background: </strong>Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and health-care access factors may be associated with adherence to recommended cancer screenings.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System. Cancer survivors eligible for United States Preventive Services Task Force-recommended breast, cervical, prostate, and colorectal screenings were included. Multivariable logistic regression models were used to identify socioeconomic factors significantly associated with screening adherence.</p><p><strong>Results: </strong>Overall, 64 958 (weighted national estimate = 29 066 143) cancer survivors were included. Adherence rates varied across cancer types: 80.9% for breast, 88.9% for cervical, 54.1% for prostate, and 84.7% for colorectal cancer. Key predictors of low adherence included lower income (breast: adjusted odds ratio [aOR] = 0.56, 95% confidence interval [CI] = 0.43 to 0.74; cervical: aOR = 0.38, 95% CI = 0.24 to 0.59; prostate: aOR = 0.36, 95% CI = 0.24 to 0.52; colorectal: aOR = 0.74, 95% CI = 0.57 to 0.96), lack of health-care coverage for colorectal cancer (aOR = 0.51, 95% CI = 0.36 to 0.73), time since last checkup between 1 and 2 years prior for breast (aOR = 0.58, 95% CI = 0.45 to 0.75), prostate (aOR = 0.66, 95% CI = 0.47 to 0.91), and colorectal (aOR = 0.69, 95% CI = 0.56 to 0.86) cancer, and no health-care provider for breast (aOR = 0.68, 95% CI = 0.47 to 0.98), prostate (aOR = 0.45, 95% CI = 0.31 to 0.65), and colorectal (aOR = 0.51, 95% CI = 0.40 to 0.66) cancer.</p><p><strong>Conclusion: </strong>Cancer survivors' adherence to screening is associated with factors including lack of health-care coverage, lower income, time since the last exam, and having a personal provider. Targeted interventions accounting for such factors may help mitigate these disparities.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: \"Narrative review of lifestyle interventions in breast cancer survivors: current evidence and future directions\".","authors":"Alain Braillon","doi":"10.1093/jncics/pkae125","DOIUrl":"10.1093/jncics/pkae125","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for a cancer exposome atlas: a scoping review.","authors":"Anna S Young, Catherine E Mullins, Neha Sehgal, Roel C H Vermeulen, P Martijn Kolijn, Jelle Vlaanderen, Mohammad L Rahman, Brenda M Birmann, Dinesh Barupal, Qing Lan, Nathaniel Rothman, Douglas I Walker","doi":"10.1093/jncics/pkae122","DOIUrl":"10.1093/jncics/pkae122","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in understanding genetic susceptibility to cancer, much of cancer heritability remains unidentified. At the same time, the makeup of industrial chemicals in our environment only grows more complex. This gap in knowledge on cancer risk has prompted calls to expand cancer research to the comprehensive, discovery-based study of nongenetic environmental influences, conceptualized as the \"exposome.\"</p><p><strong>Methods: </strong>Our scoping review aimed to describe the exposome and its application to cancer epidemiology and to study design limitations, challenges in analytical methods, and major unmet opportunities in advanced exposome profiling methods that allow the quantification of complex chemical exposure profiles in biological matrices. To evaluate progress on incorporating measurements of the exposome into cancer research, we performed a review of such \"cancer exposome\" studies published through August 2023.</p><p><strong>Results: </strong>We found that only 1 study leveraged untargeted chemical profiling of the exposome as a method to measure tens of thousands of environmental chemicals and identify prospective associations with future cancer risk. The other 13 studies used hypothesis-driven exposome approaches that targeted a set of preselected lifestyle, occupational, air quality, social determinant, or other external risk factors. Many of the included studies could only leverage sample sizes with less than 400 cancer cases (67% of nonecologic studies) and exposures experienced after diagnosis (29% of studies). Six cancer types were covered, most commonly blood (43%), lung (21%), or breast (14%) cancer.</p><p><strong>Conclusion: </strong>The exposome is underutilized in cancer research, despite its potential to unravel complex relationships between environmental exposures and cancer and to inform primary prevention.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Braillon.","authors":"Kaitlin Chakos, Lisa Tussing-Humphreys, Kelsey Gabel","doi":"10.1093/jncics/pkae126","DOIUrl":"10.1093/jncics/pkae126","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer clinical trial participation: a qualitative study of Black/African American communities' and patient/survivors' recommendations.","authors":"Linda Kaljee, Sylvester Antwi, Doreen Dankerlui, Donna Harris, Barbara Israel, Denise White-Perkins, Valerie Ofori Aboah, Livingstone Aduse-Poku, Harriet Larrious-Lartey, Barbara Brush, Chris Coombe, La'Toshia Patman, Nayomi Cawthorne, Sophia Chue, Zachary Rowe, Cassandra Mills, Kurt Fernando, Gwendolyn Daniels, Eleanor M Walker, Evelyn Jiagge","doi":"10.1093/jncics/pkae119","DOIUrl":"10.1093/jncics/pkae119","url":null,"abstract":"<p><strong>Background: </strong>Black/African Americans experience disproportionate cancer burden and mortality rates. Racial and ethnic variation in cancer burden reflects systemic and health-care inequities, cancer risk factors, and heredity and genomic diversity. Multiple systemic, sociocultural, economic, and individual factors also contribute to disproportionately low Black/African American participation in cancer clinical trials.</p><p><strong>Methods: </strong>The Participatory Action for Access to Clinical Trials project used a community-based participatory research approach inclusive of Black/African American community-based organizations, Henry Ford Health, and the University of Michigan Urban Research Center. The project aims were to understand Black/African Americans' behavioral intentions to participate in cancer clinical trials and to obtain recommendations for improving participation. Audio-recorded focus group data were transcribed and coded, and searches were conducted to identify themes and subthemes. Representative text was extracted from the transcripts.</p><p><strong>Results: </strong>Six community focus group discussions (70 participants) and 6 Henry Ford Health patient/survivor focus group discussions (29 participants) were completed. General themes related to trial participation were identified, including (1) systemic issues related to racism, health disparities, and trust in government, health systems, and clinical research; (2) firsthand experiences with health care and health systems; (3) perceived and experienced advantages and disadvantages of clinical trial participation; and (4) recruitment procedures and personal decision-making processes. Specific recommendations on how to address barriers were obtained.</p><p><strong>Conclusions: </strong>Community-based participatory research is effective in bringing communities equitably to the table. To build trust, health systems must provide opportunities for patients and communities to jointly identify factors affecting cancer clinical trial participation, implement recommendations, and address health disparities.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11781321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}