Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Clinical performance of Bladder EpiCheck™ versus voided urine cytology for detecting recurrence of nonmuscle invasive bladder cancer: Systematic review and meta-analysis","authors":"Cho-Han Chiang MD, MMSc ,&nbsp;Yu-Cheng Chang MD ,&nbsp;Chun-Yu Peng MD ,&nbsp;Shih-Syuan Wang MD ,&nbsp;Aunchalee Jaroenlapnopparat MD ,&nbsp;Jeff Chun Hao Wang MD ,&nbsp;Chen Liang Jou MD ,&nbsp;Pui-Un Tang MD ,&nbsp;Yuan Ping Hsia MD ,&nbsp;Cho-Hsien Chiang MD ,&nbsp;Cho-Hung Chiang MD","doi":"10.1016/j.urolonc.2024.07.009","DOIUrl":"10.1016/j.urolonc.2024.07.009","url":null,"abstract":"<div><h3>Background</h3><div>Nonmuscle invasive bladder cancer (NMIBC) has a favorable prognosis but has high propensity for recurrence. Recent development in one of the urinary biomarker tests, Bladder EpiCheck™, offers a noninvasive and accurate method to detect NMIBC recurrence. In this study, we aimed to compare the diagnostic performance of Bladder EpiCheck™ with urine cytology to detect NMIBC recurrence.</div></div><div><h3>Methods</h3><div>We performed a systematic review search through PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to July 2023. Diagnostic accuracy was defined by sensitivity, negative predictive value (NPV), specificity, and positive predictive value (PPV).</div></div><div><h3>Results</h3><div>A total of 6 studies involving 1588 patients were included. Bladder EpiCheck™ has a sensitivity and specificity of 0.81 (95% CI: 0.63–0.91; I²: 43%) and 0.87 (95% CI: 0.83–0.91; I²: 20%), respectively. On the other hand, urine cytology has a sensitivity and specificity of 0.63 (95% CI: 0.29–0.87; I²: 61%) and 0.97 (95% CI: 0.78–1.00; I²: 79%), respectively. EpiCheck™ has a higher NPV (0.94 (95% CI: 0.87–0.97) vs. 0.84 (95% CI: 0.80–0.87) though a lower PPV (0.62 (95% CI: 0.45–0.76) vs. 0.87 (95% CI: 0.56–0.97) than urine cytology. In our subgroup analysis, the sensitivity of Bladder EpiCheck™ for detecting high-grade tumors improved to 0.90 (95% CI: 0.83–0.94) while that for urine cytology improved to 0.72 (95% CI: 0.50–0.87).</div></div><div><h3>Conclusion</h3><div>Bladder EpiCheck™ has a high sensitivity and NPV for detecting recurrence among patients with NMIBC.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 449.e21-449.e28"},"PeriodicalIF":2.4,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142018782","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":"Radical cystectomy with stentless urinary diversion: A systematic review and meta-analysis of comparative studies.","authors":"Alessandro Veccia, Davide Brusa, Lorenzo Treccani, Sarah Malandra, Emanuele Serafin, Sonia Costantino, Francesco Cianflone, Francesco Ditonno, Francesca Montanaro, Francesca Fumanelli, Matteo Ferro, Giorgio Mazzon, Riccardo Autorino, Riccardo Bertolo, Alessandro Antonelli","doi":"10.1016/j.urolonc.2024.06.025","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.06.025","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically compare the evidence about surgical outcomes, postoperative complications, and sequelae of Radical cystectomy with urinary diversion with or without stent placement.</p><p><strong>Material and methods: </strong>A literature search was performed through PubMed, Scopus®, and Web of Science up to December 2023 in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. The study protocol was registered in PROSPERO (CRD 42023492384), and the research question was formulated according to the PICOs model. Three comparative studies were identified, 2 randomized and 1 prospective coming from a randomized cohort.</p><p><strong>Results: </strong>The stent group showed higher odds of postoperative major complications (OR 3.00 - 95%CI 1.06; 8.52; P = 0.04) than the stentless group. There was no statistically significant difference between the 2 groups regarding 30-day readmission (P = 0.06), postoperative uretero-ileal anastomotis stricture (UIAS) (P = 0.09), postoperative uretero-ileal anastomotis leak (UIAL) (P = 0.20), postoperative urinary tract infections (UTIs) (P = 0.08), and postoperative ureteral obstruction (P = 0.35). No statistically significant difference between the 2 groups was found regarding UIAS management in terms of ureteral reimplantation (P = 0.28) or dilatation (P = 0.36).</p><p><strong>Conclusions: </strong>Our pooled data analysis shows no statistically significant difference between stentless and stented urinary diversion after radical cystectomy. Stentless could be a reasonable choice when performing diversion during radical cystectomy.