Journal of Allergy and Clinical Immunology-In Practice最新文献

{"title":"One Visit, Multiple Labels: Efficient Antibiotic Allergy Delabeling for Real-World Practice","authors":"Timothy G. Chow MD, Santiago Alvarez-Arango MD, PhD","doi":"10.1016/j.jaip.2026.08.004","DOIUrl":"10.1016/j.jaip.2026.08.004","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2366-2367"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Obesity to Improve Asthma Control","authors":"","doi":"10.1016/j.jaip.2026.08.035","DOIUrl":"10.1016/j.jaip.2026.08.035","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Page 2431"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acalabrutinib for long-term prevention of recurrent idiopathic anaphylaxis","authors":"James R. Tucker MBBS(Hons), Troy Wanandy PhD, Wun Yee Lau MBBS(Hons), Emily M. Mulcahy PhD, Benoit T.B. Cotton PhD, Cesar D. Tovar Lopez PhD, Pravin Hissaria MBBS, MD, DM, Thanh-Thao Adriana Le MBBS","doi":"10.1016/j.jaip.2026.06.011","DOIUrl":"10.1016/j.jaip.2026.06.011","url":null,"abstract":"","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2408-2410"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Penicillin Allergy Documentation Completeness in a Large US Healthcare System","authors":"Hagen F. Puller MD, MBA,&nbsp;Bohang Jiang MBBS, MPH,&nbsp;Madelyn L. Eippert BA,&nbsp;Dylan T. Norton BA,&nbsp;Valerie E. Stone MD, MPH,&nbsp;Stephen J. Bartels MD, MS,&nbsp;Alysse G. Wurcel MD, MS,&nbsp;Kimberly G. Blumenthal MD, MSc","doi":"10.1016/j.jaip.2026.06.030","DOIUrl":"10.1016/j.jaip.2026.06.030","url":null,"abstract":"<div><h3>Background</h3><div>Incomplete penicillin allergy documentation impedes risk stratification necessary for safe and efficient delabeling efforts.</div></div><div><h3>Objective</h3><div>To examine completeness of penicillin allergy documentation across domains in electronic health record allergy modules.</div></div><div><h3>Methods</h3><div>We considered coded and free-text electronic health record data within the allergy module documented from January 2019 to April 2022 among adults with active penicillin allergy labels at a large academic medical center. We assessed completeness of coded domains individually and considered <em>optimal quality documentation</em>, defined as completion of all coded domains plus the presence of a free-text comment. We assessed the relation of patient characteristics to documentation completeness, reporting univariable odds ratios (ORs) with 95% CI.</div></div><div><h3>Results</h3><div>Of 47,799 penicillin allergy labels, 10,956 (23%) were complete across all coded domains and 5,185 (11%) demonstrated <em>optimal quality documentation</em>. Older age and female sex were associated with increased odds of optimal documentation (<em>P</em> for trend &lt; .001 with increasing age; OR, 1.27; 95% CI, 1.19-1.36 for female sex). Patients with higher Charlson comorbidity index, visit to an allergist, visit to an emergency department, or hospitalization had increased odds of optimal documentation (OR, 2.96 [95% CI, 2.62-3.35], 2.02 [95% CI, 1.87-2.18], 1.42 [95% CI, 1.33-1.52], 2.19 [95% CI, 2.01-2.38], respectively), as did patients with 5 or more other (ie, non-penicillin) allergy labels (OR, 2.10; 95% CI, 1.93-2.29). Across manual review of 1000 penicillin allergy label free-text comments, 785 (79%) contained clinically useful information that corresponded to at least 1 key allergy history domain.</div></div><div><h3>Conclusions</h3><div>Most patients with penicillin allergy labels lack sufficient detail in the electronic health record allergy module. Considering that documentation quality varies by patient characteristics, some patient groups may face additional barriers to penicillin allergy delabeling. Thoughtful utilization of free-text comment entries may improve penicillin allergy label completeness and offer better delabeling access.