{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,25]],"date-time":"2026-01-25T04:02:02Z","timestamp":1769313722966,"version":"3.49.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T00:00:00Z","timestamp":1715385600000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006775","name":"GE Healthcare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006775","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Philips Healthcare"},{"DOI":"10.13039\/100000002","name":"the National Institutes of Health","doi-asserted-by":"crossref","award":["R01CA221971"],"award-info":[{"award-number":["R01CA221971"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"the National Institutes of Health","doi-asserted-by":"crossref","award":["P01CA261669-01"],"award-info":[{"award-number":["P01CA261669-01"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Traditional constraints specify that 700\u2009cc of liver should be spared a hepatotoxic dose when delivering liver-directed radiotherapy to reduce the risk of inducing liver failure. We investigated the role of single-photon emission computed tomography (SPECT) to identify and preferentially avoid functional liver during liver-directed radiation treatment planning in patients with preserved liver function but limited functional liver volume after receiving prior hepatotoxic chemotherapy or surgical resection.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This phase I trial with a 3\u2009+\u20093 design evaluated the safety of liver-directed radiotherapy using escalating functional liver radiation dose constraints in patients with liver metastases. Dose-limiting toxicities were assessed 6-8\u2009weeks and 6\u2009months after completing radiotherapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>All 12 patients had colorectal liver metastases and received prior hepatotoxic chemotherapy; 8 patients underwent prior liver resection. Median computed tomography anatomical nontumor liver volume was 1584\u2009cc (range = 764-2699\u2009cc). Median SPECT functional liver volume was 1117\u2009cc (range = 570-1928 cc). Median nontarget computed tomography and SPECT liver volumes below the volumetric dose constraint were 997\u2009cc (range = 544-1576\u2009cc) and 684\u2009cc (range = 429-1244\u2009cc), respectively. The prescription dose was 67.5-75\u2009Gy in 15 fractions or 75-100\u2009Gy in 25 fractions. No dose-limiting toxicities were observed during follow-up. One-year in-field control was 57%. One-year overall survival was 73%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Liver-directed radiotherapy can be safely delivered to high doses when incorporating functional SPECT into the radiation treatment planning process, which may enable sparing of lower volumes of liver than traditionally accepted in patients with preserved liver function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>NCT02626312.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jncics\/pkae037","type":"journal-article","created":{"date-parts":[[2024,5,11]],"date-time":"2024-05-11T04:31:02Z","timestamp":1715401862000},"source":"Crossref","is-referenced-by-count":6,"title":["Phase I trial of single-photon emission computed tomography\u2013guided liver-directed radiotherapy for patients with low functional liver volume"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2879-5445","authenticated-orcid":false,"given":"Enoch","family":"Chang","sequence":"first","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franklin C L","family":"Wong","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beth A","family":"Chasen","sequence":"additional","affiliation":[{"name":"Nuclear Medicine, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William D","family":"Erwin","sequence":"additional","affiliation":[{"name":"Imaging Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prajnan","family":"Das","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma B","family":"Holliday","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert C","family":"Koong","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5472-5344","authenticated-orcid":false,"given":"Ethan B","family":"Ludmir","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce D","family":"Minsky","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonal S","family":"Noticewala","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Grace L","family":"Smith","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cullen M","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria J","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sam","family":"Beddar","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael M","family":"Martin-Paulpeter","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua S","family":"Niedzielski","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel O","family":"Sawakuchi","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emil","family":"Schueler","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis A","family":"Perles","sequence":"additional","affiliation":[{"name":"Radiation Physics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianchun","family":"Xiao","sequence":"additional","affiliation":[{"name":"Biostatistics, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janio","family":"Szklaruk","sequence":"additional","affiliation":[{"name":"Diagnostic Imaging, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter C","family":"Park","sequence":"additional","affiliation":[{"name":"Radiology Physics, University of California , Davis, Davis, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvind N","family":"Dasari","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed O","family":"Kaseb","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan K","family":"Kee","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunyoung