Diabetes, Obesity & Metabolism最新文献

{"title":"Comments on 'Propensity score matching methodology in Riley et al.'s study on type 2 diabetes and obstructive sleep apnoea'.","authors":"Shao-Wei Lo, Albert Ko, James Lin, Yung-Fang Tu","doi":"10.1111/dom.16396","DOIUrl":"https://doi.org/10.1111/dom.16396","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease risk assessment: Findings from backward-looking study using annual health check-up data in Japan.","authors":"Chihaya Fukai, Shumpei Chiba, Takaaki Itoga, Gen Kobayashi, Kohei Kaku","doi":"10.1111/dom.16390","DOIUrl":"https://doi.org/10.1111/dom.16390","url":null,"abstract":"<p><strong>Aims/introduction: </strong>While studies on kidney disease (KD) in patients with severe metabolic syndrome (MetS) have been reported, research on undiagnosed MetS individuals is limited. This study aimed to investigate KD mechanisms in early MetS stages among Japanese individuals to establish accurate KD prediction models applicable to specific health guidance using annual health check-up (HC) data.</p><p><strong>Materials and methods: </strong>Cox regression analysis was conducted using the Kokuho Database including HC and claims data over the past 10 years. Survival time was defined as the period from the initial HC during the observation period until estimated glomerular filtration rate (eGFR) fell below the following cut-offs: 60 mL/min/1.73 m² chronic kindney disease (CKD) and 15 mL/min/1.73 m² (ESKD) for primary scenarios, 45 mL/min/1.73 m² (CKD Stage 3b) and 30 mL/min/1.73 m² (CKD Stage 4) for additional scenarios. Predictive factors included age, sex and serum creatinine, which are components of eGFR, and MetS factors as follows: body mass index (BMI), glycated haemoglobin A1c (HbA1c), triglycerides (TG) and systolic blood pressure (SBP).</p><p><strong>Results: </strong>Significant increases in hazard ratios (HRs) for BMI, HbA1c, TG and SBP were observed for primary and additional cut-offs. BMI, HbA1c and TG showed progressively stronger HR increases with advancing stages. The model for all scenarios demonstrated goodness of fit with the high C-statistics.</p><p><strong>Conclusions: </strong>This study highlights the necessity of a comprehensive evaluation of MetS factors in CKD risk assessment and shows the model using annual HC data can identify CKD progression effectively and accurately. A risk assessment approach considering multiple CKD stages will be crucial for early intervention and disease prevention strategies.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duration of type 1 diabetes and glycaemic control in adults: A nonlinear relationship.","authors":"Tomás González-Vidal, Diego Rivas-Otero, Guillermo Ramos-Ruiz, Pablo Agüeria-Cabal, Carmen Lambert, Jessica Ares, Elías Delgado, Edelmiro Menéndez-Torre","doi":"10.1111/dom.16392","DOIUrl":"https://doi.org/10.1111/dom.16392","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of isocaloric early time-restricted eating on glucose metabolism in adults: A randomized controlled crossover trial.","authors":"Minfang Weng, Sisi Deng, Wei Xie, Yuqi Ma, Yeran Jia","doi":"10.1111/dom.16399","DOIUrl":"https://doi.org/10.1111/dom.16399","url":null,"abstract":"","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and postpartum cardiometabolic outcomes among women with overt diabetes compared to women with normoglycaemia, gestational diabetes and pre-existing diabetes: A systematic review and meta-analysis.","authors":"Adarsh Pal, Dimple Rawat, Sankeerth Sadananda, Alpesh Goyal, Partha Haldar, Deepali Garg, Yashdeep Gupta, Nikhil Tandon","doi":"10.1111/dom.16400","DOIUrl":"https://doi.org/10.1111/dom.16400","url":null,"abstract":"<p><strong>Background and aim: </strong>Overt diabetes in pregnancy (ODiP) is a condition identified by the International Association of Diabetes and Pregnancy Study Groups (IADPSG) in 2010. Despite the clinical significance, our knowledge regarding its impact during pregnancy and the postpartum period is limited due to small sample sizes in previous studies. This systematic review and meta-analysis (SRM) aimed to consolidate evidence on outcomes in the pregnancy and postpartum period among women with ODiP in comparison to women with gestational diabetes mellitus (GDM), pre-existing diabetes (PED) and normoglycaemia.