Clinical Medicine Insights. Cardiology最新文献

{"title":"The Risk Factors of Mitral Regurgitation Deterioration After Secundum Atrial Septal Defect Closure.","authors":"Garniswara Swandita, Irsad Andi Arso, Dyah Wulan Anggrahini, Anggoro Budi Hartopo, Cindy Elica Cipta, Lucia Kris Dinarti","doi":"10.1177/11795468231221420","DOIUrl":"10.1177/11795468231221420","url":null,"abstract":"<p><strong>Background: </strong>Association between secundum Atrial Septal Defect (ASD) and mitral valve (MV) disease has been recognized for decades. Secundum ASD closure can reduce mitral regurgitation (MR) degree. However, in some patients, deterioration of MR after ASD closure has been observed. We aimed to identify the risk factors of MR deterioration after ASD closure.</p><p><strong>Methods: </strong>This was an observational retrospective cohort study. Data were collected from the registry and echocardiogram report. We evaluated all patients with ASD closure by surgery and transcatheterization without MR intervention from January 2012 until June 2021 at Dr. Sardjito General Hospital, Yogyakarta. We excluded patients with multiple ASD and ASD with severe MR requiring MV intervention. Risk factors for MR deterioration were evaluated using multivariate logistic regression.</p><p><strong>Results: </strong>A total of 242 patients who underwent post-secundum ASD closure were included. In multivariate analysis, ASD closure by surgery, large left atrial (LA) diameter (>40 mm), low left ventricular ejection fraction (LVEF; <55%), and MV regurgitation degree were significant risk factors for MR worsening after ASD closure, with OR of 2.103 (95% CI 1.124-3.937); 2.871 (95% CI 1.032-7.985); 5.531 (95% CI 1.368-22.366); and 2.490 (95% CI 1.339-4.630) respectively.</p><p><strong>Conclusion: </strong>ASD closure by surgery, large LA diameter (>40 mm), low LVEF (<55%), and MV regurgitation degree are independent significant risk factors for MR deterioration in post-secundum ASD closure patients. In adult ASD patients with reduced LV function, it is recommended to perform balloon testing and consider fenestrated closure, as low LVEF <55% has the highest risk of causing new or deteriorating MR.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"18 ","pages":"11795468231221420"},"PeriodicalIF":3.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048959","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":"Analysis of Flow Through Extra-Anatomic Bypasses Between Supra-Aortic Branches Using Particle Image Velocimetry (PIV).","authors":"Petra N Williamson, Paul D Docherty, Adib Khanafer, Briana M Steven","doi":"10.1177/11795468231221413","DOIUrl":"10.1177/11795468231221413","url":null,"abstract":"<p><p>Supra-aortic extra-anatomic debranch (SAD) are prosthetic surgical grafts used to revascularize head and neck arteries that would be blocked during a surgical or hybrid procedure used in treating ascending and arch of the aorta pathologies. However, bypassing the supra-aortic arteries but not occluding their orifice might introduce potential for competitive flow that reduces bypass patency. Competitive flow within the bypasses across the supra-aortic arteries has not previously been identified. This research identified haemodynamics due to prophylactic inclusion of bypasses from the brachiocephalic artery (BCA) to the left common carotid artery (LCCA), and from the LCCA to left subclavian artery (LSA). Four model configurations investigated the risk of competitive flow and the necessity of intentionally blocking the proximal LSA and/or LCCA. Particle image velocimetry (PIV) was used to assess haemodynamics in each model configuration. We found potential for competitive flow in the BCA-LCCA bypass when the LSA was blocked, in the LSA-LCCA bypass, when the LCCA alone or LCCA and LSA were blocked. Flow stagnated at the start of systole within the RCCA-LCCA bypass, along with notable recirculation zones and reciprocating flow occurring throughout systolic flow. Flow also stagnated in the LCCA-LSA bypass when the LCCA was blocked. There was a large recirculation in the LCCA-LSA bypass when both the LCCA and LSA were blocked. The presence of competitive flow in all other configurations indicated that it is necessary to block or ligate the native LCCA and LSA once the debranch is made and the thoracic endovascular aortic repair (TEVAR) completed.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"18 ","pages":"11795468231221413"},"PeriodicalIF":3.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140048958","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":"Metagenomic Analysis of Bacterial Microflora in Dental and Atherosclerotic Plaques of Patients With Internal Carotid Artery Stenosis.","authors":"Ayako Sato, Shintaro Arai, Kenji Sumi, Haruka Fukamachi, Satoko Miyake, Manami Ozawa, Mie Myers, Yasubumi Maruoka, Katsuyoshi Shimizu, Tohru Mizutani, Hirotaka Kuwata","doi":"10.1177/11795468231225852","DOIUrl":"10.1177/11795468231225852","url":null,"abstract":"<p><strong>Background: </strong>Internal carotid artery stenosis is primarily attributed to atherosclerosis in the carotid artery bifurcation. Previous studies have detected oral bacteria in atherosclerotic lesions, suggesting an association between oral bacteria and atherosclerosis. In this study, we compared the bacterial flora of the atherosclerotic plaque in the carotid artery and dental plaque of patients with internal carotid artery stenosis using 16S ribosomal RNA (16S rRNA) metagenomic sequencing.