Clinical and Experimental Allergy最新文献

{"title":"Biologic Prescription Patterns and Biomarker Determinants of First-Line Dupilumab in Danish Adult Patients With Severe Asthma and Comorbid Atopic Dermatitis-Correspondence.","authors":"Yun-Cheng Tsai, Hao-Yun Chen, Chia-Jung Chang, Su-Boon Yong, Chin-Yuan Yii","doi":"10.1111/cea.70134","DOIUrl":"https://doi.org/10.1111/cea.70134","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Uncertain Utility of Skin Testing in Iodinated Contrast Media Reactions.","authors":"Maria Gabriela Vasquez Ortuño, Diego Santiago Fernández Romero","doi":"10.1111/cea.70129","DOIUrl":"https://doi.org/10.1111/cea.70129","url":null,"abstract":"","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured Cover","authors":"","doi":"10.1111/cea.70123","DOIUrl":"https://doi.org/10.1111/cea.70123","url":null,"abstract":"<p>\u0000 \u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 8","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of the Minimal Clinically Important Difference of FeNO Using the Asthma Control Questionnaire.","authors":"Jonathan Noble, Orlagh Bean, Ross Sayers, Ryan Cullen, Richard Beasley, Mark Weatherall","doi":"10.1111/cea.70131","DOIUrl":"https://doi.org/10.1111/cea.70131","url":null,"abstract":"<p><strong>Background: </strong>The minimal clinically important difference (MCID) for fractional exhaled nitric oxide (FeNO) in asthma is uncertain. The American Thoracic Society (ATS) suggests this may be a relative change ≥ 20%; however, this recommendation is not validated against a clinical outcome measure. A secondary analysis of two randomised controlled trials (RCTs) examining associations between changes in FeNO and the Asthma Control Questionnaire-5 (ACQ-5) may help estimate the MCID.</p><p><strong>Methods: </strong>The PRACTICAL and Novel START were 52-week RCTs that compared as-required short-acting beta-agonists with or without maintenance inhaled corticosteroids (ICS) versus as-required ICS-formoterol in mild-moderate asthma. In this secondary analysis, participants with measurements of FeNO and ACQ-5 were included. FeNO was analysed on the logarithm transformed scale. Logistic regression assessed associations between FeNO and ACQ-5 changes from baseline to end of study, relative to the ACQ-5 MCID (0.5 points). A t-test was used to compare the difference in log FeNO for those whose ACQ-5 fell by the MCID for an improvement in ACQ.</p><p><strong>Results: </strong>Data from 1553 participants were included. There was a weak association between the change in FeNO and change in ACQ-5; correlation coefficient was 0.08 (p = 0.002). The mean (SD) change in log FeNO for those with a clinically important improvement in ACQ-5 was -0.25 (0.64), N = 530; geometric mean ratio was 0.78, representing a 22% change in the geometric mean of FeNO. The change in log FeNO was -0.14 (0.60) for those without an improvement in ACQ-5, N = 852; geometric mean ratio was 0.87. The sensitivity and specificity for a 20% change in geometric mean FeNO were 47% and 57%, respectively.</p><p><strong>Conclusion: </strong>Changes in FeNO are a poor surrogate for changes in ACQ-5. The magnitude of FeNO changes in participants with an MCID improvement in ACQ-5 provides weak support for the ATS recommendation that the MCID for FeNO may be about a 20% relative change.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pragmatic Low-Dose Oral Immunotherapy for Preschool Children With Peanut Allergy: A Randomised Controlled Trial.","authors":"Michael O'Sullivan, Rachael Wallace, Samantha Thomas, Alyssa Godfrey, Natasha Bear, Bhaumik Mevavala, Sarah Miller, Ingrid Roche, Samara Baldwin, Jessica R Metcalfe","doi":"10.1111/cea.70126","DOIUrl":"https://doi.org/10.1111/cea.70126","url":null,"abstract":"<p><strong>Introduction: </strong>Peanut allergy is the most common childhood-onset, persistent food allergy. Peanut oral immunotherapy (OIT) is a potential treatment, but few studies prospectively examine the outcome of peanut OIT in young children using parent-measured doses compared to standard care (peanut avoidance).</p><p><strong>Objective: </strong>To determine the efficacy, safety and tolerability of a pragmatic peanut OIT protocol (parent-measured doses with low maintenance dose) compared to avoidance.