Endoscopy最新文献

{"title":"Predicting ERCP procedure time - the SWedish Estimation of ERCP Time (SWEET) tool.","authors":"Alexander Waldthaler, Anna Warnqvist, Josefine Waldthaler, Miroslav Vujasinovic, Poya Ghorbani, Erik von Seth, Urban Arnelo, Mathias Lohr, Annika Bergquist","doi":"10.1055/a-2371-1367","DOIUrl":"10.1055/a-2371-1367","url":null,"abstract":"<p><strong>Background: </strong>The duration of an endoscopic retrograde cholangiopancreatography (ERCP) is influenced by a multitude of factors. The aim of this study was to describe the factors influencing ERCP time and to create a tool for preintervention estimation of ERCP time.</p><p><strong>Methods: </strong>Data from 74 248 ERCPs performed from 2010 to 2019 were extracted from the Swedish National Quality Registry (GallRiks) to identify variables predictive for ERCP time using linear regression analyses and root mean squared error (RMSE) as a loss function. Ten variables were combined to create an estimation tool for ERCP duration. The tool was externally validated using 9472 ERCPs from 2020 to 2021.</p><p><strong>Results: </strong>Mean (SD) ERCP time was 36.8 (25.3) minutes. Indications with the strongest influence on ERCP time were primary sclerosing cholangitis and chronic pancreatitis. Hilar and intrahepatic biliary strictures and interventions on the pancreatic duct were the anatomic features that most strongly affected ERCP time. The procedure steps with most influence were intraductal endoscopy, lithotripsy, dilation, and papillectomy. Based on these results, we built and validated the SW: edish E: stimation of E: RCP T: ime (SWEET) tool, which is based on a 10-factor scoring system (e.g. 5 minutes for bile duct cannulation and 15 minutes for pancreatic duct cannulation) and predicted ERCP time with an average difference between actual and predicted duration of 17.5 minutes during external validation.</p><p><strong>Conclusions: </strong>Based on new insights into the factors affecting ERCP time, we created the SWEET tool, the first specific tool for preintervention estimation of ERCP time, which is easy-to-apply in everyday clinical practice, to guide efficient ERCP scheduling.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":"31-40"},"PeriodicalIF":11.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound-guided entero-colostomy with lumen-apposing metal stent as a rescue treatment for malignant intestinal occlusion: a multicenter study.","authors":"Benedetto Neri, Serena Stigliano, Dario Biasutto, Nicolò Citterio, Andrea Lisotti, Pietro Fusaroli, Benedetto Mangiavillano, Gianfranco Donatelli, Giuseppe Tonini, Francesco Maria Di Matteo","doi":"10.1055/a-2354-3352","DOIUrl":"10.1055/a-2354-3352","url":null,"abstract":"<p><strong>Background: </strong>Surgery is the first-choice treatment for malignant intestinal obstruction (MIO); however, many patients are deemed unfit for surgery. Endoscopic ultrasound-guided entero-colostomy (EUS-EC) with a lumen-apposing metal stent (LAMS) could represent a new treatment option.</p><p><strong>Methods: </strong>Consecutive patients undergoing EUS-EC for MIO from November 2021 to September 2023 at four European tertiary referral centers were retrospectively enrolled. Multidisciplinary meetings determined whether patients were unsuitable for surgery or colonic stent placement, or refused surgery. The primary outcome was technical success of EUS-EC and secondary outcomes were clinical outcome, safety, and hospital stay.</p><p><strong>Results: </strong>12 patients were enrolled (median age 72.5 [range 42-85] years; 58.3% female). Colonic adenocarcinoma was the primary tumor in 75.0% of patients and 91.7% had stage IV disease. Technical success was 100%. No LAMS misdeployment or other procedural adverse events occurred; three patients (25.0%) had severe post-procedural complications. Clinical success was achieved in 10 patients (83.3%), with 5 (50.0%) resuming chemotherapy after the procedure. Median post-procedural hospital stay was 9 (1-20) days and median overall survival was 47.5 (2-270) days.</p><p><strong>Conclusions: </strong>EUS-EC was a feasible technique and could be considered a possible alternative to standard approaches for MIO in highly selected patients.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":"77-82"},"PeriodicalIF":11.