Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health最新文献

{"title":"Validation of urinary Congo Red preeclampsia detection point-of-care devise","authors":"","doi":"10.1016/j.preghy.2024.101167","DOIUrl":"10.1016/j.preghy.2024.101167","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate a commercial a Congo Red urine devise for assessing preeclampsia risk.</div><div>Study design: Prospective non-intervention study among women presenting with clinical suspicion of preeclampsia. The devise was used at the time of enrolment and, depending on gestation, on 1–3 later occasions.</div><div>Outcome measures: Abnormal diffusion patterns classified as positive or negative, in relation to subsequent confirmation of preeclampsia (detection and false-positive rates, and predictive value) and the probability of diagnosis within a fixed time period (rule-in and rule-out).</div></div><div><h3>Results</h3><div>600 women were enrolled in the study and follow-up information was available on 538, of whom 95 had preeclampsia at delivery and 443 did not. At enrolment the detection rate was 18 % and the false-positive rate 3.2 %; positive predictive value – probability of positive result being associated with preeclampsia – was 55 % and negative predictive value – probability of negative result not being preeclampsia – was 85 %. A positive test ruled-in delivery with preeclampsia within 28 days among 35 % and ruled-out preeclampsia with 7 days among 98 %. Repeat testing after enrolment yielded similar results to the initial sample.</div></div><div><h3>Conclusion</h3><div>The test has screening potential although published studies differ in the observed detection rate. Using the test to rule-out preeclampsia within 7 days can provide a significant management advantage especially for triaging patients and selecting those who can be managed at the peripheral centres.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birthweight in a non-human primate model of placental ischaemia","authors":"","doi":"10.1016/j.preghy.2024.101160","DOIUrl":"10.1016/j.preghy.2024.101160","url":null,"abstract":"<div><div>Animal models for preeclampsia are mostly determined by the experimental induction of hypertension, proteinuria and latterly, endogenous production of anti-angiogenic factors (sFlt-1). The focus on maternal outcome measures is more immediately obvious, with comparative and sequential data of blood pressure and urine protein excretion. In non-human primates, the data concerning birthweight requires a greater number of observations and thus will be accumulated over a longer period of time and a greater number of experimental protocols. The following represents the outcome of over 20 years of experimental preeclampsia (EPE) compared with normal pregnancy outcome data in baboons.</div><div>MethodsThis data represents the outcomes from 91 pregnancies over the last 25 years at the Australian National Baboon Colony. These pregnancies are attributed to females who had experimental preeclampsia (EPE) and those within the general colony. EPE was induced at day 130 (of 182 days gestation length), and in some protocols, treatments such as inhibitory RNA or placental growth factor (PlGF) were tested. All studies were approved by the institutional Animal Welfare Committee.</div></div><div><h3>Results</h3><div>The overall neonatal birthweight was 697 g ± 115 g. The average birthweight for normal males was 770 ± 105 g; and for male offspring of animals with EPE, 680 ± 113 g; for normal females was 640 ± 95 g and females from EPE pregnancies, 690 ± 43 g. There was only a significant difference in weight for females compared to males overall (<em>p</em> = 0.002), and there was no significant difference in birthweight for males or females subjected to EPE. Correction for treated EPE did not change the outcome.</div></div><div><h3>Conclusions</h3><div>These data indicate that in a non-human primate model of placental dysfunction through late pregnancy acute ischaemia, there is no measurable effect on baby birthweight compared to normal pregnancy, and no impact from a number of current experimental treatment strategies.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between first trimester blood pressure, blood pressure trajectory, mid-pregnancy blood pressure drop and maternal and fetal outcomes: A systematic review and meta-analysis","authors":"","doi":"10.1016/j.preghy.2024.101164","DOIUrl":"10.1016/j.preghy.2024.101164","url":null,"abstract":"<div><h3>Background</h3><div>Hypertensive disorders of pregnancy occur in 5–10 % of pregnancies and are associated with an increased risk of adverse perinatal outcomes.</div></div><div><h3>Objectives</h3><div>This review investigates the association between first trimester blood pressure (BP), mid-pregnancy BP drop, and BP-trajectories during pregnancy and adverse perinatal outcomes, exploring the fit of prediction and prevention.