Journal of Thrombosis and Thrombolysis最新文献

{"title":"Mon4 as a novel monocyte subset with distinct profile and predictor of poor outcomes in individuals with myocardial infarction.","authors":"Maxime Boidin, Gregory Y H Lip, Eduard Shantsila","doi":"10.1007/s11239-025-03111-4","DOIUrl":"10.1007/s11239-025-03111-4","url":null,"abstract":"<p><p>Recently, a new monocyte subset known as Mon4, characterized by distinct gene expressions, has been identified but remains poorly characterized. In this study, our objective was to comprehensively characterise Mon4 in healthy individuals and explore its correlation with major adverse cardiovascular events (MACE) in patients with ST-elevation myocardial infarction (STEMI). Our study enrolled 20 healthy individuals and 245 STEMI patients who underwent primary percutaneous coronary intervention (PCI). We analysed monocyte subsets using flow cytometry and collected bone marrow samples from 11 healthy individuals. Cardiac function assessments were performed in STEMI patients through echocardiography within 3 days post-PCI. Mon4 displayed significant differences compared to Mon1, Mon2, and Mon3 in various parameters among healthy individuals, underscoring its distinct profile. In STEMI patients, above-median Mon4 counts were associated with a increased risk of MACE (hazard ratio [HR] 3.11, 95% confidence interval [CI] 1.55-6.24, p = 0.01) and heart failure (HR 3.25, 95% CI 1.14-9.24, p = 0.03) after adjusting for other predictive factors. This study highlights the unique characteristics of Mon4 and its clinical significance. The distinctive gene signature of Mon4, coupled with its association with MACE and heart failure, suggests its potential utility as a biomarker for risk assessment in MI patients. Further investigations are warranted to explore the therapeutic potential of targeting Mon4 in reducing cardiovascular complications following MACE.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"699-708"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced recovery and abbreviated length of anticoagulation for thromboprophylaxis after primary hip arthroplasty rationale and design of the ENABLE-hip trial.","authors":"Philipp Drees, Irene Schmidtmann, Manuel Herbst, Dorothea Becker, Stefano Barco, Frederikus A Klok, Karsten Keller, Lukas Hobohm, Konstantinos C Christodoulou, Christina Abele, Rupert Bauersachs, Walter Ageno, Erik Lerkevang Grove, Henrik Kehlet, Friedhelm Hufen, Thomas Klonschinski, Yama Afghanyar, Lukas Eckhard, Nadine Martin, Susanne Fischer, Stanislav Gorbulev, Dominik Rath, Anna C Mavromanoli, Claude Jabbour, Irene Lang, Francis Couturaud, Christian Heiss, Harald Binder, Stavros Konstantinides","doi":"10.1007/s11239-025-03110-5","DOIUrl":"10.1007/s11239-025-03110-5","url":null,"abstract":"<p><p>Surgical total hip arthroplasty (THA) is associated with high risk of venous thromboembolism (VTE), but the appropriate duration of postoperative anticoagulation remains controversial. \"Enhanced Recovery and Abbreviated Length of Anticoagulation for Thromboprophylaxis After Primary Hip Arthroplasty\" (ENABLE-Hip) is a multicenter investigator-initiated and academically sponsored randomized double-blind active-control non-inferiority trial. Patients will be mobilized early after surgery, following a standardized enhanced recovery protocol. After an initial open-label prophylactic anticoagulation as per local standard of care until day 2 after surgery, treatment with rivaroxaban (10 mg once daily) will be started on day 3 and continued until day 10. Subsequently, patients will be switched to placebo in the experimental arm, or continue on active drug in the control arm, until a total of 35 days. The primary endpoint is acute symptomatic or fatal VTE within 3 months. A sample size of 2,932 patients will provide ≥ 80% power to reject the null hypothesis that δ ≥ 0.01 (δ = difference between the two arms in symptomatic VTE probability) at a significance level α = 0.05. An interim analysis will be performed after 3-month follow-up of the first 1,760 randomized patients at a significance level α = 0.50, leading to stop for futility if significance is not obtained, or if recalculation yields a sample size of > 3,200 patients. ENABLE-Hip will be the first major randomized trial to test an overall reduction in the duration of post-THA thromboprophylaxis and will inform future guideline recommendations concerning this continuously growing patient population.Trial registration: ClinicalTrials.gov Identifier: NCT06611319.