{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:05:27Z","timestamp":1793070327197,"version":"4.5.0"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>UF insufficiency is a major limitation in PD efficiency and sustainability. Our study object to investigate the efficacy of intraperitoneal inflammation marker, IL-6 level as a predictor of UF insufficiency in continuous ambulatory peritoneal dialysis (CAPD) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Stable prevalent CAPD patients were enrolled in this prospective study. IL-6 concentration in the overnight effluent was determined and expressed as the IL-6 appearance rate (IL-6 AR). Patients were divided into two groups according to the median of IL-6 AR and prospectively followed up until death, transfer to permanent HD, recovery of renal function, kidney transplantation, transfer to other centers, lost to follow-up or to the end of study (January 31, 2021). Factors associated with UF capacity as well as dialysate IL-6 AR were assessed by multivariable linear regression. Cox proportional hazards model was used to examine the association between dialysate IL-6 AR and UF insufficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 291 PD patients were enrolled, including 148 males (51%) with a mean age of 56.6 \u00b1 14.1 years and a median PD duration of 33.4 (12.7\u201357.5) months. No correlation was found between dialysate IL-6 AR and UF capacity at baseline. PD duration was found positively correlated with baseline dialysate IL-6 AR, while 24h urine volume was negatively correlated with baseline dialysate IL-6 AR (<jats:italic>P<\/jats:italic> &amp;lt; 0.05). By the end of study, UF insufficiency was observed in 56 (19.2%) patients. Patients in the high IL-6 AR group showed a significantly inferior UF insufficiency-free survival when compared with their counterparts in the low IL-6 AR group (<jats:italic>P<\/jats:italic> = 0.001). In the multivariate Cox regression analysis, after adjusting for DM, previous peritonitis episode and 24h urine volume, higher baseline dialysate IL-6 AR (HR 3.639, 95% CI 1.776\u20137.456, <jats:italic>P<\/jats:italic> = 0.002) were associated with an increased risk of UF insufficiency. The area under the ROC curve (AUC) for baseline IL-6 AR to predict UF insufficiency was 0.663 (95% CI, 0.580\u20130.746; <jats:italic>P<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggested that the dialysate IL-6 AR could be a potential predictor of UF insufficiency in patients undergoing PD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.836861","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T04:40:18Z","timestamp":1660106418000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["High intraperitoneal interleukin-6 levels predict ultrafiltration (UF) insufficiency in peritoneal dialysis patients: A prospective cohort study"],"prefix":"10.3389","volume":"9","author":[{"given":"Qianhui","family":"Song","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxiao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zanzhe","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenyuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangzi","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaohui","family":"Ni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leyi","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1093\/ndt\/gfv295","article-title":"Trends in dialysis modality choice and related patient survival in the ERA-EDTA Registry over a 20-year period","volume":"31","author":"van de Luijtgaarden","year":"2016","journal-title":"Nephrol Dial Transplant."},{"key":"B2","doi-asserted-by":"publisher","first-page":"434608","DOI":"10.4061\/2011\/434608","article-title":"Peritoneal dialysis drop-out: causes and prevention strategies","volume":"2011","author":"Chaudhary","year":"2011","journal-title":"Int J Nephrol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"S175","DOI":"10.1177\/089686080302302s36","article-title":"Searching for the reasons for drop-out from peritoneal dialysis: a nationwide survey in Japan","volume":"23","author":"Kawaguchi","year":"2003","journal-title":"Perit Dial Int."},{"key":"B4","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1093\/ndt\/gfq343","article-title":"The time course of peritoneal transport parameters in peritoneal dialysis patients who develop encapsulating peritoneal sclerosis","volume":"26","author":"Sampimon","year":"2011","journal-title":"Nephrol Dial Transplant."},{"key":"B5","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1177\/089686080402400616","article-title":"Analysis of the prevalence and causes of ultrafiltration failure during long-term peritoneal dialysis: a cross-sectional study","volume":"24","author":"Smit","year":"2004","journal-title":"Perit Dial Int."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1815","DOI":"10.3389\/fphys.2018.01815","article-title":"Ultrafiltration failure is a reflection of peritoneal alterations in patients treated with peritoneal dialysis","volume":"9","author":"Krediet","year":"2018","journal-title":"Front Physiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2408","DOI":"10.1681\/ASN.2021010080","article-title":"Acquired decline in ultrafiltration in peritoneal dialysis: the role of glucose","volume":"32","author":"Krediet","year":"2021","journal-title":"J Am Soc Nephrol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"S22","DOI":"10.1177\/089686080002004S03","article-title":"Pathophysiology of peritoneal membrane failure","volume":"20","author":"Krediet","year":"2000","journal-title":"Perit Dial Int."