Current problems in diagnostic radiology最新文献

{"title":"Impact of turnaround time in radiology: The good, the bad, and the ugly.","authors":"Brandon Ritchie, Lesley Summerville, Max Sheng, Monica Choi, Sree Tirumani, Nikhil Ramaiya","doi":"10.1067/j.cpradiol.2025.04.018","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.018","url":null,"abstract":"<p><p>Turnaround time (TAT) has evolved into a complex metric in the current era of diagnostic radiology. Initially monitoring a radiologist's ability to efficiently generate a report, there is now a hierarchy of stakeholders who are affected by its modern-day interpretation and use. This article explores \"more than the metric\" and reviews the multi-faceted use and implementation of TAT through the lens of a large academic hospital network. The authors highlight \"The Good\" of turnaround time as a useful quality metric that guides patient outcomes, organizational performance, and revenue generation, and they discuss how it has been implemented at their institution to positively influence workflow and guide departmental staffing. The \"bad\" implications of TAT are discussed, which can strain radiology departmental workflows and propagate issues such as delays in finalizing reports for inpatient and outpatient worklists in the setting of rapidly growing imaging volumes. Broader systemic issues of TAT are discussed within \"The Ugly\" section of this review, which highlights TAT's negative impact on resident education, physician burnout, and its creation of \"New School\" and \"Old School\" radiologist practices. The article provides further discussion of existing strategies and future directions that can mitigate the negative impacts of TAT, including various staffing models, approaches to optimize workflow systems, and methods for re-prioritizing STAT cases using artificial intelligence. The authors conclude with a call for balanced, continued implementation of TAT as a metric but not at the expense of sacrificing the quality of work performed by radiologists and trainees.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003651","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":"Nationwide survey of benefits provided to radiology residents in the United States.","authors":"Muhammad Y Hameed, Surbhi Raichandani, Andrew Baker, Evan D Hicks, Paula K Roberson, Roopa Ram","doi":"10.1067/j.cpradiol.2025.04.009","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.009","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively evaluate key benefits offered by various diagnostic radiology residency programs in the United States, focusing on stipends, research support, educational resources, time-off policies, mini-fellowships, and additional perks. The goal is to offer insights into the diverse landscape of resident compensation, as well as the variety and type of benefits.</p><p><strong>Methods: </strong>Data collection utilized an anonymous survey of diagnostic radiology residency programs, addressing stipends, research support, educational resources, time-off policies, mini-fellowships, and additional benefits. A structured questionnaire facilitated responses from program representatives which were collected during March-April 2023. The survey employed quantitative and qualitative questions to gather comprehensive information. Descriptive statistics and correlations were subsequently performed to analyze the responses.</p><p><strong>Results: </strong>Analysis of stipends revealed significant geographic and program-related variations, impacting resident compensation. Analysis of post pandemic era stipends showed that R1 stipends ranged from less than $45,000 to over $65,000, with statistically significant differences across geographic regions (p = 0.01). R1 stipends varied significantly across different Cost-of-Living Index (COLI) groups (p < 0.01). While most programs provide support for educational and research activities, such as conference leave and funding for specialized courses, there was considerable variability in the type and extent of benefits offered, reflecting a lack of standardization among residency programs.</p><p><strong>Discussion: </strong>The study outcomes prompt actionable considerations for optimizing benefits provided by radiology residency programs. Geographic and program-specific stipend variations underscore the importance of establishing stipend compensation at par with cost-of-living expenses. Comprehensive knowledge of the trends and variation in residency benefits could guide program enhancements, with the overarching goal of supplementing current stipends to enhance resident satisfaction and well-being.