Pub Date : 2025-03-05DOI: 10.1053/j.gastro.2025.02.021
Cesare Hassan, Raf Bisschops, Prateek Sharma, Yuichi Mori
Colonoscopy, a crucial procedure for detecting and removing colorectal polyps, has seen transformative advancements through the integration of Artificial Intelligence (AI), specifically in Computer-Aided Detection (CADe) and Diagnosis (CADx). These tools enhance real-time detection and characterization of lesions, potentially reducing human error, and standardizing the quality of colonoscopy across endoscopists. CADe has proven effective in increasing adenoma detection rate, potentially reducing long-term colorectal cancer incidence. However, CADe’s benefits are accompanied by challenges, such as potentially longer procedure times, increased non-neoplastic polyp resections, and a higher surveillance burden. CADx, while promising in differentiating neoplastic and non-neoplastic diminutive polyps, encounters limitations in accuracy, particularly in the proximal colon. Real-world data also reveal gaps between trial efficacy and practical outcomes, emphasizing the need for further research in uncontrolled settings. Moreover, CADx limited specificity and binary output underscore the necessity for explainable AI to gain endoscopists' trust. This review aims to explore the benefits, harms, and limitations of AI for colon cancer screening, surveillance, and treatment focusing on CADe and CADx systems for lesion detection and characterization, respectively, while addressing challenges in integrating these technologies into clinical practice.
{"title":"Colon Cancer Screening, Surveillance, and Treatment: Novel AI driving strategies in the management of colon lesions","authors":"Cesare Hassan, Raf Bisschops, Prateek Sharma, Yuichi Mori","doi":"10.1053/j.gastro.2025.02.021","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.021","url":null,"abstract":"Colonoscopy, a crucial procedure for detecting and removing colorectal polyps, has seen transformative advancements through the integration of Artificial Intelligence (AI), specifically in Computer-Aided Detection (CADe) and Diagnosis (CADx). These tools enhance real-time detection and characterization of lesions, potentially reducing human error, and standardizing the quality of colonoscopy across endoscopists. CADe has proven effective in increasing adenoma detection rate, potentially reducing long-term colorectal cancer incidence. However, CADe’s benefits are accompanied by challenges, such as potentially longer procedure times, increased non-neoplastic polyp resections, and a higher surveillance burden. CADx, while promising in differentiating neoplastic and non-neoplastic diminutive polyps, encounters limitations in accuracy, particularly in the proximal colon. Real-world data also reveal gaps between trial efficacy and practical outcomes, emphasizing the need for further research in uncontrolled settings. Moreover, CADx limited specificity and binary output underscore the necessity for explainable AI to gain endoscopists' trust. This review aims to explore the benefits, harms, and limitations of AI for colon cancer screening, surveillance, and treatment focusing on CADe and CADx systems for lesion detection and characterization, respectively, while addressing challenges in integrating these technologies into clinical practice.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"52 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-04DOI: 10.1053/j.gastro.2025.02.002
Brian C. Jacobson, Joseph C. Anderson, Carol A. Burke, Jason A. Dominitz, Seth A. Gross, Folasade P. May, Swati G. Patel, Aasma Shaukat, Douglas J. Robertson
This document is an update to the 2014 recommendations for optimizing the adequacy of bowel cleansing for colonoscopy from the US Multi-Society Task Force on Colorectal Cancer, which represents the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy. The US Multi-Society Task Force developed consensus statements and key clinical concepts addressing important aspects of bowel preparation for colonoscopy. The majority of consensus statements focus on individuals at average risk for inadequate bowel preparation. However, statements addressing individuals at risk for inadequate bowel preparation quality are also provided. The quality of a bowel preparation is defined as adequate when standard screening or surveillance intervals can be assigned based on the findings of the colonoscopy. We recommend the use of a split-dose bowel preparation regimen and suggest that a 2 L regimen may be sufficient. A same-day regimen is recommended as an acceptable alternative for individuals undergoing afternoon colonoscopy, but we suggest that a same-day regimen is an inferior alternative for individuals undergoing morning colonoscopy. We recommend limiting dietary restrictions to the day before a colonoscopy, relying on either clear liquids or low-fiber/low-residue diets for the early and midday meals. We suggest the adjunctive use of oral simethicone for bowel preparation before colonoscopy. Routine tracking of the rate of adequate bowel preparations at the level of individual endoscopists and at the level of the endoscopy unit is also recommended, with a target of >90% for both rates.