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009565","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":"Radical cystectomy in the female patient: The pelvic floor, sexual function, and patient/provider education.","authors":"David E Rapp, Jacqueline Zillioux","doi":"10.1016/j.urolonc.2024.07.007","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.07.007","url":null,"abstract":"<p><p>Radical cystectomy in women results in numerous deleterious anatomic impacts to the pelvic floor that can result in sexual dysfunction, pelvic organ prolapse, and other disorders of pelvic floor function. A comprehensive understanding of this relationship and the quality-of-life impacts of radical cystectomy in women is important. This narrative review provides an overview of female pelvic floor disorders in the setting of radical cystectomy, with focus on present understanding of related anatomy, incidence, and prevention strategies, as well as the importance of both provider and patient education.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000744","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":"Factors influencing readmission patterns following radical cystectomy: An analysis of social determinants and discharge outcomes","authors":"Valentina Grajales M.D., M.S. ,&nbsp;Jonathan Y. Lin M.S. ,&nbsp;Danielle Sharbaugh M.P.H. ,&nbsp;Maria Pere M.D. ,&nbsp;Adam Sharbaugh M.D. ,&nbsp;David T. Miller M.D. ,&nbsp;Dan Pelzman M.D. ,&nbsp;ZhaoJun Sun Ph.D., M.S. ,&nbsp;Kirsten Y. Eom M.P.H. ,&nbsp;Benjamin J. Davies M.D. ,&nbsp;Jonathan G. Yabes Ph.D. ,&nbsp;Lindsay M. Sabik Ph.D. ,&nbsp;Bruce L. Jacobs M.D., M.P.H.","doi":"10.1016/j.urolonc.2024.06.011","DOIUrl":"10.1016/j.urolonc.2024.06.011","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Radical cystectomy readmission rates remain high, with around 25% of patients readmitted to index and nonindex hospitals in 30 days. Nonindex readmissions have been associated with poorer outcomes, including longer lengths of stay and higher mortality rates. This study aimed to examine the associations of social factors (e.g., sex, race, socioeconomic status, insurance type, and resident location) on readmission to index versus nonindex hospitals and discharge disposition.</div></div><div><h3>Methods</h3><div>We conducted a population-based retrospective study using the Pennsylvania Cancer Registry (PCR) to identify patients diagnosed with nonmetastatic muscle-invasive bladder cancer who underwent radical cystectomy in Pennsylvania between 2010 and 2018. Readmitted patients were identified using the Pennsylvania Health Care Cost Containment Council data (PHC4). The primary outcome was readmission location (i.e., index or nonindex hospital) following radical cystectomy. We used chi-square tests for categorical variables, Wilcoxon rank sum test for continuous variables, multivariable logistic regression model to assess predictors of being readmitted to an index hospital and calculating the predicted probability of being admitted to an index hospital depending on discharge disposition.</div></div><div><h3>Results</h3><div>A total of 517 patients were readmitted within 30-days after radical cystectomy. The majority of readmissions were index readmissions (83%). Median readmission hospital stay was 4 days (interquartile range [IQR] 4) for index and 5 days (IQR 7) for nonindex hospitals, <em>P</em> = 0.01. Patients readmitted to index hospitals had fewer comorbidities (median weighted Elixhauser Comorbidity Index 2 (IQR 2)) and lived in urban areas (89%). Discharge with home care was associated with a higher odds of index readmission (odds ratio, [OR] 2.40; 95% confidence interval, [CI] 1.25–4.52).</div></div><div><h3>Conclusions</h3><div>Patients residing in urban areas and with fewer comorbidities were more likely to be readmitted to index hospitals than nonindex hospitals. Socioeconomic status and insurance type did not correlate with the type of readmission. Finally, being discharged with home health care was found to be a predictor of readmission to an index hospital.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 449.e13-449.e19"},"PeriodicalIF":2.4,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996600","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":"Comprehensive behavioural assessment of TERT in bladder cancer","authors":"Meryem El Azzouzi ,&nbsp;Hajar El Ahanidi ,&nbsp;Ilias Hassan ,&nbsp;Mohammed Tetou ,&nbsp;Ahmed Ameur ,&nbsp;Mounia Bensaid ,&nbsp;Abderrahmane Al Bouzidi ,&nbsp;Mohamed Oukabli ,&nbsp;Chaimae Hafidi Alaoui ,&nbsp;Boutaina Addoum ,&nbsp;Imane Chaoui ,&nbsp;Laila Benbacer ,&nbsp;Mohammed El Mzibri ,&nbsp;Mohammed Attaleb","doi":"10.1016/j.urolonc.2024.06.024","DOIUrl":"10.1016/j.urolonc.2024.06.024","url":null,"abstract":"<div><h3>Background</h3><div>Telomerase activity plays a crucial role in cancer development and progression. Thus, telomerase activation through the interplay of mutations and epigenetic alterations in the telomerase reverse transcriptase (TERT) promoter may provide further insight into bladder cancer induction and progression.