{"id":"https://openalex.org/W4387435570","doi":"https://doi.org/10.3389/fphar.2023.1243080","title":"Effectiveness of vedolizumab and ustekinumab as second biologic agent in achieving target outcomes in tumor necrosis factor antagonists experienced patients with inflammatory bowel disease (enroll-ex study)","display_name":"Effectiveness of vedolizumab and ustekinumab as second biologic agent in achieving target outcomes in tumor necrosis factor antagonists experienced patients with inflammatory bowel disease (enroll-ex study)","publication_year":2023,"publication_date":"2023-10-09","ids":{"openalex":"https://openalex.org/W4387435570","doi":"https://doi.org/10.3389/fphar.2023.1243080","pmid":"https://pubmed.ncbi.nlm.nih.gov/37876726","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10590879"},"language":"en","primary_location":{"id":"doi:10.3389/fphar.2023.1243080","doi":"https://doi.org/10.3389/fphar.2023.1243080","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fphar.2023.1243080","pdf_url":"https://www.frontiersin.org/articles/10.3389/fphar.2023.1243080/pdf?isPublishedV2=False","source":{"id":"https://openalex.org/S132108250","display_name":"Frontiers in Pharmacology","issn_l":"1663-9812","issn":["1663-9812"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pharmacology","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.frontiersin.org/articles/10.3389/fphar.2023.1243080/pdf?isPublishedV2=False","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5016445054","display_name":"Fatema Alrashed","orcid":"https://orcid.org/0000-0003-4020-5978","observed_orcids":["https://orcid.org/0000-0003-4020-5978","https://orcid.org/0000-0002-5825-7701"]},"institutions":[{"id":"https://openalex.org/I36721946","display_name":"Kuwait University","ror":"https://ror.org/021e5j056","country_code":"KW","type":"education","lineage":["https://openalex.org/I36721946"]}],"countries":["KW"],"is_corresponding":true,"raw_author_name":"Fatema Alrashed","raw_affiliation_strings":["Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait","institution_ids":["https://openalex.org/I36721946"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5111117404","display_name":"Israa Abdullah","orcid":"https://orcid.org/0000-0001-5262-7938","observed_orcids":["https://orcid.org/0000-0001-5262-7938"]},"institutions":[{"id":"https://openalex.org/I2800519576","display_name":"Mubarak Al Kabeer Hospital","ror":"https://ror.org/05nkffb74","country_code":"KW","type":"healthcare","lineage":["https://openalex.org/I2800519576"]}],"countries":["KW"],"is_corresponding":false,"raw_author_name":"Israa Abdullah","raw_affiliation_strings":["Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait","institution_ids":["https://openalex.org/I2800519576"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5112851702","display_name":"Ahmad Alfadhli","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800519576","display_name":"Mubarak Al Kabeer Hospital","ror":"https://ror.org/05nkffb74","country_code":"KW","type":"healthcare","lineage":["https://openalex.org/I2800519576"]}],"countries":["KW"],"is_corresponding":false,"raw_author_name":"Ahmad Alfadhli","raw_affiliation_strings":["Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait","institution_ids":["https://openalex.org/I2800519576"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5022645608","display_name":"Mohammad Shehab","orcid":"https://orcid.org/0000-0003-2084-3956","observed_orcids":["https://orcid.org/0000-0003-2084-3956"]},"institutions":[{"id":"https://openalex.org/I2800519576","display_name":"Mubarak Al Kabeer Hospital","ror":"https://ror.org/05nkffb74","country_code":"KW","type":"healthcare","lineage":["https://openalex.org/I2800519576"]},{"id":"https://openalex.org/I36721946","display_name":"Kuwait University","ror":"https://ror.org/021e5j056","country_code":"KW","type":"education","lineage":["https://openalex.org/I36721946"]},{"id":"https://openalex.org/I4210165735","display_name":"Dasman Diabetes