International Journal of Gynecology & Obstetrics最新文献

{"title":"Virtual reality exoskeleton for post-partum uterine tamponade balloon training: Impact on learning and operator satisfaction.","authors":"R McConnell, A McEvoy, T Phillips, V Ouranis, E Mangina, F M McAuliffe","doi":"10.1002/ijgo.70385","DOIUrl":"https://doi.org/10.1002/ijgo.70385","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality's (VR) use in medical education is increasing; however, traditional VR controllers lack real-world dexterity. A post-partum hemorrhage (PPH) is an obstetric emergency with significant maternal morbidity. The use of an intrauterine balloon reduces the need for further surgical interventions, but resident doctors might lack experience with balloon insertion.</p><p><strong>Objectives: </strong>This study evaluates whether a novel VR exoskeleton (VRE) improves medical students' and residents' uterine balloon insertion technique and learning experience compared to traditional didactic teaching.</p><p><strong>Methods: </strong>In a parallel-group randomized controlled trial, clinical year medical students and residents were allocated to either: (i) a VRE group using an immersive VR tutorial with a haptic glove, or (ii) a control group receiving a standard slide-based tutorial. All participants were assessed on the intrauterine balloon insertion technique and times using a pelvic model. Secondary outcomes included PPH knowledge (multiple-choice questionnaire), confidence, side effects, and training acceptability. This trial was then compared to a previously published VR-only cohort.</p><p><strong>Results: </strong>The VRE group showed slightly higher insertion technique scores and faster insertion times than the control group (P > 0.05). Both groups improved in confidence following training (P < 0.05), with no significant difference between arms. Participants in the VRE group reported higher satisfaction and felt more supported (P = 0.04). Exploratory comparison with the VR-only group suggested improved technique with the exoskeleton, although demographic differences limit direct comparisons.</p><p><strong>Discussion: </strong>Virtual reality exoskeleton is a promising and well-accepted tool for teaching obstetric skills. While both groups improved with training, VRE participants reported higher satisfaction and demonstrated modest gains in technique, supporting further investigation in larger trials.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofeedback electrical stimulation combined with pelvic floor muscle training on postpartum stress urinary incontinence: A meta-analysis.","authors":"Ziying Tian, Renxin Ji","doi":"10.1002/ijgo.70378","DOIUrl":"https://doi.org/10.1002/ijgo.70378","url":null,"abstract":"<p><strong>Background: </strong>Postpartum stress urinary incontinence (PSUI) is common after childbirth, peaking at 30% incidence at 6 months and affecting about 18% overall. It results from weakened pelvic floor muscles and affects quality of life, with some cases persisting beyond the first postpartum year.</p><p><strong>Objectives: </strong>To clarify the therapeutic effect of biofeedback electrical stimulation (BFES) combined with pelvic floor muscle training (PFMT) on PSUI through a meta-analysis of relevant studies.</p><p><strong>Search strategy: </strong>PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP Database, and Wanfang Database were searched for studies published up to October, 2024.</p><p><strong>Selection criteria: </strong>Randomized controlled trials with adult females diagnosed with PSUI, focusing on clinical efficacy, PFMS, muscle fiber potential, and incontinence frequency were included. Studies were excluded if they involved severe comorbidities affecting intervention or had inaccessible outcomes.</p><p><strong>Data collection and analysis: </strong>Information was extracted for author, sample size, mean age, publication year, intervention, parity, postpartum time, delivery mode, number of fetuses, and outcome indicators. Risk of bias was assessed using Stata 15.0 and Review Manager 5.4.1, analyzing continuous and binary variables.</p><p><strong>Main results: </strong>Twenty studies with 2421 patients were analyzed, showing that BFES plus PFMT significantly improved PSUI clinical effect, pelvic floor muscle strength, and muscle fiber potential, reduced daily urinary incontinence incidence, and improved other urinary parameters compared with BFES or PFMT alone.</p><p><strong>Conclusions: </strong>BFES combined with PFMT is more effective than BFES or PFMT alone for PSUI patients. However, high heterogeneity was observed in some outcome indicators (e.g. PFMT, number of urinary incontinence events [NUI]), potentially affecting the results' precision. Furthermore, there was publication bias in the analysis of NUI. The results should be extrapolated with caution. Future large-scale, multicenter studies are needed to validate these findings.