{"title":"Study design and rationale for IFCT- 2203 TAXIO: A study that aims to evaluate the effectiveness of a first-line chemotherapy regimen without etoposide, combined with durvalumab, for patients with extensive disease small cell lung cancer","authors":"Denis Moro-Sibilot , Lionel Falchero , Camille Ardin , Ayoube Zouak , Olivier Molinier , Philippe Romand , Olivier Leleu , Karim Amrane , Célia Berndt , Alexandra Langlais , Franck Morin , Virginie Westeel","doi":"10.1016/j.resmer.2024.101113","DOIUrl":"https://doi.org/10.1016/j.resmer.2024.101113","url":null,"abstract":"<div><h3>Background</h3><p>Studies have shown improvement in overall survival with anti-PD1/PD-L1 molecules in combination with cisplatin/carboplatin and etoposide as a first-line treatment for Small Cell Lung Cancer (SCLC). However, first-line efficacy remains limited and well below that observed in Non-Small Cell Lung Cancer (NSCLC). Etoposide may have a detrimental effect on lymphocyte activation, which could explain the limited benefit of immunotherapy in the first line and the lack of benefit in the second line for patients previously exposed to high levels of etoposide.</p></div><div><h3>Methods</h3><p>We initiated a multicenter, single-arm, open-label phase II study of a chemotherapy regimen with durvalumab, combined with carboplatin and paclitaxel for extensive disease SCLC. Eligible patients will receive durvalumab plus carboplatin and paclitaxel every 3 weeks for up to 4 cycles, followed by durvalumab every 4 weeks until progression or unacceptable toxicity. A total of 67 patients will be enrolled in this study, with a 12-month enrollment period and 36-month follow-up. The primary endpoint is Overall Survival (OS) rate at 12 months. Secondary endpoints are best response rate, OS, OS at 24- and 36 months, progression free survival (PFS), duration of response, quality of life and safety.</p></div><div><h3>Results</h3><p>This study aims to establish the efficacy of durvalumab combined with carboplatin and paclitaxel in patients with extensive disease Small Cell Lung Cancer.</p></div><div><h3>Clinical trial registration</h3><p>EU CT: 2023-504670-38-00.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101113"},"PeriodicalIF":2.3,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000291/pdfft?md5=d8c5dc78c4fb0e6d28783f42e2ca43cd&pid=1-s2.0-S2590041224000291-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141264112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wenyan Zhu , Chunsheng Zhou , Xin Sun , Peijun Xue , Zongru Li , Weihong Zhang , Jiuliang Zhao , Ting Zhang , Min Peng , Juhong Shi , Chen Wang
{"title":"Interstitial lung diseases associated with ANCA positivity: A different disease spectrum from interstitial pneumonia with autoimmune features","authors":"Wenyan Zhu , Chunsheng Zhou , Xin Sun , Peijun Xue , Zongru Li , Weihong Zhang , Jiuliang Zhao , Ting Zhang , Min Peng , Juhong Shi , Chen Wang","doi":"10.1016/j.resmer.2024.101111","DOIUrl":"10.1016/j.resmer.2024.101111","url":null,"abstract":"<div><h3>Background</h3><p>Anti-neutrophil cytoplasmic antibody (ANCA) is a type of autoantibodies associated with vasculitis. ANCA positivity is commonly observed in interstitial lung disease (ILD) patients. 7%-10% of ANCA-positive ILD patients don't present any symptoms of systemic vasculitis and are termed ANCA-positive idiopathic interstitial pneumonia (ANCA-IIP). Some researchers propose that ANCA-IIP should be categorized as interstitial pneumonia with autoimmune features (IPAF), although the official ATS/ERS statements exclude ANCA-IIP from this classification. Whether ANCA-IIP should be categorized into the entity of IPAF is still debatable.</p></div><div><h3>Methods</h3><p>Patients diagnosed with ANCA-IIP and those with IPAF were analyzed in a retrospective study of ILD. The clinical outcomes were determined through pulmonary function tests (PFTs) after a one-year follow-up, as well as assessing all-cause mortality.