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050143","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":"Preparing the next generation of healthcare leaders through a longitudinal management and leadership training program for radiology residents.","authors":"Krishnaveni Parvataneni, Regina Tamposi, Theresa C McLoud, Michael S Gee, James A Brink, Dania Daye","doi":"10.1067/j.cpradiol.2025.04.013","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.013","url":null,"abstract":"<p><p>Though few feel adequately prepared, the increasing complexity of healthcare systems highlights a need for physicians to develop management skills. Some training programs for residents exist, including Physician Management Pathway. Such programs are inaccessible for radiology residents, underscoring the need for tailored, accessible management training fitting into the standard 4-year radiology residency. The James H. Thrall Management and Leadership Training (MLT) program at Massachusetts General Hospital was designed to address this gap with a tailored, comprehensive curriculum integrating didactics, practical experience, mentorship, and scholarly projects, integrated into the standard four-year radiology residency. The MLT program is comprised of five key components: a structured didactic curriculum, practical administrative experience, mentorship, a scholarly project, and a capstone in health policy and management or quality and patient safety. This manuscript outlines the design, implementation,a nd preliminary outcomes of the MLT program and serves as a model for developing future physician-leaders prepared to navigate the complexities of healthcare.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027763","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":"FDA-approved artificial intelligence products in abdominal imaging: A comprehensive review.","authors":"Pranav Ajmera, Ryan Dillard, Timothy Kline, Andrew Missert, Panagiotis Korfiatis, Ashish Khandelwal","doi":"10.1067/j.cpradiol.2025.04.011","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.011","url":null,"abstract":"<p><strong>Purpose: </strong>This review aims to provide a comprehensive overview of the transformative impact of FDA-approved artificial intelligence (AI) products in abdominal imaging. It explores the evolution of AI in radiology, its rigorous FDA clearance process, and its role in revolutionizing diagnostic and non-diagnostic tasks across various abdominal organs.</p><p><strong>Methods: </strong>Through a review of literature, this study categorizes AI products based on their applications in liver, prostate, bladder, kidney, and overall abdominal imaging. It analyzes the diagnostic and non-diagnostic functionalities of these AI solutions, elucidating their capabilities in enhancing disease detection, image quality, workflow efficiency, and longitudinal comparison standardization.</p><p><strong>Results: </strong>The review identifies numerous FDA-approved AI products tailored for abdominal imaging, showcasing their diverse applications, from lesion detection and characterization to volume estimation and quantification of organ health parameters. These AI solutions have demonstrated their efficacy in improving diagnostic accuracy, streamlining radiological workflows, and ultimately optimizing patient care across various abdominal pathologies.</p><p><strong>Conclusion: </strong>In conclusion, the integration of AI into abdominal imaging represents a paradigm shift in modern radiology. By empowering radiologists with advanced tools for timely diagnosis, precise treatment planning, and improved patient outcomes, FDA-approved AI products herald a new era of innovation in abdominal imaging. Collaboration between developers, regulatory bodies, and the medical community will be paramount in harnessing the full potential of AI to reshape the future of abdominal radiology.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060409","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":"Malpractice litigation in diagnostic radiology with special focus on cases in the abdomen and pelvis: A comprehensive analysis from a national legal database.","authors":"Sawyer D Miller, Thomas M Pender, Jake Lallo, Jonathan Lazarow, Frances Lazarow","doi":"10.1067/j.cpradiol.2025.04.003","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.003","url":null,"abstract":"<p><strong>Objective: </strong>Diagnostic radiology is regarded as a \"high-risk\" specialty in the medical malpractice literature. This study examines the causes and patterns and types of medical malpractice litigation and outcomes in radiology in the United States, with a particular focus on diagnostic radiology errors involving the abdomen and pelvis.</p><p><strong>Methods: </strong>Malpractice suits in which the defendant was a radiologist in the United States from 2008 to 2018 were identified using LexisAdvance, a national legal database. 2775 cases were initially identified, and 1165 cases fit the inclusion criteria.</p><p><strong>Results: </strong>Diagnostic error was the most prevalent error type, (n = 925, 82.9 %), followed by procedural errors (n = 106, 9.5 %), communication errors (66 cases, 5.9 %), and mixed/other errors (n = 19, 1.7 %). Breast was the most common imaging modality implicated in medical error (n = 211, 26.4 % of total cases), followed by CT (n = 186, 23.3 %), and XR (n = 146, 18.3 %). Out-of-court settlement was the most common outcome (n = 402, 44.5 %), followed by a verdict ruled in favor of the defendant (n = 246, 27.2 %) and case dismissal (n = 131, 14.5 %). The average award in a settlement was $1,500,690 USD (range: $25,000- $10,200,000 USD). The average award in a jury verdict for the plaintiff was $2,857,203 USD (range: $60,000- $31,490,000 USD), and the average award in arbitration for the plaintiff was $1,354,497 USD (range: $200,000- $2,800,000 USD). The gastrointestinal (GI) system and the genitourinary (GU) system accounted for 51.9 % and 25.9 % of errors in the abdomen and pelvis, respectively.