International Journal of Diabetes and Metabolism最新文献

{"title":"Impact of Dipeptidyl Peptidase-4 Inhibitors on Glycemic Control and Cardiovascular Safety with Adherence: An Overview","authors":"K. Bhavadasan, Ann Davis, Bharathi Kolanthavel","doi":"10.1159/000506863","DOIUrl":"https://doi.org/10.1159/000506863","url":null,"abstract":"Diabetes is a ubiquitous chronic disease worldwide. The prevalence is expected to increase further to 9.9% by the year 2045. Dipeptidyl peptidase-4 (DPP-4) inhibitors, also called as gliptins, act as incretin enhancers. They inhibit glucagon secretion and arouse postprandial insulin secretion, both in a glucose-dependent mode. In 2006, sitagliptin was approved as a first DPP-4 inhibitor in the treatment of diabetes concurrently with lifestyle modification. Sitagliptin has a high bioavailability, while linagliptin has a safety and tolerability profile similar to that of placebo, with a very low risk for hypoglycemia. DPP-4 inhibitors have a weight neutrality effect. One major benefit of gliptins is their excellent tolerability/safety profile compared with other glucose-lowering medications, including other new glucose-lowering agents such as sodium/glucose cotransporter 2 inhibitors. Compared with sulfonylureas, they have a smaller decline in HbA1c. The three gliptins showed excellent effect on glycemic control as an add-on therapy in treating type 2 diabetes. The major adverse cardiovascular events, malignancy and pancreatitis, were not associated with the treatment with sitagliptin, a DPP-4 inhibitor. The objective of establishing cardiovascular safety trials such as SAVOR-TIMI 53, EXAMINE, TECOS, CAROLINA, and CARMELINA. DPP-4 inhibitors have higher rates of adherence and persistence compared with sulfonylureas and thiazolidinediones.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121448385","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":"A Systematic Review and Meta-Analysis of Randomised Controlled Trials, Contrasting the Safety Profile between Sodium-Glucose Cotransporter-2 Inhibitors and Placebo in Type 1 Diabetes Mellitus Patients","authors":"S. Saha, Sujata Saha","doi":"10.1159/000506366","DOIUrl":"https://doi.org/10.1159/000506366","url":null,"abstract":"Background: This study aims to contrast the side effects of treatment with sodium-glucose cotransporter-2 inhibitors (SGLT2i) and placebo in insulin-treated adult type 1 diabetes mellitus (T1DM) patients. Methods: Double-blinded randomized controlled trials that compare the above outcome were searched in electronic databases. Next, the risk of bias in eligible studies was assessed, and comparable outcomes were compared by a random-effects meta-analysis. Results: Seven eligible papers comprising about 3,900 participants were studied. All trials suffered from an unclear risk of detection bias and performance bias. In comparison with the placebo group, the risk of genital infection (RR = 3.22, p < 0.001, 95% CI 2.31–4.49, I2 = 0%) and diabetic ketoacidosis (RR = 2.66, p = 0.002, 95% CI 1.45–4.89, I2 = 0%) was higher in the SGLT2i-treated group. Conclusion: SGLT2i treatment increased the risk of genital infection and diabetic ketoacidosis in adult insulin-treated T1DM patients.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117287304","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":"Analysis of Cardiovascular Fitness, Sleep Quality, Depression, Fatigue, and Quality of Life among Individuals with Respect to the Glycated Hemoglobin Level in Type 2 Diabetes Mellitus","authors":"Swetank Pathak, S. Shenoy","doi":"10.1159/000503607","DOIUrl":"https://doi.org/10.1159/000503607","url":null,"abstract":"Background: Diabetes as a metabolic disorder can affect the various systems of the body, resulting in a decrease in cardiovascular fitness, sleep quality, and life quality that can lead to depression and fatigue. Aim: We analyzed cardiovascular fitness, sleep quality, depression, fatigue, and quality of life among individuals with a glycated hemoglobin (HBA1C) level >6.5% and ≤6.5%, as well as the relationship among glycated hemoglobin, maximal oxygen consumption (VO2max), obesity, sleep quality, depression, and duration of diabetes. Method: HBA1C (mean: 5.90 ± 0.93%) was studied in a total of 70 subjects (mean age: 62.37 ± 7.5 years). The 2 study groups were as follows: group A, HBA1C >6.5%, and group B, HBA1C ≤6.5%. BMI, VO2max, quality of sleep and life, depression, and fatigue were assessed in both groups. Results: There was a statistically significant difference between the groups at a significance level of p < 0.001. Group A had a lower cardiovascular fitness, a poor sleep quality, and increased depression compared to group B. A statistically significant negative linear correlation was found between VO2max and glycated hemoglobin, and a significant positive linear correlation was found between glycated hemoglobin and duration of diabetes, poor quality of sleep, and depression for all subjects, which was insignificant in the groups. Conclusions: A long duration of diabetes and an increased glycemic status may influence cardiovascular fitness, sleep quality, and life quality, leading to depression and fatigue.