Advances in respiratory medicine最新文献

{"title":"Methodological Aspects of Induced Sputum.","authors":"Silvano Dragonieri, Andras Bikov, Alessandro Capuano, Simone Scarlata, Giovanna Elisiana Carpagnano","doi":"10.3390/arm91050031","DOIUrl":"10.3390/arm91050031","url":null,"abstract":"<p><p>We aimed to conduct a state-of-the-art review of the current literature and offer further insights into the methodological aspects concerning induced sputum. The increasing popularity of sputum induction as a non-invasive and cost-effective method for obtaining lower airway secretions from patients who cannot produce sputum naturally has led to extensive research and applications in respiratory conditions like asthma and COPD. This technique allows for analysis of the cellular and biochemical components of the sputum to take place, providing insights into airway inflammation, immune cells, and help in predicting treatment response. Furthermore, induced sputum enables various analyses, including microRNA and gene expression studies and immunophenotyping. The procedure is generally safe and well tolerated, even in patients with airflow limitations; however, monitoring lung function is essential, especially in those with airway hyperresponsiveness. Optimal saline solution concentration and inhalation duration have been investigated, recommending a 15-20 min induction with hypertonic saline. Expectoration involves coughing at the end of each inhalation time. Careful handling during sputum processing is necessary for obtaining accurate results in cell cytology, immunocytochemistry, and in situ hybridization. Overall, induced sputum offers significant advantages as a preferred alternative for large-scale and repeated airway sampling, despite some technical demands and limitations.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"397-406"},"PeriodicalIF":1.8,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10603896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54227374","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":"Epidemiological Characteristics of 101,471 Patients Hospitalized with Chronic Obstructive Pulmonary Disease (COPD) in Poland in 2019: Multimorbidity, Duration of Hospitalization, In-Hospital Mortality.","authors":"Mateusz Jankowski,&nbsp;Bogdan Bochenek,&nbsp;Joanna Wieczorek,&nbsp;Mariusz Figurski,&nbsp;Marta Gruszczyńska,&nbsp;Paweł Goryński,&nbsp;Jarosław Pinkas","doi":"10.3390/arm91050029","DOIUrl":"https://doi.org/10.3390/arm91050029","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a common lung disease. There is a limited amount of nationwide data on COPD patients in Poland. This study aimed to characterize patients hospitalized with COPD in Poland in 2019 as well as to identify factors associated with the risk of in-hospital death and prolonged hospitalization among patients with COPD. This study is a retrospective database analysis. Data on patients hospitalized with COPD in Poland were obtained from the Nationwide General Hospital Morbidity Dataset. Data on all adults aged ≥40 years with a diagnosis of COPD from a physician (J44 code) were included in the analysis. Data were analyzed separately for patients hospitalized due to COPD (primary diagnosis) and patients with COPD as a comorbidity (secondary diagnosis). Completed medical records were available for 101,471 patients hospitalized with COPD (36.9% were females). Of those, 32% were hospitalized due to COPD. The mean age was 71.4 ± 9.7 years. The mean duration of hospitalization was 9.4 ± 11.4 days (median 7 days). Most of the COPD patients (89.3%) had at least one comorbidity. The in-hospital mortality rate was 6.8%. Older age, presence of cardiovascular diseases, and diseases of the genitourinary system (<i>p</i> < 0.05) were the most important factors associated with the risk of in-hospital death among patients hospitalized due to COPD.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"368-382"},"PeriodicalIF":1.8,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41094778","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":"COVID-19 Acute Respiratory Distress Syndrome: Treatment with Helmet CPAP in Respiratory Intermediate Care Unit by Pulmonologists in the Three Italian Pandemic Waves.","authors":"Martina Piluso,&nbsp;Clarissa Ferrari,&nbsp;Silvia Pagani,&nbsp;Pierfranco Usai,&nbsp;Stefania Raschi,&nbsp;Luca Parachini,&nbsp;Elisa Oggionni,&nbsp;Chiara Melacini,&nbsp;Francesca D'Arcangelo,&nbsp;Roberta Cattaneo,&nbsp;Cristiano Bonacina,&nbsp;Monica Bernareggi,&nbsp;Serena Bencini,&nbsp;Marta Nadalin,&nbsp;Mara Borelli,&nbsp;Roberto Bellini,&nbsp;Maria Chiara Salandini,&nbsp;Paolo Scarpazza","doi":"10.3390/arm91050030","DOIUrl":"https://doi.org/10.3390/arm91050030","url":null,"abstract":"<p><p>COVID-19 Acute Respiratory Distress Syndrome (CARDS) is the most serious complication of COVID-19. The SARS-CoV-2 outbreaks rapidly saturated intensive care unit (ICU), forcing the application of non-invasive respiratory support (NIRS) in respiratory intermediate care unit (RICU). The primary aim of this study is to compare the