{"title":"Optimizing Bowel Preparation Quality for Colonoscopy: Consensus Recommendations by the US Multi-Society Task Force on Colorectal Cancer","authors":"Brian C. Jacobson, Joseph C. Anderson, Carol A. Burke, Jason A. Dominitz, Seth A. Gross, Folasade P. May, Swati G. Patel, Aasma Shaukat, Douglas J. Robertson","doi":"10.1053/j.gastro.2025.02.002","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.002","url":null,"abstract":"This document is an update to the 2014 recommendations for optimizing the adequacy of bowel cleansing for colonoscopy from the US Multi-Society Task Force on Colorectal Cancer, which represents the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy. The US Multi-Society Task Force developed consensus statements and key clinical concepts addressing important aspects of bowel preparation for colonoscopy. The majority of consensus statements focus on individuals at average risk for inadequate bowel preparation. However, statements addressing individuals at risk for inadequate bowel preparation quality are also provided. The quality of a bowel preparation is defined as adequate when standard screening or surveillance intervals can be assigned based on the findings of the colonoscopy. We recommend the use of a split-dose bowel preparation regimen and suggest that a 2 L regimen may be sufficient. A same-day regimen is recommended as an acceptable alternative for individuals undergoing afternoon colonoscopy, but we suggest that a same-day regimen is an inferior alternative for individuals undergoing morning colonoscopy. We recommend limiting dietary restrictions to the day before a colonoscopy, relying on either clear liquids or low-fiber/low-residue diets for the early and midday meals. We suggest the adjunctive use of oral simethicone for bowel preparation before colonoscopy. Routine tracking of the rate of adequate bowel preparations at the level of individual endoscopists and at the level of the endoscopy unit is also recommended, with a target of >90% for both rates.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"29 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1053/j.gastro.2025.02.016
Yun Ji, Nina Le Bert, Grace Lai-Hung Wong, Mark W. Douglas, Ariel Lee, Chong Zhu, Bing Wang, Jianxiang Lv, Dong Li, Ying Tan, Haiyan Ma, Jieliang Chen, Xiaofei Chen, Qing Zhu, Man-Fung Yuen, Antonio Bertoletti
Background and aims
The impact of HBsAg reduction from small interfering RNA (siRNA) treatments on HBV-specific immunity of CHB participants has not been adequately analyzed in human. We conducted a phase 2a study treating CHB participants with 9 4-weekly doses of HBV-targeted siRNA elebsiran (BRII-835), either alone (n=10) or in combination with a VLP-based therapeutic vaccine (BRII-179) containing Pre-S1, Pre-S2, and S antigens, co-administered with (n=39) or without (n=41) IFNα.
Methods
We analyzed longitudinally for 72 weeks virological, clinical, and immunological parameters including HBsAg, ALT, anti-HBs, the neutralizing activity of representative sera, and frequency and cytokine secretion ability of T cells specific for Pre-S1, Pre-S2, and S both directly ex vivo and after in vitro expansion.
Results
Combination therapy of elebsiran and BRII-179 was well tolerated. While no sustained HBsAg seroclearance or notable difference in mean HBsAg reduction at the group level was observed, we detected marked heterogeneity in immunological responses among groups. HBsAg reduction mediated by siRNA alone was associated with minimal HBV-specific immune response recovery. In contrast, combination of elebsiran with BRII-179 induced a significant modification of immune responses demonstrated by anti-HBs antibody production and an expansion of IL-2-producing CD4+ T cells specific for Pre-S1/Pre-S2 antigens only. Importantly, anti-HBs antibodies persisted ≥100 IU/L in approximately 40% of the participants for at least 32 weeks after combinatory treatment. Moreover, the neutralizing ability of the anti-HBs positive sera was associated with HBsAg reduction.
