Emily M. Whitmore, Amy Schnelle, Megan E. Colburn, Yvonne Wong, Jennifer Reilly, L. Adamovicz, Krista Keller, M. Allender
{"title":"Analytical Variability and Agreement of Leukocyte Quantification Methods in Inland Bearded Dragons (Pogona vitticeps)","authors":"Emily M. Whitmore, Amy Schnelle, Megan E. Colburn, Yvonne Wong, Jennifer Reilly, L. Adamovicz, Krista Keller, M. Allender","doi":"10.5818/jhms-d-22-00047","DOIUrl":"https://doi.org/10.5818/jhms-d-22-00047","url":null,"abstract":"\u0000 Hematology is a common diagnostic assay for evaluation of health in veterinary species. Several manual methods exist to evaluate the leukocyte component of reptile complete blood counts; however, there is no single method that has been proven reliable for all reptiles. To investigate the analytical variability and agreement of commonly used leukocyte quantification methods, blood was collected from ten clinically healthy bearded dragons (Pogona vitticeps) and analyzed in triplicate using Natt-Herricks (NH), eosinophilic leukopet (LO), and estimated white blood cell counts on peripheral blood smears made from fresh whole blood or blood anticoagulated with lithium heparin (LH). To investigate inter-observer variability, blood film white blood cell estimates were generated by both a novice veterinary student and a boarded clinical pathologist and analyzed for agreement. Analytical variability was highest using the LH blood film estimate by a boarded clinical pathologist (21.0%), followed by Natt-Herricks method (student) (20.8%), fresh whole blood film estimate from the clinical pathologist (16.6%), eosinophilic leukopet (student) (8.7%), and blood film estimates using fresh whole blood (6.5%) and LH blood (4.5%) read by the student. Bland Altman plots revealed there was agreement between LO and NH methods and between the two blood film estimate methods, and Passing-Bablok regression analysis revealed constant and proportional error between LO and both estimate methods and between NH and both estimate methods. There was agreement between the veterinary student and clinical pathologist for both blood smear leukocyte estimates. These results highlight the importance of considering which leukocyte quantification method is used when clinically assessing reptile patients.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"58 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Corinne Mayer, Laken Russell, Chin-Chi Liu, C. R. Lattin, Javier G. Nevarez
{"title":"Plasma and Shed Skin Corticosterone Levels in a Population of Louisiana Pine Snakes (Pituophis ruthveni)","authors":"Corinne Mayer, Laken Russell, Chin-Chi Liu, C. R. Lattin, Javier G. Nevarez","doi":"10.5818/jhms-d-23-00035","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00035","url":null,"abstract":"\u0000 Measurement of corticosterone in various tissues has been used to investigate the stress response in reptile and amphibian species for decades. The tissue source from which corticosterone is measured reflects different periods of time and chronicity of stress levels in the subject, and different tissue collection methods differ in degree of invasiveness. Studies of corticosterone in keratinized tissues of reptiles, such as shed skin, are limited in number compared to hair and feather glucocorticoid studies in avian and mammalian species, but warrant continued research as they may reflect more different periods of time and chronicity of corticosterone levels than plasma or other tissues, and can be obtained in a minimally invasive manner. In this study, we measured corticosterone concentrations in both plasma and shed skin of Louisiana pine snakes (Pituophis ruthveni) that were all previously diagnosed with subclinical Cryptosporidium serpentis infection. We also tracked stressors experienced by different individuals to identify potential relationships between periods of increased stress and corticosterone levels in plasma and shed skin. There were no significant correlations between individual plasma and shed skin corticosterone levels, or between corticosterone levels in either tissue type and stressors experienced. This is the first study where corticosterone levels were measured in plasma and shed skin of P. ruthveni, and is the first known evaluation of plasma and shed skin corticosterone levels in a snake population previously testing positive for Cryptosporidium serpentis.