iGIE最新文献

{"title":"Clinical safety of a novel over-the-scope gastroduodenal full-thickness resection device for the treatment of upper GI tract lesions: a multicenter experience","authors":"Alyssa Y. Choi MD ,&nbsp;Peter H. Nguyen MD ,&nbsp;Jaehyun Kim MD ,&nbsp;Julie Yang MD ,&nbsp;Sherif A. Andrawes MD ,&nbsp;Jean Chalhoub MD ,&nbsp;Anastasia Chahine MD ,&nbsp;Andrew Q. Giap MD ,&nbsp;David P. Lee MD ,&nbsp;Kenneth H. Park MD ,&nbsp;Quin Y. Liu MD ,&nbsp;Srinivas Gaddam MD ,&nbsp;Kendrick Che DO ,&nbsp;Michael Lajin MD ,&nbsp;Wasseem Skef MD ,&nbsp;Amirali Tavangar MD ,&nbsp;John J. Kim MD ,&nbsp;Jason B. Samarasena MD, MBA","doi":"10.1016/j.igie.2024.09.004","DOIUrl":"10.1016/j.igie.2024.09.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A novel gastroduodenal full-thickness resection device system was developed for resection of upper GI tract lesions. In this study, we evaluated the efficacy and safety of the gastroduodenal full-thickness resection device system.</div></div><div><h3>Methods</h3><div>Consecutive patients who received endoscopic resection of upper GI tract lesions from June 2020 to August 2022 using a gastroduodenal full-thickness resection device were evaluated from 8 U.S. centers. Primary endpoints were technical success and R0 resection. Secondary endpoints were en bloc resection, residual lesions at follow-up endoscopy, and immediate or delayed adverse events.</div></div><div><h3>Results</h3><div>Forty-four patients (mean age, 60.9 ± 15.8 years) received 45 resections for gastric (35, 80%) and duodenal (9, 20%) lesions. Thirty-four lesions (77%) were subepithelial and 10 (23%) were epithelial lesions. Technical success and en bloc resection were achieved in 43 (96%) and 41 (91%) patients, respectively. Furthermore, R0 resection was achieved in 32 patients (71%), including 24 of 35 (69%) with neoplastic lesions. Pathologic diagnosis included neuroendocrine tumor in 14 patients (32%), GI stromal tumor in 10 (23%), and gastric cancer or high-grade dysplasia in 7 (16%). Minor immediate and delayed bleeding occurred in 17 (38%) and 2 (4%) patients, respectively. One patient had delayed perforation, managed conservatively. On follow-up, 19 of 21 patients (90%) had no residual lesion.</div></div><div><h3>Conclusions</h3><div>In this multicenter series, the gastroduodenal full-thickness resection device demonstrated high rates of technical success and acceptable rate of R0 resection. Immediate minor bleeding was common, whereas serious adverse events were rare. This gastroduodenal full-thickness resection device should be considered in patients with gastroduodenal subepithelial lesions as an alternative to long-term surveillance.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 490-500"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel hemostatic adhesive powder to prevent delayed bleeding after endoscopic submucosal dissection in the GI tract: first U.S. multicenter experience","authors":"Dennis Yang MD ,&nbsp;Amit Bhatt MD ,&nbsp;Maham Hayat MD ,&nbsp;Muhammad K. Hasan MD ,&nbsp;Hiroyuki Aihara MD, PhD","doi":"10.1016/j.igie.2024.10.002","DOIUrl":"10.1016/j.igie.2024.10.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Delayed bleeding (DB) is a common adverse event after endoscopic submucosal dissection (ESD). We evaluated a novel hemostatic powder (UI-EWD, Nexpowder; Medtronic, Minneapolis, Minn, USA) to prevent DB after ESD.</div></div><div><h3>Methods</h3><div>This was a multicenter retrospective analysis of ESDs performed between January 2023 and March 2024 in which UI-EWD was applied to prevent DB. Cases in which endoscopic closure of the post-ESD mucosal defect was performed were excluded. DB was defined as a bleeding event requiring hospitalization, blood transfusion, or any intervention within 30 days after the procedure. Technical success of UI-EWD was defined as successful delivery and application of the hemostatic powder over the entire mucosal defect.</div></div><div><h3>Results</h3><div>Eighty-three patients (median age, 66 years) underwent ESD in the esophagus (n = 18), stomach (n = 15), colon (n = 38), and rectum (n = 12). The median lesion size was 50 mm (interquartile range, 41-70 mm). UI-EWD was successfully applied in all defects, although in 2 cases (2.4%) a second delivery catheter had to be used to complete the procedure. DB occurred in 3 patients (3.6%): 2 after gastric ESD and 1 after colonic ESD within 24 hours of the index procedure. None required intervention on repeat endoscopy. There were no cases of perforation. En bloc and R0 resection rates were 96.2% and 88.7%, respectively.