Conclusions
SiRNA-induced HBsAg reduction may contribute to the persistence and efficacy of the humoral arm of HBV-specific adaptive immunity in CHB participants receiving therapeutic vaccine BRII-179.
{"title":"The impact of HBsAg reduction via siRNA treatment on natural and vaccine (BRII-179)-induced HBV-specific humoral and cellular immune responses","authors":"Yun Ji, Nina Le Bert, Grace Lai-Hung Wong, Mark W. Douglas, Ariel Lee, Chong Zhu, Bing Wang, Jianxiang Lv, Dong Li, Ying Tan, Haiyan Ma, Jieliang Chen, Xiaofei Chen, Qing Zhu, Man-Fung Yuen, Antonio Bertoletti","doi":"10.1053/j.gastro.2025.02.016","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.016","url":null,"abstract":"<h3>Background and aims</h3>The impact of HBsAg reduction from small interfering RNA (siRNA) treatments on HBV-specific immunity of CHB participants has not been adequately analyzed in human. We conducted a phase 2a study treating CHB participants with 9 4-weekly doses of HBV-targeted siRNA elebsiran (BRII-835), either alone (n=10) or in combination with a VLP-based therapeutic vaccine (BRII-179) containing Pre-S1, Pre-S2, and S antigens, co-administered with (n=39) or without (n=41) IFNα.<h3>Methods</h3>We analyzed longitudinally for 72 weeks virological, clinical, and immunological parameters including HBsAg, ALT, anti-HBs, the neutralizing activity of representative sera, and frequency and cytokine secretion ability of T cells specific for Pre-S1, Pre-S2, and S both directly <em>ex vivo</em> and after <em>in vitro</em> expansion.<h3>Results</h3>Combination therapy of elebsiran and BRII-179 was well tolerated. While no sustained HBsAg seroclearance or notable difference in mean HBsAg reduction at the group level was observed, we detected marked heterogeneity in immunological responses among groups. HBsAg reduction mediated by siRNA alone was associated with minimal HBV-specific immune response recovery. In contrast, combination of elebsiran with BRII-179 induced a significant modification of immune responses demonstrated by anti-HBs antibody production and an expansion of IL-2-producing CD4+ T cells specific for Pre-S1/Pre-S2 antigens only. Importantly, anti-HBs antibodies persisted ≥100 IU/L in approximately 40% of the participants for at least 32 weeks after combinatory treatment. Moreover, the neutralizing ability of the anti-HBs positive sera was associated with HBsAg reduction.<h3>Conclusions</h3>SiRNA-induced HBsAg reduction may contribute to the persistence and efficacy of the humoral arm of HBV-specific adaptive immunity in CHB participants receiving therapeutic vaccine BRII-179.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"14 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-03DOI: 10.1053/j.gastro.2025.01.253
Alanna Ebigbo, Helmut Messmann, Sung Hak Lee
Artificial intelligence (AI) holds the potential to transform the management of upper gastrointestinal (GI) conditions, such as Barrett's esophagus, esophageal squamous cell cancer, and early gastric cancer. Advancements in deep learning (DL) and convolutional neural networks offer improved diagnostic accuracy and reduced diagnostic variability across different clinical settings, particularly where human error or fatigue may impair diagnostic precision. DL models have shown the potential to improve early cancer detection and lesion characterization, predict invasion depth, and delineate lesion margins with remarkable accuracy, all contributing to effective treatment planning. Several challenges, however, limit the broad application of AI in GI endoscopy, particularly in the upper GI tract. Subtle lesion morphology and restricted diversity in training datasets, which are often sourced from specialized centers, may constrain the generalizability of AI models in various clinical settings. Furthermore, the "black box" nature of some AI systems can impede explainability and clinician trust. To address these issues, efforts are underway to incorporate multimodal data, such as combining endoscopic and histopathological imaging, to bolster model robustness and transparency. In the future, AI promises substantial advancements in automated real-time endoscopic guidance, personalized risk assessment, and optimized biopsy decision-making. As it evolves, it would substantially impact not only early diagnosis and prognosis but also the cost-effectiveness of managing upper GI diseases, ultimately leading to improved patient outcomes and more efficient healthcare delivery.
