{"title":"A national analysis of obstructive sleep apnea in patients undergoing transcatheter aortic valve replacement.","authors":"Emmanuel Olumuyide, Jiun-Ruey Hu, Ezaz Rahman, Yanting Wang, Ehimen Aneni","doi":"10.1007/s11325-025-03412-1","DOIUrl":"10.1007/s11325-025-03412-1","url":null,"abstract":"<p><strong>Background: </strong>Obstructive Sleep Apnea (OSA), a common yet underdiagnosed condition, is prevalent in 15% of the general population and up to 30% of patients undergoing transcatheter aortic valve replacement (TAVR). OSA contributes to the cardiovascular burden through hypoxia, oxidative stress, and increased sympathetic activity. Despite its prevalence, the impact of OSA on TAVR outcomes remains uncertain.</p><p><strong>Methods: </strong>We stratified patients who underwent TAVR in the national inpatient sample database from 2016 to 2020 by the presence or absence of OSA. Multivariable logistic regression was performed, adjusting for age, gender, race, income, insurance, comorbidity score, hospital location, and bed size. The primary outcome was mortality. Secondary outcomes were atrial fibrillation (AF), pacemaker placement (PPM), cardiogenic shock (CS), acute heart failure (AHF), mechanical circulatory support (MCS), and cerebrovascular Accident (CVA). A Bonferroni correction was applied for multiple comparisons to reduce the risk of false-positive findings, setting statistical significance at p < 0.0033.</p><p><strong>Result: </strong>Among 296,740 patients undergoing TAVR, 49,005 had OSA. Patients with OSA were less likely to experience CS (1.46% vs. 2.08% p = 0.006) but had higher rates of acute heart failure (31.63% vs. 30.67% p = 0.04), AF (43.54% vs. 37.36%; p < 0.001) and PPM (7.66% vs. 6.86% P = 0.002) with no difference in MCS, CVA, and mortality between groups.</p><p><strong>Conclusion: </strong>In patients who underwent TAVR, OSA is associated with higher odds of AF and PPM. These findings suggest that OSA influences cardiovascular outcomes and procedural risks. Knowledge of these risks will help inform shared decision-making by physicians and patients with OSA undergoing TAVR.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"241"},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639585","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":"The effect of continuous positive airway pressure on nocturnal blood pressure among obstructive sleep apnea-hypopnea syndrome patients.","authors":"Xin Zhao, Chenxu Zhang, Ping Zeng, Jin Zhou, Xiaoying Li, Xiaoqing Zhang","doi":"10.1007/s11325-025-03406-z","DOIUrl":"10.1007/s11325-025-03406-z","url":null,"abstract":"<p><strong>Purpose: </strong>Few articles focus on the effect of CPAP on the nocturnal blood pressure in OSA patients. This study aims to evaluate the effects of continuous positive airway pressure (CPAP) therapy on nocturnal blood pressure in individuals with obstructive sleep apnea-hypopnea syndrome (OSAHS), which fills the research gap. Additionally, differences in nocturnal blood pressure measurements before and after CPAP therapy were analyzed across varying disease severities.</p><p><strong>Methods: </strong>A total of 80 individuals with newly diagnosed OSAHS who sought care at the Sleep Respiratory Disease Diagnosis and Treatment Center at West China Fourth Hospital of Sichuan University between December 2022 and June 2023 were included in this study. All participants completed a single night of CPAP therapy, administered from 10:00 PM on day 1 to 6:00 AM on day 2, during which nocturnal blood pressure measurements were assessed using pulse transit time.</p><p><strong>Results: </strong>Following CPAP therapy, significant reductions were observed in the mean nocturnal diastolic blood pressure (nDBP) [(78.40 ± 13.06) vs. (74.03 ± 9.90) mmHg] and the nocturnal blood pressure fluctuation index (NBPFI) [(21.38 ± 19.95) vs. (5.81 ± 5.40) n/h] (p < 0.05). However, no significant difference was noted in the mean nocturnal systolic blood pressure (p > 0.05). Subgroup analysis based on disease severity: The reductions in nDBP [(6.16 ± 11.89) vs. (-0.32 ± 12.43) mmHg, p < 0.05] and nocturnal blood pressure fluctuation [(20.48 ± 19.05) vs. (2.59 ± 4.44) n/h, p < 0.05] were significantly greater in the severe group compared to the mild-to-moderate group.</p><p><strong>Conclusion: </strong>The findings suggested that CPAP therapy could potentially contribute to reductions in nDBP and the NBPFI in individuals with OSAHS, with more noticeable effects in patients with severe OSAHS.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"240"},"PeriodicalIF":2.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621762","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}
Jae Rim Kim, Dana Oh, Jee-Eun Yoon, Hyo Jin Park, Sang Min Paik, Sun-Ku Han, Woo-Jin Lee, Daeyoung Kim, Kwang Ik Yang, Min Kyung Chu, Chang-Ho Yun
