Journal of gynecology obstetrics and human reproduction最新文献

{"title":"Excessive gestational weight gain associated with higher risk of cesarean delivery across body mass index categories in the United States","authors":"Pearl A. Mcelfish ,&nbsp;Nicola L. Hawley ,&nbsp;Aaron R. Caldwell ,&nbsp;James P. Selig ,&nbsp;Donya Watson ,&nbsp;Enrique Gomez-Pomar ,&nbsp;Jennifer A. Andersen ,&nbsp;Shashank Kraleti ,&nbsp;Lanita White ,&nbsp;Don E. Willis ,&nbsp;Krista Langston ,&nbsp;Nirvana Manning ,&nbsp;Jennifer A. Callaghan-Koru ,&nbsp;Austin Porter ,&nbsp;Clare C. Brown","doi":"10.1016/j.jogoh.2025.103010","DOIUrl":"10.1016/j.jogoh.2025.103010","url":null,"abstract":"<div><h3>Objectives</h3><div>This research investigated associations between rate of gestational weight gain (GWG; “below recommended rate,” “within recommended rate,” and “exceeding recommended rate”) and increased risk of cesarean delivery for women across a range of body mass index (BMI) categories (underweight, normal, overweight, obesity classes I, II, and III).</div></div><div><h3>Study Design</h3><div>We used vital records data from the National Center for Health Statistics to include nulliparous, singleton term births with cephalic presentation (n=7,891,653) to women who gave birth in the United States from 2014 through 2022. We evaluated the association of GWG on mode of birth (cesarean vs. vaginal delivery) using multivariable linear probability (categorical GWG) and generalized additive (continuous GWG) models.</div></div><div><h3>Results</h3><div>Approximately 26% of births were by cesarean delivery and 65% exceeded the recommended rate of GWG. Risk of cesarean delivery increased as BMI increased, and those in pre-pregnancy BMI above normal categories had higher risk of cesarean delivery. Excessive GWG (EGWG) increased the risk of cesarean delivery for all women, but the effect was more pronounced in those with a higher pre-pregnancy BMI. Among women whose BMI was underweight or normal, GWG had a J-shaped relationship with cesarean delivery risk, while women whose pre-pregnancy BMI was categorized as overweight or obese demonstrated a relatively linear increase in risk with any GWG.</div></div><div><h3>Conclusions</h3><div>Findings provide valuable insights on EGWG and increased risk of cesarean delivery for women across BMI categories. Additional efforts are needed at both the patient and provider level to reduce EGWG and the risk of cesarean delivery.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103010"},"PeriodicalIF":1.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835308","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":"Profile of pregnant women complying or not with physical activity recommendations during the second trimester of pregnancy: A French pilot study","authors":"M. Gerard ,&nbsp;R. Beranger ,&nbsp;B. Pereira ,&nbsp;N. Boisseau","doi":"10.1016/j.jogoh.2025.103007","DOIUrl":"10.1016/j.jogoh.2025.103007","url":null,"abstract":"<div><h3>Introduction</h3><div>Insufficient physical activity (PA) during pregnancy is a global public health concern. The aims of this study were: i) to determine retrospectively PA and sedentary time in women in the second trimester of pregnancy, and ii) to identify factors that influence adherence to the French National College of Midwives guidelines on PA (≥150 minutes of moderate to high-intensity PA per week).</div></div><div><h3>Methods</h3><div>This cross-sectional, single-centre study, conducted at the University Hospital of Rennes, included 195 pregnant women. PA levels and sedentary time before and during the second trimester of pregnancy were determined using an anonymous self-report questionnaire. The self-reported PA levels were compared to the guidelines on PA. Bivariate analyses and Poisson generalized linear regression models were used to identify factors associated with non-compliance to such guidelines.</div></div><div><h3>Results</h3><div>Only 30.7 % of pregnant women reported the recommended PA levels in the second trimester of pregnancy. Sedentary time and adherence to the PA guidelines were not associated. Fatigue was the most frequently cited reason for insufficient PA (71.6 %). Preconception PA level was the strongest predictor of adherence. Body mass index &gt;25 kg/m², &lt;2 years of higher education, limited access to transportation and sports facilities, and living in a town with &lt;2.000 inhabitants also were associated with lower PA levels.</div></div><div><h3>Conclusion</h3><div>Adherence to the PA recommendations is low among French pregnant women. Public health initiatives should emphasize PA importance before pregnancy and provide tailored support throughout gestation. Future studies should explore the interplay between PA, sedentary time and pregnancy outcomes.