Journal of Asthma最新文献

{"title":"A comparison of the impact of anti-IL5/5r therapies in allergic versus non-allergic patients with severe eosinophilic asthma in a real-life setting.","authors":"Tatiana Navarro-Cascales, Monica Colque-Bayona, Inés Fernandez-Concha, Daniel Laorden, Santiago Quirce, Javier Domínguez-Ortega","doi":"10.1080/02770903.2024.2400607","DOIUrl":"10.1080/02770903.2024.2400607","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to compare the clinical characteristics and treatment outcomes of allergic patients (AP) and non-allergic patients (NAP) with severe eosinophilic asthma (SEA) treated with anti-IL5/IL5R biologic agents (mepolizumab, benralizumab, or reslizumab) over one year. Sub-analyses assessed treatment response variations between AP and NAP based on the biological used and compared outcomes among AP with and without fungal allergy.</p><p><strong>Methods: </strong>Observational retrospective analysis. Clinical characteristics, laboratory findings, pulmonary function tests, Asthma Control Test (ACT) scores, oral corticosteroid (OCS) usage, and exacerbation frequency were assessed at the initiation of biological treatment and after one year.</p><p><strong>Results: </strong>Sixty-five patients with SEA were included, 41 AP and 24 NAP. 55.4% were treated with mepolizumab, 33.8% with benralizumab, and 10.8% with reslizumab. Before anti-IL5/5R treatment, AP had worse baseline outcomes but there were no differences in pulmonary function. Mean annual exacerbation rate and percentage of patients requiring OCS and dose of prednisone were higher in AP than NAP. AP had significantly higher total IgE values. After one year of treatment, more AP discontinued OCS than NAP (<i>p</i> = 0.025). Both experienced a significant reduction in exacerbation frequency (<i>p</i> = 0.001) and improved respiratory function. 70.7% of AP and 60% of NAP improved ACT ≥3 points. There was no significant difference between AP and NAP using mepolizumab (<i>p</i> = 0.145) or benralizumab (<i>p</i> = 0.174) in reducing OCS.</p><p><strong>Conclusions: </strong>Anti-IL5/IL5R reduced the need for OCS and improved asthma control, regardless of allergic status. Fungal allergy led to lower ACT scores and higher exacerbations than other allergens; both groups improved with anti-IL5/ILR.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"319-327"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140170","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":"Patterns and trends in burden of asthma and its attributable risk factors from 1990 to 2021 among South Asian countries: a systematic analysis for the Global Burden of Disease Study 2021.","authors":"Akashanand, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, R Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Teena Vishwakarma, Sonam Puri, Puneet Tyagi, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Megha Jagga, Rachana Mehta, Sanjit Sah, Muhammed Shabil, Abhay M Gaidhane, Diptismita Jena","doi":"10.1080/02770903.2025.2453810","DOIUrl":"10.1080/02770903.2025.2453810","url":null,"abstract":"<p><strong>Objective: </strong>Asthma poses a significant health burden in South Asia, with increasing incidence and mortality despite a global decline in age-standardized prevalence rates. This study aims to analyze asthma trends from 1990 to 2021, focusing on prevalence, incidence, mortality, and disability-adjusted life years (DALYs) across South Asia. The study also assesses the impact of risk factors like high body mass index (BMI), smoking, and occupational exposures on asthma outcomes.</p><p><strong>Method: </strong>We extracted asthma data from the Global Burden of Disease database for South Asia (1990-2021). Joinpoint regression analysis was used to assess temporal trends in asthma burden. Total Percentage change (TPC) in age-standardized rates of incidence, mortality, and DALYs were calculated. Data were stratified by gender, and the contribution of risk factors was evaluated.</p><p><strong>Results: </strong>Asthma-related mortality in South Asia decreased by 37%, from 27.78 per 100,000 (1990) to 17.54 per 100,000 (2021). The Maldives showed the most significant reduction in mortality (78.31%), while Bangladesh recorded a 47.44% reduction in prevalence and a 62.64% decrease in DALYs. High BMI, smoking, and environmental risks contributed significantly to DALYs, with environmental factors playing a major role in countries like Afghanistan (20.73%) and Bhutan (18.58%). Females, particularly those over 20, experienced higher asthma-related DALYs than males.</p><p><strong>Conclusion: </strong>Asthma burden in South Asia has reduced over the past three decades, yet the absolute number of cases continues to rise, driven by population growth and environmental risk factors. Targeted interventions addressing risk factors and healthcare disparities are essential for further reducing asthma burden.