Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association最新文献

{"title":"Sex-specific clinical presentations and outcomes in ANCA vasculitis presenting with severe kidney disease.","authors":"Marta Casal Moura, Marc Patricio Liebana, Ladan Zand, Dalia Zubidat, Maria J Vargas-Brochero, Daniela Valencia, Miriam Machado, Sana Abouzahir, Ulrich Specks, Sanjeev Sethi, Fernando C Fervenza, Maria José Soler","doi":"10.1093/ndt/gfaf120","DOIUrl":"https://doi.org/10.1093/ndt/gfaf120","url":null,"abstract":"<p><strong>Background: </strong>The impact of sex in the clinical presentation and outcomes of patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) with glomerulonephritis (AAV-GN) has not been studied, particularly in patients with severe kidney involvement at presentation (eGFR < 15 mL/min/1.73m2).</p><p><strong>Methods: </strong>A retrospective cohort study on MPO- or PR3-ANCA positive patients with AAV (MPA or GPA) and eGFR<15 ml/min/1.73m2 or end-stage kidney disease (ESKD) at presentation. Clinical presentation and renal outcomes were analyzed according with sex.</p><p><strong>Results: </strong>We analyzed 166 patients with biopsy proven active AAV-GN and eGFR < 15 mL/min/1.73m2 at the time of diagnosis: 78 (47%) were females and 88 (53%) were males. Hypertension was more frequently present in males (85.2% vs.70.5%, P = 0.022). Median serum creatinine (SCr) was higher in males when compared with females (5.2 [IQR 4.2-7.4] vs. 3.6 [IQR 2.8-5.1]mg/dL, P < 0.001). There were no statistically significant differences in the median percentage of crescents. However, the rate of dialysis initiation or progression to ESKD in the first 12 months was not different between males (15, 62.5%) versus females (29, 61.7%) at 12 months. By multivariable logistic regression, factors related with dialysis initiation within the first 4 weeks in our cohort were SCr, alveolar hemorrhage, and PR3-ANCA adjusted for sex.</p><p><strong>Conclusion: </strong>In our cohort, male patients presented with higher SCr, and dialysis was started within the first 4 weeks more frequently (53.4% vs. 30.7%). There were no differences in outcomes of kidney recovery, overall dialysis rates, and progression to ESKD within 12 months in patients with AAV-GN and eGFR < 15 mL/min/1.73m2 between groups.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary rituximab loss and rate of treatment failure in membranous nephropathy.","authors":"Marco Allinovi, Matteo Accinno, Cecilia Finocchi, Tommaso Mazzierli, Leonardo Caroti, Daniela Lazzarini, Lorenzo Cosmi, Andrea Matucci, Marco Del Carria, Michael Diomaiuti, Calogero Lino Cirami, Francesco Peyronel, Alessandra Vultaggio","doi":"10.1093/ndt/gfaf127","DOIUrl":"https://doi.org/10.1093/ndt/gfaf127","url":null,"abstract":"<p><strong>Background: </strong>Rituximab is a first-line treatment for primary membranous nephropathy, but approximately one-third of patients fail to respond. Among the proposed mechanisms of rituximab resistance, urinary rituximab loss due to non-selective proteinuria could lead to drug underexposure and treatment failure. Although hypothesized, this has never been objectively measured with a practical and reproducible method.</p><p><strong>Methods: </strong>We conducted a prospective, observational study of 25 patients with biopsy-proven primary membranous nephropathy treated with rituximab (two infusions of 1 g, two weeks apart) at Careggi University Hospital, Florence, Italy. Rituximab levels were measured in serum and urine using a commercially available ELISA adapted for urinary samples. Urinary rituximab concentrations were assessed in 60 individuals to identify a threshold below which rituximab is considered not present in urine. Eight non-responders with urinary rituximab ≥2 µg/mL (potentially underexposed) received a second treatment course to test whether a higher rituximab dose would provide benefits in terms of kidney outcomes.</p><p><strong>Results: </strong>Urinary rituximab loss was associated with markers of disease severity, including lower eGFR (r= -0.50; p =0.01), higher proteinuria (r=0.46; p =0.02), and non-selective proteinuria (r=0.61; p =0.001). Patients with urinary rituximab ≥2 µg/mL had lower serum rituximab peak levels at 1 month (p=0.04), possibly reflecting drug underexposure, and significantly lower response rates (43% vs 100%, p=0.003). PLA2R antibody depletion was significantly more frequent in patients with lower urinary rituximab levels (80% vs 17%, p=0.008). In the re-treated subgroup, five of eight non-responders showing significant urinary rituximab loss and receiving a second course of treatment achieved clinical response.