Journal of Liver Transplantation最新文献

{"title":"Antibody-mediated rejection in post-liver transplant clinical care: Are we there yet for timely diagnosis and treatment?","authors":"Kevin H. Toomer ,&nbsp;Ahmet Gurakar ,&nbsp;Kiyoko Oshima","doi":"10.1016/j.liver.2024.100236","DOIUrl":"10.1016/j.liver.2024.100236","url":null,"abstract":"<div><p>With improvements in medical management and surgical technique in the field of solid organ transplantation, many historically prominent causes of liver allograft injury have been ameliorated or, in the case of Hepatitis C virus, eliminated altogether. In this transformed clinical landscape, antibody-mediated rejection (AMR) has emerged as a defining barrier to maintenance of long-term liver allograft function. The liver's unique anatomy, high regenerative capacity, and tolerogenic immunological environment tend to mitigate the severest AMR manifestations. Consequently, the clinical importance of AMR in the liver has been recognized more slowly than for other solid organ allografts. Significant strides have been made in elucidating clinical and histopathologic features of acute and chronic liver AMR, with the Banff 2016 criteria among the most notable. However, current histopathologic definitions of AMR are lacking in sensitivity and specificity. C4d staining is an imperfect biological surrogate for antibody-mediated injury, and suffers from significant technical limitations. The frequent co-occurrence of T cell mediated rejection and non-immunologic allograft damage (including recurrence of primary disease) also hinders definitive identification of AMR and results in misattribution of its effects. The goal of this review is to summarize the current understanding of AMR in the context of liver transplantation, including risk factors, pathogenesis, and current diagnostic and treatment strategies. Potential directions of future research are also addressed.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"16 ","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000370/pdfft?md5=244fd1c1f91ffee3f2d7d5bc8f819ed6&pid=1-s2.0-S2666967624000370-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952809","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":"Success of high-flow nasal cannula oxygen therapy for the treatment of severe hypoxemia after liver transplantation in a patient with severe hepatopulmonary syndrome","authors":"Moustapha Hussein ,&nbsp;Agathe Chenal ,&nbsp;Edouard Virot ,&nbsp;Camille Besch ,&nbsp;Guillaume Martin ,&nbsp;Matthieu Canuet ,&nbsp;Romain Kessler ,&nbsp;Marianne Riou","doi":"10.1016/j.liver.2024.100234","DOIUrl":"10.1016/j.liver.2024.100234","url":null,"abstract":"<div><p>Hepatopulmonary syndrome (HPS) is a rare pulmonary complication of cirrhosis for which the only curative treatment is liver transplantation (LT). Patients with severe HPS prior to LT are at high risk of postoperative complications and mortality, and may develop refractory HPS after LT. To date, no therapeutic strategy has been validated for these patients. To our knowledge, we describe the first case of successful use of high-flow nasal cannula oxygen therapy for severe post-LT hypoxemia in a 23-year-old adult.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100234"},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000357/pdfft?md5=ec17cb95c6edb0283d2a127e81f46a57&pid=1-s2.0-S2666967624000357-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141638489","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 Field in Transition: A Scoping Review and Thematic Network Map of Qualitative Health Research in Liver Transplantation","authors":"Selena Zhang ,&nbsp;Chloe Wong-Mersereau ,&nbsp;Ani Orchanian-Cheff ,&nbsp;Maryam Makki ,&nbsp;Shikha Gandhi ,&nbsp;Kelly Fritsch ,&nbsp;Mamatha Bhat ,&nbsp;Suze Berkhout","doi":"10.1016/j.liver.2024.100233","DOIUrl":"https://doi.org/10.1016/j.liver.2024.100233","url":null,"abstract":"<div><h3>BACKGROUND</h3><p>In liver transplantation, qualitative methodologies can offer important insights from a range of perspectives into the meaning and impact of health experiences. This review aims to characterize the existing qualitative research in liver transplantation to understand how this work has evolved over time, its contribution to understanding clinical issues, and to conceptualize under-developed areas for future research.</p></div><div><h3>METHODS</h3><p>Studies from MEDLINE, Embase, Cochrane Database of Systematic Reviews, CENTRAL, CINAHL, and Web of Science were searched from database inception to January 2024. All English language studies focused on a liver transplant population with qualitative methodological components were included. Using VOSviewer network mapping software we constructed a visualization of the thematic networks within included studies.