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"31 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130967225","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":"Pharmacist’s Intervention on Pill Burden Effects on the Health-Related Quality of Life of Elderly Diabetic Patients in a Tertiary Hospital in Southwestern Nigeria","authors":"W. Ojieabu","doi":"10.1159/000503174","DOIUrl":"https://doi.org/10.1159/000503174","url":null,"abstract":"Background: Diabetes and its associated complications take a toll on the elderly. It is known that medication burden could reduce patients’ adherence, which in turn impacts negatively on the health-related quality of life (HRQOL) of those suffering from chronic diseases. Studies have been conducted on HRQOL and its associated factors among diabetic patients but none has studied pill burden effects on HRQOL. This research evaluated pharmacist’s intervention on pill burden effects on the HRQOL of elderly diabetic patients. Methods: This 8-month randomized controlled study involved 170 elderly type 2 diabetic patients. Socio-demographics, the impact of the number and dosage frequency of drugs on adherence, and the influence of the pill burden on HRQOL scores were evaluated at baseline and at 4 and 8 months. Patients in the intervention group were educated about diabetes and its management and counselled on treatment adherence. Brisk walking was specially demonstrated to them at least 4 times during the study period. The control group received only the usual call reminders for appointment days. Results: At baseline, 58.8 and 64.7%, respectively, in the control and intervention groups responded “yes” (indicating a negative effect on their adherence) to >5 pills per prescription, while the figures were 55.3 and 15.3%, respectively, at 8 months (p = 0.711 and p = 0.000, respectively). Patients on 1–5 pills per prescription in the control group had the following physical functioning scores: baseline (44.2 ± 14.2) versus 4 months (47.2 ± 19.1) and 8 months (47.7 ± 16.1); p = 0.277 and p = 0.160. The physical functioning scores in the intervention group were: baseline (41.7 ± 16.1) versus 4 months (67.6 ± 23.1) and 8 months (92.5 ± 3.5); p ≤ 0.001. The same pattern of results was found for those on >5 pills per prescription. Conclusion: This study demonstrates pharmacists’ ability to improve the HRQOL of patients through continuous counselling, supply of relevant information, and monitoring of drug, exercise, and diet adherence. Intervention such as this could be beneficial to diabetic patients and others with chronic diseases.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130772768","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 Insulin Nonadherence in Type 1 Diabetes Mellitus Patients in Mexico","authors":"P. Almeda-Valdés, Josefa Palacio Ríofrio, K. W. Zamudio Coronado, David Rivera de la Parra, Janneth Bermeo Cabrera, F. Gómez-Pérez, C. Aguilar-Salinas, R. Mehta","doi":"10.1159/000502903","DOIUrl":"https://doi.org/10.1159/000502903","url":null,"abstract":"Background: Lack of adherence to insulin therapy is common among patients with type 1 diabetes. Factors associated with insulin omission in adult persons with type 1 diabetes in Latin America have not been studied in detail. Objectives: To investigate factors associated with insulin nonadherence including the presence of psychological disorders (disordered eating behaviors and depression) in adult patients with type 1 diabetes. Methods: Cross-sectional study including 104 consecutive adults (≥18 years old) attending a tertiary care center in Mexico City. Adherence to insulin therapy was measured with a specific item in a questionnaire. Sociodemographic data and factors related to insulin omission, including validated questionnaires to evaluate disordered eating behavior and depression, were collected and compared between the nonadherent and adherent groups with parametric or nonparametric statistical tests, as appropriate. Results: We classified 51 (49.1%) patients as nonadherent and 53 (50.9%) as adherent. Adherent subjects reported that they planned their activities around insulin application more often than the nonadherent subjects did (43.4 vs. 23.5%, p = 0.032). In a logistic regression model, fear of hypoglycemia (OR = 11.39) and economic reasons (OR = 6.02) were independently associated with insulin adherence. Presence of disordered eating behavior was identified in 14.4% of subjects, the majority belonging to the nonadherent group. Conclusions: Only 50% of the patients with type 1 diabetes were adherent. The principal factors associated with nonadherence were economic reasons and fear of hypoglycemia.