Seminars in oncology最新文献

{"title":"The challenges of selecting cancer medicines for the WHO Essential Medicines List with the elephant in the room: A path forward","authors":"Tito Fojo","doi":"10.1053/j.seminoncol.2023.01.005","DOIUrl":"10.1053/j.seminoncol.2023.01.005","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 427-428"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775423000052/pdfft?md5=abe936cb5be7937f43ddbb2b72a529b3&pid=1-s2.0-S0093775423000052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9162369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of treatment refusal in patients with colorectal cancer: A systematic review","authors":"Yoshan Moodley ,&nbsp;Kumeren Govender ,&nbsp;Jacqueline van Wyk ,&nbsp;Seren Reddy ,&nbsp;Yuming Ning ,&nbsp;Steven Wexner ,&nbsp;Laura Stopforth ,&nbsp;Shona Bhadree ,&nbsp;Vasudevan Naidoo ,&nbsp;Shakeel Kader ,&nbsp;Shalen Cheddie ,&nbsp;Alfred I. Neugut ,&nbsp;Ravi P. Kiran","doi":"10.1053/j.seminoncol.2023.01.002","DOIUrl":"10.1053/j.seminoncol.2023.01.002","url":null,"abstract":"<div><p>This systematic review was conducted to investigate predictors of treatment refusal in colorectal cancer (CRC) patients. An understanding of these predictors would inform statistical models for the identification of high-risk patients who might benefit from interventions that seek to improve treatment compliance. We performed a search of PubMed and Scopus to identify potentially relevant studies on predictors of treatment refusal in CRC patients that were published between January 1, 2000 and December 31, 2021. We screened manuscripts using predefined eligibility criteria. Information on study design, study location, patient characteristics, treatments, rates and predictors of treatment refusal, and the impact of treatment refusal on mortality or survival were collected from eligible studies. Study quality was assessed using the Newcastle-Ottawa score. The overall findings of the review process were summarized using descriptive statistics and a narrative synthesis. A total of 13 studies were included in this review. Ten studies reported on refusal of CRC surgery, refusal rate: 0.25%–3.26%; three studies reported on chemotherapy refusal (one of which reported on both surgery and chemotherapy refusal), refusal rate: 7.8%–41.5%; and one study reported on refusal of any cancer treatment, refusal rate: 8.7%. The bulk of the published literature confirmed the harmful association between treatment refusal and poor survival outcomes in CRC patients. Frequently cited predictors of treatment refusal included patient demographic characteristics (age, race, gender), clinical characteristics (disease stage, comorbidity), and factors that impact access to cancer care services (healthcare insurance, facility level). Potentially high rates of treatment refusal pose a challenge to CRC control. This review has identified several factors which must be considered when attempting to reduce treatment refusal in CRC patients. Furthermore, these factors should be tested as components of predictive risk models for this important outcome.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 456-464"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9162370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway disorders associated with immune checkpoint inhibitor therapy: Two case reports and a systematic review","authors":"Naoki Kawakami ,&nbsp;Hiroaki Saito ,&nbsp;Susumu Takahashi ,&nbsp;Shinpei Kajie ,&nbsp;Rina Kato ,&nbsp;Kazuhiro Shimaya ,&nbsp;Yoko Wakai ,&nbsp;Kazuhito Saito ,&nbsp;Mai Sakashita","doi":"10.1053/j.seminoncol.2023.01.003","DOIUrl":"10.1053/j.seminoncol.2023.01.003","url":null,"abstract":"<div><p><span><span><span><span>Immune checkpoint inhibitors (ICI) are widely used for the </span>treatment of various malignant neoplasms. </span>Interstitial lung disease is a well-known immune-related adverse event, however, ICI-induced airway disease remains under-recognized. Herein, we report two similar cases of pembrolizumab-induced </span>tracheobronchitis<span><span><span> presenting as persistent chronic cough and dyspnea. Blood tests revealed elevated C-reactive protein levels without </span>eosinophilia<span>. Spirometry demonstrated mild airflow obstruction. </span></span>Computed tomography<span><span> revealed diffuse thickening of the tracheobronchial walls and bronchiectasis predominantly in the lower lobes. </span>Bronchoscopy<span> revealed edematous and erythematous tracheobronchial mucosa<span>, and bronchial biopsy tissue exhibited marked inflammation with predominant infiltration of CD8+ lymphocytes. Subsequently, pembrolizumab-induced tracheobronchitis was diagnosed in both cases. Cessation of </span></span></span></span></span>pembrolizumab<span><span> and initiation of erythromycin<span>, inhaled corticosteroids, and long-acting beta-agonists gradually improved the symptoms, airflow obstruction, and radiographic findings. These were completely resolved in one case. The other case initially showed a poor response to systemic corticosteroids combined with the aforementioned </span></span>drugs<span>, but improved gradually and almost completely. These cases exemplify ICI-induced airway disease that is, an under-recognized manifestation of immune-related adverse events. In addition, we have systematically searched the PubMed database for articles on ICI-induced airway disease, categorized the retrieved articles as eosinophilic and non-eosinophilic airway diseases, and reviewed the differences in treatment and prognoses between these two categories.