Revista Brasileira de Reumatologia (English Edition)最新文献

{"title":"Rheumatoid arthritis seems to have DMARD treatment decision influenced by fibromyalgia","authors":"Rafael Mendonça da Silva Chakr ,&nbsp;Claiton Brenol ,&nbsp;Aline Ranzolin ,&nbsp;Amanda Bernardes ,&nbsp;Ana Paula Dalosto ,&nbsp;Giovani Ferrari ,&nbsp;Stephanie Scalco ,&nbsp;Vanessa Olszewski ,&nbsp;Charles Kohem ,&nbsp;Odirlei Monticielo ,&nbsp;João Carlos T. Brenol ,&nbsp;Ricardo M. Xavier","doi":"10.1016/j.rbre.2017.01.004","DOIUrl":"10.1016/j.rbre.2017.01.004","url":null,"abstract":"<div><h3>Objective</h3><p>To compare DMARD use in patients with and without FM over time, including overtreatment and undertreatment rates in both groups.</p></div><div><h3>Methods</h3><p>A prospective cohort study with patients attending an RA outpatient clinic was conducted. Participants were consecutively recruited between March 2006 and June 2007 and were followed through December 2013. Data on DMARD use (prevalences, doses and escalation rates), DAS28, HAQ and radiographic progression were compared among RA patients with FM and without FM. Mistreatment clinical scenarios were allegedly identified and compared between groups.</p></div><div><h3>Results</h3><p>256 RA patients (32 with FM) were followed for 6.2<!--> <!-->±<!--> <!-->2.0 (mean<!--> <!-->±<!--> <!-->SD) years comprising 2986 visits. At baseline, RA duration was 11.1<!--> <!-->±<!--> <!-->7.4 years. DAS28 and HAQ were greater in RA with FM group, and were closer to RA without FM group towards the end. RA patients with FM used higher doses of tricyclic antidepressants, leflunomide and prednisone, and lower doses of methotrexate. When compared to RA patients without FM, participants with RA and FM used more often tricyclic antidepressants, leflunomide, prednisone, continuous analgesics and less often methotrexate. Groups presented similar 7-year biologic-free survival, and radiographic progression-free survival in Cox regression. RA patients with FM had greater proportions of visits in mistreatment scenarios when compared to RA patients without FM (28.4 <em>vs.</em> 19.8%, <em>p</em> <!-->&lt;<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>RA patients with FM used more leflunomide and prednisone, and RA mistreatment was more frequent in FM patients. Certainly, RA patients with FM will benefit from a personalized T2T strategy, including ultrasound (when suitable) and proper FM treatment.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 403-411"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.01.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514781","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":"Pulmonary magnetic resonance imaging is similar to chest tomography in detecting inflammation in patients with systemic sclerosis","authors":"Carolina de Souza Müller ,&nbsp;Danny Warszawiak ,&nbsp;Eduardo dos Santos Paiva ,&nbsp;Dante Luiz Escuissato","doi":"10.1016/j.rbre.2017.02.001","DOIUrl":"10.1016/j.rbre.2017.02.001","url":null,"abstract":"<div><p>Interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH) are prevalent complications of systemic sclerosis (SSc) and are currently the leading causes of death related to the disease. The accurate recognition of these conditions is therefore of utmost importance for patient management.</p><p>A study was carried out with 24 SSc patients being followed at the Rheumatology Department of the Hospital de Clínicas of Universidade Federal do Paraná (UFPR) and 14 healthy volunteers, with the objective of evaluating the usefulness of lung magnetic resonance imaging (MRI) when assessing ILD in SS patients. The results obtained with lung MRI were compared to those obtained by computed tomography (CT) of the chest, currently considered the examination of choice when investigating ILD in SS patients.</p><p>The assessed population was predominantly composed of women with a mean age of 50 years, limited cutaneous SS, and a disease duration of approximately 7 years. In most cases, there was agreement between the findings on chest CT and lung MRI. Considering it is a radiation-free examination and capable of accurately identifying areas of lung tissue inflammatory involvement, lung MRI showed to be a useful examination, and further studies are needed to assess whether there is an advantage in using lung MRI instead of chest CT when assessing ILD activity in SS patients.