Bladder Cancer (Amsterdam, Netherlands)最新文献

{"title":"Molecular Biomarkers of Response to PD-1/ PD-L1 Immune Checkpoint Blockade in Advanced Bladder Cancer1","authors":"","doi":"10.3233/blc-200013","DOIUrl":"https://doi.org/10.3233/blc-200013","url":null,"abstract":"","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132862937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CD8+ Cytotoxic Immune Infiltrate in Non-Muscle Invasive Bladder Cancer: A Standardized Methodology to Study Association with Clinico-Pathological Features and Prognosis.","authors":"Alexandra Masson-Lecomte, Pascale Maillé, Silvia Pineda, Pascale Soyeux, Ana Sagrera, Marta Rava, Evangelina Lopez de Maturana, Mirari Márquez, Adonina Tardón, Alfredo Carrato, Manolis Kogevinas, Alexandre de la Taille, Arndt Hartmann, Núria Malats, Paco Real, Yves Allory","doi":"10.3233/blc-180206","DOIUrl":"10.3233/blc-180206","url":null,"abstract":"<p><strong>Background: </strong>Major interest lies in the evaluation of immune infiltrate in bladder cancer. CD8+ cytotoxic lymphocytes are key effectors of adaptive immune response.</p><p><strong>Objectives: </strong>The aims of the study were to set up a standardized methodology for CD8+ lymphocytes estimation in NMIBC and investigate how intra-tumoral heterogeneity influences CD8+ immune infiltrate.</p><p><strong>Methods: </strong>We considered 995 NMIBC included in the Spanish Bladder Cancer (SBC)/EPICURO Study. Duplicate 0.6mm TMA spots and paired full sections (FS) for 50 selected cases were double stained with anti-pan cytokeratin antibody and anti-CD8 antibody. Slides were digitalized and CD8+ cells were automatically counted after tissue recognition (tumor vs stroma). Spatial heterogeneity was assessed and a resampling strategy was applied to estimate the proper number of 0.6mm TMA spots providing an adequate CD8+ cell estimate. Association between CD8+ count and expression of urothelial differentiation markers was estimated. Cox regression models were performed to assess association between CD8+ cell count and risk of recurrence and progression.</p><p><strong>Results: </strong>Microscopic examination of full sections showed spatial heterogeneity for CD8+ infiltrates. Simulation analyses demonstrated that 5 TMA regions provided a correct sampling of tumor and stromal compartments in Ta while 2 and 6 TMA regions were necessary in T1, respectively. CD8+ cells infiltration was associated with stage, regardless of the histological compartment analyzed (median CD8+ /mm² were 25/mm² and 129/mm² in tumor and stroma respectively in Ta and 111/mm² and 344/mm² in T1; <i>p</i>-value = 0.006). CD8+ infiltration in tumor compartment was significantly associated with low FGFR3 expression. CD8+/mm² count in the tumor compartment was not associated with prognosis.</p><p><strong>Conclusion: </strong>Differences identified between Ta and T1 tumours supported the hypothesis that rigorous efforts should be placed in proper study design. These results provide a new framework to investigate microenvironment complexity in bladder cancer.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"159-169"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/68/ff/nihms-1698441.PMC9503287.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33483639","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":"Evaluation of Hematuria in a Large Public Health Care System.","authors":"Rashed Ghandour,&nbsp;Yuval Freifeld,&nbsp;Nirmish Singla,&nbsp;Yair Lotan","doi":"10.3233/BLC-190221","DOIUrl":"https://doi.org/10.3233/BLC-190221","url":null,"abstract":"<p><strong>Background: </strong>Hematuria is the most common presenting symptom in bladder cancer, but many patients are not adequately evaluated.</p><p><strong>Objectives: </strong>To evaluate the type and frequency of hematuria evaluation in a large public health care system.</p><p><strong>Patients and methods: </strong>Electronic medical records of adult patients with urinalysis positive for hematuria (≥3 RBCs/HPF) from January 2015 to April 2018 in an outpatient setting were reviewed. Logistic regression was performed to determine factors associated with urology referral and complete evaluation.</p><p><strong>Results: </strong>11,422 patients met the inclusion criteria; the majority were females (72%) and white race (60%). There were an additional 3,221 patient's with initial diagnosis of UTI. Median age was 49.0 years. Testing included repeat urinalysis (50%), imaging (26%), urology referral (11.4%), cystoscopy (4.4%) and complete evaluation defined as cystoscopy and US/CT/MRI (4%). In the multivariable analysis, factors independently associated with higher referral to urology were age >35, male gender, hypertension, RBCs ≥20. African American race was associated with less referral to urology. Smoking was a significant variable on univariable analysis only. 37 patients (0.25%) were diagnosed with urological malignancies, with bladder cancer in 33, 12 of whom are missed by excluding UTI patients.