</p><p><strong>Conclusions: </strong>In primary membranous nephropathy, urinary rituximab loss is associated with disease severity, drug underexposure, and treatment failure. Measuring urinary rituximab could help identify patients at risk of resistance who could benefit from additional rituximab dosing. This approach could improve outcome prediction and support personalized immunosuppressive strategies.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of balcinrenone and dapagliflozin for CKD: design and baseline characteristics of the MIRO-CKD trial.","authors":"Patrick B Mark, Erika De Sousa-Amorim, Anna L Eriksson, Maria L Zachrisson, Nicolas J Guzman, Matthew T Miller, Yunyun Jiang, Hiddo J L Heerspink","doi":"10.1093/ndt/gfaf119","DOIUrl":"https://doi.org/10.1093/ndt/gfaf119","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Despite benefits of sodium-glucose co-transporter-2 inhibitors (SGLT2i) recommended for treatment of chronic kidney disease (CKD), there is still an unmet need for managing renal residual risk. Based on pre-clinical data, balcinrenone is a novel mineralocorticoid receptor antagonist that maintains cardio-renal benefits without increasing hyperkalaemia risk. Use of balcinrenone and dapagliflozin is expected to provide complementary and additive kidney and cardiovascular protection. The MIRO-CKD study tests the hypothesis that balcinrenone with dapagliflozin is superior to dapagliflozin alone in reducing albuminuria in patients with CKD.</p><p><strong>Methods: </strong>MIRO-CKD is a double-blind, active-controlled, phase 2b study evaluating the efficacy and safety of balcinrenone/dapagliflozin in 300 adults (planned) with CKD, eGFR 25-60 mL/min/1.73m2 and serum potassium within normal range. Participants are being randomized 1:1:1 to balcinrenone/dapagliflozin 15 mg/10 mg, 40 mg/10 mg or placebo/dapagliflozin 10 mg for 12 weeks, followed by an 8-week wash-out period to assess off-drug effects. The primary endpoint is the change in log-transformed urinary albumin-to-creatinine ratio (UACR) from baseline to Week 12. Other outcomes include pharmacokinetics, safety and tolerability.</p><p><strong>Results: </strong>614 patients were screened and 324 were randomized across 15 countries in Asia, Europe, North and South America. 56.2% of participants were taking SGLT2i and 87.1% renin angiotensin aldosterone system inhibitors at enrolment. The patient population are at increased risk of CKD progression by having CKD stage 3/4 and albuminuria (median UACR: 365.5 mg/g; mean eGFR: 42.2 mL/min/1.73m2). 56.5% of participants had type 2 diabetes mellitus.</p><p><strong>Conclusions: </strong>MIRO-CKD is a fully recruited global trial enrolling a contemporary CKD population at increased risk of progression and with an increased risk of hyperkalaemia based on their reduced kidney function. The study will assess the efficacy, safety and tolerability of the combination of balcinrenone and dapagliflozin to identify an optimal dose for a future phase 3 study in patients with CKD.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifactorial chronic kidney disease.","authors":"Jose Manuel Arreola Guerra, Jesus-Israel Martinez-Martinez","doi":"10.1093/ndt/gfaf122","DOIUrl":"https://doi.org/10.1093/ndt/gfaf122","url":null,"abstract":"<p><p>The burden of disease due to chronic kidney disease (CKD) has disproportionately grown in the last decades. This growth has not been similar in all regions. In the last few years, the results of clinical trials, particularly those evaluating sodium-glucose-cotransporter-2 (SGLT2) inhibitors and their efficacy in decreasing cardiovascular mortality and chronic kidney disease progression, revealed the relevance of a common protective pathway that remains non-specific as it has been detected in multiple clinical scenarios. However, the injury pathways in kidney disease are now well-defined in immunological, toxic, and genetic kidney pathologies. Therefore, the multifactoriality of chronic kidney disease is evident. Even prenatally, the number of nephrons is mostly determined by multiple factors that influence the maternal environment, and subsequently, throughout life, various exposures and pathologies gradually reduce the total number of nephrons. A better understanding of CKD as a multifactorial entity requires us to be aware of the primary injury pathways that can play a role throughout our lifetimes and implement more concrete measures to decrease the impact of CKD globally. Due to the heterogeneity of the CKD burden between world regions, local epidemiological studies are essential to understand the factors associated with CKD in each region.