Endoscopy International Open最新文献

{"title":"Successful endoscopic submucosal dissection of a duodenal neuroendocrine tumor close to the major papilla with traction from rubber band and clips.","authors":"Xiwei Ding, Guifang Xu, Shanshan Shen, Lei Wang","doi":"10.1055/a-2558-5086","DOIUrl":"https://doi.org/10.1055/a-2558-5086","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25585086"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076641","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":"Use of artificial intelligence to measure colorectal polyp size without a reference object.","authors":"Chin-Yuan Yii, Ding-Ek Toh, Tzu-An Chen, Wei-Lun Hsu, Huang-Jen Lai, Yin-Chen Wang, Chang-Ru Liu, Yow-Chii Kuo, Shih-Hao Young, Fu-Ming Chang, Chen Lin","doi":"10.1055/a-2556-1836","DOIUrl":"https://doi.org/10.1055/a-2556-1836","url":null,"abstract":"<p><strong>Background and study aims: </strong>Polyp size is crucial for determining colonoscopy surveillance intervals. We present an artificial intelligence (AI) model for colorectal polyp size measurement without a reference object.</p><p><strong>Methods: </strong>The regression model for polyp size estimation was developed using outputs from two SegFormer models, segmentation and depth estimation. Initially built on colonoscopic images of polyp phantoms, the model underwent transfer learning with 1,304 real-world images. Testing was conducted on 178 images from 52 polyps, independent of the training set, using a snare as the ground truth for size comparison with the AI-based model. Polyps were classified into three size groups: ≤ 5 mm, 5-10 mm, and ≥ 10 mm. Error rates were calculated to evaluate discrepancies in actual size values between the AI model and the snare method. Precision indicated the positive predictive value per size group and recall and Bland-Altman were also conducted.</p><p><strong>Results: </strong>The Bland-Altman analysis showed a mean bias of -0.03 mm between methods, with limits of agreement from -1.654 mm to 1.596 mm. AI model error rates for actual size discrepancies were 10.74%, 12.36%, and 9.89% for the ≤ 5 mm, 5-10 mm, and ≥ 10 mm groups, respectively, averaging 11.47%. Precision values were 0.870, 0.911, and 0.857, with overall recall of 0.846.</p><p><strong>Conclusions: </strong>Our study shows that colorectal polyp size measurement by AI model is practical and clinically useful, exhibiting low error rates and high precision. AI shows promise as an accurate tool for measurement without the need for a reference object during screening colonoscopy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25561836"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076643","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":"Interobserver variability in lymph node evaluation with endoscopic ultrasonography in cholangiocarcinoma.","authors":"David Michaël de Jong, Daniëlle Roosterman, Marco J Bruno, Lydi M J W van Driel, Wim J Lammers","doi":"10.1055/a-2577-5449","DOIUrl":"https://doi.org/10.1055/a-2577-5449","url":null,"abstract":"<p><strong>Background and study aims: </strong>Accurate preoperative lymph node (LN) assessment is crucial for patients with intrahepatic cholangiocarcinoma (iCCA) and perihilar cholangiocarcinoma (pCCA) because presence of LN metastases significantly reduces survival rates and can contraindicate surgical resection. Endoscopic ultrasound (EUS) provides a reliable method for LN assessment with the advantage of enabling tissue acquisition for pathological confirmation. This study aimed to assess interobserver agreement among endosonographers in evaluating LN characteristics in patients with iCCA and pCCA.</p><p><strong>Methods: </strong>A cross-sectional survey study was conducted among 24 endosonographers. Participants reviewed 42 EUS images from iCCA and pCCA patients, classifying LNs based on six characteristics (demarcation, shape, echogenicity, homogeneity, suspiciousness, and need to retrieve tissue). Interobserver agreement was determined using Light's kappa statistics. Accuracy, sensitivity, and specificity in identifying malignant LNs were calculated.</p><p><strong>Results: </strong>Overall kappa values indicated moderate to fair agreement on LN characteristics, with Kappa values of 0.24 for demarcation, 0.45 for shape, 0.38 for echogenicity, 0.52 for homogeneity, and 0.36 for suspiciousness. Overall accuracy of endosonographers in correctly identifying malignant LNs was 62%, with individual accuracy ranging from 44 to 75%. Sensitivity was 60% (range: 29%-90%) and specificity was 64% (range: 28%-89%).