Journal of Clinical and Experimental Hepatology最新文献

{"title":"Editorial: Role of Yttrium-90 Transarterial Radioembolisation in Advanced Hepatocellular Carcinoma","authors":"Mikin V. Patel , Anjana A. Pillai","doi":"10.1016/j.jceh.2024.101402","DOIUrl":"10.1016/j.jceh.2024.101402","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Randomised Comparative Four-arm Intervention Study of Efficacy and Safety of Saroglitazar and Vitamin E in Patients With Non-alcoholic Fatty Liver Disease (NAFLD)/Non-alcoholic Steatohepatitis (NASH)-SVIN TRIAL","authors":"Bilal A. Mir ,&nbsp;Brij Sharma ,&nbsp;Rajesh Sharma ,&nbsp;Vishal Bodh ,&nbsp;Ashish Chauhan ,&nbsp;Tahir Majeed ,&nbsp;Inaamul Haq ,&nbsp;Neetu Sharma ,&nbsp;Dikshant Sharma","doi":"10.1016/j.jceh.2024.101398","DOIUrl":"10.1016/j.jceh.2024.101398","url":null,"abstract":"<div><h3>Background and aim</h3><p>Vitamin E is widely prescribed for non-alcoholic steatohepatitis (NASH). Saroglitazar, a novel dual peroxisome proliferator-activator receptor ɑ/γ agonist, is approved in India for non-alcoholic fatty liver disease (NAFLD). No head-to-head comparative study for vitamin E and saroglitazar is available. We studied the efficacy and safety of saroglitazar and vitamin E in NAFLD/NASH.</p></div><div><h3>Materials and methods</h3><p>We prospectively randomised 175 NAFLD patients into four arms as Saroglitazar 4 mg daily alone (n = 44), vitamin E 800IU daily alone (n = 41), vitamin E and saroglitazar combination (n = 47), and control arm (n = 43). All the baseline variables including liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) were recorded. Reassessment was done after 24 weeks of treatment.</p></div><div><h3>Results</h3><p>The mean age and body mass index was 45 ± 11 years and 26 ± 3.6 kg/m², respectively. Compared to control, the decrease in alanine amino transferase levels with saroglitazar, vitamin E, and combination therapy was significant (95% confidence interval [CI]: 6.27–28.25, <em>P</em> = 0.002, 95% CI: −3.39 to 18.88, <em>P</em> = 0.047 and 95% CI: 8.10–29.54, <em>P</em> = 0.001, respectively). The reduction in CAP was significant with saroglitazar and combination therapy (95% CI: −31.94 to 11.99, <em>P</em> = 0.015 and 95% CI: −10.48 to 30.51, <em>P</em> = 0.026, respectively). Only combination therapy shows significant reduction in LSM (95% CI: 0.41–1.68, <em>P</em> = 0.001). Among glycaemic parameters, both saroglitazar alone and combination therapy significantly improved glycosylated haemoglobin levels (<em>P</em> = 0.001 and <em>P</em> = 0.015, respectively), and only combination therapy significantly improved homoeostasis model assessment–estimated insulin resistance (<em>P</em> = 0.047). Saroglitazar alone showed significant reduction in triglyceride and low-density lipoprotein levels (<em>P</em> = 0.038 and <em>P</em> = 0.018, respectively), and combination therapy showed significant increase in high-density lipoprotein levels (<em>P</em> = 0.024).</p></div><div><h3>Conclusions</h3><p>Combination of Saroglitazar and vitamin E showed statistically significant reduction of LSM and CAP along with biochemical, glycaemic, and lipid parameters.</p></div><div><h3>Clinical trial registry India no</h3><p>CTRI/2022/01/039538.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contrast Enhanced CT Versus MRI for Accurate Diagnosis of Wall-thickening Type Gallbladder Cancer","authors":"Daneshwari Kalage ,&nbsp;Pankaj Gupta ,&nbsp;Ajay Gulati ,&nbsp;Kakivaya P. Reddy ,&nbsp;Kritika Sharma ,&nbsp;Ati Thakur ,&nbsp;Thakur D. Yadav ,&nbsp;Vikas Gupta ,&nbsp;Lileswar Kaman ,&nbsp;Ritambhra Nada ,&nbsp;Harjeet Singh ,&nbsp;Santosh Irrinki ,&nbsp;Parikshaa Gupta ,&nbsp;Chandan K. Das ,&nbsp;Usha Dutta ,&nbsp;Manavjit Sandhu","doi":"10.1016/j.jceh.2024.101397","DOIUrl":"10.1016/j.jceh.2024.101397","url":null,"abstract":"<div><h3>Introduction</h3><p>Diagnosis of wall-thickening type gallbladder cancer (GBC) is challenging. Computed tomography (CT) and magnetic resonance imaging (MRI) are commonly utilized to evaluate gallbladder wall thickening. However, there is a lack of data comparing the performance of CT and MRI for the detection of wall-thickening type GBC.</p></div><div><h3>Aim</h3><p>We aim to compare the diagnostic accuracy of CT and MRI in diagnosis of wall-thickening type GBC.