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer and fertility management: FIGO best practice advice.","authors":"Nikhil Purandare, Francisco Ruiloba, Long Nguyen-Hoang, Sarikapan Wilailak, Nozomu Yanaihara, Jacqueline P W Chung, Jaideep Malhotra, Edgar Mocanu, Frédéric Amant, Orla McNally, Inge Peters, Katie Flynn, Aya El Helali, Cynthia Maxwell, Sumaiya Adam, Lina Bergman, Surabhi Nanda, Valerie Tiempo Guinto, Fionnuala M McAuliffe, Catherine Nelson-Piercy, Melanie Nana, Graeme Smith, Jonathan Berek, Sharleen O'Reilly, Pat O'Brien, Bo Jacobsson, Liona C Poon","doi":"10.1002/ijgo.70426","DOIUrl":"https://doi.org/10.1002/ijgo.70426","url":null,"abstract":"<p><p>Cancer diagnoses in patients of reproductive age require balancing urgent oncological treatment with the need to preserve fertility. This FIGO Best Practice Advice outlines key considerations for fertility management in this population given the rising cancer incidence among young women and the reproductive risks posed by cancer treatments. The guidance evaluates the impact of chemotherapy, radiotherapy, surgery, and emerging therapies-such as targeted agents and immunotherapies-on gonadal function and fertility. Established fertility preservation methods, including oocyte/embryo cryopreservation, sperm banking, and ovarian tissue freezing, are detailed alongside barriers to their adoption, such as cost and limited access. Early collaborative counseling with oncologists and fertility specialists is central to addressing timelines, psychological impacts, and priorities. Post-treatment pathways, including assisted reproduction and surrogacy, are also explored. The guidance stresses the importance of integrating fertility-sparing interventions and fertility preservation into cancer care while advocating for equitable access to resources. Further research is needed to refine preventive interventions, evaluate long-term outcomes, and expand options for survivors globally. By prioritizing fertility preservation within oncological care, healthcare providers can better support the holistic needs of young individuals facing cancer.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative diagnostic performance of the early-stage ovarian malignancy score versus other risk prediction models in early-stage ovarian cancer: A Vietnamese prospective cohort study.","authors":"Hoang Lam Vo, Doan Tu Tran, Lam Huong Le, Tran Thao Nguyen Nguyen, Minh Tam Le, Vu Quoc Huy Nguyen","doi":"10.1002/ijgo.70383","DOIUrl":"https://doi.org/10.1002/ijgo.70383","url":null,"abstract":"<p><strong>Objective: </strong>This study compares the diagnostic performance of the early-stage ovarian malignancy (EOM) score against other risk prediction models for identifying early-stage ovarian cancer.</p><p><strong>Methods: </strong>This prospective cohort study involved 925 cases from the obstetrics and gynecology departments of two tertiary hospitals from May 2018 to December 2023. The data included gynecologic examination and/or ultrasound findings, menopausal status, ultrasonography features, serum CA125, and HE4 values, which were used to calculate the EOM score and compare it with other algorithms. Preoperative predictions were validated against postoperative histopathological data.</p><p><strong>Results: </strong>In total, 792 cases (85.62%) were benign tumors, 74 cases (8.00%) were identified as early-stage ovarian cancer, and 59 cases (6.38%) were classified as advanced-stage ovarian cancer. With a cut-off of ≥13, the EOM score achieved an area under the curve (AUC) value of 0.908 for distinguishing between cancer and non-cancer, demonstrating sensitivity of 83.46% and specificity of 82.90%. For early-stage cancer, the EOM score had an AUC value of 0.843. The EOM score outperformed the risk of malignancy index, the risk of ovarian malignancy algorithm, CPH-I, CA125, and HE4 (P < 0.05).</p><p><strong>Conclusion: </strong>The EOM score is a straightforward and effective tool for predicting early-stage ovarian cancer, yielded performance similar to the IOTA Simple Rules combined with CA125.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of obstetrics and gynecology training during residency: A global perspective.","authors":"Elif Goknur Topcu, Roman Kapustin, Olivier Ami, Atziri Ramirez, Petra Gabor, Akaninyene Eseme Ubom","doi":"10.1002/ijgo.70420","DOIUrl":"https://doi.org/10.1002/ijgo.70420","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the global landscape of postgraduate obstetrics and gynecology (Ob/Gyn) training, focusing on curriculum content, dedicated training time, perceived competencies, and trainee satisfaction.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted by the World Association of Trainees in Obstetrics and Gynecology (WATOG) between 2017 and 2019. A total of 1038 respondents from seven global regions, answered 46 questions addressing nine core Ob/Gyn subspecialty modules, including delivery room, maternal medicine, fetal medicine, general Ob/Gyn ultrasound, general gynecological surgery, urogynecology, onco-gynecology, assisted reproduction, and family planning. Primary outcome measures included Ob/Gyn subspecialty module inclusion in the training curriculum, self-reported time allocation to training modules, competency attainment, and satisfaction. Secondary analyses examined correlations between time allocation, perceived competency, and satisfaction and investigated regional differences using nonparametric statistical tests.