{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T08:30:03Z","timestamp":1781857803133,"version":"3.54.5"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"1108","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives:<\/jats:title>\n                  <jats:p>To evaluate the feasibility and optimal restricted angle of the complete-directional-complete block (CDCB) technique in helical tomotherapy (HT) by including regional nodal irradiation (RNI) with the internal mammary node (IMN) in left-sided breast cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods:<\/jats:title>\n                  <jats:p>Ten left-sided breast cancer patients treated with 50\u2009Gy in 25 fractions were compared with five-field intensity-modulated radiation therapy (5F-IMRT) and six types of HT plans. In the HT plans, complete block (CB), organ-based directional block (OBDB) and CDCB with different restricted angles were used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>The conformity index (CI) between the CDCB0,10,15,20 and 5F-IMRT groups was similar. Compared to CB, OBDB and 5F-IMRT, CDCB20 resulted in a decreased ipsilateral mean lung dose. The low-dose region (V5) of the ipsilateral lung in OBDB (84.0%) was the highest among all techniques (p &amp;lt; 0.001). The mean dose of the heart in CB was significantly reduced (by 11.5\u201322.4%) compared with other techniques. The V30 of the heart in CDCB20 (1.9%) was significantly lower than that of CB, OBDB and 5F-IMRT. Compared to the mean dose of the left anterior descending (LAD) artery of 5F-IMRT (27.0\u2009Gy), CDCB0, CDCB10, CDCB15, CDCB20 and OBDB reduced the mean dose effectively by 31.7%, 38.3%, 39.6%, 42.0 and 56.2%, respectively. Considering the parameters of the organs-at-risk (OARs), CDCB10,15,20 had higher expectative values than the other techniques (p = 0.01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>HT with the CDCB technique is feasible for treating left-sided breast cancer patients. The CDCB10-20 techniques not only achieved similar planning target volume coverage, homogeneity and dose conformity but also allowed better sparing of the heart and bilateral lungs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Advances in knowledge:<\/jats:title>\n                  <jats:p>For left-sided breast cancer patients whose RNI field includes the IMN, heart avoidance is an important issue. The CDCB technique achieved good PTV coverage, homogeneity and dose conformity and allowed better sparing of the mean dose of the lung, the LAD artery, and the heart and reduced the V30 of the heart.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1259\/bjr.20190792","type":"journal-article","created":{"date-parts":[[2020,1,15]],"date-time":"2020-01-15T11:22:19Z","timestamp":1579087339000},"source":"Crossref","is-referenced-by-count":26,"title":["Helical tomotherapy with a complete-directional-complete block technique effectively reduces cardiac and lung dose for left-sided breast cancer"],"prefix":"10.1093","volume":"93","author":[{"given":"Hsin-Pei","family":"Yeh","sequence":"first","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital , New Taipei City, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chuen","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Medical Research, China Medical University Hospital , Taichung, Taiwan , Republic of China"},{"name":"School of Chinese Medicine, China Medical University , Taichung, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Ying","family":"Wang","sequence":"additional","affiliation":[{"name":"Physical Therapy Center, National Taiwan University Hospital , Taipei, Taiwan , Republic of China"},{"name":"School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University , Taipei, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Wei","family":"Shueng","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital , New Taipei City, Taiwan , Republic of China"},{"name":"Faculty of Medicine, School of Medicine, National Yang-Ming University , Taipei, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Ju","family":"Tien","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital , New Taipei City, Taiwan , Republic of China"},{"name":"Department of Biomedical Imaging and Radiological Science, National Yang- Ming University , Taipei , Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiu-Han","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital , New Taipei City, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"San-Fang","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Far Eastern Memorial Hospital, New Taipei City , Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen-Hsi","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology, Department of Radiology, Far Eastern Memorial Hospital , New Taipei City, Taiwan , Republic of China"},{"name":"Faculty of Medicine, School of Medicine, National Yang-Ming University , Taipei, Taiwan , Republic of China"},{"name":"Institute of Traditional Medicine, School of Medicine, National Yang-Ming University , Taipei, Taiwan , Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,1,21]]},"reference":[{"key":"2024050215191215900_b1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1200\/JCO.2015.63.6456","article-title":"DBCG-IMN: