Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia最新文献

{"title":"Position Statement of the Brazilian Society of Nephrology on incremental dialysis.","authors":"Fernanda Salomão Gorayeb-Polacchini, Thyago Proença de Moraes, Rosilene Motta Elias, Allison Andrade, Dirceu Reis da Silva, Felipe Costa Neves, Fernando das Mercês de Lucas Junior, Isadora Cartaxo de Sousa Calvo, Juliana El Ghoz Leme, Maria Gabriela Guimarães, Pasqual Barretti, Patrícia Ferreira Abreu, Paulo Henrique Santos Fraxino, Ramon Lima, Stenio Barbosa de Freitas, Viviane Calice-Silva, José Andrade Moura-Neto","doi":"10.1590/2175-8239-JBN-2025-0374en","DOIUrl":"10.1590/2175-8239-JBN-2025-0374en","url":null,"abstract":"<p><p>Incremental dialysis, applicable to both hemodialysis (HD) and peritoneal dialysis (PD), is an individualized approach. It consists of offering a dialysis dose adjusted to the patient's residual renal function (RRF) in order to achieve the same clinical outcomes observed with full doses, while improving quality of life and reducing exposure to the risks associated with the dialysis procedure. This Position Statement of the Brazilian Society of Nephrology (SBN) aims to present recommendations on eligibility criteria, prescription, monitoring, and safe implementation, as well as to report the clinical results already described with this approach. Eligibility includes a residual diuresis ≥ 500 mL/24h in HD or ≥ 100 mL/24h in PD and/or a urea clearance (Kru) ≥ 2.0 mL/min/1.73 m2, as well as clinical stability and adequate volume and metabolic control. Monitoring with regular reassessment of RRF is recommended. Indicators for dialysis dose intensification include hypervolemia, uremic symptoms, worsening of nutritional status, hyperkalemia, hyperphosphatemia, refractory metabolic acidosis, and laboratory findings of subdialysis. The implementation of incremental dialysis requires well-defined institutional protocols, systematic education of patients and families, a properly trained multidisciplinary team, and a shared decision-making process. Scientific evidence suggests that incremental dialysis is safe and effective, attenuating the loss of RRF, and can reduce hospitalizations, while maintaining or improving quality of life, without increasing mortality. Additionally, it may contribute to cost reduction and greater sustainability of the healthcare system, and should be considered an integral part of the contemporary therapeutic armamentarium.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250374"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338747","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":"Patients with chronic kidney disease stage 3b: do general practitioners and nephrologists follow KDIGO guidelines?","authors":"Juliana Gazzi Macedo, Alessandra Maciel Almeida, Helady Sanders-Pinheiro, Raquel Aparecida Fabreti-Oliveira","doi":"10.1590/2175-8239-JBN-2025-0229en","DOIUrl":"10.1590/2175-8239-JBN-2025-0229en","url":null,"abstract":"<p><strong>Background: </strong>Appropriate referral and management of patients with chronic kidney disease (CKD) from primary care to nephrologists are essential to prevent disease progression and complications.</p><p><strong>Objectives: </strong>To describe the demographic and follow-up characteristics of patients with CKD stage 3b at the time of nephrology referral, the medical care offered by general practitioners, and the initial care provided by nephrologists in the Brazilian Unified Health System (SUS).</p><p><strong>Methods: </strong>This retrospective cohort study included all patients with CKD stage 3b on the waiting list for nephrology consultation between January 2018 and January 2020 in a large city in southern Brazil. Sociodemographic data, comorbidities, and adherence to follow-up recommendations based on the 2021 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines were analyzed. Laboratory test requests and results were compared between the periods of general practitioner care and the period following nephrology consultation.</p><p><strong>Results: </strong>A total of 211 patients (mean age 74 ± 12 years) were included; 76.0% were hypertensive and 46.9% had diabetes. Approximately half had an adequate number of primary care appointments. Laboratory monitoring was suboptimal in both primary and specialized care. Before nephrology consultation, hemoglobin and urinalysis were available for 32.2% and 19.4% of patients, respectively. After consultation, hemoglobin and potassium results were documented in 68.3% and 58.8% of patients, respectively.