Journal of Clinical Densitometry最新文献

{"title":"Diagnosing osteoporosis despite Schmorl’s nodes and ankylosing spondylitis","authors":"Hilmi Berkan Abacıoğlu, Pelin Analay, Murat Kara, Levent Özçakar","doi":"10.1016/j.jocd.2025.101608","DOIUrl":"10.1016/j.jocd.2025.101608","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101608"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144712937","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":"How accurate are Dual-Energy X-Ray Absorptiometry measurements in clinical practice?: a retrospective single centre study.","authors":"Yunus Burak Baylr, Zeynep Kıraç Ünal, Zeynep Alpoğuz Yllmaz, Bengü Türemenoğullarl, Ömer Ata, Emre Adıgüzel","doi":"10.1016/j.jocd.2025.101606","DOIUrl":"https://doi.org/10.1016/j.jocd.2025.101606","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify common errors in DXA measurements at our hospital, establish standardization, and contribute to operator training.</p><p><strong>Design: </strong>This descriptive study at a single centre analyzed 2375 spine and femur DXA images for errors. The reports were reviewed according to a checklist prepared considering The International Society for Clinical Densitometry(ISCD) official positions. Each image was reviewed by a Radiologist and Physical Medicine and Rehabilitation (PMR) specialist trained in the principles and standards of DXA scanning prior to the study. All the assessments were double-checked by other specialists and any incorrect images were reported. All the scans taken and available during the observation period were reviewed. The study included scan images taken in our centre, including lumbar spine and proximal femur measurements, for which all information was entered correctly and completely. Forearm measurements, whole-body measurements, or measurements performed in children were excluded.</p><p><strong>Results: </strong>A total of 2375 DXA scan results from a single centre were analyzed. According to the evaluation criteria, 1023 (43.1%) lumbar spine and 1078 (45.4%) proximal femur DXA scans had at least one error. The most common error encountered was the presence of excessive degeneration (31.0%) for lumbar spine results, and inadequate hip internal rotation (23.9%) in the proximal femur results. There were found to be more errors in lumbar measurements according to BMI (p=0.04) and age (p≤0.001), and errors in the femur were higher in male gender (p<0.001).</p><p><strong>Conclusions: </strong>Although the operator and auto-interpretation error rates in this study were low compared to the literature, the results showed that standardization in operator training is not at the desired level. It is hoped that this study will raise awareness of clinicians about DXA imaging errors, and that the training of clinicians who interpret DXA results should be considered as important as the training of technicians.</p>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"101606"},"PeriodicalIF":1.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812644","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":"Changes in lean mass and fat mass in children with Osteogenesis Imperfecta","authors":"Holly Wright ,&nbsp;Sze Choong Wong ,&nbsp;Misha Gilani ,&nbsp;Helen McDevitt ,&nbsp;Sheila Shepherd ,&nbsp;Avril Mason","doi":"10.1016/j.jocd.2025.101605","DOIUrl":"10.1016/j.jocd.2025.101605","url":null,"abstract":"<div><div><em>Background:</em> Deficits in skeletal muscle and function, with resultant abnormal body composition, is a recognised feature of Osteogenesis Imperfecta (OI). Less is known about longitudinal change in body composition in OI. Our objective was to perform a retrospective analysis of longitudinal change in body composition (lean mass and fat mass) in children with OI.</div><div><em>Methodology:</em> Data was collected from 29 children, with a diagnosis of OI, who had at least two dual-energy x-ray absorptiometry (DXA) scans performed between 2015 and 2022. Assessed variables of height, body mass index (BMI), lean mass index (LMI) and fat mass index (FMI), were converted to z scores. Results were reported as median (range).</div><div><em>Results:</em> Median age at baseline and follow-up were 10.7 and 14.2 years, respectively. Median height z-score at baseline was -1.10, which was significantly lower than a control population (p&lt;0.001). Median height z-score at latest follow-up was -0.80, which was not significantly different from baseline (p=0.870). Median BMI z-score at baseline was 0.15, which was not significantly different than a control population (p=0.804). Median BMI z-score at latest follow-up was 0.02, which was not significantly different from baseline (p=0.730). At baseline, median LMI z-score was -2.43, which was significantly lower than a control population (p&lt;0.001). Median LMI z-score at follow-up was -1.78, which was not significantly different from baseline (p=0.080). At baseline, median FMI z-score was 0.57 which was significantly higher than a control population (p=0.001). Median FMI z-score at follow-up was 0.62, which was not significantly different from baseline (p=0.540).