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2276-2281"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality and Safety Intervention: Improving Care of Patients Undergoing B Cell–Targeted Therapies","authors":"Iris Otani MD,&nbsp;Roxane Labrosse MD, MMSc,&nbsp;Daniel V. DiGiacomo MD, MPH,&nbsp;Sara Barmettler MD, MPH","doi":"10.1016/j.jaip.2026.06.023","DOIUrl":"10.1016/j.jaip.2026.06.023","url":null,"abstract":"<div><div>B cell–targeted therapies (BCTT) are increasingly being used with excellent efficacy across a range of conditions and specialties, including autoimmune diseases and hematologic malignancies. However, with these BCTT, there is the potential for hypogammaglobulinemia and increased risk for infections. It is critical for clinicians to understand and manage secondary immune deficiency to ensure patient safety and optimize therapeutic outcomes. Increased monitoring including evaluating immunoglobulin levels and B-cell flow cytometry before the initiation of therapy and periodically afterward can assist in tailored management of these patients, with potential consideration of prophylactic antimicrobials and/or immunoglobulin replacement to improve outcomes through reduction of morbidity and mortality. Conversely, because inborn errors of immunity are more frequent in patients receiving BCTT, clinicians should be alert to clinical and immunologic red flags suggestive of an underlying inborn errors of immunity. Two illustrative cases are used to present important considerations in the diagnosis, evaluation, and management of patients receiving BCTT.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2237-2243"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid Stewardship: Can It Help Us Avoid the Corticosteroid Trap?","authors":"Stanley J. Szefler MD","doi":"10.1016/j.jaip.2026.08.019","DOIUrl":"10.1016/j.jaip.2026.08.019","url":null,"abstract":"<div><div>With an almost 20-year experience with asthma biologics, it is now clear that a major impact of all available asthma biologics is the opportunity to reduce the frequency of asthma exacerbations, along with the concomitant use of systemic corticosteroids. The asthma biologics allow for the reduction and occasionally discontinuation of maintenance systemic corticosteroids and permit reduction of high-dose inhaled corticosteroid dosing in patients with severe asthma. The risk of corticosteroid adverse effects in asthma has prompted experts to suggest that there be closer monitoring of corticosteroids and the term “corticosteroid stewardship” has emerged. This commentary will summarize advantages and limitations of developing a program for corticosteroid stewardship. There is an opportunity for asthma specialists to take a leadership position in developing a core stewardship program with elements including patient education materials and prototypes for shared decision-making approaches. Then, once this approach is refined, a more systematic approach within a health care system can evolve, especially with insurance providers as a partner. On one hand, corticosteroid stewardship could be viewed as adding extra burden. However, done correctly, it should be viewed as the way to go to enhance overall population asthma care within a health care system.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2220-2226"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148801404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dupilumab Efficacy in Children With Uncontrolled, Moderate-to-Severe, Type 2 Asthma by Allergen Sensitization Level","authors":"Wanda Phipatanakul MD,&nbsp;Nikolaos G. Papadopoulos MD, PhD,&nbsp;Vivian Hernandez-Trujillo MD,&nbsp;Eckard Hamelmann MD, PhD,&nbsp;Robert S. Zeiger MD, PhD,&nbsp;Francine M. Ducharme MD, FRCPC, CAHS,&nbsp;Changming Xia PhD,&nbsp;Rebecca Gall MD,&nbsp;Olivier Ledanois MD,&nbsp;Amr Radwan MB, BChir, FFPM,&nbsp;Juby A. Jacob-Nara MD, DHSc, MPH, MBA,&nbsp;Paul J. Rowe MD,&nbsp;Yamo Deniz MD","doi":"10.1016/j.jaip.2026.06.012","DOIUrl":"10.1016/j.jaip.2026.06.012","url":null,"abstract":"<div><h3>Background</h3><div>Children with uncontrolled, moderate-to-severe asthma often have type 2 disease with allergic sensitization and/or elevated serum IgE.</div></div><div><h3>Objective</h3><div>To examine dupilumab efficacy in children aged 6 to 11 years with/without allergen sensitization.</div></div><div><h3>Methods</h3><div>In VOYAGE (NCT02948959), 408 children were randomized to receive dupilumab 100/200 mg every 2 weeks (by weight) or placebo for 52 weeks. This <em>post hoc</em> analysis included 336 children from VOYAGE with type 2 inflammation (eosinophils ≥150 cells/μL or fractional exhaled nitric oxide ≥20 ppb) and known baseline allergen sensitization status (based on total serum IgE and perennial allergen–specific IgE levels). The primary outcome assessed was annualized severe exacerbation rate; we also assessed change from baseline in pre- and postbronchodilator percent predicted forced expiratory volume in 1 second (ppFEV₁), Interviewer-Administered 7-Item Asthma Control Questionnaire (ACQ-7-IA) score, and total and allergen-specific IgE levels.