Vox Sanguinis最新文献

{"title":"Studies of platelet antibodies at MacKay Memorial Hospital in Taiwan: Methods, case reviews and a possible case of post-transfusion purpura.","authors":"Chiang Chen-Yu, Chang Hsiao-Lin, Chan Yung-Shu, Cheng Wern-Cherng, Lin Marie","doi":"10.1111/vox.70200","DOIUrl":"10.1111/vox.70200","url":null,"abstract":"<p><strong>Background and objectives: </strong>Platelet antibody screening and identification are crucial and challenging. MacKay Memorial Hospital has been dedicated to this for nearly four decades. We reviewed our experience with platelet antibody detection methods and prevalence, and presented a possible case of post-transfusion purpura caused by anti-CD36.</p><p><strong>Materials and methods: </strong>We analyzed platelet antibody screening results from 1988 to 2024. We used solid phase red cell adherence test (SPRCA) from 1988 to 2018 (9268 samples), and parallel SPRCA/enzyme-linked immunosorbent assay (ELISA) from 2019 to 2024 (2037 samples). Positive results are further identified through flow cytometry, monoclonal antibody immobilization of platelet antigens (MAIPA), or in-house platelet antigen panels. We also studied a possible case of post-transfusion purpura (PTP) caused by anti-CD36. A 79-year-old woman was treated with numerous platelet transfusions that were ineffective, with generalized purpura appearing a few days later following massive transfusion.</p><p><strong>Results: </strong>From 1988-2018, 2800 of 9268 samples (30.2%) were positive. Six cases of neonatal alloimmune thrombocytopenia (NAITP) were identified (two anti-HPA-3a, two anti-HPA-5a, and two anti-CD36). From 2019-2024, 778 of 2037 samples (38.19%) were positive. Specific antibodies were identified in eight cases, and six of them were anti-CD36. Introduction of ELISA resulted in a 15-fold detection rate of anti-CD36 (0.02% to 0.29%), suggesting previous underestimation. In the possible PTP case, massive transfusion was started on Day 8 of hospitalization, purpura appeared on Day 15, anti-CD36 was identified on Day 21, and CD36-negative platelet transfusion was initiated on the following day. However, the patient eventually died of multiorgan failure on Day 29.</p><p><strong>Conclusion: </strong>The prevalence of anti-CD36 antibody in the Taiwanese population was previously underestimated. Clinicians should be aware that not only human platelet antigen (HPA) but CD36 should also be considered when platelet refractoriness persists despite HLA-matched transfusion, as anti-CD36 may cause serious complications.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"654-659"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214273","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":"Association of SARS-CoV-2 infection with interdonation interval: A matched cohort study of plasma donors in Québec, Canada.","authors":"Renée Bazin, Marc Germain, Christian Renaud, Antoine Lewin","doi":"10.1111/vox.70206","DOIUrl":"10.1111/vox.70206","url":null,"abstract":"<p><strong>Background and objectives: </strong>Blood services witnessed significant declines of donor returns during the COVID-19 pandemic. Should another public health crisis occur, this experience may provide important insights for the development of strategies to maximize donor return. Here, we explored how contracting a SARS-CoV-2 infection impacted interdonation interval.</p><p><strong>Materials and methods: </strong>This was a retrospective cohort study of plasma donors who were not SARS-CoV-2-vaccinated at the time of inclusion. The study took place in Québec, Canada. Donors were included if they had donated plasma twice: once between March 1 2020 and 30 June 2020 and once more within the next 24 months. Donors with ('infected') and without ('non-infected') a self-reported SARS-CoV-2 infection were matched 1:1 based on sex, age and number of previous donations. Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>The matched cohorts each comprised 108 donors, including 50.0% of female donors (mean age ± standard deviation [years]: infected = 40.5 ± 16.2; non-infected = 41.0 ± 16.4). Interdonation interval was significantly longer among infected donors than among non-infected donors, whether it be in the full cohort (HR [95% CI] = 0.566 [0.428-0.749]) or among female donors (HR [95% CI] = 0.429 [0.278-0.660])-but not among male donors (HR [95% CI] = 0.813 [0.527-1.254]).</p><p><strong>Conclusion: </strong>In this study, a self-reported SARS-CoV-2 infection was associated with a significantly longer interdonation interval.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"660-664"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202823","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 to 'Potential benefits of an alternative haemoglobin deferral strategy evaluated in seven countries'.","authors":"","doi":"10.1111/vox.70217","DOIUrl":"10.1111/vox.70217","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"680"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119791","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":"Higher uptake of common adult vaccines in Australian blood donors: An analysis of linked registry data.","authors":"Surendra Karki, Veronica Hoad, Bette Liu, Marijke Welvaert, Rena Hirani, David O Irving","doi":"10.1111/vox.70205","DOIUrl":"10.1111/vox.70205","url":null,"abstract":"<p><strong>Background and objectives: </strong>Understanding differences in blood donor vaccine uptake is essential for accurately interpreting serosurveillance of vaccine-preventable diseases and other research using donor samples and/or data. We aimed to assess vaccination uptake in donors and non-donors.