a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer","volume":"34","author":"Thorsen","year":"2016","journal-title":"J Clin Oncol"},{"key":"2024050215191215900_b2","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1186\/s13014-015-0568-4","article-title":"Adjuvant radiation therapy of regional lymph nodes in breast cancer - a meta-analysis of randomized trials- an update","volume":"10","author":"Budach","year":"2015","journal-title":"Radiat Oncol"},{"key":"2024050215191215900_b3","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1056\/NEJMoa1415369","article-title":"Internal mammary and medial supraclavicular irradiation in breast cancer","volume":"373","author":"Poortmans","year":"2015","journal-title":"N Engl J Med"},{"key":"2024050215191215900_b4","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1056\/NEJMoa1415340","article-title":"Regional nodal irradiation in early-stage breast cancer","volume":"373","author":"Whelan","year":"2015","journal-title":"N Engl J Med"},{"key":"2024050215191215900_b5","doi-asserted-by":"crossref","first-page":"1484","DOI":"10.1016\/j.ijrobp.2007.05.034","article-title":"Cardiac exposures in breast cancer radiotherapy: 1950s-1990s","volume":"69","author":"Taylor","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b6","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.ijrobp.2004.04.026","article-title":"Cardiac chamber and coronary artery doses associated with postmastectomy radiotherapy techniques to the chest wall and regional nodes","volume":"60","author":"Krueger","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b7","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1056\/NEJMoa1209825","article-title":"Risk of ischemic heart disease in women after radiotherapy for breast cancer","volume":"368","author":"Darby","year":"2013","journal-title":"N Engl J Med"},{"key":"2024050215191215900_b8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/741326","article-title":"Left-Sided whole breast irradiation with hybrid-IMRT and helical tomotherapy dosimetric comparison","volume":"2014","author":"Shiau","year":"2014","journal-title":"Biomed Res Int"},{"key":"2024050215191215900_b9","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1016\/j.ijrobp.2008.11.004","article-title":"Helical tomotherapy planning for left-sided breast cancer patients with positive lymph nodes: comparison to conventional multiport breast technique","volume":"73","author":"Goddu","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b10","article-title":"RTOG breast cancer contouring atlas","author":"Radiation Therapy Oncology Group"},{"key":"2024050215191215900_b11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ijrobp.2009.10.058","article-title":"Development and validation of a heart atlas to study cardiac exposure to radiation following treatment for breast cancer","volume":"79","author":"Feng","year":"2011","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b12","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1016\/j.ijrobp.2005.06.006","article-title":"Effectiveness of noncoplanar IMRT planning using a parallelized multiresolution beam angle optimization method for paranasal sinus carcinoma","volume":"63","author":"Wang","year":"2005","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"Suppl 3","key":"2024050215191215900_b13","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3171\/jns.2000.93.supplement_3.0219","article-title":"A simple scoring ratio to index the conformity of radiosurgical treatment plans. technical note","volume":"93 Suppl 3","author":"Paddick","year":"2000","journal-title":"J Neurosurg"},{"key":"2024050215191215900_b14","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.radonc.2005.08.004","article-title":"Imrt for breast. A planning study","volume":"76","author":"Fogliata","year":"2005","journal-title":"Radiother Oncol"},{"key":"2024050215191215900_b15","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.meddos.2006.05.003","article-title":"Inverse-planned, dynamic, multi-beam, intensity-modulated radiation therapy (IMRT): a promising technique when target volume is the left breast and internal mammary lymph nodes","volume":"31","author":"Popescu","year":"2006","journal-title":"Med Dosim"},{"key":"2024050215191215900_b16","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1016\/j.ijrobp.2007.06.060","article-title":"Is multibeam IMRT better than standard treatment for patients with left-sided breast cancer?","volume":"69","author":"Beckham","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b17","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.ijrobp.2015.07.2292","article-title":"Exposure of the heart in breast cancer radiation therapy: a systematic review of heart doses published during 2003 to 2013","volume":"93","author":"Taylor","year":"2015","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.radonc.2008.09.028","article-title":"Helical tomotherapy for locoregional irradiation including the internal mammary chain in left-sided breast cancer: dosimetric evaluation","volume":"90","author":"Caudrelier","year":"2009","journal-title":"Radiother