Gynecologic Oncology Reports最新文献

{"title":"When ovarian mature teratoma peritonitis mimics cancer: What is the best treatment?","authors":"Madison Klavans , Sarah E. Podwika , Michael Crawford , Paola A. Gehrig","doi":"10.1016/j.gore.2024.101539","DOIUrl":"10.1016/j.gore.2024.101539","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142560671","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":"High Rates of Germline Pathogenic Variants in Somali Patients with Ovarian Cancer","authors":"José V. Somohano-Short ,&nbsp;Natasha Crawford ,&nbsp;Mahmoud A. Khalifa ,&nbsp;Britt K. Erickson","doi":"10.1016/j.gore.2024.101538","DOIUrl":"10.1016/j.gore.2024.101538","url":null,"abstract":"<div><div>The objective of this study was to determine the rate of germline high risk ovarian cancer susceptibility pathogenic variants in Somali patients with ovarian carcinoma treated at a single institution between 2015 and 2022. Out of eight identified patients, five underwent germline and/or somatic testing, revealing a high prevalence (3 of 5, 60 %) of a BRIP1 splice site mutation (c.1936 + 1G &gt; A). Additionally, one patient had a BRCA2 pathogenic variant, and two had the same MLH1 variant of uncertain significance. The high prevalence of BRIP1 pathogenic variants warrants further study into a possible founder effect within the Somali population, emphasizing the need for targeted genetic screening and counseling. The study also highlights significant barriers to genetic testing, pointing to the critical role of healthcare disparities and social determinants of health (SDoH) in cancer outcomes. Comprehensive genomic profiling and community-based research are essential to address these disparities and improve cancer care for this underserved population. Larger studies are needed to validate these findings and to develop tailored interventions that enhance the prevention, diagnosis, treatment, and prognosis of ovarian cancer in Somali women.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553748","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":"Sleep characteristics and recurrence in platinum-sensitive ovarian cancer survivors: A prospective cohort study","authors":"Mélanie Benoit ,&nbsp;Marie-Pierre Sylvestre ,&nbsp;Geetanjali Datta ,&nbsp;Lucy Gilbert ,&nbsp;Vikki Ho ,&nbsp;Igor Karp ,&nbsp;Julie Lacaille ,&nbsp;Susie Lau ,&nbsp;Vanessa Samouëlian ,&nbsp;Anita Koushik","doi":"10.1016/j.gore.2024.101540","DOIUrl":"10.1016/j.gore.2024.101540","url":null,"abstract":"<div><h3>Objective</h3><div>To describe characteristics of sleep (quality, duration, efficiency, and insomnia) in a cohort of high-grade epithelial ovarian cancer (EOC) survivors who have completed and responded to first-line chemotherapy, and to explore their relationships with disease recurrence.</div></div><div><h3>Methods</h3><div>In this cohort of 97 women, sleep and other factors were assessed at baseline and 4 months later. The distribution of participants by categories of sleep characteristics were calculated. Hazard ratios (HRs) and 95 % confidence intervals (95 % CI) for the association between each sleep characteristic and recurrence were estimated using the Cox proportional hazards model, and adjusted for confounding using propensity scores. Associations were estimated for all women and among those defined as fully platinum-sensitive.</div></div><div><h3>Results</h3><div>At baseline, just over half of participants (52.6 % to 56.7 %) had poor sleep quality, efficiency and duration, while most (62.9 %) did not experience insomnia. Distributions remained similar 4 months later. During follow-up, 47 recurrences occurred. Among all participants, HRs (95 % CIs) of recurrence were close to the value of 1, indicating no association, for sleep quality and efficiency, 1.22 (0.66–2.23) for not meeting vs. meeting sleep duration guidelines and 0.68 (0.34–1.39) for the presence vs. absence of insomnia. In fully platinum-sensitive women, the HRs (95 % CIs) were 1.50 (0.64–3.53) for not meeting duration guidelines, 1.25 (0.56–2.79) for poor sleep efficiency, 1.44 (0.55–3.72) for the presence of insomnia, and remained null for sleep quality.</div></div><div><h3>Conclusion</h3><div>Most EOC survivors have poor sleep quality, duration, and efficiency. Research with larger sample sizes is required to better understand the relationship between these sleep characteristics and the risk of recurrence.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142573105","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":"Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study","authors":"Anastasios Pandraklakis ,&nbsp;Chrysoula Liakou ,&nbsp;MariaClelia La Russa ,&nbsp;Rocio Ochoa-Ferraro ,&nbsp;Adam Stearns ,&nbsp;Nikolaos Burbos","doi":"10.1016/j.gore.2024.101536","DOIUrl":"10.1016/j.gore.2024.101536","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to evaluate the implementation of the elements of enhanced recovery (ERAS) protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic ovarian cancer. ERAS protocols have shown improvement in the perioperative outcomes of patients who underwent cytoreductive surgery for metastatic ovarian cancer by reducing the length of stay as well as the postoperative complications and by improving patients’ postoperative experience<strong>.