European Thyroid Journal最新文献

{"title":"Risk-adapted therapy in pediatric thyroid cancer: initial experience from a national reference program by the MET group.","authors":"Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Kerstin Lorenz, Michael Abele, Ines B Brecht, Dominik T Schneider, Markus Luster, Antje Redlich","doi":"10.1530/ETJ-25-0035","DOIUrl":"10.1530/ETJ-25-0035","url":null,"abstract":"<p><strong>Background: </strong>Pediatric differentiated thyroid carcinoma (pedDTC) is rare but increasingly prevalent, requiring multidisciplinary care to ensure optimal outcomes. In 2021, the pediatric national reference program of the German Malignant Endocrine Tumor (MET) registry was established to standardize the management of pedDTC, with a particular focus on radioactive iodine (RAI) use and minimizing treatment variability.</p><p><strong>Methods: </strong>This study evaluated the program's first 3.5 years, including 43 inquiries concerning 39 patients with confirmed or suspected pedDTC. A weekly national expert tumor board provided individualized recommendations based on multidisciplinary input and risk stratification. Data were analyzed for demographic trends, therapeutic decisions, and short-term outcomes.</p><p><strong>Results: </strong>Among 34 patients with confirmed pedDTC, RAI use was reduced or omitted in 70.6% of cases, particularly among low-risk patients, in alignment with the American Thyroid Association 2015 guidelines. Surgical strategies were modified in 61.5% of cases to balance disease control with treatment-related morbidity. No systemic medical therapy was recommended during initial management. At a mean follow-up of 0.7 years, all patients were alive; persistent disease was observed in 15.4%.</p><p><strong>Conclusions: </strong>The national reference program has successfully introduced a structured, individualized approach to the management of pedDTC in Germany. Ongoing data collection and longer follow-up will be essential to assess the long-term impact of this centralized, risk-adapted model.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741683","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":"ETA guidelines for the use of levothyroxine sodium preparations in monotherapy to optimize the treatment of hypothyroidism.","authors":"Marco Centanni, Leonidas Duntas, Ulla Feldt-Rasmussen, Josef Koehrle, Robin P Peeters, Salman Razvi, Pierpaolo Trimboli, Camilla Virili","doi":"10.1530/ETJ-25-0123","DOIUrl":"10.1530/ETJ-25-0123","url":null,"abstract":"<p><p>Sodium levothyroxine (LT4) as a monotherapy represents the mainstay of treatment of hypothyroidism, and its use has increased over time. Nevertheless, it faces several potential barriers in its 'real life' utilization, and hence its clinical effectiveness may be marred. This is suggested by the frequent situation of patients failing to reach the therapeutic goals of symptom relief and serum TSH control. Thus, an expert task force was approved by the Guidelines Board of the European Thyroid Association to examine the available data and to formulate recommendations based on the available evidence and the experts' deduction. The task force provides a body of suggestions to optimize the levothyroxine treatment in monotherapy, considering the key point in the individualization of treatment. Furthermore, the nutritional, pharmacological and pathological factors, potentially leading to the increased need for levothyroxine, are discussed, with a specific focus on the use of liquid and softgel formulations of the hormone.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575141","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":"Standardization of TSH and FT4 to gestational age in early pregnancy and associations with clinical outcomes.","authors":"Joris A J Osinga, Layal Chaker, Sjoerd van den Berg, Vincent W V Jaddoe, Eric A P Steegers, Henning Tiemeier, Robin P Peeters, Tim Korevaar","doi":"10.1530/ETJ-24-0344","DOIUrl":"10.1530/ETJ-24-0344","url":null,"abstract":"<p><strong>Background: </strong>To account for pregnancy-specific changes in thyroid physiology, international guidelines recommend the use of trimester-specific reference intervals. However, the pragmatic division in trimesters does not necessarily align with the changes in thyroid physiology. While the goal of treating gestational thyroid dysfunction is to prevent thyroid hormone-mediated adverse events, it remains unclear which method of standardizing to gestational age, if any, is most effective in identifying individuals at higher risk of adverse pregnancy events.</p><p><strong>Methods: </strong>We included 5,675 women participating in a population-based prospective cohort with data on thyroid-stimulating hormone (TSH), free thyroxine (FT4) and thyroperoxidase antibodies (TPOAbs) during early pregnancy (median: 13.2 weeks, 95% range: 9.8-17.6). We studied the association of TSH and FT4 with pre-eclampsia, premature delivery, birth weight and offspring IQ with or without full gestational age standardization of TSH and FT4 using multivariable regression models.