Avicenna Journal of Medicine最新文献

{"title":"Efficacy and Safety of Biological Agents in Giant Cell Arteritis: An Updated Meta-Analysis.","authors":"Abdul Haseeb, Fabiha Athar, Hussain Abbas, Najia Sadiq, Faiza Naz, Erum Siddiqui, Osaid Ahmed, Umer Wamiq, Syed Ahmed Abbas Wasi, Hafsa Shuja, Bilal Aheed, Muhammad Ashir Shafique, Amna Sohail","doi":"10.1055/s-0045-1809621","DOIUrl":"10.1055/s-0045-1809621","url":null,"abstract":"<p><strong>Background: </strong>Giant cell arteritis (GCA), impacting individuals over 50, causes vision loss, headaches, and jaw pain due to inflammation from proinflammatory cytokines and growth factors. Standard treatment involves glucocorticoids, with tocilizumab and tumor necrosis factor (TNF) inhibitors currently being studied.</p><p><strong>Method: </strong>This meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, included adult GCA patients treated with biological agents. The search covered PubMed, Medline, Embase, and Scopus until October 2023, excluding nonhuman, pediatric, non-English, and nonrandomized studies. Data were analyzed using Review Manager 5.4, with random effects models calculating odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Result: </strong>A meta-analysis of 11 studies ( <i>n</i>  = 924) demonstrated higher remission rates with biological agents (OR = 2.58, 95% CI: 1.17-5.71; <i>p</i>  = 0.02; <i>I</i> ² = 70%), especially tocilizumab (OR = 4.30, 95% CI: 1.22-15.21; <i>p</i>  = 0.02). Nonsignificant trends favored biological agents for relapse rates (OR = 0.52, 95% CI: 0.26-1.05; <i>p</i>  = 0.07) and control for adverse effects (OR = 0.70, 95% CI: 0.49-1.02; <i>p</i>  = 0.07). However, TNF inhibitors were linked to increased infection rates (OR = 2.41, 95% CI: 1.17-4.96; <i>p</i>  = 0.02).</p><p><strong>Conclusion: </strong>Tocilizumab effectively induces remission in GCA patients, while abatacept and TNF inhibitors offer minimal benefits with increased infection risks, according to this meta-analysis. Treatment decisions should consider these factors, and larger studies are necessary to evaluate the safety and efficacy of biological agents in managing GCA.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"64-73"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477092","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":"Awareness and Attitude of First Aid Seizures Management among Medical Undergraduate Students, Tobruk University, Libya.","authors":"Zinelabedin Mohamed, Aisha A J Marajie, Nahla B S Najem, Nooralhuda G M Elmarimy, Heba M A Abdulmoula, Mohammad Amin Aly El-Din","doi":"10.1055/s-0045-1809427","DOIUrl":"10.1055/s-0045-1809427","url":null,"abstract":"<p><strong>Background: </strong>Adequate knowledge of first aid for seizures is crucial for medical students, who will eventually be responsible for managing epilepsy patients. The aim of the study was to assess the awareness and attitudes of medical undergraduate students at Tobruk University regarding first aid seizure management.</p><p><strong>Methods: </strong>A cross-sectional study was initiated in July 2023 using an online questionnaire that was prevalidated. The questionnaire gathered data on sociodemographic features, a knowledge of seizures and epilepsy, first aid practices, and attitudes toward epilepsy among 317 medical undergraduate students.</p><p><strong>Results: </strong>While 72.9% of students correctly identified a seizure, there were different beliefs about causes, such as some that attributed seizures to supernatural causes (14.2%). There were also deficiencies seen in the knowledge of epilepsy management that included antiepileptic drug treatment duration. It was alarming that 41.6% of students thought that the insertion of some objects into the mouth of a person having a seizure was first aid, which is a well-known hazardous approach. Only 23.6% were correct in the answers that involved the placement of the person in a semiprone position to prevent choking.</p><p><strong>Conclusion: </strong>The study at Tobruk University revealed significant knowledge gaps among medical students about seizure management, with 72.9% correctly identifying a seizure's basic definition, but 41.6% incorrectly believing that inserting objects into a seizing person's mouth is helpful, and only 23.6% knowing the correct first aid position. Students also demonstrated misconceptions about epilepsy causes, including supernatural beliefs, highlighting an urgent need for targeted educational interventions to improve understanding and prepare future health care professionals.