Endoscopy International Open最新文献

{"title":"Correction: Green endoscopy, one step toward a sustainable future: Literature review.","authors":"Marcello Maida, Alessandro Vitello, Endrit Shahini, Roberto Vassallo, Emanuele Sinagra, Socrate Pallio, Giuseppinella Melita, Daryl Ramai, Marco Spadaccini, Cesare Hassan, Antonio Facciorusso","doi":"10.1055/a-2649-7488","DOIUrl":"https://doi.org/10.1055/a-2649-7488","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2303-8621.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"12 8","pages":"C5"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636561","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":"Bowel preparation assessment using artificial intelligence: Systematic review.","authors":"Kristoffer Mazanti Cold, Amaan Ali, Lars Konge, Flemming Bjerrum, Laurence Lovat, Omer Ahmad","doi":"10.1055/a-2625-6327","DOIUrl":"10.1055/a-2625-6327","url":null,"abstract":"<p><strong>Background and study aims: </strong>Insufficient bowel preparation is the leading cause of missed adenomas in colonoscopy. The Boston Bowel Preparation Scale (BBPS) is the most thoroughly validated and widely used scale to estimate risk of missed adenomas. Artificial intelligence (AI) could automatically quantify bowel preparation, thus reducing bias and limitations inherent in human rating. This systematic review aimed to identify, describe, and evaluate all AI-BPS systems for colonoscopy.</p><p><strong>Methods: </strong>A systematic literature review was conducted using MEDLINE, EMBASE, and SCOPUS based on three sets of terms aligned with the inclusion criteria: colonoscopy, BPS, and AI. Two reviewers independently evaluated and completed data extraction from the articles.</p><p><strong>Results: </strong>A total of 1,449 studies were identified, with eight meeting the eligibility criteria. Six AI-BPS systems were trained on expert BBPS ratings, and two studies used a fecal-mucosal ratio. All studies compared their AI-BPS with expert BBPS ratings; two showed that their AI-BPS outperformed expert BBPS ratings, and six showed comparable performances. Three studies also demonstrated correlations with adenoma detection rates (ADRs), adenoma miss rates (AMRs), or polyp detection rates (PDRs). Only one prospective study implemented its AI-BPS, finding lower AMR in adequately prepared compared with inadequately prepared bowels.</p><p><strong>Conclusions: </strong>AI-BPS can standardize and outperform human bowel preparation evaluation by better correlating with expert BBPS ratings, AMR, ADR, and PDR. Further research following recommended reporting guidelines is needed to allow for cross-study comparisons and meta-analysis, which was not possible in this study due to heterogonous study design and reporting metrics.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26256327"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559493","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":"Non-insufflation endoscopic intermuscular dissection in the management of a rectal neuroendocrine tumor.","authors":"Xiangji Liu, Jingjing Yao, Jing Wang, Taiping Wang, Haiyan Zhang, Ling Wang, Jindong Fu","doi":"10.1055/a-2616-6799","DOIUrl":"10.1055/a-2616-6799","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26166799"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559516","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":"Diagnostic performance and agreement of auditors for evaluation of computer-aided optical polyp diagnosis: Prospective study.","authors":"Felix Huang, Thea Iulia Dimbu, Douglas K Rex, Heiko Pohl, Cesare Hassan, Roupen Djinbachian, Victoire Michal, Dong Hyun Kim, Bilal Amani, Nahlah Haddouch, Sofie Fournier, Daniel von Renteln","doi":"10.1055/a-2631-8030","DOIUrl":"10.1055/a-2631-8030","url":null,"abstract":"<p><strong>Background and study aims: </strong>Guidelines recommend independent auditing of diagnostic performance for clinical implementation of computer-aided optical polyp diagnosis (CADx). This study evaluated diagnostic performance and interobserver agreement of auditors and offered guidance on conducting CADx audits.</p><p><strong>Methods: </strong>Images and videos of all ≤ 5-mm polyps from a large, prospective study with systematic activation of CADx were audited by three expert endoscopists. Experts performed independent, blinded diagnostic review including documentation of confidence level. The primary outcome was sensitivity of audit by three experts for high-confidence adenomas compared with pathology. Secondary outcomes included number of reviewers for optimal CADx auditing and interobserver agreement.