</p><p><strong>Methods: </strong>In this unblinded randomised controlled trial (1:1 ratio), children 1-4 years old were assigned to receive peanut OIT (maintenance dose 360 mg) or avoidance for 12 months. The primary outcome was desensitisation, defined as the ability to tolerate at least 600 mg peanut protein during an end-of-treatment oral food challenge (EOT OFC), with secondary outcomes frequency and severity of adverse events, change in quality of life and change in immunological markers of peanut allergy.</p><p><strong>Results: </strong>A total of 54 children were randomised, with 23/27 in the peanut OIT and 25/27 in the avoidance group undergoing open peanut challenge after 12 months. An eliciting dose of ≥ 600 mg peanut protein was tolerated by 74% (20/27) of OIT compared to 11% (3/27) of avoidance participants. 41% of OIT (11/27) and 7% of avoidance (2/27) participants passed the end-of-treatment challenge. The OIT group reported significantly better quality of life than the avoidance group after 12 months (Food Allergy Quality of Life Questionnaire-Parent Form mean difference -0.5, p = 0.041). There were 79 treatment-related adverse events reported by 21 participants in the OIT group (median 2 per participant, range 0-13).</p><p><strong>Conclusion: </strong>Peanut OIT using parent-measured doses and a low maintenance dose of 360 mg is effective at inducing desensitisation after 12 months in 1- to 4-year-old children. In this cohort, peanut OIT is associated with improved quality of life compared to avoidance and appears to have an acceptable safety profile.</p><p><strong>Trial registration: </strong>Australian New Zealand Clinical Trials Registry: ACTRN12621001001886 (registered 30 July 2021).</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness and Safety of JAK Inhibitors in Atopic Dermatitis: A Systematic Review and Meta-Analysis","authors":"Yunha Kim,&nbsp;Gayeong Seo,&nbsp;Jacob J. E. Koopman,&nbsp;Jeong Yee","doi":"10.1111/cea.70125","DOIUrl":"10.1111/cea.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The aim of this study is to evaluate the effectiveness and safety of JAK inhibitors in patients with moderate to severe atopic dermatitis by performing a systematic review and meta-analysis using data from studies in real-world settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis. Pooled estimates for effectiveness and safety were assessed using the Freeman–Tukey Double ArcSine method. Statistical heterogeneity was assessed using <i>I</i>² statistics. A random-effects model (DerSimonian-Laird method) was applied to consider the heterogeneity within and between studies and to give a more conservative estimate. The study quality assessment tools developed by the National Heart, Lung, and Blood Institute were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Source</h3>\u0000 \u0000 <p>Relevant studies were searched in March 2025 using four databases: PubMed, Embase, Scopus, and Web of Science.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Eligibility Criteria</h3>\u0000 \u0000 <p>Studies evaluating the effectiveness or safety of systemic JAK inhibitors among patients with moderate to severe atopic dermatitis in a real-world setting were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 50 studies were included in this review. Regarding their effectiveness, the pooled estimates with a 95% CI of Eczema Area and Severity Index (EASI)-75 were 44% (34%–55%), 45% (28%–62%), 59% (51%–66%), 73% (64%–81%), 70% (57%–81%), and 86% (72%–96%) at 4, 8, 12, 16, 24, and 52 weeks. For safety, the most common adverse events were acne (16%), followed by increased creatine phosphokinase levels (13%) and increased lipids (12%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our meta-analysis of JAK inhibitors in patients with atopic dermatitis demonstrated that the overall outcomes from real-world settings are comparable to those from clinical trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Systematic Review Registration</h3>\u0000 \u0000 <p><b>Protocol Registration:</b> PROSPERO CRD42024569258.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 9","pages":"755-772"},"PeriodicalIF":5.2,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cea.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Burden of Drug-Induced Anaphylaxis Associated With 33 Classes of Antibiotics (1968-2024): A Pharmacovigilance Analysis.","authors":"Jaehyeong Cho, Jeongseon Oh, Jaeyu Park, Hyesu Jo, Tae Hyeon Kim, Hyunjee Kim, Yesol Yim, Seoyoung Park, Kyeongeun Kim, Ho Geol Woo, Yerin Hwang, Michael Miligkos, Dong Keon Yon, Nikolaos G Papadopoulos","doi":"10.1111/cea.70121","DOIUrl":"https://doi.org/10.1111/cea.70121","url":null,"abstract":"<p><strong>Background: </strong>Despite antibiotic-induced anaphylaxis being a severe allergic reaction requiring immediate care, large-scale studies examining all antibiotic subtypes remain limited. This study addresses this gap by analysing 33 antibiotic classes, along with epidemiological and regional variations.