{"title":"Artificial Intelligence Applications in Image-Based Diagnosis of Early Esophageal and Gastric Neoplasms","authors":"Alanna Ebigbo, Helmut Messmann, Sung Hak Lee","doi":"10.1053/j.gastro.2025.01.253","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.01.253","url":null,"abstract":"Artificial intelligence (AI) holds the potential to transform the management of upper gastrointestinal (GI) conditions, such as Barrett's esophagus, esophageal squamous cell cancer, and early gastric cancer. Advancements in deep learning (DL) and convolutional neural networks offer improved diagnostic accuracy and reduced diagnostic variability across different clinical settings, particularly where human error or fatigue may impair diagnostic precision. DL models have shown the potential to improve early cancer detection and lesion characterization, predict invasion depth, and delineate lesion margins with remarkable accuracy, all contributing to effective treatment planning. Several challenges, however, limit the broad application of AI in GI endoscopy, particularly in the upper GI tract. Subtle lesion morphology and restricted diversity in training datasets, which are often sourced from specialized centers, may constrain the generalizability of AI models in various clinical settings. Furthermore, the \"black box\" nature of some AI systems can impede explainability and clinician trust. To address these issues, efforts are underway to incorporate multimodal data, such as combining endoscopic and histopathological imaging, to bolster model robustness and transparency. In the future, AI promises substantial advancements in automated real-time endoscopic guidance, personalized risk assessment, and optimized biopsy decision-making. As it evolves, it would substantially impact not only early diagnosis and prognosis but also the cost-effectiveness of managing upper GI diseases, ultimately leading to improved patient outcomes and more efficient healthcare delivery.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"90 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1053/j.gastro.2024.12.015
Úrsula Figueroa, Cristián Jarry, Martin Inzunza, Isabella Montero, Francisco Garrido, Ignacio Villagrán, Francisca Belmar, Gabriel Escalona, Arnoldo Riquelme, Julián Varas
{"title":"Innovation Meets Practice: A Scalable Simulation-based Methodology for Massive Paracentesis Training.","authors":"Úrsula Figueroa, Cristián Jarry, Martin Inzunza, Isabella Montero, Francisco Garrido, Ignacio Villagrán, Francisca Belmar, Gabriel Escalona, Arnoldo Riquelme, Julián Varas","doi":"10.1053/j.gastro.2024.12.015","DOIUrl":"https://doi.org/10.1053/j.gastro.2024.12.015","url":null,"abstract":"","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":" ","pages":""},"PeriodicalIF":25.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-28DOI: 10.1053/j.gastro.2025.02.015
Francine van Wifferen, Marjolein J.E. Greuter, Veerle M.H. Coupé
No Abstract
{"title":"Reply to Yang and Shan","authors":"Francine van Wifferen, Marjolein J.E. Greuter, Veerle M.H. Coupé","doi":"10.1053/j.gastro.2025.02.015","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.015","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"23 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143526463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-27DOI: 10.1053/j.gastro.2025.02.014
Veerle M.H. Coupé, Beatriz Carvalho, Gerrit A. Meijer
No Abstract
{"title":"Reply to Hassan and Ibrahim and to Ba et al","authors":"Veerle M.H. Coupé, Beatriz Carvalho, Gerrit A. Meijer","doi":"10.1053/j.gastro.2025.02.014","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.014","url":null,"abstract":"No Abstract","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"1 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-26DOI: 10.1053/j.gastro.2025.02.013
Ofer Z. Fass, John E. Pandolfino, Jacob M. Schauer, Nisha Ganesh, Domenico A. Farina, Ayesha Lat, Eric Goudie, Linda Kelahan, Dustin A. Carlson
Background and Aims
Timed barium esophagram (TBE) is commonly used to evaluate esophageal motor disorders, though its accuracy is limited. The lack of standardized criteria for TBE interpretation, coupled with reliance on single measurements and outdated reference standards, limits its effectiveness. This study aimed to reexamine the accuracy of TBE interpretation using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) approach and updated reference standards.