</p></div><div><h3>Materials and methods</h3><p>This prospective study comprised consecutive patients suspected of wall-thickening type GBC who underwent preoperative contrast-enhanced CT and MRI. The final diagnosis was based on the histopathology of the resected gallbladder lesion. Two radiologists independently reviewed the characteristics of gallbladder wall thickening at CT and MRI. The association of CT and MRI findings with histological diagnosis and the interobserver agreement of CT and MRI findings were assessed.</p></div><div><h3>Results</h3><p>Thirty-three patients (malignancy, 13 and benign, 20) were included. None of the CT findings were significantly associated with GBC. However, at MRI, heterogeneous enhancement, indistinct interface with the liver, and diffusion restriction were significantly associated with malignancy (<em>P</em> = 0.006, &lt;0.001, and 0.005, respectively), and intramural cysts were significantly associated with benign lesions (<em>P</em> = 0.012). For all MRI findings, the interobserver agreement was substantial to perfect (kappa = 0.697–1.000). At CT, the interobserver agreement was substantial to perfect (k = 0.631–1.000).</p></div><div><h3>Conclusion</h3><p>These findings suggest that MRI may be preferred over CT in patients with suspected wall thickening type GBC. However, larger multicenter studies must confirm our findings.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound Bubble Study for Detection of Extracardiac Shunting: Endohepatology in the Diagnosis of Hepatopulmonary Syndrome","authors":"Sahaj Rathi ,&nbsp;Sunil Taneja ,&nbsp;Virendra Singh","doi":"10.1016/j.jceh.2024.101394","DOIUrl":"10.1016/j.jceh.2024.101394","url":null,"abstract":"<div><p>Contrast echo is often used to demonstrate extracardiac shunting for evaluation of hepatopulmonary syndrome. The same can also be performed via transesophageal route with endoscopic ultrasound. We here demonstrate this technique in a 58-year-old woman who underwent gastric variceal obliteration with endoscopic ultrasound. This technique can add another dimension to the “one-stop-shop” endohepatology evaluation of patients with cirrhosis in a single endoscopy appointment.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140273998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Porto-sinusoidal Vascular Disease: Classification and Clinical Relevance","authors":"Madhumita Premkumar ,&nbsp;Anil C. Anand","doi":"10.1016/j.jceh.2024.101396","DOIUrl":"10.1016/j.jceh.2024.101396","url":null,"abstract":"<div><p>Non-cirrhotic portal hypertension (NCPH) is a well-recognized clinico-pathological entity, which is associated with clinical signs and symptoms, imaging, and endoscopic features of portal hypertension (PHT), in absence of cirrhosis. In patients with NCPH without known risk factors of PHT or extrahepatic portal vein thrombosis, the condition is called idiopathic non-cirrhotic portal hypertension (INCPH). There are multiple infectious, immune related causes, systemic diseases, drug and toxin exposures, haematological disorders, and metabolic risk factors that have been associated with this INCPH. However, the causal pathogenesis is still unclear. The Vascular liver disorders interest group group recently proposed porto-sinusoidal vascular disease (PSVD) as a syndromic entity, which provides definite histopathological criteria for diagnosis of NCPH (table 1). The three classical histo-morphological lesions specific for PSVD include obliterative portal venopathy, nodular regenerative hyperplasia, and incomplete septal fibrosis. The PSVD definition includes patients with portal vein thrombosis, PVT, and even those without PHT, thus broadening the scope of diagnosis to include patients who may have presented early, prior to haemodynamic changes consistent with PHT. However, this new diagnosis has pros and cons. The cons include mandating invasive liver biopsy to assess the PSVD histological triad in all patients with NCPH, an erstwhile clinical diagnosis in Asian patients. In addition, the natural history of the subclinical forms of PSVD without PHT and linear progression to develop PHT is unknown yet. In this review, we discuss the diagnosis and treatment of INCPH/PSVD, fallacies and strengths of the old and new schema, pathobiology of this disease, and clinical correlates in an Asian context. Although formulation of standardised diagnostic criteria is useful for comparison of clinical cohorts with INCPH/PSVD, prospective clinical validation in global cohorts is necessary to avoid misclassification of vascular disorders of the liver.