UrolithiasisPub Date : 2024-08-06DOI: 10.1007/s00240-024-01608-w
Ian Berger, Robert Medairos, Ezra Margolin, Jodi Antonelli, Michael E Lipkin, Charles D Scales, Deborah R Kaye
{"title":"Work absence and productivity loss of patients undergoing a trial of spontaneous passage for ureteral stones.","authors":"Ian Berger, Robert Medairos, Ezra Margolin, Jodi Antonelli, Michael E Lipkin, Charles D Scales, Deborah R Kaye","doi":"10.1007/s00240-024-01608-w","DOIUrl":"https://doi.org/10.1007/s00240-024-01608-w","url":null,"abstract":"<p><p>Patients with ureteral stones are often managed with a spontaneous trial of passage. While cost effective, the current literature has not examined the effects of a trial of passage on patients' work productivity. In this study, we aim to characterize work absence and productivity losses in a cohort of patients undergoing a trial of passage for ureteral stones. Actively employed patients aged 18 to 64 and discharged from Duke emergency departments without surgical intervention for ureteral stones ≤ 10 mm were contacted by phone four weeks after their presentation. Participants completed the Institute for Medical Technology Assessment Productivity Cost Questionnaire which assesses three domains: absenteeism - missed work; presenteeism -productivity when returning to work; and unpaid work - assistance with household work. Linear regression associated demographic and stone factors with productivity losses.109 patients completed the survey. In total, 67% of patients missed work, 46% had decreased productivity when returning to work, and 55% required assistance with unpaid work. 59% of patients with stones ≤ 5 mm missed work versus 84% with stones > 5 mm (p = 0.009). African American race (coefficient 23.68, 95% confidence interval 2.24-45.11, p = 0.031), first-time stone formers (coefficient 20.28, 95% confidence interval 2.50-38.07, p = 0.026), and patients with stones > 5 mm (coefficient 25.34, 95% CI 5.25-45.44, p = 0.014) were associated with increased productivity losses. The majority of patients miss work while undergoing a trial of passage and many have decreased productivity when returning to work. This information may help counsel patients in emergency departments, especially first-time stone formers, and prevent return visits.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"111"},"PeriodicalIF":2.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-08-06DOI: 10.1007/s00240-024-01604-0
Marcin Popiolek, Mats Lidén, Petros Georgouleas, Klara Sahlén, Pernilla Sundqvist, Johan Jendeberg
{"title":"Radiological signs of stone impaction add no value in predicting spontaneous stone passage.","authors":"Marcin Popiolek, Mats Lidén, Petros Georgouleas, Klara Sahlén, Pernilla Sundqvist, Johan Jendeberg","doi":"10.1007/s00240-024-01604-0","DOIUrl":"10.1007/s00240-024-01604-0","url":null,"abstract":"<p><p>Stone size and location are key factors in predicting spontaneous stone passage (SSP), but little attention has been paid to the influence of radiological signs of stone impaction (RSSI). This research aims to determine whether RSSI, alongside stone size, can predict SSP and to evaluate the consistency of ureteral wall thickness (UWT) measurements among observers. In this retrospective study, 160 patients with a single upper or middle ureteral stone on acute non-enhanced computed tomography (NCCT) were analysed. Patient data were collected from medical records. Measurements of RSSI, including UWT, ureteral diameters, and average attenuation above and below the stone, were taken on NCCT by four independent readers blind to the outcomes. The cohort consisted of 70% males with an average age of 51 ± 15. SSP occurred in 61% of patients over 20 weeks. The median stone length was 5.7 mm (IQR: 4.5-7.3) and was significantly shorter in patients who passed their stones at short- (4.6 vs. 7.1, p < 0.001) and long-term (4.8 vs. 7.1, p < 0.001) follow-up. For stone length, the area under the receiver operating characteristic curve (AUC) for predicting SSP was 0.90 (CI 0.84-0.96) and only increased to 0.91 (CI 0.85-0.95) when adding ureteral diameters and UWT. Ureteral attenuation did not predict SSP (AUC < 0.5). Interobserver variability for UWT was moderate, with ± 2.0 mm multi-reader limits of agreement (LOA). The results suggest that RSSI do not enhance the predictive value of stone size for SSP. UWT measurements exhibit moderate reliability with significant interobserver variability.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"114"},"PeriodicalIF":2.