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{"title":"Swept up in the tsunami: Pediatric and adolescent steatotic (fatty) liver disease.","authors":"Scott L Friedman","doi":"10.1016/j.medj.2024.04.007","DOIUrl":"https://doi.org/10.1016/j.medj.2024.04.007","url":null,"abstract":"<p><p>The worldwide epidemic of steatotic (fatty) liver disease also affects children and adolescents. The consensus statement by Zhang et al.¹ summarizes key evidence on detection, risk factors, manifestations, comorbidities, and potential treatments in children and adolescents. The work emphasizes the need for advancements in managing this threat to the health and longevity of young individuals.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":"5 7","pages":"647-648"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604258","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":"Icosapent ethyl modulates circulating vascular regenerative cell content: The IPE-PREVENTION CardioLink-14 trial.","authors":"Ehab Bakbak, Aishwarya Krishnaraj, Deepak L Bhatt, Adrian Quan, Brady Park, Asaad I Bakbak, Basel Bari, Kristin A Terenzi, Yi Pan, Elizabeth J Fry, Daniella C Terenzi, Pankaj Puar, Tayyab S Khan, Ori D Rotstein, C David Mazer, Lawrence A Leiter, Hwee Teoh, David A Hess, Subodh Verma","doi":"10.1016/j.medj.2024.03.009","DOIUrl":"10.1016/j.medj.2024.03.009","url":null,"abstract":"<p><strong>Background: </strong>REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) showed that icosapent ethyl (IPE) reduced major adverse cardiovascular events by 25%. Since the underlying mechanisms for these benefits are not fully understood, the IPE-PREVENTION CardioLink-14 trial (ClinicalTrials.gov: NCT04562467) sought to determine if IPE regulates vascular regenerative (VR) cell content in people with mild to moderate hypertriglyceridemia.</p><p><strong>Methods: </strong>Seventy statin-treated individuals with triglycerides ≥1.50 and <5.6 mmol/L and either atherosclerotic cardiovascular disease or type 2 diabetes with additional cardiovascular risk factors were randomized to IPE (4 g/day) or usual care. VR cells with high aldehyde dehydrogenase activity (ALDH^hi) were isolated from blood collected at the baseline and 3-month visits and characterized with lineage-specific cell surface markers. The primary endpoint was the change in frequency of pro-vascular ALDH^hiside scatter (SSC)^lowCD133⁺ progenitor cells. Change in frequencies of ALDH^hiSSC^mid monocyte and ALDH^hiSSC^hi granulocyte precursor subsets, reactive oxygen species production, serum biomarkers, and omega-3 levels were also evaluated.</p><p><strong>Findings: </strong>Baseline characteristics, cardiovascular risk factors, and medications were balanced between the groups. Compared to usual care, IPE increased the mean frequency of ALDH^hiSSC^lowCD133⁺ cells (-1.00% ± 2.45% vs. +7.79% ± 1.70%; p = 0.02), despite decreasing overall ALDH^hiSSC^low cell frequency. IPE assignment also reduced oxidative stress in ALDH^hiSSC^low progenitors and increased ALDH^hiSSC^hi granulocyte precursor cell content.</p><p><strong>Conclusions: </strong>IPE-PREVENTION CardioLink-14 provides the first translational evidence that IPE can modulate VR cell content and suggests a novel mechanism that may underlie the cardioprotective effects observed with IPE in REDUCE-IT.</p><p><strong>Funding: </strong>HLS Therapeutics provided the IPE in kind and had no role in the study design, conduct, analyses, or interpretation.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"718-734.e4"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327214","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":"Endoscopic duodenal mucosa ablation techniques for diabetes and nonalcoholic fatty liver disease: A systematic review.","authors":"Giovanni Musso, Silvia Pinach, Francesca Saba, Franco De Michieli, Maurizio Cassader, Roberto Gambino","doi":"10.1016/j.medj.2024.03.014","DOIUrl":"10.1016/j.medj.2024.03.014","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is increasing at an alarming rate, and only 50% of patients with T2DM achieve or maintain adequate glycemic control with pharmacological therapies. Metabolic surgery demonstrated superior efficacy compared to medical therapy but is unfeasible for most patients with T2DM. Duodenal mucosal resurfacing (DMR) by hydrothermal mucosal ablation, recellularization via electroporation therapy (ReCET), and photodynamic therapy are novel endoscopic procedures that use thermal, electrical, and photochemical energy, respectively, to ablate and reset dysfunctional duodenal mucosa. We assessed the data on the effects of these techniques on glycemic control and nonalcoholic fatty liver disease (NAFLD).</p><p><strong>Methods: </strong>We systematically searched independently and in duplicate English and non-English language publications through January 31st, 2024. Outcomes assessed were an improvement in different metabolic health parameters and the safety of duodenal mucosal ablation (DMA) procedures. Outcomes were presented descriptively.