Journal of Clinical Sleep Medicine最新文献

{"title":"Progress in understanding the mechanism of sleep apnea in patients with PTSD.","authors":"Giora Pillar","doi":"10.1007/s44470-026-00057-z","DOIUrl":"https://doi.org/10.1007/s44470-026-00057-z","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health care expenditures associated with sleep disorders among children and adolescents in the United States: a nationally representative study.","authors":"Ana C Carney, Jennifer A Rabbitts, Caroline U A Okorie, Cornelius B Groenewald","doi":"10.1007/s44470-026-00080-0","DOIUrl":"10.1007/s44470-026-00080-0","url":null,"abstract":"<p><strong>Purpose: </strong>To determine national health care expenditures associated with sleep disorders among children and adolescents in the United States.</p><p><strong>Methods: </strong>We conducted secondary analyses of the 2017-2022 Medical Expenditure Panel Survey (MEPS), including children 0-18 years of age (n = 41,384). Children with sleep disorders were identified by International Classification of Diseases, 10th Revision code G47.x. Multivariate two-part models, adjusting for covariates, were used to estimate associations between sleep disorders and health care expenditures.</p><p><strong>Results: </strong>Among MEPS participants, on average 1.1% (95% CI: 0.9-1.3%) were diagnosed with a sleep disorder, representing 855,000 children diagnosed nationwide each year. Children with sleep disorders were more likely to be White, non-Hispanic (66.2%), categorized as having poor/near poor income (31.8%), on public insurance only (60.2%), and have significantly higher values on pediatric comorbidity index scores (2.7 vs. 0.3). The presence of a sleep disorder was associated with $3240 (95% CI: $2060-$4421, p < 0.0001) in incremental health care expenditures as compared to not having a sleep disorder ($5897 versus $2656), after controlling for predisposing, enabling, and need factors. National expenditures associated with childhood sleep disorders were estimated at $2.88 billion annually.</p><p><strong>Conclusion: </strong>Childhood sleep disorders exert a significant economic burden on society. Our analyses likely underestimate the total economic costs associated with childhood sleep disorders.</p><p><strong>Current knowledge/study rationale: </strong>Although the varied health outcomes of childhood sleep disorders are well understood, the national economic impacts of these disorders are poorly described. This information is important, as the estimated prevalence of these disorders in the pediatric population is high, and understanding the cost of these disorders could provide support for efforts promoting their early diagnosis and treatment.</p><p><strong>Study impact: </strong>We found that the incremental health care costs associated with childhood sleep disorders were significant, amounting to $2.88 billion in annual expenditures. This high cost highlights the need for more effective strategies to prevent and manage pediatric sleep disorders.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ventilatory response to arousal from sleep is elevated in young individuals with post-traumatic stress disorder symptoms.","authors":"Maya T Schenker, Amber Russell, Darsh Cherian, Yuhe Pan, Gemma Bruce, Lilith Zeng, Joanne Avraam, Fergal J O'Donoghue, Kim L Felmingham, Amy S Jordan","doi":"10.1007/s44470-026-00050-6","DOIUrl":"10.1007/s44470-026-00050-6","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality in narcolepsy and other sleep clinic patients: a 25-year propensity-matched VA cohort study.","authors":"Amir Sharafkhaneh, Yves Dauvilliers, Ahmed S BaHammam, Mehnaz Azarian, Michael Thorpy, Fang Han, Gulcin Benbir Senel, Murat Aksu, Javad Razjouyan","doi":"10.1007/s44470-026-00078-8","DOIUrl":"https://doi.org/10.1007/s44470-026-00078-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Prior research shows increased mortality in patients with narcolepsy compared to the general population; overall, the evidence remains highly controversial and comparative data with general sleep clinic populations remains limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We examined mortality and healthcare utilization among patients with narcolepsy compared to a general sleep clinic (GSC) cohort in the Veterans Affairs (VA) health system.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Retrospective cohort study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Nationwide Veterans Health Administration (VHA) data from October 1999 through March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;The study used relevant ICD-9/10 codes. We defined narcolepsy 1 (NT1) as patients with at least two NT1 ICD-9/10 codes. We constructed two propensity-matched (on age at index date, sex, race/ethnicity, and diagnosis year) comparison groups: (i) General Sleep Clinic (GSC; with no central disorders of hypersomnia ICD codes), matched 1:3 and (ii) other narcolepsy (ON) group as patients with at least two narcolepsy ICD-9/10 codes but no NT1-specific codes, matched 1:1 to NT1 group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was all-cause mortality. Secondary outcomes included all-cause hospitalization and emergency department/urgent care (ED/UC) visits. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression in the propensity score-matched cohorts, with GSC as the reference group and adjustment for age, body mass index, and Charlson Comorbidity Index.