Multidisciplinary Respiratory Medicine最新文献

{"title":"Utility of the 4C ISARIC mortality score in hospitalized COVID-19 patients at a large tertiary Saudi Arabian center.","authors":"Usama E Abu Elhassan,&nbsp;Saad M A Alqahtani,&nbsp;Naif S Al Saglan,&nbsp;Ali Hawan,&nbsp;Faisal S Alqahtani,&nbsp;Roaa S Almtheeb,&nbsp;Magda S R Abdelwahab,&nbsp;Mohammed A AlFlan,&nbsp;Abdulaziz S Y Alfaifi,&nbsp;Mohammed A Alqahtani,&nbsp;Fawwaz A Alshafa,&nbsp;Ali A Alsalem,&nbsp;Yahya A Al-Imamah,&nbsp;Omar S A Abdelwahab,&nbsp;Mohammed F Attia,&nbsp;Ibrahim M A Mahmoud","doi":"10.4081/mrm.2023.917","DOIUrl":"https://doi.org/10.4081/mrm.2023.917","url":null,"abstract":"<p><strong>Background: </strong>The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) 4C mortality score has been used before as a valuable tool for predicting mortality in COVID-19 patients. We aimed to address the utility of the 4C score in a well-defined Saudi population with COVID-19 admitted to a large tertiary referral hospital in Saudi Arabia.</p><p><strong>Methods: </strong>A retrospective study was conducted that included all adults COVID<b>‑</b>19 patients admitted to the Armed Forces Hospital Southern Region (AFHSR), between January 2021 and September 2022. The receiver operating characteristic (ROC) curve depicted the diagnostic performance of the 4C Score for mortality prediction.</p><p><strong>Results: </strong>A total of 1,853 patients were enrolled. The ROC curve of the 4C score had an area under the curve of 0.73 (95% CI: 0.702-0.758), p<0.001. The sensitivity and specificity with scores >8 were 80% and 58%, respectively, the positive and negative predictive values were 28% and 93%, respectively. Three hundred and sixteen (17.1%), 638 (34.4%), 814 (43.9%), and 85 (4.6%) patients had low, intermediate, high, and very high values, respectively. There were significant differences between survivors and non-survivors with regard to all variables used in the calculation of the 4C score. Multivariable logistic regression analysis revealed that all components of the 4C score, except gender and O₂ saturation, were independent significant predictors of mortality.</p><p><strong>Conclusions: </strong>Our data support previous international and Saudi studies that the 4C mortality score is a reliable tool with good sensitivity and specificity in the mortality prediction of COVID-19 patients. All components of the 4C score, except gender and O₂ saturation, were independent significant predictors of mortality. Within the 4C score, odds ratios increased proportionately with an increase in the score value. Future multi-center prospective studies are warranted.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 ","pages":"917"},"PeriodicalIF":2.3,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/b2/mrm-18-1-917.PMC10483479.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10221798","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 case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor.","authors":"Tetsuya Yamagishi, Masashi Matsuyama, Ryo Watanabe, Chio Sakai, Sosuke Matsumura, Masayuki Nakajima, Shinji Kikuchi, Noriaki Sakamoto, Yukio Sato, Nobuyuki Hizawa","doi":"10.4081/mrm.2022.884","DOIUrl":"10.4081/mrm.2022.884","url":null,"abstract":"<p><strong>Introduction: </strong>Ovarian granulosa cell tumor is a relatively rare tumor that accounts for 2-5% of malignant ovarian tumors. This tumor progresses slowly and may recur late in life.</p><p><strong>Case presentation: </strong>A 70-year-old woman was admitted to our hospital with a left secondary pneumothorax due to metastatic lung tumors of granulosa cell tumor. Reports of secondary pneumothorax due to granulosa cell tumor are rare. Thoracoscopic suturing and pleurodesis using talc were effective in the treatment of this pneumothorax.</p><p><strong>Conclusions: </strong>We experienced a rare case of secondary pneumothorax due to multiple pulmonary metastases of granulosa cell tumor. It should be noted that pulmonary metastasis of granulosa cell tumor can lead to secondary pneumothorax.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 1","pages":"884"},"PeriodicalIF":2.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/26/mrm-17-1-884.PMC9796701.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10457819","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":"Kidney and lung in pathology: mechanisms and clinical implications.","authors":"Ersilia Satta,&nbsp;Carmelo Alfarone,&nbsp;Alfonso De Maio,&nbsp;Sandro Gentile,&nbsp;Carmine Romano,&nbsp;Mario Polverino,&nbsp;Francesca Polverino","doi":"10.4081/mrm.2022.819","DOIUrl":"https://doi.org/10.4081/mrm.2022.819","url":null,"abstract":"<p><p>There is a close, physiological, relationship between kidney and lung that begin in the fetal age, and is aimed to keep homeostatic balance in the body. From a pathological point of view, the kidneys could be damaged by inflammatory mediators or by immune-mediated factors linked to a primary lung disease or, conversely, it could be the kidney disease that causes lung damage. Non-immunological mechanisms are frequently involved in renal and pulmonary diseases, as observed in chronic conditions. This crosstalk have clinical and therapeutic consequences. This review aims to describe the pulmonary-renal link in physiology and in pathological conditions.