{"title":"Exclusion diet and fasting practices in patients with inflammatory bowel disease: Impact on nutritional status","authors":"Didier Quilliot , Olivier Bonsack , Meliha Mahmutovic , Laurent Peyrin-Biroulet , Benedicte Caron","doi":"10.1016/j.clnesp.2024.12.010","DOIUrl":"10.1016/j.clnesp.2024.12.010","url":null,"abstract":"<div><h3>Background</h3><div>Undernutrition is purportedly highly prevalent in inflammatory bowel diseases (IBD). While several risk factors have been identified, the impact of widespread eating behaviors such as food exclusions and therapeutic fasting practices has not been evaluated. There are limited data on the prevalence of undernutrition diagnosed according to internationally recognized criteria in this population.</div></div><div><h3>Objectives</h3><div>To estimate the prevalence of undernutrition assessed with the Global Leadership Initiative on Undernutrition (GLIM) criteria and to analyze factors associated with the characteristics of the disease and factors related to undernutrition.</div></div><div><h3>Methods</h3><div>Patients attending our IBD nutrition clinic were screened between November 2021 and April 2022. The complete avoidance of a food category was defined as total exclusion while avoidance most of the time was defined as partial exclusion. Undernutrition was diagnosed according to GLIM criteria. Weight history, past maximal involuntary weight loss and minimal body mass index since diagnosis of IBD were also collected.</div></div><div><h3>Results</h3><div>A total of 434 patients with IBD were included. Undernutrition was observed in 25.8 % of the whole population at inclusion (15 % with moderate undernutrition and 10.8 % with severe undernutrition). Mean involuntary maximal weight loss since illness onset was −14.5 % ± 11.0. Previous undernutrition since IBD diagnosis was reported in 81.1 % of the population, 63.6 % for severe and 17.5 % for moderate undernutrition. In multivariate analysis, undernutrition at inclusion was independently associated with total exclusion of at least one food category (OR = 1.11 95 % CI, 1.01–1.22; p = 0.031) as well as active disease (OR = 1.16 95 % CI, 1.05–1.27; p = 0.002), and negatively with the duration of IBD (OR = 0.88 95 % CI, 0.78–0.99, p = 0.031). Exclusion diet was also the main variable significantly associated with episodes of undernutrition in the past (OR = 1.11 95 % CI, 1.01–1.22; p = 0.035) as well as previous surgery (OR = 1.11 95 % CI, 1.00–1.23; p = 0.048). In these analyses, fasting practices were not independently associated with a risk of undernutrition.</div></div><div><h3>Conclusion</h3><div>Total exclusion of at least one food category was one of the main factors associated with undernutrition independently of disease activity and duration, both at the time of inclusion and in the past, and should be avoided, whereas fasting practices were not associated with a risk of undernutrition.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 375-381"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812126","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":"An open-label, randomized, controlled trial on the benefit of β-hydroxy-β-methyl butyrate, l-arginine, l-glutamine combination beverages and locomotion training as supportive care for the treatment of unresectable hepatocellular carcinoma using lenvatinib: A pilot study (HELLO study)","authors":"Atsushi Naganuma , Fujio Makita , Rie Sugimoto , Masahiro Kikuchi , Kiyoshi Furuta , Satoru Iwamoto , Ryotaro Sakamori , Hirotaka Kouno , Keisuke Ario , Hiroshi Yatsuhashi","doi":"10.1016/j.clnesp.2024.12.005","DOIUrl":"10.1016/j.clnesp.2024.12.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Hand–foot-skin reaction (HFSR) is the most common side effect of multi-tyrosine kinase inhibitor therapy for unresectable hepatocellular carcinoma (uHCC). Sarcopenia has been reported to be a poor prognostic factor for HCC. Here, we performed a randomized controlled trial (RCT) of the efficacy of a β-hydroxy-β-methyl butyrate/<span>l</span>-arginine/<span>l</span>-glutamine (HMB/Arg/Gln) beverage and locomotion training as supportive care in the treatment of uHCC with lenvatinib.