</div><div><em>Conclusion:</em> Children with OI have abnormal body composition throughout childhood typically with low lean mass and relatively high fat mass. These abnormalities in body composition do not change with follow-up. Strategies to improve lean mass, including physical or medical therapies, should be explored in OI given the close relationship between muscle and bone.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101605"},"PeriodicalIF":1.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662177","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":"Effect of Radiation Therapy on CT Attenuation of Bone in Patients with Anorectal Cancer Treated with Chemotherapy","authors":"Gary K. Schneider ,&nbsp;Jason A. Benedict ,&nbsp;Jennifer Matsui ,&nbsp;Gavin Wu ,&nbsp;Michael Ruesch ,&nbsp;Rahul Prasad ,&nbsp;Pannaga Malalur ,&nbsp;Vedat Yildiz ,&nbsp;Eric Miller ,&nbsp;Steven W. Ing","doi":"10.1016/j.jocd.2025.101597","DOIUrl":"10.1016/j.jocd.2025.101597","url":null,"abstract":"<div><div>Radiation therapy (RT), a standard treatment modality for locally advanced anorectal cancer, may be followed by pelvic fractures, but there are currently no formal recommendations to evaluate bone health prior to RT. Recent studies have demonstrated CT attenuation measurement of lumbar vertebrae as a surrogate marker of bone mineral density (BMD). In this single-institution retrospective cohort analysis of patients with anorectal carcinoma treated with RT, we assess lumbar and sacral CT attenuation before and after RT. CT scans of 302 patients with at least one pre- and post- RT CT scan including all of L1, L3, L5, and sacrum were reviewed, and CT attenuation measured at each level. All CT scans were obtained for either cancer surveillance or other medically indicated reason. CT attenuation measurements were adjusted for presence of IV contrast and nonstandard CT tube voltage. Prior to RT, mean bone attenuation at L1, L3, L5, and sacrum were 158.4, 151.1, 157.8, and 231.0 HU respectively. Three months post-RT, L1 and L3 had mean differences of +1.7 (+1.1 %) and −7.7 (−5.1 %) HU, respectively, while L5 and sacrum had mean differences of −48.8 (−31.0 %) and −65.9 (−28.6 %) HU, respectively. There was little to no evidence of further decrease at any vertebral level beyond three months after RT, nor was there evidence for increase in HU beyond three months, by which time RT courses were completed. This suggests that bone loss from RT is associated with proximity to the radiation field and the majority of the observed decline occurs within the first three months following the start of RT.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 3","pages":"Article 101597"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518664","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":"Toe Grip Strength is Another Indicator of Muscle Strength and Bone Mass in Older Men","authors":"Elie Maliha ,&nbsp;Christophe Jacob ,&nbsp;Nour Khalil ,&nbsp;Abdel-Jalil Berro ,&nbsp;Rami Abboud ,&nbsp;Rawad ElHage","doi":"10.1016/j.jocd.2025.101603","DOIUrl":"10.1016/j.jocd.2025.101603","url":null,"abstract":"<div><div>Toe grip strength (TGS) measures foot muscle strength and evaluates stability maintenance, as well as the risk of falls. Handgrip strength (HGS) is considered a simple and effective method for assessing overall strength, and it correlates with bone variables. The aim of this study was: first, to investigate the relationship between TGS and overall strength and bone variables; and second, to compare the relationships between TGS and HGS with overall strength and bone variables. This cross-sectional study included 59 Caucasian men aged 60 to 84 years. Participants underwent muscle strength testing using exercises such as the bench press, leg extension, leg curl, and biceps curl, along with assessments of HGS and TGS. Body composition and bone mineral density (BMD) were assessed using dual-energy X-ray absorptiometry (DXA). TGS was positively correlated with bench press performance (<em>r</em> = 0.68; <em>p</em> &lt; 0.001), leg extension strength (<em>r</em> = 0.72; <em>p</em> &lt; 0.001), leg curl strength (<em>r</em> = 0.83; <em>p</em> &lt; 0.001), and biceps curl strength (<em>r</em> = 0.74; <em>p</em> &lt; 0.001). A strong positive correlation was also observed between TGS and HGS (<em>r</em> = 0.88; <em>p</em> &lt; 0.001). Finally, both TGS and HGS showed significant positive correlations with bone mass (<em>r</em> = 0.62; <em>p</em> &lt; 0.001 and <em>r</em> = 0.68; <em>p</em> &lt; 0.001, for toe grip and handgrip respectively). In conclusion, this study suggests that TGS is as good as HGS as a positive determinant of muscle strength and bone mass in older men.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101603"},"PeriodicalIF":1.