</p><p><strong>Discussion: </strong>Diagnostic error was the most prevalent source of error leading to malpractice litigation. Breast imaging was the most frequently implicated imaging modality in litigations, followed closely by CT and XR. A majority of cases were resolved through out-of-court settlement or with judgments in favor of the defendant radiologists. However, in cases with trial judgments in favor of the plaintiff, average financial awards were higher than out-of-court settlements. Abdomen and pelvic involvement accounted for frequent sources of error.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045712","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 welcoming change: Quality improvement project to improve new radiology residents' early experiences.","authors":"Scotty McKay, Arif Musa, Hassan Shaban, Ali Harb, Mohammed Twam, Alhassan Alhasson, Hassan Alfanharwi, Jacob Turner, Jared Huggins, Gulcin Altinok","doi":"10.1067/j.cpradiol.2025.04.004","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.004","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnostic radiology residents often face challenges transitioning from medical school and internship to radiology residency. To address this, senior residents in our program developed a Welcoming Committee (WC) to initiate early communication with matched applicants and support incoming radiology residents as they transition.</p><p><strong>Methods: </strong>A resident-led WC was developed by senior residents to support newly matched applicants. Matched applicants were added to a messaging platform for senior residents to communicate important program updates and answer questions. During the first week of residency, WC members organized workshops to discuss topics that may benefit incoming residents. An anonymous electronic survey was sent to first-year residents, who received WC interventions, and senior residents, who transitioned to radiology residency before the establishment of the WC. Responses were scored using a Likert scale to quantify the level of agreement or disagreement. Standard statistical methods and Mann-Whitney analysis were used to compare the responses between groups.</p><p><strong>Results: </strong>First-year residents felt they understood expectations for their rotations, felt more comfortable asking questions, felt their questions were more adequately answered, and were more enthusiastic about starting rotations than senior residents, differences that were statistically significant.</p><p><strong>Conclusions: </strong>The establishment of a resident-led WC to communicate with and advise matched applicants prior to first-year rotations appeared to improve perceptions of firstyear radiology residents regarding preparation, communication, enthusiasm, rotation experiences, and comfort in asking questions. These findings underscore the potential of resident-led interventions to improve the quality of the orientation and onboarding process for first-year radiology residents.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047009","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":"Use of pre-procedure electronic questionnaire to enhance scheduling and safety in interventional radiology procedures with anesthesia care.","authors":"Joanna Serafin, Kara M Barnett, Todd J Liu, Nina M Maresca, Patrick J McCormick, Alan L Kotin","doi":"10.1067/j.cpradiol.2025.04.008","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.008","url":null,"abstract":"<p><p>The growth of interventional radiology (IR) procedures with anesthesia team care in increasingly medically complex populations points to the need for effective and efficient pre-procedure screening. We present an ongoing quality improvement project involving a brief online questionnaire disseminated to patients three to ten days before the day of their scheduled IR procedures. The questionnaire was developed by anesthesiologists and a nurse practitioner to increase pre-procedure awareness of relevant medical concerns, guide scheduling of procedures at outpatient versus inpatient locations, and improve patient pre-procedure management. The response rate after one year was 57% and indicated that at least 1 in 10 patient histories required review and discussion by the care team. The most common concerns were shortness of breath (8%), difficult airway (3%) and syncope (3%). Most procedures proceeded as scheduled, however, 18 procedures (0.4% of patients who responded), had to be rescheduled from an outpatient to the inpatient site due to medical concerns. The electronic pre-procedure screening has been feasible to implement at a busy clinical practice and has improved team communication, patient preparedness, and scheduling at appropriate locations. The team has since expanded the questionnaire to other non-operating room anesthesia procedures and added questions about opioids and glucagon-like peptide-1 receptor agonists use. Future work needs to evaluate whether the online pre-screening was associated with decreases in cancelation rates and cost savings.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050372","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":"Assessment of Pectoralis muscle invasion using combined DBT and contrast-enhanced mammography: Retrospective multi-reader study.","authors":"Olena O Weaver, Alejandro Contreras, Ethan O Cohen, Mary S Guirguis, Megha M Kapoor, Marion E Scoggins, Rosa F Hwang, Rosalind P Candelaria, Wei T Yang, Jennifer B Dennison, Jia Sun, Gary J Whitman","doi":"10.1067/j.cpradiol.2025.04.005","DOIUrl":"10.1067/j.cpradiol.2025.04.005","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate combined digital breast tomosynthesis and contrast-enhanced mammography (DBT/CEM) for predicting pectoralis muscle invasion.