Mauricio de Carvalho, Ana Cristina Carvalho de Matos, Daniel Rinaldi Dos Santos, Daniela Veit Barreto, Fellype Carvalho Barreto, Fernanda Guedes Rodrigues, Igor Gouveia Pietrobom, Lucas Gobetti da Luz, Natasha Silva Constancio, Samirah Abreu Gomes, Ita Pfeferman Heilberg
{"title":"Brazilian Guidelines on evaluation and clinical management of Nephrolithiasis: Brazilian Society of Nephrology.","authors":"Mauricio de Carvalho, Ana Cristina Carvalho de Matos, Daniel Rinaldi Dos Santos, Daniela Veit Barreto, Fellype Carvalho Barreto, Fernanda Guedes Rodrigues, Igor Gouveia Pietrobom, Lucas Gobetti da Luz, Natasha Silva Constancio, Samirah Abreu Gomes, Ita Pfeferman Heilberg","doi":"10.1590/2175-8239-JBN-2024-0189en","DOIUrl":"10.1590/2175-8239-JBN-2024-0189en","url":null,"abstract":"<p><p>The prevalence of nephrolithiasis has been increasing in recent years, affecting appro-ximately 10% and 15% of the population. Kidney stone disease is associated with syste-mic comorbidities such as cardiovascular dis-ease, diabetes mellitus, and obesity. The first Nephrolithiasis Guideline by the Brazilian Society of Nephrology was published in 2002, and since then, the accumulation of new clinical studies and guidelines has justified a review of the subject. This updated document, prepared by the Nephrolithiasis Committee of the Brazilian Society of Nephrology, reflects the advances in the management of patients with kidney stones. The guideline aims to provide recommendations for the diagnosis, prevention, and treatment of nephrolithiasis, based on the best available evidence. Topics covered include clinical evaluation, laboratory and imaging tests, as well as dietary and pharmacological interventions, and follow-up strategies.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240189"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Eduardo da Silva, Yasmin de Souza Ciriaco, Gustavo Machado Ribeiro, Laura Almeida Vidal, Verônica Aparecida Silva Cintra, Sabrina Thalita Dos Reis
{"title":"Epidemiological profile of kidney cancer in Brazil: a multiregional ecological study.","authors":"Carlos Eduardo da Silva, Yasmin de Souza Ciriaco, Gustavo Machado Ribeiro, Laura Almeida Vidal, Verônica Aparecida Silva Cintra, Sabrina Thalita Dos Reis","doi":"10.1590/2175-8239-JBN-2024-0180en","DOIUrl":"10.1590/2175-8239-JBN-2024-0180en","url":null,"abstract":"<p><strong>Introduction: </strong>Renal neoplasia is a complex and heterogeneous disease, characterized by high morbidity and mortality.</p><p><strong>Objective: </strong>To analyze the temporal trend of hospitalization rates (HRs) for renal neoplasia in Brazil, segmented by region, states (UFs, Unidades da Federação in Portuguese), and population characteristics, from 2013 to 2023.</p><p><strong>Methods: </strong>Ecological study using data from the Hospital Information System, by analyzing Hospital Admission Authorizations, covering the period from 2013 to 2023. The annual trend of HRs was analyzed using generalized linear regression with the Prais-Winsten method by calculating the Annual Percentage Change (APC), considering sex, age, race/color, and region/state (UF). A significance level of 5% was adopted for the analyses.</p><p><strong>Results: </strong>A total of 31,388 hospitalizations for renal neoplasia were recorded in Brazil during the period, showing a significant upward trend in HRs (APC: 9.12; 95%CI: 5.30; 13.1; p < 0.001). The increase was observed in both sexes and in all regions. Among the states, most showed stationary trends. The highest average HRs were identified among young elderly individuals (3.31/100,000) and long-lived elderly individuals (2.51/100,000).</p><p><strong>Conclusion: </strong>HRIs due to renal neoplasia in Brazil showed a significant upward trend between 2013 and 2023, with regional variations, a predominance in males, and a higher incidence in the over-60 age group.