</p><p><strong>Material and methods: </strong>A comprehensive search was conducted across PubMed, Embase and Scopus for relevant studies published from January 1, 2010, to May 31, 2024. Eleven studies, including data from 16 135 pregnancies, were analysed.</p><p><strong>Results: </strong>Women with ODiP had a significantly higher risk of gestational hypertension (RR 1.93; 95% CI 1.45, 2.58), pre-eclampsia (RR 1.65; 95% CI 1.26, 2.16) and caesarean delivery (RR 1.14; 95% CI 1.01, 1.29) compared with GDM. Adverse neonatal outcomes such as large for gestational age (RR 1.45; 95% CI 1.13, 1.85), macrosomia (RR 1.66; 95% CI 1.05, 2.64), neonatal hypoglycaemia (RR 1.52; 95% CI 1.06, 2.19) and stillbirth (RR 4.30; 95% CI 1.69, 10.98) were also significantly higher than GDM. The risk of postpartum diabetes was 6 times higher than in women with GDM and 25 times higher than in women with normoglycaemia. Variations in diagnostic criteria and postpartum follow-up duration contributed to heterogeneity.</p><p><strong>Conclusion: </strong>This SRM demonstrates that ODiP is associated with significantly worse pregnancy and postpartum outcomes compared with GDM and normoglycaemia in pregnancy. These findings underscore the need for targeted clinical strategies to manage ODiP and mitigate adverse maternal and neonatal outcomes.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and tolerability of currently approved incretin mimetics: A systematic analysis of placebo-controlled clinical trials.","authors":"Yu Mi Kang, Viktoria Punov, Soo Lim, Michael A Nauck","doi":"10.1111/dom.16398","DOIUrl":"https://doi.org/10.1111/dom.16398","url":null,"abstract":"<p><strong>Aims: </strong>This study compares the therapeutic efficacy, gastrointestinal (GI) adverse event (AE) rates and the relationship between the therapeutic efficacy and GI AEs in randomized, placebo-controlled clinical trials (RCTs) of GLP-1 RAs and the dual GLP-1/GIP agonist tirzepatide.</p><p><strong>Materials and methods: </strong>A systematic PubMed search identified 38 phase 3 or 4 placebo-controlled RCTs of exenatide (b.i.d. and q.w.), lixisenatide, liraglutide, dulaglutide, albiglutide, semaglutide (s.c. and oral) and tirzepatide with a total of 16 660 individuals with type 2 diabetes (T2D) across 104 study arms. Changes in HbA1c, fasting plasma glucose and body weight and the proportion of GI AEs (nausea, vomiting or diarrhoea) were calculated by agent, preparation and dose. The correlation between odds ratios (ORs) for GI AEs and the magnitude of therapeutic efficacy was assessed in a linear regression analysis.</p><p><strong>Results: </strong>Baseline characteristics were similar across studies: mean age 57 ± 10 years, diabetes duration 8 ± 6 years, body mass index (BMI) 31.9 ± 5.8 kg/m² and HbA1c 8.2% ± 0.9%. HbA1c reductions ranged from -0.63% ± 0.03% (lixisenatide, 20 μg q.d.) to -1.79% ± 0.09% (tirzepatide, 15 mg q.w.; p < 0.0001). Weight reductions ranged from -0.75 ± 0.10 kg to -9.65 ± 0.56 kg. Despite the high variability in therapeutic efficacy, ORs for GI AEs were similar across compounds/preparations.</p><p><strong>Conclusions: </strong>The magnitude of efficacy for intended therapeutic actions (HbA1c and body weight reduction) varied widely between incretin mimetic glucose-lowering agents. However, larger therapeutic efficacy was not systematically associated with higher GI AE or drug discontinuation rates, indicating better tolerability of the more effective agents/preparations.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An open-label, multiple ascending dose trial of orally administered insulin Tregopil in patients with type 1 diabetes mellitus to evaluate its pharmacokinetics, pharmacodynamics, safety and tolerability","authors":"Esther Latres PhD,&nbsp;Leona Plum-Moerschel MD,&nbsp;Sundara Moorthi Nainar Murugesan MPharm,&nbsp;Olivia Lou PhD,&nbsp;Jayanti Panda PhD,&nbsp;Ashwani Marwah MSc,&nbsp;R. Samsonraj MSc,&nbsp;C. L. Gopu MPharm,&nbsp;Subramanian Loganathan MD,&nbsp;Sandeep Nilkanth Athalye MD","doi":"10.1111/dom.16327","DOIUrl":"https://doi.org/10.1111/dom.16327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This trial evaluated the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of oral insulin Tregopil (Part 1; results discussed in this paper) and the post-prandial glucose control with different meal types in comparison with insulin