Gastro hep advances最新文献

{"title":"Disproportionate rates of liver injury in people with cystic fibrosis on elexacaftor/tezacaftor/ivacaftor in Queensland, Australia","authors":"Ellie Johnson , Timothy Riddles , Daniel Smith , Daniel Henderson , Philip Masel , David W. Reid , Vanessa Moore , Ieuan E.S. Evans","doi":"10.1016/j.gastha.2025.100641","DOIUrl":"10.1016/j.gastha.2025.100641","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 6","pages":"Article 100641"},"PeriodicalIF":0.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923038","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":"Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study","authors":"Beau Blass BS ,&nbsp;Jay B. Lusk MD, MBA ,&nbsp;Hannah Mahoney MS ,&nbsp;Molly N. Hoffman MPH ,&nbsp;Amy G. Clark PhD ,&nbsp;Jonathan Bae MD ,&nbsp;Matthew J. Townsend MD, MSc, MPP ,&nbsp;Amit Patel MD ,&nbsp;Andrew J. Muir MD, MHS ,&nbsp;Bradley G. Hammill DrPH","doi":"10.1016/j.gastha.2025.100614","DOIUrl":"10.1016/j.gastha.2025.100614","url":null,"abstract":"<div><h3>Background and Aims</h3><div>To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to healthcare resources, and treatment facility characteristics.</div></div><div><h3>Methods</h3><div>We analyzed a nationwide sample of United States Medicare beneficiaries hospitalized from 2017-2019 for common gastrointestinal diseases, grouped by Diagnosis Related Groups (DRGs). We then estimated the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index (ADI), with 30-day mortality and readmission utilizing logistic regression models with restricted cubic splines. We performed multi-step adjustments for individual socioeconomic status and demographics, medical comorbidities, access to inpatient and outpatient healthcare resources, and hospital-level characteristics.</div></div><div><h3>Results</h3><div>In total, 1,293,483 patients in the mortality cohort and 1,289,106 patients in the readmission cohort were included in analysis. The fully-adjusted model demonstrated an association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, with the strongest associations for non-malignant pancreatic disorders (OR 1.59, 95% CI 1.25-2.01), esophageal disorders (OR 1.50, 95% 1.02-2.21), gastrointestinal hemorrhage (OR 1.40, 95% CI 1.29-1.52), and biliary tract disorders (OR 1.40, 95% CI 1.16-1.69) in the most deprived groups. Neighborhood deprivation was not associated with 30-day readmission after full adjustment.</div></div><div><h3>Conclusion</h3><div>We describe an independent association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, which remains even after controlling for individual poverty, demographics and comorbidities, access to healthcare resources, and characteristics of treating facilities.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100614"},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792377","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":"Clinical Phenotypes May be Able to Identify Populations with Non-Alcoholic Fatty Liver-Spectrum Disease","authors":"Bridget M. Geyer MD, MSc ,&nbsp;Feier Chang ,&nbsp;Peng Wu ,&nbsp;Benjamin A. Goldstein PhD ,&nbsp;Kara Wegermann MD ,&nbsp;Sunny L. Chung MD ,&nbsp;Matthew Phelan MS ,&nbsp;Joseph Wawrzynski MD ,&nbsp;Jacqueline B. Henson MD ,&nbsp;Howard Lee MD ,&nbsp;Phil Ambery MBChB, FRCP, FFPM ,&nbsp;Cynthia A. Moylan MD, MHS ,&nbsp;Neha Pagidipati MD, MPH","doi":"10.1016/j.gastha.2024.100611","DOIUrl":"10.1016/j.gastha.2024.100611","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Despite causing significant morbidity and mortality, non-alcoholic fatty liver disease (NAFLD) is underdiagnosed. Clinical indices developed to identify hepatic steatosis are often used by providers but their potential for use at the population level remains unexplored. We assessed clinical phenotypes for their ability to identify potential patients with NAFLD and non-alcoholic steatohepatitis (NASH) in the electronic health record (EHR).</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective cohort study of adult patients from January 1, 2016-Decmber 31, 2022. We developed four phenotypes: clinical NAFLD (C-NAFLD), clinical NASH (C-NASH), NAFLD with diagnosis (D-NAFLD) and NASH with diagnosis (D-NASH) and compared characteristics across them to identify differences between patients with and without ICD diagnoses.