</div></div><div><h3>Results</h3><div>Of 336 children with type 2 inflammation and known baseline allergen sensitization status, 75 (22%) were nonsensitized, 58 (17%) monoallergen sensitized, and 203 (60%) multiallergen sensitized. Dupilumab versus placebo reduced asthma exacerbations by 45%, 75%, and 60% in the non-, mono-, and multisensitized subgroups (<em>P =</em> .1286, .0376, and .0004), respectively, by week 52, with no apparent interaction between treatment group and sensitization status (<em>P</em>_int = .48). Similar improvements were observed across sensitization subgroups for pre- and postbronchodilator ppFEV₁, ACQ-7-IA, and total IgE levels.</div></div><div><h3>Conclusion</h3><div>In children with type 2 asthma, dupilumab showed significant efficacy, reducing exacerbations and improving other outcomes in monoallergen- and multiallergen-sensitized patients, and numerical but nonsignificant effects in nonsensitized patients.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2322-2333.e12"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosing Nonsteroidal Anti-Inflammatory Drug–Hypersensitivity/Allergy and Nonsteroidal Anti-Inflammatory Drug–Exacerbated or Induced Food Allergy Phenotypes in Children and Adolescents","authors":"Rocco Luigi Valluzzi MD,&nbsp;Sara Urbani MD,&nbsp;Maddalena Sciannamea MD,&nbsp;Maria Diakanthos MD,&nbsp;Francesca Carfora MD,&nbsp;Angela Klain MD,&nbsp;Veronica Calandrelli PharmD,&nbsp;Lamia Dahdah MD,&nbsp;Vincenzo Fierro MD,&nbsp;Alessandro Fiocchi MD,&nbsp;Antonino Gaetano Romano MD","doi":"10.1016/j.jaip.2026.06.044","DOIUrl":"10.1016/j.jaip.2026.06.044","url":null,"abstract":"<div><h3>Background</h3><div>Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in children. Hypersensitivity reactions (HRs) to NSAIDs represent a diagnostic challenge, particularly because NSAIDs may act as aggravating factors or cofactors as in two phenotypes recently named NSAID-exacerbated food allergy (NEFA) and NSAID-induced food allergy (NIFA).</div></div><div><h3>Objective</h3><div>To diagnose NSAID hypersensitivity/allergy (NH/A) and NEFA/NIFA phenotypes in children and adolescents, classify HRs to NSAIDs according to updated international guidelines, and identify clinical and immunologic predictors of true NH/A.</div></div><div><h3>Methods</h3><div>We prospectively studied 336 children and adolescents with a history of HRs to NSAIDs, following international guidelines, which include challenges with the suspected NSAIDs. Primary outcomes were identification of NH/A phenotypes and their predictors.</div></div><div><h3>Results</h3><div>Hypersensitivity or allergy to NSADISs was diagnosed in 104 of 336 patients (31%). The most frequent phenotypes were single-NSAID-induced urticaria, angioedema, or anaphylaxis (55.8%) and NSAID-induced urticaria, angioedema, or anaphylaxis (22.1%). We excluded NH/A in 232 patients (69%), 48 of whom received the diagnosis of NEFA/NIFA. Sensitization to Pru p 3 was strongly associated with NEFA/NIFA. Non-hypersensitive or allergic reactions were associated with antipyretic use (odds ratio [OR] = 5.92; 95% CI, 3.60-9.72), urticaria (OR = 3.06; 95% CI, 1.77-5.28), and younger age (OR per 6-year increment = 0.64; 95% CI, 0.47-0.89). Internal validation showed good discrimination (area under the receiver operating characteristic curve, 0.82; cross-validated area under the receiver operating characteristic curve, 0.79).</div></div><div><h3>Conclusions</h3><div>Approximately one third of children with suspected reactions had confirmed NH/A, whereas 14.3% had NEFA/NIFA. In 69% of patients, the NH/A label was removed. Many reactions during antipyretic use appear to be related to infection rather than true NSAID hypersensitivity.