Mediterranean Journal of Rheumatology最新文献

{"title":"Tumour Necrosis Factor α Inhibitors during Spondylarthritis: Therapeutic Maintenance, Reasons, and Predictive Factors of Discontinuation (Data from RBSMR Registry).","authors":"Oumaima Idrissi Ouali, Salma Mikou, Imane El Mezouar, Nessrine Akasbi, Moncef Maiouak, Ihsane Hmamouchi, Redouane Abouqal, Ahmed Bezza, Fadoua Allali, Rachid Bahiri, Imane El Bouchti, Imad Ghozlani, Hasna Hassikou, Linda Ichchou, Saadia Janani, Radouane Niamane, Abdellah El Maghraoui, Taoufik Harzy","doi":"10.31138/mjr.271223.ttm","DOIUrl":"10.31138/mjr.271223.ttm","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to study the therapeutic maintenance of tumour necrosis factor α inhibitors (TNFα-I) for spondyloarthritis patients enrolled in the Moroccan biotherapy registry and to analyse the reason and the predictive factors of stopping TNFα-I.</p><p><strong>Methods: </strong>Data were collected from a historical-prospective multicentre registry of adult patients with spondyloarthritis, treated with biological treatment, in the 10 rheumatology departments in Morocco. Maintenance was defined as the interval between the introduction and the suspension of the same TNFα-I.</p><p><strong>Results: </strong>190 patients under TNFα-I were included, their average age was 40.2 +/-13.6 years. The male gender predominated. On average, the duration of the disease was 11.7 years +/-6.7 years. The ongoing therapeutic maintenance of all TNFα-I drugs in our study was relatively high and exhibited a decline over time, decreasing from 63.8% at 1 year to 45% at 3 years. At the 36-month follow-up, 27.7% had stopped their treatment. It was found that taking nonsteroidal anti-inflammatory drugs (NSAIDs) between visits and having a high average Ankylosing Spondylitis Disease Activity Score with C-reactive protein on the day of the visit were identified as predictive factors for therapeutic discontinuation in multivariate analysis.</p><p><strong>Conclusion: </strong>The therapeutic maintenance level of TNFα-I in our study was satisfactory and comparable to other series. our study provides a more comprehensive understanding of the factors that contribute to the improved maintenance of treatment with TNFα-I. It delves into the reasons influencing treatment continuity and identifies predictive factors of discontinuation.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"653-659"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068378","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":"Adherence, Fears, and Beliefs about Biologic Drugs in Rheumatoid Arthritis Patients: A North African Pilot Study.","authors":"Soumaya Boussaid, Emna Hannech, Sonia Rekik, Safa Rahmouni, Khaoula Zouaoui, Maissa Abbes, Hela Sahli, Mohamed Elleuch, Helmi Ben Saad","doi":"10.31138/mjr.200823.afa","DOIUrl":"10.31138/mjr.200823.afa","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of beliefs in adherence to biologic drugs among patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>This was a cross-sectional study, including RA patients who were on biologic disease-modifying antirheumatic drugs (bDMARDs). Therapeutic adherence was evaluated arbitrarily using a self-reported method by asking them the following question: \"Do you regul arly take your biologic drug as prescribed by your doctor?\". The Beliefs about Medicines Questionnaire (BMQ) was used to evaluate medication beliefs [general overuse, general harm, specific necessity, specific concerns].</p><p><strong>Results: </strong>Seventy-five RA patients were included (80.0% females, 33.3% illiterate, and 68.0% unemployed, mean age: 57±9 years, mean disease activity score: 3.94±1.32). Adherence to the current biologic drug was reported by 71 patients (94.7%). The means ± standard deviation scores for general overuse, general harm, specific necessity, and specific concerns were 14.0±2.4, 10.8±4.4, 20.6±5.7, and 10.3±3.3, respectively. Compared to the adherent group (n=71), the non-adherent group (n=4) had a lower specific necessity score (21.0±5.4 vs. 13.5±7.5, respectively, p=0.009), a higher specific concern score (10.1±3.13 vs. 15.0±2.8, respectively, p=0.036), and similar scores for general overuse and general harm (10.0±2.3 vs. 9.5±1.9, p=0600; 13.3±4.4 vs. 11.5±4.1, p=0.400, respectively). In logistic regression, specific necessity and specific concerns scores were significantly associated with adherence (Odds-ratio (OR)= 0.855, 95% confidence interval (CI) [0.726-1.006], and 1.438, 95% CI [1.004-1.980], respectively).</p><p><strong>Conclusion: </strong>Our study showed that RA patients have strong beliefs about the necessity to take biologic drugs which significantly influence the adherent behaviour therapy.