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 2","pages":"819"},"PeriodicalIF":2.3,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/31/mrm-17-1-819.PMC8791019.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39894452","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":"Awareness towards the main ILD among primary care physicians","authors":"M. Silva, Amélia Fernandes, Ana Rita Pereira, Sofia Madanelo, Tatiana Clemêncio, P. Ferreira","doi":"10.4081/mrm.2022.848","DOIUrl":"https://doi.org/10.4081/mrm.2022.848","url":null,"abstract":"Background Interstitial lung diseases (ILDs) comprise a group of multiple entities sharing some clinical, functional, and radiological similarities. In many countries primary care setting has been devoid of pre- and post-graduate educational interventions focused on basic knowledge on ILD. This, along with usual nonspecificity of symptoms at presentation, may contribute to diagnostic delay in this disease setting. Methods We designed a study questionnaire to assess the level of awareness on basic diagnostic and management aspects of core ILDs – idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, sarcoidosis, connective tissue disease related-ILD, and drug-induced ILD - among primary care physicians (GPs) from five “ACeS Baixo Vouga” health centres and to perceive possible weaknesses. Differences in awareness between GPs under 45 and over 45 yearsold were also assessed. Results Globally, 69% of questions were correctly answered but only 21.9% of GPs considered to have a satisfactory self-perceived level of knowledge on ILD. Except sarcoidosis (p=0.017) and some isolated questions on other diseases, no significant differences were found between physicians below 45 years and above. Though, there was a trend to higher awareness in the younger group. The best awareness was seen in sarcoidosis. IPF questions had the worst performance and only 48.5% of GPs recognized the importance of velcro-type crackles in suggesting a possible diagnosis. Conclusion Specific attention should be devoted to educational interventions directed to GPs on basic notions on the main ILDs. This could improve the usual diagnostic delay in many ILDs, as a timely diagnosis is essential for an early treatment and prolonged patient survival.","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42323820","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":"Monitoring daily symptoms and (self-reported) exacerbations in patients with bronchiectasis: a prospective study.","authors":"Jéssica de Campos Medeiros,&nbsp;Ádria Cristina da Silva,&nbsp;Mônica Corso Pereira","doi":"10.4081/mrm.2022.859","DOIUrl":"https://doi.org/10.4081/mrm.2022.859","url":null,"abstract":"<p><strong>Background: </strong>Exacerbations are pivotal events in the natural history of patients with non-cystic fibrosis bronchiectasis (NCFB), since they have a negative impact on the functional evolution of these individuals. The daily symptoms of patients with NCFB show great variability, which negatively affects their self-perception of symptoms and exacerbations. The aim of this study was to identify daily symptoms in patients with NCFB, and to investigate whether there is a correlation between the frequency of self-reported exacerbations and events defined according to the criteria established in the literature to define exacerbation in bronchiectasis.</p><p><strong>Methods: </strong>This observational and prospective study was carried out in outpatient clinics of a Brazilian public university hospital. Over 24 weeks, patients completed a diary in which daily symptoms, self-reported exacerbations, and demands for medical care for respiratory symptoms were recorded. The instrument used (diary and symptom scores ranging from 0 to 12) were developed by the researchers. The participants also answered questionnaires mMRC, Leicester's, and St. George's Respiratory (SGRQ).</p><p><strong>Results: </strong>Twenty-eight patients returned the diary, their mean age was 54 years, and 50% out of them were classified as mild by the FACED score. Cough (64%) and expectoration (62%) were the most frequent symptoms. Correlations were found between the stability score and the mMRC (r=0.4727, p=0.011) and SGRQ (r=0.6748, p<0.0001) questionnaires. The number of self-perceived exacerbations (24) was significantly lower than exacerbations using the exacerbation consensus (63) (p<0.01). Additionally, no correlation was found between these two criteria.