</p></div><div><h3>RESULTS</h3><p>Our initial search yielded 9092 studies from which 229 were included in the final review. Data extraction revealed significant increases in the publication of qualitative studies since 2015, predominantly utilizing interviews and focus groups. The thematic network map we constructed placed “social support” as a dominant and central concept across many different studies, with related themes tending to cluster within four domains of research: <em>Care of the Organ &amp; Patienthood; Identity, Embodiment, Adjustment; Relational &amp; Ethical Issues; Existential Themes</em>. Medicalized subject such as “self-management” were less well-networked with identity-related, ethical, and existential topics.</p></div><div><h3>DISCUSSION</h3><p>There is a growing body of rich qualitative research in liver transplantation. Future research would benefit from more longitudinal approaches as well as increased attention to the interrelation between “clinical” issues (adherence, quality of life) and ethical, relational, and existential ones.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100233"},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000345/pdfft?md5=90219842834346a9477c0d9c9686c126&pid=1-s2.0-S2666967624000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141481284","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":"Automated segmentation of liver tumors from computed tomographic scans","authors":"R.V. Manjunath ,&nbsp;Yashaswini Gowda N","doi":"10.1016/j.liver.2024.100232","DOIUrl":"https://doi.org/10.1016/j.liver.2024.100232","url":null,"abstract":"<div><p>The precision of liver tumor segmentation heavily depends on the doctor's expertise, hence it is required to produce an algorithm for automatic liver tumor segmentation to reduce the manual intervention in assessing liver disease identification. We propose a CNN-based UNet architecture designed to segment liver tumors from CT images of size 128×128. In this model, modifications were made to the encoder, decoder, and bridge paths to enhance feature extraction efficiency. The performance of the modified UNet was evaluated against an existing segmentation method using the same CT image size. The comparison focused on the Dice similarity coefficient and accuracy. Our proposed method demonstrated a high Dice similarity coefficient of 75.37 % and an accuracy of 99.75 % on the 3Dircadb dataset. These results indicate that our modified UNet achieved superior segmentation metrics compared to state-of-the-art methods, showcasing its effectiveness in liver tumor segmentation.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100232"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000333/pdfft?md5=f4c5eea1b8e1306ce82e2e5d4e0ff7cd&pid=1-s2.0-S2666967624000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141434522","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 of the article of Furey G","authors":"Daniel Eyraud","doi":"10.1016/j.liver.2024.100231","DOIUrl":"https://doi.org/10.1016/j.liver.2024.100231","url":null,"abstract":"","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100231"},"PeriodicalIF":0.0,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000321/pdfft?md5=681759b4d21517561a731893e7d28dd9&pid=1-s2.0-S2666967624000321-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141264094","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":"Liver transplantation for polycystic liver disease: How feasible is this option?","authors":"Mahmoudreza Moein ,&nbsp;Michael Guenoun ,&nbsp;Fatemeh Moosaie ,&nbsp;Gursimran Mavi ,&nbsp;Amin Bahreini ,&nbsp;Reza Saidi","doi":"10.1016/j.liver.2024.100230","DOIUrl":"https://doi.org/10.1016/j.liver.2024.100230","url":null,"abstract":"<div><h3>Background</h3><p>Polycystic liver disease is a rare hereditary disease that can occur as an isolated disease. Because of its benign nature, polycystic liver disease rarely needs treatment. If treatment is needed, there are no standard guidelines, but usually, a liver resection or medical therapy is performed. A liver transplant is the last resort when all other possibilities have been exhausted, or complications arise. However, the risks and benefits must be carefully weighed.</p></div><div><h3>Methods and materials</h3><p>A retrospective registry analysis of the SRTR database was done for liver transplants performed in the United States from January 2001 to May 2023.</p></div><div><h3>Results</h3><p>The analysis of the data indicated a notable improvement in 5-year graft survival rates between the 2001–2010 group (mean of 92 %) and the 2011–2023 group (mean of 97 %) (<em>P</em> &lt; .001). The 2011–2023 group had a higher proportion of simultaneous kidney and liver transplants, more than 3 times, from 106 cases to 374 cases (57.7 % vs. 42.3 %, <em>P</em> = .001). The type of transplant was also considered when analyzing the 5-year survival of grafts. Patients who underwent both kidney and liver transplants simultaneously had a slightly better outcome. It was found that the only hazard affecting LT graft survival in the cohort was the cold ischemic time (HR: 2.80, <em>P</em> = .03).