Journal of Bone Oncology最新文献

{"title":"The efficacy and applicability of chimeric antigen receptor (CAR) T cell-based regimens for primary bone tumors: A comprehensive review of current evidence","authors":"","doi":"10.1016/j.jbo.2024.100635","DOIUrl":"10.1016/j.jbo.2024.100635","url":null,"abstract":"<div><div>Primary bone tumors (PBT), although rare, could pose significant mortality and morbidity risks due to their high incidence of lung metastasis. Survival rates of patients with PBTs may vary based on the tumor type, therapeutic interventions, and the time of diagnosis. Despite advances in the management of patients with these tumors over the past four decades, the survival rates seem not to have improved significantly, implicating the need for novel therapeutic interventions. Surgical resection with wide margins, radiotherapy, and systemic chemotherapy are the main lines of treatment for PBTs. Neoadjuvant and adjuvant chemotherapy, along with emerging immunotherapeutic approaches such as chimeric antigen receptor (CAR)-T cell therapy, have the potential to improve the treatment outcomes for patients with PBTs. CAR-T cell therapy has been introduced as an option in hematologic malignancies, with FDA approval for several CD19-targeting CAR-T cell products. This review aims to highlight the potential of immunotherapeutic strategies, specifically CAR T cell therapy, in managing PBTs.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synergistic effect between denosumab and immune checkpoint inhibitors (ICI)? A retrospective study of 268 patients with ICI and bone metastases","authors":"","doi":"10.1016/j.jbo.2024.100634","DOIUrl":"10.1016/j.jbo.2024.100634","url":null,"abstract":"<div><h3>Background</h3><div>Bone metastasis is a significant concern in advanced solid tumors, contributing to diminished patient survival and quality of life due to skeletal-related events (SREs). Denosumab (DMAB), a monoclonal antibody targeting the receptor activator of nuclear factor kappa-B ligand (RANKL), is used to prevent SREs in such cases. The RANK/RANKL axis, crucial in immunological processes, has garnered attention, especially with the expanding use of immune checkpoint inhibitors (ICI) in modern oncology.</div></div><div><h3>Objective</h3><div>Our study aims to explore the potential synergistic antitumor effects of combining immunotherapy with denosumab, as suggested by anecdotal evidence, small cohort studies, and preclinical research.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using the IMMUCARE database, encompassing patients receiving ICI treatment since 2014 and diagnosed with bone metastases. We examined overall survival (OS), progression-free survival (PFS) and switch of treatment line based on denosumab usage. Patients were stratified into groups: without denosumab, ICI followed by denosumab, and denosumab followed by ICI. Survival curves and multivariate Cox regression analyses were performed.</div></div><div><h3>Results</h3><div>Among the 268 patients with bone metastases, 154 received treatment with ICI alone, while 114 received ICI in combination with denosumab at some point during their oncological history. No significant differences were observed in overall survival (OS) or progression-free survival (PFS) between patients receiving ICI monotherapy and those receiving ICI with denosumab (p = 0.29 and p = 0.79, respectively). However, upon analyzing patients who received denosumab following ICI initiation (17 patients), a notable difference emerged. The group receiving ICI followed by denosumab exhibited a significant advantage compared to those without denosumab (154 patients) or those receiving denosumab before ICI initiation (72 patients) (p = 0.022).</div></div><div><h3>Conclusion</h3><div>This retrospective investigation supports the notion of potential benefits associated with sequential administration of ICI and denosumab, although statistical significance was not achieved. Future studies, including prospective trials or updated retrospective analyses, focusing on cancers treated with first-line immunotherapy, could provide further insights into this therapeutic approach.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary discrimination and evaluation of clinical application value of ChatGPT4o in bone tumors","authors":"","doi":"10.1016/j.jbo.2024.100632","DOIUrl":"10.1016/j.jbo.2024.100632","url":null,"abstract":"","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221213742400112X/pdfft?md5=023e585e4c330a169d903e280b897588&pid=1-s2.0-S221213742400112X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Groenlandicine enhances cisplatin sensitivity in cisplatin-resistant osteosarcoma cells through the BAX/Bcl-2/Caspase-9/Caspase-3 pathway","authors":"","doi":"10.1016/j.jbo.2024.100631","DOIUrl":"10.1016/j.jbo.2024.100631","url":null,"abstract":"<div><p>Groenlandicine is a protoberberine alkaloid isolated from <em>Coptidis Rhizoma</em>, a widely used traditional Chinese medicine known for its various biological activities. This study aims to validate groenlandicine’s effect on both cisplatin-sensitive and cisplatin-resistant osteosarcoma (OS) cells, along with exploring its potential molecular mechanism.