Kidney Medicine最新文献

{"title":"Concerning the article “False-positive Serum Antiglomerular Basement Membrane Antibody due to Bovine Serum Albumin-containing Surgical Adhesive: A Case Report” by Yoshida et al","authors":"Giulia Zorzi MD","doi":"10.1016/j.xkme.2025.100985","DOIUrl":"10.1016/j.xkme.2025.100985","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100985"},"PeriodicalIF":3.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transferring From Peritoneal Dialysis to Home or In-Center Hemodialysis: A Cohort Study of an Integrated Home Dialysis Model","authors":"Jana Mahmoud BSc , Louis-Charles Desbiens MD, MSc , Naoual Elftouh MSc , Louis-Philippe Laurin MD, MSc , Annie-Claire Nadeau-Fredette MD, MSc","doi":"10.1016/j.xkme.2025.100977","DOIUrl":"10.1016/j.xkme.2025.100977","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100977"},"PeriodicalIF":3.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mineralocorticoid Receptor Antagonist Use Among Patients With Chronic Kidney Disease Who Transitioned to Dialysis","authors":"Eric M. Tong MD , Hui Zhou PhD , Katherine Pak MS , Cheng-Wei Huang MD , Benjamin I. Broder MD, PhD , John J. Sim MD","doi":"10.1016/j.xkme.2025.100973","DOIUrl":"10.1016/j.xkme.2025.100973","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100973"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Testing of the Discussion of Patient Life Goals Patient-Reported Outcome Measure for Dialysis Facilities","authors":"Claudia Dahlerus , Noelle E. Carlozzi , Katrina Price , Jennifer A. Miner , Richard A. Hirth , Garrett Gremel , Peisong Han , Wei Zhang , Jennifer Sardone , Jesse Roach , Wilfred Agbenyikey , Stephanie L. Clark , Golden Horton , Alexander Yaldo , Joseph M. Messana","doi":"10.1016/j.xkme.2025.100972","DOIUrl":"10.1016/j.xkme.2025.100972","url":null,"abstract":"<div><h3>Rationale & Objectives</h3><div>To test a new patient-reported outcome measure that assesses end-stage kidney disease (ESKD) maintenance dialysis patients’ experience with life goals discussions with their dialysis facility care team.</div></div><div><h3>Study Design</h3><div>Observational cross-sectional study. Survey data collected via REDCap, paper form or telephone in a convenience sample of patients with ESKD receiving maintenance dialysis in the United States.</div></div><div><h3>Settings & Participants</h3><div>People aged 18 years or older with ESKD receiving maintenance hemodialysis or peritoneal dialysis in US dialysis facilities between the June and December 2020 study period.</div></div><div><h3>Exposures</h3><div>Testing of 6 items providing the core quality assessment and 1 item measuring whether 1 or more members of the treatment team discussed life goals with the patient.</div></div><div><h3>Outcomes</h3><div>Preliminary reliability and validity of the Discussion of Patient Life Goals survey (D-PaLS).</div></div><div><h3>Analytic Approach</h3><div>Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and item response theory methods, including the graded response model (GRM) and differential item functioning (DIF).</div></div><div><h3>Results</h3><div>Of 517 participants, 479 completed the survey via REDCap; 38 completed the survey via paper or telephone. EFA and CFA supported the unidimensionality of the 6 core items. GRM overall and item fit analyses and DIF analyses supported retention of all core items. Preliminary reliability data indicated very good internal consistency (Cronbach’s alpha<!--> <!-->=<!--> <!-->0.84). Known-groups validity was supported whereby individuals receiving home dialysis had more positive responses, than those receiving in-center hemodialysis.</div></div><div><h3>Limitations</h3><div>Study participants were not fully representative of the US ESKD dialysis population.</div></div><div><h3>Conclusions</h3><div>Preliminary analyses indicate the D-PaLS has excellent psychometric properties. The measure provides 2 important quality metrics: facilities’ level of engagement talking with patients about their life goals and the percentage of patients reporting who on the treatment team talks with them about their life goals. Additional work is needed to establish comprehensive reliability and validity to support the clinical utility of this measure in patient care.