Obstetrics and Gynecology Science最新文献

{"title":"Hysterectomy trends and outcomes: an ambispective audit from a tertiary institute in Northern India.","authors":"Anupama Bahadur, Mukesh Kumar, Ayush Heda, Rajlaxmi Mundhra, Sakshi Gattani","doi":"10.5468/ogs.26014","DOIUrl":"10.5468/ogs.26014","url":null,"abstract":"<p><strong>Objective: </strong>Hysterectomy is one of the most commonly performed gynecological surgeries worldwide. This study aimed to evaluate the clinical indications, surgical routes, and intraoperative and postoperative outcomes of hysterectomies performed at a tertiary care center over an 8-year period.</p><p><strong>Methods: </strong>This ambispective observational study was conducted from February 2016 to May 2024. It included 1,083 women who underwent hysterectomy for benign, malignant, or obstetric indications via abdominal, laparoscopic, vaginal, or robotic approaches. Data were collected retrospectively (2016-2022) and prospectively (2022-2024). Parameters analyzed included patient demographics, indications, surgical approach, anesthesia, blood loss, complications, and transfusion requirements. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 25.0 (IBM Corp., Armonk, NY, USA).</p><p><strong>Results: </strong>Of 1,083 cases, 84.21% were performed for benign and 15.78% for malignant conditions. Abdominal hysterectomy was most common (44.41%), followed by robotic (39.52%), vaginal (12.00%), and laparoscopic (4.07%). Robotic hysterectomy had the lowest blood loss (median 52.5 mL) and transfusion rates (intraoperative, 0.47%; postoperative, 1.40%), compared with abdominal (median 300 mL; intraoperative, 18.71%, postoperative, 13.30%). Vaginal hysterectomy had the shortest operative time but slightly higher blood loss than minimally invasive approaches. Major complications such as bladder, bowel, and ureteric injuries were more frequent in abdominal cases.</p><p><strong>Conclusion: </strong>Minimally invasive techniques, especially robotic surgery, are associated with reduced blood loss and complication rates. This audit highlights the need to encourage minimally invasive hysterectomy where feasible and underscores the importance of systematic documentation to inform practice and policy improvements.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"357-365"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713852","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":"First report of a combined hemostatic technique using Hydrofit® and SURGICEL Absorbable HemostatTM for intraoperative hemorrhage in gynecologic oncology surgery: a video article.","authors":"Koji Ijichi, Mariko Nakahara, Yoshinori Nakahara, Koya Fujiyama, Sumie Kaya, Saki Kuki, Saya Nagasawa, Yosuke Ito, Yojiro Maruyama, Daiki Ogishima","doi":"10.5468/ogs.26200","DOIUrl":"10.5468/ogs.26200","url":null,"abstract":"<p><strong>Objective: </strong>To report the first use of Hydrofit® (Sanyo Chemical Industries, Kyoto, Japan), a polyurethane prepolymer sealant, combined with SURGICEL Absorbable Hemostat™ (Johnson & Johnson MedTech, Somerville, NJ, USA) as an oxidized cellulose carrier, for intraoperative hemorrhage control in gynecologic oncology surgery, with video documentation.</p><p><strong>Methods: </strong>Two patients undergoing open gynecologic oncology surgery developed hemorrhage refractory to conventional hemostatic measures. SURGICEL Absorbable Hemostat™ (Johnson & Johnson MedTech) coated with Hydrofit® (Sanyo Chemical Industries) was applied to the bleeding site with 3 minutes of manual compression. Surgical findings and postoperative courses were retrospectively reviewed. Institutional ethics approval and written informed consent were obtained from both patients.</p><p><strong>Result: </strong>Case 1: high-grade serous carcinoma of the fallopian tube with neuroendocrine features; total blood loss 4,439 g. Hemostasis at the resection surface was visually confirmed; the patient was discharged 7 days after surgery. At interval debulking surgery 4 months later, a fibrous mass adherent to the sigmoid colon with foreign body giant cells was noted at the application site; R0 resection was achieved. Case 2: cervical squamous cell carcinoma, International Federation of Gynecology and Obstetrics (2018) stage IIB; total blood loss 886 g. Hemorrhage from the right internal iliac vein was controlled within 3 minutes; the patient was discharged 11 days after surgery.</p><p><strong>Conclusion: </strong>This combined hemostatic technique may serve as an adjunctive option when conventional measures fail during gynecologic oncology surgery. The adhesion formation observed at reoperation warrants caution. Prospective evaluation using site-specific blood loss measurements is required to establish efficacy and safety.