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103007"},"PeriodicalIF":1.6,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821525","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":"Factors affecting the MicroRNA expression pattern in the chorioamniotic membrane: From the perspective of preterm labor.","authors":"Yu Yang, Shuhua Yi, Yaxin Zhang, Jun He, Tingting Chen, Hongyu Li","doi":"10.1016/j.jogoh.2025.103009","DOIUrl":"10.1016/j.jogoh.2025.103009","url":null,"abstract":"<p><p>Preterm labor is a major contributor to neonatal mortality and morbidity worldwide. Despite extensive research, the molecular mechanisms driving preterm labor are not fully understood. Epigenetic modifications may play a role in the underlying mechanisms leading to adverse pregnancy outcomes, particularly preterm labor. Emerging evidence highlights the role of microRNAs (miRNAs), small non-coding RNAs that regulate gene expression post-transcriptionally, in the pathogenesis of preterm labor. This review focuses on the chorioamniotic membrane, a critical structure for fetal protection and development, and its involvement in miRNA-mediated pathways that contribute to preterm labor. The chorioamniotic membrane, composed of the amnion and chorion, plays a vital role in maintaining pregnancy through extracellular matrix (ECM) remodeling, immune regulation, and inflammatory responses. Dysregulation of miRNAs in this membrane, influenced by environmental stressors (e.g., oxidative stress, pollutants), maternal factors (e.g., age, obesity, diabetes), and fetal factors (e.g., sex, genetic disorders), disrupts these processes, leading to membrane weakening and preterm labor. Inflammation, particularly through Toll-like receptor (TLR) signaling and cytokine production, is a key driver of miRNA dysregulation in conditions like chorioamnionitis and preterm premature rupture of membranes (PPROM). This review summarizes the dysregulated expression of miRNAs in chorioamniotic membranes which are likely to play a role in premature birth.</p>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":" ","pages":"103009"},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812099","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":"Engaging education: Boosting HPV vaccination through a serious game","authors":"Pauline Ferreira ,&nbsp;Julie Duclaud ,&nbsp;Romane Tarrusson ,&nbsp;Emmanuel Chirpaz ,&nbsp;Antoine Bertolotti ,&nbsp;Vincent Balaya ,&nbsp;Phuong Lien Tran","doi":"10.1016/j.jogoh.2025.103005","DOIUrl":"10.1016/j.jogoh.2025.103005","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103005"},"PeriodicalIF":1.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799325","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":"Uterine transplantation and bioethical tensions in the post-2021 French Bioethic law: Reflections on a singular case","authors":"Vincent Morel ,&nbsp;Isis Carton ,&nbsp;Ludivine Dion ,&nbsp;Vincent Lavoué","doi":"10.1016/j.jogoh.2025.103004","DOIUrl":"10.1016/j.jogoh.2025.103004","url":null,"abstract":"","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 103004"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799326","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":"Efficacy of non-pharmacological therapies in chronic pelvic pain of endometriosis: a systematic review and meta-analysis","authors":"Hegila da Silva Dantas ,&nbsp;Maiara Costa de Oliveira ,&nbsp;Tatiana CLA da Silva ,&nbsp;Joyce MP de Oliveira ,&nbsp;Maria LAS de Carvalho ,&nbsp;Maria TABC Micussi","doi":"10.1016/j.jogoh.2025.103006","DOIUrl":"10.1016/j.jogoh.2025.103006","url":null,"abstract":"<div><h3>Introduction</h3><div>Endometriosis is a condition that manifests through chronic pelvic pain and infertility. Current therapeutic options do not provide complete relief and may result in undesirable side effects.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy of non-pharmacological therapies in relieving chronic pelvic pain compared to placebo therapies in women with endometriosis.</div></div><div><h3>Methods</h3><div>Developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in Prospero (CRD42023455704). The searches were conducted in the Web of Science, PubMed, Scielo, Embase, and Pedro databases. We included clinical trials that employed non-pharmacological therapies and evaluated chronic pelvic pain as the primary outcome. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of the evidence.</div></div><div><h3>Results</h3><div>Nine studies were included. All studies addressed pain. The intervention group showed greater efficacy in reducing pain compared to the control group, except in one study. Five studies presented a high risk of bias, while four showed a low risk of bias. The meta-analysis for the pain outcome was conducted with five articles. The intervention was superior to the control, effectively reducing pain, with a mean difference of –1.40; 95 % CI –1.71, –1.09.</div></div><div><h3>Conclusion</h3><div>The studies showed improvements in pain relief and quality of through non-pharmacological therapies. However, evidence confidence was very low. This highlights the need for more rigorous studies to confirm the efficacy of non-pharmacological interventions in reducing pain in endometriosis.