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477091","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":"The Research Fellow Position: A Gateway to U.S. Residency.","authors":"M-Nasan Abdul Baki, Hany Habib","doi":"10.1055/s-0045-1809411","DOIUrl":"10.1055/s-0045-1809411","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"94"},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477096","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":"Surgical Intervention for Isolated Tricuspid Valve Endocarditis-Refining Patients' Selection.","authors":"Ali Hage, Rami Abazid, Fadi Hage, Shevan Bladia, Linrui Guo, Nikolaos Tzemos","doi":"10.1055/s-0045-1808059","DOIUrl":"10.1055/s-0045-1808059","url":null,"abstract":"<p><strong>Background: </strong>In this study, we analyzed various clinical and imaging factors of patients with isolated tricuspid valve infective endocarditis (TVIE) who have undergone surgical intervention, and assessed short- and long-term outcomes after surgery.</p><p><strong>Methods: </strong>We retrospectively enrolled 26 patients diagnosed with definite isolated TVIE and underwent surgical intervention between February 2004 and August 2019. We collected patients' demographics, preoperative and postoperative data. The primary outcomes were death and a composite of the following: death, readmission with right-sided heart failure, or recurrent endocarditis.</p><p><strong>Results: </strong>A total of 29 isolated tricuspid valve surgical interventions were performed on 26 patients. The mean age was 38.6 ± 12.3 years. In total, 22/29 (75.8%) of TVIE were related to <i>Staphylococcus aureus</i> and 4/29 (13.8%) were secondary to fungal infection. During a follow-up of 5.4 ± 3.7 years, there were 9 (34.6%) deaths and 15 (57.7%) composite outcomes. Multivariable Cox regression analysis showed that male sex (hazard ratio [HR]: 16.68, 95% confidence interval [CI]: 1.63-170.34, <i>p</i>  = 0.018) and intravenous drug users (IVDU) (HR: 25.66, 95% CI: 1.87-352.79, <i>p</i>  = 0.015) are significantly associated with increase death; on the other hand, higher level of preoperative hemoglobin and preoperative left ventricular ejection fraction (LVEF) was found to have decreased hazard of death: HR: 0.90, 95% CI: 0.82-0.99, <i>p</i>  = 0.033 and HR: 0.92, 95% CI: 0.86-0.98, <i>p</i>  = 0.013, respectively.</p><p><strong>Conclusion: </strong>In our institution, surgical intervention for isolated TVIE has a mortality rate of 34.6%. Men, a history of IVDU, lower preoperative hemoglobin levels, and reduced LVEF were significant predictors of postsurgical mortality. Earlier surgical intervention for TVIE before the development of anemia or impaired LV systolic function may have a potential survival benefit.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"74-79"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477094","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":"Addressing the Critical Gap in Biological Therapies for Inflammatory Bowel Disease in Syria.","authors":"Marouf Mouhammad Alhalabi","doi":"10.1055/s-0045-1809039","DOIUrl":"10.1055/s-0045-1809039","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"92-93"},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477090","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":"Breast Cancer Diagnosis and Management in an Area of Protracted Conflict: A Case Series from Northwest Syria.","authors":"Mohamed Hamze, Jude Alawa, Fares Alahdab, Alaa Al-Shemali, Ahmed Najeb Alhussein, Nour Muhammed Ali Arab, Bayan Galal, Jamil Debel, Ayham Jemo, Molham Khalil, Anees Chagpar, Bassel Atassi, Kaveh Khoshnood, Aula Abbara","doi":"10.1055/s-0045-1802585","DOIUrl":"10.1055/s-0045-1802585","url":null,"abstract":"<p><p><b>Background</b>  Breast cancer remains a significant public health challenge in conflict-affected regions. This study aims to investigate the impact of armed conflict on the burden of breast cancer in female patients in northwest Syria, focusing on clinical presentations, management, diagnosis, access to care, and treatment outcomes. <b>Methods</b>  We conducted a retrospective analysis of breast cancer patients diagnosed at the Idlib Oncology Center between March 2017 and January 2022. Data were extracted from clinical files and analyzed in R. The study was conducted at the Idlib Oncology Center, the main referral center for cancer care in northwest Syria, serving a population of 4.6 million. <b>Results</b>  A total of 192 patients were included, with a median age of 45.5 years (interquartile range [IQR]: 40-56). Of 108 patients, 56.5% were internally displaced. Most patients were diagnosed with invasive ductal carcinoma (81.3%), and the majority presented at stages II and III (34.8 and 59%, respectively). Among 192 patients, 95.8% underwent surgery, with 96.6% having a mastectomy and 90.7% receiving chemotherapy. The median interval from symptom onset to diagnosis was 100.5 days, that from diagnosis to surgery was 14.5 days, and