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141455958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic Clip Closure in Preventing Delayed Bleeding After Colorectal Endoscopic Submucosal Dissection on anticoagulants: A multicenter retrospective cohort study in Japan.","authors":"Kazunori Takada, Naohisa Yoshida, Yoshikazu Hayashi, Daichi Togo, Shiro Oka, Shusei Fukunaga, Yoshinori Morita, Takemasa Hayashi, Kazunori Kozuka, Yosuke Tsuji, Takashi Murakami, Takeshi Yamamura, Yoriaki Komeda, Yoji Takeuchi, Kensuke Shinmura, Hiroko Fukuda, Shinji Yoshii, Shouko Ono, Shinichi Katsuki, Kazumasa Kawashima, Daiki Nemoto, Hiroyuki Yamamoto, Yutaka Saito, Naoto Tamai, Aya Tamura","doi":"10.1055/a-2505-7315","DOIUrl":"https://doi.org/10.1055/a-2505-7315","url":null,"abstract":"<p><strong>Background and study aims: </strong>Prophylactic clip closure after colorectal endoscopic submucosal dissection (ESD) among patients on anticoagulants is of uncertain effectiveness in reducing delayed bleeding (DB) risk. We aimed to assess the effect of prophylactic clip closure in preventing DB after colorectal ESD among patients on anticoagulants.</p><p><strong>Patients and methods: </strong>We used the ABCD-J study database, a large-scale multicenter study analyzing DB among 34,455 colorectal ESD cases from 47 Japanese institutions. DB rates among the no/partial and complete closure groups were compared in patients on direct oral anticoagulants (DOACs) and warfarin. Propensity score matching for baseline characteristics was used to reduce the effects of selection bias.</p><p><strong>Results: </strong>Overall, 1,478 cases receiving colorectal ESD on anticoagulants were examined. After propensity score matching, the complete and no/partial closure groups were compared in 212 patients on DOACs and 82 on warfarin. The complete closure group showed a significantly lower DB rate in patients receiving DOACs (10.8% vs. 5.2%, absolute risk reduction (ARR): 5.7%, P = 0.048) and warfarin (17.1% vs. 6.1%, ARR: 11.0%, P = 0.049). Additionally, complete closure significantly reduced the risk of DB among patients taking DOACs for right-sided lesions (ARR: 6.7%, P = 0.041), whereas no risk reduction was observed for left-sided (P = 1) or rectal lesions (P = 0.498). A similar trend was observed among patients on warfarin.</p><p><strong>Conclusions: </strong>Prophylactic complete clip closure after colorectal ESD significantly reduced the DB rate in patients receiving both DOACs and warfarin. It should be performed after ESD, particularly for right-sided lesions.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term clinical and technical outcomes of a modified Zenker's peroral endoscopic myotomy with mucosal flap incision.","authors":"Jose Antonio Almario, Amit Mehta, Apurva Shrigiriwar, Farimah Fayyaz, Mohamed El-Sherbiny, Karim Essam, Hany Haggag, Kerolis Yousef, Abeer A Abdallatef, Shaimaa Elkholy, Andrew Canakis, Raymond E Kim, Dennis Yang, Miguel Puga-Tejada, Juan Alcívar-Vásquez, Maria Egas-Izquierdo, Raquel S Del Valle, Domenica Cunto, Jorge Baquerizo-Burgos, Martha Arevalo-Mora, Carlos Robles-Medranda, Aleksandra Borkowicz, Michał F Kamiński, Michael Lajin, Prashant Kedia, Mouen A Khashab","doi":"10.1055/a-2451-2869","DOIUrl":"10.1055/a-2451-2869","url":null,"abstract":"<p><p>Zenker's diverticulum peroral endoscopic myotomy (Z-POEM) is an effective treatment for symptomatic Zenker's diverticulum. A modification to Z-POEM involves mucosal flap incision (MFI). We describe the technical and clinical success of patients who underwent Z-POEM with MFI.We included patients who underwent Z-POEM with MFI for Zenker's diverticulum at eight international centers. The primary outcome was the rate of clinical success, assessed by post-procedure Kothari-Haber symptom score (KHSS) without re-treatment. Secondary outcomes included technical success, serious adverse events, and clinical recurrence with need for re-treatment.36 patients (age 69 [SD 9] years; 69% male) underwent Z-POEM with MFI for symptomatic Zenker's diverticulum. Mean diverticulum size was 3.2 (SD 1.4) cm. Clinical success was achieved in 35 patients (97%). Median baseline KHSS was 6 and median post-procedure KHSS was 0 (P < 0.001). Technical success was achieved in all cases. Mean procedure time was 57 (SD 34) minutes and median follow-up time was 196 days (interquartile range 39-499). There was one adverse event (3%), which was treated endoscopically.Z-POEM with MFI had high rates of technical and clinical success. Prospective evaluation is needed to further validate this technique in patients with a large Zenker's diverticulum.