</p><p><strong>Conclusions: </strong>In the outpatient setting of a public health care system, the vast majority of patients with hematuria are not referred and evaluated properly across all age categories and regardless of smoking status. This might result in missed cancer diagnoses and requires quality improvement measures.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"119-129"},"PeriodicalIF":1.1,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-190221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37535316","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":"Clinical Trials Corner.","authors":"Piyush K Agarwal,&nbsp;Cora N Sternberg","doi":"10.3233/BLC-189040","DOIUrl":"https://doi.org/10.3233/BLC-189040","url":null,"abstract":"","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"447-449"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-189040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667946","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":"Intravesical Radiofrequency-Induced Chemohyperthermia for Carcinoma <i>in Situ</i> of the Urinary Bladder: A Retrospective Multicentre Study.","authors":"F Johannes P van Valenberg,&nbsp;Amir Kajtazovic,&nbsp;Giorgio Canepa,&nbsp;Gerson Lüdecke,&nbsp;Jill-Isabel Kilb,&nbsp;Katja K H Aben,&nbsp;Ofer Nativ,&nbsp;Sanjeev Madaan,&nbsp;Benjamin Ayres,&nbsp;Rami Issa,&nbsp;J Alfred Witjes","doi":"10.3233/BLC-180187","DOIUrl":"https://doi.org/10.3233/BLC-180187","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effect of intravesical radiofrequency-induced chemohyperthermia (RF-CHT) in carcinoma <i>in-situ</i> (CIS) patients overall and split according to previously received therapy.</p><p><strong>Methods: </strong>CIS patients that underwent an induction and maintenance phase of≥6 RF-CHT instillations, and had either pathology or cystoscopy plus cytology available at 6 months of follow-up were retrospectively included. Complete response (CR), recurrences, cystectomy-free rate, overall survival (OS), and adverse events were evaluated. Analysis was performed for overall, bacillus Calmette-Guérin (BCG)-unresponsive, other BCG-treated, and treatment naïve patients.</p><p><strong>Results: </strong>Patients (<i>n</i> = 150) had a mean of 17.5, 9.2, or 0 previous BCG instillations in the BCG-unresponsive (<i>n</i> = 50), other BCG-treated (<i>n</i> = 46, missing <i>n</i> = 4), and treatment naïve groups (<i>n</i> = 47, missing <i>n</i> = 3), respectively. After 6 months, a CR of 46.0%, 71.7%, and 83.0% was found (<i>p</i> < 0.001). Subsequent 2-year recurrence rates were 17.4%, 27.3%, and 12.8%, respectively. The overall cystectomy-free rate and OS at mean follow-up (35.8 months) were 78.5% and 78.0%, respectively. These were 71.4% vs. 84.1% vs. 86.7% (cystectomy-free rate, <i>p</i> = 0.006) and 76.0% vs. 69.6% vs. 87.2% (OS, <i>p</i> = 0.06) for BCG-unresponsive vs. other BCG-treated vs. treatment naïve patients. Progression to muscle-invasive disease was seen in 13.3% of patients. Patients stopped induction or maintenance RF-CHT instillations due to adverse events in respectively 13.4% and 17.8%.</p><p><strong>Conclusions: </strong>Intravesical RF-CHT showed good results in both treatment naïve and BCG-treated CIS patients, avoiding the need for cystectomy in 78.5% of cases for at least 3 years with a modest risk of progression. Thus, RF-CHT proves an alternative to cystectomy in selected high-risk patients.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"365-376"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-180187","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667057","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":"Challenging Cases in Urothelial Cancer.","authors":"Mark S Soloway","doi":"10.3233/BLC-189038","DOIUrl":"https://doi.org/10.3233/BLC-189038","url":null,"abstract":"This is a healthy appearing 77 year old man with bladder cancer. He presented in April 2016 with an episode of gross hematuria. He lives in Central America and was seen by a urologist there. His past medical history is uneventful. He has adult onset type 2 diabetes and takes metformin. He was never a cigarette smoker. The only surgery he had was a right inguinal hernia repair. He is not overweight. In April 2016 he had two papillary tumors which appeared to be Ta. He underwent a transurethral resection and the pathology was low grade Ta. His first surveillance cystoscopy was negative. In October 2016 he had four LG Ta tumors which were resected. This was followed by 6 weeks of intravesical chemotherapy using mitomycin C. The patient was tumor free until August 2018 at which time he was found to have multifocal bladder cancer. A transurethral resection revealed high grade Ta urothelial cancer. There was also focal carcinoma in situ. Lamina propria and muscularis propria were present and were free of cancer. He received one dose of intravesical MMC postoperatively. He elected to have a consultation here in