</p><p><strong>Conclusions: </strong>There was great variability of symptoms among the individuals sampled, and even for the same individual, over time. Patients had low self-perception of exacerbations, which suggests that strategies aimed at improving this self-perception may contribute to the early detection of exacerbations.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 1","pages":"859"},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/9d/mrm-17-1-859.PMC9761409.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10425071","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 case of <i>Pneumocystis jirovecii</i> pneumonia in a patient with acquired immune deficiency syndrome who showed eosinophilia and an increased serum TARC/CCL17 level.","authors":"Yuki Yabuuchi,&nbsp;Masashi Matsuyama,&nbsp;Sosuke Matsumura,&nbsp;Masayuki Nakajima,&nbsp;Yoshihiko Kiyasu,&nbsp;Yuto Takeuchi,&nbsp;Yoshihiko Murata,&nbsp;Ryota Matsuoka,&nbsp;Masayuki Noguchi,&nbsp;Nobuyuki Hizawa","doi":"10.4081/mrm.2022.802","DOIUrl":"https://doi.org/10.4081/mrm.2022.802","url":null,"abstract":"<p><p><i>Pneumocystis jirovecii</i> pneumonia (PCP) in patients with acquired immune deficiency syndrome (AIDS) shows eosinophilic pneumonia like condition. The detailed mechanisms how AIDS-associated PCP causes eosinophilic pneumonia has not been elucidated, but it has been suggested that beta-D-glucan, a major component of <i>Pneumocystis jirovecii</i>, and T helper type 2 immunity may be involved in the mechanism of eosinophilia in the lung. We experienced the case who developed an eosinophilic pneumonia-like condition in a patient with AIDS-associated PCP, whose clinical course indicated the importance of TARC/CCL17 but not IL-4 and IL-5 as involved in eosinophilia caused by HIV and <i>Pneumocystis jirovecii</i> infection.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 2","pages":"802"},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9c/02/mrm-17-2-802.PMC8764545.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39894451","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":"Tracheostomy healing time after decannulation","authors":"K. J. Christiansen, Louise Devantier, T. Pasgaard, T. Benson, Johanne Juel Petersen, T. Kjærgaard, Michael Pedersen","doi":"10.4081/mrm.2022.822","DOIUrl":"https://doi.org/10.4081/mrm.2022.822","url":null,"abstract":"Background Prolonged healing of tracheostomy after decannulation has a negative impact on respiration, hygiene, cosmetics, and social life. Even so, evidence-based observations of tracheostoma healing time are lacking. Therefore, the aim of this study was to determine tracheostomy wound healing time after decannulation. Methods In this prospective observational cohort study, we included 30 subjects undergoing decannulation following prolonged mechanical ventilation via tracheostomy. Our primary endpoint was tracheostomy healing time defined as time from decannulation to airtight healing. To identify any factors related to healing time, we included information about patient demographics, comorbidities, tracheostomy method, tube size, and intubation time. All subjects were observed daily until their tracheostomy wound had healed. Results The median tracheostomy healing time was 6.5 (1-22) days. The duration of tracheal cannulation was the only factor significantly correlated with prolonged healing (p=0.03). Four patients were subjected to recannulation shortly after decannulation due to hypercapnia, respiratory failure, secretion accumulation, or self-decannulation. All wounds achieved complete spontaneous airtight closure. Conclusions Duration of spontaneous tracheostomy closure after decannulation was 1-22 days, and closure time correlated with duration of cannulation.","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48521885","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":"Early effectiveness of type-2 severe asthma treatment with dupilumab in a real-life setting; a FeNO-driven choice that leads to winning management","authors":"G. E. Carpagnano, G. Scioscia, E. Buonamico, D. Lacedonia, F. Diaferia, E. Capozza, G. Lepore, O. Resta, M. F. Foschino Barbaro","doi":"10.4081/mrm.2022.797","DOIUrl":"https://doi.org/10.4081/mrm.2022.797","url":null,"abstract":"Background Dupilumab is a humanized monoclonal antibody targeting the IL4/IL13 signaling pathway, already used for atopic dermatitis and chronic rhinitis with nasal polyps, recently approved for severe type-2 asthma. Its efficacy has been demonstrated in randomized control trials. The aim of our study is to evaluate possible early clinical improvement and type 2 biomarkers modifications in severe asthmatic patients treated with dupilumab in a real-life setting. Methods We included 12 patients with severe, uncontrolled asthma and dupilumab was chosen if there was at least one evidence of blood eosinophils> 150 cells/ml and/or FeNO>25 