Current Rheumatology Reports最新文献

{"title":"Cardiac Manifestations in Behçet's Syndrome.","authors":"Federica Bello, Giacomo Bagni, Emire Seyahi, Emanuele Chiara, Iacopo Olivotto, David Saadoun, Giacomo Emmi","doi":"10.1007/s11926-025-01190-z","DOIUrl":"10.1007/s11926-025-01190-z","url":null,"abstract":"<p><strong>Purpose of the review: </strong>Behçet's Syndrome (BS) is a multisystemic vasculitis that can affect the heart, leading to pericarditis, myocarditis, intracardiac thrombosis, endomyocardial fibrosis, valvular dysfunction, and coronary artery disease. This review summarizes the clinical presentation, diagnostic challenges, and therapeutic strategies for cardiac involvement in BS.</p><p><strong>Recent findings: </strong>Advanced imaging techniques have revealed subclinical cardiac involvement in BS. Myocardial dysfunction and fibrosis contribute to heart failure and arrhythmias, while intracardiac thrombi often coexist with pulmonary artery involvement. Coronary artery vasculitis and aneurysms may mimic atherosclerotic disease, complicating diagnosis. Biologic therapies, including TNF-α inhibitors, show promise in refractory cases. Early diagnosis and immunosuppressive therapy are crucial. A multidisciplinary approach is essential to managing cardiac complications and optimizing patient outcomes. Future research should refine screening protocols and explore targeted immunotherapies for BS-related cardiovascular disease.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"31"},"PeriodicalIF":5.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12270964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658635","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":"Ectopic Nociceptor Sprouting as a Key Peripheral Driver of Pain in Rheumatoid Arthritis.","authors":"Jayden A O'Brien, Joseph B Lesnak, Theodore J Price","doi":"10.1007/s11926-025-01198-5","DOIUrl":"10.1007/s11926-025-01198-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pain is one of the most debilitating sequelae of rheumatoid arthritis. Established and emerging therapies offer effective disease control for many patients, though they often have underwhelming efficacy for pain relief. The uncoupling of pain intensity from disease activity and inflammation presents an ongoing challenge in both our understanding of the pathophysiology and our ability to treat joint pain. The generation of high-parameter, unbiased -omic data sets generated from patient-derived tissues is changing how we think about rheumatoid arthritis pain. In this review, we discuss the peripheral drivers of pain in rheumatoid arthritis-affected joints and their innervating primary afferents. We evaluate how human molecular immunology and neuroscience approaches are helping us unravel the heterogeneity of pain in rheumatoid arthritis and propose future directions to clarify how pain is maintained in the absence of inflammation.</p><p><strong>Recent findings: </strong>Synovial fibroblasts have emerged as key pronociceptive drivers within the rheumatic joint. Further to the classical proinflammatory mediators known to drive pain, such as cytokines and prostaglandins, bone morphogenetic proteins, ephrin signaling, and netrins appear to be upregulated in both rheumatoid arthritis-affected synovium and the innervating sensory neurons. Resulting adaptations to innervating primary afferents such as synaptogenesis and neurite outgrowth may occur in a sensory neuron subtype-specific manner causing pain that is disproportionate to inflammation. Nociceptor sprouting in the joint may explain why pain tends to persist despite adequate disease control. Future mechanistic work exploring the conditions under which these nociceptors sprout into the joint will provide new therapeutic avenues for ensuring that pain resolves alongside the inflammation associated with rheumatoid arthritis.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"30"},"PeriodicalIF":5.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12267312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648715","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":"Spondyloarthritis Research and Treatment Network (SPARTAN) Clinical and Imaging Year in Review 2024.","authors":"Renato Ferrandiz-Espadin, Jean W Liew","doi":"10.1007/s11926-025-01195-8","DOIUrl":"https://doi.org/10.1007/s11926-025-01195-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>Diagnostic delay remains a critical challenge in axial spondyloarthritis (axSpA). This review highlights key clinical and imaging research from 2024 that addresses this persistent issue, with a focus on the evolving roles of MRI, artificial intelligence (AI), and updated Canadian management recommendations.</p><p><strong>Recent findings: </strong>Multiple studies published in 2024 emphasized the continued problem of diagnostic delay in axSpA. Studies support the continued use of sacroiliac joint MRI as a central diagnostic tool for axSpA, particularly in patients with chronic back pain and associated conditions like uveitis, psoriasis (PsO), or inflammatory bowel disease. AI-based tools for interpreting sacroiliac joint MRIs demonstrated moderate agreement with expert assessments, offering a potential solution to variability and limited access to expert musculoskeletal radiology. These innovations may support earlier diagnosis and reduce misclassification. Innovative models of care, including patient-initiated telemedicine visits, reduced in-person visit frequency without compromising clinical outcomes in patients with stable axSpA. Updated Canadian treatment guidelines introduced more robust data on Janus kinase (JAK) inhibitors and offered stronger support for tapering biologics in patients with sustained low disease activity or remission, while advising against abrupt discontinuation. This clinical and imaging year in review covers challenges and innovations in axSpA, emphasizing the need for early access to care and the development of tools to support prompt diagnosis and sustained continuity of care.