</p><p><strong>Methods: </strong>Fifty-four patients who underwent internal carotid endarterectomy for internal carotid artery stenosis at the Showa University Hospital between April 2016 and February 2018 were included. Polymerase chain reaction targeting the 16S rRNA gene detected bacterial DNA in the carotid plaques of 11 cases, of which only 5 could be further analyzed. Thereafter, DNA extracted from the carotid and oral plaques of these 5 cases were analyzed using metagenomic sequencing targeting 16S rRNA. In addition, their general condition and oral conditions were evaluated. The patients were classified into symptomatic and asymptomatic groups based on the presence or absence of symptoms of transient ischemic attack, and their bacterial flora was evaluated.</p><p><strong>Results: </strong>The results demonstrated that the microflora of carotid plaques (n = 5) contained bacterial species from 55 families and 78 genera. In addition, 86.5% of the bacteria detected in the carotid plaques were also detected in oral plaques. Cariogenic and periodontopathic bacteria accounted for 27.7% and 4.7% of the bacteria in the carotid plaques, respectively.</p><p><strong>Conclusions: </strong>These results suggest that oral bacteria are directly or indirectly involved in the pathogenesis of atherosclerosis. More extensive studies of oral commensal bacteria detected in extra-oral lesions are warranted to comprehensively investigate the role of oral bacteria in the pathogenesis of systemic diseases.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"18 ","pages":"11795468231225852"},"PeriodicalIF":3.0,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702100","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":"Is There a Causal Link Between Acute Myocarditis and COVID-19 Vaccination: An Umbrella Review of Published Systematic Reviews and Meta-Analyses.","authors":"Amine Bouchlarhem, Soumia Boulouiz, Zakaria Bazid, Nabila Ismaili, Noha El Ouafi","doi":"10.1177/11795468231221406","DOIUrl":"10.1177/11795468231221406","url":null,"abstract":"<p><strong>Introduction: </strong>A few months after the beginning of the coronavirus disease of 2019 (COVID-19) vaccination, several reports of myocarditis secondary to the vaccines were published, sometimes with fulminant cases, but until today there is no proven causal link between these 2 events, but with many hypotheses proposed.</p><p><strong>Methods: </strong>A systematic review of current evidence regarding myocarditis after COVID-19 vaccination was performed by searching several databases including PubMed/Medline and Web of Science. The quality of Meta-analysis was assessed using the AMSTAR-2 tool as well as other qualitative criteria.</p><p><strong>Results: </strong>Our umbrella review appraised 4 Meta-analysis of retrospective studies (range: 5-12), The number of vaccine doses included ranged from 12 to 179 million, with the number of myocarditis cases observed ranging from 343 to 1489. All types of vaccines were evaluated, with no exclusions. The overall incidence ranged from 0.89 to 2.36 cases of myocarditis per 100 000 doses of vaccine received. Heterogeny was assessed in 3 of the Meta-analysis, and was highly significant (>75%) in all included studies, and with a significant <i>P</i>-value (<i>P</i> < .05). Regarding publication bias, 3 of the Meta-analysis conducted the egger and begg regression, with a significant result in only 1. Regarding the assessment of the methodology by the AMSTAR-2 scale indicating that the quality was very critical in 1, low in 2, and moderate in 1 Meta-analysis.</p><p><strong>Conclusion: </strong>The quality of current non-randomized evidence on real causality and incidence of myocarditis after COVID-19 vaccine is still low.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"18 ","pages":"11795468231221406"},"PeriodicalIF":3.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511876","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":"The Risk of Left Atrial Appendage Thrombus in Patients With Atrial Flutter Versus Atrial Fibrillation","authors":"G. Moady, Gal Rubinstein, Loai Mobarki, A. Shturman, Tsafrir Or, S. Atar","doi":"10.1177/11795468231221404","DOIUrl":"https://doi.org/10.1177/11795468231221404","url":null,"abstract":"Objective: Patients with atrial fibrillation (AF) are at increased risk of thromboembolic events originating mainly from left atrial appendage thrombus (LAAT). Patients with atrial flutter (AFL) are treated with anticoagulation based on the same criteria as patients with AF. However, whether patients with AFL have similar thromboembolic risk as AF is unclear. In the current study we aimed to estimate the prevalence of LAAT in patients with AFL undergoing trans-esophageal echocardiography (TEE). Methods/results: We included 438 patients (404 with AF and 34 with AFL) scheduled for TEE to rule out LAAT before cardioversion (patients who reported no or inadequate anticoagulation before cardioversion). Demographic and echocardiographic data were compared between patients with and without LAAT. Despite a similar CHA2DS2-VASC score (3.8 ± 1.3 vs 3.4 ± 1.5 in the AF and AFL groups, respectively, P = .09), LAAT was documented in 12 (2.8%) in the AF group and in no patient in the AFL group (P < .0001). Conclusion: Based on our results and previous studies, it seems reasonable to re-evaluate the need for oral anticoagulation in specific populations with AFL such as those with solitary AFL (without a history of AF episodes) undergoing successful ablation and in those with low CHA2DS2-VASC score.