Oncol"},{"key":"2024050215191215900_b19","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/1748-717X-9-66","article-title":"Evaluation of volumetric modulated Arc therapy for postmastectomy treatment","volume":"9","author":"Nichols","year":"2014","journal-title":"Radiat Oncol"},{"key":"2024050215191215900_b20","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1093\/jrr\/rrv052","article-title":"Volumetric-modulated Arc therapy for left-sided breast cancer and all regional nodes improves target volumes coverage and reduces treatment time and doses to the heart and left coronary artery, compared with a field-in-field technique","volume":"56","author":"Tyran","year":"2015","journal-title":"J Radiat Res"},{"key":"2024050215191215900_b21","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1269\/jrr.11159","article-title":"Single-arc volumetric modulated Arc therapy planning for left breast cancer and regional nodes","volume":"53","author":"Sakumi","year":"2012","journal-title":"J Radiat Res"},{"key":"2024050215191215900_b22","doi-asserted-by":"crossref","DOI":"10.1259\/bjr.20160874","article-title":"Comparing four radiotherapy techniques for treating the chest wall plus levels III-IV draining nodes after breast reconstruction","volume":"91","author":"Lancellotta","year":"2018","journal-title":"Br J Radiol"},{"key":"2024050215191215900_b23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0205770","article-title":"Dose to organs in the supraclavicular region when covering the internal mammary nodes (IMNs) in breast cancer patients: a comparison of volumetric modulated Arc therapy (VMAT) versus 3D and VMAT","volume":"13","author":"Dumane","year":"2018","journal-title":"PLoS One"},{"key":"2024050215191215900_b24","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1016\/j.ijrobp.2007.04.026","article-title":"A dosimetric comparison of electronic compensation, conventional intensity modulated radiotherapy, and tomotherapy in patients with early-stage carcinoma of the left breast","volume":"68","author":"Caudell","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"3 Suppl","key":"2024050215191215900_b25","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.1016\/j.ijrobp.2009.04.093","article-title":"Radiation dose-volume effects in the heart","volume":"76","author":"Gagliardi","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b26","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.ijrobp.2018.04.075","article-title":"A randomized comparison of radiation therapy techniques in the management of node-positive breast cancer: primary outcomes analysis","volume":"101","author":"Jagsi","year":"2018","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b27","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.clon.2015.06.007","article-title":"Cardiac side-effects from breast cancer radiotherapy","volume":"27","author":"Taylor","year":"2015","journal-title":"Clin Oncol"},{"key":"2024050215191215900_b28","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.ijrobp.2015.11.049","article-title":"Deep inspiration breath Hold\u2014Based radiation therapy: a clinical review","volume":"94","author":"Boda-Heggemann","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b29","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1016\/j.ijrobp.2017.07.022","article-title":"Recent time trends and predictors of heart dose from breast radiation therapy in a large quality consortium of radiation oncology practices","volume":"99","author":"Pierce","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b30","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.radonc.2011.01.020","article-title":"Cardiac dose estimates from Danish and Swedish breast cancer radiotherapy during 1977-2001","volume":"100","author":"Taylor","year":"2011","journal-title":"Radiother Oncol"},{"key":"2024050215191215900_b31","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.ijrobp.2007.12.058","article-title":"Cardiac dose from tangential breast cancer radiotherapy in the year 2006","volume":"72","author":"Taylor","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b32","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1080\/0284186X.2017.1406139","article-title":"The potential benefits from respiratory gating for breast cancer patients regarding target coverage and dose to organs at risk when applying strict dose limits to the heart: results from the DBCG HYPO trial","volume":"57","author":"Berg","year":"2018","journal-title":"Acta Oncol"},{"key":"2024050215191215900_b33","doi-asserted-by":"crossref","first-page":"2288","DOI":"10.1200\/JCO.2017.77.6351","article-title":"Cardiac structure injury after radiotherapy for breast cancer: cross-sectional study with individual patient data","volume":"36","author":"Taylor","year":"2018","journal-title":"JCO"},{"key":"2024050215191215900_b34","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1200\/JCO.2016.69.8480","article-title":"Validation and modification of a prediction model for acute cardiac events in patients with breast cancer treated with radiotherapy based on three-dimensional dose distributions to cardiac substructures","volume":"35","author":"van den Bogaard","year":"2017","journal-title":"J Clin