Institute","ror":"https://ror.org/05tppc012","country_code":"KW","type":"education","lineage":["https://openalex.org/I4210165735"]}],"countries":["KW"],"is_corresponding":false,"raw_author_name":"Mohammad Shehab","raw_affiliation_strings":["Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait","Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait","Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Biochemistry and Molecular Biology, Dasman Diabetes Institute, Kuwait City, Kuwait","institution_ids":["https://openalex.org/I4210165735"]},{"raw_affiliation_string":"Department of Internal Medicine, Mubarak Al-Kabeer University Hospital, Jabriya, Kuwait","institution_ids":["https://openalex.org/I2800519576"]},{"raw_affiliation_string":"Department of Pharmacy Practice, College of Pharmacy, Kuwait University, Kuwait City, Kuwait","institution_ids":["https://openalex.org/I36721946"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5016445054"],"corresponding_institution_ids":["https://openalex.org/I36721946"],"apc_list":{"value":3295,"currency":"USD","value_usd":3295},"apc_paid":{"value":3295,"currency":"USD","value_usd":3295},"fwci":1.5958,"has_fulltext":true,"cited_by_count":9,"citation_normalized_percentile":{"value":0.81884403,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":93,"max":97},"biblio":{"volume":"14","issue":null,"first_page":"1243080","last_page":"1243080"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10134","display_name":"Inflammatory Bowel Disease","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10134","display_name":"Inflammatory Bowel Disease","score":1.0,"subfield":{"id":"https://openalex.org/subfields/2715","display_name":"Gastroenterology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11194","display_name":"Ocular Diseases and Beh\u00e7et\u2019s Syndrome","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2731","display_name":"Ophthalmology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/vedolizumab","display_name":"vedolizumab","score":0.9929999709129333},{"id":"https://openalex.org/keywords/ustekinumab","display_name":"ustekinumab","score":1.0},{"id":"https://openalex.org/keywords/inflammatory-bowel-disease","display_name":"inflammatory bowel disease","score":0.968999981880188},{"id":"https://openalex.org/keywords/anti-tnf-failure","display_name":"anti-TNF therapy failure","score":0.8360000252723694},{"id":"https://openalex.org/keywords/crohn-s-disease","display_name":"Crohn's disease","score":0.9049999713897705},{"id":"https://openalex.org/keywords/ulcerative-colitis","display_name":"ulcerative colitis","score":1.0},{"id":"https://openalex.org/keywords/mucosal-healing","display_name":"mucosal healing","score":0.996999979019165},{"id":"https://openalex.org/keywords/steroid-free-remission","display_name":"steroid-free remission","score":0.9850000143051147},{"id":"https://openalex.org/keywords/endoscopic-outcomes","display_name":"endoscopic outcomes","score":0.6990000009536743},{"id":"https://openalex.org/keywords/hospitalization","display_name":"hospitalization","score":0.7639999985694885},{"id":"https://openalex.org/keywords/ibd-surgery","display_name":"IBD surgery","score":0.7820000052452087},{"id":"https://openalex.org/keywords/treatment-effectiveness","display_name":"treatment effectiveness","score":0.38999998569488525},{"id":"https://openalex.org/keywords/real-world-effectiveness","display_name":"real-world effectiveness","score":0.47600001096725464}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9550945162773132},{"id":"https://openalex.org/C2776207728","wikidata":"https://www.wikidata.org/wiki/Q7918002","display_name":"Vedolizumab","level":4,"score":0.9492276906967163},{"id":"https://openalex.org/C2778975655","wikidata":"https://www.wikidata.org/wiki/Q420305","display_name":"Ustekinumab","level":4,"score":0.9245707392692566},{"id":"https://openalex.org/C2778260677","wikidata":"https://www.wikidata.org/wiki/Q917447","display_name":"Inflammatory bowel disease","level":3,"score":0.6848047971725464},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6675251722335815},{"id":"https://openalex.org/C2780479503","wikidata":"https://www.wikidata.org/wiki/Q1477","display_name":"Ulcerative