</div></div><div><h3>Conclusions</h3><div>UI-EWD can be easily applied to mucosal defects after ESD throughout the GI tract. Initial data from this multicenter study demonstrate that the use of UI-EWD was associated with a relatively low rate of DB after ESD. Additional comparative studies are needed to corroborate these preliminary findings.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 501-506"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert commentary: unveiling a rare adverse event","authors":"Diogo Turiani Hourneaux de Moura MD, MSc, PhD, Post-PhD ,&nbsp;Daniel Szvarca MD","doi":"10.1016/j.igie.2024.06.007","DOIUrl":"10.1016/j.igie.2024.06.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 371-372"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric peroral endoscopic myo-neurotomy as less-invasive bariatric surgery in porcine models: an experimental study","authors":"Kenta Hamada MD, PhD ,&nbsp;Yasushi Yamasaki MD, PhD ,&nbsp;Akinobu Takaki MD, PhD ,&nbsp;Takehiro Tanaka MD, PhD ,&nbsp;Hiroyuki Okada MD, PhD","doi":"10.1016/j.igie.2024.06.002","DOIUrl":"10.1016/j.igie.2024.06.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Obesity is a global health problem, and less-invasive treatments are warranted. We developed a novel endoscopic intervention named peroral endoscopic myo-neurotomy (POEM-N) that is performed at the greater curvature of the gastric antrum as a bariatric/metabolic procedure and assessed its feasibility using porcine models.</div></div><div><h3>Methods</h3><div>Six live pigs were divided into 3 groups of 2: POEM-N with a high-fat diet (HFD) (POEM-N group); sham procedure with HFD (HF-control group); and sham procedure with normal diet (N-control group). All pigs were fed the diets for 2 weeks, underwent POEM-N or sham procedure, and were observed for 2 weeks after the procedure. The primary outcome was the safety and feasibility of POEM-N. Adverse events and histology of the area after POEM-N were evaluated to assess the procedure’s safety and feasibility. Secondary outcomes were changes in body weight and glycolipid levels.</div></div><div><h3>Results</h3><div>There was no severe worsening of vital signs during or after the POEM-N procedure. All pigs were well and food intake was good, with no delayed adverse events. Excessive storage of dietary residue, deformity of the gastric antrum, and fold concentration were observed after POEM-N, as expected. Histologic examination revealed hypertrophic regeneration of Auerbach’s plexus, which regulates gastric peristalsis, in both POEM-N pigs. After the procedure, HFD-induced weight gain in the POEM-N pigs slowed, and the increase in serum and liver cholesterol levels was suppressed.</div></div><div><h3>Conclusions</h3><div>We applied POEM-N as a bariatric/metabolic procedure and showed its safety and feasibility using porcine models.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 358-365"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental model in porcines to evaluate solutions used in endoscopic resections","authors":"Annita Cavalcante Farias Leoncio MD,&nbsp;Carlos Kiyoshi Furuya PhD,&nbsp;Christiano Makoto Sakai PhD,&nbsp;Paulo Sakai PhD,&nbsp;Edson Ide MS","doi":"10.1016/j.igie.2024.06.004","DOIUrl":"10.1016/j.igie.2024.06.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Injection of solution into the submucosa is an essential step in endoscopic resections and aims to separate the mucosal layer from the muscular layer avoiding, above all, perforatNOVA Nions. This study compares the durability of the solution in bubble formation, endoscopists' opinions on the quality of the bubble during resections, and the electrical resistance of the solutions.</div></div><div><h3>Methods</h3><div>This double-blind study compared the following solutions: Blue Eye (B-bluee), Voluven (Voluv; 6% hydroxyethyl starch solution), 10% mannitol with .45% sodium chloride (Ma-Na45), and mannitol 20% with .9% sodium chloride (Ma-Na90). In Phase 1, a total of 5 mL of the solution was injected into the gastric antrum of a live pig; in Phase 2, two endoscopists performed 20 resections over 5 weeks; and during Phase 3, the study measured the electrical resistance of pure solutions and after injections into the submucosa of ex vivo gastric tissue.</div></div><div><h3>Results</h3><div>Ma-Na90 lasted the longest (28 minutes), while Ma-Na45 had the shortest duration (10 minutes). Ma-Na45 was satisfactory, and Voluv was unsatisfactory. Ma-Na90 produced the most foam, and Voluv required the longest dissection time. There was no perforation. Ma-Na45 had the highest average electrical resistance (89.62 Ω) in both the solution and tissue (391 Ω), while Ma-Na90 exhibited lower values (23 Ω and 55.75 Ω, respectively).