Journal of Nephrology最新文献

{"title":"Correction: Clinical trial emulation in nephrology.","authors":"Carmine Zoccali, Giovanni Tripepi","doi":"10.1007/s40620-025-02403-5","DOIUrl":"10.1007/s40620-025-02403-5","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"2023-2024"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816906","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":"Clinical uptake of an antigen-based approach to membranous nephropathy: a survey of general nephrologists and glomerular disease experts.","authors":"Eibhlin Goggins, Andrew DeLaat, Bryce Barr, Jonathan Taliercio, Ali Mehdi, Georges Nakhoul, Brendan Bowman, Corey Cavanaugh","doi":"10.1007/s40620-025-02313-6","DOIUrl":"10.1007/s40620-025-02313-6","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.</p><p><strong>Methods: </strong>We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.</p><p><strong>Result: </strong>PLA2R, THSD7A, NELL1, and EXT1/2 testing were readily available while the most common response for other antigen testing was 'Not Performed' or 'Unknown'. All respondents had tested for or treated PLA2R-positive MN. Of 79 respondents, only 12.7% had treated THSD7A, 15.2% for NELL1 and 6.3% for EXT1/2 positive MN. For PLA2R, THSD7A, and NELL1, a majority chose rituximab (75.4, 87.5, and 80.0%, respectively) as initial treatment, and would treat with immunosuppression before completing 6 months of conservative therapy. A majority of respondents would routinely or occasionally omit a kidney biopsy in the setting of positive serum anti-PLA2R antibodies, however, 27.5% would rarely do so. There was no clear consensus across respondents regarding the use of anti-PLA2R serum levels in determining remission.</p><p><strong>Conclusion: </strong>Although many new MN antigens have been discovered, there is limited availability of tests identifying these less common antigens. While the survey suggests potential for utilization of an antigen-tailored approach based on identified differences in screening and treatment practices, there remains a lag in the full adoption of this new information. Further progress in accessibility of antigen testing and research into antigen associations will enable a more individualized approach to the management of MN.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1889-1900"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SGLT2i on bone health in patients with lupus nephritis: randomized double blinded placebo-controlled clinical trial.","authors":"Mohamed Hosney Badawi, Eman Nagy, Ehab Wahba Wafa, Amr El-Husseini, Nourelsabah Mohamed, Mohamed Abo El-Ghar, Wael Ibrahim Mortada, Kareem Ahmed Nabieh, Mohamed Abd El-Kader Sobh","doi":"10.1007/s40620-025-02351-0","DOIUrl":"10.1007/s40620-025-02351-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with systemic lupus erythematosus (SLE) commonly experience osteoporosis and are at increased risk of bone fractures. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have shown promising cardiovascular and renal benefits in patients with kidney disease; however emerging evidence suggests that they may negatively impact bone health. This study aims to investigate the impact of SGLT2i on bone metabolism in patients with lupus nephritis (LN).</p><p><strong>Methods: </strong>This is a randomized, double-blinded placebo-controlled clinical trial, including 84 adult patients with biopsy-proven LN and estimated glomerular filtration rate (eGFR) > 30 ml/min/1.73m². Patients were randomized 1:1 and stratified according to age and gender to Dapagliflozin (10 mg daily) or placebo groups. Serum creatinine, eGFR, urinary protein-creatinine, calcium-creatinine, and phosphorus-creatinine ratios were measured at baseline and after 12 months. Bone health was assessed at the same time points using bone formation markers (bone-specific alkaline phosphatase, procollagen type 1 N-terminal propeptide) and bone resorption markers (tartrate-resistant acid phosphatase 5b and Sclerostin). Moreover, quantitative computed tomography was used to assess volumetric bone mineral density.</p><p><strong>Results: </strong>Participants had a mean age of 38 ± 7 years, with no significant baseline differences between groups. By the end of the study, there were no significant differences in kidney function or bone turnover biomarkers between the dapagliflozin and placebo groups after adjusting for baseline values. Only the lumber spine 3 (L3) T score of the quantitative computed tomography parameters was significantly better in the dapagliflozin group compared to the placebo group (P = 0.017). In a linear mixed model analysis, dapagliflozin was associated with a significant unadjusted decline in lumbar spine bone mineral density over one year, but this effect was attenuated and became non-significant after adjusting for age, steroid dose, and gender.