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of diabetes in patients with advanced chronic kidney disease or kidney failure.","authors":"George Bonifant, Stephen N Davis, Matthew R Weir","doi":"10.1093/ndt/gfaf083","DOIUrl":"https://doi.org/10.1093/ndt/gfaf083","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is common in both type 1 and type 2 diabetes and complicated glycemic control due to fluctuating insulin resistance and metabolism. In advanced CKD (stage 4 and stage 5, or eGFR <30 ml/min/1.73m2), reduced kidney clearance of insulin can lower or eliminated insulin needs, but glycemic control remains challenging. This article reviews optimal glycemic targets, monitoring, and current therapeutic recommendations for patients with severe CKD or on dialysis, addressing the lack of efficacy data for many antihyperglycemics in this population.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment standard: CKD in the geriatric patient.","authors":"Elke Schaeffner, Markus Ketteler","doi":"10.1093/ndt/gfaf115","DOIUrl":"https://doi.org/10.1093/ndt/gfaf115","url":null,"abstract":"<p><p>The number of older people with CKD is globally increasing. The vast majority of these patients will die before they even have the chance to start kidney replacement therapy. Nevertheless, this clientele of older patients with CKD is often characterized not only by several concomitant diseases but also by frailty. This constellation comes with a general vulnerability and very heterogeneous courses of disease that need to be considered when it comes to diagnosis and treatment. The main difference to younger patients is that therapy and therapy decisions are often preceded by the need for assessments. These can relate to frailty, but also to closely related areas such as cognition, depression or malnutrition among others. The basic therapeutic approaches for CKD treatment in a geriatric patient may not differ fundamentally though from those for younger patients. This also holds true for standard as well as more novel medication administered for nephroprotection. The difference however, lies in the fact that personalized approaches are more frequently required due to survival probability, a more complex mix of chronic conditions, and individual patient's needs and aims. This also applies to the difficult decision as to whether a very old person with CKD G5 should be dialyzed or treated conservatively. Information from different areas should be incorporated into a joint decision-making process, which often requires intensive, patient-centered communication about the patient's preferences and prioritized treatment goals, psychosocial factors and their home environment, as well as their medical needs and prognosis.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardioprotection from intradialytic exercise: a randomized trial.","authors":"Claire Maufrais, Matthieu Josse, Laure Patrier, Myriam Isnard, Antoine Grandperrin, Cécile Turc-Baron, Stéphane Nottin, Jean-Paul Cristol, Doria Boulghobra, Cyril Reboul, Philippe Obert","doi":"10.1093/ndt/gfaf126","DOIUrl":"https://doi.org/10.1093/ndt/gfaf126","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Left ventricular (LV) regional wall motion abnormalities (RWMAs) related to transient ischemic events are well-documented during hemodialysis (HD). Intradialytic exercise (IDE) reduces the global occurrence of HD-induced RWMAs. However, the regionalization of its cardioprotective effects within the LV wall, and its underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>We conducted a prospective, crossover, randomized trial. 72 patients underwent two sessions: standard HD (HD-CONT) and HD with 30min of aerobic exercise (HD-EX). Segmental longitudinal strains (LS) were measured before (T0) and at peak stress (30min before HD-ending, Tpeak). An 18-segment model identified RWMAs, defined as a 20% LS reduction at Tpeak compared to T0. To evaluate the impact of circulating factors, we measured fractional shortening, Ca2+ transients and spontaneous Ca2+ waves (SCaW) following anoxia/reoxygenation (A/R) in isolated rat cardiomyocytes pre-treated with human plasma ultrafiltrates (obtained at Tpeak in both sessions).