colitis","level":3,"score":0.6283472776412964},{"id":"https://openalex.org/C2779280984","wikidata":"https://www.wikidata.org/wiki/Q1472","display_name":"Crohn's disease","level":3,"score":0.6002315878868103},{"id":"https://openalex.org/C2777138892","wikidata":"https://www.wikidata.org/wiki/Q415264","display_name":"Infliximab","level":3,"score":0.5256503820419312},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4977004826068878},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.47631344199180603},{"id":"https://openalex.org/C17991360","wikidata":"https://www.wikidata.org/wiki/Q21173843","display_name":"Tumor necrosis factor alpha","level":2,"score":0.36457228660583496},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.36301928758621216},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.2491350769996643}],"mesh":[],"locations_count":4,"locations":[{"id":"doi:10.3389/fphar.2023.1243080","doi":"https://doi.org/10.3389/fphar.2023.1243080","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fphar.2023.1243080","pdf_url":"https://www.frontiersin.org/articles/10.3389/fphar.2023.1243080/pdf?isPublishedV2=False","source":{"id":"https://openalex.org/S132108250","display_name":"Frontiers in Pharmacology","issn_l":"1663-9812","issn":["1663-9812"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pharmacology","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10590879","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10590879","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10590879/pdf/fphar-14-1243080.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Front Pharmacol","raw_type":"Text"},{"id":"pmid:37876726","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/37876726","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in pharmacology","raw_type":"Journal Article"},{"id":"pmh:oai:doaj.org/article:27eae7c9cbd344b6bb9e87adf92f8f66","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/27eae7c9cbd344b6bb9e87adf92f8f66","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Frontiers in Pharmacology, Vol 14 (2023)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.3389/fphar.2023.1243080","doi":"https://doi.org/10.3389/fphar.2023.1243080","is_oa":true,"landing_page_url":"https://doi.org/10.3389/fphar.2023.1243080","pdf_url":"https://www.frontiersin.org/articles/10.3389/fphar.2023.1243080/pdf?isPublishedV2=False","source":{"id":"https://openalex.org/S132108250","display_name":"Frontiers in Pharmacology","issn_l":"1663-9812","issn":["1663-9812"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320527","host_organization_name":"Frontiers Media","host_organization_lineage":["https://openalex.org/P4310320527"],"host_organization_lineage_names":["Frontiers Media"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Frontiers in Pharmacology","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4387435570.pdf","grobid_xml":"https://content.openalex.org/works/W4387435570.grobid-xml"},"referenced_works_count":30,"referenced_works":["https://openalex.org/W215428795","https://openalex.org/W2034795132","https://openalex.org/W2049827204","https://openalex.org/W2072640801","https://openalex.org/W2077531651","https://openalex.org/W2162805528","https://openalex.org/W2182578492","https://openalex.org/W2275737843","https://openalex.org/W2324298557","https://openalex.org/W2545034339","https://openalex.org/W2560112556","https://openalex.org/W2809001101","https://openalex.org/W2884286006","https://openalex.org/W2912182261","https://openalex.org/W2991550463","https://openalex.org/W3005544777","https://openalex.org/W3012763509","https://openalex.org/W3014838615","https://openalex.org/W3027973540","https://openalex.org/W3041405544","https://openalex.org/W3115410759","https://openalex.org/W3129081724","https://openalex.org/W3178607042","https://openalex.org/W3194395537","https://openalex.org/W4214924886","https://openalex.org/W4224444655","https://openalex.org/W4233817719","https://openalex.org/W4281553364","https://openalex.org/W4310493900","https://openalex.org/W4312047270"],"related_works":["https