</p></div><div><h3>Conclusion</h3><p>With all the surgical techniques and post-operation improvements, a liver transplant can be a feasible option for polycystic liver disease when the medical treatments are not sufficient to eliminate the symptoms.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266696762400031X/pdfft?md5=4a70a03b4cf6e9a1e9565951b8c59090&pid=1-s2.0-S266696762400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097862","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":"Hepatitis B reactivation after solid organ transplantation: A single-center experience","authors":"Josiah D. McCain ,&nbsp;Rolland C. Dickson ,&nbsp;Jacqueline Cai ,&nbsp;Nan Zhang ,&nbsp;Surakit Pungpapong ,&nbsp;Bashar A. Aqel ,&nbsp;David M.H. Chascsa","doi":"10.1016/j.liver.2024.100227","DOIUrl":"10.1016/j.liver.2024.100227","url":null,"abstract":"<div><h3>Background</h3><p>The risk of HBV reactivation after solid organ transplantation and the strategies to prevent it are not well defined.</p></div><div><h3>Methods</h3><p>We reviewed patients who received liver, kidney, pancreas, or heart transplants at our center between September 2015 and November 2020. We collected recipient and donor data on HBV serologies, prophylactic strategies, and known risk factors that associate with HBV reactivation in post-transplant patients.</p></div><div><h3>Results</h3><p>In the study period, 2126 solid organs were transplanted into 1951 patients. The recipient (R), donor (D), or both were HBcAb(+)/HBsAg(-) in 360 transplants. Post-transplant HBV DNA developed in 0/10 heart, 0/3 pancreas-kidney, 2/1517 (0.1 %) kidney, and 10/430 (2.3 %) liver recipients. Both kidney recipients with HBV DNA tested negative on re-testing without treatment. HBV DNA developed in 17.5 % of liver recipients who were D+/R- for HBcAb (10/57). All 10 liver recipients developing HBV DNA received prophylaxis. 5 patients developed detectable HBV DNA while on prophylaxis at a median 886 days (range 139 to 2287) after transplant. 5 patients developed HBV DNA after prophylaxis was discontinued at a median 955 days (range 756 to 2003) after transplant and 596 days (395 to 1638) after discontinuation.</p></div><div><h3>Conclusion</h3><p>HBcAb is found in a significant portion of our solid organ transplant donors and recipients, and HBcAb(+)/HBsAg(-) liver allografts represent the primary risk factor for HBV post-transplant. HBV infection in non-liver solid organ transplant is minimal risk using current monitoring strategies. Infection can occur long after the transplant event. Monitoring and prophylaxis strategies in this group should be reassessed.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100227"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266696762400028X/pdfft?md5=fe199cae55287c817f5efc9e5e1fc480&pid=1-s2.0-S266696762400028X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142089","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":"Cardiac Abnormalities Pre- and Post-Liver Transplantation for Metabolic Dysfunction-Associated Steatohepatitis – Evidence and Special Considerations","authors":"Steven M. Elzein,&nbsp;Elizabeth W. Brombosz,&nbsp;Sudha Kodali","doi":"10.1016/j.liver.2024.100228","DOIUrl":"10.1016/j.liver.2024.100228","url":null,"abstract":"<div><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) has an alarmingly high global prevalence. Its progressive subtype, metabolic dysfunction-associated steatohepatitis (MASH), is the leading indication for liver transplantation overall. Although MASLD has been associated with increased risk for several cardiac abnormalities including cardiac arrhythmias, structural disease, heart failure, valvular disease, and coronary artery disease, little is known about the clinical course and effects of these abnormalities in post-liver transplant patients with MASH as an etiology of their cirrhosis. This narrative review presents clinical and mechanistic evidence for the association of MASLD with the aforementioned cardiac abnormalities, as well as characterizes what is known about their significance in the post-operative period for those undergoing liver transplantation for MASH. Additionally, this review emphasizes knowledge gaps and highlights areas for further study of the impact of cardiac abnormalities in patients undergoing liver transplantation for MASH.