</p><p>The ligand-based virtual screening (LBVS) method and molecular docking were employed to screen drugs. CCK-8 and FCM were used to measure the effect of groenlandicine on the OS cells transfected by lentivirus with over-expression or low-expression of TOP1. Cell scratch assay, CCK-8, FCM, and the EdU assay were utilized to evaluate the effect of groenlandicine on cisplatin-resistant cells. WB, immunofluorescence, and PCR were conducted to measure the levels of TOP1, Bcl-2, BAX, Caspase-9, and Caspase-3. Additionally, a subcutaneous tumor model was established in nude mice to verify the efficacy of groenlandicine.</p><p>Groenlandicine reduced the migration and proliferation while promoting apoptosis in OS cells, effectively damaging them. Meanwhile, groenlandicine exhibited weak cytotoxicity in 293T cells. Combination with cisplatin enhanced tumor-killing activity, markedly activating BAX, cleaved-Caspase-3, and cleaved-Caspase-9, while inhibiting the Bcl2 pathway in cisplatin-resistant OS cells. Moreover, the level of TOP1, elevated in cisplatin-resistant OS cells, was down-regulated by groenlandicine both <em>in vitro</em> and <em>in vivo</em>. Animal experiments confirmed that groenlandicine combined with cisplatin suppressed OS growth with lower nephrotoxicity.</p><p>Groenlandicine induces apoptosis and enhances the sensitivity of drug-resistant OS cells to cisplatin via the BAX/Bcl-2/Caspase-9/Caspase-3 pathway. Groenlandicine inhibits OS cells growth by down-regulating TOP1 level.Therefore, groenlandicine holds promise as a potential agent for reversing cisplatin resistance in OS treatment.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001118/pdfft?md5=41394f38e1dad067a9c2e0bb78fbea8b&pid=1-s2.0-S2212137424001118-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142058032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved localization and segmentation of spinal bone metastases in MRI with nnUNet radiomics","authors":"","doi":"10.1016/j.jbo.2024.100630","DOIUrl":"10.1016/j.jbo.2024.100630","url":null,"abstract":"<div><h3>Objective</h3><p>Variability exists in the subjective delineation of tumor areas in MRI scans of patients with spinal bone metastases. This research aims to investigate the efficacy of the nnUNet radiomics model for automatic segmentation and identification of spinal bone metastases.</p></div><div><h3>Methods</h3><p>A cohort of 118 patients diagnosed with spinal bone metastases at our institution between January 2020 and December 2023 was enrolled. They were randomly divided into a training set (n = 78) and a test set (n = 40). The nnUNet radiomics segmentation model was developed, employing manual delineations of tumor areas by physicians as the reference standard. Both methods were utilized to compute tumor area measurements, and the segmentation performance and consistency of the nnUNet model were assessed.</p></div><div><h3>Results</h3><p>The nnUNet model demonstrated effective localization and segmentation of metastases, including smaller lesions. The Dice coefficients for the training and test sets were 0.926 and 0.824, respectively. Within the test set, the Dice coefficients for lumbar and thoracic vertebrae were 0.838 and 0.785, respectively. Strong linear correlation was observed between the nnUNet model segmentation and physician-delineated tumor areas in 40 patients (<em>R</em>² = 0.998, <em>P</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>The nnUNet model exhibits efficacy in automatically localizing and segmenting spinal bone metastases in MRI scans.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001106/pdfft?md5=1821d5886af7299365cde372beac3007&pid=1-s2.0-S2212137424001106-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic imaging and diagnosis of spinal bone tumors: AlexNet and ResNet for the classification of tumor malignancy","authors":"","doi":"10.1016/j.jbo.2024.100629","DOIUrl":"10.1016/j.jbo.2024.100629","url":null,"abstract":"<div><h3>Objective</h3><p>This study aims to explore the application of radiographic imaging and image recognition algorithms, particularly AlexNet and ResNet, in classifying malignancies for spinal bone tumors.</p></div><div><h3>Methods</h3><p>We selected a cohort of 580 patients diagnosed with primary spinal osseous tumors who underwent treatment at our hospital between January 2016 and December 2023, whereby 1532 images (679 images of benign tumors, 853 images of malignant tumors) were extracted from this imaging dataset. Training and validation follow a ratio of 2:1. All patients underwent X-ray examinations as part of their diagnostic workup. This study employed convolutional neural networks (CNNs) to categorize spinal bone tumor images according to their malignancy. AlexNet and ResNet models were employed for this classification task. These models were fine-tuned through training, which involved the utilization of a database of bone tumor images representing different categories.