Diabetes & Metabolic Syndrome-Clinical Research & Reviews最新文献

{"title":"Ankle brachial index and brachial-ankle pulse wave velocity as predictor for major adverse limb events and all-cause mortality in diabetes","authors":"Ashish Gupta ,&nbsp;Raveena Singh ,&nbsp;Sanjay Kumar Bhadada ,&nbsp;Edward B. Jude ,&nbsp;Ashu Rastogi","doi":"10.1016/j.dsx.2025.103239","DOIUrl":"10.1016/j.dsx.2025.103239","url":null,"abstract":"<div><h3>Background</h3><div>Ankle-brachial index (ABI) is not a reliable index predicting cardiovascular events, as a significant number of patients with normal ABI do have cardiovascular events. Brachial-ankle pulse wave velocity (BaPWV), a non-invasive vascular assessment index for predicting CV events in normal ABI is not studied in type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This prospective study included people with T2D from year 2013 until December 2022 or death. Demographics and T2D related complications were recorded. All participants had ABI and BaPWV measured at study entry and grouped based on initial ABI (group A: ABI 0.7–0.9, group B: ABI 0.9–1.2, and group C: ABI &gt;1.2) and sub-categorised based on BaPWV quartiles. The primary objective was to identify BaPWV cut-offs for prediction of all-cause mortality despite normal ABI.</div></div><div><h3>Results</h3><div>A total of 16000 patients with T2D were screened and 2186 individuals with first incident diabetic foot ulcer (DFU) were evaluated. The median age of participants was 61 (53–67) years, duration of T2D 10 (6–15) years, and follow-up of 6 (2–8) years. Overall, BaPWV&gt;1882 cm/s was associated with reduced survival [HR 0.750 (0.622–0.904); p = 0.003]. Participants with BaPWV &gt;2210 cm/s (HR = 0.48, 95 % CI: 0.33–0.70, p &lt; 0.001) and BaPWV&lt;1642 cm/s (HR = 0.75, 95 % CI: 0.56–1.002, p = 0.051) had higher mortality risk compared to BaPWV 1642–2210 cm/s, despite normal ABI.</div></div><div><h3>Conclusions</h3><div>A BaPWV&gt;1882 cm/s is associated with reduced survival in people of diabetes. Despite a normal ABI, a BaPWV&gt;2210 cm/s or &lt;1642 cm/s are associated with increased all-cause mortality in people with T2D.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103239"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154362","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":"Ethnic differences in skinfold thickness trajectories in children in the born in bradford 1000 cohort study provide modest support for the adipose tissue compartment hypothesis","authors":"E.S. Petherick ,&nbsp;L. Smith ,&nbsp;G. Cézard ,&nbsp;N. Bansal ,&nbsp;J. West ,&nbsp;N. Cameron ,&nbsp;W. Johnson ,&nbsp;T. Norris ,&nbsp;D.A. Lawlor ,&nbsp;J. Wright ,&nbsp;R. Bhopal","doi":"10.1016/j.dsx.2025.103227","DOIUrl":"10.1016/j.dsx.2025.103227","url":null,"abstract":"<div><h3>Background</h3><div>South Asian populations have high susceptibility to cardiometabolic diseases, with high adiposity for a given Body Mass Index implicated. This study tested the adipose tissue overflow hypothesis that, compared to White Europeans, South Asians have smaller, peripheral subcutaneous adipose tissue depots.</div></div><div><h3>Methods</h3><div>Subscapular, triceps and thigh skinfolds were measured at 6, 12, 18, 24 and 36 months in White British (Number = 561) and British Pakistani (Number = 651) children in Bradford, England. Data were available for 1295 people. Linear spline models of the three skinfold trajectories were developed by ethnic and sex group to allow exploration of mean temporal change between groups. Models were adjusted for birthweight, length of gestation and gestational diabetes.</div></div><div><h3>Results</h3><div>3-year trajectories differed between skinfold sites, with different patterns of growth observed. White British and British Pakistani children had similar adjusted subscapular skinfold thicknesses. Adjusted triceps skinfolds in British Pakistani boys and girls were mostly lower than White British children. British Pakistani children had adjusted mean thigh skinfold thicknesses mostly lower than White British children.</div></div><div><h3>Conclusion</h3><div>Our study provides modest support for the adipose tissue overflow hypothesis. Replication in larger birth cohorts and continuing consideration of the cardiometabolic impacts of potential differences are required.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 5","pages":"Article 103227"},"PeriodicalIF":4.