{"title":"Correlation Between Coagulation Index and Hormone Levels in Patients with ACTH-Independent Cushing's Syndrome.","authors":"Yanan Li, Xin Zhao, Yi Liu, Yushi Zhang","doi":"10.1055/a-2630-1124","DOIUrl":"https://doi.org/10.1055/a-2630-1124","url":null,"abstract":"<p><p>The aim of the study was to explore the relationship between hormone levels and coagulation indicators in patients with Cushing's syndrome, providing insights into disease progression and treatment. We recruited 640 patients diagnosed with ACTH-independent Cushing's syndrome with adrenocortical tumors, conducting comprehensive physical and laboratory examinations, and analyzing data using logistic regression models. We found that compound F at 8 AM (F8AM) and ACTH had better correlation with coagulation characteristics. We revealed negative association between F8AM levels and PLT or APTT, while ACTH exhibited opposite trends. With F8AM increasing, Fbg declined significantly, while ACTH had the opposite association. In patients with Cushing's syndrome, chronic cortisol elevations may lead to consumptive coagulopathy, characterized by decreased PLT and Fbg levels, apart from the hypercoagulable state implied by decreased APTT.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":"57 6","pages":"373-377"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Outcomes of 68Ga-NODAGA-Exendin-4 PET/CT Guided Surgical Management of Insulinomas in MEN1: A Preliminary Study.","authors":"Ketki Sunil Ambulkar, Ravikumar Shah, Anurag Lila, Anima Sharma, Rohit Barnabas, Manjiri Karlekar, Saba Samad Memon, Vijaya Sarathi, Sameer Rege, Priyanka Verma, Gaurav Malhotra, Vikram Lele, Tushar Bandgar","doi":"10.1055/a-2620-2931","DOIUrl":"10.1055/a-2620-2931","url":null,"abstract":"<p><p>The data on the use of 68Ga-NODAGA-exendin-4 PET/CT in localizing multiple endocrine neoplasia type 1 (MEN1)-related insulinomas is evolving; however, surgical outcomes data are not available. We describe our cohort of patients with MEN1-related endogenous hyperinsulinemic hypoglycemia (EHH), where 68Ga-NODAGA-exendin-4 PET/CT was used to guide conservative surgery. A retrospective record review of MEN1-related EHH cases managed between 2000 and 2024 was performed for clinical features, imaging, and management. Outcomes were assessed for patients whose surgical extent was determined by 68Ga-NODAGA-exendin-4 PET/CT versus conventional imaging (CECT and 68Ga-DOTATATE PET/CT). Five patients with a median age of 17 (15.5-18.5 years) with EHH underwent laparoscopic, single lesion enucleation based on 68Ga-NODAGA-exendin-4 PET/CT. On preoperative imaging, CT identified culprit lesion in four, while 68Ga-DOTATATE PET/CT localized in one, and had one false positive uptake in non-functioning NET. The median duration of hospital stay was 6 (5.5-9) days. Over a median follow-up of 48 (3.5-84.5) months, none had EHH recurrence or exocrine/endocrine pancreatic insufficiency. On follow-up, one patient had an uneventful pregnancy and delivery. In the remaining 15, who underwent surgery based on conventional imaging, 12 (80%) required extensive surgery beyond enucleation, of which two needed intraoperative ultrasound localization. This group had a postoperative hospital stay of 11 (8-23) days, one recurrence after 84 months, and pancreatic insufficiency in 5 (33%). Our center observation suggests that GLP1R-based PET/CT-guided conservative insulinoma surgery in MEN1 patients is effective and safe and needs further validation.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":"366-372"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natalia Jarzebska, Stefan R Bornstein, Sergey Tselmin, Ulrich Julius, Barbara Cellini, Richard Siow, Mike Martin, Rajeshwar P Mookerjee, Arduino A Mangoni, Norbert Weiss, Roman N Rodionov
{"title":"Asymmetric Dimethylarginine: A Never-Aging Story.","authors":"Natalia Jarzebska, Stefan R Bornstein, Sergey Tselmin, Ulrich Julius, Barbara Cellini, Richard Siow, Mike Martin, Rajeshwar P Mookerjee, Arduino A Mangoni, Norbert Weiss, Roman N Rodionov","doi":"10.1055/a-2537-4692","DOIUrl":"10.1055/a-2537-4692","url":null,"abstract":"<p><p>Human aging is intrinsically associated with the onset and the progression of several disease states causing significant disability and poor quality of life. Although such association was traditionally considered immutable, recent advances have led to a better understanding of several critical biochemical pathways involved in the aging process. This, in turn, has stimulated a significant body of research to investigate whether reprogramming these pathways could delay the progression of human ageing and/or prevent relevant disease states, ultimately favoring healthier aging process. Cellular senescence is regarded as the principal causative factor implicated in biological and pathophysiological processes involved in aging. Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and an independent risk factor for several age-associated diseases. The selective extracorporeal removal of ADMA is emerging as a promising strategy to reduce the burden of age-associated disease states. This article discusses the current knowledge regarding the critical pathways involved in human aging and associated diseases and the possible role of ADMA as a target for therapies leading to healthier aging processes.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriela Almeida Motta, Graziele Halmenschlager, Rachel Pinto Dornelles Dutra, Cláudia Ramos Rhoden, Ângela Maria Vicente Tavares, Alexandre Luz de Castro, Alex Sander da Rosa Araujo, Adriane Belló-Klein, Karen Breitenbach da Silva, Ernani Luis Rhoden
{"title":"Testosterone Deprivation Impairs Cardiac Systolic Function in Orchiectomized Wistar Rats.","authors":"Gabriela Almeida Motta, Graziele Halmenschlager, Rachel Pinto Dornelles Dutra, Cláudia Ramos Rhoden, Ângela Maria Vicente Tavares, Alexandre Luz de Castro, Alex Sander da Rosa Araujo, Adriane Belló-Klein, Karen Breitenbach da Silva, Ernani Luis Rhoden","doi":"10.1055/a-2569-7387","DOIUrl":"10.1055/a-2569-7387","url":null,"abstract":"<p><p>Several studies have linked low levels of testosterone with increased symptoms of cardiac disease and cardiovascular mortality; however, the effects of testosterone deficiency on cardiac systolic function and morphology are still not completely elucidated. The present study aims to evaluate the influence of testosterone deprivation on cardiac systolic function and morphology. Male Wistar rats were divided into two groups: Sham operation group (Sham): animals underwent sham operation and Orchiectomized group (Orchiec): animals underwent bilateral orchiectomy. The experimental protocol lasted 60 days after the surgery. All animals were weighted and blood samples collected to serum testosterone analysis, determined by chemiluminescence, on first (before orchiectomy) and on 60th days. One day before euthanasia (on the 59th day) echocardiographic parameters were assessed to evaluate left ventricle (LV) systolic function and morphology. Statistical significant difference was set at≤0.05. Orchiec rats presented reduced LV fractional shortening (p=0.032), increased myocardial performance index (MPI) (p=0.043), prolonged mitral valve closure time (p=0.013) and decreased heart rate (p=0.049) when compared to Sham. No statistically significant difference was found in the ejection fraction (p=0.666) between groups. Besides that, heart weight was lower in Orchiec group (p=0.035) when compared to Sham group. Testosterone deprivation reduced cardiac systolic function, changing contraction and relaxation parameters. Testosterone deficiency also changed heart rate and heart weight. The present study demonstrated for the first time that castrated levels of testosterone could alter parameters such as mitral valve closing time and MPI.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":"346-354"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiao Jiao, Xianjun Cao, Xuan Yi, Guangbin Li, Feng Han, Yu Su
{"title":"Clinical Study on the Correlation Between Cortisol Secretion and Type 2 Diabetes and Hypertension in Patients with Adrenal Tumors.","authors":"Jiao Jiao, Xianjun Cao, Xuan Yi, Guangbin Li, Feng Han, Yu Su","doi":"10.1055/a-2586-3681","DOIUrl":"https://doi.org/10.1055/a-2586-3681","url":null,"abstract":"<p><p>This study aimed to investigate the correlation between cortisol secretion and the prevalence of type 2 diabetes (T2D) and hypertension in patients with adrenal tumors. A total of 164 patients with benign adrenal tumors were recruited between January 2019 and December 2024. Cortisol levels were assessed using a 1 mg overnight dexamethasone suppression test, classifying patients into three groups: non-functional adrenal tumors (group A, n=73), minimal autonomous cortisol secretion (MACS, group B, n=64), and MACS with confirmed Cushing's syndrome (group C, n=27). Statistical analyses compared the prevalence of hypertension and T2D across groups. Cortisol concentrations were measured using high-performance liquid chromatography (HPLC) and ELISA. Logistic regression identified factors influencing hypertension and T2D. The prevalence of hypertension and T2D was significantly higher in group C compared to groups A and B (p<0.05). Cortisol concentrations were higher in groups C and B than in group A (p<0.05), with group C showing the highest levels. Elevated cortisol in MACS patients was associated with increased hypertension risk (p<0.05) and higher rates of T2D (p<0.05). Age was a significant predictor, with a 9% increase in risk for each additional year. Cortisol secretion in adrenal tumor patients is linked to T2D and hypertension. As cortisol levels and age increase, so does the risk of these conditions, highlighting cortisol as a potential biomarker for managing these comorbidities.