{"title":"Longitudinal associations between dietary diversity and serum lipid markers in Japanese workers","authors":"Thuy Thi Bui, Mariko Nakamoto, Kana Yamada, Akiko Nakamoto, Akiko Hata, Nanako Aki, Yosuke Shikama, Yukiko Bando, Takako Ichihara, Takako Minagawa, Ayako Tamura, Yumi Kuwamura, Makoto Funaki, Tohru Sakai","doi":"10.1038/s41430-024-01540-7","DOIUrl":"10.1038/s41430-024-01540-7","url":null,"abstract":"The aim of this study was to determine the longitudinal associations between dietary diversity score and serum lipid markers in a five-year follow-up period in Japanese workers. This study included 745 participants aged 20–60 years in 2012–2013 without dyslipidemia at baseline who participated at least once from 2013 to 2017. Dietary intake was assessed using a food frequency questionnaire, and dietary diversity score was determined using the Quantitative Index for Dietary Diversity. Principal component analysis was used to determine three dietary patterns: healthy, western, and sweetener. Lipid markers including total cholesterol, triglycerides, LDL-cholesterol, HDL-cholesterol, and non-HDL-cholesterol were measured. Generalized estimating equations were used for calculating the cumulative mean of lipid profiles in the follow-up period according to the dietary diversity score at baseline with control of confounding factors. Higher dietary diversity score was inversely associated with serum concentrations of LDL cholesterol (p for trend = 0.028), triglycerides (p for trend = 0.029), and non-HDL cholesterol (p for trend = 0.026) in women. The associations except for the association with serum triglycerides were robust after additional adjustment for three dietary patterns (healthy, western, and sweetener). The association with serum triglycerides disappeared after additional adjustment for a healthy pattern. There was no significant association between dietary diversity and dyslipidemia in men in the follow-up period. This study suggests that dietary diversity is beneficial for lipid profiles in Japanese female workers.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"273-282"},"PeriodicalIF":3.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01540-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship between HECTD4 gene variants, obesity, and coffee consumption","authors":"Min-Jeong Kim, Hyun-Seok Jin, Yong-Bin Eom","doi":"10.1038/s41430-024-01541-6","DOIUrl":"10.1038/s41430-024-01541-6","url":null,"abstract":"In genome-wide association studies, the HECT domain E3 ubiquitin-protein ligase 4 (HECTD4) gene was suggested to be associated with obesity-related traits and coffee consumption. However, the association of genetic variants between coffee consumption and obesity has not been tested in Koreans. Therefore, we investigated whether HECTD4 gene variants act as effect modifiers on the relationship between obesity and coffee. This study analyzed the correlation between coffee consumption and obesity among 58,698 individuals representing the Health Examinees. Participants were categorized into obese (BMI ≥ 25.0 kg/m2) and nonobese (18.5 ≤ BMI < 23.0 kg/m2). Food consumption was assessed by a food frequency questionnaire. We identified four HECTD4 gene variants associated with obesity-related traits and coffee consumption based on Bonferroni-corrected significance level (p < 0.00014). Furthermore, multivariate logistic regression analysis confirmed that the impact of coffee consumption on obesity differed based on the HECTD4 rs2074356 genotypes. A positive correlation between obesity and coffee consumption was observed, with a more pronounced effect in individuals with the G allele (OR = 1.61 for 1 to <2 cups/day, p = 1.89 × 10−37; OR = 1.82 for ≥2 cups/day, p = 1.73 × 10−42) than in those with the A allele (OR = 1.47 for 1 to <2 cups/day, p = 7.41 × 10−17; OR = 1.45 for ≥2 cups/day, p = 7.24 × 10−11). Our findings suggest that the influence of coffee consumption on obesity may vary in Koreans depending on the HECTD4 gene variant.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"200-206"},"PeriodicalIF":3.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesca Menichetti, Alberto Battezzati, Simona Bertoli, Ramona De Amicis, Andrea Foppiani, Federica Sileo, Alessandro Leone