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"366-370"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799075","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":"Pudendal nerve entrapment at the level of sacrospinous ligament or Alcock's canal; laparoscopic management.","authors":"Baris Mulayim, Sema Mulayim","doi":"10.5468/ogs.25396","DOIUrl":"10.5468/ogs.25396","url":null,"abstract":"<p><strong>Objective: </strong>Pudendal nerve entrapment may occur at multiple sites along the course of the nerve. The Nantes criteria have been proposed for diagnosing pudendal nerve entrapment syndrome. However, it is clinically possible to discriminate pudendal nerve entrapment at the level of the sacrospinous ligament from Alcock's canal.</p><p><strong>Methods: </strong>A step-by-step description of the surgical technique is provided based on video images.</p><p><strong>Results: </strong>A 38-year-old woman presented with sitting pain. She experienced pain from the clitoris to the anus on the left side for 2 years. Her pain score was 8/10 according to the visual analog scale. She experienced pain in the left sacrospinous ligament on palpation and showed Tinel's sign (+). The left pudendal nerve block relieved the pain for approximately 2 hours. Pudendal nerve entrapment was diagnosed based on the Nantes criteria. The pain was refractory to conservative treatment. A laparoscopic pudendal nerve release was planned. The surgery was completed uneventfully. After 1 month, her score decreased to 3/10. The Nantes criteria, which have been proposed for diagnosing pudendal nerve entrapment syndrome, were primarily developed to diagnose entrapment at the level of Alcock's canal and/or at the interligamentous plane.</p><p><strong>Conclusion: </strong>It is clinically difficult to discriminate pudendal nerve entrapment at the level of the sacrospinous ligament from Alcock's canal. Therefore, if a decision is made to perform laparoscopic pudendal nerve release, combined decompression at both sites may be considered at the sacrospinous ligament and Alcock's canal if no obvious cause is identified pre-and intraoperatively.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"371-374"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13597145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799041","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":"Hybrid surgical approach for advanced ovarian cancer: hybrid approach for robotic and minimal open abdominal cytoreduction technique.","authors":"Jaekyung Bae, Uisuk Kim, Ji Hyun Kim, Myong Cheol Lim","doi":"10.5468/ogs.26044.e1","DOIUrl":"10.5468/ogs.26044.e1","url":null,"abstract":"","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":"69 5","pages":"380"},"PeriodicalIF":2.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025832","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":"Pudendal nerve entrapment at the level of sacrospinous ligament or Alcock's canal; laparoscopic management.","authors":"Baris Mulayim, Sema Mulayim","doi":"10.5468/ogs.26396","DOIUrl":"https://doi.org/10.5468/ogs.26396","url":null,"abstract":"<p><strong>Objective: </strong>Pudendal nerve entrapment may occur at multiple sites along the course of the nerve. The Nantes criteria have been proposed for diagnosing pudendal nerve entrapment syndrome. However, it is clinically possible to discriminate pudendal nerve entrapment at the level of the sacrospinous ligament from Alcock's canal.</p><p><strong>Methods: </strong>A step-by-step description of the surgical technique is provided based on video images.</p><p><strong>Results: </strong>A 38-year-old woman presented with sitting pain. She experienced pain from the clitoris to the anus on the left side for 2 years. Her pain score was 8/10 according to the visual analog scale. She experienced pain in the left sacrospinous ligament on palpation and showed Tinel's sign (+). The left pudendal nerve block relieved the pain for approximately 2 hours. Pudendal nerve entrapment was diagnosed based on the Nantes criteria. The pain was refractory to conservative treatment. A laparoscopic pudendal nerve release was planned. The surgery was completed uneventfully. After 1 month, her score decreased to 3/10. The Nantes criteria, which have been proposed for diagnosing pudendal nerve entrapment syndrome, were primarily developed to diagnose entrapment at the level of Alcock's canal and/or at the interligamentous plane.</p><p><strong>Conclusion: </strong>It is clinically difficult to discriminate pudendal nerve entrapment at the level of the sacrospinous ligament from Alcock's canal. Therefore, if a decision is made to perform laparoscopic pudendal nerve release, combined decompression at both sites may be considered at the sacrospinous ligament and Alcock's canal if no obvious cause is identified pre-and intraoperatively.