</div></div><div><h3>Conclusions</h3><div>This experiment shows the level of complexity in choosing the best solution based on a combination of variables. Mannitol with sodium chloride stood out as a highlighted option due to its favorable overall results and easy accessibility.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 346-351"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the safety and feasibility of outpatient colorectal endoscopic submucosal dissection","authors":"Mike T. Wei MD ,&nbsp;Shai Friedland MD","doi":"10.1016/j.igie.2024.07.005","DOIUrl":"10.1016/j.igie.2024.07.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) is increasingly used for resection of benign nonpedunculated colorectal polyps and early cancers. However, there is concern that adoption of ESD may be limited by increased resource utilization with routine postprocedure admission. As endoscopic closure of ESD wounds has improved, in 2022, we adopted an outpatient colorectal ESD protocol.</div></div><div><h3>Methods</h3><div>This study was a retrospective evaluation of adult patients who underwent colorectal ESD from January 2022 to April 2023. When technically feasible, the wound was closed by clips or suturing. After the procedure, patients were observed for up to 2 hours and discharged if they had no abdominal pain and no intraoperative muscle injury was present. We evaluated for operative success (en-bloc, R0, and curative resection) as well as safety (postprocedure pain, perforation, delayed bleeding).</div></div><div><h3>Results</h3><div>One hundred eleven lesions were removed by ESD in 105 consecutive patients. Nineteen lesions (17%) had prior EMR. All lesions were successfully removed: The en-bloc resection rate was 93% and the R0 and curative resection rate was 90%. Ninety-nine wounds (89%) were closed, most commonly using clips (60/111; 54%). Two small intraprocedural perforations occurred, both managed with clip closure, and the patients did not require admission. Among patients with defect closure, there were no delayed bleeds requiring hospitalization and only 1 episode of self-limited bleeding. In contrast, among 12 patients with resection sites not amenable to closure, there were 1 delayed bleed requiring hospitalization, 2 minor bleeds assessed at the emergency department, and 2 self-limited bleeds.</div></div><div><h3>Conclusions</h3><div>In this retrospective study, we demonstrated the feasibility of outpatient colorectal ESD. Among 105 patients, only 2 required hospital admission: 1 for postprocedure pain and 1 for delayed bleeding. We found that after endoscopic closure of ESD wounds, hospital admission was generally unnecessary and significant postprocedure bleeding was rare.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 413-417"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Boldly going where no one has gone before: a history of peroral endoscopic myotomy in the United States","authors":"Stavros N. Stavropoulos MD, FASGE ,&nbsp;Phillip S. Ge MD, FASGE","doi":"10.1016/j.igie.2024.07.007","DOIUrl":"10.1016/j.igie.2024.07.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 424-444"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced practice provider angle: American Society for Gastrointestinal Endoscopy advanced practice provider case of the month","authors":"Stacia Sackmaster APN-BC ,&nbsp;Sarah Enslin PA-C ,&nbsp;Joseph Vicari MD, MBA, FASGE","doi":"10.1016/j.igie.2024.07.002","DOIUrl":"10.1016/j.igie.2024.07.002","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 445-446"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence–based skeletal muscle estimates and outcomes of EUS-guided treatment of pancreatic fluid collections","authors":"Mamoru Takenaka MD, PhD ,&nbsp;Wataru Gonoi MD, PhD ,&nbsp;Tatsuya Sato MD, PhD ,&nbsp;Tomotaka Saito MD, PhD ,&nbsp;Shouhei Hanaoka MD, PhD ,&nbsp;Tsuyoshi Hamada MD, MPH, PhD ,&nbsp;Shunsuke Omoto MD, PhD ,&nbsp;Atsuhiro Masuda MD, PhD ,&nbsp;Masahiro Tsujimae MD, PhD ,&nbsp;Takuji Iwashita MD, PhD ,&nbsp;Shinya Uemura MD, PhD ,&nbsp;Shogo Ota MD ,&nbsp;Hideyuki Shiomi MD, PhD ,&nbsp;Toshio Fujisawa MD, PhD ,&nbsp;Sho Takahashi MD, PhD ,&nbsp;Saburo Matsubara MD, PhD ,&nbsp;Kentaro Suda MD ,&nbsp;Akinori Maruta MD, PhD ,&nbsp;Kensaku Yoshida MD, PhD ,&nbsp;Keisuke Iwata MD, PhD ,&nbsp;Yuhei Iwasa","doi":"10.1016/j.igie.2024.06.006","DOIUrl":"10.1016/j.igie.2024.06.