{"title":"Adherence to the Mediterranean diet and risk of anxiety and depression in people with obesity: a cross-sectional analysis","authors":"Francesca Menichetti, Alberto Battezzati, Simona Bertoli, Ramona De Amicis, Andrea Foppiani, Federica Sileo, Alessandro Leone","doi":"10.1038/s41430-024-01536-3","DOIUrl":"10.1038/s41430-024-01536-3","url":null,"abstract":"Anxiety and depression are common mental disorders worldwide, in particular in people with obesity. Adherence to the Mediterranean diet has been found beneficial for the prevention of anxiety and depression in the general population. We aimed to evaluate this association in a large cohort of people with obesity. A cross-sectional study of 4957 patients with obesity (63.1% women, median age 49 years, IQR 40–58 years and BMI 33.6 kg/m2, IQR 31.6–36.9 kg/m2) was carried out. Clinical history, anthropometric measurements and lifestyle-related information were investigated. A 14-item MEDAS questionnaire was used to assess adherence to the Mediterranean diet. The 20-item STAI2 questionnaire and the 24-item QD questionnaire were used to assess the presence of anxious and depressive symptoms, respectively. Clinical cases of anxiety and depression were identified among patients with a physician-made diagnosis of anxiety and depression or with STAI2 and QD score ≥95th percentiles of reference population. Overall, 11.9% of participants were positive for anxiety and 11% for depression. Multivariate linear regression models showed a decrease in STAI2 and QD scores of 0.18 points (95%CI: −0.33, −0.03) and 0.10 points (95%CI: −0.16, −0.03), respectively, for each 1-point increase in MEDAS score. The multivariate logistic regression model showed a 7% reduction in the odds of anxiety and depression for each 1-point MEDAS increase (OR = 0.93, 95%CI: 0.89, 0.99; OR = 0.93, 95%CI: 0.88, 0.98). Mediterranean diet is associated with a lower risk of anxiety and depression in people with obesity. Longitudinal studies are needed to determine causality.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"230-236"},"PeriodicalIF":3.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Caloric requirement targets for nutritional support in adult autoimmune encephalitis: a retrospective cohort study","authors":"Jia-Qi Wang, Yin-Ping Li, Bo Yan, Jin-Mei Li","doi":"10.1038/s41430-024-01537-2","DOIUrl":"10.1038/s41430-024-01537-2","url":null,"abstract":"Autoimmune encephalitis (AE) is a severe neurological disease often accompanied by consciousness disturbances, severe swallowing difficulties, and gastrointestinal dysfunction, increasing the risk of malnutrition. However, the optimal caloric intake target during the acute phase of AE remains unclear. This study aims to evaluate the impact of caloric intake on short-term clinical outcomes in AE patients, specifically focusing on the improvement in Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores, to provide recommendations for nutritional support during the acute phase. A retrospective study analyzed clinical data from 128 adult AE patients requiring nutritional support, admitted to West China Hospital, Sichuan University, from January 2020 to January 2024. Patients were categorized into low-calorie intake (below 70% of requirements), standard-calorie intake (70–100% of requirements), and high-calorie intake (above 100% of requirements) groups. Multivariate linear and logistic regression models were used to quantify the associations. Higher caloric intake was significantly associated with improved CASE scores (β = 8.58, SE = 3.75, 95% CI = 1.14 to 16.03, p = 0.02). Low caloric intake negatively impacted the improvement of CASE scores (p = 0.049), particularly in seizures and speech problems. The low-calorie intake group had significantly longer hospital stays and nutrition therapy durations (45.79 ± 30.98 days, p < 0.01; 40.39 ± 31.92 days, p = 0.02). Adequate caloric intake has a significant positive impact on the short-term clinical outcomes of AE patients, suggesting that meeting or exceeding caloric requirements may promote neurological recovery in AE patients. Future prospective studies are needed to validate these findings and further optimize nutritional support strategies.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"258-265"},"PeriodicalIF":3.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nirupama Shivakumar, Douglas J. Morrison, Shalini G. Hegde, Anura V. Kurpad, Paul Kelly
{"title":"Correction: Is there dietary macronutrient malabsorption in children with environmental enteropathy?","authors":"Nirupama Shivakumar, Douglas J. Morrison, Shalini G. Hegde, Anura V. Kurpad, Paul Kelly","doi":"10.1038/s41430-024-01538-1","DOIUrl":"10.1038/s41430-024-01538-1","url":null,"abstract":"","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"283-283"},"PeriodicalIF":3.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01538-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariane de Almeida Alves, Bernardo Paz Barboza, Anabelle Retondario, Liliana Paula Bricarello, Camila Tureck, Katia Vergetti Bloch, Francisco de Assis Guedes de Vasconcelos, Amanda de Moura Souza