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"623-633"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068373","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":"Knowledge and Attitudes of Patients with Rheumatoid Diseases towards Biosimilars.","authors":"Athanasios Chantzaras, John Yfantopoulos, Katerina Koutsogianni","doi":"10.31138/mjr.140323.kaa","DOIUrl":"10.31138/mjr.140323.kaa","url":null,"abstract":"<p><strong>Objective: </strong>To assess patients' understanding and attitudes towards biosimilars in rheumatoid diseases in Greece.</p><p><strong>Methods: </strong>A convenience sample of patients with rheumatoid diseases who were members of the largest rheumatoid patient association (RHEUMAZIN) in Greece was selected for this survey. Data on patients' knowledge and attitudes towards biosimilars were collected with a web-based questionnaire.</p><p><strong>Results: </strong>Among the 309 patients, 60.2% were being treated with bio-originator products, 11% with biosimilars and another 28.8% did not know the type of their biologic therapy. Only 43.7% of the respondents reported they had adequate information about biologic treatments. About 47.9% knew what biosimilars are exactly and 81.2% stated that they need more information about them. The most influential patient information sources about biologics were rheumatologists (88.3%), the Internet (45%), and patient associations (40.5%). Only about 55-60% of the participants thought that biosimilars are comparable to their reference products in terms of safety, effectiveness, quality and regulatory requirements. Patients with adequate knowledge about biosimilars were significantly less concerned about switching from their reference products. A higher education level, previous biosimilar treatment experience, having rheumatologists, patient associations, regulatory bodies and the internet as main information sources, being better informed about the disease, biologic therapies and biosimilars, working and having adequate information about biosimilars were univariately associated with a significantly higher likelihood of having a positive attitude towards biosimilars.</p><p><strong>Conclusions: </strong>There is an urgent need for patient education about biosimilars in rheumatic diseases in Greece to enhance patient knowledge and ensure informed decisions on biosimilar use.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"608-616"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068147","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":"Late-Onset Rheumatoid Arthritis (LORA): A Diagnostic and Therapeutic Challenge Among Older Patients Visiting a Poorly Resourced Health-Care Setting.","authors":"Ujjwol Prasad Risal, Urza Bhattarai","doi":"10.31138/mjr.29084.ada","DOIUrl":"10.31138/mjr.29084.ada","url":null,"abstract":"<p><p>Late-onset rheumatoid arthritis (LORA) presents a unique diagnostic challenge among older patients, particularly in poorly resourced healthcare settings. As global life expectancy increases, so does the prevalence of LORA, a condition that differs significantly from young-onset rheumatoid arthritis (YORA). This review explores the distinct clinical presentation, differential diagnosis, laboratory findings, and treatment challenges of LORA, emphasising its impact on low- and middle-income countries. The atypical and often acute onset of LORA, coupled with limited access to healthcare and diagnostic tools, contributes to significant diagnostic delays. These delays are compounded by a scarcity of healthcare providers, particularly rheumatologists, and the lack of essential laboratory tests in remote areas. Moreover, older adults often face additional barriers, including poor social support, reluctance to use allopathic medicines, and non-compliance with follow-ups. Effective management of LORA requires not only an understanding of its unique characteristics but also a tailored approach that considers the constraints of resource-limited settings. This review highlights the urgent need for specific guidelines and strategies to improve the diagnosis and management of LORA, thereby addressing the growing healthcare needs of older population in LMICs.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"573-578"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068171","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":"Clinical Characteristics and Outcomes of Patients with Anti-MDA5 Antibody Associated Rapidly Progressive Interstitial Lung Disease (RP-ILD): A Case Series.","authors":"Harikrishnan Gangadharan, Anusree Prasad Seetha, Sajitha Musthafa, Padmanabha Shenoy, Maria Francis, Arjun Krishna, Vaishnavi Kamath, Venugopal Kp, Radha Kumar","doi":"10.31138/mjr.020324.cco","DOIUrl":"10.31138/mjr.020324.cco","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical profile and treatment outcomes of a longitudinal series of patients with rapidly progressive interstitial lung disease (RP-ILD) associated with anti MDA 5 antibody.