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Pages 439-455"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9217742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TOC","authors":"","doi":"10.1053/S0093-7754(23)00020-9","DOIUrl":"https://doi.org/10.1053/S0093-7754(23)00020-9","url":null,"abstract":"","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 6","pages":"Page A3"},"PeriodicalIF":4.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0093775423000209/pdfft?md5=8d8fb2492e80010f43e5fef7388f6f63&pid=1-s2.0-S0093775423000209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136916360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Torticollis as a presenting symptom of pediatric CNS tumors: A systematic review","authors":"Nadejda Baklizi,&nbsp;Musthafa Raswoli,&nbsp;Michala Burges,&nbsp;Daniel C. Moreira,&nbsp;Ibrahim Qaddoumi","doi":"10.1053/j.seminoncol.2022.09.003","DOIUrl":"10.1053/j.seminoncol.2022.09.003","url":null,"abstract":"<div><p><span>To assess the frequency of torticollis<span><span> as a presenting symptom of pediatric </span>CNS tumors and its impact on pre-diagnostic symptom intervals (PSIs) and patient outcomes. We performed a </span></span>systematic review<span> of studies reporting torticollis in children with various CNS tumors. We searched PubMed for studies published from January 1972 to March 2021 in English. Case reports were included in the analysis if the following criteria were met (1) torticollis was the presenting symptom secondary to a CNS tumor (2) children &lt;18 years of age, (3) underwent imaging intervention and (4) outcome data provided. Of 1,365 relevant articles, 45 were eligible for analysis according to our inclusion criteria representing 95 patients. Two independent investigators extracted the data, and a third investigator arbitrated discrepancies. We found that 38.9% of CNS tumors exhibited torticollis as the only presenting symptom. PSI lengths ranged from 0 to 4 years (median, 5 months) for low-grade tumors, and patient age and PSI length were inversely associated. Of patients with low-grade tumors, 23.8% received physiotherapy, in contrast with 0% of patients with high-grade tumors. PSI length also increased for patients who received rehabilitation, and 39.3% and 7.1% of patients with high-grade and low-grade tumors, respectively, died of their disease. Patients with low-grade tumors and torticollis as a primary presenting symptom were more likely to have a prolonged PSI. Therefore, CNS tumors should be considered in the differential diagnosis of acquired torticollis in children.</span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 419-425"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40386849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maintenance or consolidation therapy in small-cell lung cancer: an updated systematic review and meta-analysis.","authors":"Lorenzo Belluomini ,&nbsp;Sara Pilotto ,&nbsp;Alice Avancini ,&nbsp;Jessica Insolda ,&nbsp;Marco Sposito ,&nbsp;Jessica Menis ,&nbsp;Chiara Ciccarese ,&nbsp;Roberto Iacovelli ,&nbsp;Miriam Grazia Ferrara ,&nbsp;Michele Milella ,&nbsp;Emilio Bria ,&nbsp;Antonio Rossi","doi":"10.1053/j.seminoncol.2022.09.001","DOIUrl":"10.1053/j.seminoncol.2022.09.001","url":null,"abstract":"<div><p><span><span>We performed an updated meta-analysis to explore the role of maintenance therapy in SCLC. </span>Clinical trials with randomization to maintenance/consolidation (</span><em>V)</em> placebo or observation or best supportive care in SCLC, both extended and limited disease were searched from January 2009 to March 2022. The hazard ratios (HR) for progression-free survival (PFS) and overall survival (OS) with the relative 95% confidence interval (CI) were extracted from each study. Summary HR was calculated using random- or fixed-effects models, depending on the heterogeneity of the included studies. A total of 9 studies were identified. Neither PFS nor OS were improved with maintenance/consolidation (PFS: random-effect; HR 0.93; 95% CI 0.71–1.21; <em>P</em>=0.10; OS: fixed-effect; HR 0.98; 95% CI 0.89–1.08; <em>P</em><span>=0.14). Among the different strategies, immunotherapy maintenance showed a significantly decreased risk of progression (</span><em>V)</em>standard of care (random-effect; HR 0.80; 95% CI 0.66–0.97; <em>P</em>=0.03). The current updated meta-analysis did not demonstrate a benefit of maintenance/consolidation therapy in SCLC, with only a PFS benefit for immunotherapy approach.