</div></div><div><h3>Results</h3><div>Each of the (C) phenotypes identified a cohort of patients who had clinical evidence suggestive of disease without a documented diagnosis. Black patients were overrepresented in the (C) relative to (D) groups (C-NAFLD 24.3% vs. D-NAFLD 21.2%; C-NASH 28.5% vs. D-NASH 14.0%). Patients with D-NASH were more likely to be prescribed medications that may be effective in treating NAFLD-NASH spectrum disease, i.e., glucagon-like peptide 1 (GLP-1) receptor agonists (C-NASH 5.0% vs. D-NASH 16.7%, p &lt; 0.001). Fewer patients with D-NASH had cardiovascular (C-NASH 58.0% vs D-NASH 46.3%, p &lt; 0.001) and heart failure (C-NASH 33.9% vs. D-NASH 24.8%, p &lt; 0.001) hospitalizations than those with C-NASH.</div></div><div><h3>Conclusions</h3><div>Non-invasive clinical indices may improve identification of patients with or at risk for NAFLD-NASH at the population level. Systematic differences between populations with and without ICD diagnoses of NAFLD-spectrum disease suggest disparities in the application of screening and diagnostic procedures.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 5","pages":"Article 100611"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792376","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":"Alcohol Relapse After Liver Transplantation: Risk Factors, Outcomes, and a Comparison of Risk Stratification Models","authors":"Karen Young ,&nbsp;Yuval A. Patel ,&nbsp;Benson Hoffman ,&nbsp;Sarah Peskoe ,&nbsp;Shein-Chung Chow ,&nbsp;Karli Erhart ,&nbsp;Jennifer Jackson ,&nbsp;Stephanie Garbarino","doi":"10.1016/j.gastha.2024.09.005","DOIUrl":"10.1016/j.gastha.2024.09.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Alcohol-related liver disease is a leading cause of liver transplantation (LT) in the United States; however, alcohol relapse remains a risk, and real-world assessment of relapse prediction scores is lacking. The primary aim of this study was to assess risk factors for alcohol relapse and compare effectiveness of pre-existing risk scores (e.g., Sustained Alcohol Use Post-Liver Transplant (SALT) and Harmful Alcohol Use Post-Liver Transplant (HALT) scores).</div></div><div><h3>Methods</h3><div>This was a retrospective chart review of 69 adults who underwent LT for alcohol-related liver disease at Duke University Hospital from January 1, 2018, to January 1, 2021. Outcome variables included relapse post-LT, severity of relapse, and graft dysfunction.</div></div><div><h3>Results</h3><div>Sixty-seven patients with a median follow-up time of 43 months were included. Eighteen (27%) experienced alcohol relapse. Of those, 16 (89%) had heavy alcohol use and 3 of those patients (17%) experienced graft dysfunction. Factors significantly associated with relapse included younger age, prior relapse, significant psychiatric comorbidities, alcohol use after cirrhosis diagnosis, shorter abstinence before LT listing, and prior alcohol treatment program. When applying SALT and HALT scores, the area under the curve was 0.69 (95% confidence interval 0.53–0.85) and 0.66 (95% confidence interval 0.50–0.81), respectively.</div></div><div><h3>Conclusion</h3><div>In our cohort, heavy alcohol use before transplantation and legal issues did not predict relapse, which are common components of prediction scores. Less than 5% of patients had graft dysfunction due to relapse, suggesting good graft outcomes. While the HALT and SALT scores were validated in our cohort, our finding of additional significant predictors of relapse, in addition to previously reported risk factors providing protective effect, suggests opportunity for further optimization of prediction scores.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100550"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985587","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":"Association of Statin, Metformin, and Aspirin Use With Hepatocellular Carcinoma in the All of Us Research Program","authors":"Erik Almazan ,&nbsp;Raymond T. Chung","doi":"10.1016/j.gastha.2024.08.014","DOIUrl":"10.1016/j.gastha.2024.08.014","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100535"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933749","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":"Impact of Order Set on Exocrine Pancreatic Insufficiency in Chronic Pancreatitis, Pancreatic Cancer, and Pancreatic Resection","authors":"Michael Ladna ,&nbsp;Ishaan Madhok ,&nbsp;Adnan Bhat ,&nbsp;Nicole Ruiz ,&nbsp;Jackson Brown ,&nbsp;Jake Wilson ,&nbsp;Peter Jiang ,&nbsp;Robert Taylor ,&nbsp;Mark Radetic ,&nbsp;John George ,&nbsp;Christopher Forsmark","doi":"10.1016/j.gastha.2024.08.019","DOIUrl":"10.1016/j.gastha.2024.08.019","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Enzyme insufficiency (EPI) is common in chronic pancreatitis (CP), pancreatic ductal adenocarcinoma (PDAC), and after pancreatic resection. 