Brazilian Journal of Otorhinolaryngology最新文献

{"title":"Brazilian Society of Otology task force – single sided deafness – recommendations based on strength of evidence","authors":"","doi":"10.1016/j.bjorl.2024.101514","DOIUrl":"10.1016/j.bjorl.2024.101514","url":null,"abstract":"<div><h3>Objective</h3><div>To make evidence-based recommendations for the treatment of Single-Sided Deafness (SSD) in children and adults.</div></div><div><h3>Methods</h3><div>Task force members were instructed on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on SSD were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions.</div></div><div><h3>Results</h3><div>The topics were divided into 3 parts: (1) Impact of SSD in children; (2) Impact of SSD in adults; and (3) SSD in patients with temporal bone tumors.</div></div><div><h3>Conclusions</h3><div>Decision-making for patients with SSD is complex and multifactorial. The lack of consensus on the quality of outcomes and on which measurement tools to use hinders a proper comparison of different treatment options. Contralateral routing of signal hearing aids and bone conduction devices can alleviate the head shadow effect and improve sound awareness and signal-to-noise ratio in the affected ear. However, they cannot restore binaural hearing. Cochlear implants can restore binaural hearing, producing significant improvements in speech perception, spatial localization of sound, tinnitus control, and overall quality of life. However, cochlear implantation is not recommended in cases of cochlear nerve deficiency, a relatively common cause of congenital SSD.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between vestibular response to caloric stimulation and cochlear function in Ménière's disease","authors":"","doi":"10.1016/j.bjorl.2024.101513","DOIUrl":"10.1016/j.bjorl.2024.101513","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the correlation between caloric testing response patterns with respect to cochlear impairment in individuals with unilateral Ménière's disease.</div></div><div><h3>Methods</h3><div>In this observational cross-sectional study, the factor under study was Ménière's disease and the outcome was cochleovestibular function, evaluated through caloric stimulation using videonystagmography and four-frequency averages in pure tone audiometry.</div></div><div><h3>Results</h3><div>A total of 187 patients (equal sex distribution) who met the inclusion criteria were included. In impairment analysis of the affected ear, 17 patients had only vestibular impairment, 56 had only cochlear impairment, and 114 had cochleovestibular impairment. The distribution of Ménière's disease stages according to four-frequency average was grade I: 23.53%, grade II: 16.04%, grade III: 42.25%, and grade IV: 18.18%. There was a significant association (<em>p</em> &lt; 0.001) between the affected ear and labyrinthine preponderance. The Spearman correlation between four-frequency average and labyrinth preponderance (<em>r</em> = 0.326) indicated a moderate correlation, considering <em>p</em> &lt; 0.01.</div></div><div><h3>Conclusion</h3><div>Our results show that the greater the cochlear damage due to Ménière's disease, the more impaired the vestibular function in the affected ear.</div></div><div><h3>Level of evidence</h3><div>Level 2 - Individual cross-sectional studies with consistently applied reference standard and blinding</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Translation, adaptation, and validation of ASK nasal-12 into Brazilian Portuguese","authors":"","doi":"10.1016/j.bjorl.2024.101511","DOIUrl":"10.1016/j.bjorl.2024.101511","url":null,"abstract":"<div><h3>Objective</h3><div>Translate, adapt, and validate the Anterior Skull Base Nasal Inventory 12 questionnaire (ASK Nasal-12) to Brazilian Portuguese.</div></div><div><h3>Methods</h3><div>A prospective longitudinal observational study was developed at the Skull Base Surgery Center clinic of the Irmandade Santa Casa de Misericórdia de São Paulo. There were five stages to translating the original ASK-12 questionnaire: two independent translations, consensus between the two, back-translation, comparison, and revision for the semi-final version. Internal consistency, reliability, and validation with a previous already validate questionnaire were all assessed.