</p><p><strong>Conclusions: </strong>Endosonographic assessment of LN morphology and characterization demonstrates considerable variability among endosonographers. Thus, there is a clear need for standardization in preoperative LN evaluation, including establishing consensus about when to perform tissue acquisition, based on objective criteria such as short-axis diameter. Further research is required to refine and optimize these guidelines.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25775449"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076703","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":"Pilot evaluation of a novel, automated ergonomics assessment tool.","authors":"Bara El Kurdi, Sumbal Babar, Ali Soroush, Jay Bapaye, Reid D Wasserman, Juan Echavarria, Omer Shahab, Cameron Locke, Jamie Yang, Michael Koachman, Klaus Mönkemüller, Aasma Shaukat","doi":"10.1055/a-2568-9610","DOIUrl":"10.1055/a-2568-9610","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroenterologists are prone to endoscopy-related musculoskeletal injuries (ERI). Current interventions lack real-time monitoring and feedback. ErgoGenius, a novel artificial intelligence computer-vision tool, addresses this gap by providing continuous posture assessment and feedback without wearable motion trackers. The aim of this study was to determine the feasibility of ErgoGenius, its accuracy compared with human appraisers, and its ability to detect abnormal posture.</p><p><strong>Methods: </strong>The study was conducted at two large academic centers. The Rapid Entire Body Assessment (REBA) score was used as a surrogate for ergonomic performance and risk of injury. Ten endoscopists of varying gender, height, and weight were recorded performing endoscopic tasks in optimal vs. lowered bed positions. Videos were analyzed by ErgoGenius. A paired <i>t</i> -test was used to compare REBA scores between bed positions.</p><p><strong>Results: </strong>ErgoGenius was successfully deployed in a controlled endoscopy setting. ErgoGenius achieved perfect internal agreement (rho = 1) and closely correlated with human appraisers (rho = 0.987). Average REBA scores were notably higher in the lowered bed position (mean 4.64) compared with the optimal position (mean 2.55), ( <i>P</i> = 0.006).</p><p><strong>Conclusions: </strong>ErgoGenius was successfully deployed to detect abnormal postures related to changes in bed position and quantify ERI risk. It performed at par with human appraisers. This tool shows promise in enhancing ergonomic practices among gastroenterologists and trainees, potentially leading to better health outcomes and reduced injury.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25689610"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076711","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":"Contrast-enhanced vs. standard endoscopic ultrasound fine-needle aspiration for diagnosing malignant biliary tumors: Randomized controlled trial.","authors":"Rares Ilie Orzan, Sorana D Bolboacă, Cristina Pojoga, Claudia Hagiu, Ofelia Mosteanu, Ioana Rusu, Voicu Rednic, Radu Seicean, Nadim Al Hajjar, Renata Agoston, Andrada Seicean","doi":"10.1055/a-2569-8969","DOIUrl":"https://doi.org/10.1055/a-2569-8969","url":null,"abstract":"<p><strong>Background and study aims: </strong>Contrast-enhanced endoscopic ultrasound (CH-EUS) is superior to standard EUS for staging biliary duct tumors (BDTs), but its role in guiding EUS-guided fine needle aspiration (EUS-FNA) remains unclear. We compared diagnostic accuracy of CH-EUS-fine needle aspiration (CH-EUS-FNA) and standard EUS-FNA in patients with suspected malignant biliary stenosis.</p><p><strong>Patients and methods: </strong>A parallel randomized controlled trial was conducted in a tertiary medical center and included jaundiced patients with suspected malignant biliary stenosis on computed tomography. The patients were assigned randomly to EUS-FNA or CH-EUS-FNA groups. Final diagnosis was determined based on EUS-FNA, surgical specimen results, endoscopic retrograde cholangiopancreatography (ERCP), or 12-month follow-up.</p><p><strong>Results: </strong>Sixty-one patients were included in the study, 31 in the EUS-FNA group and 30 in the CH-EUS-FNA group. Mean age of participants was 74 ± 11.04 years and mean tumor size was 20.39 ± 9.17 mm, with 43 tumors in the distal bile duct. Final diagnoses were cholangiocarcinoma (37 cases), pancreatic ductal carcinoma (12 cases), other malignancies (3 cases), and benign lesion (9 cases). Diagnostic sensitivity, specificity, and accuracy were 83.3%, 100%, and 87.1% for EUS-FNA, and 82.1%, 100%, and 83.3% for CH-EUS-FNA. Plastic biliary stent placement and tumor location did not influence results. Hyperenhancement in the CH-EUS with rapid washout was observed in 90.9% of cholangiocarcinoma cases.