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 419-424"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514782","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":"Prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis in Southern Brazil","authors":"Rafael Kmiliauskis Santos Gomes ,&nbsp;Ana Carolina Albers ,&nbsp;Ana Isadora Pianowski Salussoglia ,&nbsp;Ana Maria Bazzan ,&nbsp;Luana Cristina Schreiner ,&nbsp;Mateus Oliveira Vieira ,&nbsp;Patrícia Giovana da Silva ,&nbsp;Patrícia Helena Machado ,&nbsp;Cynthia Mara da Silva ,&nbsp;Mauro Marcelo Mattos ,&nbsp;Moacyr Roberto Cuce Nobre","doi":"10.1016/j.rbre.2017.01.006","DOIUrl":"10.1016/j.rbre.2017.01.006","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate the prevalence of ischemic heart disease and associated factors in patients with rheumatoid arthritis.</p></div><div><h3>Methods</h3><p>A cross-sectional study using the American College of Rheumatology diagnostic criteria in order to select patients seen at primary or secondary health care units in Blumenau, Santa Catarina, Southern Brazil, in 2014. The presence of ischemic heart disease was defined as an acute myocardial infarction with percutaneous coronary intervention or coronary artery bypass graft surgery that has occurred after diagnosis. Fischer's exact test, Wald's linear trend test, and multivariate logistic regression analysis were used to test the associations.</p></div><div><h3>Results</h3><p>Among 296 patients (83.1% female) with a mean age of 56.6 years and a mean rheumatoid arthritis duration of 11.3 years, 13 reported having acute myocardial infarction requiring a percutaneous or surgical reperfusion procedure, a prevalence of 4.4% (95% CI 2.0–6.7). Diabetes Mellitus (odds ratio [OR] 4.9 [95% CI 1.6–13.8]) and disease duration &gt;10 years (OR 8.2 [95% CI 1.8–39.7]) were the only factors associated with an ischemic disease that remained in the final model, after the multivariate analysis.</p></div><div><h3>Conclusion</h3><p>The prevalence of acute myocardial infarction was similar to that observed in other studies. Among the traditional risk factors, Diabetes Mellitus, and among the factors related to rheumatoid arthritis, disease duration, were the variables associated with comorbidity.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 412-418"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.01.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514784","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":"Rheumatoid arthritis in elderly and young patients","authors":"Ariane Carla Horiuchi,&nbsp;Luiz Henrique Cardoso Pereira,&nbsp;Bárbara Stadler Kahlow,&nbsp;Marilia Barreto Silva,&nbsp;Thelma L. Skare","doi":"10.1016/j.rbre.2015.06.002","DOIUrl":"10.1016/j.rbre.2015.06.002","url":null,"abstract":"","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 491-494"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2015.06.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35455474","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":"Prevalence of fibromyalgia in patients treated at the bariatric surgery outpatient clinic of Hospital de Clínicas do Paraná - Curitiba","authors":"Deborah Negrão Gonçalo Dias ,&nbsp;Márcia Alessandra Arantes Marques ,&nbsp;Solange C. Bettini ,&nbsp;Eduardo dos Santos Paiva","doi":"10.1016/j.rbre.2017.02.005","DOIUrl":"10.1016/j.rbre.2017.02.005","url":null,"abstract":"<div><h3>Introduction</h3><p>Fibromyalgia (FM) is a chronic pain syndrome characterized by generalized pain. It is known that obese patients have more skeletal muscle pain and physical dysfunction than normal weight patients. Therefore, it is important that the early diagnosis of FM be attained in obese patients.</p></div><div><h3>Objective</h3><p>To determine the prevalence of FM in a group of obese patients with indication of bariatric surgery.</p></div><div><h3>Materials and methods</h3><p>The patients were recruited from the Bariatric Surgery outpatient clinic of Hospital de Clínicas of UFPR (HC-UFPR) before being submitted to surgery. Patient assessment consisted in verifying the presence or absence of FM using the 1990 and 2011 ACR criteria, as well as the presence of comorbidities.</p></div><div><h3>Results</h3><p>98 patients were evaluated, of which 84 were females. The mean age was 42.07 years and the BMI was 45.39. The prevalence of FM was 34% (<em>n</em> <!-->=<!--> <!-->29) according to the 1990 criteria and 45% (<em>n</em> <!-->=<!--> <!-->38) according to the 2011 criteria. There was no difference in age, BMI, Epworth score and prevalence of other diseases among patients who met or not the 1990 criteria. Only depression was more common in patients with FM. (24.14% vs. 5.45%). The same findings were seen in patients that met the 2011 criteria.</p></div><div><h3>Conclusions</h3><p>The prevalence of FM in patients with morbid obesity is extremely high. However, BMI does not differ in patients with or without FM. The presence of depression may be a risk factor for the development of FM in these patients.