</p><p><strong>Results: </strong>There was a positive association of gestational age at blood sampling with TSH (difference in mean TSH: +9.6%; P < 0.001) and a negative association with FT4 (difference in mean FT4: -20.2%; P < 0.001). Standardizing TSH to gestational age led to reclassification of 36 women as having normal TSH (9.9%) and 27 as having abnormal TSH (0.5%). For FT4, 62 women were reclassified as having normal FT4 (20.3%) and 57 as having abnormal FT4 (1.1%). Standardization of TSH and FT4 concentrations led to an attenuation of the associations with any outcome of up to 71% as compared to non-standardized TSH or FT4.</p><p><strong>Conclusions: </strong>Full standardization of TSH and FT4 to gestational age either does not affect or weakens their associations with clinical outcomes, suggesting that accounting for gestational age offers no benefit with regard to identifying high-risk thyroid dysfunction during early pregnancy.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642135","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":"The evolving therapeutic landscape of Graves' disease in adults: present and future.","authors":"Marius N Stan, Chrysoula Dosiou","doi":"10.1530/ETJ-25-0078","DOIUrl":"10.1530/ETJ-25-0078","url":null,"abstract":"<p><p>The therapeutic landscape of Graves' hyperthyroidism has been rapidly evolving in the past few years. There has been a shift worldwide toward antithyroid drugs as the preferred first-line therapy with significant interest in thyroid function preservation, even if it requires more than 2 years of antithyroid drug treatment. This approach, long term antithyroid drug therapy, has gained traction as a therapeutic option after it has been shown to be safe and associated with significantly higher rates of remission than the traditional 18-month course of medical treatment. In parallel, we see, after 80 years of antithyroid drugs as the only medical therapy available for Graves' disease, a strong interest in new drug development that follows more closely the pathophysiology of the disease. These approaches span the spectrum of targeting antigen presentation, B cell activation, TSHR antibody cycle and TSHR signaling. Separately, advances in wearable devices and artificial intelligence models present new opportunities for more timely diagnosis, monitoring, and treatment of patients with Graves' disease. Finally, new therapies will pose novel challenges in the management of patients that will necessitate adjustments to our clinical practices and development of guidelines suited for these new therapeutic options.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575142","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":"Prevalence of treated hyper- and hypo-thyroidism and sociodemographic and geographic disparities in France in 2020.","authors":"Joël Coste, Laurence Mandereau-Bruno, Xavier Bertagna, Jean-Louis Wémeau","doi":"10.1530/ETJ-25-0041","DOIUrl":"10.1530/ETJ-25-0041","url":null,"abstract":"<p><strong>Background: </strong>Healthcare claims data are increasingly used to investigate the epidemiology of benign thyroid diseases. Here, we estimate the prevalence of treated hyper- and hypo-thyroidism and assess the potential sociodemographic and geographic disparities in France in 2020, given the country's poor epidemiological knowledge of these conditions.</p><p><strong>Methods: </strong>We used the French national healthcare data system, which covers nearly the entire population residing in France (over 67 million inhabitants in metropolitan and overseas departments). Prevalent cases were identified based on patients' long-term disease status, hospitalisation for hyper- and hypo-thyroidism and reimbursements for thyroid hormones, antithyroid drugs, iodine-131 and thyroid surgery. Thyroid-stimulating hormone, antithyroid antibodies and previous therapy for thyroid cancer and hyperthyroidism were considered to characterise the origin and surveillance of hypothyroidism.</p><p><strong>Results: </strong>In 2020, we identified 112,992 and 2,986,333 cases of treated hyper- and hypo-thyroidism, respectively, with an overall prevalence of 0.17 and 4.45 per 100 inhabitants. Marked differences were observed in terms of sex, age group and geographic area (department) for both conditions and deprivation level of the place of residence for hyperthyroidism only. The proportion of hypothyroidism following previous therapy for thyroid cancer or hyperthyroidism was less than 10%. Adequate monitoring (thyroid-stimulating hormone checked in the past year) occurred in 73.7% of hypothyroid subjects, with large variations across departments.