South Florida. He presented with nocturia × 4 and some daytime frequency. Prior to the recent TUR BT he had nocturia × 2 and no daytime voiding complaints. I saw the patient in September 2018. I reviewed the recent bladder tissue (Figs. 1–3) and proceeded with office flexible cystoscopy. The bladder had several","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"441-444"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-189038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667064","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 Lean Muscle Mass Associated with Neoadjuvant Platinum-Based Chemotherapy in Patients with Muscle Invasive Bladder Cancer.","authors":"Kalen J Rimar,&nbsp;Alexander P Glaser,&nbsp;Shilajit Kundu,&nbsp;Edward M Schaeffer,&nbsp;Joshua Meeks,&nbsp;Sarah P Psutka","doi":"10.3233/BLC-180188","DOIUrl":"https://doi.org/10.3233/BLC-180188","url":null,"abstract":"<p><strong>Background: </strong>Baseline sarcopenia or severe lean muscle deficiency is independently associated with increased mortality after cystectomy for muscle-invasive urothelial carcinoma of the bladder (MIUC). The impact of chemotherapy on muscle mass in MIUC patients remains undefined.</p><p><strong>Objectives: </strong>To describe preoperative changes in body composition in MIUC patients receiving platinum-based neoadjuvant chemotherapy (NC).</p><p><strong>Methods: </strong>Patients with cT2-4 N0-1 M0 UC of the bladder who received NC were identified. Lumbar skeletal muscle index (SMI, cm²/m²), visceral adipose index (VAI, cm²/m²), and the subcutaneous and intramuscular adipose index (SAI, cm²/m²) were calculated using validated methodology (cross sectional area of skeletal muscle/height² at L3) from measurement of soft tissue areas on pre- (pre-NC) and post-NC (post-NC) computed tomography. Patients were classified as sarcopenic according to consensus definitions: Male: SMI <55 cm²/m², Female: SMI <38.5 cm²/m². Pre-NC and post-NC median body mass index (BMI kg/m²), SMI, and adipose indices were compared.</p><p><strong>Results: </strong>The study cohort consisted of 26 patients, with a median age 70 years, including 7 females (27%). Chemotherapy regimens included dose-dense methotrexate, vinblastine, doxorubicin and cisplatin (31%), gemcitabine/cisplatin (62%) and gemcitabine/carboplatin (3.8%) with a median of 3.5 (range 2-6) cycles. Median pre- and post-NC BMI were 27.1 kg/m² and 27.2 kg/m² (<i>p</i> = 0.36). Median pre- and post-NC SMI were 49.1 cm²/m² and 44.5 (<i>p</i> < 0.001) respectively. Median percent change in SMI was -6.4% (range -30% to 10%). Pre-NC, 18 (69%) patients were sarcopenic vs. 21 (81%, <i>p</i> = 0.002) post-NC. Median time between initiation of chemotherapy and cystectomy was 110 days.</p><p><strong>Conclusions: </strong>We observed a significant decrease in lean muscle mass among MIUC patients treated with platinum-based NC prior to cystectomy, with an associated increase in the prevalence of sarcopenia. Patients undergoing NC may benefit from pre-habilitative interventions to mitigate lean muscle loss prior to cystectomy.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"411-418"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-180188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667062","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":"Hyperthermic Intravesical Chemotherapy for BCG Unresponsive Non-Muscle Invasive Bladder Cancer Patients.","authors":"Joep J de Jong,&nbsp;Kees Hendricksen,&nbsp;Marloes Rosier,&nbsp;Hugh Mostafid,&nbsp;Joost L Boormans","doi":"10.3233/BLC-180191","DOIUrl":"https://doi.org/10.3233/BLC-180191","url":null,"abstract":"Background: Adjuvant intravesical instillations with bacillus Calmette-Guérin (BCG) is the recommended treatment option for patients with intermediate-and high-risk non-muscle invasive bladder cancer (NMIBC). Despite adequate BCG treatment, a large proportion of patients experience a recurrence. Although radical cystectomy is the gold standard for BCG unresponsive NMIBC, some patients are unfit or unwilling to consider this option. Objective: To assess the effectiveness of Hyperthermic IntraVEsical Chemotherapy (HIVEC®) in BCG unresponsive NMIBC patients. Methods: A post-hoc analysis was conducted of prospectively included intermediate-and high-risk NMIBC patients who were planned to receive HIVEC® treatment between October 2014 and November 2017. For the present analysis, only patients who met the BCG unresponsive definition were included. Patients were followed by cystoscopy and cytology every 3 months and a CT-urography scan yearly. The primary outcome was the disease-free survival (DFS). The Common Terminology Criteria for Adverse Events (CTCAE) was used to assess side-effects. Results: The study population consisted of 55 BCG unresponsive NMIBC patients of whom 52 underwent≥5 HIVEC® treatments. The median age and follow-up were 73 years and 14.0 months (IQR 7.6 – 24.6). The median DFS was 17.7 months (SE 6.72) and