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"29"},"PeriodicalIF":5.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539324","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":"Emerging Artificial Intelligence Innovations in Rheumatoid Arthritis and Challenges to Clinical Adoption.","authors":"Vinit J Gilvaz, Aishwarya Sudheer, Anthony M Reginato","doi":"10.1007/s11926-025-01193-w","DOIUrl":"https://doi.org/10.1007/s11926-025-01193-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review was written to inform practicing clinical rheumatologists about recent advances in artificial intelligence (AI) based research in rheumatoid arthritis (RA), using accessible and practical language. We highlight developments from 2023 to early 2025 across diagnostic imaging, treatment prediction, drug discovery, and patient-facing tools. Given the increasing clinical interest in AI and its potential to augment care delivery, this article aims to bridge the gap between technical innovation and real-world rheumatology practice.</p><p><strong>Recent findings: </strong>Several AI models have demonstrated high accuracy in early RA detection using imaging modalities such as thermal imaging and nuclear scans. Predictive models for treatment response have leveraged routinely collected electronic health record (EHR) data, moving closer to practical application in clinical workflows. Patient-facing tools like mobile symptom checkers and large language models (LLMs) such as ChatGPT show promise in enhancing education and engagement, although accuracy and safety remain variable. AI has also shown utility in identifying novel biomarkers and accelerating drug discovery. Despite these advances, as of early 2025, no AI-based tools have received FDA approval for use in rheumatology, in contrast to other specialties. Artificial intelligence holds tremendous promise to enhance clinical care in RA-from early diagnosis to personalized therapy. However, clinical adoption remains limited due to regulatory, technical, and implementation challenges. A streamlined regulatory framework and closer collaboration between clinicians, researchers, and industry partners are urgently needed. With thoughtful integration, AI can serve as a valuable adjunct in addressing clinical complexity and workforce shortages in rheumatology.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"28"},"PeriodicalIF":5.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526732","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":"Recent Advances in the Immunopathology of Axial Spondyloarthritis: with and without HLA-B27.","authors":"Brian Wu, Amy Tang, Akihiro Nakamura","doi":"10.1007/s11926-025-01194-9","DOIUrl":"10.1007/s11926-025-01194-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Axial spondyloarthritis (axSpA) is a chronic multi-organ rheumatic disease affecting various tissues, and recent key advancements have provided significant insight into understanding its immunopathology.</p><p><strong>Recent findings: </strong>Expanded CD8⁺ T cell subsets bearing unique T cell receptor (TCR) motifs (TRAV21/TRBV9) in HLA-B27-positive axSpA patients or those with acute anterior uveitis were recently identified. These T cells can bind to self- and bacterial-derived peptides, supporting the \"arthritogenic peptide\" hypothesis. Monoclonal antibody-mediated elimination of these expanded T cells has shown potential as a novel treatment for axSpA in a phase II clinical trial, offering a groundbreaking therapeutic approach. In addition to T cells, neutrophils have emerged as important mediators of both inflammation and new bone formation in axSpA, potentially contributing to HLA-B27-independent immune pathomechanisms. Key neutrophil-derived molecules-such as macrophage migration inhibitory factor, hypoxia-inducible factor 1-alpha, caspase recruitment domain-containing protein 9, and neutrophil extracellular traps (NETs)-have been shown in preclinical models to promote Th17-mediated inflammation and reduce regulatory T cell numbers. These mechanisms may be relevant to axSpA pathogenesis and represent potential new therapeutic targets. In recent years, significant progress has been made in understanding the immunopathology of axSpA through both HLA-B27-dependent and -independent mechanisms. However, key questions remain. The pathogenic HLA-B27:05-bound peptides driving CD8⁺ T cell expansion remain unidentified. Moreover, due to the diversity of TCR motifs that recognize self- and microbial peptides, therapies targeting a single TCR (e.g., TRBV9) may have limited efficacy. Further research is needed to clarify axSpA pathogenesis across both pathways.