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588525","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":"Bone health ECHO case report: Normocalcemic hyperparathyroidism in a patient with osteoporosis referred for pre-operative bone health evaluation before spine surgery","authors":"Danielle D’Annibale ,&nbsp;E. Michael Lewiecki ,&nbsp;Gina Woods","doi":"10.1016/j.jocd.2025.101600","DOIUrl":"10.1016/j.jocd.2025.101600","url":null,"abstract":"<div><div>Primary hyperparathyroidism can be divided into three clinical phenotypes: classical primary hyperparathyroidism with hypercalcemia and target organ involvement, asymptomatic primary hyperparathyroidism with hypercalcemia, and normocalcemic primary hyperparathyroidism. The latter phenotype is being increasingly recognized in patients having serum parathyroid hormone levels measured as part of the initial evaluation of osteoporosis. The diagnosis of normocalcemic primary hyperparathyroidism requires exclusion of secondary causes of parathyroid hormone elevation, such an vitamin D deficiency and calcium malabsorption. There is no consensus on the management of patients with normocalcemic primary hyperparathyroidism, particularly with regard to consideration of parathyroid surgery versus clinical observation. This is a case report of a patient with persistently normal calcium levels, high parathyroid hormone, and no recognized cause of secondary hyperparathyroidism. This case was presented and discussed at Bone Health Extension for Community Healthcare Outcomes, a virtual community of practice that has been meeting online weekly since 2015.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101600"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518919","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":"Letter to the editor: Persisting lymphangiogram contrast, A potential DXA confounder","authors":"N. Binkley,&nbsp;A. Eastman,&nbsp;N. Jina,&nbsp;D. Krueger","doi":"10.1016/j.jocd.2025.101601","DOIUrl":"10.1016/j.jocd.2025.101601","url":null,"abstract":"","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 3","pages":"Article 101601"},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472456","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":"Trabecular Bone Score in Type 2 Diabetes Mellitus: An Updated Systematic Review and Meta-Analysis","authors":"A.B.M. Kamrul-Hasan ,&nbsp;Saptarshi Bhattacharya ,&nbsp;Vanishri Ganakumar ,&nbsp;Lakshmi Nagendra ,&nbsp;Deep Dutta ,&nbsp;Fatema Tuz Zahura Aalpona ,&nbsp;Joseph M. Pappachan","doi":"10.1016/j.jocd.2025.101602","DOIUrl":"10.1016/j.jocd.2025.101602","url":null,"abstract":"<div><div><em>Background:</em> Trabecular bone score (TBS) independently predicts diabetic bone disease. Many studies have compared TBS in those with and without diabetes, showing inconsistent results. We conducted a systematic review and meta-analysis to evaluate TBS in type 2 diabetes mellitus (T2DM) and clarify its role, considering gender and other confounders.</div><div><em>Methodology:</em> Relevant studies were systematically searched until October 2024 using related terms across multiple databases. RevMan Web and R software were employed to conduct statistical analyses. Meta-analyses utilized random-effects models and the inverse variance statistical method; results were expressed as mean differences (MD) with 95 % confidence intervals. The primary outcome of interest was the MD in TBS (unadjusted or adjusted) between the T2DM and non-diabetes groups.</div><div><em>Results:</em> Data from 27 studies with 16,354 subjects were analyzed. Compared to controls without diabetes, subjects with T2DM exhibited lower unadjusted TBS in the combined sex group (MD -0.10 [-0.18, -0.02], <em>P</em> = 0.01), as well as in men (MD -0.02 [-0.04, -0.00], <em>P</em> = 0.02) and women (MD -0.05 [-0.07, -0.03], <em>P</em> &lt; 0.0001). Individuals with T2DM also had a lower adjusted TBS in the combined sex group (MD -0.16 [-0.24, -0.08], <em>P</em> &lt; 0.0001), men (MD -0.02 [-0.04, -0.00], <em>P</em> = 0.02), and women (MD -0.04 [-0.06, -0.02], <em>P</em> = 0.0005). While lumbar spine bone mineral density (BMD) was higher in individuals with T2DM than in those without across all three groups, total hip BMD was higher in women and the combined sex group; femoral neck BMD was higher only in the combined sex group.</div><div><em>Conclusion:</em> According to the data analyzed in this updated meta-analysis, T2DM appears to adversely affect TBS, despite having a positive effect on BMD; however, the evidence level is very low. Larger and longer-term studies are necessary to explore the implicated factors and potential remedial strategies.