40%–50% of CP patients and 70%–80% of PDAC patients develop EPI. 1/3rd of these patients are prescribed Pancreatic enzyme replacement therapy (PERT), often at an inadequate dose, with evidence that this leads to increased morbidity and mortality. This study aimed to develop and implement an EPIC-based best practice alert (BPA) and smart set to improve the management of EPI.</div></div><div><h3>Methods</h3><div>A retrospective analysis of all patients with International Classification of Diseases codes for EPI, CP, and PDAC or CPT code for pancreatic resection from Feb-2018 to Feb-2021. Appropriate use of PERT was defined as ≥ 40,000 units of lipase with each meal. The BPA and smart set were implemented into the electronic medical record in Feb-2020. The BPA fired if the patient was already on PERT or if an order for PERT was placed and directed the clinician to the smart set which provided PERT formulations each prefilled to the minimum therapeutic dose of 40,000 units of lipase.</div></div><div><h3>Results</h3><div>A significant increase in the proportion of patients on minimum therapeutic dose of PERT from 61.9% to 72.9% (<em>P</em> ≤ .001). Ordering of pancreatic elastase, A1c, vitamin D, and dual X-ray absorptiometry increased from 20.4% to 29.9% (<em>P</em> &lt; .001), 54.7%–62.1% (<em>P</em> = .001), 30.9%–48.1% (<em>P</em> &lt; .001) and 10%–18% (<em>P</em> &lt; .001), respectively. The BPA triggered a total of 30,838 times resulting in the smart being opened a total of 624 (2.02%) times over 24 months.</div></div><div><h3>Conclusion</h3><div>The BPA and smart set were associated with an improvement in the diagnosis and management of EPI and related complications in CP, PDAC, and s/p pancreatic resection.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100541"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959695","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":"Nucleos(t)ide Analog Treatment Discontinuation in Chronic Hepatitis B Virus Infection: A Systematic Literature Review","authors":"Robert Gish ,&nbsp;Kosh Agarwal ,&nbsp;Anadi Mahajan ,&nbsp;Supriya Desai ,&nbsp;Saifuddin Kharawala ,&nbsp;Rob Elston ,&nbsp;Joyeta Das ,&nbsp;Stuart Kendrick ,&nbsp;Vera Gielen","doi":"10.1016/j.gastha.2024.08.015","DOIUrl":"10.1016/j.gastha.2024.08.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The aim of this systematic literature review (SLR) was to examine outcomes and associated predictors following nucleos(t)ide analog (NA) treatment cessation in adult patients with chronic hepatitis B virus infection.</div></div><div><h3>Methods</h3><div>The SLR was conducted according to PRISMA methodology. All included studies were quality assessed using appropriate scales or checklists.</div></div><div><h3>Results</h3><div>The SLR identified 145 studies. Cumulative rates of clinical relapse (40 studies), virological relapse (53 studies), biochemical relapse (10 studies) and retreatment events (14 studies) post NA cessation varied widely across studies (clinical relapse: 40%–65%, virological relapse: 75%–94%, biochemical relapse: 63%–73%, retreatment rates: 30%–78% at 24 and 144 weeks, respectively). Significant predictors with adequate evidence of clinical relapse included older age, male gender, and higher hepatitis B surface antigen (HBsAg) and hepatitis B virus DNA at baseline and end of treatment. HBsAg loss was reported in 25 studies, with overall median HBsAg loss rates ranging from 2% at 24 weeks (5 studies) to 11% at 192 weeks (2 studies) post NA cessation. There was adequate evidence for lower HBsAg level at baseline and end of treatment as a significant and consistent predictor of HBsAg loss.