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240180"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11913370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultrasound Doppler renal pulsatility index is a predictive marker of arterial stiffness in children with solitary functioning kidney.","authors":"Seçil Conkar Tunçay, Gonca Koç, Gülden Hakverdi","doi":"10.1590/2175-8239-JBN-2024-0069en","DOIUrl":"10.1590/2175-8239-JBN-2024-0069en","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with solitary functioning kidney (SFK) have glomerular hyperfiltration, hypertension, proteinuria and impaired renal function resulting in microvascular atherosclerotic abnormalities. This condition leads to an increase in arterial stiffness. In this study, we aimed to investigate the usefulness of non-invasive renal Doppler ultrasonography hemodynamic parameters in demonstrating arterial stiffness in pediatric patients with SFK.</p><p><strong>Methods: </strong>The study included 59 children aged 6-18 years who were diagnosed with SFK. Demographic, biochemical, anthropometric, and blood pressure data were recorded. The renal Doppler ultrasound hemodynamic parameters renal resistive index (RRI), renal pulsatility index (RPI), carotid-femoral pulse wave velocity (cfPWV), central augmentation index (cAIx) and carotid intima media thickness (cIMT) were evaluated.</p><p><strong>Results: </strong>Eighteen (30.5%) cases with acquired SFK and 41 (64.5%) cases with congenital SFK were detected. Central augmentation indices were higher in children with congenital SFK than in children with acquired SFK (p = 0.038). CkiD-eGFR-SCr-CysC was lower in patients with acquired SFK (p = 0.011). LDL cholesterol levels were higher in children with acquired SFK (p = 0.018). We found a significant correlation between RPI and cfPWV with a correlation coefficient (r) of 0.321 and a statistically significant p-value of 0.013.</p><p><strong>Conclusions: </strong>Congenital SFK is associated with increased microvascular atherosclerotic burden. RPI assessment with renal Doppler ultrasound may be a non-invasive method to identify arterial stiffness.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 2","pages":"e20240069"},"PeriodicalIF":1.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabiana B Nerbass, Helbert do Nascimento Lima, Jorge P Strogoff-de-Matos, Bruno Zawadzki, José A Moura-Neto, Jocemir Ronaldo Lugon, Ricardo Sesso
{"title":"Brazilian Dialysis Survey 2023.","authors":"Fabiana B Nerbass, Helbert do Nascimento Lima, Jorge P Strogoff-de-Matos, Bruno Zawadzki, José A Moura-Neto, Jocemir Ronaldo Lugon, Ricardo Sesso","doi":"10.1590/2175-8239-JBN-2024-0081en","DOIUrl":"10.1590/2175-8239-JBN-2024-0081en","url":null,"abstract":"<p><strong>Introduction: </strong>The annual Brazilian Dialysis Survey (BDS) supports and contributes to the development of national health policies. Objective: To report the 2023 epidemiological data from the BDS of the Brazilian Society of Nephrology (BSN).</p><p><strong>Methods: </strong>A survey was carried out in a voluntary sample of Brazilian chronic dialysis centers using an online questionnaire covering clinical and epidemiological aspects of patients on chronic dialysis, and characteristics of dialysis centers. For estimates of prevalence, incidence, and source of payment for dialysis, data were obtained from a random sample of dialysis centers.</p><p><strong>Results: </strong>A total of 37.5% (n = 332) of the centers voluntarily responded to the online questionnaire, and 124 were randomly selected for specific estimates of prevalence and incidence rates. It was estimated that on July 1, 2023, the total number of patients on dialysis was 157,357 and 51,153 started dialysis in 2023. The estimated prevalence and incidence rates of patients per million population (pmp) were 771 and 251, respectively. Of the prevalent patients, 88.2% were on hemodialysis, 8.0% on hemodialfiltration, and 3.8% on peritoneal dialysis. The prevalence of anemia (Hb <10g/dL) was 29% and hyperphosphatemia (P >5.5mg/dL), 30%. There was an increase in the frequency of use of cinacalcet and paricalcitol. The estimated overall crude annual mortality rate was 16.2%.</p><p><strong>Conclusions: </strong>Estimates from a random sample of dialysis facilities show that the absolute number and the prevalence rate of patients on chronic dialysis continue to increase. A growing number of patients were undergoing hemodiafiltration and using cinacalcet and paricalcitol for hyperparathyroidism treatment.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240081"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thaíza Passaglia Bernardes, Thalita Alvarenga Ferradosa Paula, Gabriel Teixeira Montezuma Sales, Patrícia Varela Calais, Renato Demarchi Foresto, Luiz Antonio Moura, Marcelino de Souza Durão Junior, João Bosco Pesquero, Gianna Mastroianni Kirsztajn