S","family":"Lee","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J","family":"Overman","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason A","family":"Willis","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A","family":"Wolff","sequence":"additional","affiliation":[{"name":"Medical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6035-7288","authenticated-orcid":false,"given":"Ching-Wei D","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Surgical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4921-5427","authenticated-orcid":false,"given":"Jean-Nicolas","family":"Vauthey","sequence":"additional","affiliation":[{"name":"Surgical Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7675-3461","authenticated-orcid":false,"given":"Eugene J","family":"Koay","sequence":"additional","affiliation":[{"name":"Radiation Oncology, The University of Texas MD Anderson Cancer Center , Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,5,10]]},"reference":[{"issue":"10","key":"2024070606342564400_pkae037-B1","doi-asserted-by":"crossref","first-page":"1572","DOI":"10.1200\/JCO.2008.19.6329","article-title":"Multi-institutional phase I\/II trial of stereotactic body radiation therapy for liver metastases","volume":"27","author":"Rusthoven","year":"2009","journal-title":"J Clin Oncol"},{"issue":"3","key":"2024070606342564400_pkae037-B2","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1002\/bjs.5719","article-title":"Chemotherapy-associated hepatotoxicity and surgery for colorectal liver metastases","volume":"94","author":"Zorzi","year":"2007","journal-title":"Br J Surg"},{"issue":"6","key":"2024070606342564400_pkae037-B3","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.ejso.2007.07.007","article-title":"Hepatic complications following preoperative chemotherapy with oxaliplatin or irinotecan for hepatic colorectal metastases","volume":"34","author":"Morris-Stiff","year":"2008","journal-title":"Eur J Surg Oncol"},{"issue":"2","key":"2024070606342564400_pkae037-B4","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1136\/gut.2004.046524","article-title":"The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection","volume":"54","author":"Schindl","year":"2005","journal-title":"Gut"},{"issue":"5","key":"2024070606342564400_pkae037-B5","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/hpb.12164","article-title":"Systematic review of pathophysiological changes following hepatic resection","volume":"16","author":"Siu","year":"2014","journal-title":"HPB (Oxford)"},{"issue":"11","key":"2024070606342564400_pkae037-B6","first-page":"2054","article-title":"Functional measurement of nonfibrotic hepatic mass in cirrhotic patients","volume":"92","author":"Hoefs","year":"1997","journal-title":"Am J Gastroenterol"},{"issue":"3","key":"2024070606342564400_pkae037-B7","first-page":"312","article-title":"Quantitation of liver and spleen uptake of (99m)Tc-phytate colloid using SPECT: detection of liver cirrhosis","volume":"43","author":"Groshar","year":"2002","journal-title":"J Nucl Med"},{"issue":"3","key":"2024070606342564400_pkae037-B8","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/S0168-8278(03)00296-4","article-title":"Quantitative liver-spleen scan using single photon emission computerized tomography (SPECT) for assessment of hepatic function in cirrhotic patients","volume":"39","author":"Zuckerman","year":"2003","journal-title":"J Hepatol"},{"issue":"12","key":"2024070606342564400_pkae037-B9","doi-asserted-by":"crossref","first-page":"7398","DOI":"10.1118\/1.4766877","article-title":"A method for registration of single photon emission computed tomography (SPECT) and computed tomography (CT) images for liver stereotactic radiotherapy (SRT)","volume":"39","author":"Gayou","year":"2012","journal-title":"Med Phys"},{"issue":"2","key":"2024070606342564400_pkae037-B10","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.radonc.2015.04.011","article-title":"Differential hepatic avoidance radiation therapy: Proof of concept in hepatocellular carcinoma patients","volume":"115","author":"Bowen","year":"2015","journal-title":"Radiother Oncol"},{"issue":"1","key":"2024070606342564400_pkae037-B11","doi-asserted-by":"crossref","first-page":"1559325819832149","DOI":"10.1177\/1559325819832149","article-title":"Impact of (99m)Tc-GSA SPECT image-guided inverse planning on dose-function histogram parameters for stereotactic body radiation therapy planning for patients with hepatocellular carcinoma: a dosimetric comparison study","volume":"17","author":"Toya","year":"2019","journal-title":"Dose Response"},{"issue":"1","key":"2024070606342564400_pkae037-B12","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/s13550-016-0212-9","article-title":"Measuring total liver function on sulfur colloid SPECT\/CT for improved risk stratification and outcome prediction of hepatocellular carcinoma patients","volume":"6","author":"Bowen","year":"2016","journal-title":"EJNMMI Res"},{"issue":"4","key":"2024070606342564400_pkae037-B13","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.ijrobp.2018.06.017","article-title":"Regional radiation dose-response modeling of functional liver in hepatocellular carcinoma patients with longitudinal sulfur colloid SPECT\/CT: a proof of concept","volume":"102","author":"Price","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"4","key":"2024070606342564400_pkae037-B14","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.ijrobp.2018.08.029","article-title":"Functional liver imaging and dosimetry to predict hepatotoxicity risk in cirrhotic patients with primary liver cancer","volume":"102","author":"Schaub","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"2","key":"2024070606342564400_pkae037-B15","doi-asserted-by":"publisher","first-page":"101367","DOI":"10.1016\/j.adro.2023.101367:101367","article-title":"Stereotactic Body Radiation Therapy (SBRT) for Hepatocellular Carcinoma (HCC) With Single Photon Emission Computed Tomography (SPECT) functional treatment planning in patients with advanced hepatic cirrhosis","volume":"9","author":"Kirichenko","year":"2023","journal-title":"Adv Radiat Oncol"},{"issue":"7","key":"2024070606342564400_pkae037-B16","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/00003072-199007000-00009","article-title":"Automated volume determination of the liver and spleen from Tc-99m colloid SPECT imaging. Quantification of the liver functional and nonfunctional tissue in disease","volume":"15","author":"Kavanagh","year":"1990","journal-title":"Clin Nucl Med"},{"issue":"2","key":"2024070606342564400_pkae037-B17","doi-asserted-by":"crossref","first-page":"112","DOI":"10.3109\/00365529009107931","article-title":"Liver regeneration and restoration of liver function after partial hepatectomy in patients with liver tumors","volume":"25","author":"Jansen","year":"1990","journal-title":"Scand J Gastroenterol"},{"issue":"8","key":"2024070606342564400_pkae037-B18","doi-asserted-by":"crossref","first-page":"2493","DOI":"10.1245\/s10434-012-2864-7","article-title":"Optimal future liver remnant in patients treated with extensive preoperative chemotherapy for colorectal liver metastases","volume":"20","author":"Shindoh","year":"2013","journal-title":"Ann Surg Oncol"},{"issue":"6","key":"2024070606342564400_pkae037-B19","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1016\/j.surg.2016.11.034","article-title":"Proton beam radiation as salvage therapy for bilateral colorectal liver metastases not amenable to second-stage hepatectomy","volume":"161","author":"Colbert","year":"2017","journal-title":"Surgery"},{"issue":"10","key":"2024070606342564400_pkae037-B20","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1200\/JCO.2008.20.0600","article-title":"Phase I study of individualized stereotactic body radiotherapy of liver metastases","volume":"27","author":"Lee","year":"2009","journal-title":"J Clin Oncol"},{"issue":"17","key":"2024070606342564400_pkae037-B21","doi-asserted-by":"crossref","first-page":"4060","DOI":"10.1002\/cncr.25997","article-title":"Stereotactic body radiotherapy for colorectal liver metastases: A pooled analysis","volume":"117","author":"Chang","year":"2011","journal-title":"Cancer"},{"issue":"2","key":"2024070606342564400_pkae037-B22","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.ijrobp.2017.04.010","article-title":"Long-term outcomes of phase 1 and 2 studies of SBRT for hepatic colorectal metastases","volume":"99","author":"McPartlin","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"2024070606342564400_pkae037-B23","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1186\/s13014-018-1185-9","article-title":"Phase II trial on SBRT for unresectable liver metastases: long-term outcome and prognostic factors of survival after 5 years of follow-up","volume":"13","author":"Scorsetti","year":"2018","journal-title":"Radiat Oncol"},{"issue":"3","key":"2024070606342564400_pkae037-B24","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.radonc.2018.06.035","article-title":"Stereotactic body radiotherapy for colorectal cancer liver metastases: a systematic review","volume":"129","author":"Petrelli","year":"2018","journal-title":"Radiother Oncol"},{"issue":"3","key":"2024070606342564400_pkae037-B25","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1016\/j.jamcollsurg.2019.04.027","article-title":"Conditional recurrence-free survival after resection of colorectal liver metastases: persistent deleterious association with RAS and TP53 co-mutation","volume":"229","author":"Kawaguchi","year":"2019","journal-title":"J Am Coll Surg"},{"issue":"5","key":"2024070606342564400_pkae037-B26","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1097\/SLA.0000000000002450","article-title":"Deleterious effect of RAS and evolutionary high-risk TP53 double mutation in colorectal liver metastases","volume":"269","author":"Chun","year":"2019","journal-title":"Ann Surg"},{"issue":"9","key":"2024070606342564400_pkae037-B27","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djx031","article-title":"Phase II study of proton-based stereotactic body radiation therapy for liver metastases: importance of tumor genotype","volume":"109","author":"Hong","year":"2017","journal-title":"J Natl Cancer Inst"},{"key":"2024070606342564400_pkae037-B28","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.radonc.2020.02.008","article-title":"Association of tumor genomic factors and efficacy for metastasis-directed stereotactic body radiotherapy for oligometastatic colorectal cancer","volume":"146","author":"Jethwa","year":"2020","journal-title":"Radiother Oncol"},{"key":"2024070606342564400_pkae037-B29","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1200\/EDBK_320519","article-title":"Locoregional therapies for colorectal cancer liver metastases: options beyond resection","volume":"41","author":"Uhlig","year":"2021","journal-title":"Am Soc Clin Oncol Educ Book"}],"container-title":["JNCI Cancer Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jncics\/advance-article-pdf\/doi\/10.1093\/jncics\/pkae037\/57507527\/pkae037.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jncics\/article-pdf\/8\/3\/pkae037\/58455614\/pkae037.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jncics\/article-pdf\/8\/3\/pkae037\/58455614\/pkae037.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T06:35:19Z","timestamp":1720247719000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jncics\/article\/doi\/10.1093\/jncics\/pkae037\/7668446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,30]]},"references-count":29,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,4,30]]}},"URL":"https:\/\/doi.org\/10.1093\/jncics\/pkae037","relation":{},"ISSN":["2515-5091"],"issn-type":[{"value":"2515-5091","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,6]]},"published":{"date-parts":[[2024,4,30]]},"article-number":"pkae037"}}