The Journal of clinical endocrinology and metabolism最新文献

{"title":"Letter to the editor from Chertok Shacham: \"Approach to the patient with thyroid storm\".","authors":"Elena Chertok Shacham","doi":"10.1210/clinem/dgag304","DOIUrl":"10.1210/clinem/dgag304","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"e2441-e2442"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633444","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":"US patterns in clinical islet autoantibody ordering and results show key differences after teplizumab regulatory approval.","authors":"Sanjay B Dixit, Marco Marcelli, Carmen Tong, Zhen Chen, Lance A Bare, Emily K Sims","doi":"10.1210/clinem/dgag200","DOIUrl":"10.1210/clinem/dgag200","url":null,"abstract":"<p><strong>Context: </strong>Recent advances in disease-modifying therapies have increased emphasis on islet autoantibody screening to detect type 1 diabetes before clinical onset.</p><p><strong>Objective: </strong>Test impacts of teplizumab approval on real-world US autoantibody ordering patterns.</p><p><strong>Methods: </strong>Testing for biochemical and islet cytoplasmic autoantibodies in 28 206 nondiabetic individuals (glycated hemoglobin < 6.5%) before (\"PRE,\" November 2017-November 2018) vs after (\"POST,\" November 2022-November 2023) teplizumab approval was analyzed. Results were stratified by age (<20 vs ≥20 years) and glycemia (normoglycemic vs dysglycemic).</p><p><strong>Results: </strong>Islet autoantibody testing increased 1.9-fold from the PRE to POST period (P < .0001 vs other testing), especially in adults and dysglycemic children. Overall testing was more common in adults, and tested adults were more commonly dysglycemic than children. In the POST period, providers were more likely to order 3/4 or 4/4 available biochemical antibodies. For both periods, most orders in normoglycemic individuals came from primary care providers, whereas endocrinologists ordered most testing in dysglycemic groups. Provider-level testing was typically low volume in both periods, with providers ordering 1 to 3 tests/year, accounting for >80% of orders. Among dysglycemic children, multiple antibody positivity in the POST period was 35.6% higher than expected compared to the PRE period (P = .0003).</p><p><strong>Conclusion: </strong>Islet autoantibody testing in nondiabetic individuals increased following teplizumab approval, primarily among adults and dysglycemic children, suggesting that these groups allow for the easiest implementation of screening through clinical care. Despite shifts toward guideline-concordant testing, screening of normoglycemic children by primary care providers remains limited, highlighting the need to further integrate this testing into clinical care pathways.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"3209-3216"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950707","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":"Glucagon-like peptide-1 receptor agonist exposure and malignancy risk in patients with endogenous Cushing's syndrome.","authors":"Idit Dotan, Tzipora Shochat, Shiri Kushnir, Talia Diker-Cohen, Yaron Rudman, Martin Reincke, Maria Fleseriu, Amit Akirov","doi":"10.1210/clinem/dgag223","DOIUrl":"10.1210/clinem/dgag223","url":null,"abstract":"<p><strong>Context: </strong>Patients with endogenous Cushing's syndrome (CS) have increased malignancy risk. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are increasingly used for diabetes and obesity, yet their oncologic outcomes in CS remains limited.</p><p><strong>Objective: </strong>The objective of this study was to evaluate the association between GLP-1RA exposure and incident malignancy in patients with CS.</p><p><strong>Methods: </strong>This was a nationwide cohort study using the Clalit Health Services database in Israel, including patients with endogenous CS diagnosed between 2000 and 2023. Patients with adrenal carcinoma or ectopic CS were excluded. Glucagon-like peptide-1 receptor agonist exposure was defined as ≥3 prescription dispensations and modeled as a time-varying variable. The main outcome was incident malignancy following a CS diagnosis in GLP-1RA-exposed vs nonexposed patients. Sensitivity analyses included a 12-month lag-period approach and stratification by remission.</p><p><strong>Results: </strong>The cohort included 609 patients with CS (mean age ± SD, 48.05 ± 17.17 years; 65.02% women). During a mean follow-up of 14.7 ± 6.4 years, 116 patients developed cancer and 141 died. Overall, 137 patients (22.5%) received GLP-1RA therapy. A total of 8159.69 nonexposed and 795.88 exposed person-years were accrued, with cancer incidence rates of 12.50 and 17.59 per 1000 person-years, respectively. In time-varying competing risk analysis, GLP-1RA exposure was not associated with increased malignancy risk (hazard ratio [HR] 1.65; 95% CI, 0.94-2.90), with consistent results after adjustment (adjusted HR 1.22; 95% CI, 0.45-3.29). Findings were similar in lag-period and remission-stratified analyses.