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11303465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Propensity score matched comparison of transperitoneal laparoscopic ureterolithotomy and percutaneous nephrolithotomy for management of large impacted proximal ureteral stones with long-term follow-up.","authors":"Shijun Zhang, Haomin Ren, Xiang Li, Qingzhi Long, Dapeng Wu, Wei Chen","doi":"10.1007/s00240-024-01609-9","DOIUrl":"https://doi.org/10.1007/s00240-024-01609-9","url":null,"abstract":"<p><p>Impacted proximal ureteral stones (IPUS) present challenging clinical scenarios due to their persistent nature and associated complications. While ureterorenoscopy (URS) lithotripsy is recommended as the primary treatment, controversies exist regarding the optimal management of such stones. In this retrospective analysis, we compared the operative outcomes and long-term results of transperitoneal laparoscopic ureterolithotomy (LU) and percutaneous nephrolithotomy (PCNL) for IPUS larger than 15 mm. Propensity score matching (PSM) was employed to mitigate potential selection biases. Following PSM, 83 patients in each cohort exhibited comparable baseline characteristics. LU demonstrated a superior surgical success rate (100% vs. 96.4%, p = 0.244) and significantly lower perioperative hemoglobin decline (0.6 ± 0.4 g/dL vs. 1.5 ± 0.7 g/dL, p = 0.036) compared to PCNL. Additionally, LU exhibited a higher stone-free rate after 2 months (100% vs. 91.6%, p = 0.043), but a longer duration of catheterization (7.4 ± 1.2 days vs. 3.5 ± 2.2 days vs., p = 0.011). Conversely, PCNL was associated with a higher incidence of total complications (21.7% vs. 9.6%, p = 0.033) and stone recurrence during a mean period of 40-month follow-up (20.5% vs. 8.4%, p = 0.027). Transperitoneal LU and PCNL represent effective interventions for managing IPUS exceeding 15 mm. Notably, LU emerges as a preferable option over PCNL, offering superior stone clearance rates, reduced perioperative complications, and lower recurrence rates.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"109"},"PeriodicalIF":2.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-07-28DOI: 10.1007/s00240-024-01611-1
Emre Uzun, Samet Senel, Muhammed Emin Polat, Hasan Batuhan Arabaci, Antonios Koudonas, Erkan Olcucuoglu
{"title":"The predictive ability of Mayo adhesive probability score for evaluating intraoperative bleeding in standard percutaneous nephrolithotomy in adult patients.","authors":"Emre Uzun, Samet Senel, Muhammed Emin Polat, Hasan Batuhan Arabaci, Antonios Koudonas, Erkan Olcucuoglu","doi":"10.1007/s00240-024-01611-1","DOIUrl":"https://doi.org/10.1007/s00240-024-01611-1","url":null,"abstract":"<p><p>Mayo adhesive probability (MAP) score is one of the commonest tool to predict the adherence status of perirenal fat. The association between MAP score and intraoperative hemorrhage in patients undergoing micropercutaneous nephrolithotomy was comfirmed in a recent well designed study. We aimed to investigate if MAP score may predict the possibility for significant intraoperative bleeding in supine percutaneous nephrolithotomy (PCNL) performed with a 26 Fr rigid nephroscope. In this observational retrospective study, demographic, clinical, laboratory, radiological, perioperative (operation duration, hospitalization, intraoperative bleeding, success) and MAP score (perinephric fat stranding, posterior perinephric fat thickness and total MAP score) data of all patients who underwent supine PCNL between June 2021 and July 2023 were evaluated. The patients were divided into 2 groups according to their MAP scores (79 [54.1%] patients with MAP score < 3 [low MAP score] and 67 [54.1%] patients with MAP score ≥ 3 [high MAP score]). The rate of patients with intraoperative bleeding was 47.8% in the patient group with a high MAP score, while it was 22.8% in the patient group with a low MAP score (p = 0.002). In multivariate logistic regression analysis, anticoagulant drug use history (OR = 2.525; 95% CI = 1.025-6.224; p = 0.044), presence of multiple stones (OR = 3.015; 95% CI = 1.205-7.543; p = 0.018), calyx localization of the stone (OR = 2.871;95% CI = 1.166-7.068; p = 0.022), higher renal parenchymal thickness (OR = 1.119; 95% CI = 1.049-1.193; p = 0.001) and MAP score > 3 (OR = 3.486; 95% CI = 1.579-7.696; p = 0.002) were defined as independent risk factors for significant intraoperative bleeding. In clinical practice, the MAP score can be used to predict bleeding before PCNL.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"108"},"PeriodicalIF":2.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-07-22DOI: 10.1007/s00240-024-01602-2
Ahmed Zoeir, Talaat Zaghloul, Tarek Gameel, Ayman Mousa, Hasan El Tatawy, Maged Ragab, Mohammed Abo-El Enein, Hussein Mamdoh