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881686","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":"Changes in cesarean section rates before and during the COVID-19 pandemic in South Korea.","authors":"Jeong Min Song, Ju Hyeong Son, Hyun-Joo Seol, Min-Jeong Oh, Geum Joon Cho, Joong Shin Park","doi":"10.5468/ogs.25409","DOIUrl":"https://doi.org/10.5468/ogs.25409","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate changes in cesarean section (CS) rates in South Korea before and during the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed all deliveries recorded in the Korean National Health Insurance Service database (2015-2021). We compared CS rates between pre-pandemic (2015-2019) and pandemic (2020-2021) periods. Interrupted time-series analysis (ITSA) assessed temporal changes, stratified by parity. Sensitivity analyses evaluated a low-risk group, excluding major complications, and a term singleton nulliparous subgroup to assess changes in medical indications.</p><p><strong>Results: </strong>Of 2,255,524 deliveries, the overall CS rate increased from 45.7% to 56.8% (P<0.001). ITSA demonstrated a consistent pre-pandemic upward trend (relative risk [RR], 1.0023; 95% confidence interval [CI], 1.0022-1.0024) and a modest immediate increase at the onset of the pandemic (RR, 1.0097; 95% CI, 1.0011-1.0184), with no sustained slope changes. The low-risk CS rate rose from 29.5% to 42.0% (P<0.001), showing a similar immediate-onset increase (RR, 1.0087; 95% CI, 1.0005-1.017). The term singleton nulliparous rate increased from 43.1% to 56.4% (P<0.001), driven entirely by the pre-pandemic trend (RR, 1.0029; 95% CI, 1.0028-1.0030), with no statistically significant immediate pandemic effect (RR, 1.0089; 95% CI, 0.9994-1.0184).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic was associated with a brief, immediate rise in overall CS rates but did not alter the long-term upward trends. This suggests persistent structural factors - such as a medico-legal environment, obstetrician shortages, and evolving practice norms - primarily drive South Korea's rising CS rates, rather than immediate clinical disruptions.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702580","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":"Sexual dysfunction and anxiety disorders among women surviving gynecologic malignancies: a cross-sectional study.","authors":"Thananya Wannasarn, Amornrat Temtanakitpaisan, Teerayut Temtanakitpaisan, Apiwat Aue-Aungkul, Apiwat Jongjakapun","doi":"10.5468/ogs.25387","DOIUrl":"10.5468/ogs.25387","url":null,"abstract":"<p><strong>Objective: </strong>Gynecologic cancer survivors frequently experience sexual dysfunction and anxiety, which can adversely affect their quality of life. Despite its clinical importance, female sexual dysfunction (FSD) remains underrecognized and undertreated. This study aimed to assess the prevalence of FSD and anxiety, as well as their associated factors, among Thai gynecologic cancer survivors.</p><p><strong>Methods: </strong>This prospective, cross-sectional study was conducted at a university hospital between July 2024 and May 2025. Eligible women aged ≥18 years who had completed treatment for gynecologic cancer at least 6 months prior were recruited. Sexual function was evaluated using the validated female sexual function index (FSFI), with a cutoff ≤26.55 indicating FSD. Anxiety was assessed using the generalized anxiety disorder seven-item scale. Associations with FSD were analyzed using the chi-square test and logistic regression analysis.</p><p><strong>Results: </strong>Of the 202 eligible women, 160 (79.0%) participated in the study. Most participants were postmenopausal (84.38%) and had an early stage disease (78.12%). The prevalence of FSD was 84.38%, with the lowest FSFI domain scores observed for arousal, lubrication, orgasm, and pain. Anxiety was predominantly mild (77.78%), with only one participant reporting severe symptoms. Multivariable analysis identified age ≥50 years (adjusted odds ratio [OR], 9.84; P<0.001) and alcohol consumption (adjusted OR, 0.25; P=0.033) as independent factors associated with FSD.</p><p><strong>Conclusion: </strong>FSD is highly prevalent among Thai gynecologic cancer survivors; however, anxiety is generally mild. Routine assessment of sexual health and multidisciplinary management should be considered a part of survivorship care to improve overall well-being.