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100228"},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000291/pdfft?md5=b0a73ffdb2cc7b766ab50231d2e97b15&pid=1-s2.0-S2666967624000291-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132576","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":"Mitigation of cardiac disease during liver transplantation through concomitant cardiac surgery and liver transplant: Pushing the boundaries of acceptable surgical candidacy","authors":"George Furey,&nbsp;David Moros,&nbsp;Michael Zhen-Yu Tong","doi":"10.1016/j.liver.2024.100229","DOIUrl":"10.1016/j.liver.2024.100229","url":null,"abstract":"<div><h3>Introduction</h3><p>The prevalence of cardiac disease is high in patients with liver cirrhosis, making it one of the leading causes of death in this population. However, the presence of cardiac diseases (coronary artery disease and valvular heart disease) often leads to disqualification of potential liver transplantation (LT) candidates, resulting in limited treatment options available for these complex patients. In recent years, some medical centers, including Cleveland Clinic, have provided concomitant cardiac surgery (CS) and LT to carefully selected patients.</p></div><div><h3>Methods</h3><p>A comprehensive literature review was conducted, compiling our experience and that of other medical centers performing concomitant CS and LT. We highlight Cleveland Clinic's approach for LT candidates with cardiac diseases. This includes a description of our initial evaluation, designed to detect cardiac diseases, followed by an explanation of our patient selection criteria and intraoperative strategies for concomitant CS and LT.</p></div><div><h3>Conclusion</h3><p>In patients with liver cirrhosis who are candidates for LT but also present cardiac diseases, a cautious evaluation by a multidisciplinary team is required to determine the feasibility of performing concomitant CS and LT. Available evidence suggests that this combined approach is a potential treatment option, offering acceptable postoperative outcomes and overall survival, despite the often perceived high-risk nature of this complex patient population.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000308/pdfft?md5=0adf8a9d310275d6527fee9f36b6f391&pid=1-s2.0-S2666967624000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131109","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":"Outcomes of hypothermic hyperoxygenated perfusion compared to static cold storage for liver transplant. A systematic review and meta-analysis of randomized clinical trials","authors":"Mario A. O'Connor Cordova ,&nbsp;Alan G. Ortega-Macias ,&nbsp;Francisco Altamirano ,&nbsp;Maria E. Hoyos ,&nbsp;Fernando Gonzalez-Zorrilla","doi":"10.1016/j.liver.2024.100226","DOIUrl":"10.1016/j.liver.2024.100226","url":null,"abstract":"<div><h3>Background</h3><p>While liver transplant effectiveness in treating life-limiting liver disease is uncontested, challenges remain in organ preservation.</p></div><div><h3>Methods</h3><p>Following PRISMA guidelines, a systematic review was performed to determine the impact of Hypothermic Oxygenated Perfusion (HOPE) on liver transplant outcomes compared to static cold storage (SCS).</p></div><div><h3>Results</h3><p>A total of five studies were included, totaling 586 patients, out of which 267 patients had HOPE-preserved grafts and 319 SCS-preserved grafts. Analysis showed a significant decrease in early graft dysfunction and biliary complications in the HOPE group when compared to SCS (RR = 0.52; 95 % CI = 0.33–0.81]; <em>p</em> = 0.01) (RR = 0.75; 95 % CI = [0.60–0.94]; <em>p</em> = 0.02), respectively. Similarly, non-anastomotic biliary strictures were significantly reduced in the HOPE group (RR = 0.41; 95 % CI = [0.20–0.86]; <em>p</em> = 0.03). Of note, no statistical significance was found on the one-year graft loss and recipient death (RR = 0.40; 95 % CI = [0.09–1.83]; <em>p</em> = 0.12 and RR = 0.62; 95 % CI = [0.29–1.32]; <em>p</em> = 0.14, respectively). Likewise, no statistical difference was evident in acute rejection (RR = 0.54; 95 % CI = [0.04–7.14]; <em>p</em> = 0.20) and postreperfusion syndrome rate (RR = 0.92; 95 % CI = [0.35–2.41]; <em>p</em> = 0.73). After statistical analysis, no significant differences in major complications, primary nonfunction, re-transplantation, hepatic artery thrombosis, need for renal replacement therapy, intensive care unit, and hospital length of stay were evident.</p></div><div><h3>Conclusions</h3><p>Liver preservation techniques are gaining popularity by enabling rescue and transplantation of marginal livers. In this study, HOPE showed statistically significant differences in reducing rates of biliary complications, biliary stricture, and early graft dysfunction. Further studies are needed to evaluate financial burden and long-term outcomes to completely elucidate the impact of this organ preservation technique.</p></div>","PeriodicalId":100799,"journal":{"name":"Journal of Liver Transplantation","volume":"15 ","pages":"Article 100226"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666967624000278/pdfft?md5=8aafd4345bab5f3a7cc81bb71e11e7b4&pid=1-s2.0-S2666967624000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036320","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}