</div></div><div><h3>Methods</h3><div>A total of 20 patients were enrolled from the jRCTs031190252 trial in this pilot study. HFSR was the primary endpoint, and other adverse events and skeletal muscle index at the third lumbar level (L3-SMI) were secondary endpoints.</div></div><div><h3>Results</h3><div>Twelve patients had albumin-bilirubin grade 1, and eight had grade 2. No difference in HFSR was observed. Although interesting differences were observed in the secondary endpoints, a slight retention of L3-SMI values in the intervention group compared with that in the control group was observed (96.5 % vs. 89.9 %, p = 0.407).</div></div><div><h3>Conclusion</h3><div>Although the HMB/Arg/Gln beverage and locomotion training did not reduce adverse events caused by lenvatinib, they might be useful in maintaining skeletal muscle mass. Further validation studies with a larger number of patients are warranted.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 357-364"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ingrid M. Fange Gjelstad , Christian Lyckander , Anne Høidalen , Åse Bratland , Rune Blomhoff , Ingvild Paur , Christine Henriksen
{"title":"Impact of radiotherapy on body weight in head and neck cancer patients: A prospective study","authors":"Ingrid M. Fange Gjelstad , Christian Lyckander , Anne Høidalen , Åse Bratland , Rune Blomhoff , Ingvild Paur , Christine Henriksen","doi":"10.1016/j.clnesp.2024.12.019","DOIUrl":"10.1016/j.clnesp.2024.12.019","url":null,"abstract":"<div><h3>Background</h3><div>Patients with head and neck cancer (HNC) undergoing radiotherapy or chemoradiotherapy often experience symptoms that affect their ability to eat. This study aimed to explore the impact of radiotherapy on body weight in HNC patients and compare the characteristics of patients receiving enteral tube feeding with those maintaining an oral diet.</div></div><div><h3>Methods</h3><div>In this prospective study, 52 patients with HNC were examined at diagnosis, at the start and end of radiotherapy, and six weeks after end of treatment. The nutritional assessment included measurements of body weight, food intake, and malnutrition using Patient-Generated Subjective Global Assessment (PG-SGA). Other variables were retrieved from the electronic patient record.</div></div><div><h3>Results</h3><div>Critical weight loss (defined as >5 % from start of radiotherapy) was present in 60 % of the patients at the end of radiotherapy, and only half of these patients received any enteral nutrition therapy. The mean weight loss was 5.8 % during radiotherapy, and an additional 2.1 % at follow-up (<em>n</em> = 48). A nasogastric feeding tube was used by 42 % at the end of radiotherapy, and 29 % at follow-up. The tube feeding users had a lower energy intake and higher weight loss than non-tube feeding users (22 vs 27 kcal/kg body weight, 7.8 vs 4.4 % weight loss) at the end of radiotherapy treatment. According to PG-SGA, 92 % of the patients were malnourished at the end of treatment and 71 % at follow-up (p < 0.001).</div></div><div><h3>Conclusion</h3><div>Critical weight loss and malnutrition were common in HNC patients after radiotherapy, and enteral tube feeding was initiated in only half of the cases with critical weight loss. Patients receiving enteral tube feeding may need closer monitoring to ensure adequate energy intake, and other treatment options may be necessary. These results emphasize the need for improved nutritional intervention during and after radiotherapy.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 390-399"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876435","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}
Mohammad Tanashat , Mohamed Abuelazm , Mohamed Abouzid , Yazan A. Al-Ajlouni , Alaa Ramadan , Sumaya Alsalah , Abdulrahman Sharaf , Dina Ayman , Hesham Elharti , Sara Zhana , Obieda Altobaishat , Basel Abdelazeem , Fouad Jaber