</p></div><div><h3>Results</h3><p>27 patients with ANCA-IIP and 143 patients with IPAF were analyzed from a cohort of 995 patients with ILD. Patients in the ANCA-IIP group had an older age and a high proportion of males compared to those in the IPAF group. PFT results at baseline were similar between the two groups, except for a better FEV1% in the ANCA-IIP group. Glucocorticoid and immunosuppressive therapy improved pulmonary function in patients with IPAF, but it continued to deteriorate after one year of treatment in the ANCA-IIP group. Furthermore, the all-cause mortality rate was significantly higher in the ANCA-IIP group than in the IPAF group (22.2% vs. 6.3%, <em>P</em> = 0.017).</p></div><div><h3>Conclusion</h3><p>The responses to glucocorticoid and immunosuppressive therapy differ between the ANCA-IIP and IPAF groups, leading to divergent prognoses. Therefore, it is inappropriate to classify ANCA-IIP as part of IPAF.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101111"},"PeriodicalIF":2.3,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140772976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Juliette Raëth , Cécile Malbert , Julian Pinsolle , François Arbib , Gilbert R. Ferretti , Bruno Degano , Justin Benet , Giulia Berardi , Arnaud Fedi , Anne-Claire Toffart
{"title":"Different pathways to lung cancer diagnosis in a real-life setting","authors":"Juliette Raëth , Cécile Malbert , Julian Pinsolle , François Arbib , Gilbert R. Ferretti , Bruno Degano , Justin Benet , Giulia Berardi , Arnaud Fedi , Anne-Claire Toffart","doi":"10.1016/j.resmer.2024.101108","DOIUrl":"10.1016/j.resmer.2024.101108","url":null,"abstract":"<div><h3>Background</h3><p>Most lung cancers are diagnosed at an advanced stage and therefore have a poor prognosis. One major challenge is to choose the most adapted sampling technique to obtain a rapid pathological diagnosis so as to start treatment as early as possible. A growing number of techniques have been developed in recent years. This study sought to assess the diagnostic efficiency of each, along with the respective duration of the diagnostic pathways.</p></div><div><h3>Methods</h3><p>This retrospective, bicentric, observational study enrolled patients with inoperable lung cancer (stage III or IV) diagnosed in 2018–2019. Diagnostic efficiency was assessed based on the different examinations performed to achieve a precise diagnosis (pathology, immunohistochemistry, and/or molecular biology). The time between the first medical contact and treatment initiation was also assessed.</p></div><div><h3>Results</h3><p>Overall, 625 patients were included (median age 67 years; men 67 %; adenocarcinoma 55 %). The most frequent examinations were bronchial endoscopy (<em>n</em> = 469, 75 %), followed by metastasis biopsy (<em>n</em> = 137, 21.9 %) and guided transthoracic core-needle biopsy (TCNB) (<em>n</em> = 116, 18.6 %). 372 patients had only one procedure (59.5 %), mainly bronchial endoscopy (<em>n</em> = 217, 34.7 %) and metastasis biopsy (<em>n</em> = 71, 11 %). The most efficient examination was thoracic surgery (surgical pleural biopsy, (<em>n</em> = 32, 100 %); mediastinoscopy (<em>n</em> = 26, 96.3 %); surgical pulmonary biopsy (<em>n</em> = 14, 93.3 %). The second most efficient examination was metastasis biopsy (<em>n</em> = 126, 94 %) followed by guided TCNB (<em>n</em> = 108, 93.1 %). The median time from first medical contact to first examination was 4 days (interquartile range 25 %–75 % 1–8). The median time from first medical contact to pathological result was 17 days (10–34). The median time from first medical contact to treatment start was 48 days (30–69).</p></div><div><h3>Conclusions</h3><p>In order to make an accurate and rapid diagnosis of lung cancer, it is crucial to choose the most appropriate technique. Bronchial endoscopy remains the first-line examination for central lesions, as it is efficient and easily accessible. Guided TCNB and metastasis biopsy are the preferred techniques for peripheral lesions. The choice of the diagnostic technique should be part of a multidisciplinary approach and a dedicated pathway to optimize initial management.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101108"},"PeriodicalIF":2.3,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000242/pdfft?md5=6fc4fdd45ce1a13b58fc339f38801db4&pid=1-s2.0-S2590041224000242-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashwin Basavaraj , Amanda E. Brunton , Radmila Choate , Alan Barker , Kunal Jakharia , Christopher Richards , Colin Swenson , Timothy R. Aksamit , Mark L. Metersky , Bronchiectasis and NTM research registry investigators.