</div></div><div><h3>Methods</h3><div>In this study 100 bladder tumour tissues were selected, and four molecular signatures were analysed: THOR methylation status, TERT promotor mutation, telomere length, and TERT expression.</div></div><div><h3>Results</h3><div>In our study, 88% of bladder cancer patients had an hypermethylation of the THOR region and 60% had mutations in the TERT promoter region. TERT promoter methylation was observed in all stages and grades of bladder cancer. While, TERT promoter mutations were detected in advanced stages and grades. In our cohort, high levels of TERT expression and long telomeres have been found in noninvasive cases of bladder cancer, with a significant association between TERT expression and Telomere length. Interestingly, patients with low TERT expression and cases with long telomeres had significantly longer Disease-free survival and overall survival.</div></div><div><h3>Conclusion</h3><div>The methylation and mutations occurring in the TERT promoter are implicated in bladder carcinogenesis, offering added prognostic and supplying novel insight into telomere biology in cancer.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 451.e19-451.e29"},"PeriodicalIF":2.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988916","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 global view of the challenges and limitations of precision medicine for genitourinary cancers","authors":"Mariane S. Fontes M.D.","doi":"10.1016/j.urolonc.2024.07.001","DOIUrl":"10.1016/j.urolonc.2024.07.001","url":null,"abstract":"<div><div>Prostate and bladder cancers are the most common genitourinary cancers. In the past 2 decades, there has been increasing drug approval for these cancers, but there are patients who inherently do not respond or progress on such therapies highlighting the need for a better understanding of disease biology and mechanisms of resistance. Precision medicine has attempted to better select patients for specific therapies, although many advances have taken place in this field, access to targeted therapies and technology is distinct in different parts of the world. In this special Seminars issue, precision medicine and derived therapies were explored, as well as the impact on the management of prostate and bladder cancer, specially focusing on the challenges and limitations encountered by the international community when attempting to incorporate and implement the best clinical practice as recommended by worldwide accepted guidelines.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 389-391"},"PeriodicalIF":2.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988915","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":"Telehealth visit type and patient-reported outcomes among patients with cancer","authors":"Daniel S. Carson M.D., M.S. ,&nbsp;Sam Simpson B.S. ,&nbsp;Adam J. Gadzinski M.D., M.S. ,&nbsp;Sarah K. Holt Ph.D. ,&nbsp;Blair Stewart M.S. ,&nbsp;Erika M. Wolff Ph.D. ,&nbsp;Chad Ellimoottil M.D., M.S. ,&nbsp;John L. Gore M.D., M.S., F.A.C.S.","doi":"10.1016/j.urolonc.2024.07.015","DOIUrl":"10.1016/j.urolonc.2024.07.015","url":null,"abstract":"<div><h3>Background</h3><div>Relaxed licensing restrictions on telehealth use during the COVID-19 pandemic allowed broad use irrespective of visit type. As these telehealth waivers expire, optimal uses of telehealth must be assessed to inform policy and clinical care. We evaluated patient experience associated with telehealth and in-person new or established visits.</div></div><div><h3>Methods</h3><div>Patients seen in-person and via telehealth for urologic cancer care from August 2019 to June 2022 received a survey on satisfaction with care, perceptions of communication during their visit, travel time, travel costs, and days of work missed. We assessed survey responses with descriptive statistics.</div></div><div><h3>Results</h3><div>Surveys were completed for 1,031 patient visits (N = 494 new visits, N = 537 established visits). Satisfaction rates were high for all visit modalities among new and established patients (mean score range 59.9–60.7 [maximum 63], <em>P</em> &gt; 0.05). Patient-rated quality of the encounter did not differ by visit type and modality (<em>P</em> &gt; 0.05, for nearly all comparisons). New in-person patient visits were associated with significantly higher travel costs (mean $496.10, SD $1021) compared with new telehealth visits (mean $26.60, SD $141; <em>P</em> &lt; 0.001); 27% of new in-person patients required plane travel and 41% required a hotel stay (<em>P</em> &lt; 0.001 vs. 0.8% and 3.2% of new telehealth patients, respectively).</div></div><div><h3>Conclusions</h3><div>Satisfaction outcomes among patients with urologic cancer receiving new patient telehealth care equaled those of new patients cared for in-person while costs were significantly lower. Offering telehealth exemption beyond COVID-19 licensing waivers to include new patient visits would allow for ongoing delivery of high-quality urologic cancer care irrespective of geographic location.