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168069","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":"Prevalence of cardiovascular risk and atherosclerotic cardiovascular disease in people with type 2 diabetes in the United Arab Emirates: Results from the prevalence of atherosclerotic cardiovascular disease in patients with type 2 diabetes across Middle East and African countries (PACT-MEA) study","authors":"Fatheya Al. Awadi ,&nbsp;Fauzia Rashid ,&nbsp;Ghada Awada ,&nbsp;Haitham Seifeldin ,&nbsp;Hani Sabbour ,&nbsp;Hazem Aly ,&nbsp;Jalal Nafach ,&nbsp;Khadija Hafidh ,&nbsp;Loai Abudaqa ,&nbsp;Mahir K. Jallo ,&nbsp;Wael Almahmeed ,&nbsp;Zufana Nazir","doi":"10.1016/j.dsx.2025.103224","DOIUrl":"10.1016/j.dsx.2025.103224","url":null,"abstract":"<div><h3>Aim</h3><div>Atherosclerotic cardiovascular disease (ASCVD) is a significant cause of morbidity and mortality in type-2 diabetes mellitus (T2D) patients. This subset analysis of the PACT-MEA study compares T2D data from the UAE with data from other Middle Eastern and African (MEA) countries.</div></div><div><h3>Methods</h3><div>Data were extracted from the participants' medical charts from March 2022 to August 2022 across nine centers in the UAE (n = 542). The prevalence and 10-year CVD risk estimates were evaluated and categorized according to European Society of Cardiology (ESC) 2021 guidelines and compared between MEA (regional) and UAE populations.</div></div><div><h3>Results</h3><div>Participants with T2D from the UAE, enrolled in secondary care, had a median age of 55.7 years. The estimated 10-year CVD risk was 99.8 % in the UAE and 99.3 % in the MEA. Established ASCVD prevalence (eASCVD) was 29.7 % in the UAE and 20.9 % in the MEA. Coronary artery disease was the most common ASCVD type (95.0 %).</div></div><div><h3>Conclusion</h3><div>Nearly one-third of T2D patients had eASCVD in UAE, compared to one-fifth in MEA. Most participants were at high or very high risk for ASCVD, but none met all ESC 2021 guidelines, highlighting the need for developing regional strategies to reduce ASCVD risk.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103224"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834272","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":"Quantitative assessment of metabolic memory and its prediction of renal function decline in patients with type 2 diabetes: A retrospective observational study","authors":"Kentaro Oniki ,&nbsp;Takuro Shigaki ,&nbsp;Ayami Kajiwara-Morita ,&nbsp;Keiichi Shigetome ,&nbsp;Akira Yoshida ,&nbsp;Hideaki Jinnouchi ,&nbsp;Junji Saruwatari","doi":"10.1016/j.dsx.2025.103225","DOIUrl":"10.1016/j.dsx.2025.103225","url":null,"abstract":"<div><h3>Aims</h3><div>This study quantitatively assesses metabolic memory by modeling the relationship between hyperglycemic exposure and renal function decline in patients with type 2 diabetes (T2D).</div></div><div><h3>Methods</h3><div>This retrospective longitudinal study included 381 Japanese patients with T2D. Hyperglycemic exposure was presented by calculating the area under the curve (AUC) for HbA1c ≥ 6 % (AUC_{HbA1c ≥ 6 %}) during the observation period. A non-linear mixed-effects model was constructed to predict changes in estimated glomerular filtration rate (eGFR) based on AUC_{HbA1c ≥ 6 %}.</div></div><div><h3>Results</h3><div>The relationship between AUC_{HbA1c ≥ 6 %} and eGFR changes was shown by a sigmoidal curve, with sex, age, diabetic retinopathy, dyslipidemia, and hypertension incorporated as covariates. The predictive utility of the model was validated using goodness-of-fit plot, visual predictive check, and bootstrap methods.</div></div><div><h3>Conclusions</h3><div>We developed an AUC_{HbA1c ≥ 6 %}-based model to predict renal function decline in patients with T2D, showing that AUC_{HbA1c ≥ 6 %} may serve as a quantitative indicator of metabolic memory.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103225"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143834273","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":"Composite renal outcome in prospectively performed biopsy proven diabetic kidney disease versus non-diabetic kidney disease: A longitudinal follow up","authors":"Subhasis Neogi ,&nbsp;Madhurima Basu ,&nbsp;Pradip Mukhopadhyay ,&nbsp;Arpita Ray Chaudhury ,&nbsp;Nitai P. Bhattacharyya ,&nbsp;Sujoy Ghosh","doi":"10.1016/j.dsx.2025.103237","DOIUrl":"10.1016/j.dsx.2025.103237","url":null,"abstract":"<div><h3>Aims</h3><div>This study was undertaken to evaluate differences in composite renal outcomes between diabetic kidney disease (DKD) and non-diabetic kidney disease (NDKD) (prospectively performed, biopsy proven), along with predictors of renal outcome in subjects with DKD.