</p><p><strong>Conclusions: </strong>Dapagliflozin did not significantly affect bone and mineral metabolism in patients with lupus nephritis over a 12-month period. These findings suggest that dapagliflozin is unlikely to have adverse effects on bone health in patients with lupus nephritis, though further research is warranted to confirm these results over longer periods in a larger cohort.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1865-1875"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618636","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":"Correction: Nephrotic syndrome: pathophysiology and consequences.","authors":"Claudio Ponticelli, Gabriella Moroni","doi":"10.1007/s40620-025-02400-8","DOIUrl":"10.1007/s40620-025-02400-8","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"2025"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804318","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":"Importance of family history and health checkup for school-aged children for type IV collagen-associated nephropathy in hereditary kidney disease.","authors":"Ryosuke Kawamoto, Takayasu Mori, Motoko Chiga, Takuya Fujimaru, Azuma Nanamatsu, Tamami Fujiki, Yutaro Mori, Shintaro Mandai, Fumiaki Ando, Koichiro Susa, Tatemitsu Rai, Eisei Sohara, Shinichi Uchida","doi":"10.1007/s40620-025-02355-w","DOIUrl":"10.1007/s40620-025-02355-w","url":null,"abstract":"<p><strong>Background: </strong>Advancements in genetic analysis have revealed a higher prevalence of hereditary kidney disease than expected. This study focuses on the enrollment and analysis of patients with chronic kidney disease (CKD) and a family history of CKD to identify disease-causing variants. Additionally, by incorporating data from childhood urine tests, the study examines the utility of these screenings in early disease detection.</p><p><strong>Methods: </strong>An observational study utilizing genetic data and clinical assessments from patients with familial CKD. A total of 85 patients with familial CKD, diagnosed by clinicians and confirmed through genetic testing from 2014 to 2020, were included. Patients with cystic kidney diseases were excluded. The presence of COL4As (COL4A3, COL4A4, COL4A5) gene variants and other genetic variants associated with kidney disease was examined using a comprehensive gene panel.</p><p><strong>Results: </strong>Of the patients, 41.2% had disease-causing variants in COL4As variants. The median age at manifestation onset was significantly lower in the COL4As group compared to patients with other disease-causing variants or those with no identified disease-causing variants. Early manifestations of microscopic hematuria were notably prevalent, indicating potential early markers for genetic kidney diseases.</p><p><strong>Conclusions: </strong>The findings underscore the importance of family history in diagnosing genetic kidney diseases and suggest that early genetic testing, coupled with regular monitoring of urinary abnormalities, could significantly improve disease management and outcomes. Further research is necessary to explore comprehensive genetic screening and its integration into routine clinical practice.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1909-1916"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12484354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine-derived renal tubular epithelial cells resemble functional characteristics of professional antigen-presenting cells and can directly induce BKV-specific T cell responses.","authors":"Toralf Roch, Krystallenia Paniskaki, Patrizia Wehler, Constantin J Thieme, Hanieh Moradian, Arturo Blazquez-Navarro, Moritz Anft, Petra Reinke, Timm H Westhoff, Ulrik Stervbo, Nina Babel","doi":"10.1007/s40620-025-02298-2","DOIUrl":"10.1007/s40620-025-02298-2","url":null,"abstract":"<p><strong>Background: </strong>Reactivation of the BK virus (BKV) is a critical adverse event after kidney transplantation and can lead to graft loss. BKV-reactive T cell-mediated viral control can be facilitated by reducing immunosuppression. However, the exact mechanism underlying the T cell-mediated BKV clearance in the kidney transplant is not clear.</p><p><strong>Methods: </strong>Here, we used urine-derived renal tubular epithelial cells as a model system to investigate the immunomodulatory capacity of urine-derived renal tubular epithelial cells and their potential to induce T cell responses against BKV. Urine-derived renal tubular epithelial cells were generated by culturing urine-derived cell pellets. To assess the inflammatory potential of urine-derived renal tubular epithelial cells, the cells were treated with Poly I:C or TNFα/IFNγ. To investigate urine-derived renal tubular epithelial cell-induced T cell responses, autologous T cells, isolated from blood were co-cultured with urine-derived renal tubular epithelial cells, in the presence of BKV protein-derived peptides and PolyI:C or TNFα/IFNγ. BKV-reactive T cells, cytokine/chemokine secretion and expression of co-stimulatory molecules were evaluated using multiplex assays and multi-parameter flow cytometry.