</p><p><strong>Results: </strong>IDE significantly reduced RWMAs during HD-EX compared to HD-CONT (estimated difference: 1.1 segment, 95%CI: 0.33/1.90, p=0.009). A baso-apical gradient of RWMAs was observed during HD-CONT, with higher prevalence at the apex compared to the base (p=0.03). This gradient was abolished during HD-EX, suggesting greater apical cardioprotection. Pre-treatment of cardiomyocytes with ultrafiltrates from HD-EX improved fractional shortening, Ca2+ handlings and SCaW following A/R compared to cells pre-treated with ultrafiltrates from HD-CONT.</p><p><strong>Conclusions: </strong>IDE limits HD-induced RWMAs, and circulating humoral factors may contribute to this cardioprotection. IDE-induced benefits on RWMAs were greater at the apex. Further studies are needed to elucidate the mechanisms underlying the heterogeneous benefits of IDE on regional myocardial function.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Male and female drug prescription patterns and adverse drug reactions in chronic kidney disease.","authors":"Solène M Laville, Agathe Mouheb, Ziad A Massy, Christian Jacquelinet, Maurice Laville, Bénédicte Stengel, Natalia Alencar de Pinho, Sophie Liabeuf","doi":"10.1093/ndt/gfaf125","DOIUrl":"https://doi.org/10.1093/ndt/gfaf125","url":null,"abstract":"<p><strong>Background: </strong>It is acknowledged that men and women differ with regard to pharmacological responses and adverse drug reactions (ADRs), and there is some evidence to suggest that ADR rates are higher in women. However, this topic has not been extensively explored in patients with chronic kidney disease (CKD). The objectives of the present study of a cohort of patients with CKD were to describe the types of drug prescriptions by sex and to examine potential differences between men and women in the incidence of ADRs.</p><p><strong>Methods: </strong>The French Chronic Kidney Disease-Renal Epidemiology and Information Network (CKD-REIN) is a prospective cohort study including 3,011 nephrology outpatients with confirmed CKD (eGFR<60 mL/min/1.73 m²) and available data on drug prescriptions. Standard descriptive analyses were conducted to characterize drug prescriptions by gender through follow-up. ADRs were prospectively identified through hospitalization records, medical records, and patient interviews and adjudicated by expert pharmacologists using validated tools. Multivariable Cox proportional hazards model was used to explore the association between sex and ADRs.</p><p><strong>Results: </strong>Among the 3,011 included patients, 1,038 (34%) were women and 1,973 (66%) were men. Compared with men at baseline, women were younger (median [interquartile range] age: 69 [62-77] years vs 67 [58-76], respectively), and had a lower eGFR (mean ± standard deviation, 33.1±12.9 vs 34.7±13.2 mL/min/1.73 m²). Men and women presented some differences with regard to the types of drugs prescribed. Women were more often prescribed drugs for acid-related disorders, anemia, thyroid disorders, analgesics, and psychoactive drugs. Conversely, they were less often prescribed cardiovascular drugs and oral antidiabetics. During a median [interquartile range] follow-up period of 5.0 [3.6-5.2] years, 964 patients experienced a first ADR (incidence rates [95%CI]: 10.8 [9.6-11.9] per 100 person-years (PY) in women and 9.7 [9.0-10.5] in men). The most frequent ADRs were gastrointestinal disorders in women (n=59(17%)) and renal and urinary disorders in men (n=134 (22%)). The likelihood of a first ADR was higher in women than in men (adjusted HR [95%CI]: 1.17 [1.02;1.34]). However, the likelihood of a serious ADR did not differ by sex.</p><p><strong>Conclusions: </strong>In patients with CKD, significant differences between men and women were observed in drug prescriptions and ADR risks.</p>","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary orosomucoid and accelerated GFR decline: a 11-year follow-up study in a non-diabetic population.","authors":"Runa M Andreassen, Karl M Brobak, Inger Therese Enoksen, Toralf Melsom, Bjørn O Eriksen, Marit D Solbu","doi":"10.1093/ndt/gfaf113","DOIUrl":"https://doi.org/10.1093/ndt/gfaf113","url":null,"abstract":"","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving Beyond Race, Geographical Origin, and Ethnicity: Genomic Insights as a Path Forward in Nephrology Care.","authors":"Alice Doreille, Louis-Georges Tin, Marie-Chantal Fortin, Cédric Rafat, Laurent Mesnard","doi":"10.1093/ndt/gfaf124","DOIUrl":"https://doi.org/10.1093/ndt/gfaf124","url":null,"abstract":"","PeriodicalId":520717,"journal":{"name":"Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}