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":"57 5","pages":"338-345"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gut Microbial Control of Neurotransmitters and Their Relation to Neurological Disorders: A Comprehensive Review.","authors":"Kajal Gurow, Deepak Chandra Joshi, Jyoti Gwasikoti, Nirmal Joshi","doi":"10.1055/a-2536-1421","DOIUrl":"10.1055/a-2536-1421","url":null,"abstract":"<p><p>The study explores the vital role of gut microbiota in regulating neurotransmitters and its subsequent effects on brain function and mental health. It aims to unravel the mechanisms by which microbial metabolites influence neurotransmitter synthesis and signaling. The ultimate goal is to identify potential therapeutic strategies targeting gut microbiota for the management and treatment of neurological disorders, such as depression, autism spectrum disorder (ASD), anxiety, and Parkinson's disease. The review synthesizes current research on the gut-brain axis, focusing on the influence of gut microbial metabolites on key neurotransmitters, including dopamine, serotonin, and gamma-aminobutyric acid (GABA). It incorporates a multidisciplinary approach, linking microbiology, neurobiology, and clinical research. Each section presents an in-depth review of scientific studies, clinical trials, and emerging therapeutic strategies. The findings highlight the intricate interplay between gut microbiota and the central nervous system. Gut microbes significantly impact the synthesis and signaling of crucial neurotransmitters, which play a pivotal role in neurological health. Evidence supports the hypothesis that modulating gut microbiota can alter neurotransmitter output and alleviate symptoms associated with neurological disorders. Notable therapeutic potentials include microbiota-targeted interventions for managing depression, ASD, anxiety, and Parkinson's disease. This comprehensive analysis underscores the critical connection between gut microbiota and neurological health. By bridging gaps between microbiology, neurobiology, and clinical practice, the study opens avenues for innovative therapeutic approaches. It provides a valuable resource for researchers, clinicians, and students, emphasizing the need for continued investigation into gut microbiota's role in neurological disorders and its therapeutic potential.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":"315-325"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriela Almeida Motta, Graziele Halmenschlager, Rachel Pinto Dornelles Dutra, Cláudia Ramos Rhoden, Ângela Maria Vicente Tavares, Alexandre Luz de Castro, Alex Sander da Rosa Araujo, Adriane Belló-Klein, Karen Breitenbach da Silva, Ernani Luis Rhoden
{"title":"Correction: Testosterone Deprivation Impairs Cardiac Systolic Function in Orchiectomized Wistar Rats.","authors":"Gabriela Almeida Motta, Graziele Halmenschlager, Rachel Pinto Dornelles Dutra, Cláudia Ramos Rhoden, Ângela Maria Vicente Tavares, Alexandre Luz de Castro, Alex Sander da Rosa Araujo, Adriane Belló-Klein, Karen Breitenbach da Silva, Ernani Luis Rhoden","doi":"10.1055/a-2597-9671","DOIUrl":"10.1055/a-2597-9671","url":null,"abstract":"","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":"e2"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Violeta Mladenovic, Ravi Shah, Sanja Medenica, Pinaki Dutta, Nikola Zankovic, Slavica Aksam, Jayaditya Ghosh, MdSadam Hussain, Zoran Gluvic
{"title":"Thyroid Gland and Pregnancy - Clinical Update.","authors":"Violeta Mladenovic, Ravi Shah, Sanja Medenica, Pinaki Dutta, Nikola Zankovic, Slavica Aksam, Jayaditya Ghosh, MdSadam Hussain, Zoran Gluvic","doi":"10.1055/a-2604-4177","DOIUrl":"https://doi.org/10.1055/a-2604-4177","url":null,"abstract":"<p><p>Thyroid function undergoes significant alterations during pregnancy due to changes in hormone levels and higher metabolic demands. The thyroid gland in pregnancy enlarges by 10%; however, in iodine-deficient areas, this growth might reach 40%. Elevated levels of human chorionic gonadotropin (hCG) in early pregnancy leads to increased thyroid hormone production. While triiodothyronine (T3) and thyroid-stimulating hormone (TSH) do not cross the placenta, thyroxine (T4) does. Thyroid hormone demands peaks between weeks 16 and 20 of pregnancy and remains high until delivery. There is a rise in the levels of thyroxine-binding globulin (TBG), during the period of pregnancy, raising total T4 and T3 levels while TSH levels usually decrease. Pregnancy-related thyroid disorders, such as hypothyroidism, hyperthyroidism, and autoimmune thyroid diseases (AITD), carry the potential to impair the well-being of both the child as well as the