International Journal of Rheumatic Diseases最新文献

{"title":"Fracture Risk Linked to Proton Pump Inhibitors Versus H2 Receptor Antagonists in Autoimmune Rheumatic and Gastrointestinal Disease Patients","authors":"Miaoyu Zeng,&nbsp;Yung-Heng Lee,&nbsp;Shiow-Ing Wang,&nbsp;Andriko Palmowski,&nbsp;Wei-Min Chu,&nbsp;Frank Buttgereit","doi":"10.1111/1756-185X.70055","DOIUrl":"https://doi.org/10.1111/1756-185X.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To understand if proton pump inhibitors (PPIs) usage associated with an increased risk of fractures among adult patients diagnosed with autoimmune rheumatic and gastrointestinal diseases, compared with H2 receptor antagonists (H2RAs) usage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the TriNetX US collaborative database for the study, which includes detailed demographic information, diagnostic and procedural data, medication details, laboratory results, genomic information, and healthcare utilization metrics. We analyzed 61 healthcare organizations to compare fracture risks associated with PPIs and H2RAs in adults, particularly those diagnosed with autoimmune rheumatic and gastrointestinal diseases. Propensity score matching acted as a control for demographic and clinical variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study involved 1 717 598 patients, focusing on 16 299 who were new users of PPIs and 16 299 H2RAs users after propensity score matching. Over a 24-month follow-up period, no significant differences in fracture risks were observed between the PPI and H2RA groups in the overall cohort (hazard ratio, HR = 1.369, 95% confidence interval, CI = 0.933–2.009). However, subgroup analysis indicated that senior patients (≥ 65 years) who had been administered PPIs experienced a significantly higher risk of fractures (HR = 1.927 [1.153–3.221]), particularly non-vertebral fractures (HR = 2.379 [1.214–4.661]), when compared to their counterparts who had been prescribed H2RAs. Notably, the simultaneous use of PPIs and glucocorticoids further increased the fracture risk (HR = 4.273 [2.219–8.227]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study demonstrates that patients diagnosed with autoimmune rheumatic and gastrointestinal diseases who were aged 65+ face increased fracture risks when using PPIs, particularly when there is a simultaneous intake of glucocorticoids.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380760","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":"Prevalence of Human Leukocyte Antigen (HLA)-B*58:01 and Allopurinol-Induced Adverse Reactions in Filipino Patients in Hawai'i: Implications for Genotyping","authors":"Rika Terashima,&nbsp;Alejandro Jude P. Medina,&nbsp;Hans Jesper F. Del Mundo,&nbsp;Ryan Sean S. Briones,&nbsp;Joseph Arman B. Aquino,&nbsp;Ellaine M. Quiminiano,&nbsp;Yuh Miin Sin,&nbsp;Rhea A. Bautista,&nbsp;Charlie Y. Sonido,&nbsp;Seiji Yamada","doi":"10.1111/1756-185X.70127","DOIUrl":"https://doi.org/10.1111/1756-185X.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Allopurinol, a first-line treatment for gout and hyperuricemia, is associated with severe cutaneous adverse reactions (SCAR) in individuals carrying the HLA-B*58:01 allele. Genotyping is conditionally recommended in Han Chinese, Korean, and Thai populations with an allele prevalence of 7.4%, and in African Americans at 3.8%. The prevalence in Filipino patients has not been studied. We investigate the prevalence of HLA-B*58:01 among Filipino patients in Hawai'i and evaluate the incidence of allopurinol-induced adverse reactions following genotyping.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective chart review of 312 patients who underwent HLA-B*58:01 genotyping at a primary care clinic in Hawai'i between November 2021 and July 2024. After excluding patients with missing ethnicity data, non-Filipino ethnicity, or prior allopurinol use, 237 Filipino patients were included in the analysis. The prevalence of the HLA-B*58:01 allele and the incidence of allopurinol-induced adverse reactions were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 237 Filipino patients, 17 (7.2%) were HLA-B*58:01 positive. A total of 97 patients were started on allopurinol after genotyping and 1 (1.0%) developed mild cutaneous reactions, 0 (0%) developed SCAR, and 2 (2.1%) experienced gastrointestinal symptoms (nausea and diarrhea).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The high prevalence of HLA-B*58:01 allele among Filipino patients in Hawai'i suggests that genotyping may be considered before initiating allopurinol treatment. Given no instances of SCAR were observed in patients who were administered allopurinol after undergoing HLA-B*58:01 genotyping, genotyping may play a crucial role in reducing the risk of allopurinol-induced SCAR in this population. Further studies with larger cohorts are suggested to confirm our findings and assess broader clinical utility of genotyping.