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"255 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131631091","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":"The Impact of Adiponectin Gene Polymorphisms on the Insulin Resistance Index in Patients with Diabetes and Newly Diagnosed Type 2 Diabetes","authors":"H. Karimi, M. Nezhadali, M. Hedayati, M. Mahdavi, Sara Sheikholeslami","doi":"10.1159/000502904","DOIUrl":"https://doi.org/10.1159/000502904","url":null,"abstract":"Background: Some adipokine hormones can affect both human and animal models of insulin resistance. Aims: This study was conducted to assess the association between rs17300539 and rs266729 of the adiponectin gene and insulin resistance and anthropometric and metabolic characteristics in impaired fasting glucose (IFG)/type 2 diabetes mellitus (T2DM) and nondiabetic participants. Methods: DNA was extracted from 80 participants with fasting blood sugar (FBS) <100 mg/dL in nondiabetics and 80 participants with FBS ≥100 mg/dL in the IFG/T2DM group. Genotyping was performed using a polymerase chain reaction-restriction fragment length polymorphism assay. Statistical analysis was performed using SPSS software version 20. Insulin and adiponectin hormone were measured using enzyme-linked immunosorbent assay and other biochemical variables were determined using the standard methods. Results: The levels of homeostatic model assessment of insulin resistance (HOMA-IR) between the IFG/T2DM and the nondiabetic group were significantly different (IFG/T2DM = 3.27, nondiabetic = 1.71; p < 0.001). The frequency of the GA genotype of rs17300539 was higher in the insulin-resistant (HOMA-IR ≥2.6, 29.7%) than in the insulin-sensitive group (HOMA-IR <2.6, 18.4%) and the GG genotype were more frequent in the insulin-sensitive group (81.6%); however, it had a marginal association (p = 0.07). This association was not statistically significant for rs266729. HOMA-IR had a positive correlation with triglyceride (TG) and total cholesterol (TC) and was negatively correlated with adiponectin level. Conclusion: IFG/T2DM patients have a higher level of HOMA-IR in comparison with nondiabetics. The genotype of GA in rs17300539 increases the risk of HOMA-IR. HOMA-IR has a positive correlation with TC and TG. Moreover, HOMA-IR increases the risk of T2DM.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126505068","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":"An Appraisal of a Systematic Review and Meta-Analysis of Randomized Clinical Trials on the Efficacy and Safety of Sodium-Glucose Cotransporter-2 Inhibitors as an Adjunct to Insulin Therapy in Type 1 Diabetes Patients","authors":"S. Saha","doi":"10.1159/000502743","DOIUrl":"https://doi.org/10.1159/000502743","url":null,"abstract":"Dear Editor, I am writing to share a critique about a highly cited recently published (2018) paper on the efficacy and safety of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in type 1 diabetes patients [1]. In contemporary medicine, when the knowledge in this milieu is not parallelly apparent as in type 2 diabetes mellitus patients, the paper proves vital in addressing the evidence gap [1]. I thank the authors [1] for their substantial effort to address the context. I start here with some of the discrepancies between the protocol and the published paper [1, 2]. First, it is unclear if searching of the “Web of Science” database occurred as per the protocol [1, 2]. Second, in contrast to the published paper (and its supplement), the aim of testing the safety and efficacy of weekly administered SGLT2is was not prespecified [1, 2]. Lastly, as per the protocol and the title of the study, the review intended to study the safety and efficacy of SGLT2is only (as an adjunct to insulin therapy) in type 1 diabetes patients; however, data pooled from seven trials contradict this (six tested a combination of sodium-glucose cotransporter-1 inhibitor and SGLT2i [sotagliflozin] and the remaining tested the aggregate of liraglutide, dapagliflozin, and insulin). Next, while the study aimed to test the weekly administration of SGLT2is, it primarily included trials where participants received the test drug daily. Then, the incorporation of the four conference-abstract-based data in the main (quantitative) analysis is not agreeable. While the authors assumed an unclear risk of bias in these abstracts [1], it is plausibly better to avoid a risk of bias assessment when a full manuscript is unavailable. In reality, if the risk of bias is high, the summary statistic is less likely to be of any worth. A supplementary analysis may be appropriate in such a scenario. Finally, the pooled data in the metaanalysis also do not appear conceivable. For instance, regarding side effects, data was chiefly pooled for particular doses of the respective study drugs (while the paper’s aim was not dose-specific). Another illustration: in one trial, although severe hypoglycemia occurred in one of the participants in the intervention group, a placebo recipient was also accounted for the event while pooling data [3]. In light of the pitfalls discussed above, the findings of the paper necessitate a cautious interpretation and authors may consider a revision. Disclosure Statement","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134314029","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":"The Effect of Depression on Poor Glycemic Control in Adults with Type 2 Diabetes: The Mediating Roles of Self-Efficacy and Self-Management Behaviors","authors":"Golnaz Azami, K. L. Soh, S. Sazlina, Md.Said Salmiah, A. Khosravi, Sanaz