</p><p><strong>Findings: </strong>We selected 12 reports reporting results from 3 randomized and 6 uncontrolled trials (seven evaluating DMR, two evaluating ReCET, all with a low risk of bias) for a total of 317 patients enrolled. DMA reduced HbA1c, fasting plasma glucose, and liver fat. When combined with newer antidiabetic drugs, it allowed insulin discontinuation in up to 86% patients. No major safety signal emerged.</p><p><strong>Conclusions: </strong>All DMA techniques improve glucose homeostasis; DMR and ReCET appear to be safe in patients with T2DM. If confirmed by future randomized trials and by trials with histological endpoints in NAFLD, then DMA appears to be a promising alternative or complement option to medications for T2DM and NAFLD treatment.</p><p><strong>Funding: </strong>This study received no funding.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"735-758.e2"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868222","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":"An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease.","authors":"Le Zhang, Mortada El-Shabrawi, Louise A Baur, Christopher D Byrne, Giovanni Targher, Mohit Kehar, Gilda Porta, Way Seah Lee, Sander Lefere, Serap Turan, Anna Alisi, Ram Weiss, Maria Felicia Faienza, Ambika Ashraf, Shikha S Sundaram, Anshu Srivastava, Ruth De Bruyne, Yunkoo Kang, Flora Bacopoulou, Yong-Hai Zhou, Andy Darma, Monica Lupsor-Platon, Masahide Hamaguchi, Anoop Misra, Nahum Méndez-Sánchez, Nicholas Beng Hui Ng, Claude Marcus, Amanda E Staiano, Nadia Waheed, Saleh A Alqahtani, Cosimo Giannini, Ponsiano Ocama, Mindie H Nguyen, Maria Teresa Arias-Loste, Mohamed Rabea Ahmed, Giada Sebastiani, Yong Poovorawan, Mamun Al Mahtab, Juan M Pericàs, Themis Reverbel da Silveira, Peter Hegyi, Amer Azaz, Hasan M Isa, Chatmanee Lertudomphonwanit, Mona Issa Farrag, Ahmed Abd Alwahab Nugud, Hong-Wei Du, Ke-Min Qi, Nezha Mouane, Xin-Ran Cheng, Tawfiq Al Lawati, Eleonora D T Fagundes, Hasmik Ghazinyan, Adamos Hadjipanayis, Jian-Gao Fan, Nicoleta Gimiga, Naglaa M Kamal, Gabriela Ștefănescu, Li Hong, Smaranda Diaconescu, Ming Li, Jacob George, Ming-Hua Zheng","doi":"10.1016/j.medj.2024.03.017","DOIUrl":"10.1016/j.medj.2024.03.017","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in children and adolescents, particularly those with obesity. NAFLD is considered a hepatic manifestation of the metabolic syndrome due to its close associations with abdominal obesity, insulin resistance, and atherogenic dyslipidemia. Experts have proposed an alternative terminology, metabolic dysfunction-associated fatty liver disease (MAFLD), to better reflect its pathophysiology. This study aimed to develop consensus statements and recommendations for pediatric MAFLD through collaboration among international experts.</p><p><strong>Methods: </strong>A group of 65 experts from 35 countries and six continents, including pediatricians, hepatologists, and endocrinologists, participated in a consensus development process. The process encompassed various aspects of pediatric MAFLD, including epidemiology, mechanisms, screening, and management.</p><p><strong>Findings: </strong>In round 1, we received 65 surveys from 35 countries and analyzed these results, which informed us that 73.3% of respondents agreed with 20 draft statements while 23.8% agreed somewhat. The mean percentage of agreement or somewhat agreement increased to 80.85% and 15.75%, respectively, in round 2. The final statements covered a wide range of topics related to epidemiology, pathophysiology, and strategies for screening and managing pediatric MAFLD.</p><p><strong>Conclusions: </strong>The consensus statements and recommendations developed by an international expert panel serve to optimize clinical outcomes and improve the quality of life for children and adolescents with MAFLD. These findings emphasize the need for standardized approaches in diagnosing and treating pediatric MAFLD.</p><p><strong>Funding: </strong>This work was funded by the National Natural Science Foundation of China (82070588, 82370577), the National Key R&D Program of China (2023YFA1800801), National High Level Hospital Clinical Research Funding (2022-PUMCH-C-014), the Wuxi Taihu Talent Plan (DJTD202106), and the Medical Key Discipline Program of Wuxi Health Commission (ZDXK2021007).</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"797-815.e2"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874811","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":"Normal or improved cardiovascular risk factors in IGF-I-deficient adults with growth hormone receptor deficiency.","authors":"Jaime Guevara-Aguirre, Amrendra Mishra, Marco Canepa, Carolina Guevara, Álvaro Villacres, Alexandra Guevara, Gabriela Peña, Daniela Lescano, John J Kopchick, Priya Balasubramanian, Valter D Longo","doi":"10.1016/j.medj.2024.03.022","DOIUrl":"10.1016/j.medj.2024.03.022","url":null,"abstract":"<p><strong>Background: </strong>Human subjects with generalized growth hormone (GH) insensitivity due to GH receptor deficiency (GHRD)/Laron syndrome display a very low incidence of insulin resistance, diabetes, and cancer, as well as delayed age-related cognitive decline. However, the risk of cardiovascular disease (CVD) in these subjects is poorly understood. Here, we have assessed cardiovascular function, damage, and risk factors in GHRD subjects and their relatives.