Irish Journal of Medical Science最新文献

{"title":"Relationship between skeletal muscle mass and glycemic parameters in individuals with young-onset type 2 diabetes mellitus.","authors":"Anupama Harihar, Sahana Shetty, Shivashankar K N, Shyamasunder Bhat N, Dhiren Punja, Sachin Kumar, G Arun Maiya","doi":"10.1007/s11845-025-04111-2","DOIUrl":"https://doi.org/10.1007/s11845-025-04111-2","url":null,"abstract":"<p><strong>Background: </strong>Young-onset type 2 diabetes mellitus (T2DM) is an increasingly prevalent condition characterized by rapid progression. Apart from adipose tissue, there has been growing attention to the relationship between T2DM and total body skeletal muscle mass (SMM).</p><p><strong>Aim: </strong>This study investigated the relationships between body composition indicators and glycemic parameters in young-onset T2DM patients versus young, healthy adults, aiming to identify predictive markers with optimal cutoff values for the early identification of young-onset T2DM.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 252 participants aged 18-40 years, including 96 young-onset T2DM patients and 156 non-T2DM individuals. Glycemic parameters and body composition variables were assessed via bioelectrical impedance analysis. Statistical analysis included correlation, multiple logistic regression, and receiver operating characteristic curve analysis to determine optimal SMM% cutoff values for young-onset T2DM prediction.</p><p><strong>Results: </strong>The SMM% displayed a significant negative correlation with HbA1c (p =  - 0.624) and FBG (p =  - 0.656). VF demonstrated a positive correlation with both HbA1c (p = 0.636) and FBG (p = 0.580). Logistic regression analysis identified SMM, VF, and subcutaneous fat as significant predictors of HbA1c levels. Receiver operating characteristic analysis revealed gender-specific SMM% cutoff values of 23.14% for females and 28.6% for males, with high sensitivity and specificity.</p><p><strong>Conclusion: </strong>Reduced SMM% and increased VF are significant predictors of young-onset T2DM. The study established the optimal gender-specific cutoff value of SMM% for identifying individuals at risk of young-onset T2DM in the Indian population. Incorporating body composition assessments into clinical practice may facilitate early detection and targeted interventions.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238651","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":"Exploring osteomicrobiology: A narrative review of the gut-bone axis in osteoporosis.","authors":"Hugo S Pereira, Muaz Rashid, Ahmad Alissa, Salman Keraidi, Nicolas Wipf, Aubrie M Sowa, Jake M McDonnell, Stacey Darwish, Joseph S Butler","doi":"10.1007/s11845-025-04089-x","DOIUrl":"https://doi.org/10.1007/s11845-025-04089-x","url":null,"abstract":"<p><p>Osteoporosis is a chronic condition that presents with decreased bone mass and changes in bone microarchitecture, leading to an increased fracture risk. While the relationship between the gut microbiome and the immune system is well established, its impact on bone health remains underexplored. This narrative review aims to investigate the relationship between gut microbiota, bone health, and osteoporosis. Key findings indicate that the gut microbiome influences bone density through various mechanisms. Specific bacterial strains such as Lactobacillus and Bifidobacterium enhance the absorption of calcium, magnesium, and phosphorus, increasing bone mineral density. Additionally, the ability to produce essential vitamins like K and B makes the gut microbiota crucial for bone synthesis and integrity. Studies also revealed notable differences in the gut microbiome composition of individuals diagnosed with primary osteoporosis (PO) compared to those who were healthy controls. PO patients exhibited higher microbiota diversity and certain distinctive phylogenetic shifts. Important bacterial taxa such as Bacteroidetes, Faecalibacterium, and Dialister exist in high numbers in PO and may be useful as biomarkers. Additionally, a correlation was found between H. Pylori infections and reduced lumbar spine bone mineral density in older males. The review identifies certain gaps in the current knowledge and research such as the role of viral and fungal components within the gut microbiome. This review highlights the potential role of the gut microbiome as a target for osteoporosis diagnosis, treatment and prevention, underscoring the need for dietary and lifestyle interventions to modify the microbiome and improve bone health.