</p></div><div><h3>Results</h3><p>Through rigorous experimentation, the performance of AlexNet and ResNet in classifying spinal bone tumor malignancy was extensively evaluated. The models were subjected to an extensive dataset of bone tumor images, and the following results were observed. AlexNet: This model exhibited commendable efficiency during training, with each epoch taking an average of 3 s. Its classification accuracy was found to be approximately 95.6 %. ResNet: The ResNet model showed remarkable accuracy in image classification. After an extended training period, it achieved a striking 96.2 % accuracy rate, signifying its proficiency in distinguishing the malignancy of spinal bone tumors. However, these results illustrate the clear advantage of AlexNet in terms of proficiency despite a lower classification accuracy. The robust performance of the ResNet model is auspicious when accuracy is more favored in the context of diagnosing spinal bone tumor malignancy, albeit at the cost of longer training times, with each epoch taking an average of 32 s.</p></div><div><h3>Conclusion</h3><p>Integrating deep learning and CNN-based image recognition technology offers a promising solution for qualitatively classifying bone tumors. This research underscores the potential of these models in enhancing the diagnosis and treatment processes for patients, benefiting both patients and medical professionals alike. The study highlights the significance of selecting appropriate models, such as ResNet, to improve accuracy in image recognition tasks.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221213742400109X/pdfft?md5=c94f1dae2cfd227a4fe0e1942824e827&pid=1-s2.0-S221213742400109X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does liquid nitrogen recycled autograft for treatment of bone sarcoma impact local recurrence rate? A systematic review","authors":"","doi":"10.1016/j.jbo.2024.100628","DOIUrl":"10.1016/j.jbo.2024.100628","url":null,"abstract":"<div><p>The gold standard treatment for primary bone sarcomas has been surgical resection with wide margins. However, there is no consensus regarding an optimal method for limb salvage reconstruction. In 2005, a technique for recycling resected bone after intraoperative treatment with liquid nitrogen was described. This technique has been reported to have a spectrum of advantages; nonetheless, acceptance for routine use has been limited, primarily for fear of local recurrence. A systematic search of the literature using PubMed and Google Scholar was performed. Full-text articles published between 2008 and 2023 were included if the study presented sufficient information regarding patients with a diagnosis of a primary bone sarcoma of the limbs or pelvis who had undergone reconstruction with liquid nitrogen recycled autografts. Sixteen studies that included 286 patients met criteria for analyses. Local recurrence occurred in 25 patients (8.7 %) during the first 4 years following limb salvage reconstruction using recycled autografts for treatment of primary bone sarcomas, which compares favorably to the 15–30 % local recurrence rates reported for patients undergoing limb salvage reconstruction using artificial implants. Systematic synthesis of the current evidence regarding local recurrence rates following use of the liquid nitrogen recycled autograft technique for limb salvage reconstruction after bone sarcoma resection suggests a favorable comparison to other limb salvage reconstruction options. As such, this technique warrants further consideration as a viable option for indicated patients based on relative advantages regarding costs, availability, and biologic and surgical reconstruction benefits.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001088/pdfft?md5=e6cd37f6e7eabd30d30e7d6ca28f408e&pid=1-s2.0-S2212137424001088-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An enhanced AlexNet-Based model for femoral bone tumor classification and diagnosis using magnetic resonance imaging","authors":"","doi":"10.1016/j.jbo.2024.100626","DOIUrl":"10.1016/j.jbo.2024.100626","url":null,"abstract":"<div><h3>Objective</h3><p>Bone tumors, known for their infrequent occurrence and diverse imaging characteristics, require precise differentiation into benign and malignant categories. Existing diagnostic approaches heavily depend on the laborious and variable manual delineation of tumor regions. Deep learning methods, particularly convolutional neural networks (CNNs), have emerged as a promising solution to tackle these issues. This paper introduces an enhanced deep-learning model based on AlexNet to classify femoral bone tumors accurately.</p></div><div><h3>Methods</h3><p>This study involved 500 femoral tumor patients from July 2020 to January 2023, with 500 imaging cases (335 benign and 165 malignant). A CNN was employed for automated classification. The model framework encompassed training and testing stages, with 8 layers (5 Conv and 3 FC) and ReLU activation. Essential architectural modifications included Batch Normalization (BN) after the first and second convolutional filters. Comparative experiments with various existing methods were conducted to assess algorithm performance in tumor staging. Evaluation metrics encompassed accuracy, precision, sensitivity, specificity, F-measure, ROC curves, and AUC values.