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"27"},"PeriodicalIF":5.7,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339976","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":"Family Planning and Rheumatoid Arthritis.","authors":"Catherine Sims, Mehret Birru Talabi","doi":"10.1007/s11926-025-01191-y","DOIUrl":"10.1007/s11926-025-01191-y","url":null,"abstract":"<p><strong>Purpose of review: </strong>Patients with rheumatoid arthritis (RA) need tailored guidance when it comes to family planning decisions, including contraception, pregnancy, and breastfeeding. To achieve the best reproductive health outcomes, a coordinated, multidisciplinary approach is essential. This article aims to support healthcare providers in addressing key reproductive health concerns for both male and female patients, such as timing conception, infertility, and the management of RA medications during pregnancy and lactation.</p><p><strong>Recent findings: </strong>Some women with RA may experience subfertility, however assisted reproductive technology is a safe option. RA disease activity may change for some women during pregnancy, but this is influenced by disease activity going into pregnancy and medication use in pregnancy. Pregnancy complications are more common among women with RA compared to the general population, which may be explained, in part, by disease activity, extra-articular manifestations of RA, and/or use of certain medications. Neonates exposed to biologic medications in utero can receive all recommended vaccinations. Contraception, including emergency contraception, is safe for women with RA. Preliminary data suggests pregnancy termination is safe in women with RA and does not increase the risk for disease flare. RA is a chronic inflammatory disease that can impact both women and men during their reproductive years. Rheumatologists have an essential role in patient's reproductive health and family planning. This article highlights key considerations and offers strategies to assist providers in understanding and supporting their patients' reproductive goals.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"26"},"PeriodicalIF":5.7,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180778","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":"Breaking Barriers: Essential Reforms for a Competitive and Affordable Biosimilars Market.","authors":"Eric T Roberts, Jinoos Yazdany","doi":"10.1007/s11926-025-01192-x","DOIUrl":"https://doi.org/10.1007/s11926-025-01192-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>This update examines the current policy landscape for biosimilars, particularly those approved for treating rheumatoid arthritis. We review recent literature and recommend policies to align the biosimilars market with the goals of the Biologic Price Competition and Innovation Act (BPCIA). We examine updated evidence on biosimilar safety and effectiveness, recent FDA guidance on interchangeability, and challenges posed by anti-competitive behaviors and government regulations. Additionally, we analyze financial incentives and market dynamics affecting biosimilar adoption and competition.</p><p><strong>Recent findings: </strong>Building on the extensive body of RCT data demonstrating the safety and effectiveness of biosimilars, real-world evidence from North America and Europe now confirms these findings, including in patients who switched therapies. Increased biosimilar prescribing will depend on disseminating safety data and strategies to enhance patient-physician communication. The FDA updated its interchangeability guidance to no longer require large clinical studies, citing updated understanding of safety data; this may facilitate more direct price-based competition. Congress and the Federal Trade Commission need to address anticompetitive behaviors including patent law loopholes, the role of PBMs in inflating drug prices, vertical integration of healthcare conglomerates, and changes to funding for government agencies charged with reviewing biosimilar drugs. Medicare reimbursement rates and the 340B program still unfairly incentivize use of bio-originator products. There are many barriers to achieving the goals of the BPCIA. With necessary changes, the U.S. can realize the goal of a competitive and sustainable biosimilar market that gradually reduces total drug expenditures and out-of-pocket costs over time without stifling innovation.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"25"},"PeriodicalIF":5.7,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156745","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":"Biorepositories For Global Rare Disease Research: A Narrative Review.","authors":"Maria Rosa Pellico, Jessica Day, Meera Shah, Belina Y Yi, Lesley Ann Saketkoo, Christian Lood, Latika Gupta","doi":"10.1007/s11926-025-01189-6","DOIUrl":"10.1007/s11926-025-01189-6","url":null,"abstract":"<p><strong>Purpose of this review: </strong>Rare diseases, although individually infrequent, collectively impact a substantial number of people. Collaborative translational research using biospecimens is essential for advancing our understanding of the diverse characteristics and pathophysiology of rare diseases. Biobanks play a pivotal role in this endeavor by collecting, processing, transporting, and storing biospecimens, thereby serving as invaluable resources for medical research. In this review, we explore currently available biobanks, with a specific focus on those dedicated to rare rheumatic diseases. We also examine accessible best practice guidelines for establishing and maintaining high-quality biobanks, discuss the limitations and propose future directions for enhancing biobanking efforts in rare disease research.