Clinical and experimental rheumatology最新文献

{"title":"The application value of peripheral plasmablasts in the assessment of disease activity and treatment response in systemic lupus erythematosus.","authors":"Li Wan, Jun Guo, Anbang Sun, Huixin Chen, Bicheng Hu, Chengyu Liu","doi":"10.55563/clinexprheumatol/xsjjih","DOIUrl":"10.55563/clinexprheumatol/xsjjih","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the significance of peripheral plasmablasts as biomarkers for assessing disease activity and predicting treatment response in systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 108 SLE patients hospitalised at Wuhan Hospital of Traditional Chinese and Western Medicine from September 2023 to December 2024, focusing on their peripheral blood B cell subsets.</p><p><strong>Results: </strong>Based on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores, SLE patients were categorised into mild (69 cases), moderate (27 cases), and severe (12 cases) groups. Plasmablast proportions differed significantly among SLE disease activity (mild vs. moderate: 4.06%±2.43% vs. 10.91%±6.03%, p<0.001; mild vs. severe: 4.06%±2.43% vs. 14.68%±6.41%, p<0.001; moderate vs. severe: 10.91%±6.03% vs. 14.68%±6.41%, p=0.080). Plasmablast proportions positively correlated with SLEDAI-2K, anti-dsDNA antibodies, and erythrocyte sedimentation rate, and negatively correlated with C3, C4, white blood cell and platelet counts. The AUC value for predicting SLE disease activity using plasmablast proportions was 0.885. With a cut-off value of 6.06%, the sensitivity and specificity were 87.2% and 85.5%, respectively. Moreover, in 17 patients undergoing dynamic B-cell subset monitoring, those achieving remission after treatment, whether newly diagnosed or relapsed, showed decreasing plasmablast proportions and counts over time. In contrast, refractory patients displayed poor response and persistently high plasmablast proportions and counts despite treatment.</p><p><strong>Conclusions: </strong>Peripheral plasmablasts is intricately linked with the disease activity in SLE; sustained elevated levels of plasmablasts may serve as a prognostic indicator of suboptimal therapeutic response.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"903-912"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Belimumab modulates type I interferon signalling in the treatment of systemic lupus erythematosus.","authors":"Tianrong Xun, Qing Ding, Yindan Ye, Xixiao Yang, Liqian Mo","doi":"10.55563/clinexprheumatol/03t59o","DOIUrl":"10.55563/clinexprheumatol/03t59o","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the effects of belimumab on the immune atlas in patients with systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>We present a single-cell RNA-seq profile of peripheral blood mononuclear cells from six patients with active SLE before and after drug treatment initiation. Three of these patients received belimumab combined with conventional therapy, while three received conventional therapy alone, and served as the control group.</p><p><strong>Results: </strong>We found that belimumab significantly decreased the number of CD16+ monocytes after 8 weeks of treatment, whereas the opposite was observed in the control group. Compared to conventional therapy, belimumab elicited a significant reduction in IFN-stimulated gene (ISG) activity in monocytes and low-density granulocytes (LDGs). Notably, the expansion of unique subpopulations enriched among ISGs was inhibited in patients treated with belimumab. Moreover, the transcription and expression of BAFF-R and B-cell maturation antigen, two BAFF receptors, was increased in plasmacytoid dendritic cells (pDCs), B cells and plasma cells. However, the expression of BAFF-R was inhibited in monocytes and T cells in patients with SLE.</p><p><strong>Conclusions: </strong>These results revealed a novel mechanism of belimumab action, advancing our understanding of the immune atlas in SLE patients before and after belimumab-targeting treatment.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"913-924"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145653878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Cardiac involvement in newly diagnosed patients with idiopathic inflammatory myopathies is associated with skeletal muscle involvement.","authors":"Balsam Hanna, Christian L Polte, Egidija Sakiniene, Julia Von Brömsen, Entela Bollano, Ingrid E Lundberg, Rille Pullerits, Tao Jin","doi":"10.55563/clinexprheumatol/rgybcr","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/rgybcr","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"44 5","pages":"1055"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psoriatic arthritis spectrum in children: a multicentre observational study.","authors":"Serena Pastore, Alberto Tommasini, Giorgia Martini, Alessia Pin, Andrea Taddio, Cristina Tumminelli, Federica Corona, Paolo Dalena, Alessandra Meneghel, Francesca Tirelli, Filippo Dell'Apa, Michele Fastiggi, Michela Cappella, Niccolò Possemato, Francesco Zulian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study is to describe characteristics of children with the International League of Associations for Rheumatology (ILAR)-defined juvenile idiopathic arthritis (JPsA) and to assess whether more sensitive and specific criteria for defining JPsA can be identified.