Ultrasound International Open最新文献

{"title":"Student Perceptions of Instructional Ultrasound Videos as Preparation for a Practical Assessment","authors":"M. Altersberger, P. Pavelka, A. Sachs, Michael Weber, M. Wagner-Menghin, H. Prosch","doi":"10.1055/a-1024-4573","DOIUrl":"https://doi.org/10.1055/a-1024-4573","url":null,"abstract":"Abstract Background Learning ultrasound early in the medical school curriculum helps students to understand anatomy and pathology and to perform defined ultrasound standard views. Instructional videos are a potentially valuable tool for improving the process of learning ultrasound skills. It was the aim of the present study to investigate how students perceived instructional videos as a learning aid, compared to other learning opportunities, in preparation for an Objective Structured Clinical Examination (OSCE). Materials and Methods Eleven concise ultrasound videos were created and implemented in the 4th year at the Medical University of Vienna. The videos illustrate the predefined examination process, image optimization, and nine standardized ultrasound views. The videos were available to be used in preparation for the practical ultrasound examination, which was part of the objective structured clinical examination. The students’ perceptions of the instructional videos and other learning methods were surveyed using an online questionnaire. Results In total, 445 of 640 students (69.5% of the cohort) used the instructional videos. Of those students, 134 (30%) answered the questionnaire. Of this group, 88.9% rated the instructional videos as very helpful (49.6% as extremely helpful). An ANOVA revealed a significant difference between various learning materials in terms of helpfulness. Post hoc analysis showed that instructional videos were perceived as the second most helpful learning material after “self-execution and feedback.” Conclusion The study revealed that students use instructional videos frequently and appreciate them as an extra tool for effective studying.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"1 1","pages":"E81 - E88"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89541335","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":"Isolated Echogenic Cardiac Focus: Assessing Association with Trisomy 21 by Combining Results from a Prenatal Center with a Bayesian Meta-Analysis.","authors":"Elisabeth Wrede,&nbsp;Alexander Johannes Knippel,&nbsp;Pablo Emilio Verde,&nbsp;Ruediger Hammer,&nbsp;Peter Kozlowski","doi":"10.1055/a-1118-3974","DOIUrl":"https://doi.org/10.1055/a-1118-3974","url":null,"abstract":"<p><p><b>Objective</b> To investigate the clinical relevance of an isolated echogenic cardiac focus (iECF) as a marker for trisomy 21 using a large second-trimester collective including a low-risk subgroup. <b>Materials and Methods</b> We retrospectively evaluated 1 25 211 pregnancies from 2000-2016 and analyzed all iECF cases with regard to chromosomal anomalies. It consisted of an early second-trimester collective from 14+0-17+6 weeks (n=34 791) and a second-trimester anomaly scan collective from 18+0-21+6 weeks. Two a priori risk subgroups (high and low risk) of the latter were built based on maternal age and previous screening test results using a cut-off of 1:300. Likelihood ratios (LR) of iECF for the detection of trisomy 21, trisomy 13, trisomy 18 and structural chromosomal anomalies were estimated. <b>Results</b> In total, 1 04 001 patients were included. An iECF was found in 4416 of 1 02 847 euploid fetuses (4.29%) and in 64 of 557 cases with trisomy 21 (11.49%) giving a positive LR of 2.68 (CI: 2.12-3.2). The sensitivity was 11.5% at a false-positive rate of 4.29% (CI:4.17-4.42) with p≤0.01%. In the high-and low-risk subgroups, the prevalence of iECF was comparable: 5.08% vs. 5.05%. The frequency of trisomy 21 was 0.39%, 98/24 979 vs 0.16%, 69/44 103. LR+was 3.86 (2.43-5.14) and 2.59 (1.05-4). For both subgroups the association of iECF with trisomy 21 was statistically significant. The prevalence of structural chromosomal anomalies in the second-trimester anomaly scan collective was 0.08% (52/68 967), of which 2 showed an iECF. <b>Conclusion</b> The detection of an iECF at the time of 14+0-21+6 weeks significantly increases the risk for trisomy 21 in the high-risk and in the low-risk subgroups and does not statistically change the risks for trisomy 13/18 or structural abnormalitie.