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Article ; Online: Impact of serum albumin concentration and neutrophil-lymphocyte ratio score on gastric cancer prognosis.

Costa, Teresa / Nogueiro, Jorge / Ribeiro, Daniel / Viegas, Pedro / Santos-Sousa, Hugo

2023 Volume 408, Issue 1, Page(s) 57

Abstract: Introduction/aim: Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC).: Material and methods! ...

Abstract	Introduction/aim: Serum albumin concentration (COA) and neutrophil-lymphocyte ratio (NLR) could reflect immunological and nutritional status. We aim to evaluate the impact of COA-NLR score on the prognosis of gastric cancer (GC). Material and methods: We perform a retrospective analysis on a database of 637 GC cases, between January 2010 and December 2017. In 396 patients, the inclusion criteria for this study were met (non-resectional or palliative surgery were excluded). Analytic data was only available in 203 patients. COA-NLR score was defined as follows: COA under 35 g/L and NLR value of 2.585 or higher, score 2; one of these conditions, score 1; and neither, score 0. Results: In our population (n = 203), 87 patients were classified as score 0, 82 as score 1 and 34 as score 2. COA-NLR score was significantly associated with DFS (HR 1.674; CI 95% 1.115-2.513; p = 0.013) and with OS (HR 2.072; CI 95% 1.531-2.805; p < 0.001). Kaplan-Meier curve analysis (log rank test) revealed that a higher score of COA-NLR predicted a worse OS (p < 0.001) and DFS (p = 0.03). COA-NLR was an independent prognostic factor for OS when adjusted to pStage and age (adjusted HR 1.566; CI 95% 1.145-2.143; p = 0.005). Conclusions: Preoperative COA-NLR score was significantly associated with worse OS and DFS and, in this way, with worse prognosis on GC patients submitted to curative-intent resectional surgery.
MeSH term(s)	Humans ; Neutrophils ; Serum Albumin ; Stomach Neoplasms/surgery ; Retrospective Studies ; Lymphocytes ; Prognosis
Chemical Substances	Serum Albumin
Language	English
Publishing date	2023-01-23
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02799-3
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Article ; Online: Risk factors for gastrointestinal perforation and anastomotic leak in patients submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

Nogueiro, Jorge / Fathi, Nik Qisti / Guaglio, Marcello / Baratti, Dario / Kusamura, Shigeki / Deraco, Marcello

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

2023 Volume 49, Issue 10, Page(s) 107020

Abstract: Background: Gastrointestinal leak is one of the most feared complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and harbors significant postoperative morbidity and mortality. We aim to identify risk- ... ...

Abstract	Background: Gastrointestinal leak is one of the most feared complications after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and harbors significant postoperative morbidity and mortality. We aim to identify risk-factors for anastomotic leak (AL) and gastrointestinal perforation (GP) to optimize postoperative outcomes of this population. Methods: We performed a retrospective analysis of 1043 consecutive patients submitted to CRS in a single institution. Potential risk factors for AL and GP, both related to patient overall condition, disease status and surgical technique were reviewed. Results: Anastomotic leaks were identified in 5.2% of patients, and GPs in 7.0%. The independent risk-factors for AL were age at surgery (OR1.40; CI95% 1.10-1.79); peritoneal cancer index (PCI) (OR1.04, CI95% 1.01-1.07); Cisplatin dose >240 mg during HIPEC (OR3.53; CI95% 1.47-8.56) and the presence of colorectal (CR) or colo-colic (CC) anastomosis (OR5.09; CI95% 2.71-9.53, and 4.58; CI95% 1.22-17.24 respectively). Male gender and intraoperative red blood cell transfusions were the only independent risk factors for GP identified (OR1.70; CI95% 1.04-2.78 and 1.06; CI95% 1.01-1.12, respectively). Regarding 30-day and 90-day postoperative mortality, independent risk-factors were mainly related to patient's overall condition. Conclusion: Gastrointestinal leaks are a frequent source of postoperative morbidity, mainly at the expense of GP. A careful and systematic intraoperative revision of all potential gastrointestinal injuries is equally critical to perfecting anastomotic fashioning techniques to decrease gastrointestinal complication rates. We identified multiple risk-factors for AL and GP related to disease status and patient condition. Our study suggests that patient-related conditions are of paramount relevance, highlighting the importance of patient selection and preoperative patient optimization.
MeSH term(s)	Humans ; Male ; Anastomotic Leak/epidemiology ; Anastomotic Leak/etiology ; Hyperthermic Intraperitoneal Chemotherapy ; Combined Modality Therapy ; Peritoneal Neoplasms/therapy ; Prognosis ; Cytoreduction Surgical Procedures/adverse effects ; Retrospective Studies ; Chemotherapy, Cancer, Regional Perfusion/adverse effects ; Hyperthermia, Induced/adverse effects ; Risk Factors ; Survival Rate
Language	English
Publishing date	2023-08-14
Publishing country	England
Document type	Journal Article
ZDB-ID	632519-1
ISSN	1532-2157 ; 0748-7983
ISSN (online)	1532-2157
ISSN	0748-7983
DOI	10.1016/j.ejso.2023.107020
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Zs.A 1149: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Impact of Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-analysis.