},{"key":"B9","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.semnephrol.2011.01.006","article-title":"Determinants of peritoneal membrane function over time","volume":"31","author":"Davies","year":"2011","journal-title":"Semin Nephrol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.semnephrol.2016.10.007","article-title":"Inflammation and peritoneal dialysis","volume":"37","author":"Li","year":"2017","journal-title":"Semin Nephrol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/S1074-7613(01)00151-0","article-title":"Il-6 and its soluble receptor orchestrate a temporal switch in the pattern of leukocyte recruitment seen during acute inflammation","volume":"14","author":"Hurst","year":"2001","journal-title":"Immunity."},{"key":"B12","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1186\/ar1917","article-title":"Interleukin-6 and chronic inflammation","volume":"8","author":"Gabay","year":"2006","journal-title":"Arthritis Res Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1093\/ndt\/17.8.1480","article-title":"Plasma and dialysate IL-6 and VEGF concentrations are associated with high peritoneal solute transfer rate","volume":"17","author":"Pecoits-Filho","year":"2002","journal-title":"Nephrol Dial Transplant."},{"key":"B14","doi-asserted-by":"publisher","first-page":"S102","DOI":"10.1177\/089686080102103S17","article-title":"Interleukin-6 levels decrease in effluent from patients dialyzed with bicarbonate\/lactatebased peritoneal dialysis solutions","volume":"21","author":"Cooker","year":"2001","journal-title":"Perit Dial Int."},{"key":"B15","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/089686080602600109","article-title":"Systemic and intraperitoneal interleukin-6 system during the first year of peritoneal dialysis","volume":"26","author":"Pecoits-Filho","year":"2020","journal-title":"Perit Dial Int."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1093\/ndt\/gfp670","article-title":"Intra-peritoneal interleukin-6 system is a potent determinant of the baseline peritoneal solute transport in incident peritoneal dialysis patients","volume":"25","author":"Oh","year":"2010","journal-title":"Nephrol Dial Transplant."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1093\/ndt\/gfp767","article-title":"Impact of systemic and local peritoneal inflammation on peritoneal solute transport rate in new peritoneal dialysis patients: a 1-year prospective study","volume":"25","author":"Cho","year":"2010","journal-title":"Nephrol Dial Transplant."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2477","DOI":"10.1111\/j.1523-1755.2005.00357.x","article-title":"Genetic and clinical factors influence the baseline permeability of the peritoneal membrane","volume":"67","author":"Gillerot","year":"2005","journal-title":"Kidney Int."},{"key":"B19","doi-asserted-by":"publisher","first-page":"e012967","DOI":"10.1136\/bmjopen-2016-012967","article-title":"Possible role of IL-6 and TIE2 gene polymorphisms in predicting the initial high transport status in patients with peritoneal dialysis: an observational study","volume":"6","author":"Ding","year":"2016","journal-title":"BMJ Open."},{"key":"B20","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1159\/000362622","article-title":"Intraperitoneal interleukin-6 levels predict peritoneal solute transport rate: a prospective cohort study","volume":"39","author":"Yang","year":"2014","journal-title":"Am J Nephrol."},{"key":"B21","first-page":"303","article-title":"A formula to estimate the approximate surface area if height and weight be known","volume":"5","author":"Du Bois","year":"1989","journal-title":"Arch Intern Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1681\/ASN.V1251046","article-title":"Peritoneal glucose exposure and changes in membrane solute transfer with time on peritoneal dialysis","volume":"12","author":"Davies","year":"2001","journal-title":"J Am Soc Nephrol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1177\/089686088700700306","article-title":"Peritoneal equilibration test","volume":"7","author":"Twardowski","year":"1987","journal-title":"Perit Dial Bull."},{"key":"B24","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1681\/ASN.V75745","article-title":"Measurement of residual renal function in patients treated with CAPD","volume":"7","author":"Van Olden","year":"1996","journal-title":"J Am Soc Nephrol."},{"key":"B25","doi-asserted-by":"publisher","first-page":"S65","DOI":"10.1016\/S0272-6386(01)70006-6","article-title":"K\/DOQI clinical practice guidelines for peritoneal dialysis adequacy, 2000","volume":"37","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"B26","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1007\/s11255-011-9973-2","article-title":"Peritoneal dialysis in an ageing population: a 10-year experience","volume":"44","author":"Smyth","year":"2012","journal-title":"Int Urol Nephrol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1159\/000169445","article-title":"Simple assessment of the efficacy of peritoneal transfer in continuous ambulatory peritoneal dialysis patients","volume":"4","author":"Krediet","year":"1986","journal-title":"Blood Purif."