Alimentary Pharmacology & Therapeutics最新文献

{"title":"Editorial: Intestinal Ultrasound for the Assessment of Constipation—Out of the Shadows? Authors' Reply","authors":"Ryan M. Mathias, Thomas M. Goodsall, Claire E. Parker, Alice S. Day, Yoon K. An, Brandon Baraty, Chamara Basnayake, Jakob Begun, Ray K. Boyapati, Rebecca Burgell, Michael T. Dolinger, Giovanni Maconi, Kerri L. Novak, Shintaro Sagami, Rebecca L. Smith, Ashish R. Srinivasan, Stuart A. Taylor, Vipul Jairath, Christopher Ma, Robert V. Bryant","doi":"10.1111/apt.70338","DOIUrl":"10.1111/apt.70338","url":null,"abstract":"<p>We appreciate the insightful comments by Vos and colleagues on our expert position statement on the role of intestinal ultrasound (IUS) in luminal contents assessment [<span>1</span>].</p><p>IUS is a rapidly evolving area emerging as an alternative modality for the assessment of disorders of gut-brain interaction (DGBI) [<span>2</span>]. Patients with DGBI are exposed to more ionising radiation than healthy controls; IUS offers safety, cost effectiveness, and accuracy over conventional assessment methods [<span>3</span>]. Until recently, however, IUS for functional assessment has remained in the realm of paediatrics, with a paucity of adult studies and a lack of description or validation of sonographic parameters [<span>4</span>].</p><p>Our position statement [<span>2</span>] was intended to serve as initial guidance and a summation of current evidence. A narrative review has further summarised available evidence on luminal contents assessment [<span>5</span>]. A study performed in a DGBI cohort did not find a correlation between sonographic findings and symptoms, but did suggest that IUS was useful in identifying those patients who would benefit from therapy for constipation rather than treatment of diarrhoea due to identification of faecal loading [<span>6</span>]. Together, these set the scene for IUS in the assessment of luminal contents in clinical practice. However, they clearly illustrate knowledge gaps and the need for further research.</p><p>Small studies have shown that IUS is as accurate as computed tomography [<span>7, 8</span>]. However, prospective, blinded, and centrally read studies are required to measure the accuracy and validity of IUS in measuring luminal contents, to improve reliability and uptake in both clinical trials and practice [<span>9</span>]. The Sonographic Examination and Assessment of Ulcerative Colitis Associated Constipation (SEE UCAC trial, ACTRN12622001207707) is the first prospective, blinded, and centrally read study to directly compare the accuracy of luminal contents assessment against CT scan with ultrasound. Interim results of 63 patients suggest close correlation between IUS and CT in assessing luminal contents as well as excellent inter-rater agreement between sonographic parameters [<span>10</span>].</p><p>The body of evidence supporting the use of IUS in clinical practice has remained in the assessment of inflammation, particularly in adults. It is now with great optimism that we see the increasing interest and growing potential of IUS in the assessment of DGBI and luminal contents emerging from the shadows into the spotlight.</p><p><b>Ryan M. Mathias:</b> conceptualization; writing – original draft. <b>Thomas M. Goodsall:</b> writing – review and editing. <b>Claire E. Parker:</b> writing – review and editing. <b>Alice S. Day:</b> writing – review and editing. <b>Yoon K. An:</b> writing – review and editing. <b>Brandon Baraty:</b> writing – review and editing. <b>Chamara Basnayake:</b> writing – r","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 8","pages":"855-856"},"PeriodicalIF":6.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Intestinal Ultrasound for the Assessment of Constipation—Out of the Shadows?","authors":"J. M. B. W. Vos, M. A. Benninga, K. B. Gecse, F. A. E. De Voogd","doi":"10.1111/apt.70300","DOIUrl":"10.1111/apt.70300","url":null,"abstract":"<p>Constipation is a common disorder of gut-brain interaction (DGBI) affecting both paediatric and adult populations [<span>1, 2</span>]. Although Rome IV criteria are the gold standard, diagnosing a patient with constipation can be challenging due to the non-specific nature of its symptoms and the overlap with other disorders. Diagnostic tools—such as digital rectal examination or radiologic modalities including abdominal X-ray, CT scan, or MRI—are invasive and come with high costs or significant radiation exposure [<span>3</span>]. This highlights the unmet need for a non-invasive, objective approach to assess constipation and faecal loading.