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Use of Craniodorsal-Caudoventral 45° Oblique Radiographs for Diagnosis and Treatment of Coxofemoral Luxation in Two Mohave Desert Tortoises, Gopherus agassizii","authors":"Ian Kanda, Thomas Boyer","doi":"10.5818/jhms-d-23-00011","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00011","url":null,"abstract":"\u0000 Two injured wild Mohave desert tortoises (Gopherus agassizii) presented with hind leg lameness. A contaminated and infected bite wound exposed the coxofemoral joint in one individual. Dorsoventral, lateral, and craniocaudal radiographs produced less detail of the affected coxofemoral joint in each tortoise due to superimposition of soft tissue, the bones of the shell, pelvis and femur. Radio tracking devices that had been epoxied to the shell also complicated diagnosis with traditional radiographic views. Based on a view described in birds, a craniodorsal-caudoventral 45° oblique image offered a superior view of the coxofemoral joint. This image was used to prescribe a femoral head ostectomy and verify successful completion following surgery.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"46 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139384824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Schüler, Sigrid Lenz, Frank Mittenzwei, Isabell Gletscher, Elisabeth Müller, K. Heckers, Rachel E Marschang
{"title":"Ophidiomycosis in Wild Dice Snakes (Natrix tessellata) in Germany","authors":"Lisa Schüler, Sigrid Lenz, Frank Mittenzwei, Isabell Gletscher, Elisabeth Müller, K. Heckers, Rachel E Marschang","doi":"10.5818/jhms-d-23-00025","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00025","url":null,"abstract":"\u0000 Ophidiomycosis (formerly snake fungal disease) is an emerging disease in snakes caused by the fungal pathogen Ophidiomyces ophidiicola (Oo). The disease is characterized by skin lesions that can range from mild to severe with associated fatalities documented. Subclinical infections have also been described presenting a wide variability of the impact Oo has on the host. In wild snakes, infections have most often been documented in North America, but increasing numbers of reports are becoming available from other parts of the world, including Europe. While monitoring dice snake (Natrix tessellata) populations in 2018 at Schleuse Hollerich/Lahn, a nature reserve in Germany, three dice snakes were observed with cutaneous granulomas. One year later, snakes with granulomas were also observed, and two dice snakes were captured and examined. Fungal hyphae were found in skin biopsies of the lesions and Oo was detected by PCR in the shed skin from one of the snakes. After shedding, the snakes appeared clinically healthy and were released back to the location at which they had been found. This is the first report of histologically confirmed ophidiomycosis in dice snakes and the first confirmed report of ophidiomycosis in a wild snake in Germany.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"17 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139387407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jennifer Reilly, Amy N. Schnelle, L. Adamovicz, Megan E. Colburn, Emma Whitmore, Yvonne Wong, M. Allender
{"title":"Analytical Variability of Hematological Methods for White Blood Cell Counts in Prairie Rattlesnakes (Crotalus viridis)","authors":"Jennifer Reilly, Amy N. Schnelle, L. Adamovicz, Megan E. Colburn, Emma Whitmore, Yvonne Wong, M. Allender","doi":"10.5818/jhms-d-22-00048","DOIUrl":"https://doi.org/10.5818/jhms-d-22-00048","url":null,"abstract":"Evaluating leukocytes provides insight in the overall health of animals by characterizing pathologies related to infection, inflammation, and stress. In reptile species, many leukocyte quantification methods are used to evaluate white blood cell parameters; however, agreement and analytical variability between the various methods have yet to be reported and critically assessed in many species, including the prairie rattlesnake (Crotalus viridis). The objectives of this study were 1) to test agreement between hematology parameters determined by phloxine -based stain (EO), Natt & Herricks (NH), and estimate (EST) methods using fresh whole blood and lithium-heparinized blood, 2) to determine the agreement between estimates from a veterinary student and from a board-certified clinical pathologist; and, 3) to determine the analytical variability of EO, NH, and EST methods. Venipuncture was performed in 27 adult snakes and agreement was then assessed using Bland-Altman plots and Passing-Bablock regression between all methods. There was a variable degree of proportional and constant error between many of the quantification methods, but descriptive statistics for all methods fell within biologically relevant values. There was good agreement in EST between the clinical pathologist and veterinary student, but the student had a significantly higher mean WBC in fresh whole blood. The lowest analytical variability was observed with NH method (15.4%), while the highest was observed with the EST (58.6% for clinical pathologist, 59.4% for veterinary student). These results identify the intrinsic variability in reptile hematological methods currently used and emphasize the need to develop a singular diagnostic standard for leukocyte quantification in reptile species.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"26 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139157067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel E Marschang, Christal Pollock, Krista Keller, J. Bogan