Martins, Mariana / Santos-Sousa, Hugo / Araújo, Francisco / Nogueiro, Jorge / Sousa-Pinto, Bernardo

Annals of surgical oncology

2022 Volume 29, Issue 12, Page(s) 7528–7537

Abstract: Background: Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. ... ...

Abstract	Background: Despite promising results, the effectiveness of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with gastric cancer with peritoneal carcinomatosis (GCPC) has not been systematically evaluated. The aim of this systematic review is to compare the survival, complications and risk of recurrence between CRS + HIPEC versus CRS alone in GCPC. Patients and methods: A systematic review was performed in MEDLINE and Web of Science according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Primary studies with patients with GCPC older than 18 years were included. Methodological Index for Non-randomized Studies (MINORS) criteria were used to assess the quality of the studies. We performed random-effects meta-analysis of risk ratios (RR). We assessed heterogeneity using the I Results: Five studies were included in the qualitative and four in the quantitative analysis. The overall survival (OS) rate after 1 year was 3.65 times higher for CRS + HIPEC than CRS alone [RR = 3.65, 95% confidence interval (95% CI) = 1.01-13.26, I Conclusions: Results should be analysed cautiously given the detected heterogeneity and limitations of included studies. However, treatment with CRS + HIPEC seems to increase the survival of patients with GCPC, more than treatment with CRS alone, decrease the risk of peritoneal recurrence and not be associated with more complications.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures/methods ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms/surgery ; Retrospective Studies ; Stomach Neoplasms/surgery ; Survival Rate
Language	English
Publishing date	2022-08-05
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12312-7
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Article ; Online: ASO Author Reflections: Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Gastric Cancer with Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis.

Martins, Mariana / Santos-Sousa, Hugo / Araújo, Francisco / Nogueiro, Jorge / Sousa-Pinto, Bernardo

Annals of surgical oncology

2022 Volume 29, Issue 12, Page(s) 7538–7539

MeSH term(s)	Chemotherapy, Cancer, Regional Perfusion ; Combined Modality Therapy ; Cytoreduction Surgical Procedures ; Humans ; Hyperthermia, Induced ; Hyperthermic Intraperitoneal Chemotherapy ; Peritoneal Neoplasms/surgery ; Stomach Neoplasms/drug therapy ; Stomach Neoplasms/surgery
Language	English
Publishing date	2022-07-30
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Comment
ZDB-ID	1200469-8
ISSN	1534-4681 ; 1068-9265
ISSN (online)	1534-4681
ISSN	1068-9265
DOI	10.1245/s10434-022-12317-2
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Article: A Rare Case of a Migrating Inguinal Hernia Mesh Presenting as Acute Appendicitis.

Nogueiro, Jorge / Santos-Sousa, Hugo / de Almeida, Marinho / Malheiro, Luis / Barbosa, Elisabete

Case reports in surgery

2021 Volume 2021, Page(s) 2007935

Abstract: Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP ... ...