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 3","pages":"E98-E106"},"PeriodicalIF":3.2,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-1118-3974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37726562","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":"Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery - A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage.","authors":"Kristoffer Lindskov Hansen,&nbsp;Peter Møller Hansen,&nbsp;Caroline Ewertsen,&nbsp;Lars Lönn,&nbsp;Jørgen Arendt Jensen,&nbsp;Michael Bachmann Nielsen","doi":"10.1055/a-0853-2002","DOIUrl":"https://doi.org/10.1055/a-0853-2002","url":null,"abstract":"Abstract Purpose Stenosis of the superficial femoral artery (SFA) induces complex blood flow with increased velocities. Disease assessment is performed with Doppler ultrasound and digital subtraction angiography (DSA), but Doppler ultrasound is limited by angle dependency and DSA by ionizing radiation. An alternative is the vector flow imaging method based on transverse oscillation (TO), an angle-independent vector velocity technique using ultrasound. In this study, flow complexity and velocity measured with TO were compared with DSA for the assessment of stenosis in the SFA. Materials and Methods The vector concentration, a measure of flow complexity, and the velocity ratio obtained from the stenosis and a disease-free adjacent vessel segment, were estimated with TO in 11 patients with a total of 16 stenoses of the SFA. TO data were compared with the corresponding stenosis degree percentage obtained with DSA. Results The correlation between the vector concentration and DSA was very strong (R=0.93; p<0.001; 95% confidence interval (CI): 0.81–0.98), while only moderate for velocity ratio and DSA (R=0.50; p<0.07; 95% CI: 0.00–0.80). The correlation coefficients that were found were significantly different (p<0.005) without overlapping CI. Conclusion The study indicated that flow changes in the SFA induced by stenosis can be quantified with TO, and that stenosis grading may be improved by estimation of flow complexity instead of velocity ratio. TO is a potential diagnostic tool for the assessment of atherosclerosis and peripheral arterial disease.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 2","pages":"E53-E59"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0853-2002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37069737","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":"Editorial.","authors":"Adrian Saftoiu","doi":"10.1055/a-0868-8065","DOIUrl":"https://doi.org/10.1055/a-0868-8065","url":null,"abstract":"","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 2","pages":"E52"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0868-8065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37686843","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":"The ‘Disappearing’ Liver on CEUS: Nothing to Worry About","authors":"T. Müller, F. Posnien, C. Sarrazin","doi":"10.1055/a-1005-7459","DOIUrl":"https://doi.org/10.1055/a-1005-7459","url":null,"abstract":"scattered tight pattern of hyperechoic areas (▶Fig. 3). The etiology of the phenomenon is still unknown and various hypotheses have been discussed: intestinal formation of unsheathed gas, bubble fusion or gas bubble pooling (Caruso G et al. Radiol Med (Torino) 2007; 112: 56–63; Shimada T et al. Ultrasound Med Biol 2012; 38: 1317–1323; Cui XW et al. Ultraschall Med 2014; 35: 246– 252). In all reported cases except one, the patients remained free of symptoms and liver enzymes were not reported to be altered. One patient experienced “general discomfort and a transient skin rush” during the infusion of the contrast media, before the appearance of PHLE (Tana C et al. Ultrasound Med Biol 2013; 39: 2214). After days, the US image of the liver is normal again in all patients. In the few patients that received a second portion of US contrast media days later, the phenomenon did not reappear. From the case series estimations, the incidence rate seems to be somewhere around 0.01–0.8 % of CEUS examinations. These rates are questionable and do not quite match the results from a recent oral survey among experienced German medical doctors, each having performed more than 1 000 CEUS investigations. Most of them were not aware of this side effect of contrast media.","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"24 1","pages":"E78 - E79"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90541772","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-Guided Drainage of a Pancreatic Pseudocyst after a Bicycle Trauma","authors":"H. Grossjohann, T. Kristensen, C. Hansen","doi":"10.1055/a-0948-5620","DOIUrl":"https://doi.org/10.1055/a-0948-5620","url":null,"abstract":"Blunt pancreatic injuries are rare as they only comprise 1–5% of abdominal trauma, and half of the cases are seen in combination with multiple injuries. More than 60% of pancreatic injuries are located in the body and tail of the gland (Krige JE et al. Pancreatology. 2017;17(4):592–598). \u0000 \u0000Pancreatic trauma often entails severe lesions with a high morbidity and mortality if treatment is delayed or inadequate (Mohseni S et al. Injury. 2018;49(1):27–32). Treatment is controversial and depends on whether the main pancreatic duct has been injured. Grade I and II trauma is usually managed conservatively, while grade III to V trauma is generally managed operatively either with drainage or resection of major parts of the gland (Ho VP et al. J Trauma Acute Care Surg . 