{"title":"Efficacy of probiotics regimens for Helicobacter pylori eradication: A systematic review, pairwise, and network meta-analysis of randomized controlled trials","authors":"Mohammad Tanashat , Mohamed Abuelazm , Mohamed Abouzid , Yazan A. Al-Ajlouni , Alaa Ramadan , Sumaya Alsalah , Abdulrahman Sharaf , Dina Ayman , Hesham Elharti , Sara Zhana , Obieda Altobaishat , Basel Abdelazeem , Fouad Jaber","doi":"10.1016/j.clnesp.2024.11.016","DOIUrl":"10.1016/j.clnesp.2024.11.016","url":null,"abstract":"<div><h3>Background</h3><div><em>Helicobacter pylori</em> (<em>H. pylori</em>) infection increases the risks of chronic gastritis, peptic ulcer diseases, and the incidence of gastric cancer. However, antibiotic resistance and adverse effects led to the emergence of alternative treatments such as probiotics supplementation. This systematic review and network meta-analysis aims to assess the efficacy and safety of incorporating probiotics into the various eradication regimens for <em>H. pylori</em>.</div></div><div><h3>Methods</h3><div>We searched PubMed, Embase, Scopus, Cochrane, and Web of Science from inception to May 2023, for randomized controlled trials (RCTs) comparing standard therapy (triple or quadrable therapy). for <em>H. pylori</em> with or without probiotic supplementation. Dichotomous data was reported using an odds ratio (OR) for intention-to-treat (ITT) and risk ratios (RR) for side effects with a 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>We included 91 RCTs involving 13,680 patients. Adding probiotics to standard treatment was associated with a higher <em>H. pylori</em> eradication rate in the ITT analysis (78.75 % vs 62.43 %, OR = 1.62, 95 % CI: 1.41 to 1.87, P < 0.0001), and per-protocol (PP) analysis (80.33 % vs 72.63 %, OR = 1.60, 95 % CI: 1.34 to 1.91, P < 0.0001). Meanwhile, dyspepsia, gastric ulcer, and peptic ulcer were comparable in both groups. The probiotics group was associated with significantly fewer side effects including, abdominal pain (RR = 0.68, 95 % CI: 0.54 to 0.86), bad taste (RR = 0.64, 95 % CI: 0.53 to 0.78), diarrhea (RR = 0.49, 95 % CI: 0.40 to 0.61), epigastric pain/bloating (RR = 0.76, 95 % CI: 0.65 to 0.88), headache/dizziness (RR = 0.46, 95 % CI: 0.29 to 0.74), (RR = 0.65, 95 % CI: 0.55 to 0.77), or nausea/vomiting (RR = 0.69, 95 % CI: 0.56 to 0.83). The network meta-analysis showed that, compared to the placebo, <em>Bifidobacterium longum</em> had the highest efficacy in eradicating <em>H. pylori</em> (ITT: 81.06 % vs 64.88 %, PP: 88 % vs 75.71 %) (OR = 2.52, 95 % CI: 1.18 to 5.49).</div></div><div><h3>Conclusion</h3><div>Adding probiotics to standard <em>H. pylori</em> therapy not only increased the rate of eradication but also reduced some of the adverse reactions throughout therapy, particularly nausea, vomiting, diarrhea, abdominal pain, epigastric pain/bloating, and taste issues.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 424-444"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lizl Veldsman , Guy A. Richards , Carl Lombard , Renée Blaauw
{"title":"Course of measured energy expenditure over the first 10 days of critical illness: A nested prospective study in an adult surgical ICU","authors":"Lizl Veldsman , Guy A. Richards , Carl Lombard , Renée Blaauw","doi":"10.1016/j.clnesp.2024.11.009","DOIUrl":"10.1016/j.clnesp.2024.11.009","url":null,"abstract":"<div><h3>Background & aims</h3><div>Various factors may cause significant daily variations in energy expenditure in and between critically patients. This nested, prospective study (ClinicalTrials.gov Identifier: NCT04099108) in a predominantly trauma surgical ICU, aimed to determine the course of measured energy expenditure over the first 10 days of critical illness, and to identify factors contributing to energy expenditure.</div></div><div><h3>Methods</h3><div>Indirect calorimetry was performed on alternate days from ICU Day 3 ± 1 until Day 10 ± 1. The mean daily measured energy expenditure, respiratory quotient and total energy delivery as a percentage of measured energy expenditure were modelled using linear mixed regression with two fractional polynomial terms to accommodate non-linear responses over time.