</strong></div></div><div><h3>Methods</h3><div>This is a feasibility study involving retrospective analysis from (31) patients who underwent cytoreductive surgery and HIPEC versus (35) a control group that underwent cytoreductive surgery only, prior to the introduction of the HIPEC programme for metastatic ovarian cancer. All patients had undergone neoadjuvant chemotherapy prior to surgery. We compared the compliance for each element of the ERAS protocol between the two study groups.</div></div><div><h3>Results</h3><div>We analyzed data from 66 patients, 31 in HIPEC group and 35 in the control goup. We found no significant difference in the patients’ characteristics between the two groups and there were no differences in the implementation of 8 elements of the ERAS protocols (100 % for both groups). The use of nasogastric tube was more frequently observed in patients undergoing surgery and HIPEC compared to those undergoing surgery alone (42 % vs 0 %, respectively; p &lt; 0.001). The number of patients who were mobilized on the first postoperative day was higher in the group undergoing surgery and HIPEC (87.1 % vs 57.1 %, respectively; p = 0.007), however there was no significant difference in the percentage of patients that had early removal of the urinary catheter (p = 0.12), nor in the percentage of patients that received early feeding (p = 0.18). Finally, there were no statistically significant differences in the complication rates, the length of hospital stay and the re-admission rates between the two groups.</div></div><div><h3>Conclusion</h3><div>Enhanced recovery protocols can be implemented safely in patients undergoing cytoreductive surgery and HIPEC for ovarian cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539612","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":"Apixaban versus enoxaparin to prevent venous thromboembolism in post-operative patients with gynecologic cancers at an urban academic medical center","authors":"Victoria Diamond ,&nbsp;Katherine Gerber ,&nbsp;Geno Merli ,&nbsp;Rebecca Mercier ,&nbsp;Aaron Shafer ,&nbsp;Norman Rosenblum","doi":"10.1016/j.gore.2024.101535","DOIUrl":"10.1016/j.gore.2024.101535","url":null,"abstract":"<div><h3>Objective</h3><div>A recent clinical trial demonstrated that the use of apixaban was safe and equal to enoxaparin (LMWH) in post-operative gynecologic oncology patients. This study aimed to determine if these findings are applicable in a diverse patient population at a single site urban academic medical center.</div></div><div><h3>Methods</h3><div>This was a retrospective cohort study of patients who underwent an exploratory laparotomy for confirmed or presumed gynecologic cancer from the years 2017–2023 at a single-site urban academic medical center. Venous thromboembolism (VTE) prophylaxis with LMWH was standard practice at our institution up until January 2021 after which apixaban became standard for post-operative prophylaxis in our division. Baseline demographic and clinical characteristics of patients receiving apixaban post-operatively were compared to the population previously receiving enoxaparin. The primary outcome was a VTE event within 90 days of surgery. Secondary outcomes included major and minor bleeding events.</div></div><div><h3>Results</h3><div>Two hundred fifteen patients met inclusion criteria, of which 65 were discharged on enoxaparin and 150 were discharged on apixaban. Baseline characteristics in terms of age, race/ethnicity and BMI found no significant difference between the two groups. Rates of any VTE event within 90 days of surgery were similar for apixaban and LMWH (3.33 % vs. 4.61 %, p = 0.6). Secondary outcomes demonstrated that the rate of a major bleeding event in apixaban group was 1.31 % and LMWH group was 3.08 %, (<em>p = 0.38)</em>. Minor bleeding events in the apixaban group were comparable to the LMWH group (10.60 % vs 10.16 %, p = 0.5<em>)</em>.</div></div><div><h3>Conclusions</h3><div>In this real world, urban setting, for women undergoing laparotomy for gynecologic cancer, apixaban as post-operative VTE prophylaxis showed no increase in VTE events and appeared safe with no increase in bleeding events compared to LMWH. This study adds to the literature demonstrating that apixaban is safe and effective for VTE prophylaxis in our gynecologic oncology patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528592","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":"Rehabilitation of pelvic floor dysfunction after radiation therapy for a rare gynecological cancer: A case report","authors":"Eileen Coughenour ,&nbsp;Fatimah Alkhameys ,&nbsp;Neena K. Sharma","doi":"10.1016/j.gore.2024.101534","DOIUrl":"10.1016/j.gore.2024.101534","url":null,"abstract":"<div><h3>Objective</h3><div>Radiation therapy (RT) for gynecological cancers has significant effects on patients’ quality of life regarding sexual dysfunction, urinary incontinence (UI), fecal incontinence (FI), and psychological distress. There is a scarcity in literature for the inclusive therapeutic approaches of pelvic health physical therapy (PHPT) for cancer survivors. Therefore, this case describes a comprehensive PHPT program to address the complexity of pelvic floor dysfunctions due to RT.