{"title":"Reduced rank regression dietary patterns and dyslipidemia in Brazilian adolescents: results from the Study of Cardiovascular Risk in Adolescents (ERICA)","authors":"Mariane de Almeida Alves, Bernardo Paz Barboza, Anabelle Retondario, Liliana Paula Bricarello, Camila Tureck, Katia Vergetti Bloch, Francisco de Assis Guedes de Vasconcelos, Amanda de Moura Souza","doi":"10.1038/s41430-024-01539-0","DOIUrl":"10.1038/s41430-024-01539-0","url":null,"abstract":"Evidence on the harmful effects of diet on serum lipids in adolescence has not been consistent. The present study sought to establish which dietary patterns are associated with biomarkers of dyslipidemia. Data from 36,217 Brazilian adolescents participating in the Study of Cardiovascular Risk in Adolescents were evaluated. Dietary patterns were identified using the reduced rank regression analysis. Linear regression models were applied to verify the association between dietary pattern scores and the biomarkers of dyslipidemia. The two first dietary patterns identified by reduced rank regression (RRR-DP1 and RRR-DP2) were kept for further analysis. The RRR-DP1 was highly and positively loaded for sweets and red meat and negatively loaded for beans, fruits, vegetables, and rice. The RRR-DP2 was positively loaded for beans and rice and negatively loaded for sugar-sweetened beverages, fruit juices, and sweets. Linear regression models estimated that one standard deviation (SD) increase in the RRR-DP1 score was only associated with a mean increase of 0.29 mg/dL in HDL-cholesterol (95% CI 0.06;0.53), while one SD increase in the RRR-DP2 score was associated with the lower mean of triglycerides (β = −2.24, 95% CI −3.57;−0.91), LDL-c (β = −0.82 95% CI −1.53;−0.12), and total cholesterol (β = −1.30 95% CI −1.94;−0.65). Higher adherence to the dietary patterns positively loaded for red meat and sweets was associated with increased HDL-c levels, while adherence to a more Brazilian traditional dietary pattern (RRR-DP2) was associated with a better lipids profile.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"224-229"},"PeriodicalIF":3.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01539-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
William Johnson, Lukhanyo H. Nyati, Shabina Ariff, Tanvir Ahmad, Nuala M. Byrne, Leila I. Cheikh Ismail, Caroline S. Costa, Ellen W. Demerath, Divya J. Priscilla, Andrew P. Hills, Rebecca Kuriyan, Anura V. Kurpad, Cornelia U. Loechl, M. Nishani Lucas, Ina S. Santos, Christine Slater, V. Pujitha Wickramasinghe, Shane A. Norris, Alexia J. Murphy-Alford, On behalf of the Multicenter Infant Body Composition Reference Study (MIBCRS)
{"title":"The proportion of weight gain due to change in fat mass in infants with vs without rapid growth","authors":"William Johnson, Lukhanyo H. Nyati, Shabina Ariff, Tanvir Ahmad, Nuala M. Byrne, Leila I. Cheikh Ismail, Caroline S. Costa, Ellen W. Demerath, Divya J. Priscilla, Andrew P. Hills, Rebecca Kuriyan, Anura V. Kurpad, Cornelia U. Loechl, M. Nishani Lucas, Ina S. Santos, Christine Slater, V. Pujitha Wickramasinghe, Shane A. Norris, Alexia J. Murphy-Alford, On behalf of the Multicenter Infant Body Composition Reference Study (MIBCRS)","doi":"10.1038/s41430-024-01534-5","DOIUrl":"10.1038/s41430-024-01534-5","url":null,"abstract":"There is extensive evidence that rapid infant weight gain increases the risk of childhood obesity, but this is normally based on childhood body mass index (BMI) only and whether or not this is because infants with rapid weight gain accrue greater fat mass is unknown. The primary objective of our study was to test whether the proportion of infant weight gain due to concurrent increases in fat mass is greater in infants with rapid weight gain as compared to those with normal growth. Body composition was assessed by (1) air-displacement plethysmography (ADP) at 0 and 6 months in 342 infants from Australia, India, and South Africa and (2) deuterium dilution (DD) at 3 and 24 months in 555 infants from Brazil, Pakistan, South Africa, and Sri Lanka. Weight gain and length growth were each categorized as slow, normal, or rapid using cut-offs of <−0.67 or >+0.67 Z-scores. Regression was used to estimate and contrast the percentages of weight change due to fat mass change. Approximately 40% of the average weight gain between 0 and 6 months and 20% of the average weight gain between 3 and 24 months was due to increase in fat mass. In both samples, compared to the normal group, the proportion of weight gain due to fat mass was higher on average among infants with rapid weight gain and lower among infants with slow weight gain, with considerable individual variability. Conversely, slow and rapid length growth was not associated with differential gains in fat mass. Pediatricians should monitor infant growth with the understanding that, while crossing upward through the weight centiles generally is accompanied by greater adiposity gains (not just higher BMI), upward crossing through the length centiles is not.","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 3","pages":"237-248"},"PeriodicalIF":3.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01534-5.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tatyanne L N Gomes, Jessica F M Ivo, Lara G Mainardi, Gustavo D Pimentel