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"689-698"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet therapy following conservatively managed spontaneous coronary artery dissection.","authors":"Madeline K Mahowald, Luis Ortega-Paz, Claudio Laudani, Dominick J Angiolillo","doi":"10.1007/s11239-025-03114-1","DOIUrl":"10.1007/s11239-025-03114-1","url":null,"abstract":"<p><p>Spontaneous coronary artery dissection (SCAD) is a relatively uncommon but increasingly recognized etiology of acute coronary syndrome (ACS). Conservative management is generally recommended, but optimal medical therapy is unknown. The majority of patients are discharged on dual antiplatelet therapy consisting of aspirin and a P2Y12 inhibitor based on trials and guidelines developed for ACS caused by plaque rupture and subsequent platelet activation and aggregation. Observational trials have shown conflicting results on the effects of antiplatelet therapy on major adverse cardiac events after SCAD. This manuscript provides a review of the available data, including a meta- analysis, and offers recommendations for antiplatelet therapy after conservatively managed SCAD in clinical practice.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"682-688"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential association of TGFβ1 plasma levels and fibrinolysis parameters with the risk of recurrence and vascular obstruction after a first unprovoked pulmonary embolism episode.","authors":"Marc Danguy des Déserts, Claire de Moreuil, Jamal Elhasnaoui, Lenaïck Gourhant, Virginie Gourdou-Latyszenok, Benjamin Espinasse, Juliette Menguy, Cécile Tromeur, Rozenn Le Corre, Raphael Le Mao, Daniel Kraemmer, Olivier Sanchez, Francis Couturaud, Catherine A Lemarié","doi":"10.1007/s11239-025-03113-2","DOIUrl":"10.1007/s11239-025-03113-2","url":null,"abstract":"<p><p>The pathophysiology of residual pulmonary vascular obstruction (RPVO) and recurrent venous thromboembolism (VTE) after unprovoked pulmonary embolism (PE) remains poorly understood. The purpose was to evaluate fibrinolytic and tissue remodeling markers as indicators of RPVO and recurrence after a first unprovoked PE. Analyses were conducted in the 18 to 70-year-old patients included in the PADIS-PE trial, with a pulmonary vascular obstruction (PVO) index ≥ 30% at PE diagnosis. After an initial six-month vitamin K antagonist treatment, patients were randomised to receive placebo or warfarin for 18 months and assessed for the absence or presence of residual pulmonary vascular obstruction (RPVO < or ≥ 5%, respectively). Quantitative assessment of fibrinolytic (D-dimer, tPA, uPA, TFPI) and tissue remodeling (TGFβ1) markers, and a tissue-factor-based turbidimetric clot lysis assay (CLA) were performed one month after warfarin discontinuation. Symptomatic recurrent VTE was monitored for 42 months after randomisation. Among the 371 patients included in PADIS-PE, 23 fulfilled clinico-radiological criteria and had an available blood sample. Six (26%) patients presented RPVO ≥ 5% and symptomatic recurrent VTE occurred in nine (39%) patients. Clot formation and lysis parameters were not associated with RPVO. TGFβ1 plasma levels were higher in patients with RPVO. Clot formation potential measured with CLA was higher in patients with recurrent VTE. No association between recurrent VTE and TGFβ1 was observed. In adult patients with a first unprovoked PE and a PVO index ≥ 30%, TGFβ1 plasma levels were associated with RPVO, whereas clot formation parameters measured with CLA were associated with VTE recurrence.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"729-742"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12350555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of off-label DOAC underdosing in Japanese patients with atrial fibrillation: a systematic review and meta-analysis.","authors":"Akinori Sairaku, Yuka Kimura, Yukiko Nakano","doi":"10.1007/s11239-025-03107-0","DOIUrl":"10.1007/s11239-025-03107-0","url":null,"abstract":"<p><p>Japanese patients with atrial fibrillation (AF) often receive underdosed direct oral anticoagulants (DOACs), deviating from standard guidelines. The impact of underdosing compared to standard dosing on thromboembolic and bleeding risks in this population remains unclear. This meta-analysis included 13 studies with 37,633 Japanese AF patients comparing underdose and standard dose groups. Efficacy outcomes included stroke or systemic embolism and ischemic stroke. Safety outcomes were major bleeding, intracranial hemorrhage, gastrointestinal bleeding, all bleeding, and all-cause mortality. Hazard ratios and 95% confidence intervals were pooled using a random-effects model. Sensitivity analyses evaluated robustness by including studies with confounder controls. Underdosing showed similar risks of stroke or systemic embolism (HR 1.03, 95% CI 0.87-1.22) and ischemic stroke (HR 1.05, 95% CI 0.85-1.31) compared to standard dosing. Major bleeding (HR 0.86; 95% CI 0.72-1.04) and all bleeding (HR 