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 9","pages":"Article 103006"},"PeriodicalIF":1.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799324","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":"Fertility preservation for transgender, non-binary, and gender-expansive individuals in France: A comprehensive assessment of healthcare services and practices","authors":"Maxime Chaillot ,&nbsp;Sophie Brouillet ,&nbsp;Noémie Ranisavljevic ,&nbsp;Bérengère Ducrocq ,&nbsp;Anne Mayeur ,&nbsp;Brigitte Keriven-Dessomme ,&nbsp;Thomas Freour ,&nbsp;Sylvie Morel ,&nbsp;Arnaud Reignier","doi":"10.1016/j.jogoh.2025.103002","DOIUrl":"10.1016/j.jogoh.2025.103002","url":null,"abstract":"<div><h3>Introduction</h3><div>Fertility preservation (FP) consultations are recommended before treatments that may affect fertility, including gender-affirming hormone therapy (GAHT). While some FP centers in France assist individuals undergoing gender transition, many transgender, non-binary, and gender-expansive individuals still choose not to pursue gamete cryopreservation. This study provides an overview of access to FP for transgender individuals in France in 2021.</div></div><div><h3>Materials and methods</h3><div>This descriptive observational study includes 47 French centers authorized to conduct FP activities. A total of 85.1 % (40/47) of these centers responded to an online questionnaire conducted between September 2022 and March 2023. The questionnaire addressed the activities of the centers in 2021, waiting times, methods of care for transgender, non-binary, and gender-expansive individuals, and training provided to healthcare professionals.</div></div><div><h3>Results and discussion</h3><div>In 2021, 29 centers reported performing FP cycles for transgender, non-binary, and gender-expansive individuals, with some showing specialized expertise. Significant differences were noted between oocyte and sperm cryopreservation. Waiting times for sperm freezing were acceptable, but oocyte freezing faced longer delays. Some centers provided professional training and communication activities to promote services. The findings highlight the need for improved regional coverage, shorter waiting times, and better communication to ensure equitable access to fertility care for all.</div></div><div><h3>Conclusion</h3><div>This study reveals disparities in access to and quality of FP services for transgender, non-binary, and gender-expansive individuals in France. Further evaluations are needed to understand the disparities between centers and, where possible, include all centers offering FP services in France.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 103002"},"PeriodicalIF":1.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731699","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":"What are the risk factors for severe neonatal acidosis in labor at term? A single-center retrospective case-control study","authors":"A. Sauvage ,&nbsp;L. Descourvieres ,&nbsp;N. Ramdane ,&nbsp;D. Subtil ,&nbsp;L. Ghesquiere ,&nbsp;C. Garabedian","doi":"10.1016/j.jogoh.2025.103001","DOIUrl":"10.1016/j.jogoh.2025.103001","url":null,"abstract":"<div><h3>Objective</h3><div>The aim was to determine the risk factors associated with severe acidosis during labor in newborns at term.</div></div><div><h3>Methods</h3><div>This was a retrospective monocentric case-control study, from January 2018 to December 2020. Cases included were all births with pH &lt;7.0 at birth, single pregnancy, &gt;37 weeks, without severe fetal malformation, and with an attempted vaginal delivery. For each included case, two controls were selected. These were the two deliveries immediately preceding the case, with pH &gt;7.0 and no exclusion criteria. The two groups were compared as pairs, followed by a multivariate analysis of factors associated with the occurrence of severe acidosis.</div></div><div><h3>Results</h3><div>Eighty-seven cases of severe acidosis were compared with 174 controls. After multivariate analysis, factors associated with the occurrence of acidosis were induction (odds ratio (OR) 2.41, confidence interval (CI) 95 %, 1.10–5.26), meconium fluid during labor (OR 4.38, CI 95 %, 1.14–16.78), the presence of uterine hyperstimulation (OR 3.15, CI 95 %, 1.45–6.83), and the occurrence of a sentinel event (shoulder dystocia, cord prolaps, uterine rupture) with OR 11.74, CI 95 %, 2.93–46.97. Conversely, increasing gestational age at delivery in weeks was found to be a protective factor (OR 0.33, CI 95 %, 0.24–0.46).</div></div><div><h3>Conclusion</h3><div>Several factors have been identified as being associated with the occurrence of acidosis. Their presence should alert the on-call team. The main factor, however, was the occurrence of a sentinel event, which is difficult to predict.