</p><p><strong>Methods: </strong>We measured markers of CVD in two phases: one in a cohort of 30 individuals (GHRD = 16, control relatives = 14) brought to USC (in Los Angeles, CA) and one in a cohort including additional individuals examined in Ecuador (where the subjects live) for a total of 44 individuals (GHRD = 21, control relatives = 23). Data were collected on GHRD and control groups living in similar geographical locations and sharing comparable environmental and socio-economic circumstances.</p><p><strong>Results: </strong>Compared to controls, GHRD subjects displayed lower serum glucose, insulin, blood pressure, smaller cardiac dimensions, similar pulse wave velocity, lower carotid artery intima-media thickness, lower creatinine, and a non-significant but major reduction in the portion of subjects with carotid atherosclerotic plaques (7% GHRDs vs. 36%, Controls p = 0.1333) despite elevated low-density lipoprotein cholesterol levels.</p><p><strong>Conclusion: </strong>The current study indicates that individuals with GHRD have normal or improved levels of cardiovascular disease risk factors as compared to their relatives.</p><p><strong>Funding: </strong>This study was funded in part by NIH/NIA grant P01 AG034906 to V.D.L.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"816-825.e4"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865271","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":"A hybrid epithelial/mesenchymal state in head and neck cancer: A biomarker for survival with differential prognosis by self-reported race.","authors":"Angela L Mazul, Thomas F Barrett, Graham Colditz, Anuraag S Parikh, Salma Ramadan, Jose P Zevallos, Jason T Rich, R Alex Harbison, Ryan S Jackson, Patrik Pipkorn, Paul Zolkind, Itay Tirosh, Sidharth V Puram","doi":"10.1016/j.medj.2024.05.014","DOIUrl":"10.1016/j.medj.2024.05.014","url":null,"abstract":"<p><strong>Background: </strong>Head and neck squamous cell carcinoma (HNSCC) is the 6^th leading cause of cancer-related mortality, with racial disparities amplifying the challenges in treatment. Although the relationship between hybrid epithelial/mesenchymal (E/M) states and tumor progression is of interest, no studies have characterized the clinical relevance of hybrid E/M states in head and neck cancer outcomes among self-reported racial cohorts.</p><p><strong>Methods: </strong>Given the overlap in gene expression between hybrid E/M malignant cells and cancer-associated fibroblasts, we utilized deconvolution of bulk RNA sequencing data from oral cavity and laryngeal squamous cell carcinoma tumors from The Cancer Genome Atlas. We utilized our previously collected single-cell profiles to generate inferred malignant profiles and then scored these for hybrid E/M. We then conducted a survival analysis on overall and disease-free survival among self-reported Black and White Americans.</p><p><strong>Findings: </strong>The hybrid E/M state was differentially associated with head and neck cancer survival by self-reported race and ethnicity, with a stronger association in non-Hispanic Black patients. Black patients with a high hybrid E/M score had a higher risk of death or recurrence (hazard ratio [HR]: 4.18 [95% confidence interval (CI): 2.06, 8.49]) than White patients with a high hybrid E/M score (HR: 1.58 [95% CI: 1.11, 2.26]).</p><p><strong>Conclusion: </strong>Our results suggest a complex interplay of social structure, racism, and genetic diversity. We implore researchers to consider the social and biological context contributing to disparities.</p><p><strong>Funding: </strong>A.L.M. received support from the National Institute of Minority Health and Health Disparities (K01MD013897 [principal investigator (PI), A.L.M.]). S.V.P. received support from the National Institute of Dental and Craniofacial Research (R01DE032865 [PI, S.V.P.] and R01DE032371 [PI, S.V.P.]).</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"826-831.e3"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11246817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432984","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":"ALINA: Another stepping stone toward a future of LDCT lung cancer screening in never-smokers?","authors":"Misako Nagasaka, Catherine T Ly, Sai-Hong Ignatius Ou","doi":"10.1016/j.medj.2024.05.010","DOIUrl":"https://doi.org/10.1016/j.medj.2024.05.010","url":null,"abstract":"<p><p>The ALINA trial¹ demonstrated that 2 years of adjuvant alectinib achieved statistically significantly improved 2-year overall and central nervous system (CNS) disease-free survival over platinum-doublet chemotherapy in resected early-stage (IB ≥ 4 cm to IIIA) ALK+ non-small cell lung cancer (NSCLC). Identifying early-stage ALK+ NSCLC patients (60% were never-smokers in the ALINA trial) may require low-dose computed tomography (LDCT) lung cancer screening in never-smokers.