</p><p><strong>Methods: </strong>A retrospective observational multicentre study was conducted including patients with a diagnosis of JPsA according to ILAR criteria. In this population, we identified clusters using as variables the clinical criteria of JPsA according to ILAR and the CASPAR clinical criteria. In addition, we defined as undifferentiated arthritis patients that met the ERA criteria, as defined by ILAR, and presented psoriatic features such as psoriasis or a history of psoriasis or psoriatic arthritis in a first-degree relative.</p><p><strong>Results: </strong>73 patients were enrolled. Three clinical clusters were found using unsupervised principal component analysis for the patients. Cluster 1 differed significantly for older patients and psoriasis. In contrast, Cluster 2 was mainly characterised by dactylitis and Cluster 3 was defined by family history of psoriasis and a significant prevalence of dactylitis. We also showed a statistically significant presence of familiarity for psoriatic arthritis in Cluster 2. The significance for all parameters evaluated did not change even when we included the patients with undifferentiated arthritis, except for MTX treatment, which was significantly more common in Cluster 2 (p=0.02), and tenosynovitis, also in Cluster 2 (p=0.05). Moreover, we evaluated our cohort by the Vancouver criteria. Combining the ILAR, CASPAR, and Vancouver criteria only two patients remain undifferentiated.</p><p><strong>Conclusions: </strong>Our study showed three clinical clusters with diverse demographic and clinical characteristics, indicating JPsA heterogeneity. The findings highlight the need to look beyond ILAR criteria for clinical variables, including family history of psoriatic arthritis. The ILAR, CASPAR, and Vancouver criteria improve the diagnosis of paediatric psoriatic spectrum arthritis. This complex disease population needs larger cohorts and clinical data, especially on axial involvement, to better categorisation and treatment.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":"44 5","pages":"1046-1051"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient clustering by serum inflammatory mediators stratifies early disease-modifying antirheumatic drug-naive rheumatoid arthritis and reveals distinct pathobiological signatures: a prospective observational cohort.","authors":"Genki Kidoguchi, Michinori Ishitoku, Naoya Oka, Hiroki Kobayashi, Yohei Hosokawa, Tomohiro Sugimoto, Yusuke Yoshida, Sho Mokuda, Shintaro Hirata","doi":"10.55563/clinexprheumatol/bx6ql2","DOIUrl":"10.55563/clinexprheumatol/bx6ql2","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) is a heterogeneous disease; therefore, a one-size-fits-all treatment approach is suboptimal. This study aimed to explore biological heterogeneity in treatment-naive patients with early RA using serum inflammatory mediator profiles to identify distinct subgroups and investigate their longitudinal dynamics.</p><p><strong>Methods: </strong>We conducted an exploratory, hypothesis-generating post-hoc analysis of 204 disease-modifying anti-rheumatic drug (DMARD)-naive patients with early RA from a prospective cohort. Thirteen baseline serum inflammatory mediators, including interleukin (IL)-1β, IL-4, IL-6, IL-10, IL-12p40, IL-12p70, IL-23, IL-1RA, tumour necrosis factor-alpha, interferon-gamma, C-X-C motif chemokine ligand 10, C-C motif chemokine ligand 17, and arginase, were quantified. Patients were stratified using unsupervised hierarchical clustering, followed by correlation and regression analyses to compare clusters and examine response pathways. The predictive value of routine clinical markers for cluster membership was assessed using the receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>Two distinct patient clusters were identified based on differing serological and inflammatory mediator profiles. Despite these biological differences, the baseline disease activity and 52-week outcomes were largely similar. However, the pathways of clinical improvement varied by cluster; IL-6 dynamics were uniquely associated with improvement in cluster 1, whereas no dominant mediator was identified in cluster 2. In contrast to C-reactive protein, a low rheumatoid factor titre effectively identified the IL-6-driven subgroup (area under the curve=0.785).