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 389-393"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40388766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis on non-metastatic castration resistant prostate cancer: The radiation oncologist's perspective","authors":"Gianluca Ingrosso ,&nbsp;Marta Bottero ,&nbsp;Carlotta Becherini ,&nbsp;Saverio Caini ,&nbsp;Emanuele Alì ,&nbsp;Andrea Lancia ,&nbsp;Piet Ost ,&nbsp;Giuseppe Sanguineti ,&nbsp;Shankar Siva ,&nbsp;Thomas Zilli ,&nbsp;Giulio Francolini ,&nbsp;Rita Bellavita ,&nbsp;Cynthia Aristei ,&nbsp;Lorenzo Livi ,&nbsp;Beatrice Detti","doi":"10.1053/j.seminoncol.2022.09.005","DOIUrl":"10.1053/j.seminoncol.2022.09.005","url":null,"abstract":"<div><p><span><span>Prostate cancer<span> is the second most common cause of cancer-related mortality in men. In patients<span> undergoing a failure after radical treatment, one of the therapeutic option is androgen deprivation: despite initial response rates, a progression to a state of castration resistance is observed in most of the patients. In the present article, we conducted a </span></span></span>systematic review and meta-analysis of all </span>clinical trials<span><span><span><span> assessing treatment for nmCRPC with next-generation </span>androgen receptor inhibitors. We performed a review and meta-analysis of phase III </span>randomized controlled trials<span> comparing new agents (apalutamide, enzalutamide, darolutamide) with placebo as control arm, in the setting of nmCRPC. Patients treated with next-generation ARIs had a 26% reduction in the risk of death compared with placebo; compared with other ARIs, </span></span>darolutamide<span><span> had the lowest rate of grade 3 and 4 AEs and the lowest therapy discontinuation rate due to any grade AEs. This meta-analysis shows that treatment with new ARIs is safe and significantly reduces the risk of death and of metastasis onset in nmCRPC patients. Under way studies on new biomarkers such as genomic classifiers will probably allow the stratification in more specific subsets of disease. New imaging modalities such as PSMA-PET have shown greater sensibility and specificity than conventional imaging in metastases detection. All patients were randomized in a 2:1 fashion, with a total of 2,694 who underwent next-generation ARIs (806 </span>apalutamide, 955 darolutamide, 933 enzalutamide) and 1,423 in the placebo arm.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 409-418"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on the Wellbeing of International Oncology and Hematology Fellows at the Princess Margaret Cancer Center (PMCC)","authors":"Carlos E. Stecca ,&nbsp;Marie Alt ,&nbsp;Di Maria Jiang ,&nbsp;Glaucia Michelis ,&nbsp;Nazanin Fallah-Rad ,&nbsp;Sharlene Gill ,&nbsp;Mary Elliot ,&nbsp;Srikala S Sridhar","doi":"10.1053/j.seminoncol.2022.09.002","DOIUrl":"10.1053/j.seminoncol.2022.09.002","url":null,"abstract":"<div><h3>Background</h3><p>The COVID-19 pandemic has led to significant disruptions across all levels of medical training. International fellows in subspecialty training programs are essential members of the frontline physician workforce, but may face additional and unique challenges as a result of being away from their home country. In this study, we aimed to understand the impact of the COVID-19 pandemic on the wellbeing of international fellows in the Hematology and/or Oncology fellowship program at the PMCC.</p></div><div><h3>Methods</h3><p>In collaboration with our staff psychiatrist, we conducted an online survey of hematology and/or oncology fellows at the PMCC from July 6 to August 10, 2020. The survey consisted of 60 questions divided into 4 sections: demographics, wellbeing assessment using the validated Short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), fellowship specific questions (personal and professional) and coping strategies using the validated brief COPE scale.</p></div><div><h3>Results</h3><p>Overall 24/52 (46%) fellows completed the survey: 21/24 were international fellows with 48% from Asia, 3/24 were Canadian fellows but away from home; 54% were male; 48% were aged 31–35 years; 65% were married, 48% had children. Mean SWEMWBS score was 21, indicating lower overall wellbeing than the general population who had a score of 23.6. Compared to their pre-COVID status, many reported a decline in their wellbeing (63%), sense of guilt for not being with their family (45%) or helping their country (41%), stress in personal relationships (26%), fatigue (50%), sleep disorders (38%) and loss of interest in daily activities (38%). Personal events were altered by almost 80%; and 20% planned to extend their fellowship. According to the Brief-COPE scale, during the pandemic, most fellows used more adaptive coping mechanisms (mean score 39.2) as opposed to maladaptive ones (mean score 21.8).