</div></div><div><h3>Results</h3><div>Over 30 months 72 patients in total were included in the study, of which six had to be excluded afterwards according to the research criteria. The internal consistency using Cronbach’s Alpha was calculated and successful. Next the reliability and agreement between the test and retest were analyzed. The Minimally Important Clinical Difference (MCID) was calculated for the 13 scores at each of the four time points. Finally, the final translated version was validated with the SNOT-22 questionnaire.</div></div><div><h3>Conclusion</h3><div>The translation, adaptation, and validation of the ASK Nasal-12 questionnaire into Brazilian Portuguese appear consistent and effective regarding its cultural equivalence for monitoring the QOL of patients undergoing transnasal access for endoscopic anterior skull base surgeries.</div></div><div><h3>Level of evidence</h3><div>II.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of extranasopharyngeal angiofibroma arising from nasal dorsum","authors":"","doi":"10.1016/j.bjorl.2024.101508","DOIUrl":"10.1016/j.bjorl.2024.101508","url":null,"abstract":"","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of epithelial-to-mesenchymal transition and Ki-67 index in aggressive papillary thyroid cancer","authors":"","doi":"10.1016/j.bjorl.2024.101510","DOIUrl":"10.1016/j.bjorl.2024.101510","url":null,"abstract":"<div><h3>Objectives</h3><div>The present study aims to characterize immunohistochemical features of markers associated with Epithelial–Mesenchymal Transition (EMT) and proliferative activity that could lead to death in Papillary Thyroid Cancer (PTC).</div></div><div><h3>Methods</h3><div>Clinical data and tumor material were retrospectively collected. The patients were separated into death from PTC (Group 1), metastatic cases with indolent behavior (Group 2) and non-metastatic indolent PTC (Group 3). Immunohistochemical assessment of E-cadherin, β-catenin, Vimentin, ZEB-1 and Ki-67 was performed in each tumor and a semiquantitative estimation of the percentage of expression was fulfilled on the best marking area at high of the tumor invasion front.</div></div><div><h3>Results</h3><div>31 patients were included, 15 that died from PTC (Group 1), 6 in Group 2 and 10 in Group 3. The proliferative marker Ki-67 showed a significant difference in its expression in the tumor invasion front between the groups, specifically between groups 1 and 3 (<em>p</em> = 0.006). On the other hand, EMT-related immunohistochemical markers did not show significant difference in their percentage of expression, since loss of E-cadherin, β-catenin and Vimentin was observed in most cases at the invasion front.</div></div><div><h3>Conclusion</h3><div>Patients that died from PTC had a significantly higher Ki-67 labelling index compared to patients with indolent disease (cutoff of 11%). Ki-67 may have a role as a prognostic marker and could be considered for routine use in PTC.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing results following endoscopic type I tympanoplasty in medium and large perforations","authors":"","doi":"10.1016/j.bjorl.2024.101509","DOIUrl":"10.1016/j.bjorl.2024.101509","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To clarify the hearing outcomes after endoscopic type I tympanoplasty for medium and large perforations due to chronic otitis media.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We examined the clinical records of patients who underwent endoscopic type I tympanoplasty for medium and large perforations of the eardrum resulting from chronic otitis media between January 2019 and December 2021. We analyzed the changes in hearing pre- and post-operation in patients with healed eardrums and assessed the impact of tympanosclerosis on hearing. Patients with incomplete follow-up data, middle ear cholesteatoma, stapes fixation, severe lesions in the tympanic antrum and mastoid necessitating mastoidectomy and/or ossicular chain reconstruction were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 156 patients underwent analysis for audiological outcomes. Among them, 63 had medium tympanic membrane perforations, with 18 cases showing calcification of the tympanic membrane and 20 cases with calcification in the tympanic cavity. Additionally, 93 cases had large tympanic membrane perforations, with 25 cases showing tympanic membrane calcification and 32 cases with tympanic cavity calcification. Prior to surgery, the Air Conduction threshold (AC) in the large perforation group was higher than in the medium perforation group, particularly at low frequencies, measuring (47.4 ± 13.3 dB) and (41.2 ± 14.7 dB), respectively (&lt;em&gt;p&lt;/em&gt;-value &lt; 0.05). Following surgery, both groups