</p><p><strong>Methods: </strong>RP-ILD patients were identified from a prospective cohort of adult patients with idiopathic inflammatory myopathy (IIM). Clinical, demographic, and serological parameters of all patients were recorded using a structured proforma. Rapidly progressive ILD was defined as the development of radiological deterioration and hypoxemia within 3 months of the onset of respiratory symptoms. The diagnosis of RP-ILD was made after high-resolution CT chest and multidisciplinary discussion. RPILD patients were followed up with serial pulmonary function tests (PFT) every 3 months and echocardiography every 6 months.</p><p><strong>Results: </strong>Among 58 patients with IIM, five patients (3 female, 2 male) had RP-ILD. All the five patients had amyopathic presentation with polyarthritis, negative anti-nuclear antibody (ANA) and strong positivity (3+) for anti MDA 5 antibody by line immunoblot assay. The patients were treated with various combinations of immunosuppressants/immunomodulators. Two patients expired, one had stabilisation of lung function and the other two patients showed improvement of lung function over a median follow up of 24 months. High levels of serum ferritin and LDH were seen in non-survivors.</p><p><strong>Conclusion: </strong>A clinically amyopathic presentation with polyarthritis, negative ANA and a favourable long-term response to combination immunosuppressive therapy defined the clinico-serological profile and treatment response of our anti MDA5 positive RP-ILD patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"668-679"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068159","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":"Evaluation of IRF7 mRNA and its Association with Promoter Methylation in Kashmiri (North-Indian) Patients with Systemic Sclerosis: A Case-Control Study.","authors":"Sakeena Ayub, Zafar A Shah, Fayaz A Sofi, Roohi Rasool, Tabasum Shafi, Mushtaq Dangroo, Muzaffar Bindroo, Imtiyaz A Bhat","doi":"10.31138/mjr.040124.eoi","DOIUrl":"10.31138/mjr.040124.eoi","url":null,"abstract":"<p><strong>Introduction: </strong>The interferon regulatory factor 7 (IRF7), a member of the IRF family of transcription factors, plays a major role in the regulation of numerous aspects of an immune response and has increasingly been surveyed to determine the aetiology and pathogenesis of systemic sclerosis (SSc). Objective: This study aimed to investigate the transcriptional levels of IRF7 mRNA in peripheral blood mononuclear cells (PBMCs) and the impact of promoter methylation on IRF7 mRNA expression in SSc patients compared to healthy controls.</p><p><strong>Methods: </strong>PBMCs were obtained from confirmed 40 naïve SSc cases and 20 healthy controls for IRF-7 expression and methylation analysis. mRNA expression was performed using the quantitative real-time polymerase chain reaction (SYBR green method) concerning the housekeeping gene. A promoter methylation profile study was carried out by bisulfite treatment of DNA, followed by methylation-specific polymerase chain reaction (MS-PCR) in SSc cases against controls.</p><p><strong>Results: </strong>The relative expression analysis revealed that the selected IRF7 gene was upregulated in the patient group compared to healthy controls (p=0.003). In addition, mRNA expression of IRF7 was significantly increased in the limited cutaneous group compared to the diffuse cutaneous group. Moreover, SSc cases had hypomethylated IRF7 promoters compared to controls, and the significant impact of IRF7 promoter methylation on mRNA expression was observed (p=0.001).</p><p><strong>Conclusion: </strong>IRF7 overexpression in PBMCs from SSc patients may be caused by IRF7 promoter demethylation, and this aberrant expression of IRF7 in SSc might provide a link between the prominent IFN signature and the development of SSc.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"645-652"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068146","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":"Clinical Outcomes and Patients' Perspectives of Multidisciplinary Psoriasis Management: A Five-Year Retrospective Study.","authors":"Eleni Sotiriou, Katerina Bakirtzi, Ilias Papadimitriou, Eleni Paschou, Dimitra Kiritsi, Nikolaos Kougkas, Eleni Pagkopoulou, Aikaterini Tsentemeidou, Stavros Rizos, Georgia Arvaniti, Themis Chatzi-Sotiriou, Efstratios Vakirlis","doi":"10.31138/mjr.051223.cop","DOIUrl":"10.31138/mjr.051223.cop","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 3","pages":"506-509"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509461","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":"Elderly Onset