</div></div><div><h3>Plain Language Summary</h3><div>The Discussion of Patient Life Goals survey (Item S1) was developed based on conversations we had with people with kidney failure and kidney doctors who felt it was important that discussing patient life goals should be part of kidney replacement treatment planning. To make sure this patient survey accurately assesses patient-reported experience with dialysis facility care, we carried out a series of statistical tests. Our testing results showed that the survey meet","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 4","pages":"Article 100972"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Immediate Posttransplant Eruption","authors":"Ravi K. Mallavarapu, Akhil Vemuri","doi":"10.1016/j.xkme.2025.100969","DOIUrl":"10.1016/j.xkme.2025.100969","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100969"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143178063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Anticoagulant Initiation in Patients With Kidney Failure on Hemodialysis Newly Diagnosed With Atrial Fibrillation (2007-2020): An Observational Study of Trends and Disparities","authors":"Wolfgang C. Winkelmayer , Austin Hu , Pascale Khairallah , Medha Airy , Kevin F. Erickson , Tara I. Chang , Jingbo Niu","doi":"10.1016/j.xkme.2024.100926","DOIUrl":"10.1016/j.xkme.2024.100926","url":null,"abstract":"<div><h3>Rationale & Objective</h3><div>Atrial fibrillation (AF) is common in patients with kidney failure on hemodialysis (HD), but few patients receive oral anticoagulant (OAC) treatment. Availability of direct-target OACs starting in 2010 may have induced greater OAC initiation, but this has not been systematically studied.</div></div><div><h3>Study Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting & Participants</h3><div>Using Medicare fee-for-service billing claims (2006-2020), we identified previously OAC-naïve HD patients newly-diagnosed with AF between January 1, 2007, and October 1, 2020.</div></div><div><h3>Exposures</h3><div>Calendar year; race/ethnicity.</div></div><div><h3>Outcomes</h3><div>OAC initiation within 90 days from AF diagnosis (any; specific agent).</div></div><div><h3>Analytical Approach</h3><div>We estimated initiation risk ratios for each calendar year compared with the referent cohort, 2007, using unadjusted and multivariable-adjusted modified Poisson regression. We also determined differences by racial/ethnic group in OAC initiation, as well as any changes in these disparities over time.</div></div><div><h3>Results</h3><div>Among 82,389 HD patients newly-diagnosed with AF, 20,002 (24.3%) initiated new OAC treatment within 90 days: 20.5% in 2007 and 34.1% in 2020. Direct-target OACs accounted for 81.0% of OAC initiations in 2020. Adjusted regression models estimated that OAC initiation remained essentially unchanged between 2007 and 2013, but thereafter increased toward a demographics-adjusted risk ratio of 1.61 (95% CI: 1.50-1.73) in 2020. Compared with non-Hispanic Whites, the rates of OAC initiation were 15% (95% CI, 12%-17%) lower among Black patients, 29% (95% CI, 24%-34%) lower among Asian patients, and 22% (95% CI, 19%-25%) lower among Hispanic patients. These disparities were not found to have differed across time (<em>P</em><sub>interaction</sub> <!-->=<!--> <!-->0.75).</div></div><div><h3>Limitations</h3><div>Lack of clinical detail to firmly establish contraindications to OAC initiation.</div></div><div><h3>Conclusions</h3><div>While rates of OAC initiation among patients on HD with newly-diagnosed AF increased in recent years, predominantly driven by increased use of apixaban, OAC initiation rates remained low, at 34% of patients in 2020. Compared with non-Hispanic White patients, OAC initiation remained consistently lower in patients of other race and ethnic groups.</div></div><div><h3>Plain-Language Summary</h3><div>Use of oral blood thinners (anticoagulants) in patients with kidney failure undergoing hemodialysis who have a common type of heart rhythm disorder (atrial fibrillation) used to be low. We studied whether the availability of a novel class of anticoagulants increased use of this treatment approach in recent years. We were also interested in identifying any differences in anticoagulant use between patients of different racial and ethnic backgrounds. We found that us","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100926"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11750526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thiazide-Associated Hyponatremia and Mortality Risk: A Cohort Study","authors":"Steven G. Achinger ,&nbsp;Juan Carlos Ayus ,&nbsp;Ambuj Kumar ,&nbsp;Athanasios Tsalatsanis","doi":"10.1016/j.xkme.2024.100941","DOIUrl":"10.1016/j.xkme.2024.100941","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><div>There are likely over 42 million patients with hypertension taking thiazides in the United States and many more worldwide. Hyponatremia is a common complication of thiazide therapy. It is not currently known if thiazide-associated hyponatremia is also associated with increased mortality. The objective of this study was to determine if outpatients who start thiazide diuretic treatment and develop early hyponatremia are at increased risk of mortality when compared with those who do not develop hyponatremia after starting a thiazide.