</p><p><strong>Conclusion: </strong>Although patients with CKD stage 3b were regularly followed, low adherence to KDIGO testing recommendations raises concerns about the adequacy of care. Strengthening communication and guideline implementation between primary care and nephrology services is crucial to improve CKD management within the SUS.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250229"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716893","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":"Epidemiology of chronic dialysis treatment among children and adolescents in a capital of Northeastern Brazil.","authors":"Ingrid Silva Medeiros, Janeide Leonar Alves Siqueira, Giselle Andrade Silva Lima Pires, Ana Lucia Guterres Abreu Santos, Ricardo Ferreira Santos","doi":"10.1590/2175-8239-JBN-2025-0263en","DOIUrl":"10.1590/2175-8239-JBN-2025-0263en","url":null,"abstract":"<p><strong>Introduction: </strong>Information about the clinical and epidemiological profile of children and adolescents undergoing chronic dialysis in Brazil is limited.</p><p><strong>Objective: </strong>To describe the clinical and epidemiological characteristics of the pediatric population undergoing chronic outpatient dialysis treatment in a capital city in Northeastern Brazil.</p><p><strong>Methods: </strong>This is a descriptive, observational, and retrospective study whose population consisted of all children and adolescents undergoing chronic outpatient dialysis treatment in São Luís, capital of the state of Maranhão, Brazil, in 2023.</p><p><strong>Results: </strong>Thirty-two children and adolescents with chronic kidney disease (CKD) were undergoing dialysis treatment during this period, the majority (56.25%) being male. The mean age was 11.31 years (± 3.56). Regarding ethnicity, non-white individuals predominated (71.9%). The renal replacement therapy (RRT) modality was exclusively hemodialysis (HD), and the most commonly used vascular access at the end of the follow-up period was arteriovenous fistula (AVF) (56.2%). Regarding the underlying disease, 35% had an unknown etiology. There were nine transplants during the period, all from deceased donors. At that time, there was virtually universal access to erythropoiesis-stimulating agents and drugs for the prevention and treatment of bone mineral metabolic disorders.</p><p><strong>Conclusion: </strong>The high rate of unknown underlying disease and the exclusive use of HD as the RRT modality, rather than peritoneal dialysis, reflect diagnostic, therapeutic, and structural challenges. This scenario highlights the need for better planning of public policies aimed at managing pediatric CKD in the region.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250263"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13258131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251591","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":"Relationship between parathyroid hormone levels and sarcopenia and nutritional status in patients undergoing hemodialysis.","authors":"Claudia Campello Leal, Dejane de Almeida Melo, Alcione Miranda Dos Santos, Maria Conceição Chaves de Lemos, Pedro Israel Lira, Claudia Porto Sabino Pinho","doi":"10.1590/2175-8239-JBN-2025-0083en","DOIUrl":"10.1590/2175-8239-JBN-2025-0083en","url":null,"abstract":"<p><strong>Introduction: </strong>The potential effect of elevated parathyroid hormone (PTH) levels on nutritional status and sarcopenia in chronic kidney disease (CKD) patients undergoing hemodialysis (HD) has not yet been well established.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the status of sarcopenia and nutritional aspects according to PTH levels in HD patients.</p><p><strong>Methods: </strong>This cross-sectional study evaluated consecutive patients attending three HD clinics in Northeast Brazil. Patients were stratified based on PTH levels: (1) 0-199 pg/mL, (2) 200-599 pg/mL, and (3) ≥ 600 pg/mL. Group 1 was excluded due to older age, and groups 2 and 3 were matched for age, sex, and presence of diabetes. Sarcopenia was defined according to the European consensus criteria, assessing muscle strength, muscle mass, muscle quality index, and body mass index.</p><p><strong>Results: </strong>A total of 238 individuals were evaluated (119 in each group), with a mean age of 49.3 ± 14.4 years. The prevalence of sarcopenia was 18.5%, and 66.7% exhibited low muscle quality. Underweight was observed in 6.3% of the sample, while 41.4% were overweight. There were no differences in rates of underweight, low muscle mass, low muscle strength, sarcopenia, and low muscle quality according to PTH status (p > 0.05).