{"title":"Comparison of laparoscopic ureterolithotomy, retrograde flexible ureteroscopy, and mini-percutaneous antegrade flexible ureteroscopic lithotripsy for treating large (≥ 15 mm) impacted proximal ureteric stones: a prospective randomized trial.","authors":"Ahmed Zoeir, Talaat Zaghloul, Tarek Gameel, Ayman Mousa, Hasan El Tatawy, Maged Ragab, Mohammed Abo-El Enein, Hussein Mamdoh","doi":"10.1007/s00240-024-01602-2","DOIUrl":"https://doi.org/10.1007/s00240-024-01602-2","url":null,"abstract":"<p><p>The purpose of this study is to compare the outcomes of transperitoneal laparoscopic ureterolithotomy (TPLU), retrograde flexible ureteroscopy (R-fURS), and mini-percutaneous antegrade flexible ureteroscopy (A-fURS) for treating large (≥ 15 mm) impacted proximal ureteral stones. A total of 105 adult patients were randomized into 3 equal groups: group A (35) patients underwent TPLU, group B (35) patients underwent R-fURS, and group C (35) patients underwent A-fURS. The initial stone-free rate was 100%, 68.6%, and 80% in groups A, B, and C, respectively. The mean operative time (OT) was (85.0 ± 7.57 min) in group A, (61.0 ± 8.21 min) in group B, and (89.57 ± 15.12 min) in group C. The three groups were comparable concerning the overall complications. R-fURS is a less invasive modality for treating such stones; however, it is associated with a lower SFR and a higher rate of auxiliary procedures. Both TPLU and miniperc A-fURS are effective and valuable alternatives for treating large impacted proximal ureteric stones.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"107"},"PeriodicalIF":2.0,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-07-18DOI: 10.1007/s00240-024-01575-2
Mohamed Omar, Tarek Ahmed Amin Ibrahim, Sultan Sultan, Mohamed El-Gharabawy, Yasser Noureldin, Saeed Bin Hamri, Khaled Sayedahmed
{"title":"Evaluating the safety of bipolar nephrostomy tract cauterization \"BNTC\" towards a safe tubeless percutaneous nephrolithotomy: a randomized controlled trial.","authors":"Mohamed Omar, Tarek Ahmed Amin Ibrahim, Sultan Sultan, Mohamed El-Gharabawy, Yasser Noureldin, Saeed Bin Hamri, Khaled Sayedahmed","doi":"10.1007/s00240-024-01575-2","DOIUrl":"10.1007/s00240-024-01575-2","url":null,"abstract":"<p><p>To assess the safety and effectiveness of tubed versus tubeless percutaneous nephrolithotomy (PCNL) after tract inspection and bipolar cauterization of the significant bleeders. Patients who were scheduled for PCNL were screened for enrollment in this prospective randomized controlled trial. The patients were randomly assigned to one of two groups; Group 1 received tubeless PCNL with endoscopic inspection of the access tract using bipolar cauterization of the significant bleeders only, while Group 2 had a nephrostomy tube was inserted without tract inspection. We excluded patients with multiple tracts, stone clearance failure, and significant collecting system perforation. We recorded blood loss, hemoglobin drop after 6 h, postoperative analgesia requirements, hospital stay, and the need for angioembolization. A total of 110 patients completed the study. There were no significant differences between the two groups in in terms of demographic characteristics. Likewise, there was no significant difference in the mean decrease in hemoglobin after 6 h and the frequency of blood transfusion. However, the incidence of hematuria within the first 6 h (p = 0.008), postoperative pain scale (p = 0.0001), the rate of analgesia requirement (p = 0.0001) and prolonged hospital stay (p = 0.0001) were significantly higher in Group 2. Only 9 cases of tract screened patients (16% of group 1) required cauterization. Tubeless PCNL with tract inspection and cauterization of bleeders can provide a safer tubeless PCNL with less postoperative pain, analgesia requirement, and same-day discharge.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"106"},"PeriodicalIF":2.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development and validation of a predictive model for double-J stent encrustation after upper urinary tract calculi surgery.","authors":"Weihui Jia, Wenyu Chi, Chen Liu, Yifen Song, Shunshun Yang, Chonggao Yin","doi":"10.1007/s00240-024-01554-7","DOIUrl":"10.1007/s00240-024-01554-7","url":null,"abstract":"<p><p>The study is aimed to establish a predictive model of double-J stent encrustation after upper urinary tract calculi surgery. We collected the clinical data of 561 patients with indwelling double-J tubes admitted to a hospital in Shandong Province from January 2019 to December 2020 as the modeling group and 241 cases of indwelling double-J tubes from January 2021 to January 2022 as the verification group. Univariate and binary logistic regression analyses were used to explore risk factors, the risk prediction