</div><div><em>PROSPERO registration number:</em> CRD42024608004</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 4","pages":"Article 101602"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518921","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":"DXA-Measured Visceral Adipose Tissue and Incident Cardiovascular Disease Events in Middle-Aged Adults: Busselton Healthy Ageing Study","authors":"Kun Zhu ,&nbsp;Michael Hunter ,&nbsp;Chrianna Bharat ,&nbsp;Kevin Murray ,&nbsp;Jennie Hui ,&nbsp;John P. Walsh ,&nbsp;Joseph Hung","doi":"10.1016/j.jocd.2025.101599","DOIUrl":"10.1016/j.jocd.2025.101599","url":null,"abstract":"<div><div><em>Background:</em> DXA-measured visceral adipose tissue (VAT) is associated with development of metabolic syndrome in middle-aged adults, but its association with incident cardiovascular disease (CVD) has not been studied. We evaluated the longitudinal association of baseline VAT_DXA with incident CVD events within the Busselton Healthy Ageing study.</div><div><em>Methods:</em> Participants (<em>n</em> = 4866, 54 % female, aged 46-70 years, ∼99 % white) were assessed for VAT_DXA and were followed up longitudinally for a median of 7.9 years. Outcome measures were time to incident CVD or coronary heart disease (CHD) events (defined as non-fatal hospitalisations or death). Sex-stratified associations were examined using Cox proportional hazards models adjusting for baseline age, lifestyle factors and prior CVD.</div><div><em>Results:</em> Mean baseline VAT_DXA mass was 1678±877 g and 882±600 g in males and females respectively. Incident CVD and CHD events were recorded for 332 (6.8 %) and 245 (5.0 %) study participants. There was a near-linear increase in risk for CVD and CHD events with VAT_DXA in both sexes. After covariate adjustment each standard deviation (SD) increment in VAT_DXA was associated with a hazard ratio [95 % confidence interval] for incident CVD in males and females of 1.26 [1.11-1.44] and 1.30 [1.10-1.55] respectively, and a hazard ratio for CHD of 1.28 [1.11-1.49] and 1.40 [1.14-1.72] respectively. However, VAT_DXA was no longer independently associated with CVD events once adjusted for BMI and waist circumference.</div><div><em>Conclusion:</em> VAT_DXA has utility for identifying middle-aged adults at greater risk for incident CVD and CHD but further studies are needed to determine if VAT_DXA can improve risk discrimination beyond anthropometric measures.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 3","pages":"Article 101599"},"PeriodicalIF":1.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472455","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":"Bone Mineral Density and Associated Factors in Individuals with Traumatic Unilateral Transfemoral Amputation","authors":"Gizem Kılınç Kamacı,&nbsp;Merve Örücü Atar,&nbsp;Elif Tekin,&nbsp;Fatma Özcan,&nbsp;Yasin Demir,&nbsp;Koray Aydemir","doi":"10.1016/j.jocd.2025.101598","DOIUrl":"10.1016/j.jocd.2025.101598","url":null,"abstract":"<div><div><em>Introduction/background:</em> Lower extremity amputations, particularly at more proximal levels such as transfemoral amputations (TFA)s, negatively affect bone mineral density (BMD). The aim of this study was to determine the relationship between muscle strength, residual limb length (RLL), and BMD on the amputated side in individuals with traumatic unilateral TFA and to investigate other potentially related factors.</div><div><em>Methodology:</em> This is a retrospective, cross-sectional study. The study included 39 individuals with TFA. Demographic and clinical data of the individuals were recorded. RLL was determined by measuring the distance from the trochanter major to the most distal end point of the stump. Hip flexor and extensor muscle strengths were assessed by determining peak torque at an angular velocity of 60°/s using an isokinetic system. Dual-energy X-ray absorptiometry (DXA) imaging T-scores of the femoral neck and lumbar spine on the amputee side were evaluated.</div><div><em>Results:</em> There was a statistically significant relationship between peak hip flexion torque and RLL with the femoral neck BMD T-score (<em>r = </em>0.327*, <em>p = </em>0.045; <em>r = </em>0.432*, <em>p = </em>0.006, respectively). RLL and peak hip flexion torque were identified as determinants of femoral neck BMD T-score (<em>p = </em>0.004, <em>p = </em>0.031, respectively). It was found that for every 1 cm increase in RLL, the femoral neck BMD T-score increased by approximately 0.09. A one-unit increase in peak hip flexion torque was associated with an approximate increase of 0.04 in the ipsilateral femoral neck BMD T-score.</div><div><em>Conclusions:</em> In the rehabilitation program of individuals with unilateral TFA, it may be important to plan hip flexor muscle strengthening interventions that may affect BMD. Performing amputation surgeries while preserving RLL at the longest possible length may be beneficial in terms of BMD results on the amputated side.</div></div>","PeriodicalId":50240,"journal":{"name":"Journal of Clinical Densitometry","volume":"28 3","pages":"Article 101598"},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144279885","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}