0.80; 95% CI 0.63-1.03) showed a non-significant reduction with underdosing. Sensitivity analyses confirmed a significant reduction in major bleeding risk with underdosing (HR 0.77, 95% CI 0.64-0.94). All-cause mortality was significantly higher in the underdose group throughout the primary (HR 1.47, 95% CI 1.13-1.90) and sensitivity analyses. In conclusion, Japanese patients receiving an underdose of DOACs had thromboembolic event rates comparable to those seen with standard dosing, with a reduction in bleeding events confirmed by sensitivity analyses and higher mortality. These findings indicate that ethnic-specific factors may influence DOAC effects, warranting further investigation to validate these observations and inform tailored dosing recommendations for Japanese AF patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"709-720"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased circulating microRNA-22 expression as a potential biomarker for predicting a higher risk of recurrent ischemic stroke related to inner carotid artery stenosis: a multicenter study.","authors":"Li-Yang Wen, Na Qi, Shi-Yan Li","doi":"10.1007/s11239-025-03112-3","DOIUrl":"10.1007/s11239-025-03112-3","url":null,"abstract":"<p><p>Carotid endarterectomy has proved to be beneficial in the prevention of stroke in patients with carotid artery stenosis ≥ 70%, while the benefit in symptomatic patients with moderate stenosis (50-69%) was undetermined, and some of them may be at higher risk of recurrent ipsilateral stroke (RIS). To date, it's hard to define vulnerable populations and novel biomarkers should be exploited. Thus, we aim to explore the predictive role of miR-22 in the presence of RIS and the prognosis of symptomatic patients with moderate stenosis. 400 patients were prospectively recruited, and miR-22 levels were assessed. The incidence of RIS and major adverse cardiovascular and cerebrovascular events (MACCE)-free survival were presented and the risk factors for RIS and MACCE-free survival were investigated. The area under the curve (AUC) was also investigated for RIS. The degree of carotid artery stenosis was negatively associated with miR-22 level (P < 0.001). The median value of miR-22 was 4.16 in the overall distribution, patients with miR-22 levels ≥ 4.16 had a significantly improved MACCE-free survival (P = 0.012) and lower incidence of RIS (P = 0.020) compared with miR-22 levels < 4.16. The multivariable cox regression analysis demonstrated that patients with lower miR-22 levels were prone to the presence of RIS (P < 0.001). The AUC of miR-22 in predicting RIS was 0.662 (95% CI, 0.550-0.774). This study implies that lower miR-22 levels may play a predictive role in the higher incidence of RIS in patients with moderate stenosis. Moreover, lower miR-22 levels can also prognosticate a higher risk for MACCE in these patients.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":"721-728"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between elevated plasma levels of factor VIII and risk of recurrent venous thromboembolism: a systematic review and meta-analysis.","authors":"Soodabe Teymoori, Majid Dezfouli, Awat Feizi, Huriyeh Hashemi, Mohammad Shirzadi","doi":"10.1007/s11239-025-03161-8","DOIUrl":"https://doi.org/10.1007/s11239-025-03161-8","url":null,"abstract":"<p><p>Although several studies have examined the relationship between factor VIII levels and recurrent venous thromboembolism (VTE), findings remain inconsistent. This systematic review and meta-analysis aimed to assess the association between elevated plasma factor VIII levels and VTE recurrence. A comprehensive search was conducted in PubMed, Web of Science, Scopus, and Embase databases, and Google Scholar up to May 2025 to identify observational studies evaluating the association between elevated factor VIII levels and recurrent VTE. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects model. Eighteen studies (12 cohort and 6 case-control studies) involving 9835 participants and 1554 recurrent events were included. Plasma factor VIII levels > 200 IU/dL were associated with an increased risk of VTE recurrence (RR = 1.70; 95% CI: 1.32-2.19; I² = 85.0%, P < 0.001). Subgroup analyses based on the type of effect measures indicated increased risk of VTE recurrence across studies reporting hazard ratios (HRs), odds ratios (Ors), and RRs. Similarly, the association remained significant in both cohort and case-control studies. Elevated factor VIII levels were associated with recurrence only in patients not receiving anticoagulation (RR = 1.64; 95% CI: 1.28-2.10), whereas no significant association was observed among those receiving anticoagulation (RR = 1.89; 95% CI: 0.36-9.87). This meta-analysis demonstrates a possible relationship between elevated factor VIII levels and VTE recurrence. These findings highlight the potential of factor VIII as a prognostic marker. Further prospective studies are needed to confirm this association and support clinical decision-making.