patients' clinical characteristics and outcomes (Helmet-Continuous Positive Airway Pressure (H-CPAP) success/failure and survival/death). The secondary aim is to evaluate and detect the main predictors of H-CPAP success and survival/death. A total of 515 patients were enrolled in our observational prospective study based on CARDS developed in RICU during the three Italian pandemic waves. All selected patients were treated with H-CPAP. The worst ratio of arterial partial pressure of oxygen (PaO₂) and fraction of inspired oxygen (FiO₂) PaO₂/FiO₂ during H-CPAP stratified the subjects into mild, moderate and severe CARDS. H-CPAP success has increased during the three waves (62%, 69% and 77%, respectively) and the mortality rate has decreased (28%, 21% and 13%). H-CPAP success/failure and survival/death were related to the PaO₂/FiO₂ (worst score) ratio in H-CPAP and to steroids' administration. D-dimer at admission, FiO₂ and positive end expiratory pressure (PEEP) were also associated with H-CPAP success. Our study suggests good outcomes with H-CPAP in CARDS in RICU. A widespread use of steroids could play a role.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"383-396"},"PeriodicalIF":1.8,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41096122","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":"The Constrained Disorder Principle Accounts for the Variability That Characterizes Breathing: A Method for Treating Chronic Respiratory Diseases and Improving Mechanical Ventilation.","authors":"Ofek Adar,&nbsp;Adi Hollander,&nbsp;Yaron Ilan","doi":"10.3390/arm91050028","DOIUrl":"https://doi.org/10.3390/arm91050028","url":null,"abstract":"<p><p>Variability characterizes breathing, cellular respiration, and the underlying quantum effects. Variability serves as a mechanism for coping with changing environments; however, this hypothesis does not explain why many of the variable phenomena of respiration manifest randomness. According to the constrained disorder principle (CDP), living organisms are defined by their inherent disorder bounded by variable boundaries. The present paper describes the mechanisms of breathing and cellular respiration, focusing on their inherent variability. It defines how the CDP accounts for the variability and randomness in breathing and respiration. It also provides a scheme for the potential role of respiration variability in the energy balance in biological systems. The paper describes the option of using CDP-based artificial intelligence platforms to augment the respiratory process's efficiency, correct malfunctions, and treat disorders associated with the respiratory system.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"350-367"},"PeriodicalIF":1.8,"publicationDate":"2023-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41094692","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":"The Clinical Significance of Aspergillus Detected in Lower-Respiratory-Tract Samples of Critically Ill COVID-19-Positive Patients.","authors":"Heba Osman,&nbsp;Asra N Shaik,&nbsp;Paul L Nguyen,&nbsp;Zachary Cantor,&nbsp;Mirna Kaafarani,&nbsp;Ayman O Soubani","doi":"10.3390/arm91050027","DOIUrl":"https://doi.org/10.3390/arm91050027","url":null,"abstract":"<p><p><b>Objective</b>: Critically ill patients with acute respiratory distress syndrome (ARDS) due to viral infection are at risk for secondary complications, including invasive aspergillosis. Our study aimed to characterize the clinical significance and outcome of <i>Aspergillus</i> species isolated from lower-respiratory-tract samples of critically ill OVID-19 patients at a single center. <b>Design</b>: We conducted a retrospective cohort study to evaluate the characteristics of patients with COVID-19 and <i>aspergillus</i> isolated from the lower respiratory tract and to identify predictors of outcomes in this population. <b>Setting</b>: The setting was a single-center hospital system within the metropolitan Detroit region. <b>Results</b>: The prevalence of <i>Aspergillus</i> isolated in hospitalized COVID-19 patients was 1.18% (30/2461 patients), and it was 4.6% in critically ill ICU patients with COVID-19. Probable COVID-19-associated invasive pulmonary aspergillosis (CAPA) was found in 21 critically ill patients, and 9 cases were classified as colonization. The in-hospital mortality of critically ill patients with CAPA and those with <i>aspergillus</i> colonization were high but not significantly different (76% vs. 67%, <i>p</i> = 1.00). Furthermore, the in-hospital mortality for ICU patients with or without <i>Aspergillus</i> isolated was not significantly different 73.3% vs. 64.5%, respectively (OR 1.53, CI 0.64-4.06, <i>p</i> = 0.43). In patients in whom <i>Aspergillus</i> was isolated, antifungal therapy (<i>p</i> = 0.035, OR 12.3, CI 1.74-252); vasopressors (0.016, OR 10.6, CI 1.75-81.8); and a higher mSOFA score (<i>p</i> = 0.043, OR 1.29 CI 1.03-1.72) were associated with a worse outcome. In a multivariable model adjusting for other significant variables, FiO₂ was the only variable associated with in-hospital mortality in patients in whom <i>Aspergillus</i> was isolated (OR 1.07, 95% CI 1.01-1.27). <b>Conclusions</b>: The isolation of <i>Aspergillus</i> from lower-respiratory-tract samples of critically ill patients with COVID-19 is associated with high mortality. It is important to have a low threshold for superimposed infections such as CAPA in critically ill patients with COVID-19.