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380349","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":"Drug Induced Autoimmunity: Propylthiouracil Induced ANCA Vasculitis","authors":"Abraham Mohan,&nbsp;Manoj T. Koshy,&nbsp;Reejamol Abraham,&nbsp;Philip Philip Puthumana","doi":"10.1111/1756-185X.70111","DOIUrl":"https://doi.org/10.1111/1756-185X.70111","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380297","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":"Associations of Healthcare Utilization and Health Expenditures in Older Adults With Osteoarthritis: Korean Health Panel Survey Study","authors":"Yejin Kim,&nbsp;Bomgyeol Kim,&nbsp;Jun Su Park,&nbsp;Vasuki Rajaguru,&nbsp;Hyuk-Jae Chang,&nbsp;Sang Gyu Lee,&nbsp;Tae Hyun Kim","doi":"10.1111/1756-185X.70099","DOIUrl":"https://doi.org/10.1111/1756-185X.70099","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated the association between healthcare utilization and expenditures, including non-covered services in Korean older adults with osteoarthritis (OA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study used data from the 2019 Korean Health Panel (KHP) annual data of participants aged ≥ 60 years who had OA. Healthcare utilization and expenditures were determined by hospitalization, outpatient, and emergency visits. A generalized linear model was used to examine healthcare utilization and expenditures associated with OA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 5877 participants, 1645 (27.9%) had OA. Participants with OA had higher healthcare utilization (Increment = 6.5 visits, SE = 0.8, <i>p</i> &lt; 0.0001) and expenditures (Increment = USD 432.8, SE = 111.8, <i>p</i> = 0.0001) compared to those without OA. The increase in utilization was primarily in outpatient visits (Increment = 6.4 visits, SE = 0.8, <i>p</i> &lt; 0.0001), especially at clinics (Increment = 5.6 visits, SE = 0.9, <i>p</i> &lt; 0.0001). Healthcare expenditures were also higher for both inpatient (Increment = USD 200.9, SE = 89.8, <i>p</i> = 0.0254) and outpatient visits (Increment = USD 236.6, SE = 51.7, <i>p</i> &lt; 0.0001). Male with OA spent higher cost (USD 242.9) on outpatient visits than non-OA participants. In contrast, females with OA reported higher expenditures for both inpatient (USD 301.3) and outpatient (USD 259.6) visits than those without OA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>OA was associated with a significant increase in healthcare utilization and expenditure. Appropriate strategies are required to reduce the burden of OA. Further study is required to explore how various healthcare facilities might be used together to provide safe and cost-efficient treatment for OA patients within the healthcare system and in the community.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380348","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":"Life's Essential 8 and Risk of All-Cause and Cardiovascular Mortality in US Adults With Arthritis: A Retrospective Cohort Study Utilizing NHANES Database","authors":"Feiyu Yao,&nbsp;Jiafeng Zhang,&nbsp;Xianhua Li,&nbsp;Meng Sun,&nbsp;Po-Cheng Shih,&nbsp;Tuo Li","doi":"10.1111/1756-185X.70105","DOIUrl":"https://doi.org/10.1111/1756-185X.70105","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Life's Essential 8 (LE8) is a recently updated algorithm for evaluating cardiovascular health (CVH). This study investigates the association between LE8 and mortality risk among individuals with arthritis in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using data from the US National Health and Nutritional Examination Survey (NHANES) 2005–2018. Participants with arthritis were included. Mortality data, including underlying causes of death, were obtained through linkage to national death records up to December 31, 2019. LE8 components (diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, glucose, and pressure) were measured and scored from 0 to 100. The total LE8 score, calculated as the unweighted average of all components, was categorized into low (0–49), moderate (50–79), and high (80–100) CVH. We employed Kaplan–Meier curves to estimate survival probabilities and weighted Cox proportional hazards regression models to evaluate hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause and cardiovascular disease (CVD) mortality. Stratified analyses and interaction tests were performed to explore potential effect modifications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 4519 participants with arthritis (median follow-up: 7.67 years), we observed 793 all-cause deaths, including 213 CVD deaths. Every 10-point increase in the LE8 score was associated with a 17% lower risk of all-cause mortality (HR: 0.83, 95% CI: 0.77–0.89) and a 25% lower risk of CVD mortality (HR: 0.75, 95% CI: 0.66–0.85). Compared to the lowest CVH tertile, individuals in the highest tertile demonstrated a 38% lower risk of all-cause mortality (HR: 0.62, 95% CI: 0.41–0.92) and a 62% lower risk of CVD mortality (HR: 0.38, 95% CI: 0.18–0.80). Kaplan–Meier survival curves revealed significantly higher survival probability for patients with high CVH compared to those with lower CVH (log-rank <i>p</i> &lt; 0.05). Stratified analyses confirmed consistent associations across various subgroups. Similar findings were observed in sensitivity analyses focusing on osteoarthritis and other arthritis subtypes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Higher adherence to LE8 recommendations is associated with reduced risks of all-cause and cardiovascular mortality among US adults with arthritis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380296","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":"Evaluation of Patient Information Provided by ChatGPT on Antimalarial Use in Systemic Lupus Erythematosus: Spanish Language Translation","authors":"Pamela Munguía-Realpozo,&nbsp;Claudia Mendoza-Pinto,&nbsp;Ivet