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort included 4161 NT1, 4161 ON, and 12,843 GSC participants. The mean age differed in the groups (48.0, 47.6, and 43.8 years for NT1, ON, and GSC, respectively). All-cause mortality was more frequent in NT1 and ON compared to GSC (24.7%, 29.1%, and 15.0% in NT1, ON, and GSC, respectively). Compared with GSC, aOR was higher in NT1 (aOR 1.64, 95% CI 1.47-1.82) and ON (aOR 2.40, 95% CI 2.16-2.66). In contrast, increased aOR of all-cause hospitalization was observed only in NT1 (aOR 1.13, 95% CI 1.05-1.22) compared to GSC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;Among veterans referred for sleep evaluation, adjusted OR of all-cause mortality was higher in narcolepsy patients compared to patients with other sleep disorders. The generalizability to non-VA populations remains uncertain. Future studies should identify cause-specific mortality and modifiable risk factors for prevention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Question: In veterans referred for sleep evaluation, is narcolepsy associated with higher all-cause mortality than general sleep clinic patients?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt; In a retrospective propensity-matched cohort study of VA data (1999-2025) including 4161 NT1, 4161 other narcolepsy, and 12,843 general sleep clinic participants, mortality was 24.7%, 29.1%, and 15.0%; adju","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early childhood insomnia phenotypes and temperament: a theoretical review with clinical implications for precision assessment and treatment.","authors":"Oliviero Bruni, Maria Breda, Valeria Mammarella, Maria Grazia Melegari, Raffaele Ferri","doi":"10.1007/s44470-026-00094-8","DOIUrl":"https://doi.org/10.1007/s44470-026-00094-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This theoretical review examines the clinical heterogeneity of early childhood insomnia and proposes a phenotype-based framework that integrates temperament into assessment and treatment planning in infants and preschool children (approximately 0-5 years). We focus on three clinically relevant presentations: (1) motor restlessness with fragmented sleep, (2) prolonged early-morning awakenings, and (3) sleep-maintenance insomnia with repeated awakenings frequently amplified by somatic triggers such as allergic symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a targeted PubMed/MEDLINE search for English-language literature published from 2006 through February 9, 2026. Search terms covered early childhood insomnia phenotypes, temperament/personality, hyperarousal and circadian factors, iron/dopamine-related motor restlessness, and allergic/histamine pathways. This review was designed as a targeted theoretical synthesis rather than a systematic review, with emphasis on clinically relevant pediatric studies, established insomnia frameworks, and mechanistic literature that could inform interpretation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across infancy and the preschool years, higher negative emotionality/affectivity is repeatedly associated with poorer sleep continuity, more night waking, and greater caregiver involvement at bedtime and during the night. A phenotype-based reading of the literature suggests that temperament may help explain why children with similar sleep complaints present differently and respond differently to treatment. Specifically, novelty seeking may increase bedtime \"downshifting\" difficulty and align with motor-restless insomnia presentations linked to dopamine/iron pathways; harm avoidance may increase vigilance, stress sensitivity, and hyperarousal relevant to early-morning-awakening insomnia; and allergic symptom burden may promote sleep-maintenance insomnia through histaminergic and noradrenergic arousal, with temperament shaping the child's appraisal of awakenings and the caregiver-child reinforcement cycle.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A temperament-informed, phenotype-guided approach may improve clinical evaluation, parent counseling, and treatment matching in early childhood insomnia while preserving behavioral strategies as first-line care. Prospective studies should test whether early temperament profiles moderate objective sleep trajectories and response to behavioral, circadian, allergy-focused, and iron-targeted adjunctive interventions. Current knowledge/review rationale Early childhood insomnia is clinically heterogeneous and cannot be fully understood within a child-behavior or parent-management framework alone. A targeted theoretical review allows integration of developmental sleep, temperament, neurobiological, and clinical literature to generate a phenotype-based model for assessment and treatment. Review impact A phenotype-based model that incorporates temperament may help ","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13139526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of obstructive sleep apnea on idiopathic pulmonary fibrosis clinical outcomes.","authors":"Amina Hamza, David A Helfinstine, Michelle B Herberts, Eric J Olson, Timothy M Dempsey, Andrew H Limper","doi":"10.1007/s44470-026-00054-2","DOIUrl":"10.1007/s44470-026-00054-2","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative AI vs web search for patient education: a comparative evaluation of OSA information quality.","authors":"Sholem Hack, Luca Giovanni Locatello, Tomer Boldes, Ameen Biadsee, Samanta Dall'Agnese, Angelo Cannavicci, Benyamin Meir Kaminer, Christopher Gouveia, Christopher R Roxbury, Ron J Karni, Daor Hayu, Habib G Zalzal, Omar G Ahmed, Masayoshi Takashima","doi":"10.1007/s44470-026-00090-y","DOIUrl":"10.1007/s44470-026-00090-y","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with obstructive sleep apnea (OSA) frequently seek information online, yet the comparative quality of content delivered by web search engines versus generative AI systems is unclear. This study evaluated how different digital information sources perform in answering common patient questions about OSA.