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 5","pages":"337-349"},"PeriodicalIF":1.8,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10514834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41093990","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":"Benefits from Incorporating Virtual Reality in Pulmonary Rehabilitation of COPD Patients: A Systematic Review and Meta-Analysis.","authors":"Irini Patsaki, Vasiliki Avgeri, Theodora Rigoulia, Theodoros Zekis, George A Koumantakis, Eirini Grammatopoulou","doi":"10.3390/arm91040026","DOIUrl":"10.3390/arm91040026","url":null,"abstract":"<p><p>Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. Patient participation in Pulmonary Rehabilitation (PR) programs has a beneficial effect on disease management, improving patients' functional capacity and quality of life. As an alternative to traditional programs or as a complementary activity, the inclusion of virtual reality (VR) games is proposed. The aim of this research study was to investigate the effectiveness of incorporating VR in the pulmonary rehabilitation program of patients with COPD. A systematic literature search was performed for randomized controlled trials (RCTs) in the electronic databases Google Scholar, PubMed, and Pedro from January 2014 to March 2022. The search involved screening for studies examining the effectiveness of enhancing PR with VR. The PEDro (Physiotherapy Evidence Database) scale was chosen as the tool to assess the quality of studies. A meta-analysis was performed where possible. Six studies were included in this systematic review. The PEDro scale showed five studies of good methodological quality and one of fair quality. The variables examined were: aerobic capacity for exercise, lung function, anxiety and depression, with non-significant improvement for the MRC Dyspnea scale, marginally non-significant improvement regarding 6MWT (p = 0.05) and significant improvement for FEV1 (p < 0.05). There was variability noted in the VR applications and the proposed rehabilitation that the experimental groups followed. The application of VR is recommended for COPD patients, in combination with conventional PR. VR was found to be effective in increasing therapeutic effect and should be considered as a mean of increasing accessibility to PR. Therefore, further research, as well as additional RCTs regarding the effectiveness of VR in patients with COPD, seems necessary.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 4","pages":"324-336"},"PeriodicalIF":1.8,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110382","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 Machine Learning-Based Model to Predict In-Hospital Mortality of Lung Cancer Patients: A Population-Based Study of 523,959 Cases.","authors":"Que N N Tran,&nbsp;Minh-Khang Le,&nbsp;Tetsuo Kondo,&nbsp;Takeshi Moriguchi","doi":"10.3390/arm91040025","DOIUrl":"https://doi.org/10.3390/arm91040025","url":null,"abstract":"<p><p><b>Background:</b> Stratify new lung cancer patients based on the risk of in-hospital mortality rate after diagnosis. <b>Methods:</b> 522,941 lung cancer cases with available data on the Surveillance, Epidemiology, and End Results (SEER) were analyzed for the predicted probability based on six fundamental variables including age, gender, tumor size, T, N, and AJCC stages. The patients were randomly assigned to the training (<i>n</i> = 115,145) and validation datasets (<i>n</i> = 13,017). The remaining cohort with missing values (<i>n</i> = 394,779) was then combined with the primary lung tumour datasets (<i>n</i> = 1018) from The Cancer Genome Atlas, Lung Adenocarcinoma and Lung Squamous Cell Carcinoma projects (TCGA-LUAD & TCGA-LUSC) for external validation and sensitivity analysis. <b>Results:</b> Receiver Operating Characteristic (ROC) analyses showed high discriminatory power in the training and internal validation cohorts (Area under the curve [AUC] of 0.78 (95%CI = 0.78-0.79) and 0.78 (95%CI = 0.77-0.79), respectively), whereas that of the model on external validation data was 0.759 (95%CI = 0.757-0.761). We developed a static nomogram, a web app, and a risk table based on a logistic regression model using algorithm-selected variables. <b>Conclusions:</b> Our model can stratify lung cancer patients into high- and low-risk of in-hospital mortality to assist clinical further planning.