</p><p><strong>Results: </strong>Delivery room training was universally included in training curriculums (≥94% across all regions) and garnered high satisfaction. Conversely, subspecialty modules, such as fetal medicine and assisted reproduction, were underrepresented in training curriculums in low- and middle-income regions. Correlation analyses revealed that increased training time had a weak but positive association with competency acquisition in several subspecialty modules (e.g., general gynecological surgery and onco-gynecology). However, satisfaction did not consistently correlate with training duration, suggesting that factors beyond time allocation-such as quality of instruction and supervision-might play a larger role. Notably, trainees in resource-limited settings reported more heterogeneous and often lower satisfaction scores, despite spending equal or greater total time on clinical activities.</p><p><strong>Conclusion: </strong>Global Ob/Gyn curriculums share core elements, yet differ widely in time allocations and competencies achieved. The findings underscore a need for both international harmonization of minimum standards and context-specific adaptations to address local healthcare priorities and resource constraints. Competency-based frameworks that balance global benchmarks with regional realities could improve the training experience and outcomes for future Ob/Gyn specialists.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to \"Associations between the time interval from myomectomy to subsequent pregnancy and the obstetric outcomes: A population-based cohort study\".","authors":"","doi":"10.1002/ijgo.70430","DOIUrl":"https://doi.org/10.1002/ijgo.70430","url":null,"abstract":"","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a risk prediction model for lower limb lymphedema in postoperative cervical cancer patients.","authors":"Zhiyue Li, Ping Wang, Dan Lu, Zhiyun Ding","doi":"10.1002/ijgo.70423","DOIUrl":"https://doi.org/10.1002/ijgo.70423","url":null,"abstract":"<p><strong>Objective: </strong>Lower limb lymphedema (LLL) is a common postoperative complication in patients with cervical cancer. Here, we analyzed the independent risk factors of LLL and constructed a nomogram prediction model for the early detection of LLL in postoperative cervical cancer patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a tertiary hospital in China between January 2020 and December 2023. A univariate analysis was carried out to determine the risk factors possibly related to LLL, and a logistic regression analysis was utilized to determine the independent risk factors related to LLL. Area under the receiver-operating characteristic curve (AUC) calibration plots and decision curve analysis were used to assess the performance of the nomogram model.</p><p><strong>Results: </strong>Independent predictors for LLL risk included body mass index, hypertension, urinary tract infection, number of lymph nodes dissected, radiotherapy, chemotherapy, and functional exercise frequency. The clinical prediction model was established based on the above seven risk factors and showed superior predictive power both in the training cohort (AUC = 0.861) and the validation cohort (AUC = 0.837). The nomogram was well-calibrated. The decision curve analysis demonstrated that the LLL risk nomogram was clinically applicable.</p><p><strong>Conclusion: </strong>The model has good discrimination and accuracy for LLL risk assessment, which can provide a reference for individualized clinical prediction of the risk of LLL in postoperative cervical cancer patients. Multicenter prospective trials are required to verify the predictive value of the model.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer of the vulva: 2025 update: FIGO Cancer Report 2025.","authors":"Alexander B Olawaiye, Mauricio A Cuello, Sushil Beriwal, Linda J Rogers","doi":"10.1002/ijgo.70390","DOIUrl":"https://doi.org/10.1002/ijgo.70390","url":null,"abstract":"<p><p>Vulvar cancer is an uncommon gynecological malignancy primarily affecting postmenopausal women. No specific screening exists and the most effective strategy to reduce the incidence of vulvar cancer is the opportune treatment of predisposing and preneoplastic lesions associated with its development. Although vulvar cancer may be asymptomatic, most women present with vulvar pruritus or pain or have noticed a lump or ulcer. Therefore, any suspicious vulvar lesion should be biopsied to exclude invasion. Once established, the most common subtype is squamous cell carcinoma. The treatment of vulvar cancer depends primarily on histology, clinical, radiological, or surgical staging. Treatment is predominantly surgical and/or adjuvant radiation therapy, particularly for squamous cell carcinoma, although definitive concurrent chemoradiation is an effective alternative, particularly for advanced tumors. In those cases where vulvar cancer presents with distant metastases, systemic therapy is modeled after cervical cancer, a more common cancer where there is more robust data to guide treatment. Management should be individualized and carried out by a multidisciplinary team in a cancer center experienced in the treatment of these tumors.