{"title":"Nebulized hypertonic saline and positive expiratory pressure device use in patients with bronchiectasis: Analysis from the United States Bronchiectasis and NTM research registry","authors":"Ashwin Basavaraj , Amanda E. Brunton , Radmila Choate , Alan Barker , Kunal Jakharia , Christopher Richards , Colin Swenson , Timothy R. Aksamit , Mark L. Metersky , Bronchiectasis and NTM research registry investigators.","doi":"10.1016/j.resmer.2024.101107","DOIUrl":"10.1016/j.resmer.2024.101107","url":null,"abstract":"<div><h3>Background</h3><p>Nebulized Hypertonic saline (HS) and positive expiratory pressure device (PEP) are often used in patients with bronchiectasis. We sought to describe the clinical characteristics in patients using HS and PEP, utilizing a large national database registry.</p></div><div><h3>Methods</h3><p>Data from the US Bronchiectasis and NTM Research Registry were used in this study. Patients with a diagnosis of bronchiectasis were included. Eligible patients were assigned to one of four mutually exclusive groups: HS only, PEP only, HS & PEP, or no airway clearance or mucoactive agent. Descriptive statistics were computed for the overall study population and stratified by the four groups. One-way ANOVA and chi-square tests were used to test the difference in the means in continuous variables and the association between categorical variables (respectively) across the four groups.</p></div><div><h3>Results</h3><p>A total of 2195 patients were included. Of those with bronchiectasis and a productive cough, a greater number of patients utilized HS only vs PEP only (17.5 % vs 9.1 %, <em>p</em> < 0.001). Similar association was found in those with <em>Pseudomonas aeruginosa</em> (22.3 % HS only vs 6.5 % PEP only, <em>p</em> < 0.001). There was a higher number of patients who used HS and PEP therapy in combination vs PEP therapy alone (25.0 % vs 9.1 %, <em>p</em> = 0.002), in those with a productive cough.</p></div><div><h3>Conclusions</h3><p>In patients with bronchiectasis and a productive cough or <em>Pseudomonas aeruginosa</em>, HS is used more often than PEP alone. There is a need for further analysis to compare these two modalities and explore the factors influencing their utilization.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101107"},"PeriodicalIF":2.3,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140777264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Justine Leroux , Naji Khayath , Cezar Matau , Christophe Marcot , Nicolas Migueres , Cindy Barnig , Anita Molard , Diana Ochea , Mickael Ohana , François Lefebvre , Frédéric de Blay
{"title":"Efficacy of bronchial thermoplasty in patients with severe asthma and frequent severe exacerbations: A randomized controlled study✰","authors":"Justine Leroux , Naji Khayath , Cezar Matau , Christophe Marcot , Nicolas Migueres , Cindy Barnig , Anita Molard , Diana Ochea , Mickael Ohana , François Lefebvre , Frédéric de Blay","doi":"10.1016/j.resmer.2024.101109","DOIUrl":"10.1016/j.resmer.2024.101109","url":null,"abstract":"<div><h3>Background</h3><p>Bronchial thermoplasty (BT) is a bronchoscopic procedure for patients with severe uncontrolled asthma, but randomized controlled studies of its efficacy in severe asthma with frequent exacerbations are lacking. The current aim was to assess BT efficacy in this patient population.</p></div><div><h3>Methods</h3><p>Thirty patients with asthma (GINA 5) who had experienced at least four severe exacerbations in the preceding year were randomized to BT (<em>n</em> = 15) or control groups (<em>n</em> = 15). All patients had four follow-up visits over the following 15 months, corresponding to 3, 6, 9, and 12 months after the last procedure for the BT group. The primary outcome was number of exacerbations at 15 months after inclusion (i.e. 12 months after bronchial thermoplasty).