{"title":"Collapsing glomerulopathy associated with parvovirus B19 and systemic lupus erythematosus in a patient with APOL1 high-risk variant for nephropathy.","authors":"Thaíza Passaglia Bernardes, Thalita Alvarenga Ferradosa Paula, Gabriel Teixeira Montezuma Sales, Patrícia Varela Calais, Renato Demarchi Foresto, Luiz Antonio Moura, Marcelino de Souza Durão Junior, João Bosco Pesquero, Gianna Mastroianni Kirsztajn","doi":"10.1590/2175-8239-JBN-2024-0104en","DOIUrl":"10.1590/2175-8239-JBN-2024-0104en","url":null,"abstract":"<p><p>Collapsing glomerulopathy (CG) has a severe course typically associated with viral infections, especially HIV and parvovirus B19, systemic lupus erythematosus (SLE), among other etiologies. A 35-year-old woman with recent use of a JAK inhibitor due to rheumatoid arthritis presented with a 2-week history of fever, cervical adenopathy, and facial erythema. After admission, anemia, hypoalbuminemia, proteinuria, and severe acute kidney injury were noted. SLE was diagnosed and parvovirus B19 DNA was detected in serum samples. Kidney biopsy showed CG without any typical features of lupus nephritis. The patient was treated with prednisone and presented marked improvement of anemia and kidney function after a few weeks. In this case, the patient with SLE presented CG possibly caused by parvovirus B19 infection associated with homozygous apolipoprotein 1 (APOL1) G1 genotype, which has been described as a determinant risk factor for this glomerulopathy. It is not clear whether SLE had a causal relationship with glomerular disease or was a concurrent cause. Treatment can be challenging in such a context, as no antiviral drug is efficient and immunosuppression has no discernable benefit, although steroid use was efficient in treating renal manifestations in this case.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240104"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Isolated renal glucosuria due to SLC5A2 gene mutation: a rare presentation.","authors":"Priyanka Dua, Ashok Singh, Om P Mishra","doi":"10.1590/2175-8239-JBN-2024-0193en","DOIUrl":"10.1590/2175-8239-JBN-2024-0193en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240193"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Protein restriction in CKD: an outdated strategy in the modern era.","authors":"Abdullah Bawazir, Joel M Topf, Swapnil Hiremath","doi":"10.1590/2175-8239-JBN-2024-PO03en","DOIUrl":"10.1590/2175-8239-JBN-2024-PO03en","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) management has traditionally emphasized dietary protein restriction to slow disease progression and delay end-stage renal disease (ESRD). However, evidence from trials questions the supposed efficacy of this approach and also highlights potential risks such as malnutrition and reduced quality of life. This review discusses the rational for protein restriction in CKD, critiques the existing evidence, and advocates for personalized care that focuses on nutritional adequacy and effective pharmacotherapy. Important advances in CKD treatment, including ACE inhibitors, SGLT2 inhibitors, and GLP-1 receptor agonists, are discussed to propose a comprehensive strategy that optimizes patient outcomes.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e2024PO03"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11813190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute kidney injury in critically ill COVID-19 patients in a tertiary hospital: short and long-term kidney and patient outcomes.","authors":"Juliana Alves Manhães de Andrade, Gisele Meinerz, Raphael Palma, Eduardo Rech, Marco Antônio Vinciprova Dall'Agnese, Cristiane Bundchen, Fernanda Bordignon Nunes, Gisele Branchini, Elizete Keitel","doi":"10.1590/2175-8239-JBN-2024-0107en","DOIUrl":"10.1590/2175-8239-JBN-2024-0107en","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data.