equation was established, and the receiver operating characteristic (ROC) curve analysis model was used for prediction. In this study, 104 of the 561 patients developed double-J stent encrustation, with an incidence rate of 18.5%. We finally screened out BMI (body mass index) > 23.9 (OR = 1.648), preoperative urine routine white blood cell quantification (OR = 1.149), double-J tube insertion time (OR = 1.566), postoperative water consumption did not reach 2000 ml/d (OR = 8.514), a total of four factors build a risk prediction model. From the ROC curve analysis, the area under the curve (AUC) was 0.844, and the maximum Oden index was 0.579. At this time, the sensitivity was 0.735 and the specificity was 0.844. The research established in this study has a high predictive value for the occurrence of double-J stent encrustation in the double-J tube after upper urinary tract stone surgery, which provides a basis for the prevention and treatment of double-J stent encrustation.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"105"},"PeriodicalIF":2.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-07-05DOI: 10.1007/s00240-024-01603-1
Kadir Serefhan Erten, Nursah Sariduman, Ilker Sen, Mustafa Ozgur Tan
{"title":"Re: Extracorporeal shock wave lithotripsy: retrospective study on possible predictors of treatment success and revisiting the role of non-contrast-enhanced computer tomography in kidney and ureteral stone disease.","authors":"Kadir Serefhan Erten, Nursah Sariduman, Ilker Sen, Mustafa Ozgur Tan","doi":"10.1007/s00240-024-01603-1","DOIUrl":"https://doi.org/10.1007/s00240-024-01603-1","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"104"},"PeriodicalIF":2.0,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-07-03DOI: 10.1007/s00240-024-01601-3
Mingrui Wang, Chin-Hui Lai, Jiaxiang Ji, Haopu Hu, Runfeng Ni, Jun Liu, Luping Yu, Hao Hu
{"title":"Association of health-related quality of life with urinary tract infection among kidney stone formers.","authors":"Mingrui Wang, Chin-Hui Lai, Jiaxiang Ji, Haopu Hu, Runfeng Ni, Jun Liu, Luping Yu, Hao Hu","doi":"10.1007/s00240-024-01601-3","DOIUrl":"10.1007/s00240-024-01601-3","url":null,"abstract":"<p><p>Kidney stones and infections significantly affect patients' health-related quality of life (HRQOL); however, the relationship between urinary tract infections (UTIs) and HRQOL in patients with kidney stones remains unclear. This study aimed to investigate the relationship using the validated Chinese version of the Wisconsin Stone Quality of Life questionnaire (C-WISQOL). We prospectively recruited 307 patients with kidney stones to complete the C-WISQOL before and after stone removal. The participants were diagnosed with UTI based on the presence of pyuria or bacteriuria with or without clinical symptoms. The psychometric properties of the C-WISQOL were statistically analyzed. Multivariate linear regression was used to predict the risk factors for impaired HRQOL in patients with stones and UTIs. The questionnaire is a reliable and robust tool for evaluating HRQOL in Chinese-speaking patients with urolithiasis. The UTI and kidney stone co-occurrence was significantly associated with female sex, diabetes mellitus, more previous stone events, higher antibiotic usage, positive stone- or UTI-related symptoms, and postoperative residual stones. The preoperative C-WISQOL scores and improvement in the HRQOL after stone removal in patients clinically diagnosed with UTI were significantly inferior to those in patients without UTI. The regression analyses showed that worse HRQOL was predicted by more previous stone events and positive stone- or UTI-related symptoms. In contrast, the presence of diabetes mellitus and postoperative residual stone fragments predicted a lower improvement in the HRQOL. These findings underscore UTI's harmful impact on perioperative HRQOL in patients with kidney stones and could help strategies benefit those patients.</p>","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"103"},"PeriodicalIF":2.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11222279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
UrolithiasisPub Date : 2024-06-27DOI: 10.1007/s00240-024-01600-4
Ali Şahin, Emre Altıntaş, Murat Gül
{"title":"Commentary on \"develop a radiomics-based machine learning model to predict the stone-free rate post-percutaneous nephrolithotomy\".","authors":"Ali Şahin, Emre Altıntaş, Murat Gül","doi":"10.1007/s00240-024-01600-4","DOIUrl":"https://doi.org/10.1007/s00240-024-01600-4","url":null,"abstract":"","PeriodicalId":23411,"journal":{"name":"Urolithiasis","volume":"52 1","pages":"101"},"PeriodicalIF":2.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}