progression occurred in four patients. The 1-year cumulative incidence rate of disease recurrence/progression was 53%. Two patients experienced severe side-effects (CTCAE≥3). Conclusions: HIVEC® seems a valid treatment option for BCG unresponsive NMIBC patients. We report a median DFS of 17.7 months (SE 6.72), potentially avoiding or postponing the need for radical surgery in a proportion of these patients.","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"395-401"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-180191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667060","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":"Perioperative Blood Transfusions and Bladder Cancer Outcomes.","authors":"Edward M Messing","doi":"10.3233/BLC-189039","DOIUrl":"https://doi.org/10.3233/BLC-189039","url":null,"abstract":"There are many reasons to restrict administration of allogeneic perioperative blood transfusions (PBTs) including avoiding transfusion reactions, transmission of infections, sensitization against future transfusions and organ transplantations, and of course, “waste” of a precious and scarce resource. However, the one that concerns bladder cancer surgeons the most is having worse oncologic outcomes, particularly reducing cause specific (CSS) and overall survival (OS) for patients undergoing radical cystectomy. The most compelling articles which point to this possibility are two structured reviews [1, 2] which show marginal improvements in OS and CSS and reduction in all-cause mortality (ACM) in patients who have not received a PBT. However, neither review has had the opportunity to analyze patient specific data and very few of the individual studies comprising the reviews actually show a benefit on their own. Moreover, the two structured reviews share 6 studies. The biggest concern with this type of analysis is that they only included retrospective studies with many uncontrolled variables, including different thresholds for administering transfusions, and of course, complicating factors such as prior surgery and or radiation therapy, which lengthen cases and increase the likelihood of administering PBTs. While demographics and stage of disease were often controlled for in the studies, other factors including tumor size, patient frailty, and specific comorbidities","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"445-446"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-189039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667945","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":"Increased Surgical Complications in Smokers Undergoing Radical Cystectomy.","authors":"Niranjan J Sathianathen,&nbsp;Christopher J Weight,&nbsp;Stephanie L Jarosek,&nbsp;Badrinath R Konety","doi":"10.3233/BLC-180185","DOIUrl":"https://doi.org/10.3233/BLC-180185","url":null,"abstract":"<p><strong>Background: </strong>Not only is smoking a risk factor for the development of bladder cancer, it has also been implicated in increasing surgical morbidity and mortality. In general, the demographic and clinical characteristics of smokers are different to non-smokers which can bias the results of the impact of smoking.</p><p><strong>Objective: </strong>To evaluate the impact of smoking on radical cystectomy outcomes.</p><p><strong>Methods: </strong>Radical cystectomy cases were identified in the National Surgical Quality Improvement Program database from 2007-2015. Smokers were matched with non-smokers using propensity scores in a 1:1 ratio. Multivariate logistic regression was performed to evaluate the overall incidence of Clavien III-V complications. Secondary analysis was performed for the incidence of each complication recorded in NSQIP.</p><p><strong>Results: </strong>A total of 850 smokers undergoing radical cystectomy were matched to 850 non-smokers. The matching process improved the balance of covariates between smokers and non-smokers. The overall incidence of Clavien III-V complications was higher in smokers (13.1% vs 7.4%, <i>p</i> < 0.001). This corresponded to an adjusted odds ratio of 1.9 [95% CI 1.4-2.6, <i>p</i> = 0.028]. Other comorbid conditions worsened post-operative complications amongst smokers. When evaluating each complication recorded in the database, smokers had a higher incidence of wound dehiscence, pneumonia and myocardial infarction.</p><p><strong>Conclusion: </strong>Current smokers have a greater risk of morbidity following radical cystectomy. This should be considered when evaluating safety of surgery and patients should be counselled accordingly. Furthermore, even a short period of pre-operative smoking cessation can improve surgical outcomes.</p>","PeriodicalId":290379,"journal":{"name":"Bladder Cancer (Amsterdam, Netherlands)","volume":" ","pages":"403-409"},"PeriodicalIF":1.1,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3233/BLC-180185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36667061","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}