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232570","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":"Exogenous pigmentation mimicking dermatosis: a benign consequence of silver nitrate use.","authors":"Áine O'Flynn","doi":"10.1007/s11845-025-04110-3","DOIUrl":"https://doi.org/10.1007/s11845-025-04110-3","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225357","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":"Assessing the use of modified 5-item frailty index as a prognostic marker of long-term survival and perioperative outcomes after radical cystectomy for bladder cancer.","authors":"Ubeyd Sungur, Nahide Kerim Özfiliz, Mithat Ekşi, Taner Kargı, Serdar Karadağ, Alper Bitkin","doi":"10.1007/s11845-025-04108-x","DOIUrl":"https://doi.org/10.1007/s11845-025-04108-x","url":null,"abstract":"<p><strong>Background and aim: </strong>This study investigated the relationship between preoperative Modified 5-item Frailty Score (mFI-5) and long-term survival as well as 30-day postoperative complications in patients who underwent radical cystectomy for bladder cancer.</p><p><strong>Methods: </strong>Patients who underwent radical cystectomy between 2012-2023 were analyzed and divided into two groups based on their mFI-5 scores: low-risk (≤ 1) and high-risk (≥ 2). Overall survival (OS), cancer-specific survival (CSS), and 30-day postoperative complications were compared between these groups. Additionally, Cox proportional hazards regression analysis was used to examine the impact of the mFI-5 score on OS and CSS.</p><p><strong>Results: </strong>Our study included 288 patients with an average age of 63.8 ± 9.1 years at the time of surgery. Patients with a low mFI-5 score comprised 77.4% (n = 223) of the cohort, while 22.6% (n = 65) had a high mFI-5 score. The majority of patients had advanced-stage disease (pT3-pT4 for 53.8% (n = 155)). Patients with a high mFI-5 score demonstrated significantly worse OS and CSS compared to those with a low mFI-5 score (p = 0.002 and p = 0.007, respectively). Although 30-day mortality rates were significantly higher in the high mFI-5 score group (p = 0.002), the difference in overall complication rates was not statistically significant (p = 0.120). In multivariate Cox proportional hazards analysis, the mFI-5 score was identified as an independent predictor for both OS and CSS (p = 0.001 and p = 0.003, respectively).</p><p><strong>Conclusion: </strong>mFI-5 score can provide valuable prognostic information regarding survival after radical cystectomy in bladder cancer patients, based on preoperative findings. It is an independent predictor of long-term survival.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212583","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":"Predictive value of adding end-tidal CO₂ and perfusion index to NEWS2 for 30-day in-hospital mortality: a prospective study.","authors":"Ali Sarıdas, Hakan Aydin","doi":"10.1007/s11845-025-04106-z","DOIUrl":"https://doi.org/10.1007/s11845-025-04106-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate whether integrating end-tidal carbon dioxide (ETCO₂) and perfusion index (PI) into the National Early Warning Score 2 (NEWS2) enhances its ability to predict 30-day in-hospital mortality in patients visitted to the emergency department (ED).</p><p><strong>Methods: </strong>This prospective, single-center cohort study was conducted between March 15 and May 15, 2025, in a tertiary ED. Adult patients requiring continuous monitoring were included. ETCO₂ and PI were measured upon admission and incorporated into the NEWS2 score using predefined thresholds. The primary outcome was 30-day all-cause in-hospital mortality. Model performance was assessed via ROC analysis, Brier score, Hosmer-Lemeshow test, decision curve analysis (DCA), and Net Reclassification Index (NRI).</p><p><strong>Results: </strong>A total of 375 patients were analyzed (mean age: 76.5 ± 7.6 years; 56.8% female), with a 30-day mortality rate of 5.9%. The base NEWS2 had an AUC of 0.804 (95%CI: 0.734-0.868), while the extended NEWS2 + ETCO₂ + PI model demonstrated a significantly higher AUC of 0.893 (95%CI: 0.824-0.944; p < 0.001). The optimal cut-off for the combined model was > 12, yielding 77.3% sensitivity and 90.9% specificity. It also showed superior calibration (Brier score: 0.039; HL p = 0.265) and the highest net clinical benefit between threshold probabilities of 0.22 and 0.45. NRI analysis showed a net reclassification improvement of 46.3%.</p><p><strong>Conclusion: </strong>The integration of ETCO₂ and PI into the NEWS2 score significantly improves its predictive accuracy for short-term mortality. The combined model may contribute to earlier and more accurate identification of high-risk patients in emergency care settings.