</p><p><strong>Results: </strong>Urine-derived renal tubular epithelial cells phenotypically resemble renal tubular epithelial cells, as they express CD13, EPCAM, cytokeratin and the myo-inositol oxygenase. After stimulation with PolyI:C, urine-derived renal tubular epithelial cells showed increased levels of CD40 and HLA-ABC, whereas TNFα/IFNγ only induced HLA-DR/ABC expression. Poly I:C and TNFα/IFNγ stimulation of urine-derived renal tubular epithelial cells induced a district pattern of inflammatory cytokines and chemokines that facilitate the migration of certain immune cell subsets. Interestingly, urine-derived renal tubular epithelial cells can present BKV peptides, thereby inducing a functional BKV-reactive CD4 and CD8 T cell response.</p><p><strong>Conclusions: </strong>Urine-derived renal tubular epithelial cells express immunomodulatory molecules, and induce BKV-directed T cell reactivity, indicating that renal epithelial cells may serve as non-conventional antigen-presenting cells in the kidney and thereby help BKV clearance.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1841-1854"},"PeriodicalIF":2.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216145","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":"Comparison of the effect of allopurinol and febuxostat on 2,8-dihydroxyadenine in plasma and urine: a clinical trial.","authors":"Hrafnhildur Linnet Runolfsdottir, Unnur Arna Thorsteinsdottir, Steinunn Johannesdottir, Thorunn Oskarsdottir, Inger Maria Schweitz Agustsdottir, Margret Thorsteinsdottir, Runolfur Palsson, Vidar Orn Edvardsson","doi":"10.1007/s40620-025-02392-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02392-5","url":null,"abstract":"<p><strong>Background: </strong>Adenine phosphoribosyltransferase (APRT) deficiency is a rare, inherited metabolic disorder characterized by abundant urinary excretion of 2,8-dihydroxyadenine (DHA), causing urinary stones and chronic kidney disease. The aim of this study was to examine the effect of allopurinol and febuxostat on plasma levels and urinary excretion of DHA in individuals with APRT deficiency.</p><p><strong>Methods: </strong>Adult individuals enrolled in the Icelandic APRT Deficiency Registry were invited to participate in a single-center, open-label, crossover, randomized clinical trial comparing the effect of allopurinol 400 mg/day and 800 mg/day and febuxostat 40 mg/day and 80 mg/day on plasma concentration and urinary excretion of DHA.</p><p><strong>Results: </strong>Of 12 participants who initiated the study, 7 (3 females) completed the trial; median (range) age 57.7 (37.3-65.1) years. Off pharmacotherapy, the median plasma DHA was 300 (178-1315) ng/mL. In individuals taking allopurinol 400 mg/day and 800 mg/day, the median plasma DHA was 25 (below the limit of detection [LOD]-95) ng/mL and below the limit of detection (< LOD-92) ng/mL, respectively. On febuxostat 40 mg/day, the median plasma DHA was below the limit of detection (< LOD-35) ng/mL and on 80 mg/day DHA was below the limit of detection in all samples tested. The median urine DHA-to-creatinine ratio was 8.18 (6.21-18.69) mg/mmol off pharmacotherapy and 1.90 (< LOD-4.52) mg/mmol and 0.35 (< LOD-4.32) mg/mmol on allopurinol 400 mg/day and 800 mg/day, respectively. During treatment with febuxostat 40 mg/day and 80 mg/day, the urine DHA-to-creatinine ratio was 0.54 (< LOD-1.33) mg/mmol and below the limit of detection (< LOD-0.64) mg/mmol, respectively.</p><p><strong>Conclusions: </strong>The plasma concentration and urinary excretion of DHA decreased markedly on treatment with both study drugs, although febuxostat was more efficacious than allopurinol in both prescribed doses. Trial registration number and date of registration. EudraCT No. 2021-002185-40; https://www.clinicaltrialsregister.eu/ctr-search/search?query=Research+Registry Date on which this record was first entered in the EudraCT database: 2019-03-19.