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 425-430"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35514783","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":"Chronic low back pain in patients with systemic lupus erythematosus: prevalence and predictors of back muscle strength and its correlation with disability","authors":"Raíssa Sudré Cezarino ,&nbsp;Jefferson Rosa Cardoso ,&nbsp;Kedma Neves Rodrigues ,&nbsp;Yasmin Santana Magalhães ,&nbsp;Talita Yokoy de Souza ,&nbsp;Lícia Maria Henrique da Mota ,&nbsp;Ana Clara Bonini-Rocha ,&nbsp;Joseph McVeigh ,&nbsp;Wagner Rodrigues Martins","doi":"10.1016/j.rbre.2017.03.003","DOIUrl":"10.1016/j.rbre.2017.03.003","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the prevalence of Chronic Low Back Pain and predictors of Back Muscle Strength in patients with Systemic Lupus Erythematosus.</p></div><div><h3>Methods</h3><p>Cross-sectional study. Ninety-six ambulatory patients with lupus were selected by non-probability sampling and interviewed and tested during medical consultation. The outcomes measurements were: Point prevalence of chronic low back pain, Oswestry Disability Index, Tampa Scale of Kinesiophobia, Fatigue Severity Scale and maximal voluntary isometric contractions of handgrip and of the back muscles. Correlation coefficient and multiple linear regression were used in statistical analysis.</p></div><div><h3>Results</h3><p>Of the 96 individuals interviewed, 25 had chronic low back pain, indicating a point prevalence of 26% (92% women). The correlation between the Oswestry Index and maximal voluntary isometric contraction of the back muscles was <em>r</em> <!-->=<!--> <!-->−0.4, 95% CI [−0.68; −0.01] and between the maximal voluntary isometric contraction of handgrip and of the back muscles was <em>r</em> <!-->=<!--> <!-->0.72, 95% CI [0.51; 0.88]. The regression model presented the highest value of <em>R</em>² being observed when maximal voluntary isometric contraction of the back muscles was tested with five independent variables (63%). In this model handgrip strength was the only predictive variable (<em>β</em> <!-->=<!--> <!-->0.61, <em>p</em> <!-->=<!--> <!-->0.001).</p></div><div><h3>Conclusions</h3><p>The prevalence of chronic low back pain in individuals with systemic lupus erythematosus was 26%. The maximal voluntary isometric contraction of the back muscles was 63% predicted by five variables of interest, however, only the handgrip strength was a statistically significant predictive variable. The maximal voluntary isometric contraction of the back muscles presented a linear relation directly proportional to handgrip and inversely proportional to Oswestry Index i.e. stronger back muscles are associated with lower disability scores.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 438-444"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.03.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34957798","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":"Effect of vitamin D supplementation on patients with systemic lupus erythematosus: a systematic review","authors":"Joyce Ramalho Sousa ,&nbsp;Érica Patrícia Cunha Rosa ,&nbsp;Ivone Freires de Oliveira Costa Nunes ,&nbsp;Cecilia Maria Resende Gonçalves de Carvalho","doi":"10.1016/j.rbre.2017.08.001","DOIUrl":"10.1016/j.rbre.2017.08.001","url":null,"abstract":"<div><p>The objective of this systematic review was to analyze clinical trials carried out for the investigation of the effect of vitamin D supplementation on systemic lupus erythematosus. The research was performed from August to September 2016, without limits regarding year of publication, restriction of gender, age, and ethnicity. For the guiding question, the PICO strategy was employed. To evaluate the quality of the publications the PRISMA protocol and Jadad scale were used. The risk of bias analysis of the clinical trials was performed using the Cochrane collaboration tool. After the process of article selection and removal of duplicates, four articles were identified as eligible. The results of three studies showed a positive effect of supplementation on disease activity reduction and significant improvement in levels of inflammatory markers, fatigue, and endothelial function. Only one study showed no improvement in disease activity after supplementation. Moreover, all studies showed an increase in serum vitamin D levels. The data from this review provide evidence on the benefits of vitamin D supplementation in patients with lupus and vitamin D insufficiency/deficiency. However, it is still necessary to elucidate whether vitamin D acts in the protection against this metabolic disorder, as well as the standardization of the type, dose and time of vitamin D supplementation.