that from surgery to radiotherapy was 229 days. No significant effect was observed for chemical weapon exposure or family loss on survival. Displacement was associated with significantly lower predicted survival ( <i>p</i>  = 0.0038; 95% confidence interval [CI]: 0.05064-0.2570). <b>Conclusions</b>  This study highlights a high prevalence of late-stage breast cancer, a high rate of mastectomies, delayed access to radiotherapy, and long delays between diagnosis and treatment in northwest Syria. Displacement negatively affects survival rates. Additionally, the substantial lack of radiotherapy in patients needing it and prolonged intervals between treatments contribute to poorer outcomes. Establishing localized oncology services and increasing funding for cancer medications and radiotherapy would improve access to necessary oncology care in this region.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111250","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":"Enhanced Recovery after Pediatric Cardiac Surgery: A Meta-Analysis.","authors":"Osama Abu-Shawer, Abdel-Rahman E'mar, Abdel-Rahman Jaber, Shatha Tailakh, Amer Abu-Shawer, Caroline Al-Haddadin","doi":"10.1055/s-0045-1808072","DOIUrl":"10.1055/s-0045-1808072","url":null,"abstract":"<p><strong>Background: </strong>The Enhanced Recovery After Surgery (ERAS) protocols are a set of steps taken before, during, and after surgery to improve patient care and outcomes. While ERAS is well known for its benefits in various surgeries, its application in pediatric cardiac surgery is relatively new. With the recent emergence of studies on its implementation in pediatric cardiac surgery, this study is the first to systematically review the current evidence on the efficacy of ERAS in the field.</p><p><strong>Methods: </strong>A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers independently searched PubMed, Cochrane, Google Scholar, Web of Science, Embase, and Scopus databases for comparative studies with control groups that described the use of ERAS in all types of pediatric cardiac surgeries from 2000 to 2024. The data collected included study design, patient demographics, elements of the ERAS protocols, and postoperative outcomes. The random-effects model was used to calculate the pooled odds ratios (ORs) and mean differences (MDs) with the corresponding confidence intervals (CIs) for proportional and continuous variables, respectively.</p><p><strong>Results: </strong>Five studies, involving 1,008 patients, were included in the final analysis: three randomized controlled trials (RCTs), one retrospective cohort, and one case-control study. The ERAS protocols were applied in 430 (43%) patients, and standard perioperative care was applied in 578 (57%) patients. The analysis revealed that implementing the ERAS protocol significantly reduced ICU length of stay ( <i>I</i> ²  = 98.26%; MD = -1.441; 95% CI: -2.610 to -0.273; <i>p</i>  = 0.016). The ERAS group had a comparable rate of postoperative complications to the standard care group ( <i>I</i> ²  = 15.3%; OR: 0.889; 95% CI: 0.622-1.269; <i>p</i>  = 0.516).</p><p><strong>Conclusions: </strong>The ERAS protocols in pediatric cardiac surgery appear to be safe and effective in improving certain short-term outcomes. However, evidence is limited due to the small number of studies. Further multicenter RCTs that fully incorporate the ERAS protocol elements and assess both immediate and long-term outcomes are needed.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"80-85"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477093","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":"The Diagnosis of Sepsis-Associated Encephalopathy Using Biomarkers: Are We There Yet?","authors":"Florin Scarlatescu, Ecaterina Scarlatescu, Dana R Tomescu, Daniela Bartos","doi":"10.1055/s-0045-1808060","DOIUrl":"10.1055/s-0045-1808060","url":null,"abstract":"<p><p>Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction that occurs in patients with sepsis in the absence of direct central nervous system infection or other causes of encephalopathy. SAE is common, occurring in up to 70% of patients with sepsis, and is linked to various clinical manifestations and significantly poorer outcomes. The diagnosis of SAE usually relies on clinical examination, which is often difficult due to confounding factors in critically ill patients. Other diagnostic tools used include electroencephalography, neuroimaging, and biomarkers. We performed a systematic search and review to synthesize all available evidence on biomarkers used for SAE diagnosis in clinical practice and highlight future directions for research. The literature search in MEDLINE identified 18 eligible studies. Biomarkers reflecting inflammation, endothelial activation and damage, astrocytic and microglial activation, neuronal injury, and metabolism changes were described, demonstrating their usefulness and potential in diagnosing and evaluating SAE. However, among different studies, the reported sensitivity and specificity of the biomarkers for diagnosing SAE varied based on the populations studied and the cutoff levels considered for each biomarker. In conclusion, biomarkers may be useful for diagnosing and predicting outcomes in SAE, but their usefulness in clinical practice remains limited for the moment. More research is needed to identify biomarkers that can improve SAE diagnosis.