</p><p><strong>Materials and methods: </strong>We linked the Sax Institute's 45 and Up Study data to blood donation records, the Australian Immunization Register and death records. Participants were categorized as active donors, lapsed donors or non-donors. Influenza, herpes-zoster, pneumococcal and COVID-19 vaccine uptake were analysed in the age groups recommended and eligible for free vaccination and for pertussis in the age group recommended. We calculated age- and sex-adjusted uptake percentages and differences averaged across 2021-2023, except for COVID-19 vaccine. Multivariable regression models were used to assess the association between donor status and vaccination uptake, adjusting for potential confounders.</p><p><strong>Results: </strong>Of the 266,432 participants available for this research, 216,338 were eligible for analysis in 2021. Of these, 5734 (2.7%) were active donors, 29,237 (13.5%) were lapsed donors and 181,367 (83.8%) were non-donors. Active donors had higher vaccination uptake than non-donors (adjusted uptake ratio [95% confidence interval, CI] for influenza 1.05 [1.04, 1.06], herpes-zoster 1.20 [1.13, 1.28], pneumococcal 1.10 [1.03, 1.17], pertussis 1.09 [1.00, 1.18]), ≥2 doses of COVID-19 vaccine in 2021 1.02 [1.01, 1.02] and booster COVID-19 dose in the second half of 2023 1.08 [1.02, 1.15]. Similarly, lapsed donors had higher vaccination uptake than non-donors.</p><p><strong>Conclusion: </strong>Blood donors have a higher uptake for funded/recommended adult vaccines than non-donors. These findings provide evidence of vaccination rate differences that may impact interpretation of studies where blood donor samples and/or data are used.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"570-580"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146202829","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":"Determination of IgG1 and IgG3 subclasses of red blood cell antibodies: An important tool for predicting harmfulness.","authors":"Regina Cardoso, Taynara Vieira, Marina Conrado, Fabio Luz, Karen Ziza, Thamy C S Silva, Alfredo Mendrone, Vanderson Rocha, Arnaud Reggiani, Carla Luana Dinardo","doi":"10.1111/vox.70201","DOIUrl":"10.1111/vox.70201","url":null,"abstract":"<p><strong>Background and objectives: </strong>Immune-mediated haemolysis caused by red blood cell (RBC) auto or alloantibodies depends on several factors, including antibody subclass. Immunoglobulin (Ig) IgG1 and IgG3 are more efficient at triggering phagocytosis and complement activation. This study evaluated whether IgG subclass determination can help predict the clinical relevance of RBC antibodies in different immunohaematological contexts.</p><p><strong>Materials and methods: </strong>Blood donors and patients with IgG-positive direct antiglobulin tests (DATs) were included. IgG subclasses were determined using monospecific gel cards for IgG1/IgG3. The monocyte monolayer assay (MMA) assessed in vitro biological relevance. Antibody specificity was established by standard immunohaematological techniques. Statistical comparisons were performed using Chi-square, Fisher's exact and Mann-Whitney U tests.</p><p><strong>Results: </strong>Among patients with IgG autoantibodies (n = 29), 51.7% had IgG1 or IgG3, versus 3.7% of donors (n = 27; p < 0.001). The presence of IgG1/IgG3 autoantibodies showed 93% positive predictive value (PPV) and 96.3% specificity for distinguishing patients from donors. IgG1/IgG3 autoantibodies were more frequently associated with positive MMA results (83.3% vs. 33.3%). Among RBC alloantibodies (n = 17), 64% were IgG1/IgG3, correlating with MMA positivity (sensitivity 78%; PPV 77%). Antibodies traditionally considered benign were often IgG1/IgG3 and MMA-positive.</p><p><strong>Conclusion: </strong>IgG subclass determination provides diagnostic value beyond IgG quantification alone. In DAT-positive donors, not detecting IgG1/IgG3 is compatible with a low haemolysis risk and often obviates follow-up; when IgG1/IgG3 are detected, selective evaluation may be appropriate. For alloantibodies, subclass identification may help predict clinical relevance, especially in urgent transfusion settings when MMA is unavailable, supporting transfusion safety decisions and efficient resource use.