</p><p><strong>Conclusions: </strong>Baseline serum inflammatory mediator profiles can stratify DMARD-naive patients with early RA into subgroups with distinct pathobiological mechanisms. These subgroup-specific signatures, including those of the IL-6-driven pathway, offer a basis for developing biomarker-guided therapeutic strategies.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1004-1013"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-year follow-up from a randomised controlled trial of a single intra-articular polyacrylamide hydrogel injection in subjects with knee osteoarthritis.","authors":"Henning Bliddal, Jannie Beier, Andreas Hartkopp, Philip G Conaghan, Marius Henriksen","doi":"10.55563/clinexprheumatol/5lofry","DOIUrl":"10.55563/clinexprheumatol/5lofry","url":null,"abstract":"<p><strong>Objectives: </strong>A randomised controlled trial demonstrated comparable efficacy and safety of a single 6 mL intra-articular (IA) injection of 2.5% polyacrylamide hydrogel (2.5% iPAAG) versus hyaluronic acid (HA) over one year in adults with moderate-to-severe knee osteoarthritis (OA). This study evaluated the long-term effectiveness and safety of 2.5% iPAAG.</p><p><strong>Methods: </strong>This 3-year extension of a randomised controlled trial (RCT) (ClinicalTrials.gov Identifier: NCT04045431) followed participants who received a single 6 mL IA injection of 2.5% iPAAG. Outcomes included changes from baseline to year 3 in WOMAC pain, stiffness, and physical function subscales (0-100 scale) and patient global assessment (PGA) of OA impact. Safety was assessed up to year 3.</p><p><strong>Results: </strong>A total of 119 participants received IA 2.5% iPAAG. After one year, 91 participants (44 females) entered the extension study, and 75 completed 3-years of follow-up. At year 3, the mean change in WOMAC pain was -13.1 (95% CI: -17.9 to -8.4; p<0.0001). Between the 1-year and 3-year visits, fifty adverse events (AEs) were reported by 36 participants (29.8%), none of which were assessed as related to 2.5% iPAAG.</p><p><strong>Conclusions: </strong>A single 6 mL IA injection of 2.5% iPAAG appears to be safe and effective in providing sustained symptom relief for up to 3 years in individuals with knee OA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"996-1003"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gout: one year in review 2026.","authors":"Leonardo Punzi, Chiara Baggio, Paola Galozzi, Mariagrazia Lorenzin, Giacomo Cozzi, Amelia C Damasco, Paolo Sfriso, Francesca Oliviero, Roberta Ramonda","doi":"10.55563/clinexprheumatol/9xhnbu","DOIUrl":"10.55563/clinexprheumatol/9xhnbu","url":null,"abstract":"<p><p>The year 2025 marked a significant evolution in the understanding and management of gout, characterised by a growing focus on personalised medicine and multidimensional pathogenetic models.This review provides a comprehensive analysis of the scientific literature published during 2025, highlighting key advancements across several fields. Specifically, we discuss emerging epidemiological trends, such as the rising incidence of early-onset gout, and the integration of artificial intelligence into diagnostic imaging. Groundbreaking genetic studies are explored, identifying early-onset disease as a potentially distinct subset, alongside new insights into the 'gut-kidney axis' and the role of the microbiome in urate homeostasis.Furthermore, this review examines updated pathogenetic mechanisms involving immunometabolic reprogramming and evaluates the latest therapeutic strategies for both gouty arthritis and asymptomatic hyperuricaemia.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"883-894"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there place for TNF-alpha inhibitors in the treatment of connective tissue diseases?","authors":"Agata Matusiewicz, Martyna Dziewit, Sylwia Ornowska, Marzena Olesińska","doi":"10.55563/clinexprheumatol/r24pfo","DOIUrl":"10.55563/clinexprheumatol/r24pfo","url":null,"abstract":"<p><p>Tumour necrosis factor alpha (TNF-α) plays a crucial role in the inflammatory and immune responses. While TNF-α inhibitors (TNFi) have demonstrated efficacy in inflammatory diseases like rheumatoid arthritis, their use in connective tissue diseases remains controversial. Various studies highlight inconsistent benefits, particularly in systemic lupus erythematosus where limited evidence supports TNFi therapies despite some positive outcomes in resistant cases. In antiphospholipid syndrome, TNFi therapy has shown promise in specific refractory cases, increasing live birth rates. Conversely, the effectiveness of TNFi in systemic sclerosis, Sjögren's syndrome and idiopathic inflammatory myopathies is less well established, with reports of exacerbated symptoms and severe adverse effects. Existing literature suggests that while TNFi may provide some benefits, particularly in refractory cases, their overall safety and efficacy remain uncertain. This underscores the necessity for further clinical trials to elucidate the therapeutic role of TNFi and ensure patient safety in these complex autoimmune conditions. The aim of this review was to collect and evaluate the current scientific evidence on the efficacy and safety of TNF-α inhibitors in the treatment of connective tissue diseases.