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005748","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 the mechanisms and relationship between body mass index and asthma: findings from Mendelian randomization.","authors":"Yanjiang Yang, Xiaorui Wang, Wenwen Yang","doi":"10.1080/02770903.2024.2400279","DOIUrl":"10.1080/02770903.2024.2400279","url":null,"abstract":"<p><strong>Background: </strong>The mechanism linking BMI and asthma remains unclear.</p><p><strong>Method: </strong>Mendelian Randomization (MR) analysis was conducted using summary-level GWAS data from the FinnGen Biobank and the Open GWAS project. The analysis considering potential variables as mediators, including blood cell counts, blood pressure, and blood biomarkers. Three commonly used MR methods-the inverse-variance-weighted (IVW) method, weighted median (WM) method, and MR-Egger method-were employed to infer causal links. A two-step approach was used in mediation analysis to evaluate the causal links among BMI, candidate mediators, and asthma.</p><p><strong>Result: </strong>Elevated BMI demonstrated a substantial correlation with increased asthma risk. Thirteen biomarkers mediated the relationship between BMI and asthma, mainly including leukocyte count (5.070%), apolipoprotein A levels (7.395%), cystatin C levels (5.345%), urate levels (9.057%), diastolic blood pressure (7.365%), and albumin levels (10.888%). These factors collectively explained over 50% of the increased asthma risk associated with BMI elevation. Additionally, eosinophil count and C-reactive protein were also identified as important mediators using the WM method.</p><p><strong>Conclusion: </strong>This study highlights the complex relationship between obesity, blood biomarkers, and asthma risk. Additional studies are required to validate these results and investigate causal relationships in various populations.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"248-260"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119872","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":"Adult patients with an exacerbation of asthma and a higher risk for pulmonary embolism: a cluster analysis.","authors":"Javad Sadeghi, Neda Esfandiari, Babak Mohammadi","doi":"10.1080/02770903.2025.2458509","DOIUrl":"10.1080/02770903.2025.2458509","url":null,"abstract":"<p><strong>Objective: </strong>Current literature acknowledges the complexity of exacerbation triggers in patients with asthma. We studied the clinical heterogeneity of patients with asthma exacerbation suspected of having pulmonary embolism using cluster analysis and compared the clusters regarding of the risks for pulmonary embolism.</p><p><strong>Methods: </strong>In a secondary analysis of a dataset from the University of Florida, USA, individuals who experienced asthma exacerbation between June 2011 and October 2018 were included. All patients had undergone pulmonary CT angiography. Overall, 18 variables consisting of demographic, clinical, comorbidity, and therapeutic characteristics were used to cluster patients. The clusters were then profiled and compared in the percentages of pulmonary embolism.</p><p><strong>Results: </strong>In total, 758 patients (226; 29.8% men) with an exacerbation of asthma were included in the analysis. The frequency of a confirmed pulmonary embolism was 145 (19.1%). Two distinct clusters were identified with a statistically significant difference in pulmonary embolism [<i>p</i> < 0.001, odds ratio (95%CI)=2.24 (1.55, 3.24)]. We developed a high-performance classifier to profile the low- and high-risk clusters (area under the curve = 0.923, positive likelihood ratio = 20.2). The three top important variables discriminating the two clusters were age, heart rate, and body mass index. Older age, lower heart rate, higher body mass index, black race, and positive medical history (including atrial fibrillation) were more frequent in the high-risk group. Despite the higher percentage of women in the high-risk group, the sex ratios were not significantly different between the clusters.</p><p><strong>Conclusion: </strong>There are two clusters in patients with an exacerbation of asthma with different prognoses percentages of pulmonary embolism. The clusters can be well identified based on patient characteristics.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032978","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":"Letter to the editor regarding \"assessing ChatGPT's accuracy and reliability in asthma general knowledge\".","authors":"Simon Høj, Howraman Meteran","doi":"10.1080/02770903.2025.2458525","DOIUrl":"10.1080/02770903.2025.2458525","url":null,"abstract":"","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-2"},"PeriodicalIF":1.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028845","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 assessment of exhaled nitric oxide in patients with obesity and asthma before and after exercise.","authors":"Burcu Parlak, Zeynep Ülker Tamay Altinel, Nermin Güler","doi":"10.1080/02770903.2025.2453507","DOIUrl":"10.1080/02770903.2025.2453507","url":null,"abstract":"<p><strong>Objective: </strong>It is well-known that children who suffer from obesity and asthma may also have exercise-induced bronchospasm. Exhaled nitric oxide is an indicator of airway inflammation, and could be affected by exercise. This study looked at how exercise, which is a typical cause of acute airway obstruction, affects the levels of FeNO and spirometric parameters in obese and asthmatic children.