</div></div><div><h3>Conclusion</h3><div>There is considerable heterogeneity among studies of NA cessation. Data are currently incomplete to provide strong recommendations for NA cessation or to identify patients who may benefit most from this approach in clinical practice. Further studies are required to provide clearer guidelines, and tools to assess and monitor patients who may benefit from NA treatment cessation.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 1","pages":"Article 100536"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959699","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":"Family History of Eosinophilic Esophagitis or Other Eosinophilic Gastrointestinal Disease Is Not Associated With Response to Topical Steroids in Eosinophilic Esophagitis","authors":"Angela Z. Xue ,&nbsp;Sean S. LaFata ,&nbsp;Timothy S. Gee ,&nbsp;Hannah L. Thel ,&nbsp;Brenderia A. Cameron ,&nbsp;Akshatha Kiran ,&nbsp;Adolfo A. Ocampo ,&nbsp;Justin McCallen ,&nbsp;Christopher J. Lee ,&nbsp;Stephanie A. Borinsky ,&nbsp;Walker D. Redd ,&nbsp;Trevor S. Barlowe ,&nbsp;Rayan N. Kaakati ,&nbsp;Cary C. Cotton ,&nbsp;Swathi Eluri ,&nbsp;Craig C. Reed ,&nbsp;Evan S. Dellon","doi":"10.1016/j.gastha.2024.11.001","DOIUrl":"10.1016/j.gastha.2024.11.001","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 3","pages":"Article 100585"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139833","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":"A Comprehensive Assessment of Liver Transplant Trends and Outcomes Among Adults With Steatotic Liver Disease in the U.S.","authors":"Shyam Patel ,&nbsp;Sohil Patel ,&nbsp;Wei Zhang ,&nbsp;Ashwani K. Singal ,&nbsp;Ramsey Cheung ,&nbsp;Robert J. Wong","doi":"10.1016/j.gastha.2024.100609","DOIUrl":"10.1016/j.gastha.2024.100609","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Steatotic liver disease (SLD) is the leading indication for liver transplantation (LT) among U.S. adults. We aim to provide comprehensive updates of LT trends and outcomes among adults with SLD, highlighting racial, ethnic, and sociodemographic disparities.</div></div><div><h3>Methods</h3><div>Using data from the 2010 to 2023 United Network for Organ Sharing registry, we performed a retrospective cohort study evaluating LT waitlist trends, waitlist outcomes, and post-LT survival among 65,675 adults with SLD. Disparities in LT outcomes were evaluated using adjusted competing risks analyses.</div></div><div><h3>Results</h3><div>From 2014 to 2023, there was an increasing proportion of Hispanics, women, and younger adults with SLD listed for LT. For Hispanics, this was driven by metabolic dysfunction–associated steatohepatitis (MASH); 19.9% of MASH wait-listings in 2023 were Hispanics. For women and younger adults (18–39 years), this was driven by alcohol-associated liver disease (ALD); 30.9% and 16.4% of ALD-related wait-listings in 2023 were women and younger adults, respectively. Women (vs men) had greater waitlist removal risk (subdistribution hazard ratio (sHR) 1.12, 95% confidence interval (CI) 1.07–1.18) and lower likelihood of LT receipt (sHR 0.87, 95% CI, 0.85–0.90). Ethnic minorities had worse outcomes, particularly Hispanics, who had a 37% higher risk of waitlist removal (sHR 1.37, 95% CI, 1.30–1.45) and 16% lower likelihood of LT receipt (sHR 0.86, 95% CI, 0.82–0.87) vs non-Hispanic whites. Disparities in post-LT survival were also observed.</div></div><div><h3>Conclusion</h3><div>In 2023, nearly one-quarter of MASH liver transplant waitlist registrants were Hispanics. Approximately half and 1 in 6 ALD waitlist registrants were women and younger adults, respectively. These concerning trends are amplified by the disparities in LT outcomes observed among women and ethnic minorities.</div></div>","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100609"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378148","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":"Microfluidic Flow Promotes a Steatotic Phenotype in Induced Pluripotent Stem Cell–Derived Hepatocytes that is Influenced by Disease State of the Donor","authors":"Ekta Minocha ,&nbsp;Linan Jiang ,&nbsp;Ashwani Kumar Gupta ,&nbsp;Richard M. Green ,&nbsp;Yitshak Zohar ,&nbsp;Jason A. Wertheim","doi":"10.1016/j.gastha.2024.100601","DOIUrl":"10.1016/j.gastha.2024.100601","url":null,"abstract":"","PeriodicalId":73130,"journal":{"name":"Gastro hep advances","volume":"4 4","pages":"Article 100601"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143237195","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}