</p><p><strong>Methods: </strong>This study utilised the world's largest pharmacovigilance database, with over 35 million individual case safety reports from 140 countries. The study employed a two-step approach: first, the antibiotics were grouped into 10 categories according to their third-level ATC codes and their frequencies were collectively analysed. These categories comprised tetracyclines (J01A), amphenicols (J01B), beta-lactam antibacterial penicillins (J01C), other beta-lactam antibacterials (J01D), sulfonamides and trimethoprim (J01E), macrolides, lincosamides and streptogramins (J01F), aminoglycoside antibacterials (J01G), quinolone antibacterials (J01M), combinations of antibacterials (J01R) and other antibacterials (J01X). Second, a more detailed analysis was performed at the fourth level of the ATC codes for the antibiotics categorised at the third level, focusing on 33 individual antibiotics. For statistical analysis, disproportionality metrics, including the information component (IC) with IC₀₂₅ and reporting odds ratio (ROR) with 95% CI, were used to classify and analyse the risk of anaphylaxis related to these drugs.</p><p><strong>Results: </strong>A total of 144,820 reports were identified as antibiotic-induced anaphylaxis. All antibiotics showed significant signal detection for anaphylaxis (ROR, 20.50 [95% CI, 20.37-20.63]; IC, 3.77 [IC₀₂₅, 3.76]) across all age groups and sexes. The following three antibiotics took the most proportion of the reports: penicillins (39,696/144,820 [27.4%]; ROR, 18.82 [95% CI, 18.62-19.01]; IC, 4.04 [IC₀₂₅, 4.02]), other beta-lactam antibiotics (63,644/144,820 [43.9%]; 27.59 [27.35-27.83]; 4.48 [4.46]) and quinolones (20,303/144,820 [14.0%]; 13.40 [13.21-13.60]; 3.63 [3.61]). The median time-to-onset was 1 day (interquantile range, 1-1), with most r recovered (96.09%) and the fatality rate accounting for 1.23%.</p><p><strong>Conclusion: </strong>Although our findings do not permit causal inference, the analysis highlights the need for standardised grading systems, patient-specific risk factors and long-term outcome studies to improve prevention and management.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards an Optimal Decision Threshold for Specific IgE to rCan s 3 the Non-Specific Lipid Transfer Protein of Cannabis sativa.","authors":"Didier G Ebo, Christel Mertens, Michel Van Houdt, Margo Hagendorens, Hans-Peter Rihs, Alessandro Toscano, Michiel Beyens, Vito Sabato, Athina L Van Gasse, Jessy Elst","doi":"10.1111/cea.70122","DOIUrl":"https://doi.org/10.1111/cea.70122","url":null,"abstract":"<p><strong>Background: </strong>Cannabis allergy is increasingly reported, with Can s 3 as a major allergen. Investigations into sensitisation to Can s 3 utilise sophisticated techniques, including the cytometric bead assay and the basophil activation test. This study aims to utilise a fluorescence enzyme immunoassay to quantify sIgE to Can s 3, employing a recombinant Can s 3 protein.</p><p><strong>Methods: </strong>This study included 104 cannabis allergic patients, 20 healthy controls and 70 exposed atopic controls. Specific IgE by a fluorescence enzyme immunoassay or cytometric bead assay and the basophil activation test all used the same recombinant allergen. Two-graph ROC curves were used to determine the clinically validated allergen-specific cut-off for maximal sensitivity and specificity and to facilitate direct comparison of the test performances.</p><p><strong>Results: </strong>Twenty-two individuals were non-responding in the basophil activation test and were excluded from all analyses involving basophil activation test results. The clinically validated cut-off points are > 0.16 kU_A/L, ≥ 0.14 kU_A/L and > 5% for a fluorescence enzyme immunoassay, cytometric bead assay and basophil activation test, respectively. Utilising these thresholds, the fluorescence enzyme immunoassay exhibited a sensitivity of 72% and specificity of 74%, the cytometric bead assay demonstrated a sensitivity of 49% and specificity of 89%. In responders, the basophil activation test exhibited a sensitivity of 51% and specificity of 82%. Remarkably, low positive fluorescence enzyme immunoassay results, particularly below 0.35 kU_A/L, are negative for both cytometric bead assay and basophil activation test. Conversely, utilising the conventional threshold of > 0.35 kU_A/L, the sIgE a fluorescence enzyme immunoassay results exhibited greater congruence with those of the cytometric bead assay and basophil activation test.