</div></div><div><h3>Case description</h3><div>A 54-year-old female was diagnosed with high-grade neuroendocrine carcinoma of the vagina. After a one-year treatment of chemotherapy and RT, the patient presented with overall fatigue, psychological distress, dyspareunia, mixed UI, fecal urgency and FI, and bilateral vulvar lymphedema. The PHPT exam revealed vaginal dryness, vulvovaginal fibrosis, and pelvic floor muscle (PFM) weakness.</div><div>A comprehensive treatment approach included referrals to multidisciplinary specialists. PHPT incorporated motor learning, strengthening and stretching of PFM, internal and external fascia mobilization for PFM and vulvar tissues, lymphatic drainage, vaginal dilators, pain neuroscience education and nutrition recommendations. After seven sessions, the patient demonstrated improved PFM strength, improved psychosocial measures, no UI or FI, as well as reduced discomfort during intercourse.</div></div><div><h3>Conclusions</h3><div>Symptoms were clinically improved with a multidisciplinary approach and comprehensive PHPT. However, considering the consistency and time required for physiological and psychological recovery for gynecological cancer survivors, it was recommended to continue the plan of care and home program developed to address the patient’s goals.</div></div><div><h3>Impact statement</h3><div>Treatment utilized a holistic and interdisciplinary approach to address the multifactorial nature of vaginal cancer and side effects of RT. PHPT, which promptly maximized improvement, included manual therapy, exercises, education, and motivational interviewing strategies that prioritized the patient’s goals and built a nurturing clinician-patient relationship. Health care providers are strongly encouraged to refer to PHPT as interventions may significantly improve the patient’s quality of life.</div><div>This case report follows the CARE Guidelines (Riley et al., 2017).</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528591","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":"Feasibility of neoadjuvant chemotherapy for bulky early stage to stage IIIB cervical cancer in Uganda","authors":"Jane Namugga ,&nbsp;Janice Wong ,&nbsp;Carolyn Nakisige ,&nbsp;Anthony Okoth ,&nbsp;Judith Ajeani ,&nbsp;Josephine Irene Najjemba ,&nbsp;Stefanie Ueda ,&nbsp;Paula S. Lee","doi":"10.1016/j.gore.2024.101533","DOIUrl":"10.1016/j.gore.2024.101533","url":null,"abstract":"<div><h3>Introduction</h3><div>External beam radiotherapy (EBRT) became unavailable in Uganda from February 2016 to November 2017. Following resource stratification guidelines, an alternative treatment strategy was developed.</div></div><div><h3>Methods</h3><div>Bulky early stage to Stage IIIB patients received at least 3 cycles of neoadjuvant chemotherapy (NAC). Surgery was performed if adequate response was achieved and adjuvant therapy given for high risk factors. Chemotherapy versus supportive care was advised in unresectable disease. NAC protocol completion was defined as receiving at least 3 cycles of NAC followed by either surgery, chemotherapy and/or radiation, or best supportive care. The purpose of this study was to determine the completion rate of NAC and assess the adverse events associated with treatment. Data were collected through retrospective chart review.</div></div><div><h3>Results</h3><div>From February 2016 to November 2018, 53 evaluable patients were identified. 86.8% (46/53) of patients presented in Stage IIB or higher. The completion rate of the NAC protocol was 75.5% (40/53). 94.3% (50/53) received platinum-taxane combination. 7.6% (4/52) grade 3 adverse events occurred related to chemotherapy, all hematologic. 18.8% (10/53) patients underwent surgery with 2 aborted cases due to metastatic or inoperable disease. No adverse events related to surgery were reported. 5 patients underwent adjuvant therapy after surgery due to high risk factors or incomplete pathology findings. 26 patients received adjuvant radiation (3 brachytherapy, 23 EBRT after it became available). Reported side effects related to radiation included vaginal fibrosis and skin reactions.</div></div><div><h3>Conclusion</h3><div>In this limited-resource setting, majority of patients completed a NAC treatment strategy for cervical cancer with acceptable toxicities.