aspart (Part 2) in patients with type 1 diabetes mellitus (T1DM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This Phase 1, open-label, multiple ascending dose (30/45/60 mg/60 + 30 mg rescue insulin Tregopil) trial enrolled 37 patients with T1DM (3 female [8.1%], 34 male [91.9%]; median age: 39.5 years). Following screening, patients entered a run-in phase to optimize their basal-bolus (insulin glargine and insulin aspart) insulin therapy, and insulin Tregopil was administered orally 10 min before the three major meals of the day in all cohorts during this period. Safety assessments included adverse events and hypo−/hyperglycaemic episodes, vital signs, electrocardiograms, laboratory safety parameters and physical examination. PK and PD were the secondary objectives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall safety profile of insulin Tregopil indicated no safety concerns except a PD effect (hypoglycaemia). The incidence of hypoglycaemia did not increase with increasing doses of insulin Tregopil, and none of the episodes were severe. In general, the variability of the PK/PD parameters was high. Insulin Tregopil demonstrated a rapid onset of action, with peak blood concentrations reached within 15–20 min post-dosing. Subsequently, insulin Tregopil exerted a PD effect for up to 105 min.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fixed-dose insulin Tregopil reduced the requirement for insulin aspart supplementation, although it was not a viable stand-alone option for the daily management of T1DM. Insulin Tregopil could be explored with a flexible dosing approach and be titrated based on individual needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>The trial is registered at Clinicaltrials.gov (CT.gov identifier: NCT04141423). The ethical approval number for the protocol is 2019146.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 6","pages":"3154-3164"},"PeriodicalIF":5.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Goldilocks for chronic weight management-Balancing quantity with quality of weight loss.","authors":"Kim Henriksen, M V Chakravarthy, C L Bager, A T Larsen, K E Mohamed, M A Karsdal","doi":"10.1111/dom.16379","DOIUrl":"https://doi.org/10.1111/dom.16379","url":null,"abstract":"<p><p>Anti-obesity medications have reached new heights in terms of efficacy, with presently available pharmacological options almost reaching the efficacy of the surgical techniques, and thus these are starting to fill the treatment void. Because of the increased weight loss efficacy, benefits on a host of obesity complications are being reported, with prevention of diabetes, reduction of liver and cardiovascular complications and improvements in osteoarthritis among the prominent features. On the other hand, present anti-obesity strategies also lead to loss of lean and bone mass, and while the consequences hereof are only beginning to present, they are highly likely to be of importance in a target population that contains a large number of elderly and potentially frail individuals. Therefore, there is a need to address the issue of weight loss quality, both in the context of existing possibilities, but especially in the context of the myriad of novel anti-obesity medications on the horizon.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy and safety of pharmacologic therapies for metabolic dysfunction-associated steatotic liver disease over 24 weeks in reducing liver steatosis and fibrosis: A network meta-analysis","authors":"Jiaxin Zhong MS,&nbsp;Zixin Cai MD,&nbsp;Guanghui Zhu MD,&nbsp;Jingjing Zhang MD","doi":"10.1111/dom.16348","DOIUrl":"https://doi.org/10.1111/dom.16348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Metabolic-associated steatotic liver disease (MASLD) is a prevalent chronic liver condition associated with significant morbidity and mortality. Effective pharmacological interventions targeting liver steatosis and fibrosis are essential to improving patient outcomes. This study aims to systematically compare the efficacy and safety of various pharmacologic therapies for MASLD over 24 weeks using a comprehensive network meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A systematic review and network meta-analysis were conducted on randomized controlled trials (RCTs) evaluating pharmacologic treatments for MASLD. The primary