</p><p><strong>Materials and methods: </strong>Seventy children between the ages of 6 and 18 were divided into four groups: healthy children, obese children with asthma, obese children without asthma, and normal-weight asthmatic children. FeNO and spirometric parameters were assessed before and after exercise. Their heart rate was raised to 160-170 beats per minute by walking on a flat surface.</p><p><strong>Results: </strong>The highest mean FeNO was seen in the asthmatic-obese group, while the lowest mean FeNO was found in the healthy group. MEF25-75 increased with exercise in the obese non-asthmatic group. FEV1/FVC was the lowest in the asthmatic-obese group.</p><p><strong>Conclusions: </strong>FeNO and FEV1/FVC have a strong association with asthma. The highest values of FeNO found in asthma-obesity combined. It was seen that obesity increased inflammation but exercise did not affect FeNO values. FeNO and FEV1 values were found to be higher in obese patients with and without asthma than normal weight and overweight asthmatics and non-asthmatics.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970854","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":"Regional challenges to optimize the management of patients with severe asthma type 2 inflammation: a Delphi consensus in seven countries.","authors":"Liam G Heaney, Desiree Larenas-Linnemann, Riyad Al-Lehebi, Rodrigo Athanazio, Paulina Barria, Abraham Ali Munive, Daniel Colodenco, Anahi Yañez, Libardo Jimenez, Marcia M Pizzichini, Deepak Talwar, Emilio Pizzichini, Gur Levy, Maria E Laucho-Contreras","doi":"10.1080/02770903.2024.2449233","DOIUrl":"https://doi.org/10.1080/02770903.2024.2449233","url":null,"abstract":"<p><p><b>Objective:</b>Severe asthma burdens patients and presents clinical management challenges for healthcare professionals. Biologics are crucial interventions for severe type two (T2) patients with high eosinophil counts. We conducted a Delphi consensus in seven developing or typically underrepresented countries to understand expert agreement on managing severe asthma with type two (T2) inflammation.</p><p><p><b>Methods:</b>The study comprised two online survey rounds and a participant meeting, involving 21 and 20 respiratory experts in the first and second survey, respectively. We developed a 70-statement questionnaire after literature review. Responses were recorded on a Likert scale (0-9) with 75% consensus threshold.</p><p><p><b>Results:</b>Consensus was reached on 37/60 closed-ended questions, including subtypes, in survey-1 and 20/47 closed-ended questions in survey-2. 95% of participants agreed on biomarker use for biologic treatment selection. 100% agreed timely biologic treatment leads to improvement in patients with severe asthma and an eosinophilic phenotype. 90% agreed to avoid maintenance oral corticosteroids (OCS) and start biologic therapy directly. Experts defined clinical remission on treatment as no exacerbations, no OCS use, Asthma Control Questionnaire (ACQ)-5 score < 1.5, and lung function optimization (forced expiratory volume in one second [FEV₁] ≥ 80% of predicted or pre-bronchodilator FEV₁ increase ≥ 100 mL from baseline). In survey-1, 81% agreed these outcomes are achievable in practice. All referral statements achieved consensus.</p><p><p><b>Conclusions:</b>This Delphi study focused on understanding patients with severe asthma and T2 inflammation in developing/underrepresented countries. Appropriately utilizing biomarkers, timely treatment interventions for best outcomes, expert consensus on clinical remission, and referral are crucial for improving patient management.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-16"},"PeriodicalIF":1.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032979","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":"Machine learning models for preventative mobile health asthma control.","authors":"Alan Wong","doi":"10.1080/02770903.2025.2453812","DOIUrl":"10.1080/02770903.2025.2453812","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma attacks are set off by triggers such as pollutants from the environment, respiratory viruses, physical activity and allergens. The aim of this research is to create a machine learning model using data from mobile health technology to predict and appropriately warn a patient to avoid such triggers.</p><p><strong>Methods: </strong>Lightweight machine learning models, XGBoost, Random Forest, and LightGBM were trained and tested on cleaned asthma data with a 70-30 train-test split. The models were measured on Precision Score, Accuracy Score, Recall Score, F1 Score and model speed.</p><p><strong>Results: </strong>The best model, XGBoost, obtained an Accuracy score of 0.902, Recall score of 0.904, Precision score of 0.835, and F1 score of 0.860 and a model training speed of 14 s.