{"title":"Infectious Agents of Reptiles and Amphibians: Peer-reviewed publications, January–June 2023","authors":"Rachel E Marschang, Christal Pollock, Krista Keller, J. Bogan","doi":"10.5818/i2374-9504-33-4-195","DOIUrl":"https://doi.org/10.5818/i2374-9504-33-4-195","url":null,"abstract":"","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"76 3","pages":"195 - 204"},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138952878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Concurrent Diffuse B-cell Lymphoma and Paraganglioma in a Red-tailed Boa (Boa constrictor constrictor) with Inclusion Body Disease","authors":"Megan Coyne, J. Struthers, Matti Kiupel","doi":"10.5818/JHMS-D-23-00009","DOIUrl":"https://doi.org/10.5818/JHMS-D-23-00009","url":null,"abstract":"Abstract A 15-yr-old, male, captive red-tailed boa (Boa constrictor constrictor) was submitted for postmortem examination after it was euthanized after becoming nonresponsive and laterally recumbent. The snake had a history of respiratory disease, coelomic swelling, leukocyte intracytoplasmic inclusion bodies, and an antemortem negative Reptarenavirus PCR. At necropsy, there were solid white masses in the lungs and throughout the alimentary tract, and firm, smooth yellow masses in the pericardium and adventitia of heart base vessels. Histopathology revealed an anaplastic large-cell lymphoma that infiltrated multiple tissue types, most severely the lungs and esophagus. Neoplastic lymphocytes were negative for CD3 and positive for Pax5, consistent with a B-cell lymphoma. The yellow pericardial masses were composed of neoplastic neuroendocrine cells with moderate amounts of vacuolated cytoplasm and small, ovoid nuclei with finely stippled chromatin arranged in packets separated by fine fibrovascular stroma. Neoplastic cells were positive for β-endorphin consistent with a diagnosis of paraganglioma. Additionally, many cell types, including neoplastic lymphocytes and neuroendocrine cells, contained cytoplasmic viral eosinophilic inclusions, and Reptarenavirus PCR on spleen detected a virus in the species Reptarenavirus giessenae. This snake was diagnosed with concurrent paraganglioma, inclusion body disease, and anaplastic lymphoma, morphologically represented as a diffuse lymphoma of B-cell phenotype. Whether Reptarenavirus predisposes to neoplasia in snakes is debated. This case describes multiple neoplasms in a snake with a concurrent Reptarenavirus infection.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"5 8","pages":"229 - 235"},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138949248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ava Mastrostefano, Salvatore Frasca, Brian Stacy, B. Wickes, Nathan P Wiederhold, C. Cañete-Gibas, Nicole Stacy, Shelley Beck, K. Tuxbury, Melissa J. Joblon, J. Cavin, E. S. Weber, C. Innis
{"title":"Clinical Observations, Identification, and Antimicrobial Susceptibility of Fungi Isolated from Sea Turtles with Histologically Confirmed Mycotic Infections: 20 Cases, 2005-2020","authors":"Ava Mastrostefano, Salvatore Frasca, Brian Stacy, B. Wickes, Nathan P Wiederhold, C. Cañete-Gibas, Nicole Stacy, Shelley Beck, K. Tuxbury, Melissa J. Joblon, J. Cavin, E. S. Weber, C. Innis","doi":"10.5818/jhms-d-23-00007","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00007","url":null,"abstract":"Fungal infections were histologically confirmed in 20 stranded sea turtles, including 18 Kemp’s ridley turtles (Lepidochelys kempii), one green turtle (Chelonia mydas), and one leatherback turtle (Dermochelys coriacea). Infection was detected antemortem in 6 cases. Gross external findings in live turtles included carapace lesions (n = 3) and dermatitis (n = 1). Radiographs revealed evidence of pneumonia in 18 animals. Bronchoscopy detected excessive fluid, mucus, clotted blood, or caseous material within the bronchi and lungs of 3 turtles. At necropsy, the most common gross lesions were pulmonary granulomas, consolidation, and, or hemorrhage (n = 18), and the most common histologic lesion was severe heterophilic to granulomatous pneumonia (n = 18). Nine animals had fungal infection at sites outside of the lung. The most commonly identified genera were Purpureocillium, Beauveria, and Fusarium. Other isolates included Metarhizium sp., Trichoderma sp., Clavispora lusitaniae (Candida lusitaniae), Leptospherulina sp., Penicillium chrysogenum, Mucor sp., and Aspergillus section Nigri. Antifungal susceptibility performed for 10 isolates indicated minimum inhibitory concentrations (mg/L) for fluconazole ranging from 8 to >64, often >32; itraconazole 0.06 to 16, often ≤1; voriconazole 0.06 to 2, often ≤0.5; terbinafine 0.06 to >2, often ≤2. These data indicate that fluconazole resistance is common among the fungi that cause infection in sea turtles. Based on susceptibility data, itraconazole, voriconazole, or terbinafine may be appropriate for treatment of such infections, but additional clinical research is needed. Results of this study indicate that fungal infections can be difficult to diagnose antemortem in sea turtles, and more aggressive methods of diagnosis, such as lung biopsy, may be indicated for suspected cases.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"280 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicholas G. Dannemiller, Ashley R. Souza, Taylor Sherrod, Mandy Womble, Sarah M. Ozawa, G. Lewbart, Kathryn A. Zagzebski, Craig A. Harms