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":"5 7","pages":"649-651"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604256","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":"Exploiting the potential of dupilumab in the treatment of eosinophilic COPD.","authors":"Maria Gabriella Matera, Mario Cazzola","doi":"10.1016/j.medj.2024.05.011","DOIUrl":"10.1016/j.medj.2024.05.011","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) often involves type 1 (T1) inflammation, but 40% of patients have T2 inflammation, which worsens outcomes. Dupilumab, targeting interleukin (IL)-4 and IL-13, shows promise in phase 3 trials. The new NOTUS trial¹ showed effectiveness in reducing exacerbations and improving lung function. However, its predominantly white population limits generalizability. Future research should include diverse populations and assess different therapies combined with dupilumab to improve outcomes.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":"5 7","pages":"652-654"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604257","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":"Cancer research is not correlated with driver gene mutation burdens.","authors":"Gaurav Mendiratta, David Liarakos, Melinda Tong, Satoko Ito, Eugene Ke, George Goshua, Edward C Stites","doi":"10.1016/j.medj.2024.05.013","DOIUrl":"10.1016/j.medj.2024.05.013","url":null,"abstract":"<p><strong>Background: </strong>Cancer research is pursued with the goal of positively impacting patients with cancer. Decisions regarding how to allocate research funds reflect a complex balancing of priorities and factors. Even though these are subjective decisions, they should be made with consideration of all available objective facts. An accurate estimate of the affected cancer patient population by mutation is one variable that has only recently become available to inform funding decisions.</p><p><strong>Methods: </strong>We compared the overall incident burden of mutations within each cancer-associated gene with two measures of cancer research efforts: research grant funding amounts and numbers of academic manuscripts. We ask to what degree the aggregate set of cancer research efforts reflects the relative burdens of the different cancer genetic drivers. We thoroughly investigate the design of our queries to ensure that the presented results are robust and conclusions are well justified.</p><p><strong>Findings: </strong>We find cancer research is generally not correlated with the relative burden of mutation within the different genetic drivers of cancer.</p><p><strong>Conclusions: </strong>We suggest that cancer research would benefit from incorporating, among other factors, an epidemiologically informed mutation-estimate baseline into a larger framework for funding and research allocation decisions.</p><p><strong>Funding: </strong>This work was supported in part by the National Institutes of Health (NIH) P30CA014195 and NIH DP2AT011327.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"832-838.e4"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440930","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":"Unlocking the power of nanomedicine: Cell membrane-derived biomimetic cancer nanovaccines for cancer treatment.","authors":"Guo Zhao, Shuhang Wang, Guangjun Nie, Ning Li","doi":"10.1016/j.medj.2024.03.012","DOIUrl":"10.1016/j.medj.2024.03.012","url":null,"abstract":"<p><p>Over the past decades, nanomedicine researchers have dedicated their efforts to developing nanoscale platforms capable of more precisely delivering drug payloads to attack tumors. Cancer nanovaccines are exhibiting a distinctive capability in inducing tumor-specific antitumor responses. Nevertheless, there remain numerous challenges that must be addressed for cancer nanovaccines to evoke sufficient therapeutic effects. Cell membrane-derived nanovaccines are an emerging class of cancer vaccines that comprise a synthetic nanoscale core camouflaged by naturally derived cell membranes. The specific cell membrane has a biomimetic nanoformulation with several distinctive abilities, such as immune evasion, enhanced biocompatibility, and tumor targeting, typically associated with a source cell. Here, we discuss the advancements of cell membrane-derived nanovaccines and how these vaccines are used for cancer therapeutics. Translational endeavors are currently in progress, and additional research is also necessary to effectively address crucial areas of demand, thereby facilitating the future successful translation of these emerging vaccine platforms.</p>","PeriodicalId":29964,"journal":{"name":"Med","volume":" ","pages":"660-688"},"PeriodicalIF":12.8,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871069","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}