</div></div><div><h3>Search strategy</h3><div>Observational studies published before September 2023, reporting on desired determinants of BP and outcomes (preeclampsia (PE), severe hypertension, small for gestational age (SGA), fetal growth restriction (FGR)) were identified in MEDLINE, Embase and Cochrane.</div></div><div><h3>Data collection and analysis</h3><div>Data were collected in Excel. Results were analysed per BP-determinant. Meta analysis was performed for first trimester BP.</div></div><div><h3>Main results</h3><div>Ten studies met selection criteria. A great variety of cut-off values were used for BP categorization. Pooled analysis of 6 studies showed that women with borderline or hypertensive first trimester BP had a higher risk of PE compared to normotensive BP, OR 3.23 (95 % CI 1.99–5.26) and 7.86 (95 % CI 1.28–48.31), respectively. Additionally, first trimester hypertension correlated with a higher risk of SGA neonate (pooled OR of 1.87 (95 % CI 1.17–2.99)) compared to normotension or borderline hypertension. Throughout pregnancy, prehypertension, hypertension, elevated and high stable trajectories increased PE risk. High-stable trajectory increased SGA neonate risk.</div></div><div><h3>Conclusions</h3><div>The findings suggest that women with borderline and hypertensive BP in the first trimester are at increased risk for PE and SGA. However, standardization of cut-off values and BP measurement is necessary to estimate outcome risks more accurately.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142440988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal characteristics impact the relationship between fetal sex and superimposed preeclampsia","authors":"","doi":"10.1016/j.preghy.2024.101165","DOIUrl":"10.1016/j.preghy.2024.101165","url":null,"abstract":"<div><h3>Objectives</h3><div>Associations between female fetal sex and preeclampsia occurring preterm have been reported but data is inconsistent across populations. We explored if the relationship between fetal sex and various hypertensive disorders of pregnancy (HDP) is modified by maternal characteristics.</div></div><div><h3>Study design</h3><div>We conducted a retrospective cohort study analyzing data from 43,737 singleton pregnancies. A modified Poisson regression model with robust error variance was used to calculate relative risk (RR) and 95% confidence intervals (CI) for the association between female fetal sex and HDP.</div></div><div><h3>Main outcome measures</h3><div>Models were adjusted for maternal age, smoking, body mass index, and gravidity. Relative excess risk due to interaction examined interaction between maternal characteristics and female fetal sex, on risk of HDP.</div></div><div><h3>Results</h3><div>Female fetal sex was marginally associated with superimposed preeclampsia (RR_adj. 1.13, 95 % confidence interval [CI] 1.00 – 1.28) but no other associations were observed. There was interaction between female fetal sex and advanced maternal age (&gt;35 years), obesity, and parity. After stratifying by these variables, those with a female fetus and advanced maternal age had an increased risk of superimposed preeclampsia (RR_adj. 1.29, 95 %CI 1.05–1.58). We observed a similar trend among parous (RR_adj. 1.15, 95 %CI 1.00–1.34), foreign-born (RR_adj. 1.20, 95 %CI 1.00–1.44), and obese (RR_adj. 1.27, 95 %CI 1.03–1.35) individuals.</div></div><div><h3>Conclusions</h3><div>Female fetuses may respond differently to underlying maternal characteristics influencing risk of superimposed preeclampsia, but no other associations were observed.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142437881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare providers’ knowledge of cardiovascular disease risk after preeclampsia: A pilot of five healthcare facilities in Lusaka, Zambia","authors":"","doi":"10.1016/j.preghy.2024.101163","DOIUrl":"10.1016/j.preghy.2024.101163","url":null,"abstract":"<div><h3>Objective</h3><div>To assess Healthcare providers (HCPs’) knowledge of cardiovascular disease risk after preeclampsia across five healthcare facilities in Lusaka, Zambia.</div></div><div><h3>Study design</h3><div>A cross-sectional study was conducted at selected health facilities in Lusaka Zambia from August 5, 2023, to October 31, 2023. A self-administered questionnaire was distributed among obstetricians, general practitioners, registered nurse midwives, registered nurses, enrolled nurses, enrolled midwives, medical licentiates, and registered public health nurses. The knowledge scores were calculated for each participant, and Logistic regression was used to assess the predictors of high knowledge of cardiovascular disease risk after preeclampsia.