Abstract	Acute appendicitis is a very common event. Migration of hernia mesh is rare, especially intraluminal migrations. We aim to report a case of a migrated inguinal mesh presenting as an acute appendicitis. A 58-year-old male previously submitted to ONSTEP right inguinal hernia repair with a PolySoft™ hernia patch eight years before, was admitted in the emergency department with acute appendicitis, and submitted to laparoscopic appendectomy. Intraoperatively, the "recoil ring" from the inguinal hernia patch was extended from the anterior abdominal wall to the appendix, perforating it and progressing intraluminally. Appendectomy was performed, as well as removal of the mesh by an anterior approach. Hernia mesh migration to an intraluminally position is extremely rare with only a few cases described in literature. Pathogenesis of migration is still poorly understood. Clinicians should consider hernia mesh migration in their differential diagnosis for causes of acute appendicitis, in the right clinical setting, when a previous hernia defect correction is present. To the best of our knowledge, this is the first reported case of inguinal hernia mesh migration to the appendix, presenting as acute appendicitis.
Language	English
Publishing date	2021-09-14
Publishing country	United States
Document type	Case Reports
ZDB-ID	2657697-1
ISSN	2090-6919 ; 2090-6900
ISSN (online)	2090-6919
ISSN	2090-6900
DOI	10.1155/2021/2007935
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Article ; Online: The impact of the prognostic nutritional index (PNI) in gastric cancer.

Nogueiro, Jorge / Santos-Sousa, Hugo / Pereira, André / Devezas, Vítor / Fernandes, Cristina / Sousa, Fabiana / Fonseca, Telma / Barbosa, Elisabete / Barbosa, José Adelino

Langenbeck's archives of surgery

2022 Volume 407, Issue 7, Page(s) 2703–2714

Abstract: Background: Regarding the assessment of patients' immune and nutritional status, prognostic nutritional index (PNI) has been reported as a predictive marker for surgical outcomes in various types of cancer. The aim of our study was to evaluate the ... ...

Abstract	Background: Regarding the assessment of patients' immune and nutritional status, prognostic nutritional index (PNI) has been reported as a predictive marker for surgical outcomes in various types of cancer. The aim of our study was to evaluate the effect of PNI in prognosis of gastric cancer patients submitted to curative-intent resectional surgery. Material and methods: A retrospective analysis with 637 gastric cancer cases submitted to curative-intent surgery, between 2010 and 2017, in an upper GI surgery unit. We analyzed 396 patients that met the inclusion criteria for this study. The median follow-up was 37 (0-113) months. Results: According to Youden's method, the optimal PNI cutoff for OS was 41.625 (sensitivity 89.3% and specificity 41.3%). OS was significantly shorter in the lower-PNI group of patients when compared to the higher-PNI group (40.26 vs 77.49 months; p < 0.001). Higher PNI had a positive impact on OS in univariable analysis. When adjusted to pStage, higher PNI was still significantly associated with better OS (HR 0.405; CI 95% 0.253-0.649; p < 0.001). Regarding DFS, higher PNI was associated with better DFS (HR 0.421; CI 95% 0.218-0.815; p = 0.010). Higher-PNI group had a protective effect regarding postoperative morbidity and mortality. Conclusions: In this cohort, PNI was disclosed to significantly impact GC patients' OS and DFS, including in multivariable analysis when adjusting for classical prognostic features. PNI can be used to predict patients at increased risk of postoperative morbidity and mortality. This index may be of use in identifying candidate patients who would benefit from perioperative nutritional support to improve surgical outcomes.
MeSH term(s)	Humans ; Nutrition Assessment ; Stomach Neoplasms/surgery ; Gastrectomy/adverse effects ; Prognosis ; Retrospective Studies ; Nutritional Status
Language	English
Publishing date	2022-08-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02627-0
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Article: Late Recurrence of Pancreatic Solid Pseudopapillary Neoplasm With Peritoneal Carcinomatosis Treated With Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): A Case Report.

Nogueiro, Jorge / Gomes, Fábio / Pacheco, João / Santos-Sousa, Hugo / Meireles, Sara / Bessa Melo, Renato / Aral, Marisa / Barbosa, Elisabete

Cureus

2022 Volume 14, Issue 11, Page(s) e31189

Abstract: Pancreatic solid pseudopapillary neoplasm (SPN) is a rare malignant tumour predominantly affecting young women. The occurrence of peritoneal carcinomatosis (PC) in this setting is an even rarer condition, usually related to perioperative tumour rupture. ... ...