</p><p><strong>Aim: </strong>To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital.</p><p><strong>Methods: </strong>Prospective single-center cohort of critically ill COVID-19 adult patients with NC-AKI from May 1st, 2020, to April 30th, 2021. Kidney replacement therapy (KRT), recovery of kidney function, and death at 90-day and 1-year follow-up were evaluated.</p><p><strong>Results: </strong>360 patients were included, 60.6% were male, median age was 66.0 (57.0-72.0) years, 38.1% had diabetes, and 68.6% had hypertension. AKI stages 1, 2, and 3 were detected in 3.6%, 5.6%, and 90.8% of patients, respectively. KRT was indicated in 90% of patients. At the 90-day follow-up, 88.1% of patients died and 10.0% had recovered kidney function. Female gender (p = 0.047), older age (p = 0.047), AKI stage 3 (p = 0.005), requirement of KRT (p < 0.0001), mechanical ventilation (p < 0.0001), and superimposed bacterial infection (p < 0.0001) were significantly associated death within 90 days. At 1 year, mortality was 89.3%. Amongst surviving patients, 72% recovered kidney function, although with significantly lower eGFR compared to baseline (85.5 ± 23.6 vs. 65.9 ± 24.8 mL/min, p = 0.003).</p><p><strong>Conclusion: </strong>Critically ill COVID-19 patients with NC-AKI presented a high frequency of AKI stage 3 and KRT requirement, with a high 90-day mortality. Surviving patients had high rates of recovery of kidney function, with a lower eGFR at one-year follow-up compared to baseline.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240107"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Thymoglobulin induction in kidney transplantation: real-world cost-effectiveness in Brazil's public healthcare system.","authors":"Roberto Ceratti Manfro","doi":"10.1590/2175-8239-JBN-2025-E005en","DOIUrl":"10.1590/2175-8239-JBN-2025-E005en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e2025E005"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Economic analysis of hemodialysis and urgent-start peritoneal dialysis therapies.","authors":"Alexandre Minetto Brabo, Dayana Bitencourt Dias, Everton Nunes da Silva, Daniela Ponce","doi":"10.1590/2175-8239-JBN-2024-0051en","DOIUrl":"10.1590/2175-8239-JBN-2024-0051en","url":null,"abstract":"<p><strong>Introduction: </strong>Unplanned initiation of renal replacement therapy (RRT) in chronic kidney disease (CKD) patients is a common situation worldwide. In this scenario, peritoneal dialysis (PD) has emerged as a therapeutic option compared to hemodialysis (HD). In planned RRT, the costs of PD are lower than those of HD; however, the literature lacks such analyses when initiation is urgent.</p><p><strong>Objective: </strong>To clinically and economically evaluate, from the perspective of the Unified Health System (SUS, Sistema Único de Saúde), the strategy of initiating unplanned RRT using HD or PD in patients during their first year of therapy.</p><p><strong>Methodology: </strong>Quasi-experimental study with cost-effectiveness analysis based on primary data from incident patients on RRT, over a twelve-month follow-up period, using the intention-to-treat approach. Data collection occurred prospectively, directly from medical records, computing data on the use of dialysis therapy, high-cost medications, procedures in dialysis accesses and recorded events. Costs were estimated using the amounts reimbursed by the SUS. In the economic analysis, the application of the bootstrap method and the construction of graphical representations were proposed.</p><p><strong>Results: </strong>At the end of one year, there were no differences between costs and effectiveness when initiating unplanned RRT using either PD or HD.</p><p><strong>Conclusion: </strong>Starting RRT with PD is a similar option to starting with HD in patients requiring unplanned methods. The minimal initial investment required to establish PD slots makes it a strong option as a public health policy for expanding RRT in developing countries.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"47 1","pages":"e20240051"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}