Methods
Adult patients with esophageal dysphagia were prospectively enrolled from 2019 to 2022 and underwent motility testing with esophageal manometry, FLIP panometry, and TBE. TBE accuracy for predicting achalasia/FLIP+ esophagogastric junction outflow obstruction (EGJOO), as defined by Chicago Classification 4.0 and FLIP, was assessed using two approaches: barium column height >2 cm at 5 minutes/impacted tablet and a classification tree model.
Results
The study included 290 participants: 121 (42%) with EGJ outflow disorders, 151 (52%) without, and 18 (6%) with inconclusive results. The optimal classification tree had three levels: maximum esophageal body width at the top, maximum EGJ diameter and barium height at the second level, and tablet passage at the bottom. The TBE column height and tablet approach had a sensitivity of 77.8%, specificity 86.0%, and accuracy 82.2%, while the classification tree model achieved a sensitivity of 84.2%, specificity 92.1%, and accuracy of 88.3%.
Conclusions
TBE can accurately identify achalasia/FLIP+ EGJOO when using multiple metrics in a classification tree model. This provides a simple, standardized approach to TBE interpretation that is superior to traditional single-metric methods.
{"title":"Diagnostic Accuracy of Timed Barium Esophagram for Achalasia","authors":"Ofer Z. Fass, John E. Pandolfino, Jacob M. Schauer, Nisha Ganesh, Domenico A. Farina, Ayesha Lat, Eric Goudie, Linda Kelahan, Dustin A. Carlson","doi":"10.1053/j.gastro.2025.02.013","DOIUrl":"https://doi.org/10.1053/j.gastro.2025.02.013","url":null,"abstract":"<h3>Background and Aims</h3>Timed barium esophagram (TBE) is commonly used to evaluate esophageal motor disorders, though its accuracy is limited. The lack of standardized criteria for TBE interpretation, coupled with reliance on single measurements and outdated reference standards, limits its effectiveness. This study aimed to reexamine the accuracy of TBE interpretation using the Standards for Reporting of Diagnostic Accuracy Studies (STARD) approach and updated reference standards.<h3>Methods</h3>Adult patients with esophageal dysphagia were prospectively enrolled from 2019 to 2022 and underwent motility testing with esophageal manometry, FLIP panometry, and TBE. TBE accuracy for predicting achalasia/FLIP+ esophagogastric junction outflow obstruction (EGJOO), as defined by Chicago Classification 4.0 and FLIP, was assessed using two approaches: barium column height >2 cm at 5 minutes/impacted tablet and a classification tree model.<h3>Results</h3>The study included 290 participants: 121 (42%) with EGJ outflow disorders, 151 (52%) without, and 18 (6%) with inconclusive results. The optimal classification tree had three levels: maximum esophageal body width at the top, maximum EGJ diameter and barium height at the second level, and tablet passage at the bottom. The TBE column height and tablet approach had a sensitivity of 77.8%, specificity 86.0%, and accuracy 82.2%, while the classification tree model achieved a sensitivity of 84.2%, specificity 92.1%, and accuracy of 88.3%.<h3>Conclusions</h3>TBE can accurately identify achalasia/FLIP+ EGJOO when using multiple metrics in a classification tree model. This provides a simple, standardized approach to TBE interpretation that is superior to traditional single-metric methods.","PeriodicalId":12590,"journal":{"name":"Gastroenterology","volume":"2 1","pages":""},"PeriodicalIF":29.4,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：