</p><p><strong>Conclusions: </strong>Standard EUS-FNA and CH-EUS-FNA demonstrated comparable diagnostic accuracy in evaluation of extrahepatic bile duct tumors, but with better slightly efficiency and inaccuracy indices than standard EUS-FNA.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25698969"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076637","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":"Biliary stent insertion after stone clearance in patients awaiting cholecystectomy: Systematic review and meta-analysis.","authors":"Marco Valvano, Daniele Balducci, Antonio Vinci, Andrea Ghezzi, Shirin Djahandideh, Stefano Fabiani, Gianpiero Stefanelli, Silvia Buccilli, Amedeo Montale, Filippo Antonini, Luca Maroni, Chiara Campanale","doi":"10.1055/a-2586-6007","DOIUrl":"https://doi.org/10.1055/a-2586-6007","url":null,"abstract":"<p><strong>Background and study aims: </strong>Laparoscopic cholecystectomy is the standard treatment for patients with cholecystitis or gallbladder stones after common bile duct (CBD) clearance. According to the sequential strategy, cholecystectomy should be performed within 2 weeks after CDB clearance with endoscopic retrograde cholangiopancreatography (ERCP). However, in real-life experience, the average waiting time is 60 to 180 days. We aimed to evaluate the clinical rationale for prophylactic stent placement in CBD to prevent recurrent biliary events.</p><p><strong>Patients and methods: </strong>This systematic review and meta-analysis was performed following a protocol designed a priori (PROSPERO: CRD42024564804; July 13, 2024). All published studies involving patients who had undergone ERCP for CBDs and who were awaiting cholecystectomy were included.</p><p><strong>Results: </strong>At the end of the revision process, four full texts including 755 patients were included in the meta-analysis. The odds ratio (OR) for symptom recurrence in patients awaiting cholecystectomy was 0.74 (95% confidence interval [CI] 0.30-1.79; I ² 67%). The pooled OR for adverse event occurrence was 0.74 (95% CI 0.45-1.24) in the stent group. The post-ERCP pancreatitis and cholangitis risk were 0.76 (95% CI 0.25-2.34) and 0.92 (95% CI 0.31-2.67), respectively.</p><p><strong>Conclusions: </strong>This meta-analysis showed no benefit for stent insertion after bile duct clearance in patients scheduled for delayed cholecystectomy. Further randomized controlled trials with bigger cohorts are needed to assess any benefit for this procedure, which in the meantime, cannot be recommended.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25866007"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076700","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":"Impact of age and comorbidities on colorectal endoscopic submucosal dissection outcomes: Large multicenter study in a Western cohort.","authors":"Sandro Sferrazza, Giulio Calabrese, Marcello Maida, Antonio Capogreco, Roberto de Sire, Paolo Cecinato, Romano Sassatelli, Giuseppe De Roberto, Federico Barbaro, Cristiano Spada, Michele Francesco Chiappetta, Francesco Pugliese, Francesco Cutolo, Mauro Manno, Paola Soriani, Erik Rosa Rizzotto, Alessandro Gubbiotti, Gianluca Andrisani, Francesco Di Matteo, Francesco Azzolini, Alessandro Repici, Roberto Di Mitri, Roberta Maselli","doi":"10.1055/a-2568-1366","DOIUrl":"https://doi.org/10.1055/a-2568-1366","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) has emerged as the standard treatment for colorectal lesions. Considering aging of the global population, we aimed to assess effectiveness and safety of colorectal ESD in patients aged ≥ 80 years compared with those aged 65 to 79 years in a large Western cohort.</p><p><strong>Patients and methods: </strong>We retrospectively enrolled patients aged > 64 years undergoing colorectal ESD, classifying them into a very elderly group (VE-Group, aged > 80 years) and elderly group (E-Group, 65-79 years). Procedure outcomes and safety were compared between the VE-Group and E-Group and between patients with comorbidities and those who were healthy (1-CM-Group and H-Group).