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"46 2","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395745","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":"Comparison of Inotropes for Use With the Impella Device in Cardiogenic Shock.","authors":"Essilvo Sulejmani, Nathaniel Wayne, Laura Provost, Aaron Chase, Andrea Sikora","doi":"10.1177/11795468231221416","DOIUrl":"10.1177/11795468231221416","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"17 ","pages":"11795468231221416"},"PeriodicalIF":3.0,"publicationDate":"2023-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139033157","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":"Salt-Sensitive Hypertension: Mediation by Salt-Induced Hypervolemia and Phosphate-Induced Vascular Calcification.","authors":"Ronald B Brown","doi":"10.1177/11795468231158206","DOIUrl":"10.1177/11795468231158206","url":null,"abstract":"<p><p>Preventing hypertension by restricting dietary salt intake, sodium chloride, is well established in public health policy, but a pathophysiological mechanism has yet to explain the controversial clinical finding that some individuals have a greater risk of hypertension from exposure to salt intake, termed salt-sensitive hypertension. The present perspective paper synthesizes interdisciplinary findings from the research literature and offers novel insights proposing that the pathogenesis of salt-sensitive hypertension is mediated by interaction of salt-induced hypervolemia and phosphate-induced vascular calcification. Arterial stiffness and blood pressure increase as calcification in the vascular media layer reduces arterial elasticity, preventing arteries from expanding to accommodate extracellular fluid overload in hypervolemia related to salt intake. Furthermore, phosphate has been found to be a direct inducer of vascular calcification. Reduction of dietary phosphate may help reduce salt-sensitive hypertension by lowering the prevalence and progression of vascular calcification. Further research should investigate the correlation of vascular calcification with salt-sensitive hypertension, and public health recommendations to prevent hypertension should encourage reductions of both sodium-induced hypervolemia and phosphate-induced vascular calcification.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"17 ","pages":"11795468231158206"},"PeriodicalIF":2.3,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191205","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":"The impact of the COVID-19 pandemic on the incidence of non-suicidal self-injury; a comparison between Iran and Belgium","authors":"Shokoufeh Vatandoost, Imke Baetens, Joyce Van Den Meersschaut, Martijn Van Heel, Lisa Van Hove","doi":"10.1177/11795573231206378","DOIUrl":"https://doi.org/10.1177/11795573231206378","url":null,"abstract":"Introduction The outbreak of COVID-19 has heightened mental health challenges among adolescents worldwide, while also hindering the development of effective emotion regulation strategies. Nevertheless, there exists a pertinent requirement to further investigate the psychological ramifications of COVID-19 on adolescents, as well as to discern disparities in these impacts across various nations. In order to address this gap in research, this study compares the prevalence of NSSI (characterized by purposefully injuring one's own body tissues without suicidal intention or engaging in behaviors that are not socially approved or sanctioned.), emotion regulation strategies, and psychopathology (internalization and externalization) among Belgian and Iranian adolescents pre- and during the COVID-19 pandemic. Method Adolescents between the ages of 13-21 from Iran and Belgium participated in a two-wave longitudinal design. In Iran, the sample consisted of 117 adolescents in wave 1 (April 2019) and 142 adolescents in wave 2 (Nov 2020). The Belgian sample consisted of 376 participants in wave 1 and 356 adolescents in wave 2. NSSI was assessed using the Self-Harm Inventory (SHI). Emotion Regulation was examined via the Emotion Regulation Inventory (ERI). The S trengths and Difficulties Questionnaire for Youth (SDQ) was used to assess psychological symptoms. Result Across the whole sample, lifetime NSSI prevalence was 35% in the first wave and 43.8% in the second wave. Longitudinal analysis across waves and counties did not show an increase in the prevalence of NSSI but did find that emotion dysregulation and internalizing symptoms are important risk factors for NSSI across countries. Emotional suppression and emotional dysregulation were the most prevalent emotion regulation strategies in Iran, whereas emotional integration was most prevalent in the Belgian sample. Conclusion Our study highlights cultural differences on the impact of COVID-19 on adolescent mental health. But it also indicates the importance of certain universal risk factors, for example, emotional dysregulation. These findings can inform developers to tailor programs for (early) intervention culturally.