</p><p><strong>Results: </strong>Four hundred eighty-seven diminutive polyps were audited (510 patients). Sensitivity was 99.4% (95% confidence interval [CI] 96.0-100) using three experts (Strategy A); 88.7% (95% CI 84.1-92.1) using two experts and one referee (Strategy B); 99% (95% CI 96-99.8), 98.8% (95% CI 95.4-99.8), and 99.4% (95% CI 96.3-100) using two-expert combinations (Strategy C); and 98.2% (95% CI 95.1-99.4), 97.3% (95% CI 94.0-98.9), and 88.9% (95% CI 83.6-92.7) for each expert individually (Strategy D). Among 266 pathology-based adenomas, Strategy A evaluated 160 polyps versus 196, 172, and 170 in Strategy C; and 220, 223, and 207 in Strategy D. Strategy B evaluated all 266 adenomas. Overall interobserver agreement was moderate (kappa 0.52), but very high for high-confidence adenomas (kappa 0.89).</p><p><strong>Conclusions: </strong>Expert audit for evaluating CADx resulted in high sensitivity and interobserver agreement for high-confidence adenomas. Audit by two experts, with a third expert for arbitration, permitted audit of all polyps and effective assessment of CADx within clinical studies.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26318030"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559496","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":"Bridging the gap in gastrointestinal healthcare in a resource-limited setup: Feasibility study of weekend endoscopy services in Southwest Ethiopia.","authors":"Guda Merdassa Roro, Elias Merdassa Roro, Tsegaye Melaku, Esayas Kebede Gudina","doi":"10.1055/a-2625-6225","DOIUrl":"10.1055/a-2625-6225","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopy is essential for diagnosis and management of gastrointestinal disorders. However, its accessibility in Africa is limited by the need for extensive training and costly equipment. This study aimed to assess the feasibility of a weekend outreach endoscopy service led by a trained gastroenterologist in southwest Ethiopia, where endoscopy services were previously unavailable.</p><p><strong>Patients and methods: </strong>A weekend outreach endoscopy service was launched in 2019 at a primary hospital in Jimma City, located 360 km from Addis Ababa. Procedures were performed using the Fujinon EPX-2500-HD system. Demographic data, endoscopy findings, and histology results were documented electronically. Findings were compared with those from four Ethiopian referral hospitals offering full-time endoscopy services.</p><p><strong>Results: </strong>A total of 2165 esophagogastroduodenoscopies (EGDs) were performed with a diagnostic yield of 93.3%. The most common indications for EGD were dyspepsia (53.7%) and dysphagia (17.0%). Patients who underwent endoscopy for alarm symptoms as an indication had a 77% to 83% chance of having a major finding compared with those with dyspepsia without an alarm symptom (24%). Squamous cell carcinoma (40.2%), adenocarcinoma (29.6%), and chronic nonspecific inflammation (16.2%) were the predominant histologic findings among those who had a biopsy (n = 425).</p><p><strong>Conclusions: </strong>The study demonstrates the feasibility and effectiveness of a weekend outreach endoscopy service led by a trained gastroenterologist in a rural Ethiopian setting. The unexpectedly high prevalence of upper gastrointestinal disorders, including cancers, and the long duration of symptoms before endoscopy likely reflect delayed diagnoses due to limited access to endoscopy. Moreover, presence of alarm symptoms predicted major endoscopic findings. Expanding endoscopy services, increasing public awareness, and further research into risk factors and preventive strategies for these diseases are recommended.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26256225"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559494","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":"Effectiveness and safety of endoscopic submucosal dissection for residual or recurrent colorectal neoplasia: Meta-analysis.","authors":"Maximilian Eisele, Alessandra Ceccacci, Mehul Gupta, Emily Heer, Sherif Elhanafi, Saowanee Ngamruengphong, Nirav Thosani, Jordan Iannuzzi, Puja Kumar, Paul Belletrutti, Richdeep Gill, Nauzer Forbes","doi":"10.1055/a-2606-0982","DOIUrl":"10.1055/a-2606-0982","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a potentially surgery-sparing technique for colorectal neoplasia resection. Outcomes of ESD for residual or recurrent colorectal neoplasia are not well described. This meta-analysis aimed to evaluate the effectiveness and safety of ESD in treating residual or recurrent colorectal neoplasia.