2017;82(1):185–99). However, an increasing number of studies suggest that non-operative management with drainage alone rather than resection may provide acceptable outcomes (Menahem B et al. Hepato Biliary Surg Nutr. 2016;5(6):470–77). \u0000 \u0000We present an acute case with a grade III lesion of the pancreatic neck in an adult treated with surgical drainage and subsequent drainage of a pseudocyst with a lumen-apposing metal stent (LAMS) with conservation of the gland. \u0000 \u0000Case presentation \u0000A 27-year-old healthy female suffered a grade III lesion of her pancreas after she fell from a bicycle and landed on the handlebar. At a local hospital a pancreatic contusion was found on a trauma CT scan, and the patient was referred to a level 1 trauma center with specialized HPB function. A reassessment of the CT scan revealed complete rupture of the pancreatic neck with a retroperitoneal hematoma without signs of other abdominal injuries. An MRCP confirmed rupture of the main duct with a diastasis measuring 2 cm ( Fig. 1 ). A conservative approach was chosen, and the patient was treated with a nasogastric tube with continuous suction, intravenous proton pump inhibitor (pantoprazole 40 mg b.i.d.), subcutaneous octreotide 100 microgram t.i.d., intravenous cefuroxime 1500 mg t.i.d., metronidazole 1500 mg q.d. and parenteral nutrition. On the third day of admission an endoscopic retrograde cholangiopancreatography (ERCP) with papillotomy of the pancreatic duct was performed to ease the flow to the duodenum and diminish the leakage from the severed duct. Due to the considerable diastasis of the duct ends and the large hematoma with displacement of the fractured parts, an attempt to insert a bridge prosthesis over the contused area was not attempted. On the fourth day the patient’s condition deteriorated with increasing abdominal pain, inflammatory parameters and on free intraperitoneal fluid seen on ultrasonography. A laparotomy was performed with removal of 2000 ml ascites, but the surgeon refrained from resection of the distal part of the gland due to a large retroperitoneal hematoma in the retroperitoneal space. Instead two external 18 Fr tubes were placed along the superior and inferior pancreatic border, r","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"87 1","pages":"E75 - E77"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75410125","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":"Thyroid Lymphoepithelial Cysts Mimicking Calcified or Solid Nodules on Ultrasonography.","authors":"Yukie Tsutsuura,&nbsp;Mitsuyoshi Hirokawa,&nbsp;Ayana Suzuki,&nbsp;Hisashi Ota,&nbsp;Maki Oshita,&nbsp;Mitsuhiro Fukushima,&nbsp;Kaoru Kobayashi,&nbsp;Akira Miyauchi","doi":"10.1055/a-0943-6553","DOIUrl":"https://doi.org/10.1055/a-0943-6553","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid lymphoepithelial cysts (TLECs) are rare, and detailed ultrasonography (US) findings have not been reported. This study aimed to examine in detail the US findings for 32 TLECs and to clarify the diagnostic problems associated with them.</p><p><strong>Materials and methods: </strong>We examined 32 TLECs resected from 21 patients at the Kuma hospital between January 2008 and April 2018. All patients underwent US before resection. From the patients' medical records, we retrospectively assessed US reports and photographs of TLECs.</p><p><strong>Results: </strong>The following four types of TLECs were classified: cystic, mixed solid and cystic, pseudo-solid, and pseudo-calcified types. The incidences were 50.0%, 12.5%, 12.5%, and 25.0%, respectively. Among the four types, pseudo-calcified TLECs were the smallest in size (mean: 7.1 mm). Of 24 nodules that had been interpreted in US reports, 11, 9, 1, 2, and 1 were benign, very low, low, intermediate, and high, respectively. Calcification and intramural solid growth were not identified by histological examination.</p><p><strong>Conclusion: </strong>We should be aware that approximately half of TLECs do not exhibit US appearances typical of simple cysts, and TLECs may mimic calcified or solid nodules on US, although the reason remains unknown.