Sleep & breathing = Schlaf & Atmung最新文献

{"title":"Response to letter to the editor: \"association between obstructive sleep apnea and hearing loss among a cohort of emergency responders\".","authors":"David W Appel, David G Goldfarb, Rachel Zeig-Owens, Jaeun Choi, Gregory Flamme, Yang Liu, Theresa Schwartz, David J Prezant","doi":"10.1007/s11325-025-03464-3","DOIUrl":"https://doi.org/10.1007/s11325-025-03464-3","url":null,"abstract":"","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"295"},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126956","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":"Validation study of the Arabic translation of the sleep regularity questionnaire (SRQ).","authors":"Khaled Trabelsi, Waqar Husain, Khaled Ai Oweidat, Hadeel Ghazzawi, Achraf Ammar, Joseph M Dzierzewski, Haitham Jahrami","doi":"10.1007/s11325-025-03461-6","DOIUrl":"https://doi.org/10.1007/s11325-025-03461-6","url":null,"abstract":"<p><strong>Background: </strong>The Sleep Regularity Questionnaire (SRQ) assesses sleep regularity, increasingly recognized as essential for overall health. However, there is a lack of an Arabic validated version. This study aims to translate the SRQ into Arabic and evaluate its psychometric properties, including reliability, validity, factor structure, and convergent validity.</p><p><strong>Methods: </strong>A total of 481 participants (53% males, 47% females; median age = 39) from four Arabic countries completed the SRQ-Arabic, the Pittsburgh Sleep Quality Index (PSQI), and the Athens Insomnia Scale (AIS). The psychometric properties of the SRQ-Arabic were examined using reliability analysis, confirmatory factor analysis (CFA), invariance analysis (IA), bifactor Item Response Theory (IRT), surface response analysis, and convergent validity assessment.</p><p><strong>Results: </strong>The SRQ-Arabic demonstrated acceptable internal consistency (Cronbach's α = 0.70, McDonald's ω = 0.66, Guttman's λ2 = 0.73) and a factorial structure with acceptable overall fit (CFI/TLI > 90), though some indices (RMSEA = 0.09) suggest areas for model improvement. CVA supported its two-factor structure, IRT analysis identified strong items (D6, D8) and others requiring refinement (D1, D3, D5) due to low discrimination or extreme difficulty. The surface response analysis revealed significant negative associations between SRQ scores and both PSQI (p < 0.001) and AIS (p < 0.001). The SRQ-Arabic total score correlated with PSQI (r = 0.39, p < 0.001) and AIS (r = 0.32, p < 0.001), supporting its convergent validity.</p><p><strong>Conclusions: </strong>The SRQ-Arabic is a reliable and valid tool for efficiently assessing sleep regularity in Arabic-speaking populations, with potential for refinement to improve sensitivity.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"290"},"PeriodicalIF":2.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088808","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":"Sleep patterns, genetic susceptibility, and gastrointestinal cancer mortality: a large-scale prospective cohort study.","authors":"Shujuan Lin, Simeng Gu, Junpeng Li, Qinghai Gong, Yan Zhang, Feng Tong, Yanchang Xu, Danjie Jiang","doi":"10.1007/s11325-025-03452-7","DOIUrl":"https://doi.org/10.1007/s11325-025-03452-7","url":null,"abstract":"<p><strong>Background: </strong>The impact of sleep patterns on gastrointestinal cancer mortality has not been comprehensively explored. Moreover, the interaction between sleep patterns and genetic susceptibility with gastrointestinal cancer mortality remains uncertain.</p><p><strong>Methods: </strong>The study included a total of 379 845 participants from the UK Biobank. A poor sleep pattern was defined by short sleep (< 7 h/day) or long sleep (> 9 h/day), late chronotype, frequent insomnia, snoring, and frequent daytime dozing. The outcomes were mortality of any gastrointestinal cancers and six site-specific gastrointestinal cancers. Polygenic risk score was generated to characterize genetic risk. Multivariable cox proportional hazards regression models were use to analyze the associations of sleep patterns and genetic susceptibility with gastrointestinal cancer mortality.</p><p><strong>Results: </strong>A poor sleep pattern was associated with the increased risk of mortality from overall gastrointestinal cancer (HR 1.32, 95% CI 1.16-1.49), esophagus cancer (HR 1.37, 95% CI 1.02-1.85) and liver cancer (HR 2.01, 95% CI 1.48-2.74). Participants with a poor sleep pattern and high genetic risk combination had the highest mortality risks for esophagus, stomach, colorectal, and liver cancer. Significant multiplicative interactions (HR 1.51, 95% CI 1.05-2.18) and additive interactions (RERI 0.54, 95% CI 0.13-0.95; AP 0.34, 95% CI 0.10-0.58) of an intermediate sleep pattern and high genetic risk were observed on esophagus cancer mortality.