</p></div><div><h3>Results</h3><p>All but three patients had received an asthma biologic without receiving benefit. In the year preceding enrollment, patients in the BT group had an average of five exacerbations, compared with six among controls. For patients in the BT group, oral steroid intake was 9.3 mg/d, compared with 11.0 mg/d among controls. The BT group had 1.58 fewer severe exacerbations (mean, 6.09) compared with controls (mean, 8.28) in the 12-month period after the therapy (<em>p</em> = 0.047). Oral steroid intake during follow-up after BT was significantly lower in the BT group (ratio vs controls: 0.61; <em>p</em> = 0.0002). Quality-of-life measures between inclusion and the last visit were significantly improved in the BT group, but not among controls. Few mild to moderate adverse events were reported, and all were controlled within days.</p></div><div><h3>Conclusion</h3><p>In patients with severe asthma and frequent severe exacerbations, BT significantly decreased the rate of severe exacerbations and oral steroid intake and led to improved quality of life during the 15 months after inclusion. BT appears to offer a therapeutic option for severe asthma with frequent exacerbations.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101109"},"PeriodicalIF":2.3,"publicationDate":"2024-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140769653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jenny King , James Wingfield Digby , Sarah Hennessey , Paul Marsden , Jaclyn Smith
{"title":"Productive cough, a forgotten phenotype of refractory chronic cough","authors":"Jenny King , James Wingfield Digby , Sarah Hennessey , Paul Marsden , Jaclyn Smith","doi":"10.1016/j.resmer.2024.101106","DOIUrl":"10.1016/j.resmer.2024.101106","url":null,"abstract":"<div><h3>Background</h3><p>Refractory chronic cough (RCC) patients typically complain of a dry cough. Sputum production in these patients has rarely been described in the literature. However, sputum production in RCC may be common, troublesome and particularly challenging to manage.</p></div><div><h3>Aims</h3><p>We aimed to characterise patients referred to our regional specialist cough clinic who have significant sputum production (≥1 teaspoon of sputum daily) and compare their demographics, symptomatology and investigation results to those presenting with a dry RCC.</p></div><div><h3>Methods</h3><p>A retrospective case note analysis of all consecutive referrals to a tertiary cough clinic identified as having a productive cough (≥1 teaspoon of sputum daily) was performed over a 12-month period. They were compared to a paired number of patients with dry RCC.</p></div><div><h3>Results</h3><p>Patients with productive cough represented nearly a quarter (98/398, 24.6 %) of new patient referrals to the clinic. Demographic information, symptomatology and investigation results were comparable to those with a dry RCC. Over a third, 35.8 % of patients with a productive cough reported expectorating an egg-cupful of sputum or more a day. Nearly half, 40% of those with high volume sputum production (≥egg-cupful daily) had both a normal CT thorax and normal spirometry.</p></div><div><h3>Conclusions</h3><p>Patients with RCC can expectorate significant volumes of sputum in the absence of underlying lung disease. This group have similar demographics to those with dry RCC. This is the first piece of work to our knowledge to describe this cohort. Future work needs to acknowledge this forgotten phenotype to ensure that they receive comprehensive evaluation and evidenced based treatment.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101106"},"PeriodicalIF":2.3,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140779370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lucie Barateau , Sébastien Baillieul , Claire Andrejak , Émilie Bequignon , Pierre Boutouyrie , Yves Dauvilliers , Frédéric Gagnadoux , Pierre-Alexis Geoffroy , Jean-Arthur Micoulaud-Franchi , David Montani , Christelle Monaca , Maxime Patout , Jean-Louis Pépin , Pierre Philip , Charles Pilette , Renaud Tamisier , Wojciech Trzepizur , Dany Jaffuel , Isabelle Arnulf
