Open Respiratory Medicine Journal最新文献

{"title":"Urinary Incontinence and Quality of Life in Women With Cystic Fibrosis","authors":"Marinice Nunes Soares, Luciana L. Paiva, P. Dalcin, B. Ziegler","doi":"10.2174/18743064-v16-e220927-2022-9","DOIUrl":"https://doi.org/10.2174/18743064-v16-e220927-2022-9","url":null,"abstract":"\u0000 \u0000 Stress urinary incontinence (SUI) is recognized as a common complication in women with CF.\u0000 \u0000 \u0000 \u0000 The primary objective of this study was to verify the prevalence of urinary incontinence (UI) and its associations with quality of life (QoL) in adult women with CF. The secondary objective was to identify possible associations of UI with cough score, nutritional parameters, and pulmonary function.\u0000 \u0000 \u0000 \u0000 This cross-sectional study included female patients aged 18 years and older. All patients answered the International Consultation on Incontinence Questionnaire Short Form, the Kings Health Questionnaire, and the Leicester Cough Questionnaire. Nutritional assessment was obtained. Sputum bacteriology and lung function were also performed.\u0000 \u0000 \u0000 \u0000 Fifty-two women were included, with mean age of 29.0±9.7 years and mean forced expiratory volume in one second (FEV1) of 50.1±21.7% of predicted. Thirty-two patients (61.5%) presented symptoms of UI, 23 (44.2%) of stress UI and 9 (17.3%) of mixed UI. However, there was no significant association between UI and pulmonary function, sputum bacteriology, and cough score (p>0.05). There was a significant association between UI and QoL variables (p<0.05).\u0000 \u0000 \u0000 \u0000 This study identified a prevalence of 61.5% of UI in women with CF. The presence of UI in women with CF resulted in a negative impact on QoL.\u0000","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47013007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragm Ultrasound in the Evaluation of Diaphragmatic Dysfunction in Lung Disease","authors":"S. Lux, Daniel Ramos, A. Pinto, Sara Schilling, M. Salinas","doi":"10.2174/1874306402115010082","DOIUrl":"https://doi.org/10.2174/1874306402115010082","url":null,"abstract":"The diaphragm is the most important respiratory muscle, and its function may be limited by acute and chronic diseases. A diaphragmatic ultrasound, which quantifies dysfunction through different approaches, is useful in evaluating work of breathing and diaphragm atrophy, predicting successful weaning, and diagnosing critically ill patients. This technique has been used to determine reduced diaphragmatic function in patients with chronic obstructive pulmonary disease and interstitial diseases, while in those with COVID-19, diaphragmatic ultrasound has been used to predict weaning failure from mechanical ventilation.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41581562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoxemia and Respiratory Failure: Clinical Conditions and Pathophysiological Approaches","authors":"R. Castillo","doi":"10.2174/1874306402115010059","DOIUrl":"https://doi.org/10.2174/1874306402115010059","url":null,"abstract":"Type 1 (hypoxemic) RF has a PaO2 < 60 mmHg with normal or subnormal PaCO2. In this type, the gas exchange is impaired at the level of the aveolo-capillary membrane. Examples of type I RF are carcinogenic or non-cardiogenic pulmonary edema and severe pneumonia. Type 2 (hypercapnic) RF has a PaCO2 > 50 mmHg. Hypoxemia is common, and it is due to respiratory pump failure. Also, respiratory failure is classified according to its onset, course, and duration into acute and chronic; acute (ARF) on top of chronic respiratory failure (CRF) [1].","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44114863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Flow Nasal Cannula as Support in Immunocompromised Patients with Acute Respiratory Failure: A Retrospective Study","authors":"C. Giugliano-Jaramillo, J. Leon, Cristobal Enriquez, J. Keymer, R. Pérez-Araos","doi":"10.2174/1874306402115010061","DOIUrl":"https://doi.org/10.2174/1874306402115010061","url":null,"abstract":"\u0000 \u0000 High Flow Nasal Cannula (HFNC) is a novel technique for respiratory support that improves oxygenation. In some patients, it may reduce the work of breathing. In immunocompromised patients with Acute Respiratory Failure (ARF), Non-Invasive Ventilation (NIV) is the main support recommended strategy, since invasive mechanical ventilation could increase mortality rates. NIV used for more than 48 hours may be associated with increased in-hospital mortality and hospital length of stay. Therefore HFNC seems like a respiratory support alternative.\u0000 \u0000 \u0000 \u0000 To describe clinical outcomes of immunocompromised patients with ARF HFNC-supported.\u0000 \u0000 \u0000 \u0000 Retrospective study in patients admitted with ARF and HFNC-supported. 