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic work-up of bile duct strictures: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.","authors":"Antonio Facciorusso, Stefano Francesco Crinò, Paraskevas Gkolfakis, Marco Spadaccini, Marianna Arvanitakis, Torsten Beyna, Michiel Bronswijk, Jahnvi Dhar, Mark Ellrichmann, Rodica Gincul, Istvan Hritz, Leena Kylänpää, Belen Martinez-Moreno, Martina Pezzullo, Mihai Rimbaş, Jayanta Samanta, Roy L J van Wanrooij, George Webster, Konstantinos Triantafyllou","doi":"10.1055/a-2481-7048","DOIUrl":"https://doi.org/10.1055/a-2481-7048","url":null,"abstract":"<p><p>1: ESGE recommends the combination of endoscopic ultrasound-guided tissue acquisition (EUS-TA) and endoscopic retrograde cholangiopancreatography (ERCP)-based tissue acquisition as the preferred diagnostic approach for tissue acquisition in patients with jaundice and distal extrahepatic biliary stricture in the absence of a pancreatic mass. 2: ESGE suggests that brushing cytology should be completed along with fluoroscopy-guided biopsies, wherever technically feasible, in patients with perihilar biliary strictures. 3: ESGE suggests EUS-TA for perihilar strictures when ERCP-based modalities yield insufficient results, provided that curative resection is not feasible and/or when cross-sectional imaging has shown accessible extraluminal disease. 4: ESGE suggests using standard ERCP diagnostic modalities at index ERCP. In the case of indeterminate biliary strictures, ESGE suggests cholangioscopy-guided biopsies, in addition to standard ERCP diagnostic modalities. Additional intraductal biliary imaging modalities can be selectively used, based on clinical context, local expertise, and resource availability.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stent misdeployment and factors associated with failure in endoscopic ultrasound-guided choledochoduodenostomy: analysis of the combined datasets from two randomized trials.","authors":"Yen-I Chen, Clara Long, Anand V Sahai, Bertrand Napoleon, Gianfranco Donatelli, Rastislav Kunda, Myriam Martel, Shannon M Chan, Paolo G Arcidiacono, Eric Lam, Pradermchai Kongkam, Nauzer Forbes, Alberto Larghi, Jeffrey D Mosko, Schalk Van der Merwe, Seng Ian Gan, Jeremie Jacques, Sana Kenshil, Thawee Ratanachu-Ek, Corey Miller, Payal Saxena, Etienne Desilets, Gurpal Sandha, Yousef Alrifae, Anthony Y B Teoh","doi":"10.1055/a-2463-1601","DOIUrl":"10.1055/a-2463-1601","url":null,"abstract":"<p><strong>Background: </strong> Stent misdeployment (SMD) is a feared and poorly characterized technical challenge of endoscopic ultrasound (EUS)-guided choledochoduodenostomy (CDS) using lumen-apposing stents. We aimed to ascertain the rate of stent misdeployment in EUS-CDS for malignant distal biliary obstruction (MDBO) and describe its outcomes while identifying variables associated with its occurrence.</p><p><strong>Method: </strong> This was a post hoc analysis of two randomized controlled trials comparing EUS-CDS vs. endoscopic retrograde cholangiopancreatography in MDBO. The primary end point was rate of SMD, classified as misdeployment of the distal flange (type I), proximal flange (type II), contralateral bile duct wall injury (type III), or double mucosal puncture (type IV). Multivariable analysis was performed to identify variables associated with SMD and/or technical failure, and with clinical failure or stent dysfunction.</p><p><strong>Results: </strong> 152 patients were included. Technical success was 93.4 %. SMD occurred in 11 patients (7.2 %; 95 %CI 3.1 %-11.4 %): 8 type I, 1 type II, and 2 type III. Endoscopic salvage of SMD was successful in 81.8 %. Misdeployment led to adverse events in four patients (two mild, two moderate), giving an overall SMD-related adverse event rate of 2.6 % (95 %CI 0.7 %-6.6 %). On multivariable analysis, extrahepatic bile duct diameter of ≤ 15 mm was associated with increased odds of SMD and/or technical failure.</p><p><strong>Conclusion: </strong> SMD was relatively common in EUS-CDS and was associated with an extrahepatic bile duct diameter of ≤ 15 mm. The majority of misdeployments could be rescued endoscopically with low risk for adverse events.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence for a rare disease.","authors":"Yuichi Mori","doi":"10.1055/a-2487-1252","DOIUrl":"https://doi.org/10.1055/a-2487-1252","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142821997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-use gastroscopes: evolution, revolution, or involution?","authors":"Enrique Rodriguez de Santiago, Heiko Pohl","doi":"10.1055/a-2490-0752","DOIUrl":"https://doi.org/10.1055/a-2490-0752","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical assessment of scars after endoscopic mucosal resection of large colorectal polyps in a multicenter, community hospital setting: is routine biopsy still necessary?","authors":"Lonne W T Meulen, Roel M M Bogie, Peter D Siersema, Bjorn Winkens, Marije S Vlug, Frank