</div></div><div><h3>Main outcome</h3><div>The overall mean knowledge score of cardiovascular disease risk after preeclampsia was 4.7/7 (67.1 %). The majority correctly reported hypertension 101 (92.7 %), Ischemic heart disease 84 (77.1 %), Stroke 83 (76.2 %), and kidney disease 75(68.8 %) as future conditions associated with preeclampsia. Knowledge and practice had a significant but moderate negative correlation (r = -0.21, p = 0.037). Compared to obstetricians/general practitioners, registered nurse midwives (adjusted odds ratio [aOR] = 0.21, 95 % CI: 0.05–0.80, p = 0.023) and enrolled midwives/enrolled nurses/medical licentiates/registered public health nurses (aOR = 0.15, 95 % CI: 0.03–0.91, p = 0.039) were less likely to have high knowledge. Additionally, HCPs with 5–10 years (aOR = 7.15, 95 % CI: 1.99–25.72, p = 0.003) and more than 15 years of work experience (aOR = 3.21, 95 % CI: 1.03–9.99, p = 0.017) were more likely to have high knowledge than those with less than five years.</div></div><div><h3>Conclusion</h3><div>Most HCPs were knowledgeable about the future risk of cardiovascular diseases after preeclampsia. Nevertheless, positive behavioral change interventions may be required to address the disconnect between knowledge and practice.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of genetic ancestry with pre-eclampsia in multi-ethnic cohorts of pregnant women","authors":"","doi":"10.1016/j.preghy.2024.101162","DOIUrl":"10.1016/j.preghy.2024.101162","url":null,"abstract":"<div><h3>Objectives</h3><div>Maternal self-reported ethnicity is recognised as a risk factor for pre-eclampsia in clinical screening tools and models. This study investigated whether ethnicity is acting as a proxy for genetic variants in this context.</div></div><div><h3>Study design</h3><div>A total of 436 women from multi-ethnic backgrounds recruited to two UK observational pregnancy hypertension cohort studies were genotyped. Genetically-computed individual ancestry estimates were calculated for each individual through comparison to the multi-ethnic 1000 Genomes reference panel genotypes. Regression models for pre-eclampsia using clinical risk factors including self-reported ethnicity with and without ancestry estimates were built and compared using Likelihood Ratio Tests (LRT).</div></div><div><h3>Main outcome measures</h3><div>Pre-eclampsia (early- and late-onset).</div></div><div><h3>Results</h3><div>In these multi-ethnic cohorts (mean age 34.9 years; 41.3 % White, 34.2 % Black, 13.1 % Asian ethnic backgrounds; 82.6 % chronic hypertension), discrepancies between self-reported ethnicity and genetically-computed individual ancestry estimates were present in all ethnic groups, particularly minority groups. Genetically-computed pan-African ancestry percentage was associated with early-onset (&lt; 34 weeks) pre-eclampsia in adjusted models (aOR 100 % vs 0 % African ancestry: 3.81, 95 % CI 1.04–14.14, p-value 0.044) independently of self-reported ethnicity and established clinical risk factors. Addition of genetically-computed African ancestry to a clinical risk factor model including self-reported ethnicity, improved model fit (Likelihood ratio test p-value 0.023).</div></div><div><h3>Conclusions</h3><div>Self-reported maternal ethnicity is an imperfect proxy for genetically-computed individual ancestry estimates, particularly in ethnic minority groups. Genetically-computed African ancestry percentage was associated with early-onset pre-eclampsia independently of self-reported maternal ethnicity. Well-powered studies in multi-ethnic cohorts are required to delineate the genetic contribution to pre-eclampsia.</div></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: Comment on Article: Aspirin resistance in pregnancy is associated with reduced interleukin-2 concentration in maternal serum","authors":"","doi":"10.1016/j.preghy.2024.101161","DOIUrl":"10.1016/j.preghy.2024.101161","url":null,"abstract":"","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142271989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperaldosteronism secondary to renal agenesis: An unusual cause for hypertension in pregnancy","authors":"","doi":"10.1016/j.preghy.2024.101157","DOIUrl":"10.1016/j.preghy.2024.101157","url":null,"abstract":"<div><p>Literature with regards to pregnancy related outcomes in persons with the presence of a solitary kidney of any cause is scarce. Most of the available information has been extrapolated from persons who have been renal donors. Unilateral renal agenesis affects 1 in 1500 people and can present with resistant hypertension. When a woman with a solitary kidney presents in pregnancy, it may be both a challenging diagnostic and therapeutic problem. Eplerenone, a selective aldosterone blocker has been prescribed for resistant hypertension and in the presence of pregnancy, been useful in persons with primary hyperaldosteronism and resistant hypertension due to obstructive sleep apnoea. We describe the use of Eplerenone in a patient with resistant hypertension in pregnancy, due to secondary hyperaldosteronism precipitated by renal agenesis.