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"625-631"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146166891","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":"Red blood cell alloantibodies in transfused patients with haematological malignancies at Mbarara Regional Referral Hospital and the Uganda Cancer Institute: Prevalence, specificities and associated factors.","authors":"Ivan Mugisha Taremwa, Nixon Niyonzima, Scholastic Ashaba, Elizabeth Kemigisha, Deusdedit Tusubira, Benson Okongo, Grace Nambozi, May Y Choi, Craig N Jenne, Guido van Marle, Bernard Natukunda","doi":"10.1111/vox.70198","DOIUrl":"10.1111/vox.70198","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with haematological malignancies often require blood transfusion support. Multiple allogeneic blood transfusions may result in alloimmunization, complicating future transfusions. This study determined alloantibody prevalence, specificities and factors associated with the presence of red blood cell (RBC) alloantibodies among transfused patients with haematological malignancies at Mbarara Regional Referral Hospital (MRRH) and the Uganda Cancer Institute (UCI).</p><p><strong>Materials and methods: </strong>This was a cross-sectional study among patients with haematological malignancies who had been multiply transfused and were seeking cancer care at MRRH and the UCI, in Uganda. Patient plasma was screened for the presence of RBC alloantibodies using haemagglutination testing with a 3-cell commercial reagent RBC and antibody identification with 11-cell antibody panels.</p><p><strong>Results: </strong>A total of 427 patients with a median age of 36 (inter-quartile range: 26-56 years) were investigated. Twenty-five participants (5.9%) possessed RBC alloantibodies whose specificities were as follows: anti-C, two; anti-D, four; anti-E, six; anti-K, four; and anti-c, anti-Fy^a, anti-Jk^a, anti-Le^a and anti-M, one each. Four patients possessed pan-reactive antibodies. Patients with chronic cancer (adjusted odds ratio [AOR] = 2.62, 95% confidence interval [CI]: 1.16-7.21), leukaemia (AOR = 2.71, 95% CI: 1.81-4.03), human immunodeficiency virus (HIV) infection (AOR = 4.34, 95% CI: 1.69-5.11), antibiotic use (AOR = 5.08, 95% CI: 2.11-7.41) and a history of ≥5 transfusions were significantly associated with RBC alloimmunization (p ≤ 0.05).</p><p><strong>Conclusion: </strong>RBC alloimmunization prevalence was 5.9% and associated with clinical and transfusion-related factors. Alloantibodies to Rh, Kell, MNS, Duffy, Kidd and Lewis blood group systems were detected, underscoring the need for improved pre-transfusion testing in Uganda.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"614-624"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158274","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 to 'Abstract'.","authors":"","doi":"10.1111/vox.70228","DOIUrl":"10.1111/vox.70228","url":null,"abstract":"","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"681"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277323","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":"The distribution of glycophorin GYP(B-A-B) hybrids among blood donors in north-eastern Thailand.","authors":"Pornsawan Srichankhot, Patcharaporn Tippayawat, Songpol Haohan, Chalunda Kongmaroeng, Piyapong Simtong","doi":"10.1111/vox.70202","DOIUrl":"10.1111/vox.70202","url":null,"abstract":"<p><strong>Background and objectives: </strong>Glycophorin GYP(B-A-B) hybrid alleles encode a set of low-frequency antigens, including Mi^a. Such hybrids are predominantly found in East and Southeast Asians and demonstrate variation in frequency within that region. These antigens and their corresponding antibodies are clinically significant. We aimed to characterize the GYP(B-A-B) hybrid alleles among north-eastern Thai blood donors.</p><p><strong>Materials and methods: </strong>Altogether, 1377 DNA samples from north-eastern Thai blood donors were genotyped for GYP(B-A-B) using high-resolution melting (HRM) assay. Samples exhibiting aberrant melting profiles were investigated by Sanger sequencing. The immunogenic potential of the Mi^a antigen across diverse populations was also assessed using the Giblett equation.</p><p><strong>Results: </strong>Among the 1377 donors, 249 (18.08%) were identified as carrying GYP(B-A-B) hybrids. Of these, 17 samples (1.24%) were GYP*Mur homozygotes, 219 (15.90%) were GYP*Mur/GYPB heterozygotes, 12 (0.87%) were GYP*Thai/GYPB heterozygotes and one sample (0.07%) was a compound GYP*Mur/GYP*Thai heterozygote. Additionally, six single-nucleotide polymorphisms (SNPs) were identified in five donors with the wild-type GYPB/GYPB genotype. Furthermore, one sample carried two variants at positions c.136+743C>G and c.136+746C>T within intron 2. The Giblett equation calculation predicted a high immunogenic potential of Mi^a antigen with substantial variation across populations (1.269-10.468).</p><p><strong>Conclusion: </strong>In this study, GYP*Mur was the predominant hybrid allele with a frequency of 254/2754 (9.22%). GYP(B-A-B) hybrid alleles show considerable heterogeneity and immunogenicity, with population-dependent differences driven by variations in antigen distribution and antibody prevalence. The use of our molecular approach may help identify compatible blood products for transfusion and prevent alloimmunization.