mother. A range of 5-20% of women belonging to the reproductive age group have AITD, which can be associated with the possibility of infertility, miscarriages, and/or poor pregnancy outcomes. If improperly managed, overt hypothyroidism can cause severe complications such as developmental delay and preeclampsia. Effective management requires regular monitoring and appropriate treatment adjustment. Treatment for hypothyroidism involves levothyroxine, whereas cautious use of antithyroid medications is advised for hyperthyroidism. Postpartum thyroiditis (PPT), an autoimmune condition occurring after childbirth, requires careful management to address both hyperthyroid and hypothyroid phases. A comprehensive understanding and management of these conditions are critical for optimizing maternal and fetal health outcomes. Thyroid disorders are common in women of reproductive age group.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":"57 5","pages":"303-314"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy, Safety, and Future of GLP-1 Receptor Agonists: A Systematic Literature Review and Meta-Analysis.","authors":"Griffin Katz","doi":"10.1055/a-2569-7315","DOIUrl":"10.1055/a-2569-7315","url":null,"abstract":"<p><p>GLP-1 receptor agonists have emerged as important therapeutic agents for type 2 diabetes mellitus (T2DM), but their comparative efficacy and broader applications remain subjects of ongoing research. The aim of the study was to evaluate and compare the efficacy, safety, and clinical applications of three GLP-1 receptor agonists - Semaglutide, Dulaglutide, and Exenatide - through systematic review and meta-analysis. A comprehensive search of PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science (2015-2023) identified 20 randomized controlled trials and observational studies. Primary outcomes included changes in HbA1c and body weight. Risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Semaglutide demonstrated superior efficacy with mean HbA1c reduction of 1.45% and weight loss of 1.44 kg. Dulaglutide showed consistent reductions in HbA1c (1.1%) and weight (1.2 kg). while Exenatide exhibited moderate effects. Meta-analysis revealed a significant pooled effect estimate favoring GLP-1 receptor agonists. with a mean HbA1c difference of -0.81 (95% CI: -0.92 to -0.70). Gastrointestinal side effects were most common, with Semaglutide showing the highest incidence. This meta-analysis establishes Semaglutide as the most effective GLP-1 receptor agonist for glycemic control and weight reduction, while Dulaglutide and Exenatide offer viable alternatives with fewer side effects. These findings support evidence-based decision-making in T2DM management and highlight the potential broader therapeutic applications of GLP-1 receptor agonists beyond diabetes care.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":"326-337"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Romy Walther, Bhawana Singh, Xiaoke Yin, Philip Mavberg, Anna Mücke, Roman Rodionov, Mahmoud Babir, Manuel Mayr, Stefan R Bornstein
{"title":"Proteomic Profiling of Age-Related Proteins Following Extracorporeal Apheresis.","authors":"Romy Walther, Bhawana Singh, Xiaoke Yin, Philip Mavberg, Anna Mücke, Roman Rodionov, Mahmoud Babir, Manuel Mayr, Stefan R Bornstein","doi":"10.1055/a-2563-1187","DOIUrl":"https://doi.org/10.1055/a-2563-1187","url":null,"abstract":"<p><p>Lipoprotein apheresis (LA) is often the last option to adequately reduce lipoproteins in patients with familial hypercholesterolemia and lipoprotein (a) hyperlipidemia. Characterized by mild side effects, it is now the most effective method of preventing major cardiovascular events (CVEs). This benefit is due not only to the lowering of lipoprotein levels, but probably also to many other pleiotropic effects that have been extensively described in the literature. These include the reduction of inflammatory signaling substances, fibrinogen, plasminogen or components of the oxidative stress response. Here, we performed a proteomic analysis of 12 patients treated with therapeutic apheresis using two different pore size filters to quantify the effect on age-related plasma proteins. This study showed that important proteins such as α-2-macroglobulin, apolipoprotein C-III, complement C1s subcomponent, C4b-binding protein alpha chain, CD5 antigen-like and pregnancy zone protein, whose role in numerous aging processes has been well described, were significantly reduced by apheresis treatment. We conclude that therapeutic apheresis may be a promising approach to reduce these age-related proteins and that these treatments may become an essential part of managing cardiovascular risk in an aging population.</p>","PeriodicalId":12999,"journal":{"name":"Hormone and Metabolic Research","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}