25 adult patients were included, 21 pharmacologically and 4 non- pharmacologically immunosuppressed. Median age of the patients was 64 [60-76] years, APACHE II 15 [11-19], and PaO2:FiO2 218 [165-248]. Demographic information, origin of immunosuppression, Respiratory Rate (RR), Heart Rate (HR), Mean Arterial Pressure (MAP), oxygen saturation (SpO2) and PaO2:FiO2 ratio were extracted from clinical records of our HFNC local protocol. Data acquisition was performed before and after the first 24 hours of connection. In addition, the need for greater ventilatory support after HFNC, orotracheal intubation, in-hospital mortality and 90 days out-patients’ mortality was recorded.\u0000 \u0000 \u0000 \u0000 Mean RR before the connection was 25±22 breaths/min and 22±4 breaths/min after the first 24 hours of HFNC use (95% CI; p=0.02). HR mean before connection to HFNC was 96±22 beats/min, and after, it was 86±15 beats/min (95%CI; p=0.008). Previous mean MAP was 86±15 mmHg, and after HFNC, it was 80±12 mmHg (95%CI; p=0.09); mean SpO2 after was 93±5% and before it was 95±4% (95% CI; p=0.13); and previous PaO2:FiO2 mean was 219±66, and after it was 324±110 (95%CI; p=0.52). In-hospital mortality was 28% and 90 days out-patients’ mortality was 32%.\u0000 \u0000 \u0000 \u0000 HFNC in immunosuppressed ARF subjects significantly decreases HR and RR, being apparently an effective alternative to decrease work of breathing. In-hospital mortality in ARF immunosuppressed patients was high even though respiratory support was used. Better studies are needed to define the role of HFNC-support in ARF.\u0000","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46492682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidative Stress Markers in COPD Patients Admitted to Pulmonary Rehabilitation","authors":"C. Romero-Dapueto, R. Castillo","doi":"10.2174/1874306402115010068","DOIUrl":"https://doi.org/10.2174/1874306402115010068","url":null,"abstract":"\u0000 \u0000 Chronic obstructive pulmonary disease (COPD) is a pathology, which leads to an irreversible and progressive reduction of the airflow, usually caused by smoking, but only present in 25% of smokers. Some mechanisms involved in the onset and progression of the disease are local and systemic factors such as inflammation, exacerbated immune response and the appearance of oxidative stress. For all these reasons, the use of oxidative stress parameters as progression markers or even as a way to monitor the response of any kind of non-pharmacological interventions, like the use of pulmonary rehabilitation (PR), is feasible.\u0000 \u0000 \u0000 \u0000 The study aims to determine markers of oxidative stress levels in plasma and erythrocytes in patients with COPD through the application of a PR protocol.\u0000 \u0000 \u0000 \u0000 The study included 25 patients diagnosed with COPD according to the GOLD criteria with a medical indication of PR and attendance at the gym in San José Hospital, Santiago, Chile. Blood samples were obtained before the start of the protocol, in the 10th session, and at the end of the protocol (20th session). These samples were stored for oxidative stress determinations: FRAP (ferric reducing ability of plasma), F2-isoprostanes, reduced (GSH)/oxidized (GSSG) ratio and antioxidant enzyme activity in the erythrocyte. In all stages, associations between events and clinical parameters in patients have been observed. The clinical parameters assessed were the six-minute walking test (6MWT), maximal inspiratory and expiratory pressure, the BODE index and Saint George’s respiratory questionnaire, which includes quality of life.\u0000 \u0000 \u0000 \u0000 The intracellular and extracellular capacity (GSH/GSSG and FRAP) in patients in PR at the 10th session were 53.1 and 34% higher than basal values, respectively. Only the GSH/GSSG ratio was 38.2% lower at the 20th session, related in part with higher plasma and erythrocyte lipid peroxidation at baseline. This could be due to the high concentration of reactive oxygen species in the first sessions, which has been reported in the literature as the acute effect of controlled exercise. Blood lipid peroxidation was 43.34 and 58.34% lower at the 10th and 20th sessions, respectively, demonstrating the improvements in the oxidative parameters with long-term exercise. With respect to oxidative enzyme activity, superoxide dismutase and catalase showed higher values of activity at the 10th and 20th sessions compared to the baseline. In the clinical parameters of the PR, significant changes were found in the BODE index and Saint George’s questionnaire, with these results being associated with a less predictive mortality score and a better understanding of the disease. This may be because the patients achieved longer distances in the 6MWT and better understood the disease at the end of the PR.