</p><p><strong>Conclusions: </strong>This study provides prevalence estimates of treated hyper- and hypo-thyroidism at the national and departmental levels in France and improves epidemiological knowledge of both conditions. It also supports using healthcare claims data for their epidemiological surveillance.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247182","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":"Response to letter: 'why so many doses, and why now?'","authors":"Michaela Kuhlen, Marina Kunstreich, Friederike Eilsberger, Markus Luster, Antje Redlich","doi":"10.1530/ETJ-25-0155","DOIUrl":"10.1530/ETJ-25-0155","url":null,"abstract":"","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186874","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":"Potential of bone marrow mesenchymal stem cells in iodine-induced autoimmune thyroiditis therapy.","authors":"Xun Liu, Likun Cui, Jianwei Dong, Jiancong Ren, Dongdong Xu, Yanshuo Han, Jian Zhang","doi":"10.1530/ETJ-24-0137","DOIUrl":"10.1530/ETJ-24-0137","url":null,"abstract":"<p><strong>Objective: </strong>Hashimoto's thyroiditis (HT) is a prevalent autoimmune disease without a cure. Mesenchymal stem cells (MSCs) may offer the opportunity to improve autoimmune thyroiditis.</p><p><strong>Methods: </strong>We replicated the pathogenic factors of HT and established a stable autoimmune thyroiditis model in NOD.H-2h4 mice by administering iodine for 12 weeks. We used orthotopic injection to transplant bone MSCs (BMSCs) into the thyroid. Immunohistochemistry, enzyme-linked immunosorbent assay, flow cytometry, and hematoxylin and eosin and immunofluorescence staining were used to evaluate the effects of cell transplantation.</p><p><strong>Results: </strong>Orthotopic BMSC transplantation decreased serum thyroglobulin antibody and caspase 3 levels; increased proliferating cell nuclear antigen levels; decreased CD4+/CD3+ T cells, Th1/Th2, and Th17/Treg ratios; decreased TNF-alpha (a proinflammatory cytokine) and interferon-gamma levels; and increased transforming growth factor-beta and interleukin-10 levels. In addition, it increased CD90/S100A4 and CD90/TTF-1 co-expression.</p><p><strong>Conclusion: </strong>Orthotopic BMSC transplantation improved the inflammatory environment by regulating the secretion of anti-inflammatory cytokines, promoting regeneration, and reducing apoptosis in the thyroid tissue. Bone marrow-derived stem cells inhibited T cell activation, maintained a balance between T cell subpopulation ratios, and halted thyroiditis progression. Finally, transplanted BMSCs could transform into fibroblasts and thyroid cells. This study elucidated the pathogenesis of HT and provided evidence supporting the potential of MSCs in HT treatments.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12164285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172983","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":"The impact of autoimmune thyroid disease on cognitive and psychiatric disorders: focus on clinical, pre-clinical and molecular studies.","authors":"Agnieszka Piekiełko-Witkowska, Monika K Duda, Joanna Bogusławska, Urszula Mackiewicz","doi":"10.1530/ETJ-24-0406","DOIUrl":"10.1530/ETJ-24-0406","url":null,"abstract":"<p><p>Autoimmune thyroid disease (AITD) is the most prevalent organ-specific autoimmune condition, encompassing Graves' disease (typically linked with hyperthyroidism) and Hashimoto's thyroiditis (generally associated with hypothyroidism). The growing body of evidence suggests that AITD can interfere with brain function. Here, we review the impact of AITD on cognition, mood, and psychiatric disorders by analysing data from clinical, animal, ex vivo and in vitro studies to reveal the molecular mechanisms by which AITD affects brain function. Most reports indicate a stronger association between cognitive impairments and hyperthyroidism (including AITD-related) than hypothyroidism. Both hypothyroidism and hyperthyroidism are linked with a higher risk of depression. At least some of those effects can be mediated by altered concentrations of T3 (3,3',5-triiodo-L-thyronine), which regulates gene expression in the brain microenvironment, affecting neurogenesis, angiogenesis, neurotransmitter release, and synaptic transmission. Diminished TSH (thyrotropin) signalling may also impair learning and memory by inhibiting the Wnt5a-β-catenin pathway. Thyroid disorders may also contribute to neurodegeneration by T3-mediated attenuation of amyloid-β elimination or TRH-induced formation of neurofibrillary tangles. Surprisingly, most clinical studies do not specify the immune origin of hypothyroidism or hyperthyroidism, therefore further studies involving large, well-characterised patient cohorts are needed to clarify the relationships between AITD and cognitive impairments and psychiatric disorders. Furthermore, data on the effect of anti-thyroid antibodies on brain function are scarce and inconclusive. Given the association between hyperthyroidism and an increased risk of dementia, cognitive impairment and mood disorders, adequate treatment and careful monitoring of AITD patients are essential to prevent the induction of exogenous hyperthyroidism.