</p><p><strong>Conclusion: </strong>As proved by the XGBoost model, predicting asthma triggers can be a viable option for asthma control using machine learning. In addition, the actionable information of triggers, allows patients to make behavior changes. However there will still need to be work testing the system in a mobile health system.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005544","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":"Real-world mepolizumab treatment in patients with severe asthma decreased exacerbations, oral corticosteroid use, and healthcare resource utilization and costs over 4 years: a retrospective analysis.","authors":"Wendy C Moore, Alexandra Stach-Klysh, Thomas Corbridge, Elizabeth Packnett, Donna McMorrow, Megan Richards, Arijita Deb","doi":"10.1080/02770903.2025.2450640","DOIUrl":"10.1080/02770903.2025.2450640","url":null,"abstract":"<p><strong>Objective: </strong>Although the efficacy of mepolizumab in reducing exacerbations and oral corticosteroid (OCS) use in severe asthma is well-established, real-world long-term effectiveness data are limited. This study evaluated the real-world impact of mepolizumab treatment in patients with severe asthma over a 4-year follow-up period.</p><p><strong>Methods: </strong>This was a retrospective cohort study of patients with asthma initiating mepolizumab (index date: first claim, November 2015-September 2019) using the Merative MarketScan Commercial and Medicare Databases. Outcomes included asthma exacerbations, OCS use, and exacerbation-related healthcare resource utilization (HCRU) and costs, assessed 12-months pre-index (baseline) and annually during the 4-year follow-up period.</p><p><strong>Results: </strong>Among 189 eligible patients, mean asthma exacerbation rate (AER) declined progressively from baseline during follow-up: AER decreased by 53.8% at Year 1 and 73.8% by Year 4 (<i>p</i> < 0.001). The annual OCS prescription rate reduced from baseline by 41.1% at Year 1 and 62.2% at Year 4 (<i>p</i> < 0.001). The proportion of patients with both no exacerbations and no OCS use progressively increased from 6.4% at baseline to 18.5% at Year 1 and 41.8% at Year 4. Exacerbation-related HCRU including inpatient, emergency room, and outpatient office visits decreased from baseline (9.0%, 21.7%, and 78.8%, respectively), at Year 1 (3.2%, 12.2%, and 49.2%), and Year 4 (0.0%, 4.8%, and 31.8%). Exacerbation-related healthcare costs declined from $4,635 at baseline to $1,487 at Year 1 and $217 at Year 4 (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Patients treated with mepolizumab demonstrated progressive and sustained long-term, real-world reductions in exacerbation frequency, OCS dependency, and exacerbation-related HCRU and costs over 4 years.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-13"},"PeriodicalIF":1.7,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949321","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":"Analysis of the economically justifiable price of mepolizumab in adults with asthma in Colombia.","authors":"Jefferson Antonio Buendia, Diana Guerrero-Patino, Juan Antonio Buendia Sanchez","doi":"10.1080/02770903.2024.2448736","DOIUrl":"https://doi.org/10.1080/02770903.2024.2448736","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma imposes a critical economic burden on health systems, especially with the incorporation of new drugs. Recently, mepolizumab has been approved to prevent exacerbations in patients with eosinophilic asthma, however their high cost constitutes a barrier for their use, especially in middle- and low-income countries. This study aimed to estimate the economically justifiable price of mepolizumab for preventing exacerbations in patients with severe asthma in Colombia.</p><p><strong>Materials and methods: </strong>A model was developed using the microsimulation to estimate the quality-adjusted costs and life years of two interventions: mepolizumab versus not applying standard treatment without mepolizumab. This analysis was made during a lifetime horizon and from a third-payer perspective. We analyzed the economically justifiable price using two recent willingness to pay (WTP) estimates in Colombia ($4,828 and $5,128) and $19,992, equivalent to up to three times the GDP per capita, as previously used in conjunction with the two estimates mentioned above.</p><p><strong>Results: </strong>At current costs of US$781 per dose of 100 mg of mepolizumab, this drug is not cost-effective using a WTP of U$4828, U$ 5128, and U$19 992 per QALY. Based on the thresholds of $4,828, $5,128, and $19,992 per QALY assessed in this study, the economically justifiable costs of mepolizumab were determined to be $147, $165, and $691 per dose, respectively.</p><p><strong>Conclusion: </strong>The economically justifiable cost for mepolizumab in Colombia is between $147 and $691 per dose, depending on the WTP used. This result should encourage more studies in the region that optimize decision-making processes when incorporating this drug into the health plans of each country.</p>","PeriodicalId":15076,"journal":{"name":"Journal of Asthma","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005233","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}