Abstract	Pancreatic solid pseudopapillary neoplasm (SPN) is a rare malignant tumour predominantly affecting young women. The occurrence of peritoneal carcinomatosis (PC) in this setting is an even rarer condition, usually related to perioperative tumour rupture. We present a case of a 43-year-old woman who previously underwent distal splenopancreatectomy after the diagnosis of a pancreatic SPN. Thirteen years later, the patient underwent a radical hysterectomy due to a uterine myoma. Intraoperatively, a peritoneal mass was additionally found and resected. Histological examination revealed an implant with morphology compatible with pancreatic SPN. The patient was then referred to our institution. Staging MRI and CT revealed multiple nodular lesions adjacent to the left colon, suggestive of peritoneal implants. The patient was then submitted to cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) with oxaliplatin and irinotecan. Histological examination confirmed peritoneal involvement by a pancreatic SPN. The postoperative course was unremarkable. Two years after surgery, the patient remains asymptomatic with no evidence of relapse. Despite SPN being cancer with a relatively indolent evolution, one needs to be aware of a possible recurrence several years after the primary resection, mainly in patients with evidence of intraoperative tumour rupture.
Language	English
Publishing date	2022-11-07
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.31189
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Article ; Online: Incidence of symptomatic gallstones after bariatric surgery: the impact of expectant management.

Nogueiro, Jorge / Santos-Sousa, Hugo / Ribeiro, Miguel / Cruz, Filipe / Pereira, André / Resende, Fernando / Costa-Pinho, André / Preto, John / Sousa-Pinto, Bernardo / Lima-da-Costa, Eduardo / Carneiro, Silvestre

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 160

Abstract: Background: Bariatric surgery is the most effective treatment for sustained weight reduction and obesity-related comorbidities. The development of gallstones as a result of rapid weight loss is a well-known consequence of bariatric procedures. It ... ...

Abstract	Background: Bariatric surgery is the most effective treatment for sustained weight reduction and obesity-related comorbidities. The development of gallstones as a result of rapid weight loss is a well-known consequence of bariatric procedures. It remains unclear, if there is an increased risk of these gallstones becoming symptomatic. Methods: A retrospective analysis of 505 consecutive patients submitted to either Roux-en-Y Gastric Bypass or Sleeve Gastrectomy between January and December 2019 was performed. The aim of our study was to determine the incidence of symptomatic cholelithiasis in asymptomatic patients with their gallbladder in situ after bariatric surgery and to identify potential risk factors for its development. Results: Of the 505 patients included, 79 (15.6%) underwent either previous cholecystectomy. (n = 67, 84.8%) or concomitant cholecystectomy during bariatric surgery (n = 12, 15.2%). Among the remaining 426 (84.4%) patients, only 8 (1.9%) became symptomatic during the 12-month follow-up period. When compared with patients who remained asymptomatic, they had a higher median preoperative BMI (47.0 vs. 42.8, p = 0.046) and prevalence of cholelithiasis on preoperative ultrasound (62.5% vs. 10.7%, p = 0.001). Multivariate analysis revealed preoperative BMI and cholelithiasis on preoperative ultrasound as independent risk factors for symptomatic biliary disease (OR 1.187, 95%CI 1.025-1.376, p = 0.022 and OR 10.720, 95%CI 1.613-71.246, p = 0.014, respectively). Conclusion: Considering a low incidence of symptomatic gallstones after bariatric surgery, concomitant cholecystectomy should only be performed in symptomatic patients undergoing bariatric surgery. Preoperative factors, such as a higher BMI and positive ultrasound for cholelithiasis, may be related to the development of symptomatic gallstones.
MeSH term(s)	Humans ; Gallstones/surgery ; Retrospective Studies ; Incidence ; Watchful Waiting ; Obesity, Morbid/surgery ; Bariatric Surgery/adverse effects ; Gastric Bypass/adverse effects ; Gastrectomy/adverse effects
Language	English
Publishing date	2023-04-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-02904-6
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Article ; Online: Roux-en-Y gastric bypass and sleeve gastrectomy as revisional bariatric procedures after adjustable gastric banding: a retrospective cohort study.

Santos-Sousa, Hugo / Nogueiro, Jorge / Lindeza, Luis / Carmona, Maria Neves / Amorim-Cruz, Filipe / Resende, Fernando / Costa-Pinho, André / Preto, John / Sousa-Pinto, Bernardo / Carneiro, Silvestre / Lima-da-Costa, Eduardo

Langenbeck's archives of surgery

2023 Volume 408, Issue 1, Page(s) 441

Abstract: Introduction: The frequency of revisional bariatric surgery is increasing, but its effectiveness and safety are not yet fully established. The aim of our study was to compare short-term outcomes of primary (pRYGB and pSG) and revisional bariatric ... ...

