Internal and Emergency Medicine最新文献

{"title":"Association between lipid comprehensive index and carotid atherosclerosis: evidence from a large-scale ultrasound screening program.","authors":"Dajie Chen, Siyu Zhang, Yuxia Wu, Wenzhen Li, Qingzhou Cheng, Jie Dou, Ping Ren","doi":"10.1007/s11739-026-04467-y","DOIUrl":"10.1007/s11739-026-04467-y","url":null,"abstract":"<p><p>Carotid atherosclerosis (CA) has not been well characterized in relation to the Lipid Comprehensive Index (LCI) in middle-aged and elderly populations. This large-sample study aimed to examine the association between LCI and prevalent CA. This cross-sectional study analyzed data from 56,383 participants aged ≥ 40 years enrolled in the 2017-2020 Hubei Stroke Screening and Prevention Project. All participants underwent carotid ultrasonography for the evaluation of CA. LCI was calculated as [TC × TG × LDL-C/HDL-C]. Logistic regression and restricted cubic spline (RCS) modeling analyses were performed to examine the association of LCI, treated as both a continuous variable and quartiles, with CA. Subgroup analyses were conducted to explore effect modifications across various population characteristics. Logistic regression analysis showed that higher LCI levels were significantly associated with greater odds of CA, carotid intima-media thickening (CMT), plaque, and stenosis (all p_trend < 0.001). Compared with the lowest quartile of LCI, the highest quartile had increased odds ratios (ORs) for CA, CMT, plaque, and stenosis, with ORs of 1.918 (1.751-2.201), 1.950 (1.749-2.174), 1.641 (1.487-1.812), and 1.531 (1.203-1.947), respectively. Additionally, per one-standard-deviation increase in LCI, the adjusted ORs for CA, CMT, plaque, and stenosis were 1.020 (1.017-1.022), 1.020 (1.017-1.022), 1.017 (1.014-1.019), and 1.011 (1.005-1.017), respectively. Subgroup analyses further indicated that the positive association between LCI and CA was generally consistent across most subgroups (all p_trend < 0.001; p_interaction > 0.05 for most subgroups). In populations aged ≥ 40 years, LCI shows a significant positive association with prevalent CA, suggesting that LCI may be a useful marker for assessing atherosclerosis risk.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2321-2330"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497538","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":"Effect of SGLT2 inhibitors on mean platelet volume in heart failure with reduced ejection fraction: a real-world analysis independent of diuretic therapy.","authors":"Hüseyin Orta, Cihan Aydin, Aykut Demirkiran, Ferhat Perk, Aydin Akyuz","doi":"10.1007/s11739-026-04398-8","DOIUrl":"10.1007/s11739-026-04398-8","url":null,"abstract":"<p><p>Sodium-glucose co-transporter 2 (SGLT2) inhibitors have emerged as cornerstone therapies for heart failure with reduced ejection fraction (HFrEF), owing to their cardioprotective and hematologic effects. While their impact on hemoglobin and hematocrit levels is increasingly recognized, the influence of SGLT2 inhibitors on mean platelet volume (MPV), a surrogate marker of platelet activation and cardiovascular risk, remains underexplored in HFrEF patients. While SGLT2 inhibitors' effects on MPV have been studied in DM, this is the first study examining MPV changes specifically in HFrEF patients with adjustment for diuretic therapy. This retrospective study included 80 HFrEF patients receiving guideline-directed medical therapy to which SGLT2 inhibitors were subsequently added. Baseline and 6-month follow-up data on hematological and biochemical parameters were collected. Exclusion criteria included active infection, malignancy, advanced renal failure, hematologic disorders, and recent transfusions. MPV and platelet counts were analyzed using standardized protocols and equipment. Following 6 months of SGLT2 inhibitor therapy, MPV values decreased significantly (p < 0.05), while platelet counts increased significantly (p < 0.05). Although hemoglobin and hematocrit levels showed upward trends, these changes were not statistically significant. No significant correlation was observed between ΔMPV and ΔPLT. Other biochemical markers remained stable throughout the study period. SGLT2 inhibitor therapy was associated with a significant reduction in MPV and an increase in platelet count among patients with HFrEF. These hematological changes may represent an additional mechanism by which SGLT2 inhibitors exert cardiovascular benefit. However, prospective, randomized trials are needed to validate these findings and explore the clinical significance of MPV modulation in heart failure management.