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Skeletal muscle status may affect clinical outcomes of a variety of pancreatic diseases. Skeletal muscle quality and quantity have not been fully examined in relation to the outcomes of EUS-guided treatment of pancreatic fluid collections (PFCs).</div></div><div><h3>Methods</h3><div>Using a multi-institutional cohort of 372 patients receiving EUS-guided treatment of PFCs in 2010 to 2020, we examined the association of skeletal muscle status with adverse outcomes, including clinical treatment failure and in-hospital mortality. We used an in-house deep learning–based platform for preprocedural CT images, and skeletal muscle density (SMD) and skeletal muscle index (SMI; height-adjusted muscle area) were calculated as surrogates for muscular quality and quantity, respectively. Multivariable logistic regression analysis was conducted to calculate odds ratios (ORs) for adverse outcomes.</div></div><div><h3>Results</h3><div>Lower-level SMD was associated with higher risks of clinical failure and in-hospital mortality (<em>P</em>_trend &lt; .001). The adjusted OR for clinical failure comparing the extreme quartiles was 3.64 (95% confidence interval, 1.52-8.72). Compared with patients in the top 2 quartiles, patients in the lowest quartile had an adjusted OR for in-hospital mortality of 12.4 (95% confidence interval, 3.43-44.8). No effect modification according to the PFC types on the SMD–outcome relationship (<em>P</em>_interaction &gt; .16) was observed. SMD was not associated with the risk of procedure-related adverse events or PFC recurrence. SMI was not associated with adverse outcomes (<em>P</em>_trend &gt; .39).</div></div><div><h3>Conclusions</h3><div>In patients with endoscopically managed PFCs, SMD (but not SMI) was associated with the risks of clinical failure and in-hospital mortality, supporting the prognostic role of skeletal muscle quality.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 382-392.e8"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cecal intubation rates: data from the New Hampshire Colonoscopy Registry","authors":"Alexander Miller MD ,&nbsp;Nima Kamalpour MD ,&nbsp;Lynn F. Butterly MD ,&nbsp;Joseph C. Anderson MD","doi":"10.1016/j.igie.2024.07.003","DOIUrl":"10.1016/j.igie.2024.07.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Women and older or thinner patients have lower colonoscopy cecal intubation rates. We used data from the New Hampshire Colonoscopy Registry (NHCR) to examine the association between these and other endoscopist factors and trends of colonoscopy cecal intubation rates.</div></div><div><h3>Methods</h3><div>Our sample included patients ≥40 years from the NHCR with an adequate bowel preparation. We examined colonoscopy completion rates over quartiles (2004-2011, 2012-2014, 2015-2017, and 2018-2021) as stratified by men versus women and body mass index (BMI). In addition to these factors, we also adjusted for age and year of examination. Other variables of interest were specialty of the endoscopist and adenoma detection rates (ADRs).</div></div><div><h3>Results</h3><div>Our sample included 143,095 individuals (52.5% women [n = 75,180]). Multivariable analysis showed that BMI &lt;25 (odds ratio [OR], .87; 95% confidence interval [CI], .76-.99), obesity (BMI ≥30) (OR, .88; 95% CI, .77-.99), and older age (per year) (OR, .96; 95% CI, .96-.97) were associated with a decreased likelihood of having a complete colonoscopy. Men were more likely than women to have a higher completion rate (OR, 1.46; 95% CI, 1.30-1.63). Gastroenterology specialty (OR, 1.78; 95% CI, 1.56-2.03) and an ADR ≥25% (OR, 2.01; 95% CI, 1.79-2.26) were associated with an increased likelihood of cecal intubation. These endoscopist-related factors were also observed to be predictive of cecal intubation in a subset of thin (BMI &lt;25) women. Men and obese patients (BMI ≥30) were more likely to have incomplete examinations halted in the right-sided versus left-sided colon.</div></div><div><h3>Conclusions</h3><div>Even after adjusting for endoscopist factors, our study demonstrated that older or female patients and those with a BMI &lt;25 or ≥30 had lower colonoscopy completion rates. Our data also suggest that colonoscopies performed in thin women were more likely to be completed if they were performed by a gastroenterologist as opposed to a nongastroenterologist.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 393-400.e1"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}