</p><p><strong>Patients and methods: </strong>We searched MEDLINE and Embase up to July 24, 2023 for studies on ESD for residual or recurrent colorectal neoplasia at prior surgery or endoscopic resection sites. The primary outcome of the meta-analysis was R0 resection; secondary outcomes included recurrence, adverse events (AEs), procedure time, and hospitalization length. Pooled effect sizes were obtained using inverse variance random effects models. Subgroup analyses were based on study location, lesion size, and endoscopist experience.</p><p><strong>Results: </strong>From 1,133 abstracts, data from 25 observational studies were included, reporting on 863 residual or recurrent lesions treated with ESD. R0 resection was achieved in 80.7% of patients (95% confidence interval 72.7-86.7%, I ² = 81%) of patients, whereas recurrence occurred in 2.0% (0.7-5.1%, I ² = 0%). Incidence of delayed bleeding and delayed perforation were 1.8% (0.7-4.2%, I ² = 0%) and 1.9% (0.6-6.3%, I ² = 35%), respectively. The former was independent of country of study, recurrent lesion size, or endoscopist experience. Mean procedure duration was 80.4 minutes (66.6-94.2, I ² = 96%) and hospitalization length was 4.2 days (2.0-6.4, I ² = 98%).</p><p><strong>Conclusions: </strong>This meta-analysis suggests that ESD is effective and safe for treating residual or recurrent colorectal neoplasia after previous resection, with further prospective validation studies needed to compare ESD with other endoscopic resection methods and surgery in this context.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26060982"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559498","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":"Retrospective study comparing rectal endoscopic submucosal dissection with and without Foley catheter drainage tube placement.","authors":"Yuka Kagaya, Hiroaki Ishii, Yoshikazu Hayashi, Hiroki Hayashi, Satoshi Sato, Stefano Kayali, Kohei Suzuki, Takaaki Morikawa, Masahiro Okada, Takahito Takezawa, Ayman Qawasmi, Keijiro Sunada, Hirotsugu Sakamoto, Tomonori Yano, Hironori Yamamoto","doi":"10.1055/a-2631-7694","DOIUrl":"10.1055/a-2631-7694","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for rectal tumors but maintaining a clear surgical field during the procedure is challenging, especially for novice operators. This study aimed to investigate whether continuous drainage using a Foley catheter could enhance efficiency and safety of rectal ESD performed by novice endoscopists under expert supervision.</p><p><strong>Patients and methods: </strong>This retrospective study involved 26 patients who underwent rectal ESD between March 2023 and October 2024. Patients were divided into two groups: those who received continuous drainage with Foley catheter placement (n = 12) and those who did not (n = 14). Key outcomes evaluated were dissection speed, total procedure time, R0 resection rates (complete tumor resection with clear margins), and occurrence of any adverse events (AEs) during or after the procedure. All procedures were performed by novice endoscopists under expert guidance.</p><p><strong>Results: </strong>The results showed that dissection speed was significantly higher in the Foley catheter group, with a median of 18.6 mm²/min compared with 10.5 mm²/min in the non-catheter group ( <i>P</i> = 0.027). Although total procedure time and sodium hyaluronate usage were lower in the catheter group, these differences were not statistically significant. Importantly, no AEs were reported in either group.</p><p><strong>Conclusions: </strong>Foley catheter placement notably improved efficiency of rectal ESD performed by novice endoscopists, particularly by increasing dissection speed. This technique may contribute to safer and more effective ESD. However, larger studies are needed to confirm these findings and further assess their benefits.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26317694"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559530","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":"Exegesis on using a customized GPT to provide guideline-based recommendations for the management of pancreatic cystic lesions.","authors":"Ilker Sengul, Demet Sengul","doi":"10.1055/a-2605-1215","DOIUrl":"10.1055/a-2605-1215","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051215"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559511","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":"Mobile health technology in quality assessment of pediatric ileocolonoscopy: Results of the SIGENP national program.","authors":"Salvatore Oliva, Giusy Russo, Lucia Cococcioni, Francesca Destro, Marco Deganello Saccomani, Claudia Banzato, Barbara Parma, Giulia Franchino, Giovanni Di Nardo, Emanuele Nicastro, Paolo Orizio, Emanuele Dabizzi, Giorgio Raffaele Fava, Andrea Chiaro, Maristella Pellegrino, Fabiola Fornaroli, Antonio Pizzol, Caterina Strisciuglio, Caterina Pacenza, Sara Renzo, Cosimo Ruggiero, Francesco Morotti, Lorenzo Norsa","doi":"10.1055/a-2592-2914","DOIUrl":"10.1055/a-2592-2914","url":null,"abstract":"<p><strong>Background and study aims: </strong>Currently, there is no formal quality assessment of pediatric gastrointestinal endoscopy. We innovatively used mobile health (mHealth) technology to determine the quality of pediatric ileocolonoscopy (IC) in Italy.