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1025-1035"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145451149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexistence of sarcoidosis and spondyloarthritis: a rare but intriguing association.","authors":"Alessia Alunno, Francesco Carubbi, Begoña De Escalante, Guillem Policarpo, Soledad Retamozo, Jose Salvador García Morillo, Angel Robles, Fabiola Atzeni, Jesus Ballano, Ricardo Gómez de la Torre, Jesus Miguel Lopez Dupla, Manuel Ramos-Casals, Pilar Brito-Zerón","doi":"10.55563/clinexprheumatol/s678e6","DOIUrl":"10.55563/clinexprheumatol/s678e6","url":null,"abstract":"<p><strong>Objectives: </strong>To characterise the key epidemiological, clinical, immunological, imaging, and pathological features of the coexistence between sarcoidosis and spondyloarthritis (SpA).</p><p><strong>Methods: </strong>All centres included in two large multicentre registries (the Sjögren Syndrome Big Data Consortium and the Sarco-GEAS-SEMI Registry) identified potential cases of coexisting SpA and sarcoidosis. Inclusion criteria were the fulfilment of the current classification criteria both for SpA (ASAS) and sarcoidosis (WASOG).</p><p><strong>Results: </strong>We identified twenty-three patients (14 females and 9 males) with a mean age of 44 years at diagnosis of SpA and of 45 years at diagnosis of sarcoidosis. Most of the patients fulfilled the ASAS criteria for axial SpA. In 8 patients, sarcoidosis was diagnosed after SpA, in 9 patients sarcoidosis preceded SpA and in 6 patients the diagnoses were concurrent. Within these groups, the HLA*B-27 haplotype was detected in 5 (62%), 2/8 (25%) and 3 (50%) of patients respectively. A median of 2 years (range 1-19) occurred between the diagnosis of the two diseases in the first 2 groups. Lung, skin, and extra-thoracic lymph nodes were the most frequent sarcoidosis manifestations in all 3 groups.</p><p><strong>Conclusions: </strong>We have characterised 23 patients who fulfilled the current classification criteria for both SpA and sarcoidosis. Therefore, sarcoidosis may coexist with SpA like other systemic autoimmune diseases, and this may be explained by shared pathogenic mechanisms. Since Th17 cells are leading actors in the pathogenesis of both SpA and sarcoidosis, these cells may be the missing link connecting the two diseases.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1014-1021"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and immunologic status of a child conceived following maternal administration of CD19 CAR T-cells for systemic lupus erythematosus.","authors":"Neil Kramer, Elliot D Rosenstein, Mohammad Cherry","doi":"10.55563/clinexprheumatol/g0ehvq","DOIUrl":"10.55563/clinexprheumatol/g0ehvq","url":null,"abstract":"<p><strong>Objectives: </strong>To report pregnancy outcome and neonatal immune parameters following early conception after maternal CD19 chimeric antigen receptor T-cell (CAR-T) therapy for refractory systemic lupus erythematosus (SLE).</p><p><strong>Methods: </strong>Maternal and neonatal CAR-T cells were assessed by transgene polymerase chain reaction (PCR) at delivery. CD19+ B-cell counts and immunoglobulin levels were measured in maternal and neonatal blood at birth. Infant health outcomes were assessed during the first year of life.</p><p><strong>Results: </strong>Conception occurred approximately seven weeks after CD19 CAR-T infusion. CAR-T cells were not detected in maternal peripheral blood or cord blood at delivery. Neonatal CD19+ B-cell counts and IgG levels were within age-appropriate reference ranges and exceeded maternal values, which remained subnormal. During one year of follow-up, the infant experienced no recurrent or severe infections.</p><p><strong>Conclusions: </strong>This case represents the earliest reported pregnancy following CD19 CAR-T therapy for SLE and the first to include neonatal immune assessment at birth. No evidence of transplacental CAR-T transfer or clinically significant neonatal immunodeficiency was observed. Additional cases and long-term follow-up are required to guide reproductive counseling after CAR-T therapy.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1022-1024"},"PeriodicalIF":3.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}