</p></div><div><h3>Conclusions</h3><p>The ongoing COVID-19 pandemic has negatively affected the overall wellbeing of international fellows. Understanding the specific challenges and coping mechanisms used by international fellows may help institutions develop better targeted strategies to promote wellbeing, professional development and ensure high-quality patient care during unprecedented times like the COVID pandemic.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 383-388"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9452400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10728878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The psychosocial and emotional experiences of cancer patients during the COVID-19 pandemic: A systematic review","authors":"A. Muls,&nbsp;S. Georgopoulou,&nbsp;E. Hainsworth,&nbsp;B. Hartley,&nbsp;G. O'Gara,&nbsp;S. Stapleton,&nbsp;S. Cruickshank","doi":"10.1053/j.seminoncol.2022.08.001","DOIUrl":"10.1053/j.seminoncol.2022.08.001","url":null,"abstract":"<div><h3>Background</h3><p>COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. Global social lockdowns were instigated to reduce spread and prevent health-services from becoming overwhelmed. People having treatment for cancer are known to have heightened psychological/emotional burden. The combined impact of managing pandemic regulations alongside this may present additional burden. The purpose of this systematic review is to examine current evidence of the psychological and emotional impact of COVID-19 on people with cancer, early in the pandemic.</p></div><div><h3>Methods</h3><p>Five electronic databases were searched (Embase, Global Health, HMIC, PsychINFO, CINAHL) from September 2019 to October 2021. Qualitative, quantitative and mixed-method primary research studies exploring emotional and psychological impacts of COVID-19 on cancer patients, limited to English language, were included. Quality appraisal was conducted using the MMAT.</p></div><div><h3>Results</h3><p>Fifty-one papers, with 27,356 people from 21 countries treated for cancer, were included. 43 studies were quantitative with a survey method approach, six studies qualitative and four used a mixed methods design. MMAT score was mostly two or three. Four themes were identified: Emotional aspects and Quality of Life; Psychosocial aspects; Impact of COVID-19 on self; Impact of COVID-19 on cancer, with themes overlapping.</p></div><div><h3>Conclusion</h3><p>Whilst emotional/psychological impacts such as anxiety, isolation, employment fears, and uncertainty about the future were potentially universal concerns early in the pandemic, they may have been particularly acute for people living with cancer and represent complex, overlapping factors. As COVID-19 continues to impact health-services and society, it is important to focus on any ongoing impact to the experience of cancer patients. Most of the studies reviewed used tools that do not provide deeper understanding of how and why emotional states of people with cancer were affected. Further qualitative work may reveal patterns of what was unique to cancer patients during the pandemic, compared to general populations.</p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 371-382"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9554234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Under-representation of women in Randomized Clinical Trials testing anticancer immunotherapy may undermine female patients care. A call to action","authors":"Laura Pala ,&nbsp;Tommaso De Pas ,&nbsp;Fabio Conforti","doi":"10.1053/j.seminoncol.2022.09.004","DOIUrl":"10.1053/j.seminoncol.2022.09.004","url":null,"abstract":"<div><p><span><span>Immunotherapy<span> with immune-checkpoint inhibitors (ICIs) has revolutionized the landscape of cancer treatment, dramatically improving the prognosis of patients with several </span></span>solid tumors. </span>Sex and gender<span><span><span> are variables that affect immune responses to both foreign and self-antigens and growing preclinical and clinical evidence show that they also affect efficacy and tolerability of anticancer immunotherapy </span>in patients<span> with several advanced solid tumors. Despite such strong biological rationale and available evidence highlighting the need to take into account sex-based differences in the context of both research and clinical practice for anticancer immunotherapy, we described here an impressive under-representation of women enrolled in randomized clinical trials (RCTs) testing such </span></span>drugs<span> over the last 10 years. We critically discuss limitations the under-representation of women has on the generalization of results of RCTs to female patients, as well as the importance in the future of ensuring increased enrollment of women in trials, including sex as stratifying factor in trials design, and guaranteeing sex-specific analysis of efficacy and safety results, in order to avoid less than optimal treatment of women with cancer.</span></span></p></div>","PeriodicalId":21750,"journal":{"name":"Seminars in oncology","volume":"49 5","pages":"Pages 400-404"},"PeriodicalIF":4.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}