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528602","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":"Tailoring neoadjuvant chemotherapy for a pregnant patient diagnosed with IB2 squamous cervical carcinoma","authors":"Anna Babkova ,&nbsp;Helena Robova ,&nbsp;Hana Malikova ,&nbsp;Jana Drozenova ,&nbsp;Tomas Pichlik ,&nbsp;Michael J. Halaska ,&nbsp;Lukas Rob","doi":"10.1016/j.gore.2024.101532","DOIUrl":"10.1016/j.gore.2024.101532","url":null,"abstract":"<div><div>The incidence of cancer during pregnancy is steadily rising because of the postponement of plans for childbearing. One of the most common cancers diagnosed during pregnancy is cervical cancer. Diagnosis of most cases usually occurs in the early stages, but there are still cases of tumors staged IB2 and higher. In these cases, the treatment strategy entails administration of neoadjuvant chemotherapy. However, a universally recognized standardized regimen for neoadjuvant chemotherapy treatment of cervical cancer during pregnancy has yet to be established. The chemotherapy agents used during treatment are known for their fetal adverse effects. The aim of the therapy is to attain full-term pregnancy while minimizing fetal toxicity and decreasing tumor size. In this case report, we present a first-time sequential chemotherapy administration to minimize the cumulative toxicity of individual regimens and demonstrate the benefits for the patient and fetus.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528493","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":"Ovarian stimulation with letrozole in nulliparous young women with relapsing early-stage serous borderline ovarian tumors","authors":"Valeria Lombardi Fäh ,&nbsp;Federico Del Vento ,&nbsp;S. Intidhar Labidi-Galy ,&nbsp;Manuela Undurraga","doi":"10.1016/j.gore.2024.101531","DOIUrl":"10.1016/j.gore.2024.101531","url":null,"abstract":"<div><div>Fertility preservation (FP) is an important aspect of the treatment of young women diagnosed with serous borderline ovarian tumors (SBOT), with fertility sparing surgery recommended when possible. Concurrent treatment with aromatase inhibitor letrozole during ovarian stimulation (OS) could be used in women with hormone-sensitive breast cancer, but very little is known in gynecological tumors. Here, we report the cases of 2 young nulliparous women with early stage SBOT who underwent successful OS with letrozole. Patient 1 is 22-years old, FIGO IIB. She had a bilateral ovarian recurrence 5 months after the first surgery. She underwent OS with letrozole (four oocytes were collected and vitrified), followed by cytoreduction. The patient is in complete remission since 2 years. Patient 2 is 27-years old, FIGO IC3, treated by right adnexectomy. Ten months after surgery, she was in complete remission. OS with letrozole was performed and 4 oocytes were retrieved, resulting in 2 blastocysts that were cryopreserved. She had a successful pregnancy after in-vitro fertilization. She underwent a delivery via C-Section for obstetrical reasons that revealed a macroscopic suspicious lesion on the left ovary. Cystectomy was performed during C-section, confirming tumor recurrence. She underwent a second pregnancy uneventfully. During the second C-section, a partial cystectomy and multiples peritoneal biopsies were performed revealing tumor recurrence limited to the left ovary. She underwent left adnexectomy two months after C-Section without any recurrence. In conclusion, our case report described successful oocytes cryopreservation, without changes in the appearance of ovarian cysts, in nulliparous women with early-stage SBOT who underwent OS with simultaneous administration of letrozole.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528590","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":"Use of a PD-1 checkpoint inhibitor in a patient with ultra-high-risk gestational trophoblastic neoplasia and gastrointestinal metastases","authors":"Amalia Brawley,&nbsp;Casey Moffitt,&nbsp;Shaina Feldman Bruce,&nbsp;Caitlin Stashwick Farabaugh,&nbsp;Edward Podczaski,&nbsp;Joel Sorosky","doi":"10.1016/j.gore.2024.101530","DOIUrl":"10.1016/j.gore.2024.101530","url":null,"abstract":"<div><div>Gestational trophoblastic neoplasia (GTN) are rare diseases that are typically chemo-responsive. While the majority of patients are cured with chemotherapy alone, a small portion of cases are fatal due to chemotherapy resistance. Risk factors for treatment failure are liver and brain metastases, extensive disease, and chemo-refractory disease. Gastrointestinal (GI) metastases are extremely rare and indicate a poor prognosis. Treatment with immunotherapy has been studied and included in treatment guidelines for high-risk and chemotherapy-resistant GTN. This case reports on the early use of programmed cell death protein 1 (PD-1) inhibitor in combination with systemic chemotherapy in a patient with ultra-high risk GTN with GI metastases.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438226","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}