</div></div><div><h3>Results</h3><div>Fifty ICU patients (mean age 36.9 ± 11.8 years, Acute Physiology and Chronic Health Evaluation (APACHE II) 13.5 ± 6.6, Sequential Organ Failure Assessment (SOFA) 4.5 ± 3.2) were included. Mean body mass index (BMI) was 24.8 ± 4.0 kg/m<sup>2</sup> and mean ventilation duration 7.7 ± 2.7 days. Mean daily measured energy expenditure showed a significant non-linear response (p = 0.006) increasing over the first 4 days peaking on day 5 and then plateauing. Mean daily respiratory quotient increased over the first 7 days, thereafter plateauing with a slight downward trend from day 8 despite a progressive increase in total energy delivery as a percentage of measured energy expenditure. Mean daily measured energy expenditure was significantly lower in the early than in the late acute phases (p = 0.024), whereas the late- and post-acute phases were similar. Age, sex and BMI significantly influenced measured energy expenditure.</div></div><div><h3>Conclusion</h3><div>Measured energy expenditure showed a significant non-linear response over the first 10 days in ICU, increasing over the first 4 days peaking on day 5 then plateauing. The observed variability highlights the complexity of managing critically ill patients and the importance of personalised nutrition therapy. Additionally, the observed trend with a peak in measured energy expenditure around day five could inform timing and strategies for nutritional intervention in this patient cohort.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 227-235"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647114","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}
Matin Sepehrinia , Shaghayegh Khanmohammadi , Nima Rezaei , Mohammad Shafi Kuchay
{"title":"Dietary inflammatory potential and metabolic (dysfunction)-associated steatotic liver disease and its complications: A comprehensive review","authors":"Matin Sepehrinia , Shaghayegh Khanmohammadi , Nima Rezaei , Mohammad Shafi Kuchay","doi":"10.1016/j.clnesp.2024.11.032","DOIUrl":"10.1016/j.clnesp.2024.11.032","url":null,"abstract":"<div><div>Metabolic (dysfunction)-associated steatotic liver disease (MASLD) represents a spectrum of liver pathologies linked to metabolic syndrome components. Inflammation emerges as a pivotal player in MASLD pathogenesis, initiating and perpetuating hepatic injury. Diet, a modifiable risk factor, influences inflammation levels and MASLD progression. This review synthesizes existing evidence on the association between pro-inflammatory diets, assessed via the Dietary Inflammatory Index (DII) and Empirical Dietary Inflammatory Potential (EDIP), and MASLD. Evidence suggests a significant association between higher DII/EDIP scores and MASLD risk, with studies revealing a positive correlation between inflammatory diet intake and MASLD occurrence, particularly in males. However, inconsistencies exist regarding the influence of body mass index (BMI) on this association and criticisms regarding adjustment for BMI and reliance on surrogate markers necessitate cautious interpretation. Limited data suggest a potential link between dietary inflammatory potential and advanced liver fibrosis and heightened risk of hepatocellular carcinoma (HCC) with increased DII/EDIP scores, albeit requiring further confirmation through gold-standard assessment methods. Dietary-induced inflammation exacerbates MASLD pathogenesis through multiple pathways, including insulin resistance, adipose tissue dysfunction, gut microbiota alterations, and oxidative stress, culminating in hepatic steatosis, inflammation, and fibrosis. Further research utilizing robust methodologies is imperative to confirm these findings and elucidate underlying mechanisms, thus informing targeted dietary interventions for MASLD management.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 162-171"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nutritional risk screening and nutritional assessment for children with cerebral palsy: A review of the current research status and future directions","authors":"Jixun Zhao , Yuyang Qiu , Huiqun Wang","doi":"10.1016/j.clnesp.2024.12.018","DOIUrl":"10.1016/j.clnesp.2024.12.018","url":null,"abstract":"<div><h3>Background</h3><div>Although the primary impairment involved in Cerebral palsy (CP) is motor function, malnutrition is also common. However, there is a lack of tool recommendations for early malnutrition risk screening in children with CP, and the means of nutritional intervention for children with CP are also limited.