Abstract	Introduction: The frequency of revisional bariatric surgery is increasing, but its effectiveness and safety are not yet fully established. The aim of our study was to compare short-term outcomes of primary (pRYGB and pSG) and revisional bariatric surgeries (rRYGB and rSG). Methods: We performed a retrospective cohort study assessing all patients submitted to primary and revisional (after a failed AGB) RYGB and SG in 2019. Each patient was followed-up at 6 months and 12 months after surgery. We compared pRYGB vs. rRYGB, pSG vs. rSG and rRYGB vs. rSG on weight loss, surgical complications, and resolution of comorbidities. Results: We assessed 494 patients, of which 18.8% had undergone a revisional procedure. Higher weight loss at 6 and 12 months was observed in patients undergoing primary vs. revisional procedures. Patients submitted to rRYGB lost more weight than those with rSG (%EWL 12 months = 82.6% vs. 69.0%, p < 0.001). Regarding the resolution of obesity-related comorbidities, diabetes resolution was more frequent in pRYGB than rRYGB (54.2% vs. 25.0%; p = 0.038). Also, 41.7% of the patients who underwent rRYGB had dyslipidemia resolution vs. 0% from the rSG group (p = 0.035). Dyslipidemia resolution was also more common in pSG vs. rSG (68.6% vs. 0.0%; p = 0.001). No significant differences in surgical complications were found. Conclusion: Revisional bariatric surgery is effective and safe treating obesity and related comorbidities after AGB. Primary procedures appear to be associated with better weight loss outcomes. Further prospective studies are needed to better understand the role of revisional bariatric surgery.
MeSH term(s)	Humans ; Bariatric Surgery ; Bariatrics ; Dyslipidemias ; Gastrectomy ; Gastric Bypass ; Gastroplasty ; Obesity/surgery ; Retrospective Studies ; Weight Loss
Language	English
Publishing date	2023-11-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-023-03174-y
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Article ; Online: Risk and Prophylactic Management of Gallstone Disease in Bariatric Surgery: a Systematic Review and A Bayesian meta-analysis.

Amorim-Cruz, Filipe / Santos-Sousa, Hugo / Ribeiro, Miguel / Nogueiro, Jorge / Pereira, André / Resende, Fernando / Costa-Pinho, André / Preto, John / Lima-da-Costa, Eduardo / Sousa-Pinto, Bernardo

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2023 Volume 27, Issue 2, Page(s) 433–448

Abstract: Background: The frequency and management of gallstone disease (GD) in bariatric patients, including the role of routine prophylactic concomitant cholecystectomy (CCY), are still a matter of debate. This study aims to assess the risk of de novo GD in ... ...

Abstract	Background: The frequency and management of gallstone disease (GD) in bariatric patients, including the role of routine prophylactic concomitant cholecystectomy (CCY), are still a matter of debate. This study aims to assess the risk of de novo GD in patients undergoing bariatric surgery (BS) and their predictive factors, as well as mortality and morbidity in prophylactic CCY compared to BS alone. Methods: We performed a systematic review, searching PubMed, EMBASE, and Web of Science until April 2021. We performed a Bayesian meta-analysis to estimate the risk of GD development after BS and the morbidity and mortality associated with BS alone versus BS + prophylactic CCY. Sources of heterogeneity were explored by meta-regression analysis. Results: The risk of de novo post bariatric GD was 20.7% (95% credible interval [95% CrI] = 13.0-29.7%; I Conclusion: The risk of de novo symptomatic GD after BS is not substantially high. Although mortality is similar between groups, odds of major postoperative complications were higher in patients submitted to BS + prophylactic CCY. It is still arguable if prophylactic CCY is a fitting approach for patients with a preoperative lithiasic gallbladder.
MeSH term(s)	Female ; Humans ; Bariatric Surgery/adverse effects ; Bayes Theorem ; Cholecystectomy/adverse effects ; Cholelithiasis/surgery ; Obesity, Morbid/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/prevention & control
Language	English
Publishing date	2023-01-10
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-022-05567-8
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