://openalex.org/W7106808444","https://openalex.org/W4403726391","https://openalex.org/W4407285707","https://openalex.org/W4381251762","https://openalex.org/W4224444655","https://openalex.org/W4394691786","https://openalex.org/W3000723587","https://openalex.org/W4414353356","https://openalex.org/W4396903863","https://openalex.org/W2912369380"],"abstract_inverted_index":{"Background:":[0],"About":[1],"a":[2,45,71,108],"third":[3],"of":[4,27,52,75,95,112,124,141,365],"patients":[5,39,53,76,147,168,175,181,197,203,209,218,228,243,249,255,261,276,281,288,297,303,318,324,333,349,358,370],"with":[6,40,54,78,148,182,219,229,262,304,350],"inflammatory":[7],"bowel":[8],"disease":[9,130],"(IBD)":[10],"do":[11],"not":[12],"respond":[13],"to":[14,56,379],"anti-tumor":[15],"necrosis":[16],"factor":[17],"(anti-TNF)":[18],"therapy.":[19],"In":[20],"our":[21],"study,":[22],"we":[23],"evaluated":[24,68],"the":[25,93,160,163],"effectiveness":[26],"vedolizumab":[28,81,340],"and":[29,34,67,100,120,172,200,246,285,321,339],"ustekinumab":[30,79,222,360],"in":[31,37,70,116,128,159,344,348],"achieving":[32,345],"clinical":[33,346],"endoscopic":[35,110],"outcomes":[36,91,347,368],"anti-TNF-experienced":[38],"IBD.":[41],"Methods:":[42],"We":[43],"conducted":[44],"retrospective":[46],"cohort":[47],"study.":[48,161],"Electronic":[49],"medical":[50],"records":[51],"moderate":[55],"severe":[57],"IBD,":[58],"who":[59,150,184,231,264,306],"were":[60,65,87,92,133,157,169,176,189,198,236,244,269,277,311,319,341],"previously":[61,152],"received":[62,153],"anti-TNF":[63,85,155,187,234,267,309,355],"therapies,":[64],"reviewed":[66],"retrospectively":[69],"gastroenterology":[72],"center.":[73],"Outcomes":[74,132],"treated":[77],"or":[80,114],"after":[82,352],"failing":[83,353],"one":[84,154,186,213,233,266,308],"agent":[86,156],"evaluated.":[88],"The":[89],"primary":[90],"percentage":[94],"hospitalization,":[96],"surgery,":[97],"mucosal":[98,224,257,299,335],"healing":[99,104],"steroid-free":[101],"remission.":[102],"Mucosal":[103],"was":[105],"defined":[106],"as":[107],"Mayo":[109],"score":[111,123],"0":[113],"1":[115,292,328],"ulcerative":[117],"colitis":[118],"(UC)":[119],"an":[121,354],"SES-CD":[122],"less":[125],"than":[126,369],"3":[127,279],"Crohn\u2019s":[129],"(CD).":[131],"quantified":[134],"using":[135],"descriptive":[136],"analysis.":[137],"Results:":[138],"A":[139,373],"total":[140,164],"207":[142],"(130":[143],"CD:":[144],"77":[145],"UC)":[146],"IBD":[149,351],"had":[151,204,210,250,282,289,325,361],"included":[158],"Of":[162,192,239,272,314],"cohort,":[165],"62":[166],"(30.0%)":[167],"receiving":[170,237,312,359,371],"vedolizumab,":[171],"145":[173],"(70.0%)":[174],"on":[177,190,221,270],"ustekinumab.":[178,191,271],"101":[179],"(77.6%)":[180],"CD":[183,220,230],"failed":[185,232,265,307],"therapy":[188,235,268,310],"these":[193,273,381],"patients,":[194],"26":[195],"(19.7%)":[196],"hospitalized,":[199,245,278,320],"12":[201],"(11.9%)":[202],"IBD-related":[205,251,283],"surgery.":[206,252],"16":[207,322],"(16.1%)":[208],"at":[211,290,326],"least":[212,291,327],"corticosteroid":[214,293,329],"course.":[215,294,330],"60":[216],"(59.0%)":[217],"achieved":[223,256,298,334],"healing.":[225,258,300,336],"29":[226],"(22.3%)":[227],"vedolizumab.":[238,313,372],"those,":[240,315],"7":[241],"(25%)":[242],"11":[247],"(37.9%)":[248],"15":[253],"(51.0%)":[254],"44":[259],"(57.1%)":[260],"UC":[263,305],"6":[274,316],"(14.1%)":[275],"(7.0%)":[280],"surgery":[284],"13":[286],"(30%)":[287],"25":[295],"(57.0%)":[296],"33":[301],"(42.8%)":[302],"(18.6%)":[317],"(49.6%)":[323],"17":[331],"(53.2%)":[332],"Conclusion:":[337],"Ustekinumab":[338],"both":[342],"effective":[343],"agent.":[356],"However,":[357],"numerically":[362],"higher":[363],"percentages":[364],"reaching":[366],"target":[367],"prospective":[374],"head-to-head":[375],"trial":[376],"is":[377],"warranted":[378],"confirm":[380],"findings.":[382]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":2},{"year":2024,"cited_by_count":4}],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2023-10-09T00:00:00"}