Oncol"},{"key":"2024050215191215900_b35","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.ijrobp.2006.12.016","article-title":"The risk of early and late lung sequelae after conformal radiotherapy in breast cancer patients","volume":"68","author":"Kah\u00e1n","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b36","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1186\/1748-717X-8-268","article-title":"Meta-Analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas","volume":"8","author":"Gokula","year":"2013","journal-title":"Radiat Oncol"},{"key":"2024050215191215900_b37","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.radonc.2009.12.015","article-title":"Minimising contralateral breast dose in post-mastectomy intensity-modulated radiotherapy by incorporating conformal electron irradiation","volume":"94","author":"van der Laan","year":"2010","journal-title":"Radiother Oncol"},{"key":"2024050215191215900_b38","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.ejmp.2015.02.005","article-title":"Dosimetric comparison of left-sided whole-breast irradiation with 3DCRT, forward-planned IMRT, inverse-planned IMRT, helical tomotherapy, and volumetric Arc therapy","volume":"31","author":"Haciislamoglu","year":"2015","journal-title":"Phys Med"},{"key":"2024050215191215900_b39","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijrobp.2009.07.1705","article-title":"Tomotherapy and multifield intensity-modulated radiotherapy planning reduce cardiac doses in left-sided breast cancer patients with unfavorable cardiac anatomy","volume":"78","author":"Coon","year":"2010","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"9-10","key":"2024050215191215900_b40","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1080\/07357907.2018.1545854","article-title":"Skin toxicity after chest wall\/breast plus level III-IV lymph nodes treatment with helical tomotherapy","volume":"36","author":"Lancellotta","year":"2018","journal-title":"Cancer Invest"},{"key":"2024050215191215900_b41","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.12659\/AJCR.905245","article-title":"Comparison of helical tomotherapy and direct tomotherapy in bilateral whole breast irradiation in a case of bilateral synchronous grade 1 and stage 1 breast cancer","volume":"18","author":"Lancellotta","year":"2017","journal-title":"Am J Case Rep"},{"key":"2024050215191215900_b42","doi-asserted-by":"crossref","first-page":"2087","DOI":"10.1016\/S0140-6736(05)67887-7","article-title":"Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials","volume":"366","author":"Clarke","year":"2005","journal-title":"Lancet"},{"key":"2024050215191215900_b43","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1056\/NEJM199203193261201","article-title":"Cancer in the contralateral breast after radiotherapy for breast cancer","volume":"326","author":"Boice","year":"1992","journal-title":"N Engl J Med"},{"key":"2024050215191215900_b44","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.ijrobp.2006.03.046","article-title":"Reduction of cardiac and pulmonary complication probabilities after breathing adapted radiotherapy for breast cancer","volume":"65","author":"Korreman","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b45","doi-asserted-by":"crossref","first-page":"e899","DOI":"10.1259\/bjr\/18685881","article-title":"Simultaneous irradiation of the breast and regional lymph nodes in prone position using helical tomotherapy","volume":"85","author":"Kainz","year":"2012","journal-title":"Br J Radiol"},{"key":"2024050215191215900_b46","first-page":"44","article-title":"Determinants of mammographic densities among women of Asian, native Hawaiian, and Caucasian ancestry","volume":"11","author":"Maskarinec","year":"2001","journal-title":"Ethn Dis"},{"key":"2024050215191215900_b47","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/S0360-3016(01)01741-2","article-title":"Preliminary results for prone-position breast irradiation","volume":"52","author":"Mahe","year":"2002","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215191215900_b48","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2011.00031","article-title":"The role of a prone setup in breast radiation therapy","volume":"1","author":"Huppert","year":"2011","journal-title":"Front Oncol"}],"container-title":["The British Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1108\/20190792\/57376627\/bjr.20190792.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjr\/article-pdf\/93\/1108\/20190792\/57376627\/bjr.20190792.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T16:34:46Z","timestamp":1714667686000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjr\/article\/doi\/10.1259\/bjr.20190792\/7449048"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,21]]},"references-count":48,"journal-issue":{"issue":"1108","published-online":{"date-parts":[[2020,1,21]]},"published-print":{"date-parts":[[2020,4,1]]}},"URL":"https:\/\/doi.org\/10.1259\/bjr.20190792","relation":{},"ISSN":["0007-1285","1748-880X"],"issn-type":[{"value":"0007-1285","type":"print"},{"value":"1748-880X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,4,1]]},"published":{"date-parts":[[2020,1,21]]},"article-number":"20190792"}}