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"285-293"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158227","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":"Comparative prognostic performance of International Federation of Gynecology and Obstetrics 2023 staging system and the 2025 European Society of Gynaecological Oncology-European Society for Radiotherapy and Oncology-European Society of Pathology risk classification in endometrial cancer.","authors":"Jin Hwa Hong, Sohyeon Jeong, Yung Taek Ouh, Jae Kwan Lee, Yikyeong Chun","doi":"10.5468/ogs.26086","DOIUrl":"10.5468/ogs.26086","url":null,"abstract":"<p><strong>Objective: </strong>To compare the prognostic performance of the International Federation of Gynecology and Obstetrics (FIGO) 2023 staging system (FIGO 2023) and the 2025 European Society of Gynaecological Oncology (ESGO), European Society for Radiotherapy and Oncology, and European Society of Pathology (ESGO 2025) risk classification in endometrial cancer (EC).</p><p><strong>Methods: </strong>We retrospectively analyzed 296 patients who underwent primary surgical treatment for EC at a single tertiary institution. All cases were reclassified according to FIGO 2023 and ESGO 2025 using clinicopathological and molecular data. Recurrence-free survival (RFS) and disease-specific survival (DSS) were analyzed using the Kaplan-Meier method. Prognostic performance was assessed using the Akaike information criterion (AIC) and Harrell's concordance index (C-index) with bootstrap-derived 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Kaplan-Meier analysis demonstrated significant differences in RFS and DSS according to both ESGO 2025 and FIGO 2023 (log-rank p<0.001). For recurrence prediction, ESGO 2025 showed better model fit than FIGO 2023, with a lower AIC value (410.849 vs. 428.644), and demonstrated a numerically higher C-index (0.8657; 95% CI, 0.8266-0.9114 vs. 0.8519; 95% CI, 0.8110-0.9005). In contrast, for disease-specific mortality prediction, FIGO 2023 showed better model fit than ESGO 2025, with a lower AIC value (143.758 vs. 148.109), and demonstrated a numerically higher C-index (0.9360; 95% CI, 0.9028-0.9769 vs. 0.9063; 95% CI, 0.8624-0.9628).</p><p><strong>Conclusion: </strong>ESGO 2025 and FIGO 2023 demonstrated distinct prognostic characteristics according to the clinical endpoint, suggesting complementary roles for molecularly integrated risk stratification and anatomical staging in the management of EC.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"264-273"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406088","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":"Polymerase epsilon mutations in endometrial cancer: addressing heterogeneity, clinical applicability, and methodological refinements.","authors":"Siyuan Zhu","doi":"10.5468/ogs.26134","DOIUrl":"10.5468/ogs.26134","url":null,"abstract":"","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"303-304"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164697","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":"Acetaminophen use in pregnancy and autism: separating controversy from scientific evidence.","authors":"Soon Cheol Hong, Jung Yeol Han, Sae Kyung Choi","doi":"10.5468/ogs.26022","DOIUrl":"10.5468/ogs.26022","url":null,"abstract":"<p><p>Acetaminophen (paracetamol) has long been recommended as the preferred first-line analgesic and antipyretic in pregnancy, supported by decades of clinical experience, and has a more favorable safety profile than nonsteroidal anti-inflammatory drugs or opioids. Recently, however, political statements and media coverage linking maternal tylenol use to autism risk have amplified public concern and created uncertainty in clinical practice. This narrative review summarizes the current epidemiological evidence and positions of major professional societies and regulatory agencies on prenatal acetaminophen exposure and neurodevelopmental outcomes. A large Swedish nationwide cohort with a siblingcontrol analysis found no significant association between acetaminophen use during pregnancy and children's risk of autism spectrum disorder, attentiondeficit/hyperactivity disorder, or intellectual disability, suggesting that the previously reported modest risk elevations largely reflect confounding and methodological limitations. Similar null findings from other high-quality cohort and siblingcomparison studies indicate no causal relationship between therapeutic prenatal acetaminophen use and major neurodevelopmental disorders. Consistent with these data, organizations such as the World Health Organization, American College of Obstetricians and Gynecologists, and national regulators continue to endorse short-term guideline-concordant acetaminophen use as appropriate in pregnancy. In routine obstetric care, emphasis should be placed on maternal safety, fetal well-being, and evidence-based counseling rather than non-evidencebased concerns, with acetaminophen used at the lowest effective dose for the shortest necessary duration unless future high-quality data indicate otherwise.</p>","PeriodicalId":37602,"journal":{"name":"Obstetrics and Gynecology Science","volume":" ","pages":"249-253"},"PeriodicalIF":2.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148164665","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}