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2133-2139"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148301616","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":"The bleeding puzzle: unmasking a hidden culprit.","authors":"Mariangela Palladino, Giulia Gammaitoni, Cristina Santoro, Maurizio Muscaritoli","doi":"10.1007/s11739-026-04316-y","DOIUrl":"10.1007/s11739-026-04316-y","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2193-2195"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148029979","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":"Age-stratified trends in myocardial infarction subtype composition among U.S. adults.","authors":"Jay Manadan, Alexander R Zheutlin","doi":"10.1007/s11739-026-04397-9","DOIUrl":"10.1007/s11739-026-04397-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2349-2352"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149792","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":"Impact of age on the prognostic benefit of follow-up in UMIPIC units: analysis of the RICA registry.","authors":"Pau Llàcer, François Croset, Álvaro González Franco, José Manuel Cerqueiro, Manuel Méndez, Manuel Montero-Pérez-Barquero, José Pérez Silvestre, Alicia Conde, Melitón Dávila, Margarita Carrera, Fernando Aguilar, Eduardo Martínez Litago, Francesc Formiga, Luis Manzano","doi":"10.1007/s11739-026-04371-5","DOIUrl":"10.1007/s11739-026-04371-5","url":null,"abstract":"<p><p>Multidisciplinary management programs are recommended for patients with heart failure (HF), yet it remains uncertain whether their prognostic benefits extend uniformly across all ages, particularly among the very elderly. This study evaluated whether age modifies the benefit of follow-up in UMIPIC (Comprehensive Management Unit for Patients with Heart Failure), using data from the Spanish RICA registry. We conducted a prospective, multicenter cohort study including 5644 patients (mean age 79.9±8.6 years; 52.7% women) hospitalized for acute HF and followed for one year. Patients were managed either within UMIPIC units or with conventional care. The primary outcomes were all-cause mortality and HF readmissions. Cox regression models tested the interaction between UMIPIC and age, modeled categorically (<90 vs ≥90 years), continuously, and with restricted cubic splines. During a median follow-up of 363 days, 1.419 patients (25.1%) died and 1.287 (22.8%) were rehospitalized for HF. In multivariable Cox models, UMIPIC participation was independently associated with lower mortality, with a significant age interaction (p=0.026). Among patients, 90 years, UMIPIC follow-up reduced mortality by 40% (HR 0.60; 95% CI 0.50-0.73; p<0.001), with consistent benefit across age groups (p for interaction=0.971). UMIPIC follow-up was associated with lower mortality and rehospitalization in older adults with HF. The survival benefit was most pronounced among nonagenarians, supporting the inclusion of very old patients in multidisciplinary HF programs.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2041-2051"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149813","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":"E-cigarette use among individuals with chronic obstructive pulmonary disease.","authors":"Sultan Alhabdan, Abdalkareem Alashjaai, Yusuff Adebayo Adebisi","doi":"10.1007/s11739-026-04385-z","DOIUrl":"10.1007/s11739-026-04385-z","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is strongly linked to tobacco smoking, and smoking cessation is central to disease management. E-cigarettes are widely promoted as a harm reduction option in the United Kingdom, yet patterns of use among people with COPD remain poorly described. This study examined the prevalence and correlates of current e-cigarette use among individuals with COPD in Scotland using data from the 2018 to 2022 Scottish Health Survey. The analysis included adults aged 16 years and above who reported a COPD diagnosis (n = 891). Survey-weighted logistic regression was used to estimate crude and adjusted associations between sociodemographic, behavioural, and health characteristics and current e-cigarette use, with additional models stratified by smoking status and smoking intensity. The weighted prevalence of current e-cigarette use was 11.9% (95%CI 9.7-14.5). Older age was associated with lower odds of current use (adjusted odds ratio [aOR] 0.60; 95%CI 0.41-0.89), while socioeconomic deprivation showed a positive gradient (aOR 1.21; 95%CI 1.01-1.45). Smoking status was the strongest correlate: odds were higher among ex-smokers (aOR 10.80; 95%CI 1.66-70.06) and current smokers (aOR 14.86; 95%CI 2.37-93.33) compared with never-smokers. Among current smokers, younger age, female sex, and higher deprivation were associated with use, whereas no clear determinants were identified among former smokers. Light and moderate smokers had greater odds of current e-cigarette use than non-smokers, while heavy smokers did not differ. Overall, e-cigarette use was relatively common and concentrated among younger, more deprived adults with a smoking history. Longitudinal studies are needed to determine the implications for respiratory outcomes.