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The abnormal coagulation status in endometriosis patients: a systematic review and meta-analysis.","authors":"Xue Zeng, Jinling Zhang, Yijuan Peng, Ke Zhuang, Yan Huang","doi":"10.1007/s11239-025-03157-4","DOIUrl":"https://doi.org/10.1007/s11239-025-03157-4","url":null,"abstract":"","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes in autoimmune acquired factor XIII deficiency with and without underlying diseases: a systematic review.","authors":"Juanjuan Song, Liu Liu, Bingjie Ding, Ao Xia, Jingyuan Liu, Yu Han, Ao Xie, Hu Zhou","doi":"10.1007/s11239-025-03148-5","DOIUrl":"https://doi.org/10.1007/s11239-025-03148-5","url":null,"abstract":"<p><p>Autoimmune acquired factor XIII deficiency (AiF13D) is an exceptionally rare and serious bleeding disorder. This condition may occur idiopathically or in association with comorbidities, such as malignancies or autoimmune diseases. Data comparing these distinct etiological subgroups remain limited. Therefore, we conducted a systematic literature review of published case reports, case series, and cohort studies on AiF13D indexed in PubMed, Web of Science, and Scopus up to December 2023. We compared the clinical characteristics, treatment modalities, and outcomes between patients with AiF13D associated with underlying disorders and those with idiopathic AiF13D. Our analysis revealed a higher proportion of female patients in the AiF13D group with underlying diseases compared to the idiopathic group. Statistically significant differences were observed that patients with underlying diseases exhibited slightly higher inhibitor levels and a greater frequency of Grade III bleeding events. Furthermore, fewer AiF13D patients with underlying diseases received combination therapy (prednisone plus rituximab or cyclophosphamide) compared to the idiopathic group. Additionally, this group experienced higher rates of relapse and/or mortality. Collectively, these findings indicated that AiF13D patients with underlying diseases experience more severe bleeding manifestations and poorer outcomes. Consequently, clinicians managing concomitant conditions should maintain vigilance for potential AiF13D development. Regular monitoring of FXIII activity and inhibitor titers is essential, coupled with prompt initiation of anti-inhibitor therapy when indicated.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell RNA sequencing of platelets: challenges and potential.","authors":"Giacomo Viggiani, Kilian Kirmes, Jiaying Han, Melissa Klug, Stephanie Kühne, Gianluigi Condorelli, Karl-Ludwig Laugwitz, Conor J Bloxham, Clelia Peano, Philip Raake, Isabell Bernlochner, Dario Bongiovanni","doi":"10.1007/s11239-025-03153-8","DOIUrl":"https://doi.org/10.1007/s11239-025-03153-8","url":null,"abstract":"<p><p>Platelets are small, anuclear cells crucial for hemostasis, coagulation, immune responses, and vascular diseases. While unable to produce their own RNA, platelets inherit RNA from their megakaryocyte precursors, exchange RNA with other cells, and possess all the necessary machinery for protein synthesis. However, several challenges, including their limited RNA content, high reactivity of these small cells leading to their activation, have hindered single-cell transcriptomic studies of these cells. The primary objective of this study is to perform single-cell RNA sequencing (scRNA-seq) on platelets obtained from whole blood. Peripheral whole blood from a healthy donor was obtained by venipuncture and was purified to obtain platelet-rich plasma (PRP). ScRNA-seq was performed using the 10X genomics platform on PRP for the first time. Data normalization and UMAP clustering with cluster-specific differential gene expression analysis were performed. ScRNA-seq performed on platelets identified three distinct clusters, with one enriched for platelet-specific lineage markers, such as PPBP and PF4. Mitochondrial RNA was highly expressed accounting for approx. 14% of the total RNA counts. Despite procedural challenges and technical considerations including high exhaustion potential and sensitivity to handling, small cell size and limited RNA content, this pilot study demonstrates feasibility of scRNA-seq of platelets from whole blood. This advancement paves the way for groundbreaking insights into platelet biology and more focus for clinician researchers on potential research avenues.</p>","PeriodicalId":17546,"journal":{"name":"Journal of Thrombosis and Thrombolysis","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}