</p><p><strong>Conclusion: </strong>Patients undergoing HD with moderate to severe hyperparathyroidism (PTH ≥ 600 pg/mL) did not show higher nutritional impairment or sarcopenia compared to patients with PTH levels within the recommended range (200-599 pg/mL).</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250083"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689070","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":"Why don't we provide the best treatment for chronic kidney disease?","authors":"Gisele Meinerz, Valter Duro Garcia","doi":"10.1590/2175-8239-JBN-2026-E014en","DOIUrl":"10.1590/2175-8239-JBN-2026-E014en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e2026E014"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706640","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":"Brazil between guidelines and reality: the challenges of chronic kidney disease care in Brazil.","authors":"Thyago Proença de Moraes, Caio Pellizzari, Maria Fernanda de Aguiar Soares","doi":"10.1590/2175-8239-JBN-2026-E0012en","DOIUrl":"10.1590/2175-8239-JBN-2026-E0012en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e2026E012"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396785","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":"Translation, cross-cultural adaptation and psychometric validation of the Brazilian version of the dialysis patient-perceived exercise benefits and barriers scale.","authors":"Graziella Alves da Silva, Cid André Fidelis de Paula Gomes, Thamiê Cristina Stella, Barbara G Miura, Jing Zheng, Renato D Foresto, Renata Kelly de Palma, Almir V Dibai-Filho, Luciana Maria Malosá Sampaio","doi":"10.1590/2175-8239-JBN-2025-0199en","DOIUrl":"10.1590/2175-8239-JBN-2025-0199en","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) in dialysis patients compromises musculoskeletal health and reduces physical activity levels. The Dialysis Patient-Perceived Exercise Benefits and Barriers Scale (DPEBBS) was specifically developed to assess dialysis patients' perceptions of exercise. This study aimed to translate, cross-culturally adapt, and evaluate the psychometric properties of the Brazilian version of the DPEBBS (EPAD).</p><p><strong>Methods: </strong>A cross-sectional study was conducted following the COSMIN guidelines. Psychometric properties assessed included reliability, internal consistency, and construct validity. Participants were recruited from the hemodialysis department of Unifesp. A total of 112 adults on dialysis completed the DPEBBS, the Short Form Health Survey-36 (SF-36), and underwent anthropometric evaluation. The interval between test-retest was one week. Descriptive and inferential analyses were performed to test validity and reliability.</p><p><strong>Results: </strong>The scale demonstrated high test-retest stability, with consistent mean scores across assessments. Internal consistency was strong, and reliability was supported by a low minimal detectable change and a high intraclass correlation coefficient. Convergent validity with the SF-36 Physical Functioning domain was weak but statistically significant (r = -0.326; p = 0.001), and the correlation with the General Health domain was weak and not statistically significant (r = -0.185; p = 0.052). Consistency analysis showed α = 0.885, ICC = 0.794, SEM = 4.96%, and demonstrated the absence of floor and ceiling effects.</p><p><strong>Conclusion: </strong>The EPAD showed robust validity and reliability for dialysis patients. Despite adequate reliability and validity, this study has limitations, including a single-center sample. The EPAD may support individualized exercise counseling and rehabilitation planning in hemodialysis units.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250199"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874265","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":"Parathyroid hormone levels and sarcopenia in dialysis patients: absence of association or methodological limitations?","authors":"Amanda Carina Coelho de Morais, Cássia Gomes da Silveira Santos, Fellype Carvalho Barreto","doi":"10.1590/2175-8239-JBN-2026-E013en","DOIUrl":"10.1590/2175-8239-JBN-2026-E013en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e2026E013"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148689034","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":"Impact of acute kidney injury on clinical and functional outcomes in patients undergoing coronary artery bypass grafting: a prospective cohort study.","authors":"André Luiz Lisboa Cordeiro, Lucas Oliveira Soares, Beatriz Rodrigues Mortari, Hanna Beatriz de Melo Moraes, Heitor S Ribeiro","doi":"10.1590/2175-8239-JBN-2025-0241en","DOIUrl":"10.1590/2175-8239-JBN-2025-0241en","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) is a common complication after coronary artery bypass grafting (CABG), associated with worse clinical outcomes. However, its impact on functional outcomes remains uncertain.