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2282-2294"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold Urticaria With Negative Standard Cold Stimulation Testing: Results From the COLD-CE Study","authors":"Dorothea Terhorst-Molawi MD,&nbsp;Dalia Melina Ahsan MD,&nbsp;Daria Fomina MD, PhD,&nbsp;Pascale Salameh PhD,&nbsp;Sabine Altrichter MD,&nbsp;Gerelma Andrenova MD,&nbsp;Andrea Bauer MD,&nbsp;Elena Borzova MD, PhD,&nbsp;Dejan Dinevski PhD,&nbsp;Ana Maria Giménez-Arnau MD, PhD,&nbsp;Margarida Gonçalo MD, PhD,&nbsp;Annika Gutsche MSc,&nbsp;Jesper Grønlund Holm MD, PhD,&nbsp;Maryam Khoshkhui MD,&nbsp;Aliya Klyucharova MD,&nbsp;Emek Kocatürk MD,&nbsp;Mitja Košnik MD, PhD,&nbsp;Kanokvalai Kulthanan MD,&nbsp;Michael Makris MD,&nbsp;Raisa Meshkova MD, PhD,&nbsp;Mojca Bizjak-Suran MD, PhD","doi":"10.1016/j.jaip.2026.08.022","DOIUrl":"10.1016/j.jaip.2026.08.022","url":null,"abstract":"<div><h3>Background</h3><div>Cold urticaria (ColdU) is defined by recurrent wheals and/or angioedema after cold exposure. Typical ColdU is confirmed by positive standard cold stimulation testing (SCST), defined as whealing within 10 minutes over the stimulated area on the volar forearm after provocation with an ice cube and/or TempTest. SCST-negative ColdU remains insufficiently characterized.</div></div><div><h3>Objective</h3><div>To characterize SCST-negative ColdU and identify factors independently associated with it.</div></div><div><h3>Methods</h3><div>We analyzed 364 patients with ColdU from the international, cross-sectional Comprehensive Evaluation of ColdU study across 11 GA²LEN UCARE centers. Detailed clinical history was obtained, SCST was performed, and group comparisons and logistic regression were conducted.</div></div><div><h3>Results</h3><div>Of 364 patients, 121 (33.2%) had SCST-negative and 243 (66.8%) had SCST-positive ColdU. Compared with SCST-positive ColdU, SCST-negative patients were younger (<em>P</em> = .004), had earlier onset (<em>P</em> = .002), and more often had a positive family history of ColdU (<em>P</em> = .005) and concomitant chronic spontaneous urticaria (CSU; <em>P</em> &lt; .001). SCST-positive ColdU was associated with more reported cold triggers (<em>P</em> &lt; .001), mucosal angioedema involving the oropharynx (<em>P</em> = .009), difficulty breathing (<em>P</em> &lt; .001), and cardiovascular symptoms (<em>P</em> = .001). In multivariable analysis, SCST-negative ColdU remained independently associated with a family history of ColdU (adjusted odds ratio [aOR], 2.47; 95% confidence interval [CI], 1.12-5.43), fewer reported cold triggers (aOR per trigger, 0.66; 95% CI, 0.55-0.79), an obligatory feeling of cold for symptom development (aOR, 3.85; 95% CI, 2.03-7.32), and concomitant CSU (aOR, 2.23; 95% CI, 1.13-4.37).</div></div><div><h3>Conclusion</h3><div>SCST-negative ColdU is common and clinically distinct from SCST-positive ColdU.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2397-2407.e4"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of Clinical Practice to Minimize Environmental Impact","authors":"Susan E. Pacheco MD,&nbsp;Stella Hartono MD, PhD,&nbsp;Stuart L. Abramson MD, PhD,&nbsp;Michelle L. Hernandez MD","doi":"10.1016/j.jaip.2026.06.046","DOIUrl":"10.1016/j.jaip.2026.06.046","url":null,"abstract":"<div><div>Although the health care sector is dedicated to promoting health, it paradoxically contributes to climate change by burning fossil fuels, a major source of greenhouse gas emissions and air pollutants. Its energy-intensive facilities, extensive supply chains, and massive waste production account for approximately 4.6% of global net emissions. In this contradictory position, the promotion of health is undermined by the resulting environmental degradation, leading to rising global temperatures, heat waves, air pollution, intensified droughts and precipitation, and more frequent and severe extreme weather events. Ironically, the health care sector contributes to the chronic medical conditions it aims to address, such as respiratory, cardiovascular, and heat-related diseases; atopic conditions; adverse pregnancy outcomes; and vector-borne diseases. Vulnerable populations, including children, older adults, individuals with chronic medical conditions, ethnic minorities, and socioeconomically marginalized communities, who are already affected by systemic inequities, bear a disproportionate burden of these climate-driven health outcomes. This article reviews the negative impact of the health care sector on human health and global equity, identifies sources of emissions, and outlines actionable procurement measures the medical sector can adopt to lessen its carbon footprint.</div></div>","PeriodicalId":51323,"journal":{"name":"Journal of Allergy and Clinical Immunology-In Practice","volume":"14 10","pages":"Pages 2179-2187"},"PeriodicalIF":7.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149096262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}