</p><p><strong>Conclusion: </strong>This study underscores the complexity of establishing an optimal decision threshold for the sIgE rCan s 3 fluorescence enzyme immunoassay and indicates that the clinically validated decision cut-off may not always represent the most efficacious approach.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Siglecs: Potential Modulators of Immune Cells in Food Allergy and Therapeutic Applications.","authors":"J S H Schaapherder, K C M Verhoeckx, A M Ehlers, E F Knol, A C Knulst, L A P M Meulenbroek","doi":"10.1111/cea.70119","DOIUrl":"https://doi.org/10.1111/cea.70119","url":null,"abstract":"<p><p>Food allergies (FAs) are common in society with limited treatment options available. Therefore, there is an urgent need for new targets and treatment options. Sialic acid-binding immunoglobulin-type lectins (Siglecs) are mostly inhibitory receptors differentially expressed on all immune cells. There are many different types of Siglecs, and they are involved in the regulation of several signalling pathways. The specific role that Siglecs can have on various diseases, including cancer and immune-driven disorders, is gaining interest. This review focusses on the current knowledge of the role of Siglecs on immune cells involved in FA sensitisation and elicitation and how targeting these Siglecs could possibly prevent or treat FA. Most research is focussed on targeting Siglecs expressed by mast cells and basophils, and how this can dampen the activation and/or degranulation of these cells. Targeting Siglecs on cells involved in the sensitisation phase of FA could be an interesting option to intervene earlier on in the allergic response, thus preventing the onset of FA rather than treating it. Siglec-2 on B cells is already of great interest for the treatment of FA, and results seem promising as B cell receptor signalling and antibody production were inhibited. Siglecs on other cell types in the sensitisation phase, such as dendritic cells, seem promising, but functional assays with human cells are lacking so far. Overall, Siglecs are broadly expressed on all immune cells involved in the allergic response, which support the hypothesis that Siglecs are involved in the allergic response itself and may act as a potential target in the treatment of FA. Especially, treatments focussed on targeting Siglecs on multiple immune cell types may have great potential, as this could enhance both efficacy and safety.</p>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Allergic Rhinitis in China: Trends, Challenges and Implications Over the Past Two Decades","authors":"Nan Wang,&nbsp;Yin Yao,&nbsp;Yin-Hao Liu,&nbsp;Ming Zeng,&nbsp;Zheng Liu","doi":"10.1111/cea.70118","DOIUrl":"10.1111/cea.70118","url":null,"abstract":"<div>\u0000 \u0000 <p>Allergic rhinitis (AR), as a common and challenging-to-cure allergic upper respiratory disease, poses severe health and economic burdens globally, including in China. Over the past two decades, the significant environment and lifestyle changes resulting from rapid socio-economic development and urbanisation had a profound impact on the onset and progression of AR in China. This review examines the epidemiological trends in China. Specifically, the regional variation in allergen sensitisation patterns, the changes of these patterns over the past two decades, and the implications of these changes for disease prevention and diagnosis are discussed. We also outline the effects of indoor and outdoor air pollution on AR development, along with exploring corresponding solutions. Allergen immunotherapy (AIT) is recommended as the first-line treatment for AR in China, and this review provides an overview of its current application, recent advancements, and remaining challenges in its implementation. Notably, biological therapies, administered as monotherapy or combined with AIT, are discussed in light of their revolutionary impact on AR management. Overall, this review highlights the trends and challenges of AR in China over the past two decades, along with their implications for disease prevention and treatment.</p>\u0000 </div>","PeriodicalId":10207,"journal":{"name":"Clinical and Experimental Allergy","volume":"55 8","pages":"648-658"},"PeriodicalIF":5.2,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}