</div></div><div><h3>Methods</h3><div>A composite renal outcome comprising of doubling of creatinine, end stage renal disease (ESRD) or renal death was documented in biopsy proven DKD and NDKD subjects. Differences in outcome (DKD vs. NDKD) were compared. Clinical, biochemical and histopathological parameters were evaluated as possible predictors of composite renal outcome in DKD.</div></div><div><h3>Results</h3><div>91 subjects (72 DKD and 19 NDKD) were included for analysis. The hazard ratio (HR) for composite renal outcome was 0.27 (0.08–0.9) (p = 0.03) in favour of NDKD. Kaplan-Meier analysis demonstrated NDKD subjects had better composite renal outcome compared to DKD (log rank chi-square 6.69, p = 0.009). Degree of proteinuria and renal pathology society (RPS) class (III/IV) predicted worse outcome in those with DKD.</div></div><div><h3>Conclusions</h3><div>Composite renal outcomes in NDKD was better as compared to those with DKD. RPS class III/IV on histopathology and degree of proteinuria was associated with poorer composite renal outcome in patients with DKD.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103237"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123409","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 metabolically healthy obesity and atrial fibrillation: A systematic review and meta-analysis of longitudinal studies","authors":"Xiao Liu ,&nbsp;Jitao Ling ,&nbsp;Yifan Wu ,&nbsp;Huilei Zhao ,&nbsp;Yuzhe Hu ,&nbsp;Zhiwei Yan ,&nbsp;Wengen Zhu ,&nbsp;Peng Yu ,&nbsp;Jinfeng Wang ,&nbsp;Yuling Zhang ,&nbsp;Tommaso Bucci ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.dsx.2025.103228","DOIUrl":"10.1016/j.dsx.2025.103228","url":null,"abstract":"<div><h3>Introduction</h3><div>Obesity is not a single diagnosis, and the association of ‘metabolically unhealthy’ obesity with cardiovascular disease is well-described. However, the relationship between metabolically healthy obesity (MHO) and atrial fibrillation (AF) is still debated.</div></div><div><h3>Objective</h3><div>Our objective is to investigate the association between MHO and the risk of AF.</div></div><div><h3>Methods</h3><div>A comprehensive search of databases, including PubMed, EMBASE, Web of Science, and the Cochrane Library regarding longitudinal studies of MHO and risk of AF was performed. Random effects were used to pool the effect estimates.</div></div><div><h3>Results</h3><div>Nine cohort studies comprising 4,250,557 participants were included. The pooled results revealed that individuals with MHO were associated with a greater incidence of AF than those with a metabolically healthy normal weight (HR: 1.34, 95 % CI: 1.26 to 1.42) with moderate certainty according to the Grading of Recommendations Assessment, Development, and Evaluation assessment. Individuals with MHO were associated with a lower risk of AF compared with participants with metabolically unhealthy obesity (RR: 0.48, 95 % CI: 0.36 to 0.64). Individuals with MHO were not significantly associated with the risk of AF as compared to metabolically unhealthy normal weight (HR: 1.04, 95 % CI: 0.89 to 1.22).</div></div><div><h3>Conclusion</h3><div>MHO is associated with a greater incidence of AF, highlighting the importance of weight reduction in individuals without metabolic disorders in reducing the risk of AF.</div></div><div><h3>Registration</h3><div>PROSPERO - registration number CRD42023432195.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103228"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882965","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":"Rational application of weight loss therapies according to new obesity guidelines in Asian Indians: A perspective for low-income settings","authors":"Anoop Misra","doi":"10.1016/j.dsx.2025.103226","DOIUrl":"10.1016/j.dsx.2025.103226","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103226"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879142","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":"Glucagon-Like Peptide-1 receptor agonists, dual GIP/GLP-1 receptor agonist tirzepatide and suicidal ideation and behavior: A systematic review of clinical studies and pharmacovigilance reports","authors":"Ramona Di Stefano ,&nbsp;Lorenzo V. Rindi ,&nbsp;Valentina Baldini ,&nbsp;Rodolfo Rossi ,&nbsp;Francesca Pacitti ,&nbsp;Emmanuele A. Jannini ,&nbsp;Alessandro Rossi","doi":"10.1016/j.dsx.2025.103238","DOIUrl":"10.1016/j.dsx.2025.103238","url":null,"abstract":"<div><h3>Aims</h3><div>Suicide is a global public health concern, accounting for nearly 700,000 deaths annually. Although well-established risk factors, including mental health disorders, are widely recognized, emerging concerns have surfaced regarding a potential association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the dual Gastric Inhibitory Polypeptide (GIP)/GLP-1 Receptor Agonist tirzepatide and suicidal behavior. This systematic review aims to synthesize the available evidence on the potential association between these drugs and suicidal behavior.