experienced an improvement in AC, measuring (33.6 ± 13.9 dB) and (32.6 ± 12.8 dB), respectively, with no significant difference noted (&lt;em&gt;p&lt;/em&gt;-value &gt; 0.05). There was no significant change in Bone Conduction threshold (BC) before and after surgery in either the large or medium perforation groups (all &lt;em&gt;p&lt;/em&gt;-values &gt; 0.05). Except for 4000 Hz an increase, bone conduction did not increase post-surgery, instead showing further improved. Pre-surgery, the Air-Bone Gap (ABG) in the large and medium perforation groups was (27.7 ± 8.5 dB) and (21.8 ± 8.3 dB), respectively, mainly affecting low frequencies, with a statistically significant difference noted (&lt;em&gt;p&lt;/em&gt;-value &lt; 0.05). Following surgery, ABG in both groups improved to (16.3 ± 7.6 dB) and (15.7 ± 8.4 dB), respectively, with no significant difference observed (&lt;em&gt;p&lt;/em&gt;-value &gt; 0.05). There was no significant difference in hearing pre-surgery among the groups with No calcification (No), Tympanic Membrane Calcification (TM), and Tympanic Cavity Calcification (TC). However, TC significantly impacted low frequency (250–500 Hz) AC and ABG. The differences in AC and ABG pre-surgery between TC and No group, and TC and TM group (at 250–500 Hz) were statistically significant (all &lt;em&gt;p&lt;/em&gt;-values &lt; 0.05). Preoperative ABG in TM group was better than in No group and TC group, suggesting minimal impact of tympanic membrane calcification on hearing. No interaction was observed between tympanic","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"V Brazilian Consensus on Rhinitis – 2024","authors":"","doi":"10.1016/j.bjorl.2024.101500","DOIUrl":"10.1016/j.bjorl.2024.101500","url":null,"abstract":"<div><div>Since we published the “IV Brazilian Consensus on Rhinitis”, in<!--> <!-->2017, several advances have been achieved and have enabled a further understanding of the different aspects of “Rhinitis”. This new guideline, developed jointly by ASBAI, SBP and SBORL, represents a relevant milestone in the updated and integrated management of the different forms of the disease, and it aims to unify evidence-based approaches to improve the diagnosis and treatment of this common and often underestimated condition. The document covers a wide range of topics, including clear definitions of the different phenotypes and endotypes of rhinitis, risk factors, updated diagnostic criteria, and recommended methods for clinical and laboratory investigation. We stress the importance of detailed clinical history and objective assessment, as well as tools for control and assessing severity tools an accurate diagnostic approach to the disease. Regarding treatment, it emphasizes the treatment customization, considering the severity of symptoms, the presence of comorbidities and the impact on the patient's quality of life. We discuss different drug treatment, in addition to non-pharmacological measures, such as environmental control and specific immunotherapy; and the possible role of immunobiological agents. Furthermore, the consensus addresses issues related to patient education, prevention and management of special situations, such as rhinitis in children, in pregnant women and in the elderly. In short, the “V Brazilian Consensus on Rhinitis” represents a comprehensive and updated guide for healthcare professionals involved in the diagnosis and management of rhinitis, aiming to improve patients' quality of life through an integrated and evidence-based approach.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of mastoid volume and dimensions in unilateral microtia patients: retrospective study using High Resolution Computed Tomography (HRCT)","authors":"","doi":"10.1016/j.bjorl.2024.101501","DOIUrl":"10.1016/j.bjorl.2024.101501","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to evaluate mastoid volume and dimensions in patients with unilateral microtia using High-Resolution Computed Tomography (HRCT) to enhance the precision of reconstructive surgical planning.</div></div><div><h3>Methods</h3><div>A retrospective analysis of HRCT mastoid scans from patients with unilateral microtia was carried out at Cipto Mangunkusumo General Hospital between May 2020 and August 2022. Parameters such as mastoid volume, height, and surface area were measured at the ear canal, Superior Semicircular Canal (SCC), and lateral SCC levels.