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the causal association between body composition and primary ovarian insufficiency: A retrospective cohort study and Mendelian randomization analyses.","authors":"Junge Zheng, Jiaoxue Zheng, Fang Yao, Jian Gao, Zheng Zheng, Shan Duan, Weiwei Zeng","doi":"10.1002/ijgo.70425","DOIUrl":"https://doi.org/10.1002/ijgo.70425","url":null,"abstract":"<p><strong>Objective: </strong>Primary ovarian insufficiency (POI) is a significant gynecologic condition characterized by menstrual irregularities, sex hormone imbalances, and reduced fertility. Understanding the nature of body composition changes in POI patients is crucial for elucidating its pathologic mechanisms and guiding treatment and management strategies.</p><p><strong>Methods: </strong>This study employed a retrospective research approach to comprehensively analyze body composition measurements of 1157 POI patients. The Mendelian randomization method served as an inferential tool to assess the causal relationship between body composition indices and POI risk. The heterogeneity and pleiotropy of the results were appraised to ensure the robustness of the causal relationship.</p><p><strong>Results: </strong>POI patients exhibited significant deviations in various body composition indices from the normal range. Specifically, 76.9% of POI patients displayed an abnormal \"Fat\" indicator, and 94.6% had a \"waist-to-hip ratio (WHR)\" exceeding the normal range, particularly among those under 30 years of age. Mendelian randomization analysis further corroborated a significant causal association between \"body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters)\" and \"age at menopause (last menstrual period)\" (OR = 1.014, 95% CI: 1.00-1.03, p = 0.021), indicating that abnormal menstrual status resulting from alterations in body composition may contribute to the development of POI.</p><p><strong>Conclusion: </strong>Several lipid metabolism indices in POI patients were outside the normal range observed in the general population. Among these, increased BMI may be an independent factor in the increased risk of POI, suggesting that a genetic predisposition to POI may play a role by influencing body composition. Clinically, monitoring and managing lipid metabolism and BMI levels should be integral components of POI prevention and management strategies.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity of radical surgery and postoperative radiotherapy in cervical cancer.","authors":"Nathalia Mora-Soto, Carolina Morante-Caicedo, Maria Caicedo-Martínez, David Viveros-Carreño, Emmanuel Sánchez Díaz, Juliana Rodríguez, Santiago Vieira, Jonathan A Peralta, Nadeem R Abu-Rustum, Rene Pareja","doi":"10.1002/ijgo.70281","DOIUrl":"https://doi.org/10.1002/ijgo.70281","url":null,"abstract":"<p><p>Cervical cancer is among the most common cancers affecting women worldwide. The standard treatment for early-stage cervical cancer (International Federation of Gynecology and Obstetrics [FIGO] 2018 stages IA1-IB2, IIA1) typically involves a radical or simple hysterectomy with lymph node assessment. Postoperative management may include observation or tailored adjuvant therapy, such as radiotherapy or chemoradiotherapy, depending on individual pathological risk factors. However, these interventions are associated with significant complications: surgical management can lead to urinary and sexual dysfunction, lymphocysts, and lower limb lymphedema, while radiotherapy may cause genitourinary, gastrointestinal, and sexual toxicities. Less-radical surgery for selected cases could reduce surgical morbidity and advances in radiotherapy techniques, such as intensity-modulated radiotherapy, volumetric modulated arc therapy, and other three-dimensional conformal radiation therapies, have the potential to enhance precision and reduce toxicity. Nonetheless, the morbidity associated with combining radical surgery and adjuvant (chemo)radiotherapy remains an area of uncertainty, particularly in light of these emerging technologies. Most current data on this topic derive from retrospective studies involving heterogeneous populations and inconsistent quality-of-life assessment methods. Prospective studies employing standardized morbidity assessment tools are essential to determine the true impact of combined treatments compared to single-modality approaches. Future research should prioritize understanding the long-term effects of these treatment strategies, aiming to minimize adverse outcomes while maintaining optimal oncological control.</p>","PeriodicalId":14164,"journal":{"name":"International Journal of Gynecology & Obstetrics","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}