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 466-471"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35515219","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":"Devic's disease in an adolescent girl with juvenile dermatomyositis","authors":"Melissa Mariti Fraga ,&nbsp;Enedina Maria Lobato de Oliveira ,&nbsp;Claudio Arnaldo Len ,&nbsp;Maria Fernanda Campos ,&nbsp;Maria Teresa Terreri","doi":"10.1016/j.rbre.2014.12.004","DOIUrl":"10.1016/j.rbre.2014.12.004","url":null,"abstract":"","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 475-478"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2014.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35515221","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":"Quality of life and functional capacity of patients with adhesive capsulitis: identifying risk factors associated to better outcomes after treatment with nerve blocking","authors":"Marcos Rassi Fernandes ,&nbsp;Maria Alves Barbosa ,&nbsp;Ruth Minamisawa Faria","doi":"10.1016/j.rbre.2017.05.003","DOIUrl":"10.1016/j.rbre.2017.05.003","url":null,"abstract":"<div><h3>Introduction</h3><p>The objectives of this study were to assess the quality of life and functional capacity of adhesive capsulitis patients at the beginning and end of procedure and to identify risk factors associated to better outcomes after treatment with nerve blocking.</p></div><div><h3>Methods</h3><p>A prospective cohort study was performed. Inclusion criteria were clinical signs of adhesive capsulitis and disease changes on shoulder imaging exams. The short form of World Health Organization Quality of life and Disabilities of the Arm, Shoulder and Hand questionnaires were administered at the beginning and end of treatment. A score of 55 points or more on the Constant index was used for discontinuation of treatment. We used the Wilcoxon test for paired samples. Multiple regression analysis of Poisson was carried out using exposure variables with <em>p</em> <!-->&lt;<!--> <!-->0.20 in the univariate analysis and the satisfactory quality of life and better functional capability as outcomes. The significance level was 5%.</p></div><div><h3>Results</h3><p>43 patients were evaluated. For the comparison between medians values at the beginning and end of treatment (physical domain: 46.43–67.86; psychologic domain: 66.67–79.17; social domain: 66.67–75; environment domain: 62.5–68.75; DASH: 64.16–38.33), <em>p</em> was &lt;0.05. Aging (physical/psychologic/DASH), higher educational level (physical/environment/DASH), less severity (only physical) and fewer nerve blocking (only psychologic) were these independent risk factors.</p></div><div><h3>Conclusions</h3><p>Quality of life and functional capacity of the patients improve at the end of procedure. Older patients and higher education levels are the risk factors most associated to satisfactory quality of life and better functional capacity after treatment with nerve blocking.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 445-451"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2017.05.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35094118","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":"Intestinal parasites infection: protective effect in rheumatoid arthritis?","authors":"Sandra Maximiano de Oliveira ,&nbsp;Ana Paula Monteiro Gomides ,&nbsp;Lícia Maria Henrique da Mota ,&nbsp;Caliandra Maria Bezerra Luna Lima ,&nbsp;Francisco Airton Castro Rocha","doi":"10.1016/j.rbre.2016.06.004","DOIUrl":"10.1016/j.rbre.2016.06.004","url":null,"abstract":"<div><p>Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease, with a progressive course, characterized by chronic synovitis that may evolve with deformities and functional disability, and whose early treatment minimizes joint damage. Its etiopathogenesis is not fully elucidated but comprises immunologic responses mediated by T helper cells (Th1). An apparent minor severity of RA in patients from regions with lower income could be associated with a higher prevalence of gut parasites, especially helminths. Strictly, a shift in the immune response toward the predominance of T helper cells (Th2), due to the chronic exposure to helminths, could modulate negatively the inflammation in RA patients, resulting in lower severity/joint injury. The interaction between the immunological responses of parasitic helminths in rheumatoid arthritis patients is the purpose of this paper.</p></div>","PeriodicalId":101096,"journal":{"name":"Revista Brasileira de Reumatologia (English Edition)","volume":"57 5","pages":"Pages 461-465"},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbre.2016.06.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35515218","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}