</p><p><strong>Conclusions: </strong>A poor sleep pattern is associated with increased risks of gastrointestinal cancer mortality independent of the conventional risk factors, and the association is modified by genetic susceptibility.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"288"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083064","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":"Sleep environment is associated with sleep control in fly-in, fly-out mining shift workers.","authors":"Philipp Beranek, Mitchell Turner, Johnny Lo, Michael Grandner, Ian C Dunican, Travis Cruickshank","doi":"10.1007/s11325-025-03454-5","DOIUrl":"10.1007/s11325-025-03454-5","url":null,"abstract":"<p><p>Control over sleep timing, duration, and quality is essential for obtaining healthy sleep. Fly-in, Fly-out (FIFO) mining shift workers face unique challenges in maintaining control over their sleep due to their roster. However, the impact of their sleep environment on perceived sleep control in this population remains underexplored. This study evaluates the sleep environment of FIFO mining shift workers and its association with sleep control. A cross-sectional study was conducted (2023-2024) on Australian FIFO mining shift workers residing in remote camp accommodations. Data were collected via an online survey using the Assessment of Sleep Environment (ASE) and the Brief Index of Sleep Control (BRISC). Linear regression and Random Forest analyses were used to explore associations and identify key environmental factors influencing sleep control. Respondents (n = 538, 29% female) reported a mean ASE score of 12.6 ± 7.4 and a BRISC score of 2.3 ± 0.9. Two-thirds (n = 366) rated their sleep environment as moderately or highly sleep-disruptive. Higher ASE scores were negatively associated with BRISC scores (p < 0.001). Key environmental factors included pillow/blanket comfort, mattress comfort, room temperature, noise, light, and safety, of which all were negatively correlated (p < 0.05) with sleep control. The findings highlight the importance of optimising sleep environments to improve FIFO mining shift workers' sleep control. Addressing bedding comfort, noise and light levels, temperature, and safety could improve sleep in this population. However, the cross-sectional design does not allow for the identification of causal relationships. Longitudinal and objective studies are warranted to confirm causality and guide interventions.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"289"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical indicators of sleep quality: insights from nasal and neck measurements.","authors":"Menekşe Karahan, Melike Akcaalan, Mehtap Seyaz, Selin Erpek Paçaci","doi":"10.1007/s11325-025-03460-7","DOIUrl":"https://doi.org/10.1007/s11325-025-03460-7","url":null,"abstract":"","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"287"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081852","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":"Effects of steam-assisted respiratory muscle training on sleep apnoea symptoms and pulmonary function in men and women: a pilot study.","authors":"U Al-Rammahi, T Soukka, J Malinen, R P Happonen, A Sovijärvi, U Anttalainen","doi":"10.1007/s11325-025-03449-2","DOIUrl":"10.1007/s11325-025-03449-2","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnoea (OSA) negatively impacts quality of life and increases cardiovascular and metabolic risks. Although continuous positive airway pressure is the gold-standard treatment, limited adherence reduces its clinical effectiveness. This study investigates whether steam-assisted respiratory muscle training (RMT) can alleviate symptoms, improve pulmonary function, and explore potential differences in response between men and women with OSA.</p><p><strong>Methods: </strong>This open-label, 12-week prospective pilot study included 60 participants with mild to moderate OSA, who performed individualized inspiratory and expiratory counter-pressure breathing exercises with steam inhalation. Pulmonary function tests, sleep-related questionnaires, and general health assessments were conducted at baseline and post-intervention. Participants showing notable improvements from baseline were classified as high responders, enabling subgroup analyses.</p><p><strong>Results: </strong>Final results of 33 of the 60 participants showed significant mean improvements, with the Insomnia Severity Index (ISI) decreasing by 1.8 points, the Pittsburgh Sleep Quality Index (PSQI) by 2 points, and the 12-item General Health Questionnaire (GHQ-12) by 7.9 points (all p < 0.01). Forced expiratory volume in one second (FEV₁) increased from from 3.6 L to 3.8 L (p = 0.04). Subgroup analysis revealed an enhancement in sleep-related symptoms and pulmonary function.