</p><p><strong>Objective: </strong>To evaluate the clinical and functional outcomes of patients undergoing cardiac surgery who developed AKI during hospitalization.</p><p><strong>Methods: </strong>A prospective cohort study was conducted with 60 patients evaluated preoperatively, at ICU discharge and at hospital discharge. Clinical and functional variables were collected, including the six-minute walk test (6MWT), sit-to-stand test (STS), Timed Up and Go (TUG), peripheral muscle strength, and the functional independence measure (FIM). Patients were divided into two groups: those with and those without AKI.</p><p><strong>Results: </strong>Fifteen patients (25%) developed AKI. There was no significant difference in ICU length of stay between groups; however, hospital stay was longer in the AKI group (14 ± 5 vs. 9 ± 3 days), and mortality was higher. Patients with AKI showed a 33.53% reduction in the 6MWT distance at ICU discharge, with partial recovery by the time of hospital discharge. In the STS test, patients without AKI performed better at hospital discharge. In the TUG test, AKI patients showed better performance at discharge compared to those without AKI. FIM scores were lower in the AKI group, indicating reduced functional independence.</p><p><strong>Conclusion: </strong>Patients with AKI presented worse clinical outcomes and lower functional independence, although they demonstrated potential for functional recovery by the time of hospital discharge, highlighting the importance of postoperative rehabilitation.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250241"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815609","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":"Assessment of allopurinol use in patients with chronic kidney disease and asymptomatic hyperuricemia: a retrospective cohort study.","authors":"Maria Elaine Latosinski Santos de Souza, Tiago Antônio Heringer, Ana Paula Helfer Schneider, Lia Gonçalves Possuelo, Andreia Rosane de Moura Valim","doi":"10.1590/2175-8239-JBN-2025-0243en","DOIUrl":"10.1590/2175-8239-JBN-2025-0243en","url":null,"abstract":"<p><strong>Introduction: </strong>Asymptomatic hyperuricemia (AH) is common in patients with chronic kidney disease (CKD) and has been identified as a modifiable condition. Addressing it could increase the possibilities for preventing and treating kidney injury.</p><p><strong>Objective: </strong>To assess whether administering allopurinol to people with chronic kidney disease and asymptomatic hyperuricemia enhances kidney function and delays progression to kidney failure.</p><p><strong>Methods: </strong>This is a retrospective cohort study with data collection from medical records at a specialized center from 2006 to 2020. Eighty people in stages 3 and 4 of CKD with AH were divided into two groups: 40 patients received allopurinol and 40 did not receive medication. Patients were followed for 24 months, with four consultations. Serum uric acid levels and creatinine-based estimated glomerular filtration rate (eGFRcr), estimated by the CKD-EPI formula, were compared within groups and between groups using mean, standard deviation, and analysis of variance (ANOVA).</p><p><strong>Results: </strong>Eighty patients were included in the study. Comparing 40 patients with no treatment for hypertension with 40 patients receiving hypouricemic therapy (HUT) with allopurinol, it was observed that mean serum uric acid decreased at all review visits in the allopurinol group, and there was a significant increase in mean eGFRcr after starting allopurinol (p < 0.001). None of the patients in the allopurinol group developed end-stage kidney disease (ESKD) within 24 months (p < 0.001). Similar results were not observed in the control group.</p><p><strong>Conclusion: </strong>Allopurinol was useful in reducing serum uric acid levels, improving kidney function, and delaying progression to kidney failure in patients with AH.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250243"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771932","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}