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 in Liver Transplant Recipients: Less to Fear Than Originally Thought?","authors":"Melissa G. Kaltenbach,&nbsp;Jessica P.E. Davis,&nbsp;Atoosa Rabiee","doi":"10.1016/j.jceh.2024.101399","DOIUrl":"10.1016/j.jceh.2024.101399","url":null,"abstract":"","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Forgotten Virus, Hepatitis D: A Review of Epidemiology, Diagnosis, and Current Treatment Strategies","authors":"Adam Khattak ,&nbsp;Tahne Vongsavath ,&nbsp;Lubaba Haque ,&nbsp;Amrit Narwan ,&nbsp;Robert G. Gish","doi":"10.1016/j.jceh.2024.101395","DOIUrl":"10.1016/j.jceh.2024.101395","url":null,"abstract":"<div><p>Hepatitis D virus (HDV) is an RNA subvirus that infects patients with co-existing hepatitis B virus (HBV) infections. HDV burden is estimated to be approximately 15–20 million people worldwide. Despite HDV severity, screening for HDV remains inadequate. HDV screening would benefit from a revamped approach that automatically reflexes testing when individuals are diagnosed with HBV if HBsAg-positive, to total anti-HDV, and then to quantitative HDV-RNA polymerase chain reaction (PCR) rather than only testing those at high risk sequentially. There are no current treatments in the United States that are Food and Drug Administration (FDA)-approved for the treatment of HDV; however, bulevirtide (BLV) is approved in the European Union conditionally and is under review with the United States FDA. Current treatment strategies in many countries are centered on the use of pegylated-interferon-alfa-2a (PEG-IFNa-2a). There are other therapies in development globally that have shown promise, including BLV, pegylated-interferon-lambda (PEG-IFN-lambda), and lonafarnib (LNF). LNF has shown substantial response in the LOWR trials. BLV is a well-tolerated drug, but it is not finite therapy and has shown significant on-treatment responses in the MYR clinical trials, and the FDA cited concerns with the manufacturing and patient preparation of the drug that have delayed approval. The PDUFA date for BLV in the United States is mid-2024. Current studies with both BLV and LNF are limited in providing sustained virological response (SVR); future trials will need to demonstrate more substantial SVR with possible triple combination trials as options.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bloody Bile and Rescue Intervention—A Case Series of Post-PTBD Hemorrhagic Complications With a Review of the Literature","authors":"Ranjan K. Patel ,&nbsp;Alamellu Alagapan ,&nbsp;Taraprasad Tripathy ,&nbsp;Hemant K. Nayak ,&nbsp;Bramhadatta Pattnaik ,&nbsp;Tanmay Dutta ,&nbsp;Sunita Gupta ,&nbsp;Sudipta Mohakud ,&nbsp;Suprava Naik ,&nbsp;Nerbadyswari Deep Bag","doi":"10.1016/j.jceh.2024.101392","DOIUrl":"10.1016/j.jceh.2024.101392","url":null,"abstract":"<div><p>Percutaneous transhepatic biliary drainage (PTBD) is a routinely performed interventional radiological procedure. A myriad of complications can occur after PTBD, the most important being hemorrhagic complications that require immediate attention. Hemorrhage following PTBD may result from arterial, portal, or hepatic venous injury. A catheter or pull-back cholangiogram often demonstrates the venous injury. A computed tomogram angiogram aids in identifying bleeding sources and procedural planning. Catheter repositioning, upsizing, or clamping often suffice for minor venous bleeding. However, major venous injury necessitates tract embolization, portal vein embolization, or stent grafting. Arterial injury may lead to significant blood loss unless treated expeditiously. Transarterial embolization is the treatment of choice in such cases. Adequate knowledge about the hemorrhagic complications of PTBD will allow an interventional radiologist to take necessary precautionary measures to reduce their incidence and take appropriate steps in their management. This article entails four different hemorrhagic complications of PTBD and their interventional management. It also discusses the various treatment options to manage different kinds of post-PTBD hemorrhagic complications.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140086165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement of Gallbladder Reporting and Data System for Gallbladder Wall Thickening at Ultrasonography: A Multireader Validation Study","authors":"Raghuraman Soundararajan ,&nbsp;Pavithra Subramanian ,&nbsp;Pankaj Gupta ,&nbsp;Pratyaksha Rana ,&nbsp;Manika Chhabra ,&nbsp;Shravya Singh ,&nbsp;Ruby Siddiqui ,&nbsp;Chandan Das ,&nbsp;Thakur D. Yadav ,&nbsp;Vikas Gupta ,&nbsp;Lileswar Kaman ,&nbsp;Harjeet Singh ,&nbsp;Santosh Irrinki ,&nbsp;Parikshaa Gupta ,&nbsp;Uma N. Saikia ,&nbsp;Ritambhra Nada ,&nbsp;Usha Dutta ,&nbsp;Manavjit S. Sandhu","doi":"10.1016/j.jceh.2024.101393","DOIUrl":"https://doi.org/10.1016/j.jceh.2024.101393","url":null,"abstract":"<div><h3>Objective</h3><p>This article aims to evaluate the intrareader and interreader agreement of ultrasound (US) gallbladder reporting and data system (GB-RADS) and validate the risk of malignancy in each GB-RADS category.