</p><p>Intestinal ultrasound (IUS) is emerging as an ideal point-of-care tool, with a growing body of evidence supporting its use in monitoring inflammatory bowel disease [<span>4</span>]. More recently, its potential application has expanded to include the evaluation of DGBI, particularly constipation [<span>5, 6</span>]. However, standardised sonographic criteria for these conditions are lacking, and the diagnostic accuracy of IUS in constipation remains to be fully established.</p><p>To address this gap, a RAND/UCLA-modified Delphi consensus panel—comprising international experts in gastroenterology and radiology—integrated current evidence with expert opinion to develop guidance on the use of IUS in the evaluation of constipation [<span>7</span>]. The panel endorsed 43 statements supporting the use of IUS to assess luminal contents and colonic architecture. Notably, IUS was rated as an appropriate modality for detecting faecal loading across various colonic segments, including the rectum. In paediatric patients, the transverse rectal diameter was identified as a key metric: a diameter > 30 mm was considered predictive of faecal loading. This aligns with prior systematic reviews, although rectal size varies among children and is perhaps age- or sex-dependent [<span>5</span>]. Future implementation requires standardisation and assessment of reliability and reproducibility for adult and paediatric populations. In addition, a transperineal approach instead of an abdominal approach might increase accuracy, as has been demonstrated for ulcerative proctitis [<span>8</span>].</p><p>Additional sonographic features, including posterior acoustic shadowing, echogenic foci, and haustral loss, were considered useful in identifying faecal loading beyond the rectum. However, these features are not specific, as intraluminal gas may produce similar artefacts. This overlap introduces interpretation variability, particularly among less experienced operators. Although some studies have demonstrated concordance between IUS findings and CT imaging in detecting constipation-related features [<span>9, 10</span>], data remain limited. Further validation studies are needed to establish reliability against robust reference standards.</p><p>Despite current limitations, the potential of IUS in constipation assessment is substanti","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 8","pages":"853-854"},"PeriodicalIF":6.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70300","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144851081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review Article: Liver Transplantation for Hepatocellular Carcinoma in the Era of Immune Checkpoint Inhibitors","authors":"Anand V. Kulkarni,&nbsp;Amit G. Singal,&nbsp;K. Rajender Reddy","doi":"10.1111/apt.70333","DOIUrl":"10.1111/apt.70333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ablation, surgical resection and liver transplantation (LT) are curative therapies for patients with hepatocellular carcinoma (HCC). Milan Criteria and University of California San Francisco Criteria are traditionally accepted for liver transplantation, with the expectation of favourable outcomes. In recent years, immune checkpoint inhibitors (ICI) have revolutionised the management of unresectable HCC (uHCC) and are now considered first-line systemic therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>In this narrative review, we aimed to comprehensively discuss the role of ICIs in the peri-transplant period, with the goal of enhancing the chances of a successful LT for advanced HCC while also decreasing the risk of recurrence post-LT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search of PubMed and manual screening of references was performed to identify studies evaluating ICIs in the context of LT, and relevant articles were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ICIs can achieve complete response and ultimately provide long-term survival in a subset of patients. There has been an exponential increase in the use of these drugs, and increasing interest in the use of combination locoregional therapies plus ICIs as a strategy for downstaging or bridging to LT. While there can be objective responses with ICI therapy, there are potentially serious adverse events, including immune-mediated liver injury and enhanced risk of infections in the pre-LT period. Rejections and recurrence post-LT are relevant in the context of ICIs, while endeavouring to downstage or bridge HCC pre-transplant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ICI therapy is nuanced during the peri-transplant period and should therefore be selectively used in specific patients rather than being used ubiquitously.