{"title":"Positive association of the thigh muscle thickness to intracellular-water ratio with handgrip strength, but not with the risk of mortality in hospitalized cancer patients: a longitudinal study.","authors":"Tatyanne L N Gomes, Jessica F M Ivo, Lara G Mainardi, Gustavo D Pimentel","doi":"10.1038/s41430-024-01532-7","DOIUrl":"10.1038/s41430-024-01532-7","url":null,"abstract":"<p><p>This study explored the relationship between handgrip strength, muscle thickness, and the intracellular water ratio (MT/ICW) in cancer patients. It aimed to identify a cut-off point for the MT/ICW ratio that might influence survival. Conducted as an exploratory, longitudinal study in a public hospital, it included patients from 2018 to 2022, with follow-up until August 31, 2023. The cut-off for the MT/ICW ratio was determined based on its sensitivity for mortality. Results indicated that patients with an MT/ICW ratio >0.97 had significantly lower extracellular water percentages and greater muscle thickness. A positive association was found between the MT/ICW ratio and handgrip strength, even after adjusting for age, sex, extracellular water, and body mass index. However, patients with an MT/ICW ratio ≤0.97 showed no significant mortality risk. In conclusion, MT/ICW ratio >0.97 mm/L in hospitalized cancer patients was positively associated with handgrip strength, but not risk of mortality.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sabire Gokalp, Ener Cagri Dinleyici, Cansu Muluk, Asli Inci, Emine Aktas, Ilyas Okur, Fatih Ezgu, Leyla Tumer
{"title":"Correction: Intestinal microbiota composition of children with glycogen storage Type I patients","authors":"Sabire Gokalp, Ener Cagri Dinleyici, Cansu Muluk, Asli Inci, Emine Aktas, Ilyas Okur, Fatih Ezgu, Leyla Tumer","doi":"10.1038/s41430-024-01533-6","DOIUrl":"10.1038/s41430-024-01533-6","url":null,"abstract":"","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":"79 2","pages":"176-176"},"PeriodicalIF":3.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41430-024-01533-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaja Falkenhain, Corby K Martin, Eric Ravussin, Leanne M Redman
{"title":"Energy expenditure, metabolic adaptation, physical activity and energy intake following weight loss: comparison between bariatric surgery and low-calorie diet.","authors":"Kaja Falkenhain, Corby K Martin, Eric Ravussin, Leanne M Redman","doi":"10.1038/s41430-024-01523-8","DOIUrl":"10.1038/s41430-024-01523-8","url":null,"abstract":"<p><strong>Objective: </strong>Bariatric surgery remains the most effective treatment to achieve substantial weight loss; however, total daily energy expenditure and physical activity changes in response to such interventions have been seldom explored.</p><p><strong>Methods: </strong>In this prospective observational study, total daily energy expenditure (TDEE) using doubly labeled water and physical activity (SenseWear armband) was assessed in 17 females (mean ± SD: 48.6 ± 9.7 kg/m2, 43 ± 12 years) at baseline and 8 and 52 weeks following either bariatric surgery (BSG, N = 9) or a low-calorie diet (LCD, N = 8). Energy intake was assessed using the intake-balance method.</p><p><strong>Results: </strong>After 8 weeks, weight loss was 16.0 ± 3.5 kg and TDEE decreased by 552 ± 319 kcal/d in BSG (P < 0.001) compared to 8.8 ± 3.4 kg and 256 ± 239 kcal/d in LCD (P < 0.05). After 52 weeks, weight loss was 44.3 ± 16.4 kg and TDEE decreased by 583 ± 418 kcal/d (P < 0.001), compared to 4.3 ± 6.7 kg and 84 ± 285 kcal/d in LCD (P > 0.05). TDEE was lower than predicted in BSG at 8 (P = 0.03) but not 52 weeks (P = 0.77). There was no evidence of metabolic adaptation in LCD. Average daily energy intake in BSG was 1403 ± 245 kcal/d compared to 2545 ± 398 kcal/d in LCD (P < 0.001). In BSG, step count and physical activity minutes were increased at 52 weeks compared to baseline (P = 0.03), whereas no significant changes were observed in LCD.</p><p><strong>Conclusion: </strong>Bariatric surgery-induced weight loss decreased TDEE at 8 weeks and 1 year, resulting in metabolic adaptation after 8 weeks that was reversed at 1 year. These changes were accompanied by an increase in physical activity.</p>","PeriodicalId":11927,"journal":{"name":"European Journal of Clinical Nutrition","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}