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 103001"},"PeriodicalIF":1.6,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722095","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":"Factors associated with intrauterine procedure for suspected retained placenta after medical termination of pregnancy in the 2nd and 3rd trimesters","authors":"Annaëlle Amous ,&nbsp;Célia Bettiol ,&nbsp;Louise Paret Perinelli ,&nbsp;Yann Tanguy Le Gac ,&nbsp;Paul Guerby ,&nbsp;Aurélie Buffeteau","doi":"10.1016/j.jogoh.2025.103000","DOIUrl":"10.1016/j.jogoh.2025.103000","url":null,"abstract":"<div><h3>Introduction</h3><div>In cases of medical termination of pregnancy (MTOP) in the second and third trimesters, incomplete placental expulsion is a common complication, often leading to intrauterine procedure. Factors associated with intrauterine procedure for suspected retained placenta after labor induction for MTOP remain poorly described. Moreover, these procedures may lead to various complications (uterine perforation, infections, secondary bleeding, intrauterine adhesions, fertility disorders). This study aims to identify these factors to support a more evidence-based use of intrauterine procedures.</div></div><div><h3>Materials and Methods</h3><div>A retrospective single-center study was conducted at Toulouse University Hospital, between January 1, 2019, and December 31, 2021. All patients who underwent labor induction for MTOP between 14 and 41 weeks of gestation were included. Maternal, obstetric, and fetal characteristics were collected and analyzed.</div></div><div><h3>Results</h3><div>A total of 371 patients were included. Gestational age was the only factor significantly associated with the performance of intrauterine procedures for suspected retained placenta (continuous variable (aOR 0.84 [0.80–0.88], <em>p</em> &lt; 0.0001) and categorical variable divided into &lt;22 weeks and ≥22 weeks of gestation (OR 0.15 [0.10–0.24], <em>p</em> &lt; 0.001)).</div></div><div><h3>Discussion</h3><div>Identifying factors associated with intrauterine procedures after MTOP in the 2nd and 3rd trimesters could lead to modified management strategies, based on gestational age, which is associated in this study, with a lower likelihood of performing intrauterine procedures beyond 22 weeks.</div></div><div><h3>Conclusion</h3><div>Gestational age was associated with the performance of intrauterine procedures for suspected retained placenta after MTOP, with a lower likelihood beyond 22 weeks of gestation.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 103000"},"PeriodicalIF":1.6,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718010","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":"Baby-friendly Hospital Initiative: descriptive analysis of regional implementation, maternity units and women characteristics. The 2021 French National Perinatal Survey","authors":"Madeleine Santraine ,&nbsp;Anne Alice Chantry ,&nbsp;Camille Le Ray ,&nbsp;Caroline François ,&nbsp;Julie Boudet-Berquier ,&nbsp;Véronique Pierrat ,&nbsp;Ayoub Mitha","doi":"10.1016/j.jogoh.2025.102999","DOIUrl":"10.1016/j.jogoh.2025.102999","url":null,"abstract":"<div><div>Background: Initially created to promote breastfeeding, the Baby-Friendly Hospital Initiative (BFHI) has evolved into a broader quality-of-care approach, centered on the needs of newborns and their families. In France, BFHI adoption increased from 2 % to 17 % of maternity units between 2010 and 2024. However, it remains unclear whether structural or population characteristics influence implementation. Objective: To describe the characteristics of maternity units, women and newborns in units BFHI-accredited or in-process of accreditation, compared to non-accredited. Methods: Data were extracted from the 2021 French National Perinatal Survey, including 10,446 women who gave birth to live infants between 36 and 42 weeks of gestation in 453 maternity units. Bivariate analyses compared three groups: BFHI-accredited, in-process, and non-accredited units. Results: Among maternity units, 12 % were BFHI-accredited and 9 % were in-process. Regional implementation varied widely (0–44 % for accredited and from 0–29 % for in-process). There were no significant differences regarding maternity units’ characteristics (size, level of care, administrative status, use of temporary staff). Women's profiles were similar in terms of age, education, employment, and low-risk pregnancy. Women with high social deprivation index were less represented in accredited and in-process units compared to non-accredited (4 % and 3 % vs. 5%), as well as foreign-born women (14 % and 15 % vs. 22%). Conclusion: In France in 2021, implementation of the BFHI program in France does not appear to be associated with structural, demographic or health characteristics of units and women. Further research should explore the motivations for adopting BFHI and its effects on perinatal care practices.</div></div>","PeriodicalId":15871,"journal":{"name":"Journal of gynecology obstetrics and human reproduction","volume":"54 8","pages":"Article 102999"},"PeriodicalIF":1.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690411","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}