Etchegaray-Morales,&nbsp;Socorro Méndez-Martínez,&nbsp;Edith Ramírez-Lara,&nbsp;Juan Carlos Solis-Poblano,&nbsp;Máximo Alejandro García Flores","doi":"10.1111/1756-185X.70126","DOIUrl":"https://doi.org/10.1111/1756-185X.70126","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380350","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":"Case Report: Dynamic Contrast-Enhanced Magnetic Resonance Imaging Depicting Intramuscular Small Vessel Vasculitis in a Patient With Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis","authors":"Masayori Moriyama,&nbsp;Ken Yoshida,&nbsp;Kentaro Noda,&nbsp;Takeshi Fukuda,&nbsp;Daitaro Kurosaka","doi":"10.1111/1756-185X.70104","DOIUrl":"https://doi.org/10.1111/1756-185X.70104","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380387","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":"Case Report: Multiple Autoimmune Syndrome—A Multidisciplinary Clinical Approach to a Spectrum of Organ Involvement","authors":"Jia Tang,&nbsp;Xiucai Fang,&nbsp;Jun Feng,&nbsp;Yingxian Liu,&nbsp;Jie Yu,&nbsp;Hanhui Fu,&nbsp;Tong Su,&nbsp;Yunlu Feng,&nbsp;Lidan Zhao","doi":"10.1111/1756-185X.70027","DOIUrl":"https://doi.org/10.1111/1756-185X.70027","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248693","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":"Harnessing Large Language Models for Rheumatic Disease Diagnosis: Advancing Hybrid Care and Task Shifting","authors":"Fabian Lechner,&nbsp;Sebastian Kuhn,&nbsp;Johannes Knitza","doi":"10.1111/1756-185X.70124","DOIUrl":"https://doi.org/10.1111/1756-185X.70124","url":null,"abstract":"&lt;p&gt;Rheumatology is facing an expanding care gap, as the number of newly referred patients continues to outpace the availability of rheumatologists [&lt;span&gt;1&lt;/span&gt;], resulting in longer diagnostic delays—often weeks to months—that lead to irreversible damage, poorer treatment outcomes, and higher societal costs [&lt;span&gt;2&lt;/span&gt;]. Patients and physicians alike struggle with fluctuating, often nonspecific symptoms (e.g., joint pain), and this challenge is compounded by limited awareness of rheumatic diseases among both the general population and general practitioners. The poor specificity of referrals and the inability of traditional triage approaches to improve the situation widen the care gap further. Although patient education is integral to rheumatology care, it remains underutilized due to inadequate reimbursement and workforce shortages, leaving many patients feeling poorly informed about their disease. Clinicians also face a significant time burden with clinical documentation [&lt;span&gt;3&lt;/span&gt;], especially for newly referred patients.&lt;/p&gt;&lt;p&gt;In response to these multifaceted challenges, digital health technologies (DHT) have emerged as a promising cornerstone to enhance diagnosis, information provision, patient education, documentation and alleviating workforce shortages. With the rapid proliferation of smartphones and advanced DHT, traditional care delivery models should be reevaluated to leverage these innovations [&lt;span&gt;4&lt;/span&gt;]. Task-shifting is increasingly being implemented to mitigate workforce shortages, wherein tasks are delegated from physicians to nurses, medical students, or other healthcare professionals. However, task-shifting remains limited in scale and cost-efficiency and DHT could significantly leverage widespread implementation [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Currently increasing numbers of rheumatic patients turn to online platforms for initial symptom assessment [&lt;span&gt;6&lt;/span&gt;], and diagnostic decision support systems (DDSS), that can empower patients to receive preliminary diagnoses within minutes. Although computer-aided diagnosis for rheumatologists has existed for decades [&lt;span&gt;7&lt;/span&gt;], adoption has been hindered by poor usability [&lt;span&gt;8&lt;/span&gt;], including time-intensive data entry [&lt;span&gt;9&lt;/span&gt;] and restricted querying options. These limitations also affect patient education, as static, often printed information leaves patients scrolling through lengthy materials rather than engaging in open-ended, personalized exploration. To bridge these limitations recently made advancements in large-language-model-technology (LLM) can be used for unprecedented scalability and multimodal data processing. Therefore DHT usability, performance, and the patient-provider relationship could be significantly improved by integrating LLM-driven decision support within a collaborative digital health triad [&lt;span&gt;4&lt;/span&gt;]. By continuously processing patient- and provider-generated data, LLMs can deliver more personalized, accessible, and dynam","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185X.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Patient-Reported Quality of Life and Physician-Derived Clinical Outcomes in Rheumatoid Arthritis in the Australian OPAL Dataset","authors":"Geoffrey Littlejohn,&nbsp;Nithila Anbumurali,&nbsp;Catherine O'Sullivan,&nbsp;Tegan Smith,&nbsp;Tina Racunica,&nbsp;Peta Pentony,&nbsp;Suren Jayaweera,&nbsp;Laila Girgis,&nbsp;Christine M. Smyth,&nbsp;Claire T. Deakin","doi":"10.1111/1756-185X.70123","DOIUrl":"https://doi.org/10.1111/1756-185X.70123","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143111916","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}