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"632-642"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158408","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":"A quality improvement initiative to reduce inappropriate plasma transfusions across community hospitals in the Niagara region.","authors":"Krista Walter, Ismael Ahmad, Tanja Groeneveld, Ankush Chander, Mohammad Refaei","doi":"10.1111/vox.70192","DOIUrl":"10.1111/vox.70192","url":null,"abstract":"<p><strong>Background and objectives: </strong>Plasma transfusion is indicated for patients with coagulopathy and active bleeding or those undergoing major surgery. Appropriate use is defined by an international normalized ratio (INR) >1.7 and a dose of 3-4 units for adults. However, audits in tertiary care settings consistently revealed high rates of inappropriate plasma use. At Niagara Health, audits across three community hospitals showed that 42% of plasma transfusions in hospitalized adults were inappropriate, largely due to limited understanding of proper indications. This misuse leads to resource wastage, higher costs and unnecessary patient exposure to transfusion-related risks. The aim of this project was to improve appropriate plasma transfusion rates among hospitalized adults in three Niagara region hospitals by 25% over a 12-month period.</p><p><strong>Materials and methods: </strong>This non-randomized, interrupted time series quality improvement project followed the Model for Improvement (MFI) framework. Sequential Plan-Do-Study-Act cycles began in July 2024, with monthly monitoring of transfusion rates. Interventions included an awareness campaign, enhanced audit and feedback and implementation of an electronic transfusion order set in the electronic medical record (EMR).</p><p><strong>Results: </strong>During the study, 253 plasma units were transfused. Median monthly appropriateness rates were 90% (INR >1.7), 89% (dose >2 units) and 78% (both criteria). Appropriateness improved, particularly in dosing. Out-of-guideline requests screened by technologists decreased by 15%, with no significant change in plasma or red cell use.</p><p><strong>Conclusion: </strong>Electronic order sets, technologist screening, education and audit-feedback improved adherence to plasma transfusion guidelines without increasing workload or affecting other blood product use. These strategies may be scalable to other components.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"593-602"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150674","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":"Meteorological elements associated with vasovagal reactions in blood donors: Influence of collection setting and donation type.","authors":"Satohiro Nakagawa, Hiroko Shima, Toshiya Nishikubo, Yoshihiko Sakurai","doi":"10.1111/vox.70204","DOIUrl":"10.1111/vox.70204","url":null,"abstract":"<p><strong>Background and objectives: </strong>Vasovagal reactions (VVRs) are common adverse events associated with blood donation. While previous research has focused on intrinsic donor-related risk factors, we previously identified an association between specific meteorological elements and VVR incidence. This study aims to build on our earlier findings by investigating the potential modifying effects of collection setting and donation type.</p><p><strong>Study design and methods: </strong>This study analysed VVR incidence data from blood donations collected in northern Nara Prefecture, Japan, over a 3-year period (April 2020-March 2023). Daily VVR incidence rates were calculated and analysed in relation to meteorological elements, including temperature, humidity, atmospheric pressure and other related factors. Comparisons across quartiles of meteorological values were performed using Kruskal-Wallis and Jonckheere-Terpstra tests. Subgroup analyses were conducted by collection setting and donation type.</p><p><strong>Results: </strong>In mobile collections (whole blood only), significant associations were found only with the 7-day weighted moving average (7d WMA) of temperature and precipitation. In fixed-site collections, several temperature-related elements were significantly associated with VVR incidence in both same-day and 7d WMA analyses. Further stratification showed that whole blood donations at fixed sites showed limited associations with meteorological elements, whereas apheresis donations showed significant relationships with multiple temperature-related parameters in both same-day and 7d WMA analyses.</p><p><strong>Conclusion: </strong>Meteorological elements affecting VVR incidence vary by the collection setting and donation type. Apheresis donations appear to be susceptible to environmental influences, especially ambient temperature. These findings highlight the importance of incorporating meteorological considerations into donor safety measures and operational planning, particularly for apheresis collections.</p>","PeriodicalId":23631,"journal":{"name":"Vox Sanguinis","volume":" ","pages":"562-569"},"PeriodicalIF":1.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150663","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}