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186875","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":"Insight into the metabolic shifts in Graves' hyperthyroidism: a study of acylcarnitine and lipid profiles.","authors":"Mikael Thomassen Neset, Arve Ulvik, Kristian Løvås, Johnny Laupsa-Borge, Lars Ertesvåg Breivik, Ann-Elin Meling Stokland, Bjørn Gunnar Nedrebø, Eyvind Rødahl, Eystein Husebye, Grethe Åstrøm Ueland, Hans Olav Ueland","doi":"10.1530/ETJ-25-0004","DOIUrl":"10.1530/ETJ-25-0004","url":null,"abstract":"<p><strong>Objective: </strong>Graves' disease increases metabolism and leads to net lipid degradation. Circulating acylcarnitines reflect lipid metabolism and the state of fatty acid oxidation in individuals. The aim of this study was to explore the lipid and acylcarnitine profiles in patients with Graves' disease.</p><p><strong>Methods: </strong>Seven lipids/apolipoproteins and 23 acylcarnitines were analysed in 100 newly diagnosed Graves' disease patients and validated in another 51 patients. Both groups were age- and sex-matched with healthy subjects.</p><p><strong>Results: </strong>The hyperthyroid Graves' disease patients (n = 88) from the main cohort (78 females, median age 42 (17-67) years) had significantly (P < 0.05) higher levels of medium- and long-chain acylcarnitines, and lower levels of short-chain acylcarnitines, compared with healthy subjects. Factor analysis showed that medium- and long-chain acylcarnitines explained most of the differences between the two groups. Serum levels of the five lipids/apolipoproteins were significantly lower in the hyperthyroid Graves' disease patients compared with healthy subjects. Patients (n = 21) treated with antithyroid drugs for 6 weeks had acylcarnitine levels closer to healthy subjects, compared with 79 treatment-naïve hyperthyroid patients. The main findings were confirmed in the validation group.</p><p><strong>Conclusion: </strong>Increased levels of medium- and long-chain acylcarnitines in patients with newly diagnosed Graves' disease may reflect accelerated catabolism. Lower levels of short-chain acylcarnitines point to Graves' disease being a catabolic condition, with a shift in energy source from carbohydrates to fat.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172974","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":"Usefulness of local therapy for distant metastases of differentiated thyroid cancer.","authors":"Sueyoshi Moritani, Masao Takenobu, Masakazu Yasunaga, Taihei Fujii, Hiroya Kitano","doi":"10.1530/ETJ-24-0237","DOIUrl":"10.1530/ETJ-24-0237","url":null,"abstract":"<p><strong>Objective: </strong>Treatment for distant metastases (DM) of differentiated thyroid cancer (DTC) aims to improve the prognosis and quality of life (QOL). Radioactive iodine and molecular targeted therapies are the primary systemic treatments for DM. Combining these with local treatments, such as surgery and radiotherapy targeting metastatic sites, may provide additional benefits to systemic therapy.</p><p><strong>Methods: </strong>This study reviewed the additional effects of local therapies on common metastatic sites of DTC, such as pulmonary or bone metastases (BM), the efficacy of bone-modifying agents (BMAs) for BM, and the therapeutic effects of local treatments for less common brain metastases.</p><p><strong>Results: </strong>Although based on retrospective studies with no definitive conclusions on the effectiveness of each treatment, local therapy for DM in DTC patients has been shown to enhance prognosis and QOL in several studies. Considering the results of clinical trials for metastatic tumors, local therapy for one or a few pulmonary or BM in DTC should be considered, if expected to improve prognosis and QOL. Surgical intervention is recommended for spinal metastases presenting with spinal compression symptoms or for long BM in extremities at risk of pathological or impending fractures. BMAs are also recommended to reduce the risk of skeletal-related events. Surgery, stereotactic radiotherapy, and whole-brain radiotherapy are suggested for brain metastases to improve the prognosis and QOL.</p><p><strong>Conclusion: </strong>Incorporating local therapy alongside systemic treatment can enhance the prognosis and QOL and should be considered a viable treatment option.</p>","PeriodicalId":12159,"journal":{"name":"European Thyroid Journal","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173007","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}