</p><p><strong>Results: </strong>A total of 980 patients were included (269; 27.5% in the VE-Group and 711; 72.5% in the E-Group). En-bloc, R0, and oncological curative resection rates did not differ, nor did intra-procedure or post-procedure adverse events (AEs). Delirium occurrence was registered in VE-group [6 (2.2%) in VE-Group vs 1 (0.1%) in E-Group; <i>P</i> = 0.001; OR = 16.2, (95%CI:1.9-135.2)]. The 1-CM-Group had a higher rate of intra-procedure bleeding ( <i>P</i> = 0.001), delayed perforation ( <i>P</i> = 0.03), fever onset ( <i>P</i> < 0.001), and systemic infections ( <i>P</i> = 0.02) compared with the H-Group. Having one or more comorbidities was associated with increased overall AEs ( <i>P</i> < 0.001; OR 2.3, 95% CI 1.5-3.6).</p><p><strong>Conclusions: </strong>Colorectal ESD is feasible in elderly patients. Physicians should consider delirium a possible AE in patients older than age 80 years. These findings, which bridge the gap between Asian and Western clinical data, underscore the importance of tailored pre-procedure and post-procedure assessments in a global clinical context.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25681366"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076722","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":"Journey to complete remission of dysplasia and intestinal metaplasia after ESD and EMR of Barrett's esophagus-related neoplasia.","authors":"Abel Joseph, Kornpong Vantanasiri, Rohit Goyal, Nikita Garg, Cadman Leggett, D Chamil Codipilly, Kenneth Wang, William S Harmsen, John J Vargo, Sunguk Jang, Prasad Iyer, Amit Bhatt","doi":"10.1055/a-2422-2815","DOIUrl":"https://doi.org/10.1055/a-2422-2815","url":null,"abstract":"<p><strong>Background and study aims: </strong>Although endoscopic submucosal dissection (ESD) is associated with higher en-bloc and R0 resection rates than cap-assisted endoscopic mucosal resection (cEMR), its comparative impact on achieving complete remission of dysplasia (CRD) and intestinal metaplasia (CRIM) in BE endoscopic eradication therapy (EET) is not well defined. We aimed to compare the journey of patients from initial endoscopic resection (ER) with ESD and cEMR to achieving CRD and CRIM.</p><p><strong>Patients and methods: </strong>Patients undergoing ESD or cEMR followed by ablation for BE neoplasia at two academic institutions in the United States were included. Primary outcomes included CRD and CRIM rates following ER in the two groups. Secondary outcomes included the number of resection/ablative procedures from initial ER to achieving CRD and CRIM. Inverse probability treatment weighting (IPTW) was used to balance confounding variables between groups.</p><p><strong>Results: </strong>A total of 801 patients (606 cEMR, 195 ESD) were included. ESD group patients had higher en-bloc resection rates (ESD 94.4%, cEMR 44.7%). Higher rates of CRD were observed in patients undergoing initial ESD (HR 1.53, <i>P</i> < 0.01). With time-to-event and IPTW analyses, rates of achieving CRD and CRIM were comparable between the groups. There were no significant differences in mean number of endoscopic resection or ablative procedures among patients undergoing initial cEMR resection compared with those treated with initial ESD.</p><p><strong>Conclusions: </strong>Despite larger lesion sizes and more cancers in patients undergoing ESD, the EET journey to achieving CRD and CRIM was comparable to that in patients receiving cEMR. Prospective studies are required to further study differences between these two treatment approaches.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24222815"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076706","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":"Longitudinal mucosal incision prior to balloon dilation: Novel and advanced approach for severe esophageal stenosis.","authors":"Ippei Tanaka, Gantuya University Koto Toyosu Boldbaatar, Kei Ushikubo, Kazuki Yamamoto, Yohei Nishikawa, Mayo University Koto Toyosu Tanabe, Haruhiro Inoue","doi":"10.1055/a-2569-8517","DOIUrl":"10.1055/a-2569-8517","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25698517"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076707","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":"Endoscopic ultrasound-guided antegrade stenting under guiding sheath assistance for malignant distal biliary obstruction.","authors":"Tadahisa Inoue, Rena Kitano, Tomoya Kitada, Kazumasa Sakamoto, Satoshi Kimoto, Jun Arai, Kiyoaki Ito","doi":"10.1055/a-2573-8442","DOIUrl":"https://doi.org/10.1055/a-2573-8442","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25738442"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076715","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}