</div></div><div><h3>Results</h3><div>The analysis revealed statistically significant decreases in median mastoid air cell volume and mastoid bone volume in the affected ears compared to contralateral ears (<em>p</em> =  0.0312 and <em>p</em> =  0.02, respectively). Additionally, decreased mastoid height and surface areas at the ear canal and superior SCC levels were identified in affected ears (<em>p</em> &lt;  0.05).</div></div><div><h3>Conclusions</h3><div>Patients with unilateral microtia have diminished mastoid bone volumetric parameters and dimensions on the affected side. These findings offer critical data for surgeons in preoperative planning, enabling the selection of appropriate reconstructive techniques and providing comprehensive patient counselling.</div></div><div><h3>Level of evidence</h3><div>Level 4.</div></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001162/pdfft?md5=bcbfabefe33d064253b97bcdf0bb80a2&pid=1-s2.0-S1808869424001162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of cervical vestibular miogenic evoked potential and electrococleography in the diagnosis of vestibular migraine","authors":"","doi":"10.1016/j.bjorl.2024.101489","DOIUrl":"10.1016/j.bjorl.2024.101489","url":null,"abstract":"<div><h3>Objectives</h3><p>Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibular-evoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine.</p></div><div><h3>Method</h3><p>Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography.</p></div><div><h3>Results</h3><p>The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance.</p></div><div><h3>Conclusions</h3><p>Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops.</p></div><div><h3>Level of evidence</h3><p>Level 4.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001046/pdfft?md5=570e291654172bcc5766ca34d46860cb&pid=1-s2.0-S1808869424001046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A proposal for analyzing the inflammatory and remodeling processes of mucosa in chronic rhinosinusitis with nasal polyposis through MRI","authors":"","doi":"10.1016/j.bjorl.2024.101490","DOIUrl":"10.1016/j.bjorl.2024.101490","url":null,"abstract":"<div><h3>Objectives</h3><p>Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) is a disease characterized by chronic inflammation and tissue remodeling process. The remodeling process in nasal polyps has mainly been studied by histology analysis. However, it is limited to a polyp fragment and requires tissue removal. The present study aims to evaluate the ability of Magnetic Resonance Imaging (MRI) to depict and characterize the remodeling process in patients with CRSwNP.</p></div><div><h3>Methods</h3><p>30 patients that met clinical diagnostic criteria for CRSwNP, without previous history of rhinosinusitis surgery were submitted to MRI scan (conventional, diffusion-weighted and DCE MRI) and compared with polyp tissue histological findings, IL-6 concentrations in the tissue and eosinophil count in the blood. The examinations were evaluated, independently, by two radiologists blinded to other radiological and histological data. The pathologist, blinded to MRI results, also compared the tissue sample from the most central and the most peripheral portion of the polypoid tissue adjacent to the floor of the nasal fossa.</p></div><div><h3>Results</h3><p>This study demonstrated a characteristic pattern of nasal polyps, whose peripheral portions of nasal polypoid tissue are edematous, whereas the central portions in the middle meatus and in the middle and upper ethmoid are predominantly fibrotic. ADC values found in the most anterior portion of the polyps may be a marker for radiological phenotyping the remodeling process. This non-invasive analysis presented a high degree of agreement in the fibrosis and edema rating by two radiologists and the histological analysis was concordant with the MRI findings. The polyps were characterized as eosinophilic, and no relationship was found between the severity of the eosinophilic inflammatory process or concentration of IL-6 and the remodeling process.</p></div><div><h3>Conclusion</h3><p>MRI by using T2-weighted imaging sequence and ADCs values allows tissue characterization and is an effective tool for the differentiation of edematous and fibrotic components in CRSwNP.</p></div><div><h3>Level of evidence</h3><p>3.</p></div>","PeriodicalId":49099,"journal":{"name":"Brazilian Journal of Otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1808869424001058/pdfft?md5=3100f007cc6065ed2b0d7a365b6cfae5&pid=1-s2.0-S1808869424001058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142158392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}