</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 6","pages":"585-601"},"PeriodicalIF":6.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70333","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Does Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) With Advanced Fibrosis Also Equate to Risk of Advanced Coronary Artery Disease?","authors":"C C Mark Cheah, B B George Goh","doi":"10.1111/apt.70323","DOIUrl":"https://doi.org/10.1111/apt.70323","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843874","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":"Editorial: Does Metabolic Dysfunction-Associated Steatotic Liver Disease With Advanced Fibrosis Also Equate to Risk of Advanced Coronary Artery Disease? Authors' Reply.","authors":"Xiao-Dong Zhou, Yusuf Yilmaz, Ming-Hua Zheng","doi":"10.1111/apt.70337","DOIUrl":"https://doi.org/10.1111/apt.70337","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843875","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":"Efficacy and Safety of Tenofovir Alafenamide (TAF) and Tenofovir Disoproxil Fumarate (TDF) Followed by TAF in Chronic Hepatitis B Patients of East Asian Ethnicity Following 5 Years of Treatment.","authors":"Grace Lai-Hung Wong,Edward Gane,Calvin Q Pan,Scott Fung,Mang M Ma,Namiki Izumi, Shalimar,Seng Gee Lim,Wan-Long Chuang,Rajiv Mehta,Young-Suk Lim,Leland J Yee,John F Flaherty,Frida Abramov,Hongyuan Wang,Maria Buti","doi":"10.1111/apt.70327","DOIUrl":"https://doi.org/10.1111/apt.70327","url":null,"abstract":"BACKGROUNDTenofovir alafenamide (TAF) has shown non-inferior efficacy to tenofovir disoproxil fumarate (TDF), with superior bone and renal safety.AIMTo characterise 5-year TAF efficacy and safety in patients of East Asian ethnicity from pivotal Phase 3 studies.METHODSPatients were randomised (2:1) to receive TAF or TDF for up to 3 years of double-blind treatment, followed by open-label TAF. Patients either continued TAF or switched from TDF to TAF at Week 96 (TDF → TAF 3 years) or Week 144 (TDF → TAF 2 years) of treatment. Efficacy endpoints (virologic, biochemical and serologic) and safety were assessed.RESULTSAmong 591 patients of East Asian ethnicity (TAF, n = 401; TDF → TAF 3 years, n = 84; TDF → TAF 2 years, n = 106), high rates of virologic control were achieved (89%, 94% and 92%, respectively) at Year 5 (missing = failure analysis). At Year 5, rates of alanine aminotransferase normalisation (85%, 90% and 78%) and hepatitis B e antigen loss (36%, 43% and 44%) were similar. Following the switch from TDF to TAF, changes in fasting lipid parameters were consistent with removal of the known lipid-lowering effect of TDF. However, changes in the total cholesterol to high-density lipoprotein ratio (marker of cardiovascular risk) were minimal and comparable in all groups by Year 5. Renal and bone parameters improved after switching.CONCLUSIONSThrough 5 years, rates of virologic suppression were high in East Asian patients treated with TAF or switched from TDF to TAF. TAF and TDF were well tolerated, with improved renal and bone safety observed in patients switching from TDF to TAF.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"4 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819767","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":"Systematic Review: The Relationship Between the Faecal Microbiome and Colorectal Neoplasia in Shotgun Metagenomic Studies","authors":"Sarah Manning,&nbsp;Eleanor Hackney,&nbsp;Yashvee Dunneram,&nbsp;Mark A. Hull,&nbsp;Suparna Mitra,&nbsp;Christopher J. Stewart,&nbsp;Panayiotis Louca,&nbsp;Nick Meader,&nbsp;Linda Sharp,&nbsp;Colin Rees","doi":"10.1111/apt.70252","DOIUrl":"10.1111/apt.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The human gut microbiome is of academic and clinical interest. Associations between certain organisms and colorectal neoplasia have been reported, but findings have limited reproducibility in different populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a systematic review of whole metagenome shotgun sequencing studies using faecal samples from patients with colorectal neoplasia and control populations. Searches were performed on 30th June 2023. We identified 26 studies, reporting on 22 study populations (13 from Asia, five from Europe and four from North America). Study size ranged from 14 to 971 individuals (mean 170).