</p><p><strong>Recent findings: </strong>Advances in molecular and genomic technologies have expanded the role of biobanks, enhancing biomarker discovery and precision medicine. However, despite growth in biobanking capabilities, key challenges persist concerning ethics, interoperability, and biospecimen exchange, prompting active responses by various regulatory and governing bodies. Biobanking has transformed rare disease research. Strengthening national and international collaborations is essential for driving progress in this field and accelerating the development of novel therapeutic and precision medicine approaches.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"24"},"PeriodicalIF":5.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110018","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":"Anti- Melanoma Differentiation-Associated Gene 5 Antibody Positive Dermatomyositis: Recent Progress in Pathophysiology and Treatment.","authors":"Tsuneyasu Yoshida, Ran Nakashima","doi":"10.1007/s11926-025-01188-7","DOIUrl":"https://doi.org/10.1007/s11926-025-01188-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis (MDA5-DM) is a rare systemic autoimmune disease characterized by a clinically amyopathic presentation and a high-risk association with rapidly progressive interstitial lung disease. Although frequently fatal, the underlying mechanisms remain incompletely understood. This review provides a comprehensive summary of recent advances in research on MDA5-DM, aiming to deepen our understanding of its pathogenic mechanisms and to accelerate future basic research that will contribute to the development of novel therapeutic strategies.</p><p><strong>Recent findings: </strong>Recent advancements have shed light on various aspects of this disease, including genetic and environmental factors contributing to disease susceptibility and the immunopathological processes and cytokine networks. Furthermore, significant progress has been made in understanding the pathogenicity, epitope recognition, and production mechanisms of anti-MDA5 antibodies, which have long been subjects of debate. On the therapeutic front, in addition to the conventional triple-combination regimen, emerging efficacy of JAK inhibitors and rituximab has been recognized. The development of biologics targeting lymphocytes offers additional hope for advancing therapeutic options. Advancing our understanding of the latest pathophysiological mechanisms of MDA5-DM is expected to pave the way for the development of safer and more effective therapeutic strategies.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"23"},"PeriodicalIF":5.7,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957034","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":"Gout, Hyperuricemia and Psoriatic Arthritis: An Evolving Conundrum.","authors":"Priyanka Chandratre, Ricardo Sabido-Sauri, Sizheng Steven Zhao, Abhishek Abhishek","doi":"10.1007/s11926-025-01187-8","DOIUrl":"10.1007/s11926-025-01187-8","url":null,"abstract":"<p><strong>Purpose of review: </strong>The co-existence of gout and psoriatic disease (PD) is long standing but more recently frequently encountered in clinical settings due to increased awareness of their shared comorbidities and clinical phenotypes, often posing diagnostic and management challenges. Here we review the overlap in gout and PD focusing on shared clinical features, common inflammatory pathophysiology and comorbidities which may prompt a diagnosis of 'Psout' and lead to changes in management.</p><p><strong>Recent findings: </strong>Several epidemiological studies have highlighted the increased incidence of hyperuricemia and gout in those with PD and vice versa. Although the role of monosodium urate (MSU) crystals is well recognized in activation of innate immunity via inflammasome and NETosis, it is likely that they have a role in triggering adaptive immunity via antigen presenting cells and their autocrine effect on keratinocytes in psoriasis (PSO), ultimately leading to T cell secretion of proinflammatory cytokines such as IL17. Hyperuricemia (HU) is common in PD (up to 30%) and underpins metabolic syndrome comorbidities that are common to both gout and PD. Shared clinical phenotypes and co-morbidities are routinely observed in clinical practice yet there is a paucity of evidence evaluating the effect of treating hyperuricemia/gout on PD activity, with small scale clinical trials showing a positive effect. There were no studies to our knowledge assessing gout disease activity with concurrent treatment of PD. The association between gout and PD is likely due to shared multimorbidity and perhaps to a smaller extent, the direct role of HU in triggering the release of proinflammatory cytokines in PD. There is often a significant overlap in clinical and radiological presentation of gout and Psoriatic arthritis (PsA). In those with atypical response to standard treatments of the primary condition (either gout or PsA), it would be plausible to investigate and treat for the other 'secondary' condition. This is particularly relevant and relatively feasible in those with PsA (and features of HU and multimorbidity) who respond poorly to standard immunomodulating treatments.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"22"},"PeriodicalIF":5.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718199","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}