\u0000 \u0000 \u0000 \u0000 The goal of this study was to contribute to the pathophysiological basis for further research on COPD patients, a disease of high prevalence in Chile. This study c","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42585998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathophysiology of Acute Respiratory Failure by CoV-2 Infection: Role of Oxidative Stress, Endothelial Dysfunction and Obesity","authors":"R. Castillo, Alejandro González-Candia, Alejandro A. Candia","doi":"10.2174/1874306402115010076","DOIUrl":"https://doi.org/10.2174/1874306402115010076","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) due to CoV-2 (coronavirus type 2) virus possess a particular risk of developing acute respiratory distress syndrome (ARDS) or SARS (severe acute respiratory syndrome coronavirus 2)-CoV2 in people with pre-existing conditions related to endothelial dysfunction and increased pro-inflammatory and pro-oxidant state. In between these conditions, chronic systemic inflammation related to obese patients is associated with the development of atherosclerosis, type 2 diabetes, and hypertension, comorbidities that adversely affect the clinical outcome in critical patients with COVID-19. Obesity affects up to 40% of the general population in the USA and more than 30% of the adult population in Chile. Until April 2021, 1,019,478 people have been infected, with 23,524 deaths. Given the coexistence of this worldwide obesity epidemic, COVID-19 negative outcomes are seriously enhanced in the current scenario. On the other hand, obesity is characterized by endothelial dysfunction observed in different vascular beds, an alteration which can be associated with impaired vasodilation, oxidative stress, and inflammatory events. Emerging evidence shows that obesity-related conditions such as endothelial dysfunction are associated with detrimental outcomes for COVID-19 evolution, especially if the patient derives to Intensive Care Units (ICU). This implies the need to understand the pathophysiology of the infection in the obese population, in order to propose therapeutic alternatives and public health policies, especially if the virus remains in the population. In this review, we summarize evidence about the pathogeny of Cov-2 infection in obese individuals and discuss how obesity-associated inflammatory and prooxidant status increase the severity of COVID-19.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49458948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food and Aeroallergen Sensitization in IgE -Mediated Asthma in Egypt","authors":"A. Ali","doi":"10.2174/1874306402115010052","DOIUrl":"https://doi.org/10.2174/1874306402115010052","url":null,"abstract":"Purpose: Identifying the distribution of allergens is valuable to the effective diagnosis and treatment of allergic disease. So, our aim is to explore the sensitization of food and aeroallergens in Egyptian patients with atopic asthma. Methods: Cross-sectional study recruited 268 Egyptian patients with atopic asthma. Asthmatic patients were assessed by the enzyme allegro sorbent test (EAST) method for specific IgE to a panel of 19 common regional inhaled allergens and 15 food allergens. Results and Discussion: One hundred percent of the patients were sensitive to at least one allergen. Allergy to food allergens only was 2.9%; inhaled allergens only were 26.2% and both were70.9%. Fungi (62%) were the most frequent sensitizing aeroallergen amongst our asthmatic patients, followed by the pollen allergens (42.5%) and house dust mites (HDMs) (26%). Cows’ milk (30.5%) was the most frequent sensitizing food amongst our asthmatic patients, followed by eggs (22.4%) and fish (21.6%). Mono-sensitized patients accounted for 6.7% of all cases, while polysensitized was 93.3%. Moderate and severe asthma showed a significantly higher frequency of polysensitization compared to mild asthma. Conclusion: Fungi and cow's milk are the chief sensitizing allergens in Egyptian patients with atopic asthma. This study represents the first report of sensitization in atopic adult asthma using a large extract panel in Upper Egypt.","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"15 1","pages":"52 - 58"},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45480425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Suboptimal Control of Asthma among Adult Asthma Patients: A Cross-sectional Study.","authors":"Kuol Peter Lual,&nbsp;Mengist Awoke Yizengaw","doi":"10.2174/1874306402115010035","DOIUrl":"https://doi.org/10.2174/1874306402115010035","url":null,"abstract":"<p><strong>Introduction: </strong>Asthma is a major public health problem that negatively impacts patients, families, and the community. Identifying risk factors for poor asthma control may greatly enhance the establishment of more effective treatment of asthma. The level of asthma control and risk factors for poor asthma control is relatively unknown in Ethiopia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 150 adult asthma patients at the Outpatient Department (OPD) chest clinic of Jimma Medical Center (JMC), from February 15 -March 20, 2019. The Statistical Package for Social Science (SPSS) 21.0 was used for data analysis. Multivariate logistic regression was conducted to analyze the potential associated factors of suboptimal control of asthma.