{"title":"Guidelines for the assessment and management of residual sleepiness in obstructive apnea-hypopnea syndrome","authors":"Lucie Barateau , Sébastien Baillieul , Claire Andrejak , Émilie Bequignon , Pierre Boutouyrie , Yves Dauvilliers , Frédéric Gagnadoux , Pierre-Alexis Geoffroy , Jean-Arthur Micoulaud-Franchi , David Montani , Christelle Monaca , Maxime Patout , Jean-Louis Pépin , Pierre Philip , Charles Pilette , Renaud Tamisier , Wojciech Trzepizur , Dany Jaffuel , Isabelle Arnulf","doi":"10.1016/j.resmer.2024.101105","DOIUrl":"10.1016/j.resmer.2024.101105","url":null,"abstract":"<div><p>Excessive daytime sleepiness (EDS) is frequent among patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and can persist despite the optimal correction of respiratory events (apnea, hypopnea and respiratory efforts), using continuous positive airway pressure (CPAP) or mandibular advancement device. Symptoms like apathy and fatigue may be mistaken for EDS. In addition, EDS has multi-factorial origin, which makes its evaluation complex. The marketing authorization [<em>Autorisation de Mise sur le Marché</em> (AMM)] for two wake-promoting agents (solriamfetol and pitolisant) raises several practical issues for clinicians. This consensus paper presents recommendations of good clinical practice to identify and evaluate EDS in this context, and to manage and follow-up the patients. It was conducted under the mandate of the French Societies for sleep medicine and for pneumology [<em>Société Française de Recherche et de Médecine du Sommeil</em> (SFRMS) and <em>Société de Pneumologie de Langue Française</em> (SPLF)]. A management algorithm is suggested, as well as a list of conditions during which the patient should be referred to a sleep center or a sleep specialist. The benefit/risk balance of a wake-promoting drug in residual EDS in OSAHS patients must be regularly reevaluated, especially in elderly patients with increased cardiovascular and psychiatric disorders risks. This consensus is based on the scientific knowledge at the time of the publication and may be revised according to their evolution.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"86 ","pages":"Article 101105"},"PeriodicalIF":2.3,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140780123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charlotte Chen , John Kolbe , Julian F.R. Paton , James P. Fisher
{"title":"Clinical utility of the Borg dyspnoea score in 6-minute walk tests in interstitial lung disease: A systematic review","authors":"Charlotte Chen , John Kolbe , Julian F.R. Paton , James P. Fisher","doi":"10.1016/j.resmer.2024.101103","DOIUrl":"10.1016/j.resmer.2024.101103","url":null,"abstract":"<div><h3>Background</h3><p>Exertional dyspnoea, a cardinal symptom in interstitial lung disease (ILD), can be objectively measured during a 6-min walk test (6MWT) using the Borg Dyspnoea Score (BDS). However, the clinical utility of this measurement is unclear. The purpose of this systematic review was to determine the association between 6MWT BDS and prognosis (mortality and lung transplantation), other 6MWT variables and measures of pulmonary function.</p></div><div><h3>Methods</h3><p>MEDLINE, EMBASE, Cochrane and SCOPUS databases were used to identify studies reporting an association between post-6MWT BDS and the relevant outcomes in adults with ILD. Language was limited to English. Study quality was assessed using the Quality in Prognosis Study risk of bias tool. A narrative synthesis for each outcome was performed.</p></div><div><h3>Results</h3><p>Ten full-text studies (<em>n</em> = 518) were included. Four studies had high overall risk of bias. Two studies (<em>n</em> = 127) reported prognosis and both found that higher 6MWT BDS was associated with increased all-cause mortality. However, the certainty of evidence was very low due to study design and likely publication bias. Higher post-6MWT BDS may be associated with shorter, or no effect on 6MWD; and lower pulmonary function. There was insufficient evidence that BDS correlated with 6MWT oxygen saturation.</p></div><div><h3>Conclusions</h3><p>Post-6MWT BDS has a potential role as a predictor of all-cause mortality in ILD, 6MWD and lower pulmonary function. Larger studies designed to confirm these relationships and assess the independent association between the 6MWT BDS and clinical outcomes are required.</p></div>","PeriodicalId":48479,"journal":{"name":"Respiratory Medicine and Research","volume":"85 ","pages":"Article 101103"},"PeriodicalIF":2.3,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590041224000199/pdfft?md5=61b3a150a154cbcfccbc749f780470eb&pid=1-s2.0-S2590041224000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}