{"title":"Esophageal Stricture and Occlusion in a Green Sea Turtle (Chelonia mydas)","authors":"Nicholas G. Dannemiller, Ashley R. Souza, Taylor Sherrod, Mandy Womble, Sarah M. Ozawa, G. Lewbart, Kathryn A. Zagzebski, Craig A. Harms","doi":"10.5818/jhms-d-23-00020","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00020","url":null,"abstract":"In December 2022, a juvenile female green sea turtle (Chelonia mydas) was stranded in North Carolina, USA. On admission to rehabilitation, physical exam and point-of-care diagnostics found severe emaciation, a healing wound to the left cranial neck, abnormal buoyancy, a heavy burden of epibiota on its carapace, anemia, and hypoproteinemia. Over time, the turtle exhibited progressive weight loss, dysphagia, and regurgitation characterized by forcefully ejecting water and masticated fish from its nares. When attempted tube feeding was unsuccessful, a cranial esophageal stricture was suspected. Computed tomography and ultrasonography revealed no evidence of an esophageal foreign body or intraluminal and extraluminal masses. Esophagoscopy confirmed a cranial esophageal stricture; however, neither bouginage nor surgical resection via an esophagostomy was successful, and the turtle was euthanized. Necropsy confirmed an esophageal stricture and occlusion, diffuse serous atrophy of fat, and widespread muscle atrophy. Histopathology revealed the esophageal stricture was comprised of focal marked fibrosis with edema and mild perivascular lymphoplasmacytic inflammation. Given the age class and size of the turtle, the authors suspect the esophageal stricture and occlusion were acquired secondary to unknown prior trauma. Esophageal stricture in sea turtles is a possible severe sequela of esophageal injury and likely carries a guarded prognosis for survival and release.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"102 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139258594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah B Gafen, Chin-Chi Liu, N. E. Ineck, Elise Barras, Maria S. Mitchell, Christine E. Walsh, P. Camacho-Luna, Renee T. Carter, Andrea Kirkpatrick, Andrew C Lewin
{"title":"Ophthalmic Parameters of Healthy Captive Blue-Tongued Skinks (Tiliqua scincoides)","authors":"Hannah B Gafen, Chin-Chi Liu, N. E. Ineck, Elise Barras, Maria S. Mitchell, Christine E. Walsh, P. Camacho-Luna, Renee T. Carter, Andrea Kirkpatrick, Andrew C Lewin","doi":"10.5818/jhms-d-23-00021","DOIUrl":"https://doi.org/10.5818/jhms-d-23-00021","url":null,"abstract":"Normal ophthalmic parameters of the blue-tongued skink (Tiliqua scincoides), one of the largest members of the skink family of lizards, have yet to be evaluated. The objective of this study was to establish baseline ophthalmic parameters for a captive population of 12 healthy, one year old, blue-tongued skinks. Ophthalmic examination, corneal touch threshold, tear production including phenol red thread test (PRTT) and modified Schirmer tear test-2 (mSTT-2), horizontal palpebral fissure length (HPFL), rebound tonometry (TONOVET and TONOVET Plus), and bacterial and fungal culture were performed. The blue-tongued skinks were all amenable to ocular diagnostic testing. Corneal touch threshold (mean ± SD) was 5.48 ± 0.81 cm. PRTT (mean ± SD) was 9.17 ± 6.62 mm/15 seconds. mSTT-2 (mean ± SD) was 2.54 ± 2.72 mm/60 seconds. HPFL (mean ± SD) was 6.96 ± 0.62 mm and was positively correlated with body weight. Intraocular pressure (IOP) assessed using TONOVET (mean ± SD) was 8.43± 1.51 mmHg, while IOP assessed using TONOVET Plus (mean ± SD) was 12.39± 1.54 mmHg. Differences in TONOVET and TONOVET Plus tonometry values were statistically significant (P<0.0001) and TONOVET values positively correlated with body weight. The most common bacterial species identified were Staphylococcus xylosus (10/12) and Staphylococcus sciuri (8/12). Fungal cultures were all negative. One animal had superficial corneal ulceration which resolved with treatment. Ophthalmic examination and testing is readily performed in blue-tongued skinks. These parameters may be useful for ocular assessment of this species in a clinical setting.","PeriodicalId":16054,"journal":{"name":"Journal of Herpetological Medicine and Surgery","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}