</p></div><div><h3>Results</h3><p>The analysis of precision, sensitivity, specificity, and F1 score from the results demonstrates that the method introduced in this paper offers several advantages, including a low feature dimension and robust generalization (with an accuracy of 98.34 %, sensitivity of 97.26 %, specificity of 95.74 %, and an F1 score of 96.37). These findings underscore its exceptional overall detection capabilities. Notably, when comparing various algorithms, they generally exhibit similar classification performance. However, the algorithm presented in this paper stands out with a higher AUC value (AUC=0.848), signifying enhanced sensitivity and more robust specificity.</p></div><div><h3>Conclusion</h3><p>This study presents an optimized AlexNet model for classifying femoral bone tumor images based on convolutional neural networks. This algorithm demonstrates higher accuracy, precision, sensitivity, specificity, and F1-score than other methods. Furthermore, the AUC value further confirms the outstanding performance of this algorithm in terms of sensitivity and specificity. This research makes a significant contribution to the field of medical image classification, offering an efficient automated classification solution, and holds the potential to advance the application of artificial intelligence in bone tumor classification.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001064/pdfft?md5=2b4c672034139c0c68135debac089a03&pid=1-s2.0-S2212137424001064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone niches in the regulation of tumour cell dormancy","authors":"","doi":"10.1016/j.jbo.2024.100621","DOIUrl":"10.1016/j.jbo.2024.100621","url":null,"abstract":"<div><p>Secondary metastases, accounting for 90 % of cancer-related deaths, pose a formidable challenge in cancer treatment, with bone being a prevalent site. Importantly, tumours may relapse, often in the skeleton even after successful eradication of the primary tumour, indicating that tumour cells may lay dormant within bone for extended periods of time. This review summarises recent findings in the mechanisms underlying tumour cell dormancy and the role of bone cells in this process. Hematopoietic stem cell (HSC) niches in bone provide a model for understanding regulatory microenvironments. Dormant tumour cells have been shown to exploit similar niches, with evidence suggesting interactions with osteoblast-lineage cells and other stromal cells via CXCL12-CXCR4, integrins, and TAM receptor signalling, especially through GAS6-AXL, led to dormancy, with exit of dormancy potentially regulated by osteoclastic bone resorption and neuronal signalling. A comprehensive understanding of dormant tumour cell niches and their regulatory mechanisms is essential for developing targeted therapies, a critical step towards eradicating metastatic tumours and stopping disease relapse.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001015/pdfft?md5=d6f9dc5ed2cb3efa095c8ec2ccfa9b0e&pid=1-s2.0-S2212137424001015-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141691648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacologic Hedgehog inhibition modulates the cytokine profile of osteolytic breast cancer cells","authors":"","doi":"10.1016/j.jbo.2024.100625","DOIUrl":"10.1016/j.jbo.2024.100625","url":null,"abstract":"<div><p>The establishment and progression of bone metastatic breast cancer is supported by immunosuppressive myeloid populations that enable tumor growth by dampening the innate and adaptive immune response. Much work remains to understand how to target these tumor-myeloid interactions to improve treatment outcomes. Noncanonical Hedgehog signaling is an essential component of bone metastatic tumor progression, and prior literature suggests a potential role for Hedgehog signaling and its downstream effector Gli2 in modulating immune responses. In this work, we sought to identify if inhibition of noncanonical Hedgehog signaling alters the cytokine profile of osteolytic breast cancer cells and the subsequent communication between the tumor cells and myeloid cells. Examination of large patient databases revealed significant relationships between Gli2 expression and expression of markers of myeloid maturation and activation as well as cytokine expression. We found that treatment with HPI-1 reduced tumor cell expression of numerous cytokine genes, including <em>CSF1</em>, <em>CSF2</em>, and <em>CSF3</em>, as well as <em>CCL2</em> and <em>IL6</em>. Secreted CSF-1 (M−CSF) was also reduced by treatment. Changes in tumor-secreted factors resulted in polarization of THP-1 monocytes toward a proinflammatory phenotype, characterized by increased CD14 and CD40 surface marker expression. We therefore propose M−CSF as a novel target of Hedgehog inhibition with potential future applications in altering the immune microenvironment in addition to its known roles in reducing tumor-induced bone disease.</p></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2212137424001052/pdfft?md5=521b0e442616311f4a4fd691ed686f1d&pid=1-s2.0-S2212137424001052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}