ppb during last year. Recent blood eosinophil count report, assessment through ACT, FeNO test and spirometry were performed at baseline and after 3 months of treatment. We calculated also the number of patients achieving a minimal, yet clinically relevant difference in FEV1 and ACT. Results After three months of treatment with dupilumab, ACT had a significant improvement (mean ACT pre 13.25±4.65 vs mean ACT post 19.17±4.45; p<0.01), so as FEV1% (mean FEV1% pre 62.58±15.73 vs mean FEV1% post 71.00±13.11; p<0.01). FeNO had a significant reduction (median FeNO 32 pre, IQR 19-48.5 vs median FeNO19 post, IQR 16.5-26), differently from eosinophils blood count (median eosinophils pre 280, IQR 193.8-647.3 vs median eosinophils post 349.5, IQR 103-836.8; p=0.52). Four patients (33%) had a positive MCID for FEV1, and eight patients (67%) had a positive MCID for ACT. Conclusions In RCTs performed during clinical development program dupilumab showed an early efficacy in increasing FEV1, reducing FeNO and improving asthma control. Our study demonstrates early improvement in asthmatic symptoms, lung function and FeNO in severe type-2 asthma patients after only 3 months of dupilumab biologic therapy. The introduction of FeNO levels evaluation in the selection criteria for dupilumab, further helps the identification of eligible patients among type-2 severe asthma patients and allows a complete outpatient assessment. Further real-life studies with a longer follow up time will be useful to confirm dupilumab efficacy and to promote its use in clinical practice.","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46182898","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":"“Tracheostomy healing time after decannulation”: can we improve it?","authors":"Özlem Özkan Kuşcu, D. Özcengiz, A. Esquinas","doi":"10.4081/mrm.2022.857","DOIUrl":"https://doi.org/10.4081/mrm.2022.857","url":null,"abstract":"Dear Editor,\u0000We read with great interest the article “Tracheostomy healing time after decannulation” by Christiansen et al. The authors aimed to determine the tracheostomy wound healing time after decannulation...\u0000 ","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46065227","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":"Risk factors for rheumatoid arthritis-associated interstitial lung disease: a retrospective study.","authors":"Aicha Ben Tekaya,&nbsp;Salma Mokaddem,&nbsp;Selma Athimini,&nbsp;Hela Kamoun,&nbsp;Ines Mahmoud,&nbsp;Leila Abdelmoula","doi":"10.4081/mrm.2022.877","DOIUrl":"https://doi.org/10.4081/mrm.2022.877","url":null,"abstract":"<p><strong>Background: </strong>The objective of this study was to assess clinical and imaging features of rheumatoid arthritis (RA) associated with interstitial lung disease (ILD), (RA-ILD) group, in comparison to RA without ILD (RA-C) and to identify the associated factors to ILD.</p><p><strong>Methods: </strong>This was a retrospective comparative study (from June 2015 to March 2022) including RA patients aged ≥18 years. The RA-C control group was matched according to age (±2 years), gender, and RA duration (±2 years). General data, RA characteristics, ILD features, and treatment modalities were recorded. Statistical analysis was performed to determine the predictive factors of ILD.</p><p><strong>Results: </strong>A total of 104 patients were included (52 RA-ILD and 52 RA-C); sex ratio was 0.36. Mean age was 66.3±11 years (RA-ILD) <i>versus</i> 65.6±10.8 years (RA-C) (p=0.72). In comparison to RA-C, RA-ILD patients were significantly higher smokers (p=0.01) and physically inactive (p=0.01). Regarding RA features, RA-ILD patients have significantly increased positive anti-citrullinated peptide antibody (ACPA) (p=0.01), ACPA rate (p<0.001), erosive disease (p<0.001), and disease activity score (p<0.001). Mean time to ILD diagnosis was 5.85±7.16 years. Chest high-resolution computed tomography (HRCT) patterns of disease were identified: nonspecific interstitial pneumonia (NSIP) (28.8%), usual interstitial pneumonia (UIP) (17.3%), organizing pneumonia (OP) (25%), acute interstitial pneumonia (13.5%), and respiratory bronchiolitis (3.8%). Multivariate analysis identified smoking, high baseline DAS28 (disease activity score 28) and ACPA positivity as predictive factors of ILD.</p><p><strong>Conclusion: </strong>Our results confirmed the reported associated factors of ILD in RA (smoking, higher disease activity, ACPA positivity). Thus, we need to target the modifiable factors by supporting and educating RA patients to quit smoking and intensify disease modifying anti-rheumatoid drugs (DMARD) to reach remission.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"17 ","pages":"877"},"PeriodicalIF":2.3,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/f5/mrm-17-1-877.PMC9728125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10337805","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}