</p><p><strong>Results and discussion: </strong>Of 150 adults diagnosed with asthma recruited in this study, 81 [54.0%] of them were females, and the mean age of the patients was 41.1 ± 12.4 years. Inhaled corticosteroid (ICS) plus short-acting beta-agonist (SABA) (64, 42.7%) was the most frequently used anti-asthmatic medication. Over one-fourth (26.0%) (95% CI, 19.2-33.8) of study participants had suboptimal asthma control. On multivariate logistic regression, being an urban dweller (AOR=3.70, p=0.025) and not applying proper inhalation technique (AOR=16.23, p=0.022) were increased the risk of suboptimal asthma control, while non-prescription anti-asthmatic drugs taking habit (AOR=0.25, p=0.010) reduces the odds of having suboptimal asthma control.</p><p><strong>Conclusion: </strong>Suboptimal asthma control is high among adult asthma patients. Being an urban dweller and not applying proper inhalation techniques were increased the likelihood of suboptimal asthma control, while non-prescription anti-asthmatic drugs taking habits had lower odds of suboptimal asthma control. The authors recommend large sample size studies on the comparative status of asthma control using prescription <i>versus</i> non-prescription anti-asthmatic medication.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"15 ","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2021-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39396504","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":"Prevalence and Predictors of Metabolic Syndrome among Patients with Bronchial Asthma: A Cross Sectional Study.","authors":"Abdellah H K Ali","doi":"10.2174/1874306402115010014","DOIUrl":"https://doi.org/10.2174/1874306402115010014","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have reported the epidemiological link between Metabolic Syndrome (MS) and asthma, but it has rarely been studied in Egypt. The study aimed to investigate the prevalence of MS and its predictors among asthma patients in Egypt.</p><p><strong>Methods: </strong>In total, 320 patients with bronchial asthma were included. The following were assessed: spirometric evaluation, anthropometric indices, blood pressure, fasting blood sugar and serum lipid profile. We analyzed the correlation between metabolic scores and patient characteristics. Predictors of MS were identified using logistic regression analysis.</p><p><strong>Results: </strong>The prevalence of MS was 57.5% in asthma patients. For asthma patients, low High-Density Lipoprotein (HDL) and abdominal obesity were the commonest metabolic abnormality. Waist circumference, Fasting Blood Sugar (FBS) and triglyceride correlated significantly with asthma (P ‹ 0.05). FBS and DBP were the best predictors of MS.</p><p><strong>Conclusion: </strong>MS is frequent in asthma patients in Egypt. Obesity and lipid abnormalities were the commonest metabolic abnormality. Screening of these patients for components of metabolic syndrome should be a part of routine workup.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"15 ","pages":"14-18"},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39174146","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":"Granulomatous <i>Pneumocystis jiroveci</i> Pneumonia in an HIV-Positive Patient on Antiretroviral Therapy: A Diagnostic Challenge.","authors":"Montserrat Diaz-Abad,&nbsp;Kathryn S Robinett,&nbsp;Anayansi Lasso-Pirot,&nbsp;Teklu B Legesse,&nbsp;Mariam Khambaty","doi":"10.2174/1874306402115010019","DOIUrl":"https://doi.org/10.2174/1874306402115010019","url":null,"abstract":"<p><p>Human Immunodeficiency Virus (HIV)-related Opportunistic Infections (OI), including <i>Pneumocystis jiroveci</i> pneumonia (PCP), have become much less commonplace with anti-retroviral therapy (ART). Despite this, OIs are still common and it is important to remain vigilant for their presence and be aware of how ART and OI chemoprophylaxis may lead to atypical disease presentations. We present the case of a 51-year-old woman with HIV and CD4+ T helper lymphocytes cell count > 200 cells/ul on both ART and trimethoprim/sulfamethoxazole prophylaxis who presented with cavitating lung masses, mediastinal lymphadenopathy and pleural effusions. Negative bronchoalveolar lavage (BAL) and transbronchial biopsy (TBBx) prompted a second diagnostic procedure with a transthoracic core needle biopsy; the final diagnosis was granulomatous PCP. This case showcases a very rare presentation of PCP, with both large cavitating lung masses on imaging and granulomatous reaction on pathology, as well as the challenge of a potentially missed diagnosis with negative BAL and TBBx requiring transthoracic core needle biopsy for a final diagnosis.</p>","PeriodicalId":39127,"journal":{"name":"Open Respiratory Medicine Journal","volume":"15 ","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2021-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8227459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39174147","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}