</p><p><strong>Methods: </strong>Thirty high-volume, patient-facing OSA questions were identified using Google Trends. Each question was submitted verbatim to four general-purpose large language models (GPT-4, GPT-5, DeepSeek, Mistral), a medically specialized retrieval-augmented model (OpenEvidence), and Google Search. Seven otolaryngologists with clinical experience in OSA independently rated each response for accuracy, clarity, completeness, relevance, and usefulness using a five-point rubric. Composite and domain scores were analyzed using one-way analysis of variance with multiple-comparison correction; inter-rater reliability was assessed with two-way random-effects intraclass correlation coefficients.</p><p><strong>Results: </strong>A total of 180 question-system pairs received 6295 domain-level ratings. OpenEvidence achieved the highest mean composite score (4.33), followed by a tightly clustered group of LLMs (means 4.00-4.04). Google Search scored significantly lower (3.15). Differences among systems were statistically significant across all domains (p < 0.001), with large effect sizes for comparisons of OpenEvidence and general LLMs versus Google. Composite average-rater reliability was good (ICC = 0.70).</p><p><strong>Conclusion: </strong>For common OSA questions, generative AI systems-particularly a retrieval-augmented medical model-produced higher-quality patient-facing information than standard web search. These findings support cautious consideration of GenAI tools to supplement patient education in OSA, while underscoring the need for ongoing evaluation across diseases, disciplines, and patient populations.</p><p><strong>Current knowledge/study rationale: </strong>Patients with obstructive sleep apnea (OSA) frequently rely on online sources such as Google Search to understand symptoms, testing, and treatment, yet the quality of patient-facing information varies widely. As generative artificial intelligence tools are increasingly used for health questions, their comparative performance for OSA education has not been systematically evaluated using blinded expert review.</p><p><strong>Study impact: </strong>In this blinded comparative study, generative AI systems, particularly a retrieval-augmented medical model, provided more accurate, clear, complete, and useful answers to common OSA questions than standard web search. These findings highlight that the choice of digital information source can meaningfully influence the quality of patient education in sleep medicine and support further evaluation of AI tools within clinical practice.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mandibular advancement devices in severe obstructive sleep apnea: a second-line option that deserves greater recognition.","authors":"Yaron Haviv","doi":"10.1007/s44470-026-00081-z","DOIUrl":"https://doi.org/10.1007/s44470-026-00081-z","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk in narcolepsy: Comparison of type 1 and type 2 in a real-world cohort.","authors":"Munaza Riaz, Christopher N Kaufmann, Rakesh Bhattacharjee, Debbie Wilson, Weihsuan Lo-Ciganic, Emerson M Wickwire, Atul Malhotra, Haesuk Park","doi":"10.1007/s44470-026-00069-9","DOIUrl":"https://doi.org/10.1007/s44470-026-00069-9","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the differences in the risk of cardiovascular disease (CVD) events between narcolepsy type 1 (NT1) and type 2 (NT2) among patients with narcolepsy, while accounting for real-world use of stimulants.</p><p><strong>Methods: </strong>Using the 2005-2023 MarketScan Commercial and Medicare Supplemental databases, we identified patients newly diagnosed with narcolepsy, either NT1 or NT2, using International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification diagnosis codes. Stabilized inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between the NT1 and NT2 groups. Primary outcomes included time to first (1) composite CVD event and (2) major adverse cardiovascular event (MACE). We used multivariable Cox proportional hazards regression models following IPTW to estimate adjusted hazard ratios (AHRs), accounting for time-fixed and time-varying covariates, including stimulant use. Individual cardiovascular outcomes were assessed separately, and analyses were stratified by age and sex.</p><p><strong>Results: </strong>After IPTW, the overall effective sample size was 30,154 patients (NT1 = 3,068, NT2 = 27,086; mean [SD] age, 39.8 [16.5] years; 61.8% female). In models adjusting for baseline covariates and time-varying stimulant use, there was no difference in risk of CVD (AHR, 0.95; 95% CI, 0.75-1.22) or MACE (AHR, 0.98; 95% CI, 0.72-1.33) between NT1 and NT2. Results were consistent across individual CVD and MACE outcomes, as well as in subgroup analyses by age and sex.</p><p><strong>Conclusion: </strong>Findings from this IPTW cohort study suggest that, after adjusting for medication use, there was no significant difference in cardiovascular risk between individuals with NT1 and NT2. Patients with narcolepsy are at elevated cardiovascular risk, but little is known about how this risk differs between narcolepsy type 1 (NT1) and type 2 (NT2). Previous studies have not directly compared cardiovascular risk by narcolepsy subtype while accounting for real-world use of medications, including stimulants, which may change over time and influence outcomes. In this large, national cohort of commercially insured individuals, we found no significant difference in cardiovascular disease risk for individuals with NT1 vs. NT2 after adjusting for baseline characteristics and the use of narcolepsy medications, including stimulants. These findings address the gap in the literature regarding cardiovascular risks across narcolepsy subtypes and may inform clinical management of the disorder.</p>","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Clinical pathway implications of bilateral hypoglossal nerve stimulation for PAP-intolerant OSA\".","authors":"B Tucker Woodson, David T Kent, Colin Huntley","doi":"10.1007/s44470-026-00071-1","DOIUrl":"https://doi.org/10.1007/s44470-026-00071-1","url":null,"abstract":"","PeriodicalId":50233,"journal":{"name":"Journal of Clinical Sleep Medicine","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}