},{"key":"B28","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1159\/000183652","article-title":"Peritoneal permeability to proteins in diabetic and non-diabetic continuous ambulatory peritoneal dialysis patients","volume":"42","author":"Krediet","year":"1986","journal-title":"Nephron."},{"key":"B29","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1177\/0896860820982218","article-title":"ISPD recommendations for the evaluation of peritoneal membrane dysfunction in adults: Classification, measurement, interpretation and rationale for intervention","volume":"41","author":"Morelle","year":"2021","journal-title":"Perit Dial Int."},{"key":"B30","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: a practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J R Stat Soc B."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2018","DOI":"10.1093\/bioinformatics\/btu124","article-title":"A general method for accurate estimation of false discovery rates in identification of differentially expressed genes","volume":"30","author":"Tan","year":"2014","journal-title":"Bioinformatics."},{"key":"B32","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.semnephrol.2016.10.009","article-title":"Peritoneal membrane preservation","volume":"37","author":"Bajo","year":"2017","journal-title":"Semin Nephrol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s11684-017-0571-2","article-title":"Strategies for preventing peritoneal fibrosis in peritoneal dialysis patients: new insights based on peritoneal inflammation and angiogenesis","volume":"11","author":"Zhang","year":"2017","journal-title":"Front Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1038\/nrneph.2013.99","article-title":"Peritoneal changes in patients on long-term peritoneal dialysis","volume":"9","author":"Krediet","year":"2013","journal-title":"Nat Rev Nephrol."},{"key":"B35","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/S0272-6386(00)70011-4","article-title":"Changes of cytokine profiles during peritonitis in patients on continuous ambulatory peritoneal dialysis","volume":"35","author":"Lai","year":"2000","journal-title":"Am J Kidney Dis."},{"key":"B36","doi-asserted-by":"publisher","first-page":"S37","DOI":"10.1177\/089686089701702S07","article-title":"Evidence for the presence of chronic inflammation during peritoneal dialysis: therapeutic implications","volume":"17","author":"Breborowicz","year":"1997","journal-title":"Perit Dial Int."},{"key":"B37","doi-asserted-by":"publisher","first-page":"3739","DOI":"10.1093\/ndt\/gfr170","article-title":"Variability of effluent cancer antigen 125 and interleukin-6 determination in dialysis patients","volume":"26","author":"Barreto","year":"2011","journal-title":"Nephrol Dial Transplant."},{"key":"B38","doi-asserted-by":"publisher","first-page":"912595","DOI":"10.1155\/2012\/912595","article-title":"Inflammation and the peritoneal membrane: causes and impact on structure and function during peritoneal dialysis","volume":"2012","author":"Baroni","year":"2012","journal-title":"Mediators Inflamm."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1038\/ki.1996.430","article-title":"Superinduction of IL-6 synthesis in human peritoneal mesothelial cells is related to the induction and stabilization of IL-6 mRNA","volume":"50","author":"Witowski","year":"1996","journal-title":"Kidney Int."},{"key":"B40","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1177\/039139889702001104","article-title":"Variations of cytokine levels and production in CAPD patients","volume":"20","author":"Serre","year":"1997","journal-title":"Int J Artif Organs."},{"key":"B41","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/1471-2369-15-8","article-title":"Dialysate interleukin6 predicts increasing peritoneal solute transport rate in incident peritoneal dialysis patients","volume":"15","author":"Cho","year":"2014","journal-title":"BMC Nephrol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1159\/000342523","article-title":"Biocompatible peritoneal dialysis solution preserves residual renal function","volume":"36","author":"Kim","year":"2012","journal-title":"Am J Nephrol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1177\/089686089501500208","article-title":"Analysis of inflammatory mediators and peritoneal permeability to macromolecules shortly before the onset of overt peritonitis in patients treated with CAPD","volume":"15","author":"Zemel","year":"1995","journal-title":"Perit Dial Int."},{"key":"B44","doi-asserted-by":"publisher","first-page":"1609","DOI":"10.1111\/j.1523-1755.2005.00243.x","article-title":"Longitudinal membrane function in functionally anuric patients treated with APD: data from EAPOS on the effects of glucose and icodextrin prescription","volume":"67","author":"Davies","year":"2005","journal-title":"Kidney Int."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.1111\/j.1523-1755.2004.66021.x","article-title":"Longitudinal relationship between solute transport and ultrafiltration capacity in peritoneal dialysis patients","volume":"66","author":"Davies","year":"2004","journal-title":"Kidney Int."},{"key":"B46","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1093\/oxfordjournals.ndt.a027318","article-title":"Longitudinal changes in peritoneal kinetics: the effects of peritoneal dialysis and peritonitis","volume":"11","author":"Davies","year":"1996","journal-title":"Nephrol Dial Transplant."