</p></div><div><h3>Materials and methods</h3><p>This retrospective study comprised consecutive patients with nonacute gallbladder wall thickening who underwent US evaluation between January 2019 and December 2022. Three radiologists independently read the static US images and cine-loops for GB-RADS findings and assigned GB-RADS categories. The intraobserver (static images) and interobserver (static images and cine-loops) agreement was calculated using kappa statistics and Krippendorff's alpha. Another radiologist assigned a consensus GB-RADS category. The percentage of malignancy in each GB-RADS category was calculated.</p></div><div><h3>Results</h3><p>Static US images of 414 patients (median age, 56 years; 288 women, benign = 45.6% and malignant = 54.4%) and cine-loops of 50 patients were read. There was weak to moderate intrareader agreement for most GB-RADS findings and moderate intrareader agreement for the GB-RADS category for all readers. On static images, the interreader agreement was acceptable for GB-RADS categories. On cine-loops, the interreader agreement for GB-RADS findings and categories was better than static images. The percentage of malignancy was 1.2%, 37%, 71.1%, and 89.1% in GB-RADS 2, 3, 4, and 5 categories.</p></div><div><h3>Conclusion</h3><p>GB-RADS has moderate intrareader for GB-RADS categories. As originally proposed, the risk of malignancy is negligible in GB-RADS 2 category and highest in GB-RADS 5 category. However, the discriminatory performance of GB-RADS 3 and 4 categories is low. Larger multicenter studies with more readers must assess the reader agreement and validate the GB-RADS systems for wider clinical utilization.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing Etiological Spectrum of Hepatocellular Carcinoma in India—A Systematic Review and Meta-analysis","authors":"Suprabhat Giri ,&nbsp;Ashok Choudhury ,&nbsp;Dibya L. Praharaj ,&nbsp;Ankita Singh ,&nbsp;Arun Vaidya ,&nbsp;Sidharth Harindranath ,&nbsp;Prajna Anirvan ,&nbsp;Shivam Kalia ,&nbsp;Akash Shukla","doi":"10.1016/j.jceh.2024.101391","DOIUrl":"10.1016/j.jceh.2024.101391","url":null,"abstract":"<div><h3>Background</h3><p>Recent studies from both India and outside India have shown a change in the etiological profile of hepatocellular carcinoma (HCC). We aimed to analyze the etiological spectrum and changing trends of HCC etiology in India using a systematic review of current literature and meta-analysis.</p></div><div><h3>Methods</h3><p>Electronic databases of PubMed/Medline, Scopus, and Embase were searched from inception to July 2023 for studies reporting the data on the etiology of HCC from India. The pooled proportions with 95% confidence interval were calculated using summative statistics.</p></div><div><h3>Results</h3><p>A total of 60 studies (n = 12,327) were included in the final analysis. The pooled proportions of HCC cases with at least one positive and negative viral marker were 56.0 (49.5–62.6) and 43.1% (36.5–49.8), respectively. The pooled proportion of HCC cases with positive hepatitis B virus (HBV) markers was 41.0 (35.8–46.1), while those with positive markers for hepatitis C virus were 20.3 (17.0–23.6). The pooled proportion of cases with HCC with significant alcohol intake was 19.0% (15.6–22.4), and those related to nonalcoholic fatty liver disease (NAFLD) were 16.9% (12.1–21.7). Around 7.9% (5.8–10.0) of the cases had HCC with multiple etiologies. Subgroup analysis showed a significant variation with the location of the study based on zone. Meta-regression analysis based on publication year (1990–2023) showed a significant reduction in the proportion of cases with HBV and an increase in cases with NAFLD. In contrast, the proportion of cases with hepatitis C virus and alcohol did not change significantly.</p></div><div><h3>Conclusion</h3><p>Viral hepatitis is the most common etiology of HCC in India, predominantly HBV. The proportions of cases with HCC related to NAFLD are increasing, and those related to HBV are declining.</p></div>","PeriodicalId":15479,"journal":{"name":"Journal of Clinical and Experimental Hepatology","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140083254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}