{"title":"Exploring the link between grit and excessive daytime sleepiness: a study in a population sample.","authors":"Jae Rim Kim, Dana Oh, Jee-Eun Yoon, Hyo Jin Park, Sang Min Paik, Sun-Ku Han, Woo-Jin Lee, Daeyoung Kim, Kwang Ik Yang, Min Kyung Chu, Chang-Ho Yun","doi":"10.1007/s11325-025-03414-z","DOIUrl":"10.1007/s11325-025-03414-z","url":null,"abstract":"<p><strong>Purpose: </strong>Excessive daytime sleepiness (EDS) is a common condition with implications for individual health and public safety. While factors such as snoring and depression are known contributors to EDS, the role of grit in EDS remains unexplored. This study aimed to investigate the association between and EDS in a representative sample of Korean adults, with a specific focus on the two components of grit: perseverance of effort (PE) and consistency of interest (CI).</p><p><strong>Methods: </strong>A nationwide cross-sectional survey was conducted through door-to-door interviews using structured questionnaires between September and December 2018 in Korea. EDS was assessed using the Epworth Sleepiness Scale, while grit was measured using the Short Grit Scale, comprising PE and CI subscales. Multivariable logistic regression analyses were performed to explore the association between grit and EDS, adjusting for covariates.</p><p><strong>Results: </strong>A total of 2,356 participants (49.3% male; aged 19-92 years) were enrolled in the study. The prevalence of EDS was 15.2%. Participants with EDS had significantly lower overall grit scores, driven by lower CI subscale scores. After adjusting for confounders, higher grit scores were significantly associated with EDS (OR 0.35, 95% CIs 0.26-0.45, p < 0.001). This association persisted in subgroup analyses, including those with depression and habitual snoring. In contrast, no significant association was observed between the PE subscales and EDS.</p><p><strong>Conclusion: </strong>Our findings suggest that intrinsic motivation, as reflected by the CI subscale of grit, is inversely associated with EDS. Therefore, exploring interventions that include nurturing grit could be a potential approach to addressing EDS.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"239"},"PeriodicalIF":2.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621761","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}
Ewa Migacz, Wioletta Olejarz, Andrzej Łoś, Katarzyna Bednarek-Rajewska, David F Smith, Andrzej Kluk, Wojciech Kukwa
{"title":"S100a8 and s100a9 are elevated in aortic wall from patients with moderate-and-severe obstructive sleep apnea syndrome.","authors":"Ewa Migacz, Wioletta Olejarz, Andrzej Łoś, Katarzyna Bednarek-Rajewska, David F Smith, Andrzej Kluk, Wojciech Kukwa","doi":"10.1007/s11325-025-03400-5","DOIUrl":"10.1007/s11325-025-03400-5","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) is associated with systemic inflammation and cardiovascular disease, including atherosclerosis. S100A8 and S100A9 are pro-inflammatory proteins involved in atherogenesis, but their expression in the aortic walls of OSA patients remains unknown. This study aimed to determine the relationship between OSA severity and S100A8/S100A9 expression in aortic tissue from patients undergoing coronary artery bypass grafting (CABG).</p><p><strong>Methods: </strong>This study included 46 patients who underwent CABG. OSA severity was assessed using the WatchPAT™ home sleep apnea test, classifying patients into control and mild (0 < AHI < 15), and moderate to severe (AHI ≥ 15) OSA groups. Aortic wall samples were collected intraoperatively, and S100A8 and S100A9 expression was evaluated using immunohistochemistry. Statistical analysis compared protein expression across OSA severity groups.</p><p><strong>Results: </strong>Patients with moderate-to-severe OSA exhibited higher S100A8 and S100A9 expression in aortic tissue compared to control and mild OSA groups. The difference was statistically significant for S100A9 (p < 0.01), while S100A8 showed a non-significant increasing trend (p = 0.073).</p><p><strong>Conclusion: </strong>This study provides novel evidence that S100A8 and S100A9 are overexpressed in the aortic walls of patients with moderate-to-severe OSA. These findings suggest a potential role for these proteins in OSA-related vascular inflammation and atherosclerosis. Further research is needed to explore their potential as biomarkers or therapeutic targets in OSA-related cardiovascular disease.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"236"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586183","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":"Obstructive sleep apnea as a predictive indicator for in vitro fertilization and embryo transfer outcomes in patients with polycystic ovary syndrome: a prospective cohort study.","authors":"Nidong Li, Rui Yang, Yue Zhao, Yuanyuan Wang, Qiaoya Tang, Jing Li, Yali Huang, Yongwei Huang, Liqiang Zhang, Ying Wang, Rong Li, Jie Qiao","doi":"10.1007/s11325-025-03399-9","DOIUrl":"10.1007/s11325-025-03399-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the impact of obstructive sleep apnea (OSA) on in vitro fertilization (IVF) and embryo transfer outcomes in infertile patients with polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study of 360 infertile PCOS patients scheduled for IVF with either fresh or frozen embryo transfer at The Reproductive Medical Center of Peking University Third Hospital between January 2019 and September 2022. All participants underwent home sleep apnea test (HSAT) prior to IVF treatment. We collected clinical characteristics and reproductive outcomes, analyzing the association between OSA and IVF results using univariate and logistic regression analyses.