outcomes were changes in liver steatosis (measured by magnetic resonance imaging proton density fat fraction) and fibrosis (measured by magnetic resonance elastography-derived liver stiffness measurement), with safety assessed through adverse events. A Bayesian framework was employed to integrate and compare data across treatments, generating rankings for efficacy and safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A systematic search was conducted across databases, identifying 23 RCTs from 10 144 initial records. For steatosis reduction, resmetirom showed the most significant improvement (mean difference: −3.86, 95% confidence interval [CI]: −7.33 to −0.39) compared with placebo. In terms of fibrosis improvement, pegozafermin demonstrated the greatest effect (−4.85, 95% CI: −5.50 to −4.19). Most treatments showed acceptable safety profiles, with efruxifermin showing slightly higher adverse events (0.32, 95% CI: 0.06–0.70) compared with placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This comprehensive network meta-analysis demonstrates the varying efficacy of pharmacologic interventions for MASLD, with resmetirom and pegozafermin emerging as particularly promising treatments for steatosis and fibrosis, respectively. While most treatments exhibited favourable safety profiles, careful monitoring is warranted, particularly with efruxifermin due to its slightly elevated adverse event profile. These findings provide valuable evidence to guide clinical decision-making in MASLD management, though longer-term studies are needed to confirm the durability of these therapeutic effects and further establish safety profiles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":"27 6","pages":"3309-3323"},"PeriodicalIF":5.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dom.16348","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-glucose cotransporter-2 inhibitors and subtype-specific dementia risk: A multinational and multiethnic cohort study.","authors":"Mingyang Sun, Xiaoling Wang, Zhongyuan Lu, Yitian Yang, Shuang Lv, Mengrong Miao, Wan-Ming Chen, Szu-Yuan Wu, Jiaqiang Zhang","doi":"10.1111/dom.16403","DOIUrl":"https://doi.org/10.1111/dom.16403","url":null,"abstract":"<p><strong>Aims: </strong>Type 2 diabetes mellitus (T2DM) significantly increases the risk of dementia, including Alzheimer's disease (AD), vascular dementia (VaD) and mixed dementia. Although sodium-glucose cotransporter-2 inhibitors (SGLT2i) have shown potential neuroprotective effects, previous studies were limited by small sample sizes, single-country datasets and a lack of detailed analyses of dementia subtypes.</p><p><strong>Materials and methods: </strong>This retrospective cohort study utilized the TriNetX database, comprising de-identified electronic health records from over 100 million patients across 98 healthcare organizations worldwide. Adults with T2DM initiating treatment with either SGLT2i or dipeptidyl peptidase-4 inhibitors (DPP4i) between November 20, 2004, and November 20, 2024, were included. Propensity score matching (PSM) at a 1:1 ratio ensured balanced baseline characteristics. Primary outcomes included overall dementia and specific dementia subtypes (VaD, AD, other dementias), while secondary outcomes included all-cause mortality.</p><p><strong>Results: </strong>After 1:1 propensity score matching, 278 689 patients per group were analysed. SGLT2i use was associated with a lower incidence of overall dementia (2.9% vs. 6.7%; adjusted hazard ratio [AHR] 0.77, 95% confidence interval [CI], 0.75-0.79) and a lower risk of vascular dementia (AHR 0.80), Alzheimer's disease (AHR 0.82) and other dementias (AHR 0.68). These associations remained consistent across age, sex, baseline glycaemic control and concurrent medication use in subgroup analyses. SGLT2i use was also linked to lower all-cause mortality (4.1% vs. 11.2%; AHR 0.66, 95% CI, 0.65-0.68). Findings were robust across sensitivity and subgroup analyses, supporting the potential neuroprotective effects of SGLT2i.</p><p><strong>Conclusions: </strong>This large-scale observational study suggests that SGLT2i use is associated with lower risks of multiple dementia subtypes and all-cause mortality in patients with T2DM.</p>","PeriodicalId":158,"journal":{"name":"Diabetes, Obesity & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}