</div></div><div><h3>Study Design</h3><div>A retrospective cohort study.</div></div><div><h3>Setting &amp; Participants</h3><div>This study used data from the TriNetX federated health research network comprising deidentified electronic medical records of ∼93 million patients from 76 health care organizations located primarily in the United States. The study population was adult patients 40-90 years old, with essential hypertension and who started on a thiazide diuretic between January 1, 2010, and December 31, 2021. The patients were then subdivided into a hyponatremia cohort and a control cohort. 22,057 patients met the inclusion criteria for the hyponatremia cohort, and 234,466 patients met the inclusion criteria for the control cohort. After propensity score matching, 22,052 remained in both cohorts. The primary outcome is one-year mortality.</div></div><div><h3>Exposure</h3><div>The hyponatremia cohort developed early hyponatremia defined as a serum sodium<!--> <!-->≤<!--> <!-->135<!--> <!-->mmol/L within 6 months after initiation of thiazide versus a control that had a serum sodium 136-144<!--> <!-->mmol/L after initiation of thiazide.</div></div><div><h3>Outcomes</h3><div>Primary outcome is mortality. Secondary outcomes include development of sepsis, pneumonia, urinary tract infection, cellulitis, myocardial infarction, stroke, congestive heart failure, ataxia, fall, and hip fracture.</div></div><div><h3>Analytical Approach</h3><div>The design is a retrospective cohort study, propensity score matched.</div></div><div><h3>Results</h3><div>Patients in the hyponatremia cohort had a higher hazard of mortality than patients in control, HR 1.96 (95% CI, 1.72-2.28; <em>P</em> <!-->&lt;<!--> <!-->0.001). In addition, patients in the hyponatremia cohort had higher hazard of developing sepsis, pneumonia, urinary tract infection, cellulitis, myocardial infarction, stroke, congestive heart failure, ataxia, and hip fracture.</div></div><div><h3>Limitations</h3><div>The study had a retrospective design.</div></div><div><h3>Conclusions</h3><div>Patients who develop early hyponatremia (serum sodium<!--> <!-->≤<!--> <!-->135<!--> <!-->mmol/L) following initiation of a thiazide diuretic have a higher risk of mortality when compared with those who do not develop hyponatremia after initiation of a thiazide diuretic.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100941"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11759562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EPO-Mimetic Peptide Pegmolesatide Therapy for Pure Red Cell Aplasia in a Patient with Non-dialysis-dependent Type 1 Diabetic Nephropathy: A Case Report","authors":"Qiong Chen ,&nbsp;Xuan Liu ,&nbsp;Juan Wang ,&nbsp;Man Yang ,&nbsp;Qiu-ling Fan","doi":"10.1016/j.xkme.2024.100947","DOIUrl":"10.1016/j.xkme.2024.100947","url":null,"abstract":"<div><div>Pure red cell aplasia (PRCA) is a rare complication of erythropoietin (EPO) therapy, characterized by a severe deficiency in red blood cell production. There is no guideline on the treatment for PRCA because there have been too few cases to perform prospective cohort studies. The main treatments for PRCA include immediate cessation of EPO, restrictive transfusion, and immunosuppressive therapies. A 35-year-old male patient with type 1 diabetic nephropathy was diagnosed with PRCA. Enarodustat and roxadustat were administered successively after discontinuation of EPO, but anemia did not improve, and the patient was maintained with weekly blood transfusions. Subsequently, the EPO-mimetic peptide pegmolesatide was administered, and the patient’s hemoglobin started to increase after 1 week and increased from 50<!--> <!-->g/L to 92<!--> <!-->g/L over approximately 3 months. Based on these findings, we speculate that pegmolesatide can provide a safe, effective, and convenient therapeutic strategy for PRCA in Chinese patients with chronic kidney disease.