</p></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical maternal risk parameters for the occurrence of maternal and fetal complications during preeclampsia in Congolese women","authors":"","doi":"10.1016/j.preghy.2024.101156","DOIUrl":"10.1016/j.preghy.2024.101156","url":null,"abstract":"<div><p>Several studies have demonstrated that predicting complications of preeclampsia up to 48 h before their occurrence enhances clinical management. This predictive ability allows for rational approaches in dealing with groups at high risk of maternal-fetal complications.</p></div><div><h3>Objective</h3><p>This study aims to identify the clinical parameters strongly associated with maternal-fetal complications during preeclampsia in Congolese pregnant women.</p></div><div><h3>Method</h3><p>A descriptive and analytical study was conducted in the provincial city of Kinshasa from July 2018 to December 2021. The study population consisted of pregnant women with preeclampsia in three maternity units in Kinshasa. Determinants of complications were assessed using univariate and multivariate logistic regression.</p></div><div><h3>Results</h3><p>In univariate logistic regression models, obesity, a history of hypertension, severe hypertension, and SpO₂ &lt; 90 % were identified as determinants of maternal-fetal complications. Conversely, a history of preeclampsia, treatment with MgSO₄, or a combination of AntiHTA and MgSO₄ reduced the risk of complications.</p><p>In the multivariate model, after adjusting for all significant variables in the univariate model, severe hypertension, obesity, and SpO₂ &lt; 90 % were identified as independent determinants of maternal-fetal complications. The risk of complication was multiplied by 5 for severe hypertension, by 4 for obesity, and by 2 for SpO₂ &lt; 90 %. However, treating women with MgSO₄ or a combination of AntiHTA and MgSO₄ reduced the risk of complications by a factor of 4 and 6, respectively.</p></div><div><h3>Conclusion</h3><p>The presence of symptoms is more useful in predicting complications of preeclampsia than their absence in ruling out adverse events.</p></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining the relationship between severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia","authors":"","doi":"10.1016/j.preghy.2024.101155","DOIUrl":"10.1016/j.preghy.2024.101155","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the relationship between the severity of proteinuria and adverse maternal and neonatal outcomes in patients with preeclampsia (PE).</p></div><div><h3>Design</h3><p>Prospective cohort study conducted in Gauteng, South Africa<!--> <!-->over 12 months. Patients<!--> <!-->with PE 18 years or older<!--> <!-->with singleton pregnancies<!--> <!-->were recruited. We<!--> <!-->included<!--> <!-->248<!--> <!-->in the final analysis.</p></div><div><h3>Methods</h3><p>Proteinuria was quantified using urine protein: creatinine ratio (UPCR). Preeclamptic patients’ outcomes<!--> <!-->were compared according to the UPCR values using regression models and by generating receiver operator characteristic (ROC) curves. Primary maternal outcomes were gestational age (GA) at diagnosis, GA at delivery, development of eclampsia, development of severe features and the need for more than one antihypertensive<!--> <!-->agent. Neonatal outcomes were admission to neonatal unit, 5-min APGAR score, need for ventilatory support and early neonatal death.</p></div><div><h3>Results</h3><p>There was a weak but significant negative correlation between GA at delivery and UPCR (Spearman’s correlation coefficient (SCC) −0.191, p = 0.002). Most patients (77 %) required &gt;1 agent to control their blood pressure, however there was no correlation between UPCR and the need for additional agents (SCC −0.014, p = 0.828). There was a statistically significant correlation between UPCR and severe features, especially the development of haemolysis, elevated liver enzymes and low platelet (HELLP) syndrome (p = 0.005). There was no significant correlation between neonatal outcomes and UPCR.</p></div><div><h3>Conclusion</h3><p>Severity of proteinuria correlated with earlier delivery and development of severe features, specifically HELLP syndrome and pulmonary oedema. There was no correlation between UPCR and requiring additional antihypertensive<!--> <!-->agents<!--> <!-->or neonatal outcomes.</p></div>","PeriodicalId":48697,"journal":{"name":"Pregnancy Hypertension-An International Journal of Womens Cardiovascular Health","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221077892400182X/pdfft?md5=a18c5485fffb586f852dd50f67c5cb63&pid=1-s2.0-S221077892400182X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}