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135773248","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":"Quality of life, depressive symptoms, suicidal behavior and social support among pregnant adolescents in Mexico","authors":"Enrique Soto-Chavarría, Carlos Hidalgo-Rasmussen, Lourdes Nieto","doi":"10.1177/11795573231204015","DOIUrl":"https://doi.org/10.1177/11795573231204015","url":null,"abstract":"Background Suicidal behavior in adolescents is a public health problem. Although it has been reported that there is a link between suicidal behavior and Quality of life (QoL), this relationship has not been explored in pregnant adolescents, nor have depressive symptoms been examined as mediators and social support as a moderator in a moderated mediation model. Methods In 2021, 143 pregnant adolescents between 13 and 19 years old from different states in Mexico were evaluated. The KIDSCREEN-52 instrument was applied to evaluate the Health-Related Quality of Life, the scale of expectation of living and dying of Okasha, the Edinburgh Postpartum Depression Scale, the family and partner support scale (AFA-R) and sociodemographic information. Moderated mediation analyses were completed. Results A relationship between QoL and suicidal behavior was found, and that relationship was mediated by depressive symptoms on all eighteen models. In addition, social support from the family moderated the mediation of depressive symptoms in 4 of 9 QoL dimensions, and social support from the partner moderated the mediating effect of depressive symptoms in 8 of 9 QoL dimensions. Conclusion The relationship between QoL and suicidal behavior was consistent with previous studies. The moderating role of social support and the mediation of depressive symptoms on the relationship between QoL and suicidal behavior were also consistent with the literature. Professionals who work with pregnant adolescents should consider both depressive symptoms and social support as important factors that influence QoL and suicidal behaviors.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135771723","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":"Factors affecting the association between maternal adverse childhood experiences and preschool children’s behavioural problems: a systematic review of mediators and moderators","authors":"Stefan Kurbatfinski, Nicole Letourneau, Deborah Dewey, Andrew F. Hayes, K. Alix Hayden, Lubna Anis, Aliyah Dosani","doi":"10.1177/11795573231212175","DOIUrl":"https://doi.org/10.1177/11795573231212175","url":null,"abstract":"Background Adverse childhood experiences (ACEs) are pernicious events (e.g., physical abuse) that occur before 18 years of age within the household. Mothers’ ACEs are associated intergenerationally with their preschool children’s (two-to-five-year-old) behavioural problems, impacting lifelong mental health trajectories. Mediators (e.g., mental health) may explain how mothers’ ACEs exert their influence on children's behavioural development whereas moderators (e.g., child sex) may affect the strength and direction of the association, revealing potential points of intervention. Therefore, this study aimed to: (1) identify mediators and moderators of this association; and (2) describe and compare moderation and mediation outcomes. Methods This review (#CRD42022307214) extracted data from peer-reviewed literature formally analyzing at least one moderating or mediating variable of the association between maternal ACEs and preschool children’s behavioural problems using MEDLINE, Embase, APA PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, SCOPUS, and Web of Science databases (n = 7). Validity was assessed using the Joanna Briggs Institute checklists. Results Thirteen full-text studies with moderate-to-high validity were identified. Most studies examined mediating variables, with unanimous support for mediation through maternal depression. The mediating roles of adult attachment styles and anxiety were conflicting. No studies examined environmental factors (e.g., neurotoxins). Conclusions Mothers’ depression is a significant contributor to children’s behavioural problems in the context of ACEs and should be a target of early intervention to prevent lifelong challenges. Future research should focus on examining more moderating variables and consider the roles of environmental factors. More research is needed on the moderating and mediating roles of genes.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135776375","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}