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100947"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney Biopsy-Proven Diabetic and Non-Diabetic Kidney Diseases and Outcomes in Patients With Type 2 Diabetes Receiving Dialysis: The REIN Registry","authors":"Maxime Ingwiller ,&nbsp;Arnaud Delautre ,&nbsp;Jean-Michel Tivollier ,&nbsp;Stephane Edet ,&nbsp;Nans Florens ,&nbsp;Cécile Couchoud ,&nbsp;Thierry Hannedouche ,&nbsp;REIN registry","doi":"10.1016/j.xkme.2024.100944","DOIUrl":"10.1016/j.xkme.2024.100944","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Chronic kidney disease (CKD) in patients with diabetes does not always equate to diabetic kidney disease (DKD). This study aims to delineate and compare the clinical characteristics, survival rates, and access to kidney transplantation among patients with type 2 diabetes commencing dialysis, who were classified by kidney biopsy as having either DKD or non-diabetic kidney disease (non-DKD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;We used the comprehensive French Renal Epidemiology and Information Network registry to analyze baseline clinical characteristics at dialysis inception and outcomes defined as death and access to kidney transplantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes &amp; Analytical Approach&lt;/h3&gt;&lt;div&gt;We employed a multivariate Cox proportional hazards model and the Fine-Gray competing risk model to assess the probabilities of mortality and transplantation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Settings &amp; Participants&lt;/h3&gt;&lt;div&gt;Adults in the Renal Epidemiology and Information Network registry in France with a diagnosis of type 2 diabetes who initiated kidney replacement therapy from January 2009 to December 2015 and had a previous native kidney biopsy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We analyzed data from 2,869 patients with diabetes, 45% of whom had a biopsy-confirmed diagnosis of DKD. Among these patients, half presented additional histopathological findings indicative of nephroangiosclerosis and focal segmental glomerulosclerosis. The clinical profiles of patients with DKD and non-DKD were largely comparable. There were no significant differences in dialysis survival rates or kidney transplantation access between the groups, even after adjusting for confounding variables and considering competing risks. At the 6-year mark, the mortality rate was 60.3% (95% CI: 55.5-64.5) for the DKD group and 60.3% (95% CI: 55.9-64.3) for the non-DKD group. Multivariable Cox analysis revealed no significant difference in mortality risk between the DKD and non-DKD groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The study limitations include potential residual confounders, lack of predialysis data, kidney biopsies possibly outdated, nonrandom biopsy indications, and survival bias because of analysis at dialysis inception.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In patients with diabetes initiating dialysis, clinical characteristics and outcomes following dialysis initiation were similar in biopsy-proven DKD versus non-DKD. Our results suggest that the diabetic milieu has a more significant impact on outcomes in patients with diabetes treated with dialysis than the underlying pathological kidney diagnosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain Language Summary&lt;/h3&gt;&lt;div&gt;This study explored whether chronic kidney diseases in patients with diabetes are always caused by diabetes or if other conditions might be responsible. By examining medical records from the nationwide French registry, researchers compared patients with diabetic kidn","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100944"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Cytokine Profile in IgA Nephropathy","authors":"Friederike Selbach MD ,&nbsp;Umberto Maggiore MD ,&nbsp;Micaela Gentile MD ,&nbsp;Kristin Meliambro MD ,&nbsp;Kirk N. Campbell MD ,&nbsp;Janusz Tucholski PhD ,&nbsp;Bruce A. Julian PhD ,&nbsp;William J. Placzek PhD ,&nbsp;Sara Alibrandi MD ,&nbsp;Seunghee Kim-Schulze PhD ,&nbsp;Maria Lanau Martínez MD ,&nbsp;M Loreto Fernandez-Lorente MD ,&nbsp;Joaquin Manrique MD ,&nbsp;Paolo Cravedi MD, PhD","doi":"10.1016/j.xkme.2024.100940","DOIUrl":"10.1016/j.xkme.2024.100940","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 2","pages":"Article 100940"},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}