Spondyloarthropathy and VEXAS Syndrome: A Case Report.","authors":"Harsh Jain, Debaditya Roy, Sunil Mavidi, Subhankar Haldar, Sumantro Mondal, Paramita Bhattacharya, Alakendu Ghosh","doi":"10.31138/mjr.271223.eos","DOIUrl":"10.31138/mjr.271223.eos","url":null,"abstract":"<p><p>We report the case of a 67-year-old male with a two-year history of inflammatory polyarthritis, fatigue, and low back pain. He also had a history of biopsy proven neutrophilic dermatosis in the past. On admission and examination, he had pallor. Laboratory evaluation showed macrocytic anaemia, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). MRI of Sacroiliac joints showed presence of bilateral sacroiliitis. Bone marrow examination showed the presence of cytoplasmic vacuolisation in myeloid and erythroid precursor cells. Genetic analysis confirmed a diagnosis of VEXAS syndrome. He improved with prednisolone and Sulfasalazine with no further relapse on follow up. This case report highlights the importance of considering VEXAS syndrome in older adults with presentation of spondyloarthritis and macrocytic anaemia. Early diagnosis and treatment with corticosteroids and steroid-sparing agents can lead to significant improvement in symptoms and are important for a good outcome.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 3","pages":"490-493"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509462","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":"Cardiovascular Risk in Rheumatoid Arthritis: Considerations on Assessment and Management.","authors":"Panagiota Anyfanti, Alexandra Ainatzoglou, Elena Angeloudi, Olga Michailou, Kleopatra Defteraiou, Eleni Bekiari, George D Kitas, Theodoros Dimitroulas","doi":"10.31138/mjr.310824.cri","DOIUrl":"10.31138/mjr.310824.cri","url":null,"abstract":"<p><p>In the context of holistic therapeutic practices, the cardiovascular risk of patients with rheumatoid arthritis (RA) needs to be addressed as a major factor of compromised disease prognosis and increased mortality. The elevated prevalence of cardiovascular disease (CVD) by more than twofold in RA has been attributed, inter alia, to chronic inflammation exacerbating arterial stiffness, increased onset of hypertension, dyslipidaemia and diabetes mellitus, sedentary lifestyle, and antirheumatic drug complications. CVD risk in RA can be currently assessed by practitioners through accessible adapted calculators, but it remains problematic as their diagnostic accuracy is not superior to calculators designed for the general population. Implementation of guideline-oriented personalised interventions remains the cornerstone for cardiovascular risk management in RA. Remarkably, there is lack of a consortium that brings together different health care providers engaged in the care of patients with RA (e.g., rheumatologists, cardiologists, general practitioners, etc), to guide cardiovascular risk assessment and management. This narrative review aims at providing an overview of current CVD risk assessment and management options, highlighting their pivotal role in the comprehensive treatment of RA patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 3","pages":"402-410"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509459","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":"Immunomodulatory Effects of SGLT2 Inhibitors and Metformin in Managing Rheumatic Diseases: A Narrative Review.","authors":"Naveenkumar Nallathambi, Rahul Bisaralli, Mahabaleshwar Mamadapur","doi":"10.31138/mjr.010324.ies","DOIUrl":"10.31138/mjr.010324.ies","url":null,"abstract":"<p><p>Limited studies summarise the immunomodulatory effects of SGLT2 inhibitors and Metformin in managing rheumatic diseases. The present narrative review aims to fill this knowledge gap by gathering information based on existing clinical evidence. A narrative review was conducted in November 2023 to identify studies investigating the impact of SGLT2 inhibitors and Metformin on rheumatic diseases. A literature search was performed across primary databases, including Medline/PubMed, Scopus, and Web of Science. Supplementary sources like Google Scholar, PubMed Central, Cochrane Library, and ScienceDirect were also consulted. Studies were screened for relevance, and those lacking pertinent outcome data were excluded. The review corroborates the multifaceted potential of Metformin as an adjunctive therapy in autoimmune rheumatologic conditions, offering avenues for further exploration and clinical application to enhance patient outcomes. However, limited literature exists on the clinical effects of SGLT2 inhibitors in rheumatic diseases.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 3","pages":"411-421"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509464","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}