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2087-2097"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147959908","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":"Early effects of antifibrotic therapy on respiratory muscle stiffness and dyspnea in SSc-ILD: a shear wave elastography study.","authors":"Buğra Kerget, İsmail Çınar, Esen Saba Öktem, Aynur Daşdan, Sırma Merve Çetin, Mustafa Yeşilyurt, Alperen Aksakal, Fatih Alper","doi":"10.1007/s11739-026-04388-w","DOIUrl":"10.1007/s11739-026-04388-w","url":null,"abstract":"<p><p>Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is characterized by microvascular injury and progressive fibrosis leading to respiratory impairment. This study aimed to evaluate the effect of anti-fibrotic therapy on intercostal and diaphragmatic shear wave elastography (SWE) measurements in patients with SSc-ILD and to assess their relationship with pulmonary function tests and Borg dyspnea scores. 30 patients with SSc-ILD receiving stable background therapy and 30 healthy controls were evaluated prospectively between January and August 2025. Intercostal and diaphragmatic SWE, pulmonary function tests, and Borg dyspnea scores were obtained before and three months after initiation of anti-fibrotic therapy. At three months, SSc-ILD patients showed significant improvement in FVC and FEV₁ (p = 0.009 and p = 0.02), while Borg scores and intercostal and diaphragmatic SWE values decreased (all p < 0.001). Elastography measurements regressed to levels comparable with controls. Changes in intercostal SWE correlated with ΔFVC and ΔFEV₁ (R = -0.769, p < 0.001 and R = -0.492, p = 0.007), and ΔBorg correlated with both intercostal and diaphragmatic SWE (R = 0.89 and R = 0.793, both p < 0.001). In multivariable analysis, elastographic improvement was the strongest determinant of dyspnea reduction (p < 0.001). Anti-fibrotic therapy initiation was associated with early reductions in respiratory muscle elastographic stiffness parameters and dyspnea in SSc-ILD. These short-term changes may reflect early biomechanical or functional alterations rather than definitive structural remodeling.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2099-2108"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972127","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":"Effects of direct oral anticoagulants on cardiac outcomes in atrial fibrillation: a systematic review and network meta-analysis.","authors":"Danilo Menichelli, Daniele Malatesta, Arianna Pannunzio, Alessio Farcomeni, Francesco Violi, Pasquale Pignatelli, Daniele Pastori","doi":"10.1007/s11739-026-04480-1","DOIUrl":"10.1007/s11739-026-04480-1","url":null,"abstract":"<p><strong>Background: </strong>Direct oral anticoagulants (DOACs) reduce thromboembolism in atrial fibrillation (AF), but their effect on cardiac outcomes is less studied.</p><p><strong>Methods: </strong>Systematic review and network meta-analysis were performed on AF patients on DOACs/vitamin K antagonists (VKAs). Both observational studies and randomized clinical trials (RCTs) were included. Endpoints were myocardial infarction (MI) and major adverse cardiac events (MACE). Rankograms and SUCRA were performed. Sub-group analysis included age (</≥ 75 years) and length of follow-up (</≥ 12 months).</p><p><strong>Results: </strong>50 studies (3 RCTs, 4 post hoc analyses of RCTs and 43 observational studies) with 1,769,987 patients were included (59.9% on DOACs and 45.3% women). The MI risk (46 studies with 1,554,704 patients) was lower in all DOACs compared to VKA (apixaban: hazard ratio [HR] 0.83, 95% credible interval [95%CI 0.72-0.96], edoxaban: HR 0.68, 95%CI 0.53-0.86, rivaroxaban: HR 0.84, 95%CI 0.74-0.95, dabigatran: HR 0.85, 95%CI 0.75-0.97). SUCRA showed edoxaban as first choice for preventing MI overall. In patients aged < 75 years, a lower MI risk was found for edoxaban (HR 0.60, 95%CI 0.41-0.85), while in those aged ≥ 75 years, no significant difference was found among anticoagulants. Heterogeneity was low in all analyses. Network meta-analysis showed no differences among DOACs. Compared to VKA, apixaban (HR 0.77, 95%CI 0.63-0.97) was associated with lower MACE risk. Analysis of SUCRA showed apixaban as first choice for preventing MACE overall and in patients treated for < 12 months.</p><p><strong>Conclusion: </strong>DOACs were associated with a lower risk of MACE/MI in AF. The effect of DOACs on cardiovascular risk differs according to aging and follow-up length. However, our findings are based on indirect evidence, and further studies are needed.