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 2","pages":"E60-E64"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0943-6553","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37398048","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":"Review of Dancing Parasites in Lymphatic Filariasis","authors":"C. Dietrich, N. Chaubal, A. Hoerauf, K. Kling, M. Piontek, L. Steffgen, S. Mand, Yi Dong","doi":"10.1055/a-0918-3678","DOIUrl":"https://doi.org/10.1055/a-0918-3678","url":null,"abstract":"Abstract Lymphatic filariasis is an infection transmitted by blood-sucking mosquitoes with filarial nematodes of the species Wuchereria bancrofti, Brugia malayi und B. timori. It is prevalent in tropical countries throughout the world, with more than 60 million people infected and more than 1 billion living in areas with the risk of transmission. Worm larvae with a length of less than 1 mm are transmitted by mosquitoes, develop in human lymphatic tissue to adult worms with a length of 7–10 cm, live in the human body for up to 10 years and produce millions of microfilariae, which can be transmitted further by mosquitoes. The adult worms can be easily observed by ultrasonography because of their size and fast movements (the so-called “filarial dance sign”), which can be differentiated from other movements (e. g., blood in venous vessels) by their characteristic movement profile in pulsed-wave Doppler mode. Therapeutic options include (combinations of) ivermectin, albendazole, diethylcarbamazine and doxycycline. The latter depletes endosymbiotic Wolbachia bacteria from the worms and thus sterilizes and later kills the adult worms (macrofilaricidal or adulticidal effect).","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"96 1","pages":"E65 - E74"},"PeriodicalIF":3.2,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73932667","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":"EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound.","authors":"Dieter Nuernberg,&nbsp;Adrian Saftoiu,&nbsp;Ana Paula Barreiros,&nbsp;Eike Burmester,&nbsp;Elena Tatiana Ivan,&nbsp;Dirk-André Clevert,&nbsp;Christoph F Dietrich,&nbsp;Odd Helge Gilja,&nbsp;Torben Lorentzen,&nbsp;Giovanni Maconi,&nbsp;Ismail Mihmanli,&nbsp;Christian Pallson Nolsoe,&nbsp;Frank Pfeffer,&nbsp;Søren Rafael Rafaelsen,&nbsp;Zeno Sparchez,&nbsp;Peter Vilmann,&nbsp;Jo Erling Riise Waage","doi":"10.1055/a-0825-6708","DOIUrl":"https://doi.org/10.1055/a-0825-6708","url":null,"abstract":"<p><p>This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). PNUS sometimes is more flexible and convenient compared to ERUS. However, the technique of ERUS is quite well established, especially for the staging of rectal cancer. EAUS also gained ground in the evaluation of perianal diseases like fistulas, abscesses and incontinence. For the staging of perirectal tumors, the use of PNUS in addition to conventional ERUS could be recommended. For the staging of anal carcinomas, PNUS can be a good option because of the higher resolution. Both ERUS and PNUS are considered excellent guidance methods for invasive interventions, such as the drainage of fluids or targeted biopsy of tissue lesions. For abscess detection and evaluation, contrast-enhanced ultrasound (CEUS) also helps in therapy planning.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 1","pages":"E34-E51"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0825-6708","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36983343","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":"The Role of US Contrast Agents in US-Guided Biopsy of Focal Liver Lesions: A Pictorial Review.","authors":"Torben Lorentzen,&nbsp;Christian Pallson Nolsoe","doi":"10.1055/a-0770-4237","DOIUrl":"https://doi.org/10.1055/a-0770-4237","url":null,"abstract":"<p><p>US-guided percutaneous biopsy of focal liver lesions (FLL) is a classic interventional procedure performed by almost all radiology units. Typically, an incidental focal finding on US or a focal indeterminate lesion diagnosed on CT, MRI or PET/CT is referred for US-guided biopsy for final diagnosis. The introduction of microbubble US contrast agents has overcome some of the limitations of standard US in diagnosing FLLs by displaying the microvasculature together with the US morphology, which has increased both the sensitivity and the specificity. The combination of CEUS and intervention is facilitated by newer US equipment providing split-screen mode, which displays the CEUS mode alongside the standard US mode simultaneously on a single monitor. The puncture line is displayed in both modes as well as on the monitor. The interventional device (i. e., biopsy needle) is typically best visualized in the standard US mode, while the characteristic tissue pattern in an FLL is typically best visualized in CEUS mode. There are 3 main categories in which CEUS has an impact on US-guided biopsy of FLLs: • CEUS improves the visualization of FLLs • CEUS improves the quality of the biopsy specimen from an FLL • CEUS reduces the need for US-guided biopsy of an FLL In the two first categories, CEUS is utilized simultaneously with US-guided biopsy to ensure correct needle targeting. In the last category, US-guided biopsy of the FLL becomes superfluous as a result of the CEUS examination.</p>","PeriodicalId":44852,"journal":{"name":"Ultrasound International Open","volume":"5 1","pages":"E11-E19"},"PeriodicalIF":3.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0770-4237","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36815481","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}