</div></div>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"42 12","pages":"Pages 448.e17-448.e22"},"PeriodicalIF":2.4,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983348","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":"Intraoperative margin assessment with near real time pathology during partial gland ablation of prostate cancer: A feasibility study.","authors":"Miles P Mannas, Fang-Ming Deng, Adrian Ion-Margineanu, Christian Freudiger, Derek Jones, Deepthi Hoskoppal, Jonathan Melamed, James Wysock, Daniel A Orringer, Samir S Taneja","doi":"10.1016/j.urolonc.2024.06.023","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.06.023","url":null,"abstract":"<p><strong>Background: </strong>In-field or in-margin recurrence after partial gland cryosurgical ablation (PGCA) of prostate cancer (PCa) remains a limitation of the paradigm. Stimulated Raman histology (SRH) is a novel microscopic technique allowing real time, label-free, high-resolution microscopic images of unprocessed, un-sectioned tissue which can be interpreted by humans or artificial intelligence (AI). We evaluated surgical team and AI interpretation of SRH for real-time pathologic feedback in the planning and treatment of PCa with PGCA.</p><p><strong>Methods: </strong>About 12 participants underwent prostate mapping biopsies during PGCA of their PCa between January and June 2022. Prostate biopsies were immediately scanned in a SRH microscope at 20 microns depth using 2 Raman shifts to create SRH images which were interpreted by the surgical team intraoperatively to guide PGCA, and retrospectively assessed by AI. The cores were then processed, hematoxylin and eosin stained as per normal pathologic protocols and used for ground truth pathologic assessment.</p><p><strong>Results: </strong>Surgical team interpretation of SRH intraoperatively revealed 98.1% accuracy, 100% sensitivity, 97.3% specificity for identification of PCa, while AI showed a 97.9% accuracy, 100% sensitivity and 97.5% specificity for identification of clinically significant PCa. 3 participants' PGCA treatments were modified after SRH visualized PCa adjacent to an expected MRI predicted tumor margin or at an untreated cryosurgical margin.</p><p><strong>Conclusion: </strong>SRH allows for accurate rapid identification of PCa in PB by a surgical team interpretation or AI. PCa tumor mapping and margin assessment during PGCA appears to be feasible and accurate. Further studies evaluating impact on clinical outcomes are warranted.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917546","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 contemporary review: mpMRI in prostate cancer screening and diagnosis.","authors":"Bryn M Launer, Taryn A Ellis, Kristen R Scarpato","doi":"10.1016/j.urolonc.2024.05.012","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.05.012","url":null,"abstract":"<p><p>Prostate cancer (PCa) screening has evolved beyond PSA and digital rectal exam to include multiparametric prostate MRI (mpMRI). Incorporating this advanced imaging tool has further limited the well-established problem of overdiagnosis, aiding in the identification of higher grade, clinically significant cancers. For this reason, mpMRI has become an important part of the diagnostic pathway and is recommended across guidelines in biopsy naïve patients or for patients with prior negative biopsy. This contemporary review evaluates the most recent literature on the role of mpMRI in the screening and diagnosis of prostate cancer. Barriers to utilization of mpMRI still exist including variable access, high cost, and requisite expertise, encouraging evaluation of novel techniques such as biparametric MRI. Future screening and diagnostic practice patterns will undoubtedly evolve as our understanding of novel biomarkers and artificial intelligence improves.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917545","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":"Controversies in prostate cancer screening.","authors":"Daisy Obiora, Oluwaseun Orikogbo, Benjamin J Davies, Bruce L Jacobs","doi":"10.1016/j.urolonc.2024.06.022","DOIUrl":"https://doi.org/10.1016/j.urolonc.2024.06.022","url":null,"abstract":"<p><p>Prostate cancer is the second most diagnosed cancer and the fifth leading cause of cancer death among men worldwide. In the 1980s, the development and implementation of Prostate-Specific Antigen (PSA) testing for diagnosing prostate cancer led to a surge in the number of prostate cancer diagnoses. We explore the trends in recommendations and new innovations in adjunctive testing for prostate cancer screening.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914123","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}