</p><p><strong>Conclusions: </strong>RMT may serve as a patient-centered alternative for managing the symptomatic burden of mild to moderate OSA. While larger trials are needed to confirm these preliminary findings, these pilot results do not yet demonstrate sustained benefit and should be interpreted with caution. Trial registration ClinicalTrials.gov, register no. NCT05320952.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"286"},"PeriodicalIF":2.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145067630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the role of drug-induced sleep endoscopy in optimizing upper airway stimulation therapy for non-responders.","authors":"E Kant, J A Hardeman, R J Stokroos, M P Copper","doi":"10.1007/s11325-025-03468-z","DOIUrl":"10.1007/s11325-025-03468-z","url":null,"abstract":"<p><strong>Purpose: </strong>Upper airway stimulation by means of unilateral hypoglossal nerve stimulation is an alternative therapy for patients with obstructive sleep apnea and continuous positive airway pressure intolerance or failure. Optimal device settings are essential for effective treatment of obstructive sleep apnea with this therapy. Some patients experience therapy failure, despite standard titration methods. We perform a drug induced sleep endoscopy with upper airway stimulation in these patients. This study provides an overview of this procedure and our patient outcomes.</p><p><strong>Methods: </strong>Retrospective chart review of patients implanted with an upper airway stimulation device between 2015 and 2022.</p><p><strong>Results: </strong>The drug-induced sleep endoscopy with upper airway stimulation therapy is performed in 29 non-responders of therapy. In seven patients, a change in device settings was sufficient to prevent an upper airway collapse during the drug-induced sleep endoscopy, while additional therapy was recommended for the remaining. Eventually, six patients were fitted with a change in device settings and fourteen patients were treated with additional therapy, being oral appliance therapy, barbed wire pharyngoplasty or alternative upper airway surgery. At follow-up, the apnea-hypopnea index declined significantly from 41.6 ± 15.0 to 23.2 ± 9.9 events/hour and resulted in eight additional responders to therapy.</p><p><strong>Conclusion: </strong>The drug-induced sleep endoscopy might be a valuable addition in the clinical pathway of upper airway stimulation therapy. It provides a better evaluation of the stimulation process and offers the opportunity for alterations in settings or targeted additional therapy.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"285"},"PeriodicalIF":2.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between nighttime sleep duration trajectories and risk of digestive diseases among middle-aged and older Chinese adults.","authors":"Zhou Su, Jie Liang, Zhihai Liang","doi":"10.1007/s11325-025-03458-1","DOIUrl":"10.1007/s11325-025-03458-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to explore the relationship between nighttime sleep duration trajectories and the risk of digestive diseases among middle-aged and older adults in China.</p><p><strong>Methods: </strong>A total of 9521 participants aged 45 years or older from China Health and Retirement Longitudinal Study (CHARLS) were included in this longitudinal study. Nighttime sleep duration was analyzed using group-based trajectory model (GBTM) to identify distinct sleep duration trajectories. Binary logistic regression models were used to assess the associations between sleep duration trajectory groups and risks of digestive diseases and liver diseases. Data were analyzed using STATA and R.</p><p><strong>Results: </strong>The average age of 9,521 participants was 58.3 ± 8.5 years, and 53% were female. Baseline analysis indicated a negative correlation between sleep duration and digestive diseases risk. Over the seven-year follow-up period, GBTM identified four distinct sleep duration trajectories: short-descent trajectory (n = 1728, 18.1%), short-stable trajectory (n = 3824, 40.2%), short-ascent trajectory (n = 1476, 15.5%) and normal-stable trajectory (n = 2493, 26.2%). Compared to the normal-stable trajectory, the short-descent trajectory was significantly associated with higher risk of incident digestive diseases (OR = 2.063; 95% CI 1.724, 2.466; P < 0.001) and liver diseases (OR = 1.622; 95% CI 1.256, 2.094; P < 0.001). In stratified analysis, the results were consistent.</p><p><strong>Conclusion: </strong>A short sleep duration trajectory was associated with an increased risk of incident digestive diseases among middle-aged and older Chinese adults. These findings highlight the importance of considering dynamic sleep duration patterns in strategies for managing digestive diseases.