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212640","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":"The intersection of ferroptosis and non-coding RNAs: a novel approach to lung cancer.","authors":"Jian Ding","doi":"10.1007/s11845-025-04099-9","DOIUrl":"https://doi.org/10.1007/s11845-025-04099-9","url":null,"abstract":"<p><p>Lung cancer remains a major global health challenge, with non-small cell lung cancer (NSCLC) accounting for nearly 85% of cases and deaths. Although advances in targeted therapy and immunotherapy have improved patient outcomes, drug resistance and limited long-term survival continue to pose serious obstacles. Ferroptosis, an iron-dependent and lipid peroxidation-driven form of regulated cell death, has attracted growing attention as a novel therapeutic approach to address these challenges. At the same time, non-coding RNAs (ncRNAs), including microRNAs, long non-coding RNAs, and circular RNAs, are increasingly recognized as crucial regulators of cancer progression, therapy resistance, and cellular homeostasis. Recent studies reveal that ncRNAs and ferroptosis are closely interconnected in lung cancer, with ncRNAs influencing iron metabolism, antioxidant defense, and lipid peroxidation, thereby modulating sensitivity or resistance to ferroptotic death. Importantly, this crosstalk not only shapes tumor biology but also provides opportunities for clinical translation. Ferroptosis-related ncRNAs are emerging as potential biomarkers for prognosis, therapeutic response, and disease stratification. In addition, pharmacological induction of ferroptosis, combined with modulation of specific ncRNAs, offers a promising strategy to overcome resistance to chemotherapy, radiotherapy, and immunotherapy. This review highlights the latest advances in understanding the interplay between ncRNAs and ferroptosis in lung cancer and discusses their implications for precision medicine. By integrating ferroptosis induction with ncRNA-targeted strategies, new avenues may emerge for developing more effective and personalized therapies against NSCLC.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206586","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":"Quality and safety of Ireland's first robotic oesophagectomy program.","authors":"Mohammad Al Azzawi, Orla Brett, Claire Coleman, Domhnall O'Connor, Mohammed Albagir, Jarlath C Bolger, William B Robb","doi":"10.1007/s11845-025-04105-0","DOIUrl":"https://doi.org/10.1007/s11845-025-04105-0","url":null,"abstract":"<p><strong>Introduction: </strong>Oesophageal cancer incidence is rising, with a concurrent increase in oesophagectomy as neoadjuvant and perioperative therapies improve. Oesophagectomy remains the cornerstone of curative treatment. The adoption of robotic-assisted surgery (RAS) in oesophagectomy has been slow, with concerns regarding the learning curve and safety. This series describes the safe introduction of RAS for oesophagectomy in Ireland.</p><p><strong>Methods: </strong>A review of prospectively maintained data from a single surgeon was performed, encompassing the period from February 2016 to December 2024. Standard clinicopathological variables were extracted. The RAS program (using DaVinci X/Xi) for oesophagectomy began in March 2020. Operations were classified as open, hybrid, minimally invasive, RAS-hybrid, or totally RAS. Length of stay (LOS), margin status, nodal yield, perioperative complications, and mortality were compared, as well as ERAS outcomes, where applicable.</p><p><strong>Results: </strong>A total of 198 patients underwent oesophagectomy; 93 underwent RAS (52 total RAS, 41 hybrid). Demographics were comparable between RAS and non-RAS groups. There was an improvement in nodal yield for the total-RAS patients compared to non-RAS patients (mean 27.8, SD 8.7 vs 23.2, SD 9.1; p = 0.1). There was no difference in margin status (p = 0.55), overall complications (p = 0.23), LOS (p = 0.31), or 90-day mortality (p = 0.85) between RAS and non-RAS groups. The anastomotic leak rate was 3% for RAS versus 10% for non-RAS (p = 0.08). The chyle leak rate increased with RAS (22% vs 10%, p = 0.01), although this decrease was observed over time. R0 resection rate was comparable for RAS and non-RAS (90% vs 91% p = 0.55).</p><p><strong>Conclusions: </strong>RAS oesophagectomy can be introduced safely for experienced RAS surgeons. Early in the learning curve, similar perioperative outcomes occur, with no significant increase in overall complications. RAS has the potential to improve oncologic outcomes.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206569","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":"An assessment of the prescribing preferences of Irish dermatology consultants for the treatment of severe psoriasis in the setting of a cancer diagnosis.","authors":"Stephanie Bowe, Michelle Murphy, John Bourke, Caitriona Ryan","doi":"10.1007/s11845-025-04113-0","DOIUrl":"https://doi.org/10.1007/s11845-025-04113-0","url":null,"abstract":"<p><strong>Aim: </strong>We aimed to investigate the systemic and biologic agent choices of dermatologists in Ireland for those patients with psoriasis and a cancer diagnosis.</p><p><strong>Methods: </strong>An electronic questionnaire was circulated to the Irish Association of Dermatology members using the survey platform, Jotform, between December 2023-June 2025.