},{"key":"B47","doi-asserted-by":"publisher","first-page":"4445","DOI":"10.1093\/ndt\/gfs314","article-title":"The effect of low glucose degradation product, neutral pH versus standard peritoneal dialysis solutions on peritoneal membrane function: the balANZ trial","volume":"27","author":"Johnson","year":"2012","journal-title":"Nephrol Dial Transplant."},{"key":"B48","doi-asserted-by":"publisher","first-page":"107","DOI":"10.2215\/CJN.08180621","article-title":"Monitoring daily ultrafiltration in automated peritoneal dialysis","volume":"17","author":"Eibensteiner","year":"2022","journal-title":"Clin J Am Soc Nephrol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1177\/089686080802800214","article-title":"The clinical usefulness of peritoneal dialysis fluids with neutral pH and low glucose degradation product concentration: an open randomized prospective trial","volume":"28","author":"Choi","year":"2008","journal-title":"Perit Dial Int."},{"key":"B50","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1111\/nep.12746","article-title":"Interleukin-6 trans-signalling induces vascular endothelial growth factor synthesis partly via Janus kinases-STAT3 pathway in human mesothelial cells","volume":"22","author":"Yang","year":"2017","journal-title":"Nephrology."},{"key":"B51","doi-asserted-by":"publisher","first-page":"305","DOI":"10.3747\/pdi.2010.00115","article-title":"A peritoneal dialysis regimen low in glucose and glucose degradation products results in increased cancer antigen 125 and peritoneal activation","volume":"32","author":"Poole","year":"2012","journal-title":"Perit Dial Int."},{"key":"B52","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1093\/ndt\/18.3.590","article-title":"Association between residual renal function, inflammation and patient survival in new peritoneal dialysis patients","volume":"18","author":"Chung","year":"2003","journal-title":"Nephrol Dial Transplant."},{"key":"B53","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1046\/j.1523-1755.2000.00181.x","article-title":"Role of different dialysis membranes in the release of interleukin-6-soluble receptor in uremic patients","volume":"58","author":"Memoli","year":"2000","journal-title":"Kidney Int."},{"key":"B54","doi-asserted-by":"publisher","first-page":"F310","DOI":"10.1152\/ajprenal.00428.2016","article-title":"IL-6 promotes epithelial-to-mesenchymal transition of human peritoneal mesothelial cells possibly through the JAK2\/STAT3 signaling pathway","volume":"313","author":"Xiao","year":"2017","journal-title":"Am J Physiol Renal Physiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1681\/ASN.V132470","article-title":"Morphologic changes in the peritoneal membrane of patients with renal disease","volume":"13","author":"Williams","year":"2002","journal-title":"J Am Soc Nephrol."},{"key":"B56","doi-asserted-by":"publisher","first-page":"129","DOI":"10.3747\/pdi.2014.00038","article-title":"Biocompatible dialysis solutions preserve peritoneal mesothelial cell and vessel wall integrity. A case-control study on human biopsies","volume":"36","author":"del Peso","year":"2016","journal-title":"Perit Dial Int"},{"key":"B57","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1177\/089686080002000609","article-title":"Risk factors responsible for ultrafiltration failure in early stages of peritoneal dialysis","volume":"20","author":"Selgas","year":"2020","journal-title":"Perit Dial Int."},{"key":"B58","first-page":"5932","article-title":"Protective effect of COMP-angiopoietin-1 on peritoneal vascular permeability and peritoneal transport function in uremic peritoneal dialysis rats","volume":"11","author":"Shi","year":"2019","journal-title":"Am J Transl Res."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1681\/ASN.2015101169","article-title":"IL-6 trans-signaling links inflammation with angiogenesis in the peritoneal membrane","volume":"28","author":"Catar","year":"2017","journal-title":"J Am Soc Nephrol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.immuni.2013.10.022","article-title":"Interleukin-6 signaling drives fibrosis in unresolved inflammation","volume":"40","author":"Fielding","year":"2014","journal-title":"Immunity."},{"key":"B61","doi-asserted-by":"publisher","first-page":"F338","DOI":"10.1152\/ajprenal.00319.2019","article-title":"IL-6 trans-signaling drives a STAT3-dependent pathway that leads to structural alterations of the peritoneal membrane","volume":"318","author":"Yang","year":"2020","journal-title":"Am J Physiol Renal Physiol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1093\/ndt\/gfv440","article-title":"Peritoneal inflammation precedes encapsulating peritoneal sclerosis: results from the GLOBAL Fluid Study","volume":"31","author":"Lambie","year":"2016","journal-title":"Nephrol Dial Transplant."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.836861\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T04:40:24Z","timestamp":1660106424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.836861\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,10]]},"references-count":62,"alternative-id":["10.3389\/fmed.2022.836861"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.836861","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,10]]},"article-number":"836861"}}