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 4","pages":"310-323"},"PeriodicalIF":1.8,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10451707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455605","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":"Volatile Organic Compound Identification-Based Tuberculosis Screening among TB Suspects: A Diagnostic Accuracy Study.","authors":"Mayank Badola,&nbsp;Anurag Agrawal,&nbsp;Debabrata Roy,&nbsp;Richa Sinha,&nbsp;Avisham Goyal,&nbsp;Narayan Jeet","doi":"10.3390/arm91040024","DOIUrl":"https://doi.org/10.3390/arm91040024","url":null,"abstract":"<p><p>Tuberculosis (TB) affects a third of the global population, and a large population of infected individuals still remain undiagnosed-making the visible burden only the tip of the iceberg. The detection of tuberculosis in close-proximity patients is one of the key priorities for attaining the Sustainable Development Goals (SDG) of TB elimination by 2030. With the current battery of screening tests failing to cover this need, the authors of this paper examined a simple and inexpensive point-of-care breath analyzer (TSI-3000(I)), which is based on detecting the volatile organic compounds that are emitted from infected cells and released in exhaled breath as a screening tool for the detection of TB. A single-center pilot study for assessing the diagnostic accuracy of the point-of-care Tuberculosis Breath Analyzer was conducted, and it was compared against the WHO-recommended TrueNat assay, which is a rapid molecular test and was also treated as the reference standard in this study. Of the 334 enrolled participants with TB signs/symptoms, 42.51% were TrueNat positive for Mycobacterium tuberculosis. The sensitivity of the Tuberculosis Breath Analyzer was found to be 95.7%, with a specificity of 91.3% and a ROC area of 0.935. The test kit showed considerable/significant high sensitivity and specificity as reliability indicators. The performance of the Tuberculosis Breath Analyzer tested was found to be comparable in efficiency to that of the TrueNat assay. A large cohort-based multicentric study is feasibly required to further validate and extrapolate the results of the pilot study.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 4","pages":"301-309"},"PeriodicalIF":1.8,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865521","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":"Open and Closed Triple Inhaler Therapy in Patients with Uncontrolled Asthma.","authors":"Serafeim-Chrysovalantis Kotoulas,&nbsp;Ioanna Tsiouprou,&nbsp;Kalliopi Domvri,&nbsp;Polyxeni Ntontsi,&nbsp;Athanasia Pataka,&nbsp;Konstantinos Porpodis","doi":"10.3390/arm91040023","DOIUrl":"https://doi.org/10.3390/arm91040023","url":null,"abstract":"<p><p>Long-acting muscarinic antagonists (LAMAs) are a class of inhalers that has recently been included as add-on therapy in the GINA guidelines, either in a single inhaler device with inhaled corticosteroids plus long-acting β2-agonists (ICS + LABA) (closed triple inhaler therapy) or in a separate one (open triple inhaler therapy). This review summarizes the existing evidence on the addition of LAMAs in patients with persistently uncontrolled asthma despite ICS + LABA treatment based on clinical efficacy in the reduction of asthma symptoms and exacerbations, the improvement in lung function, and its safety profile.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 4","pages":"288-300"},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865517","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":"Application and Technical Principles of Catheter High-Frequency Jet Ventilation.","authors":"Peter Musil,&nbsp;Stefan Harsanyi,&nbsp;Pavol Torok,&nbsp;Monika Paulikova,&nbsp;Didier Moens,&nbsp;Ladislav Kalas,&nbsp;Peter Kalas","doi":"10.3390/arm91040022","DOIUrl":"https://doi.org/10.3390/arm91040022","url":null,"abstract":"<p><p>The aim of this publication is to analyze the topic of high-frequency jet ventilation (HFJV), namely catheter HFJV (C-HFJV), from a mathematical-physical as well as a clinical point of view. There are known issues with applying anesthesia and artificial lung ventilation (ALV) during surgical procedures in the upper airways, e.g., during bronchoscopy or tracheostomy. The principles, advantages, and disadvantages of HFJV are discussed in context with basic physical principles to clarify the proper use of this method. The basic technical principles of catheter construction, as well as its functional properties from a biophysical point of view, are introduced. Also, the placement of the catheter in the airways, the set-up of the HFJV ventilator, and the indications as well as the risks and contraindications of the use of C-HFJV are analyzed. This leads to the explanation of potentially optimal techniques for C-HFJV applications. In this article, we present the positive effects of C-HFJV even with complications such as bacterial or viral pneumonia, including COVID-19. In conclusion, we offer recommendations for clinical practice obtained from a literature review and from our rich clinical experience.</p>","PeriodicalId":7391,"journal":{"name":"Advances in respiratory medicine","volume":"91 4","pages":"278-287"},"PeriodicalIF":1.8,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10366769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9865520","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}