Aazami, R. Valizadeh","doi":"10.1159/000502126","DOIUrl":"https://doi.org/10.1159/000502126","url":null,"abstract":"Background: High levels of depression and poor self-efficacy and self-management are associated with worse glycemic control, but the linkage and pathway between these variables are poorly understood. We conducted this study to investigate the hypothesis that self-efficacy and self-management mediate the influence of depression on poor glycemic control. Methods: We studied a purposive sample of 142 adults with type 2 diabetes attending a public clinic in Ilam, Iran. Hierarchical linear regression analysis and structural equation modeling were used to explore the relationships among the variables of interest. Result: Depression directly and negatively affects self-efficacy and indirectly affects self-management behaviors, which in turn have direct effects on hemoglobin A1c (HbA1c). Self-efficacy mediates the relationship between depression and self-management behaviors. Self-efficacy and self-management behaviors partially mediate the effect of depression on HbA1c. These results confirmed that the data fit the hypothesized model very well. Conclusion: Careful monitoring of glycemic control might be important in those individuals who exhibit clinical signs of depression. Effective treatment programs should probably pay close attention to not only screening and treatment of depression but also skills training to enhance patient self-efficacy and self-management of diabetes to improve HbA1c.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129976455","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":"Preventing Diabetes Mellitus in Nigeria: Effect of Physical Exercise, Appropriate Diet, and Lifestyle Modification","authors":"O. R. Adeleke, G. Ayenigbara","doi":"10.1159/000502006","DOIUrl":"https://doi.org/10.1159/000502006","url":null,"abstract":"In this systematic review, we explored the effects of physical activity, diet, and lifestyle on the prevention of diabetes mellitus in Nigeria. Diabetes is an autoimmune disease which occurs when the body does not produce or respond properly to insulin, a hormone essential for daily life. Diabetes is an incurable disease, which has no racial, social, or sex barrier. The risk factors include a poor diet, lack of physical activity, obesity, and an unhealthy lifestyle. About 100 million people in the United States have diabetes mellitus, and the total economic costs of diabetes exceed USD 132 billion a year. Diabetes accounts for 1 of every 10th USD spent on health care in the United States, and an estimated 48 million Americans may develop diabetes by 2050. However, it is estimated that in 90% of the patients with type 2 diabetes the disease could be prevented if people adopted a healthy lifestyle, including regular physical activity, a moderate-good diet, and modest weight. Because of the deleterious health consequences which include blindness; kidney damage; cardiovascular disease; and reduced life span, as well as high treatment costs, prevention of the disease in Nigeria, where you are confronted with a poor health care system, poverty, and ignorance, but also have ample opportunities for physical activity and rich local nutrients to supply an ideal diet, is a viable option. Consequent upon this, the paper recommends, among others, that available local resources be used for this purpose.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131882203","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":"Association between Lipid Profiles and Renal Functions among Adults with Type 2 Diabetes","authors":"S. Hamzah","doi":"10.1159/000502005","DOIUrl":"https://doi.org/10.1159/000502005","url":null,"abstract":"Introduction: Type 2 diabetes mellitus (T2DM) affects renal functions and lipid profiles of patients. Objectives: In this study, 100 patients (65 females, 35 males) with T2DM were evaluated to determine whether renal function characteristics and lipid profiles are associated with T2DM. Methods: Blood samples were collected from all patients with T2DM, and the levels of hemoglobin A1c (HbA1c), blood urea, serum creatinine, cholesterol, triglyceride (TGR), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL) were analyzed. Results: A direct correlation of blood sugar and HbA1c was observed with blood urea, serum creatinine, serum cholesterol, serum TGR, HDL, LDL, and VLDL. The results revealed elevated TGR levels in patients administered medications for hyperglycemia. Furthermore, serum TGR levels were significantly correlated with blood sugar levels (p = 0.035). Blood urea levels were significantly correlated with glycated hemoglobin (p = 0.008). Blood urea, serum creatinine, and serum cholesterol levels were highly significantly correlated with HbA1c (p = 0.008, 0.017, and 0.005, respectively), while HDL, LDL, and VLDL were not significantly correlated with HbA1c. Conclusion: This study highlights the importance of serum TGR and serum creatinine measurement for guiding the treatment of T2DM.","PeriodicalId":405374,"journal":{"name":"International Journal of Diabetes and Metabolism","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121608624","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}