H J Wolfhagen, Martine A M C Baven-Pronk, Michael P J A van der Voorn, M P Schwartz, Lauran Vogelaar, Tom C J Seerden, W L Hazen, R W M Schrauwen, Lorenza Alvarez Herrero, Ramon Michel Schreuder, Annick B van Nunen, Gijs J de Bruin, Willem A Marsman, Marc de Bièvre, Robert Roomer, Rogier de Ridder, Maria Pellisé, Michael J Bourke, Ad Masclee, Leon Mg Moons","doi":"10.1055/a-2498-7114","DOIUrl":"https://doi.org/10.1055/a-2498-7114","url":null,"abstract":"<p><strong>Background and study aims: </strong>Piecemeal EMR of large (≥20mm) non-pedunculated colorectal polyps (LNPCPs) is succeeded by a 6-month surveillance endoscopy to evaluate the post-EMR scar for recurrence. Data from expert centers suggest that routine tattoo placement and scar biopsies can be omitted, but data from community hospitals are lacking.</p><p><strong>Patients and methods: </strong>In a post-hoc analysis of the STAR-LNPCP study (NTR7477), containing prospective data on 6-month post-pEMR scar assessments in 30 Dutch community hospitals (October 2019 to May 2022), the agreement between optical assessment and histological confirmation by routine biopsies was evaluated. Documentation of optical characteristics, imaging, and biopsies of the post-EMR scar were performed according to a standardized protocol.</p><p><strong>Results: </strong>In 1277 post-EMR scar assessments, identification of the scar was achieved in 1215/1277 (95%). Tattoo placement did not influence scar identification. Scar biopsy was performed in 1050/1215 cases (86%). Recurrences were seen in 200/1050 cases (19%). There was a good agreement between optical assessment of recurrence and histological confirmation (Cohen's kappa 0.78 [0.73-0.83]). The NPV was 98% [97-99%] and the PPV was 74% [68-80%]. Higher false positive rate was seen after prior use of clips (11% vs. 5%, p=0.017). Dedicated endoscopists identified the scar more often (96% vs. 88%, p<0.001), and showed a lower optical recurrence miss rate (1%vs. 3%, p=0.111) compared to non-dedicated endoscopists.</p><p><strong>Conclusion: </strong>Based on this multicenter community hospital study, routine tattoo placement and scar biopsies of the post-EMR scar can be omitted. Assessment of post-EMR scars by dedicated endoscopists is advised.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemospray as first-line treatment option for malignant gastrointestinal bleeding: A cost-utility analysis in the United Kingdom.","authors":"Dawn Andrew Cooper, Benjamin Norton, Neil D Hawkes, Srisha Hebbar, Andrea Telese, John Morris, Rehan Haidry, Alan Barkun","doi":"10.1055/a-2495-2813","DOIUrl":"https://doi.org/10.1055/a-2495-2813","url":null,"abstract":"<p><strong>Aims: </strong>For managing malignant upper gastrointestinal bleeding (MUGIB), randomised control trial data have shown the haemostatic powder; Hemospray (TC-325), results in greater immediate haemostasis and lower 30-day rebleeding rates than standard endoscopic therapy (SET). We sought to determine if using TC-325 as a first-line option for patients with MUGIB would be cost-effective compared with SET in the United Kingdom.</p><p><strong>Methods: </strong>A decision tree was developed among patients with MUGIB, assessing initial therapy with TC-325 or SET over a 30-day time horizon. Patients with failed initial haemostasis, or a rebleed within 30 days, underwent further endoscopic treatment, escalation to either transcatheter arterial embolisation or surgery, or radiotherapy. Overall, 30-day mortality was applied. Costs, in Great British Pounds, were based on the United Kingdom National Health Services costs for 2023/2024. Results are reported as incremental differences in cost, quality-adjusted life years, and net monetary benefit. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed.</p><p><strong>Results: </strong>The cost of treating MUGIB patients with TC-325 was £245.88 lower than SET, with an incremental increase of 0.001 Quality Adjusted Life Years (QALYs). TC-325 remained cost-saving for sensitivity and scenario analyses. Probabilistic sensitivity analysis revealed TC-325 as more effective and cost-saving in 82.0% of simulations (range 68.8-97.8%).</p><p><strong>Conclusions: </strong>Initial treatment of MUGIB with TC-325 compared to SET is more effective (higher primary haemostasis and lower 30-day rebleeding) and cost-saving due to requiring fewer interventions, readmissions, and length of stay. Additional studies are needed to address model uncertainties in the follow-up management of these complex patients.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.5,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}