</div></div><div><h3>Methods</h3><div>This study systematically searched the literature about clinical nutrition related content of cerebral palsy in Pubmed, MEDLINE, Embase, and the Cochrane Library in Jan 2024 and by hand searching, and we checked reference lists and citations to identify additional studies. Search terms include cerebral palsy, children, diagnosis, prediction, malnutrition, nutritional risk screening, nutritional assessment, nutritional support. Additions are marked in red in the modified version.</div></div><div><h3>Results</h3><div>The timing of diagnosis of CP has been moving forward, and some new diagnostic tools have been developed. Nutritional status is correlated with regional economic level, but there is still a malnutrition rate of nearly 30 % in developed countries. Severe restrictions in terms of gross motor function, swallowing dysfunction, feeding difficulties, cognitive impairment, and insufficient energy intake are common risk factors for malnutrition in children with CP. Z-score should be calculated in combination with measurement indicators in the assessment of physical development of children with CP. The nutritional outcomes of children with CP can be improved by various means, including diversified a Nutrition Support Team (NST) interventions.</div></div><div><h3>Conclusions</h3><div>The incidence of malnutrition in children with CP is high, which needs to be paid more attention. More effective malnutrition risk screening tools need to be developed for children with CP to guide the implementation of comprehensive and personalized nutritional interventions and improve malnutrient-related outcomes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 382-389"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The association between vitamin C and breast cancer, prostate cancer and colorectal cancer: A systematic review and meta-analysis","authors":"Maedeh Arshadi , Nima Ghazal , Fatemeh Ghavidel , Zahra Beygi , Zohal Nasiri , Pardis Zarepour , Sedigheh Abdollahi , Hosein Azizi , Farzad Khodamoradi","doi":"10.1016/j.clnesp.2024.12.001","DOIUrl":"10.1016/j.clnesp.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>For a comprehensive evaluation and due to the inconsistent results of previous studies, we performed this meta-analysis with the aim of vitamin C effect on breast cancer and prostate cancer and colorectal cancer.</div></div><div><h3>Methods</h3><div>PubMed, Scopus and Web of Science were searched to identify studies on the association between vitamin C and breast cancer, prostate cancer and colorectal cancer through September 11, 2023. The pooled RR and the 95 % confidence intervals were used to measure the association between vitamin C and breast cancer, prostate cancer and colorectal cancer by assuming a random effects meta-analytic model. Newcastle–Ottawa scale was used for quality appraisal.</div></div><div><h3>Results</h3><div>A total of 69 studies were included. The pooled RR for the association between vitamin C (dietary) and breast cancer in the cohort study was 0.99 [95 % CI: 0.95, 1.03], but the pooled RR in the case-control study was 0.72 [95 % CI: 0.60, 0.85]. No association was found between vitamin E (supplemental, total intake) and breast cancer in studies. The pooled RR for the association between vitamin C (dietary) and prostate cancer was 0.88 [95 % CI: 0.77, 1.00], which represents a decrease in prostate cancer. No association was found between vitamin C (supplemental) and prostate cancer in studies. The pooled RR for the association between vitamin C (dietary) and colorectal cancer was 0.55 [95 % CI: 0.42, 0.73], which represents a decrease in colorectal cancer.</div></div><div><h3>Conclusion</h3><div>Our analysis shows an inverse significant relationship between vitamin C (dietary) and breast cancer in the case-control study. Also between vitamin C (dietary) and prostate cancer and colorectal cancer in studies, which represents a decrease in cancers.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 400-407"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}