</p><p><strong>Prospero registration number: </strong>CRD42023407778.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2305-2320"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669393","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":"Prognostic performance of the BAN-ADHF score in acute decompensated heart failure: a sub-analysis of the Spanish Heart Failure Registry (RICA).","authors":"A Campos-Sáenz de Santamaría, F Croset, J Pérez-Santana, M Sánchez-Marteles, J Pérez-Silvestre, M Montero-Pérez-Barquero, P Llàcer, J C Trullàs, J L Morales-Rull, J Casado, A Pandey, J Rubio-Gracia","doi":"10.1007/s11739-026-04370-6","DOIUrl":"10.1007/s11739-026-04370-6","url":null,"abstract":"<p><p>The BAN-ADHF score is a recently developed measure designed to predict low diuretic efficiency and adverse outcomes using eight simple routinely available clinical and laboratory variables. However, its performance in real-world settings remains understudied. This is a retrospective analysis using data from the Spanish Heart Failure Registry (RICA), a nationwide, prospective cohort of patients admitted for ADHF to internal medicine departments. Only patients with complete data to calculate the BAN-ADHF score were included. Patients were classified into low BAN-ADHF (< 12) and high BAN-ADHF (≥ 12) groups. The primary endpoint was all-cause mortality. Secondary endpoints included the composite of mortality and/or heart failure (HF) readmission and length of hospital stay. A total of 2110 were eligible. High BAN-ADHF patients (17.5%) were older, with a higher burden of comorbidities, worse functional class and a higher proportion of reduced left ventricular ejection fraction (LVEF). Additionally, high BAN-ADHF patients showed lower hemoglobin, sodium, and estimated glomerular filtration rate, together with higher levels of creatinine, potassium, CA125, and NT-proBNP. After a median follow-up of 363 days, all-cause mortality occurred in 30.3% of patients, predominantly in the high BAN-ADHF group (HR 1.75, 95% CI 1.46-2.08, p = 0.001). The composite endpoint occurred in 44.9% of patients and was more frequent in the high BAN-ADHF group (HR 1.47, 95% CI 1.24-1.76, p = 0.001). Moreover, the BAN-ADHF score was independently associated with longer hospital stays (p = 0.001). No interaction was found between LVEF and the BAN-ADHF categories. The BAN-ADHF score is a valuable prognostic tool for identifying ADHF patients at greater risk of mortality, rehospitalization, and longer hospitalization in a real-world setting. Its integration into routine care may help guide early therapeutic strategies and resource allocation.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2029-2040"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684141","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":"Thrombotic microangiopathy with features of thrombotic thrombocytopenic purpura in a patient with Vibrio parahaemolyticus bacteremia: a rare case report.","authors":"Hassan Aziz, Waqas Siddiqui, Marium Rashid, Shehzad Shah, Ayesha Arefeen, Mohammad Junaid Patel","doi":"10.1007/s11739-026-04322-0","DOIUrl":"10.1007/s11739-026-04322-0","url":null,"abstract":"<p><p>We report the first documented case of thrombotic microangiopathy highly suggestive of thrombotic thrombocytopenic purpura (TTP) associated with Vibrio parahaemolyticus bacteremia in an immunocompetent adult. A 62-year-old man developed acute gastroenteritis following seafood ingestion and rapidly progressed to bacteremia with severe thrombocytopenia, microangiopathic hemolytic anemia, acute kidney injury, and neurological impairment. Laboratory evaluation revealed  ~ 3% schistocytes, markedly elevated lactate dehydrogenase, indirect hyperbilirubinemia, preserved coagulation parameters, and a negative direct Coombs test. The PLASMIC score indicated a high probability of severe ADAMTS13 deficiency. Given the classical clinical presentation, urgent plasma exchange (PLEX) was initiated, resulting in rapid and sustained hematologic and clinical recovery. Blood cultures confirmed Vibrio parahaemolyticus, and targeted ciprofloxacin therapy was administered. Although ADAMTS13 activity testing was unavailable, the constellation of findings and dramatic response to PLEX strongly support a diagnosis of TTP triggered by Vibrio bacteremia. This case highlights the importance of early recognition of TTP-like TMA, even when triggered by uncommon pathogens, and demonstrates the lifesaving role of prompt PLEX therapy.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"2197-2200"},"PeriodicalIF":4.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473514","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}