</p><p><strong>Methods: </strong>Between April 2019 and March 2021, we prospectively collected data (demographics, procedure information, pre/intra/post-procedure indicators, patient satisfaction questionnaires) from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition using the ENDO-PED mobile app.</p><p><strong>Results: </strong>Of 3410 registered procedures, 827 ICs were analyzed. Mean patient age was 11.1 ± 4.7 years. The most frequent indication was IBD follow-up or diagnosis (57.9%). Therapeutic ICs accounted for 11%, with polypectomy being the most common procedure. Among pre-procedure indicators, waiting time < 30 days was reported in 70.7%, informed consent was signed in 99.8% of cases, and 90.8% of patients completed > 90% of bowel preparation. In terms of intra-procedure indicators, deep sedation was the most commonly used method (77.8%). A high level of bowel cleansing was achieved in 87.4% of patients, with a terminal ileal (TI) intubation rate of 91.6%. Mean IC time with and without TI intubation was 24.2 ± 15.5 and 22.6 ± 15.6 minutes, respectively ( <i>P</i> =0.2). Regarding post-procedure indicators, late complications occurred in three children (0.4%), and a final report was issued in 96% of cases, with 67.2% being completed after more than 15 days.</p><p><strong>Conclusions: </strong>mHealth was effective in assessing the quality of pediatric endoscopy. Levels of bowel preparation, sedation, TI intubation rate, and safety were adequate in Italy, whereas waiting time and post-procedure communication seemed to be the most critical areas of concern.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25922914"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559515","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":"Positive provocative testing and symptom evaluation for detecting upper extremity repetitive use injuries among endoscopists.","authors":"Gregory Toy, Elizabeth Cardell, John C Fang, Jamie Latham, Natalie Mudrow, Kathryn Byrne, Daryl Ramai","doi":"10.1055/a-2606-1076","DOIUrl":"10.1055/a-2606-1076","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopists have reported experiencing musculoskeletal pain, yet a comprehensive and objective investigation into repetitive use symptoms or injuries has not been conducted. We aimed to evaluate a cohort of endoscopists for upper extremity repetitive use injury.</p><p><strong>Methods: </strong>We employed a 43 author-developed questionnaire as well as the validated QuickDASH (Disability of Arm, Shoulder, Hand) questionnaire. Subjects were evaluated by occupational therapists to identify clinical evidence of injury. Demographic factors, reported symptoms, and signs of injury were then analyzed.</p><p><strong>Results: </strong>Overall, 34.3% reported experiencing pain while 17.1% reported numbness. In the prior week, 48.5% of participants had been bothered by pain, 11.4% felt tingling, 17.1% experienced interrupted sleep, and 17.1% reported limitations in work duties. Physical testing revealed that many endoscopists had below-normal strength in their right grip (48.6%) and left grip (42.9%), and 88.6% had below-normal pinch strengths for their age and gender. In addition, 71.4% of the group had at least one abnormal positive provocative test. Participants who reported numbness at night ( <i>P</i> = 0.015) and those who reported current pain ( <i>P</i> < 0.001) reported higher DASH disability scores. Current pain was also associated with performing 20+ procedures per week ( <i>P</i> = 0.007). Those with a positive provocative test of the neck or elbow were likely to have below-normal pinch ( <i>P</i> < 0.05) and grip strength ( <i>P</i> < 0.05). Performing ERCP 20% to 60% of the week was more likely to result in decreased bilateral pinch strength.</p><p><strong>Conclusions: </strong>Our study found a high prevalence of repetitive use injury symptoms among endoscopists, corroborated by objective physical examination and testing.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26061076"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559518","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}