</p><p><strong>Results: </strong>Among the 360 PCOS patients, OSA prevalence was 30.0%. Univariate analysis revealed significantly lower clinical pregnancy and live birth rates during the first embryo transfer cycle in PCOS&OSA patients compared to non-OSA PCOS patients. Logistic regression confirmed OSA as an independent risk factor for reduced live birth rates in PCOS patients undergoing IVF. PCOS&OSA patients also demonstrated lower anti-Müllerian hormone (AMH) levels and higher rates of insulin resistance, hyperlipidemia, and metabolic syndrome. These metabolic disturbances associated with OSA likely contribute to poorer IVF outcomes in PCOS patients.</p><p><strong>Conclusion: </strong>Our findings demonstrate a negative association between OSA and IVF outcomes in PCOS patients, particularly regarding clinical pregnancy and live birth rates. Reproductive endocrine and metabolic disorders appear to play a critical role in these adverse outcomes.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"237"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586182","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}
Hawal Lateef Fateh, Dyari H Ahmed, Jamal Hallajzadeh, Jalal Moludi
{"title":"Association between body roundness index (BRI) and sleep quality: a cross sectional study from 2022 to 2024.","authors":"Hawal Lateef Fateh, Dyari H Ahmed, Jamal Hallajzadeh, Jalal Moludi","doi":"10.1007/s11325-025-03392-2","DOIUrl":"10.1007/s11325-025-03392-2","url":null,"abstract":"<p><strong>Background: </strong>Sleep is essential for mental and physical health, significantly impacting overall quality of life. The Body Roundness Index (BRI) has emerged as a novel measure that captures body fat distribution more accurately than traditional indices such as BMI. Thus, aim of this study is to find the relationship between BRI and sleep quality.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at the Nutrition and Obesity Awareness Center, Xzmat Medical City, Kurdistan Region, Iraq, from 2022 to 2024. A total of 4,813 participants aged 18-65 were recruited. BRI was calculated using standard equations incorporating height, weight, and waist circumference. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and wearable actigraphy devices. Statistical analysis was performed using SPSS version 26.0, with logistic regression models used to determine the association between BRI and sleep quality, adjusting for potential confounders.</p><p><strong>Results: </strong>Participants were categorized into BRI tertiles: T1 (< 3.19), T2 (3.20-6.01), and T3 (> 6.02). Higher BRI was associated with poorer sleep quality, shorter sleep duration, increased sleep disturbances, longer sleep latency, and greater day dysfunction due to sleepiness. Adequate sleep quality significantly decreased from 75.6% in T1 to 23.4% in T3 (p < 0.001). Logistic regression revealed that higher BRI tertiles were significantly associated with increased odds of inadequate sleep quality (OR for T3: 11.75, 95% CI: 10.13-13.60, p < 0.001) even after adjusting for confounders.</p><p><strong>Conclusion: </strong>The study demonstrates a significant association between higher BRI and poorer sleep quality among Kurdish adults. These findings underscore the importance of considering body fat distribution in addressing sleep health. Public health interventions targeting weight management may also improve sleep quality and overall health in this population.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"233"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577623","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}
Mariana Tavares, Maria João Lúcio, Joana Borges, Filipa Carriço, Maria José Guimarães, Marta Drummond