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Some reproducible data were identified, such as the significant enrichment of <i>Fusobacterium nucleatum</i> and <i>Parvimonas micra</i> in colorectal cancer patients compared to controls (in 10 and nine studies, respectively). However, 21 out of 26 studies scored poorly on quality appraisal, specifically surrounding selection of cases and controls. Definitions of controls varied; some studies used individuals with normal endoscopic investigations, some used ‘healthy’ individuals where no colonoscopy was performed, and one used those with non-neoplastic findings (haemorrhoids). There was even less reproducibility of data in studies where individuals with colorectal polyps were compared to controls, possibly because of heterogeneity in these patient groupings as a variety of definitions for ‘polyp cases’ were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Heterogeneity and potential for bias indicates that findings should be interpreted with caution. Standardised protocols to ensure robust methodology and allow pooling of large-scale data are required before these findings can be used in clinical practice (PROSPERO: CRD42023431977).</p>\u0000 </section>\u0000 </div>","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"62 6","pages":"568-584"},"PeriodicalIF":6.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/apt.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Cephalosporin-Induced Liver Injury-Interesting but Tricky.","authors":"Einar S Björnsson","doi":"10.1111/apt.70313","DOIUrl":"https://doi.org/10.1111/apt.70313","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"17 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819770","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":"Editorial: Cephalosporin-Induced Liver Injury-Interesting but Tricky. Authors' Reply.","authors":"Raj Vuppalanchi,Jay H Hoofnagle,Don C Rockey,Herbert L Bonkovsky,Yi-Ju Li,Dina Halegoua-DeMarzio,Robert J Fontana,Christopher Koh,Joseph Odin,Huiman Barnhart, ","doi":"10.1111/apt.70331","DOIUrl":"https://doi.org/10.1111/apt.70331","url":null,"abstract":"","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"18 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819801","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":"MetALD: Diagnosis and Prognosis With Non-Invasive Tests.","authors":"Nikolaj Torp,Mads Israelsen,Stine Johansen,Georg Semmler,Camilla Dalby Hansen,Katrine Tholstrup Bech,Mette Lehmann Andersen,Katrine Holtz Thorhauge,Peter Andersen,Helle Lindholm Schnefeld,Johanne Kragh Hansen,Ellen Lyngbeck Jensen,Emil Deleuran Hansen,Ida Villesen,Katrine Prier Lindvig,Diana Julie Leeming,Morten Karsdal,Emmanuel A Tsochatzis,Maja Thiele,Aleksander Krag","doi":"10.1111/apt.70281","DOIUrl":"https://doi.org/10.1111/apt.70281","url":null,"abstract":"BACKGROUNDNon-invasive tests (NITs) are central to diagnosing and stratifying risk in steatotic liver disease (SLD). However, it remains unclear whether guideline-recommended NIT cut-offs apply to metabolic and alcohol-related liver disease (MetALD).AIMEvaluate the diagnostic and prognostic performance of five NITs in patients with MetALD.METHODSSingle-centre study with 423 SLD patients, of whom 102 (24%) had MetALD. Patients were classified using histological or controlled attenuation parameter-defined hepatic steatosis and self-reported alcohol intake. We assessed the circulating markers of FIB-4, LiverRisk score, ELF and ADAPT together with transient elastography (TE) using established cut-offs for advanced fibrosis (≥ F3). Liver histology served as reference. Prognostic performance for hepatic decompensation and all-cause mortality was evaluated over a median follow-up of 62 months.RESULTSAmong circulating NITs in MetALD, ELF and ADAPT both had the highest diagnostic accuracy (AUROC = 0.90), while it was lowest with LiverRisk score (AUROC = 0.74). The indeterminate zone between rule-out and rule-in cut-offs was largest for FIB-4 (34%). TE and circulating NIT concordance was highest for LiverRisk score (81%) to rule-out ≥ F3, and highest for ELF (88%) to rule-in ≥ F3. All included NITs predicted decompensation-free survival with their corresponding rule-out or rule-in cut-offs. A sequential 2-tier testing strategy (FIB-4 → TE) effectively stratified risk of decompensation. Incorporating a second-tier test (ELF or ADAPT) before TE reduced the number of TE referrals by 43% and 45%, without loss of prognostic performance.CONCLUSIONWidely available NITs are applicable for MetALD, where cut-offs can be used to diagnose advanced fibrosis and predict clinical outcomes.","PeriodicalId":121,"journal":{"name":"Alimentary Pharmacology & Therapeutics","volume":"15 1","pages":""},"PeriodicalIF":7.6,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144813064","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}