</p><p><strong>Results: </strong>In total there were 27 responses. Methotrexate was selected most commonly for all scenarios > 5 years remission. In all clinical scenarios, fumaric acid esters were the least frequently selected agents. In general, tumour necrosis factor-alpha inhibitors were the next least commonly selected. Apremilast was selected most commonly for a current malignancy of stage 1 breast cancer (26%), lymphoma (22%) and metastatic RCC (30%).</p><p><strong>Conclusion: </strong>In general, systemic and biologic agents are used by Irish dermatologists in the setting of psoriasis and cancer.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199359","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":"Alterations in proximal shoulder muscles in stroke-related pain: a myotonometric study.","authors":"Tuba Maden, Hakan Polat, Mehmet Ali Guner, Begümhan Turhan","doi":"10.1007/s11845-025-04098-w","DOIUrl":"https://doi.org/10.1007/s11845-025-04098-w","url":null,"abstract":"<p><strong>Background: </strong>Post-stroke shoulder pain is one of the most common complications.</p><p><strong>Aim: </strong>We aimed to investigate the shoulder pain-related myotonometric changes of the biceps brachii (BB) and triceps brachii (TB) muscles and emphasize the differences in viscoelastic parameters according to pain severity in subacute stroke patients.</p><p><strong>Methods: </strong>In this cross-sectional study, 45 subacute stroke patients were allocated into the painless group (CG, n = 15), mild shoulder pain group (MiPG, n =16), and moderate shoulder pain group (MoPG, n = 14) using the Visual Analog Scale. The muscle tone, stiffness, and elasticity of BB and TB muscles were evaluated with the MyotonPro® (Myoton AS, Estonia).</p><p><strong>Results: </strong>Tone was similar on both sides in all groups (p > 0.05), except for the triceps in the painless group. The tone of TB muscle was higher on the affected side in the CG (p = 0.041). BB and TB tones were lower in the pain groups compared to CG (p < 0.05). BB stiffness was higher on the unaffected side in MiPG and CG (p = 0.016 and p = 0.041). BB stiffness was also higher in the CG compared to patients with shoulder pain on both sides (p = 0.001, p = 0.044). TB stiffness was similar across all groups (p > 0.05). TB elasticity was higher on the unaffected side in MiPG and CG (p = 0.023, p = 0.010), while BB and TB elasticity did not differ significantly between groups (p > 0.05).</p><p><strong>Conclusions: </strong>The differences between affected and unaffected extremities in stroke patients may result from adaptations in the non-paretic limb or abnormal scapular rhythm. In contrast to common knowledge, in this study, tone and stiffness decreased as pain increased. Additionally, changes in muscle elasticity may not have occurred in stroke patients during subacute phase. CTN: NCT05920837.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199271","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":"The effect of kinesiophobia on motor symptoms in individuals with Parkinson's Disease.","authors":"Miray Baser, İsmail Uysal, Fatih Özden, Mehmet Özkeskin, Zehra Benzer, Funda Alparslan","doi":"10.1007/s11845-025-04103-2","DOIUrl":"https://doi.org/10.1007/s11845-025-04103-2","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's Disease (PD) is characterized by motor and non-motor symptoms that impair balance, mobility, and overall physical function. Kinesiophobia, defined as the fear of movement due to pain or injury concerns, may further exacerbate these impairments by promoting activity avoidance. This study aimed to investigate the impact of kinesiophobia on motor symptoms in individuals with PD.</p><p><strong>Methods: </strong>A total of 51 individuals diagnosed with PD were included in the study. Participants were divided into two groups-low and high kinesiophobia-based on their scores on the Tampa Scale for Kinesiophobia (TSK). Motor assessments included the Unified Parkinson's Disease Rating Scale (UPDRS), Berg Balance Scale (BBS), Timed Up and Go (TUG) test, Activities-specific Balance Confidence (ABC) scale, and Six-Minute Walk Test (6MWT).</p><p><strong>Results: </strong>High kinesiophobia was significantly associated with older age and longer disease duration. MANCOVA revealed significant group differences in balance (BBS) and walking endurance (6MWT), with the high kinesiophobia group performing worse (p < 0.05). Partial correlations showed a strong negative association between kinesiophobia and walking capacity (r = -0.608, p < 0.001). Hierarchical regression analyses revealed that kinesiophobia was a significant independent predictor of poorer motor function, reduced walking endurance, and decreased balance confidence (p < 0.05).</p><p><strong>Conclusions: </strong>Kinesiophobia negatively impacts motor symptoms and functional mobility in PD, beyond demographic and disease-related factors. Addressing the fear of movement in rehabilitation may improve physical function and reduce the risk of falls in this population.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199310","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}