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 2","pages":"51-63"},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477095","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":"The Methodological Quality of Case Series Published Early vs. Late in the Course of a Pandemic: A Meta-Epidemiologic Study.","authors":"Yahya Alsawaf, Mohammed Firwana, Tarek Nayfeh, Mohamed O Seisa, Reem A Alsibai, Alzhraa S Abbas, Elizabeth H Lees, Ye Zhu, Michael E Wolf, Greg Vanichkachorn, Moustafa Hegazi, Larry J Prokop, M Hassan Murad, Samer Saadi","doi":"10.1055/s-0045-1806762","DOIUrl":"10.1055/s-0045-1806762","url":null,"abstract":"<p><p><b>Introduction</b>  Case reports and series are critical to guide initial decision-making in a pandemic, but may have lower rigor because of the need to publish them quickly. This meta-epidemiologic study compares the methodological quality of case series that described the acute coronavirus disease 2019 (COVID-19) pandemic in 2020 versus those that described long-haul cases. <b>Methods</b>  We conducted a systematic review in multiple databases for long-haul case series and reports. We identified early cases of acute COVID-19 synthesized in published systematic reviews. We evaluated the methodological quality by pairs of independent reviewers using a tool dedicated for appraising case series. <b>Results</b>  We included 239 original case series (81 published in the first year of the pandemic and 158 published later describing long-haul COVID). The methodological quality of both groups of case series was very good (80-100% of series satisfying quality items) except for two items, the selection approach of cases included in the series and ruling out other causes that can explain the main finding described in the series. The appraisal tool demonstrated high agreement and reliability between reviewers. <b>Conclusion</b>  The methodological quality of modern case series is high, except for two quality items that represent an area for potential for improvement for authors of case series describing future pandemics.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 1","pages":"29-33"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112019","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":"Varicella Pneumonia with Deep Venous Thrombosis and Pulmonary Embolism as Rare Presentations for Male: Case Report.","authors":"Mohammad Dallah, Ahmad Hmaideh, Yaser Hashoom, Ammaar Kaesom, Nusima Gazhal","doi":"10.1055/s-0045-1802594","DOIUrl":"10.1055/s-0045-1802594","url":null,"abstract":"<p><p>This case report presents the case of a middle-aged man who experienced a rare and severe presentation of varicella infection, with the development of varicella pneumonia and the rare complications of deep venous thrombosis, and a subsequent pulmonary embolism. Despite being immunocompetent, the patient's varicella infection resulted in an atypical and complex clinical course. The individual initially presented with a vesicopustular rash, fever, and fatigue, which progressed to severe hypoxia and dyspnea. Radiological findings revealed diffuse bilateral nodular consolidation consistent with varicella pneumonia. Although varicella pneumonia is well documented, its occurrence in immunocompetent individuals is uncommon. In the context of varicella infection, it is very rare, particularly in the absence of immunodeficiency and with no other risk factors, in a male patient. This case underscores the importance of maintaining a high index of clinical suspicion to promptly diagnose and treat potentially life-threatening complications associated with varicella infection in otherwise healthy individuals. Key learning points include the necessity of early recognition and intervention to mitigate severe complications and the potential need for thromboprophylaxis in varicella pneumonia patients and suggests the potential need for thromboprophylaxis in patients with varicella pneumonia to prevent thrombotic events.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"15 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112020","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}