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"284"},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042792","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":"Eustachian tube dysfunction in obstructive sleep apnea patients: implications for a multimodal treatment approach. A systematic review.","authors":"Antonio Moffa, Francesco Iafrati, Domiziana Nardelli, Luca Carnuccio, Giannicola Iannella, Lorenzo Sabatino, Peter M Baptista, Manuele Casale","doi":"10.1007/s11325-025-03456-3","DOIUrl":"10.1007/s11325-025-03456-3","url":null,"abstract":"<p><strong>Introduction: </strong>It is well known that Obstructive Sleep Apnea (OSA) is a complex disease characterized by an Upper Airway (UA) collapse during sleep, with potential consequences on ENT districts. Recent evidence suggests a possible association with Eustachian Tube Dysfunction (ETD). However, the potential effects of both surgical and non-surgical therapeutic strategies on ET function remain poorly explored in the current literature. This review aims to analyze the correlation between OSA and ETD, and to evaluate how invasive and non-invasive treatment OSA strategies influence ET function.</p><p><strong>Methods: </strong>An electronic search was performed on PubMed/MEDLINE, Google Scholar, and Ovid databases using keywords as \"eustachian tube,\" \"eustachian tube dysfunction,\" \"OSA,\" \"obstructive sleep apnea,\" \"pharyngeal surgery,\" and \"CPAP.\" Additional cross-referencing was performed to identify relevant studies. The last search was completed in July 2024.</p><p><strong>Results: </strong>Out of the 334 identified articles, 15 met the inclusion criteria, encompassing 125,178 patients. Studies were categorized into three groups: correlation between OSA and ETD (n = 6), effects of CPAP on ETD (n = 6), and outcomes of pharyngeal surgery on ET function (n = 3). CPAP use was associated with improved ETD symptoms and middle ear pressure. Postoperative ETD worsening was noted after pharyngeal surgery due to tissue edema and inflammation.</p><p><strong>Conclusion: </strong>ETD appears to be a prevalent comorbidity in OSA patients. While CPAP shows a beneficial effect on ET function, surgical outcomes are less clear. Larger studies are needed to clarify these associations and guide therapeutic decisions in OSA management.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"283"},"PeriodicalIF":2.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031616","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":"Proposition of a new, minimally-invasive, software smartphone device to predict sleep apnea and its severity.","authors":"Justine Frija, Juliette Millet, Emilie Béquignon, Ala Covali, Guillaume Cathelain, Josselin Houenou, Hélène Benzaquen, Pierre A Geoffroy, Emmanuel Bacry, Mathieu Grajoszex, Marie-Pia d'Ortho","doi":"10.1007/s11325-025-03441-w","DOIUrl":"10.1007/s11325-025-03441-w","url":null,"abstract":"<p><strong>Purpose: </strong>obstructive sleep apnea is underdiagnosed due to limited access to polysomnography (PSG). We aimed to assess the performances of Apneal^®, an application recording sound and movements thanks to a smartphone's microphone, accelerometer and gyroscope, to estimate patients' apnea-hypopnea index (AHI).</p><p><strong>Methods: </strong>monocentric proof-of-concept study with a first manual scoring step, then automatic detection of respiratory events from recorded signals using a sequential deep-learning model (version 0.1 of Apneal^® automatic scoring of respiratory events, end 2022), in adult patients.</p><p><strong>Results: </strong>46 patients (women 34%, BMI 28.7 kg/m²) were included. Sensitivity of manual scoring was 0.91 (95% CI [0.8-1]) for IAH > 15 and 0.85 [0.67-1] for AHI > 30, and positive predictive values (PPV) 0.89 [0.76-0.97] and 0.94 [0.8-1]. We obtained an AUC-ROC of 0.85 (95% CI [0.69-0.96]) and AUC-PR of 0.94 (95% CI [0.84-0.99]) for the identification of AHI > 15, and AUC-ROC of 0.95 [0.860.99] and AUC-PR of 0.93 [0.81-0.99] for AHI > 30. The ICC between the AHI estimated manually, and from the PSG is 0.89 (p = 6.7 × 10^- 17), Pearson correlation 0.90 (p = 1.25 × 10^- 17). Automatic scoring found sensitivity of 1 [0.95-1], PPV of 0.9 [0.8-0.9] for AHI > 15, and sensitivity 0.95 [0.84-1], PPV 0.69 [0.52-0.85] for AHI > 30. The ICC between the estimated AHI, and PSG scorings is 0.84 (p = 5.4 × 10^- 11) and Pearson correlation is 0.87 (p = 1.7 × 10^- 12).</p><p><strong>Conclusion: </strong>Manual scoring of smartphone-based signals is possible and accurate compared to PSG-based scorings. Automatic scoring method based on a deep learning model provides promising results.</p><p><strong>Trial registration: </strong>NCT03803098.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"282"},"PeriodicalIF":2.0,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}