</p><p><strong>Methods: </strong>This retrospective multi-reader cohort study included research patients who underwent combined DBT/CEM for breast cancer staging and had prepectoral masses. Images were independently reviewed by six fellowship-trained breast radiologists. Diagnostic performance, reader confidence, and inter-reader agreement were calculated for each image type/modality.</p><p><strong>Results: </strong>Among 10 patients with prepectoral masses on DBT/CEM, muscle invasion was present in 3 and absent in 7. The overall diagnostic accuracy of DBT/CEM for PMI was 0.6 (range 0.4-0.9); for predefined radiologic signs it was 0.5-0.7 for low energy (LE) CEM, 0.4-0.7 for DBT, and 0.4-0.8 for recombined (RC) CEM. Muscle deformity on MLO views had the highest accuracy (0.7-0.8). On a scale of 1-3, mean radiologist confidence for combined DBT/CEM was 1.9 (1.5-2.3; SD=0.65). Median confidence ranged from 1.9 for RC to 2.2 for DBT. Per-case reader agreement was poor (K=-0.01) for DBT/CEM; poor to slight (K= -0.13-0.40, median 0.28) for RC; slight to fair (K = 0.04-0.43, median 0.27 and K = 0.02-0.42, median 0.19, respectively) for DBT and LE. In two patients with subpectoral breast implants CEM was accurate in PMI detection, while MRI had one false-positive result.</p><p><strong>Conclusion: </strong>Combined DBT/CEM accuracy and inter-reader agreement are suboptimal for PMI evaluation, except in patients with breast implants. RC images marginally improve accuracy compared to LE images but have lowest radiologist confidence. DBT has lowest accuracy but highest confidence. Muscle deformity on MLO view was the most accurate sign.</p><p><strong>Critical relevance statement: </strong>Combined DBT/CEM demonstrated suboptimal diagnostic accuracy, reader confidence, and inter-reader agreement for detecting pectoralis muscle invasion (PMI) in prepectoral breast cancer (BC) except for patients with subpectoral breast implants, where recombined images on implant-displaced CEM views performed better than MRI.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12359063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994967","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 breakdown of how diagnostic radiology residency became increasingly competitive for US doctors of osteopathic medicine (DOs) and international medical graduates (IMGs).","authors":"Sakina Divan, Hebatullah M Elsingergy, Arif Musa, Mohamed M Elsingergy, Brigitte Berryhill, Gulcin Altinok","doi":"10.1067/j.cpradiol.2025.04.007","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.007","url":null,"abstract":"<p><p>Diagnostic Radiology has emerged as an increasingly competitive specialty posing a significant challenge for aspirants, particularly for Doctors of Osteopathic Medicine (DOs) and International Medical Graduates (IMGs). This could be attributed to the field's dynamic nature, flexibility of career paths, and high job demand. This article delves into a decade's worth of matching trends in diagnostic radiology, underscoring the unique obstacles faced by DOs and IMGs including possible implicit biases, logistical hurdles, and the implications of the USMLE Step 1's transition to pass/fail scoring. It offers practical solutions to level the playing field, such as expanding clinical and research opportunities for applicants, encouraging residency programs to address implicit biases, increasing curriculum adaptability in osteopathic and foreign medical schools, and exploring accreditation reforms. Together, these recommendations aim to create a more equitable selection process and mitigate the systemic barriers DOs and IMGs face in securing highly sought-after radiology residency spots.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014892","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":"Theranostics: A primer for medical students and residents.","authors":"Ibrahim A Rehman, Richard B Gunderman","doi":"10.1067/j.cpradiol.2025.04.016","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.016","url":null,"abstract":"<p><p>A key component of the introduction of any medical innovation is education. Simply put, health professionals not involved in such an innovation's development need to learn about it, and such education needs to be tailored to the needs of different learning communities, including those who will someday incorporate it into the care of their patients and those who will receive queries about it from patients and colleagues. Among such key groups are medical students and residents, and one such promising innovation is theranostics, a burgeoning field whose name is a portmanteau of therapeutics and diagnostics that combines targeted therapeutics with molecular imaging to deliver individualized care. The field is sufficiently new that it is not included in the curricula of many medical schools and residency programs, yet physicians in training need a basic understanding of its current and projected future role in healthcare. This article serves as such an introduction.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054825","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}