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957760","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":"Hypertonic continuous venovenous hemodialysis managing nontraumatic subdural hematoma in a hemodialysis patient. A lesson for the clinical nephrologist.","authors":"Pepijn Van Hove, Rowena Vleut, Symen Ligthart","doi":"10.1007/s40620-025-02344-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02344-z","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957857","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":"Early-mid pregnancy renal parameters and adverse pregnancy outcomes in women with early stage CKD: a case series.","authors":"Alessandra Orsillo, Erandi Hewawasam, Shilpanjali Jesudason","doi":"10.1007/s40620-025-02398-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02398-z","url":null,"abstract":"<p><strong>Background: </strong>Early CKD may affect pregnancy outcomes, but identifying women at most risk remains challenging. We aimed to understand the predictive role of clinical parameters in early-mid pregnancy in women with early stage CKD.</p><p><strong>Methods: </strong>Women with CKD stage 1-3 with a pregnancy > 20 weeks gestation between 2018 and 2023 were evaluated for 'red flag' markers previously linked with risk of adverse pregnancy outcomes: failure of ≥ 10% fall in serum creatinine; urinary protein: creatinine ratio (uPCR) ≥ 30 mg/mmol in second trimester; lack of physiological fall in blood pressure by mid-pregnancy. The relationship between these red flags and a composite adverse pregnancy outcome of gestational age < 37 weeks, birth weight < 2500 g and pre-eclampsia was determined.</p><p><strong>Results: </strong>Of 38 mothers with 47 deliveries, 72% of pregnancies were in women with stage 1 CKD, 38% had hypertension and 19% had pre-eclampsia. Infants had median birth weight 2895 g (IQR: 2460-3170) and median gestational age 37.3 weeks (IQR 35.8-38). Serum creatinine did not fall ≥ 10% in 66% (n = 27/41) of women, uPCR was ≥ 30 mg/mmol in 69% (n = 24/35) and blood pressure did not fall in 73% (n = 24/33). Eighty-six percent had one or more 'red flags'. The composite adverse pregnancy outcome occurred in 49% (n = 22/45). Women exhibiting any early-mid pregnancy red flags did not have increased rates of composite adverse pregnancy outcome (no creatinine fall, composite adverse pregnancy outcome n = 15, p = 0.176; proteinuria n = 15, composite adverse pregnancy outcome p = 0.066; no blood pressure fall, composite adverse pregnancy outcome n = 12, p = 1.00).</p><p><strong>Conclusions: </strong>The high rate of composite adverse pregnancy outcome in early stage CKD was not associated with traditional mid-pregnancy red flags. Best models of care for this cohort remain uncertain.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957754","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":"Importance of age and timing of referral when initiating dialysis.","authors":"David Antoine Jaques, Anne Dufey, Cyrielle Alves, Sophie De Seigneux, Patrick Saudan","doi":"10.1007/s40620-025-02390-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02390-7","url":null,"abstract":"<p><strong>Background: </strong>Mortality of patients > 75 years of age initiating dialysis is high. Late referral to a nephrologist prior to dialysis initiation is associated with poor outcomes. Herein, we report the outcomes of patients initiating dialysis according to their age and timing of referral.</p><p><strong>Methods: </strong>We reviewed a prospective cohort of patients initiating dialysis from 2000 to 2022 at a single university center. Primary outcome was one-year all-cause mortality. Secondary outcomes were overall all-cause mortality and one-year hospitalization days. Late referral was defined as dialysis initiation < 1 month after a first consultation with a nephrologist.</p><p><strong>Results: </strong>We included 906 patients, including 246 (27%) aged over  75 years. Late referral was more common in elderly patients compared to younger ones, with rates of 26% and 34%, respectively (p = 0.027). Regarding one-year mortality, considering patients aged over 75 years with early referral as the reference, patients aged > 75 years with late referral were at higher risk (Hazard Ratio [HR] 2.30, p = 0.001), while patients aged < 75 years with either early or late referral were at similar risk. Regarding overall mortality, patients aged > 75 years with late referral were at higher risk (HR 1.56, p = 0.002), while patients aged < 75 years with either early (HR 0.65, p < 0.001) or late referral (HR 0.62, p = 0.001) were at lower risk. Finally, patients aged over 75 years with late referral had more hospitalization days per year (coef 0.09, p < 0.001), while patients < 75 years with either early (coef - 0.07, p < 0.001) or late referral (coef - 0.05, p < 0.001) had fewer hospitalization days per year.</p><p><strong>Conclusions: </strong>Late referral of elderly patients prior to dialysis initiation is common and adversely associated with short- and long-term mortality as well as hospitalization days. Conversely, early referral of elderly patients is associated with a favorable short-term prognosis that is comparable to that of younger patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957786","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}