</div></div><div><h3>Methods</h3><div>This review was conducted following PRISMA guidelines. A systematic search was performed in MEDLINE, Embase, and APA PsycInfo up to September 24, 2024, using terms related to GLP-1 RAs/GIP/GLP-1 RAs and suicidal behavior.Three independent reviewers conducted article screening and data extraction. Risk of bias was evaluated using the Newcastle-Ottawa Scale for cohort studies and ROB2 for RCTs.</div></div><div><h3>Results</h3><div>The review identified 16 studies published between 2017 and 2024, consisting of 5 observational studies, 2 randomized controlled trials, 8 pharmacovigilance analyses, and 1 post-hoc analysis of RCTs. No consistent evidence indicated an increased suicide risk among GLP-1 RA users. Pharmacovigilance analyses produced mixed findings; while some disproportionality analyses reported higher rates relative to other antihyperglycemic drugs, no causal link was confirmed. Cohort studies involving diabetic and obese populations generally did not demonstrate a significant increase in suicidal behavior.</div></div><div><h3>Conclusions</h3><div>Although current data do not warrant changes in prescribing practices, further research is needed before definitive conclusions can be drawn. Moreover, the generalizability and reliability of these findings should be interpreted in light of the methodological limitations of the included studies.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103238"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072478","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":"Prevalence of diabetes and disability among older adults in West Bengal and India: A comparative analysis","authors":"Ujjwal Das ,&nbsp;Nishamani Kar ,&nbsp;Tomo Riba ,&nbsp;Nihar Ranjan Rout","doi":"10.1016/j.dsx.2025.103236","DOIUrl":"10.1016/j.dsx.2025.103236","url":null,"abstract":"<div><h3>Background</h3><div>Aging is a heterogeneous process, and older adults are at greater risk of experiencing physical and functional health challenges. This study examines the comparative prevalence of diabetes-related disability among older adults in West Bengal and India.</div></div><div><h3>Methods</h3><div>Data were drawn from the first wave of the Longitudinal Aging Study in India (2017–18), comprising 72,250 individuals aged 45 years and above, including 3933 respondents from West Bengal. A multistage stratified sampling method was used. Functional disability was assessed using six Activities of Daily Living (ADL) and seven Instrumental Activities of Daily Living (IADL). Logistic regression was used to assess the association between diabetes and disability, and the Blinder–Oaxaca decomposition technique was applied to identify the contribution of various factors to the observed differences.</div></div><div><h3>Results</h3><div>The prevalence of ADL and IADL difficulties among older adults with diabetes was 24.1 % in West Bengal and 18.9 % at the national level. The risk of disability among diabetic elderly was significantly higher in West Bengal [OR = 6.20 (3.74–10.26) for ADL; OR = 6.71 (4.69–9.61) for IADL] compared to India [OR = 3.92 (1.10–14.03) for ADL; OR = 3.91 (1.17–13.12) for IADL]. Decomposition analysis showed that comorbidity factors accounted for 37 % of the ADL/IADL disability gap between West Bengal and India.</div></div><div><h3>Conclusion</h3><div>Nearly one-fourth of older adults with diabetes in West Bengal experience ADL limitations. There is urgent need to enhance healthcare services for individuals in West Bengal who are face higher levels of diabetes and disability.</div></div>","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 4","pages":"Article 103236"},"PeriodicalIF":4.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143918262","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":"Highlights of the current issue","authors":"Ningjian Wang ,&nbsp;Anoop Misra","doi":"10.1016/j.dsx.2025.103229","DOIUrl":"10.1016/j.dsx.2025.103229","url":null,"abstract":"","PeriodicalId":48252,"journal":{"name":"Diabetes & Metabolic Syndrome-Clinical Research & Reviews","volume":"19 3","pages":"Article 103229"},"PeriodicalIF":4.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143855990","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}