{"title":"The impact of obstructive sleep apnea and the prognostic role of level III polysomnography at the onset of amyotrophic lateral sclerosis.","authors":"Mariana Tavares, Maria João Lúcio, Joana Borges, Filipa Carriço, Maria José Guimarães, Marta Drummond","doi":"10.1007/s11325-025-03410-3","DOIUrl":"10.1007/s11325-025-03410-3","url":null,"abstract":"<p><strong>Purpose: </strong>Sleep disturbances are considered an early manifestation of Amyotrophic lateral sclerosis (ALS). However, sleep-disordered breathing (SDB) in ALS remains underexplored. The primary outcome of this study is to describe the clinical, functional and polygraphic characteristics of ALS patients with baseline SDB and to compare those with and without obstructive sleep apnea (OSA) in level III polysomnography (PSG) at diagnosis. Secondary outcomes included identification of baseline factors predictive of non-invasive ventilation (NIV) initiation/death during follow-up and assessing the role of level III PSG performed at the initial clinical evaluation in ALS prognosis regarding timing to NIV initiation and death.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 74 patients between September 2023 and September 2024. For the primary outcome, only patients that exhibited baseline SDB were included (45 patients). The population (45) was divided into 2 groups: Group 1 (n = 26; obstructive apnea/hypopnea index ≥ 5) and Group 2 (n = 19; obstructive apnea/hypopnea index < 5). For the secondary outcomes, all 74 patients were included regardless of sleep events.</p><p><strong>Results: </strong>Patients with OSA had a higher baseline body mass index (p = 0.03) and lower nocturnal average oxygen saturation (p = 0.03). A lower forced vital capacity (p < 0.001) and higher transcutaneous carbon dioxide (p = 0.005) at baseline were predictive of timing to NIV initiation.</p><p><strong>Conclusions: </strong>Our study highlights the importance of performing respiratory functional testing and transcutaneous carbon dioxide assessment in ALS prognosis, regarding timing to NIV initiation. Although level III PSG is vital in the diagnosis and treatment of SDB, further studies are needed to clarify its role at disease onset and identify additional potentially predictors of timing to NIV initiation/death in ALS patients.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"235"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586184","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}
Christian Schaaff, Tejal H Patel, Dania Alazawi, Evan Thomas, Mary H Kress, Nicholas R Lenze, Jeffrey J Stanley, Paul T Hoff
{"title":"Evaluating outcomes of hyoid suspension combined with other upper airway surgery for obstructive sleep apnea.","authors":"Christian Schaaff, Tejal H Patel, Dania Alazawi, Evan Thomas, Mary H Kress, Nicholas R Lenze, Jeffrey J Stanley, Paul T Hoff","doi":"10.1007/s11325-025-03370-8","DOIUrl":"10.1007/s11325-025-03370-8","url":null,"abstract":"","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"234"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12234598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577624","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":"Respiratory events and sleep structure of children suffering from congenital central hypoventilation syndrome under assisted ventilation: a cross-sectional descriptive study.","authors":"Benjamin Dudoignon, Rodrigue Fikiri Bavurhe, Fatima Benterki, Plamen Bokov, Christophe Delclaux","doi":"10.1007/s11325-025-03402-3","DOIUrl":"10.1007/s11325-025-03402-3","url":null,"abstract":"<p><strong>Purpose: </strong>It has been reported that children with congenital central hypoventilation syndrome (CCHS) are at risk of sleep disturbances. The objectives of our cross-sectional study were to describe nighttime assisted ventilation in children with CCHS, to assess whether children follow the backup rate of home ventilators, whether sleep structure is altered and whether sleep study and PCO<sub>2</sub> monitoring on a systematic basis are useful.</p><p><strong>Methods: </strong>Children followed up for annual evaluation, including polysomnography under assisted ventilation (pressure-controlled ventilation with a mask or tracheostomy) with transcutaneous PCO<sub>2</sub> recording, were enrolled between 2022 and 2024.</p><p><strong>Results: </strong>Thirty-eight children (median age [25th; 75th percentiles]: 7.9 years [4.5; 11.1], 18 girls) were enrolled. The observed respiratory rate was significantly lower than the backup rate of the ventilator due to central apneas with upper airway closure under mask ventilation in both NREM and REM sleep during assisted ventilation with mild hypocapnia (nighttime PCO<sub>2</sub>: 33.2 mmHg [28.9; 42.1]). A normal sleep structure was found regardless of the CCHS mutations (sleep efficiency: 92% [81; 97]; N3 z-score: -0.58 [-1.35; -0.12]; REM z-score: -0.04 [-1.07; 1.54]) and regardless of the interface used for assisted ventilation (nasal mask, n = 15; facial mask, n = 16; tracheostomy, n = 7). Following the evaluation, changes in assisted ventilation settings were made for 28/38 children (74%; 95% confidence interval: 67-87).</p><p><strong>Conclusion: </strong>When the assisted ventilation is set to ensure mild hyperventilation due to the backup respiratory rate, a normal sleep structure is found, and assisted ventilation settings are often modified based on transcutaneous PCO<sub>2</sub> measurement.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"232"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562656","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}