</p><p><strong>Conclusion: </strong>In this nationwide cohort of patients with CS, GLP-1RA exposure was not associated with altered malignancy risk. These findings provide reassuring evidence regarding the oncologic safety of GLP-1RAs in this high-risk population.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"3102-3110"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148153185","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":"Determinants of quality of life in patients with immune checkpoint inhibitor-induced secondary adrenal insufficiency.","authors":"Justine Herndon, Yana Hleibiehova, Sara J Achenbach, Alexandra N Bancos, Elizabeth J Atkinson, Diane Donegan, Irina Bancos","doi":"10.1210/clinem/dgag219","DOIUrl":"10.1210/clinem/dgag219","url":null,"abstract":"<p><strong>Context: </strong>Limited data are available on quality of life (QoL) and adrenal crises in patients with immune checkpoint inhibitor-induced secondary adrenal insufficiency (ICI-SAI).</p><p><strong>Objective: </strong>To (1) characterize the presentation, management, and outcomes of patients with ICI-SAI; (2) compare outcomes of ICI-SAI with other etiologies of secondary adrenal insufficiency (oSAI); and (3) identify variables associated with QoL and adrenal crisis.</p><p><strong>Methods: </strong>In this single-center cross-sectional study, adults with ICI-SAI or oSAI (2018-2025) completed questionnaires assessing symptoms, management, adrenal crises, and the Addison's Disease-Specific QoL survey (AddiQoL); outcomes included AddiQoL score and adrenal crisis events.</p><p><strong>Results: </strong>Patients with ICI-SAI (n = 109) were older (median age 66 vs 60 years), more often women (59% vs 43%), and more frequently diagnosed within 1 year of symptom onset (88% vs 42%, P < .001), compared to patients with oSAI (n = 139). Patients with ICI-SAI had higher AddiQoL scores (median 87 vs 85, P = .020). In a multivariable analysis of age, sex, glucocorticoid dose and type, insurance support, and duration of SAI, ICI-SAI remained independently associated with higher AddiQoL (estimate 5.4, P = .010). The prevalence of reported adrenal crises within the prior year was similar between groups (15% vs 14%, P = .782). In a multivariable analysis, higher AddiQoL scores were independently associated with lower odds of adrenal crisis (OR 0.57; 95% CI 0.42-0.76).</p><p><strong>Conclusion: </strong>Patients with ICI-SAI report better QoL compared with patients with other causes of SAI, despite similar adrenal crisis rates. These differences may be related to earlier diagnosis and differing clinical contexts, underscoring the importance of timeline recognition and patient-centered management.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"e2369-e2381"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059528","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":"Dysregulation of glycogen metabolism in cardiomyopathy caused by glycogenin-1 (GYG1) missense variants.","authors":"Kittichate Visuttijai, Carola Hedberg-Oldfors, Oscar Braun, Elisabet Englund, Emma Glamuzina, Clinton Turner, Kristina Vukusic, Joakim Sandstedt, Göran Dellgren, Kristjan Karason, Anders Oldfors","doi":"10.1210/clinem/dgag212","DOIUrl":"10.1210/clinem/dgag212","url":null,"abstract":"<p><strong>Context: </strong>Glycogen storage diseases are inherited disorders of glycogen metabolism and are commonly associated with hypoglycemia, hepatic dysfunction, or skeletal and cardiac myopathy, depending on the affected enzyme. Glycogen storage disease type 15 (GSD15) is caused by pathogenic variants in GYG1, which encodes glycogenin-1, the autoglucosylating primer required for glycogen synthesis. GSD15 is characterized by cardiomyopathy and storage of abnormal glycogen and polyglucosan in cardiomyocytes.</p><p><strong>Objective: </strong>To understand the pathobiology of GSD15, we investigated the storage material in heart explants from 2 previously reported patients and described a new case of GSD15.</p><p><strong>Methods: </strong>The characteristic storage material was investigated using laser capture microdissection followed by quantitative mass spectrometry (MS) and immunohistochemistry comparing differentially abundant proteins in the storage material with normal-appearing cytoplasmic regions from the same patient. Global protein dysregulation in GSD15 was assessed by quantitative MS of whole-myocardial tissue samples from patients and normal controls.</p><p><strong>Results: </strong>The storage material was enriched in proteins involved in glycogen metabolism, including glycogen synthase, UDP-glucose pyrophosphorylase 2, glycogenin-1, glycogen phosphorylase, and glycogen debranching enzyme. Sequestosome 1 (p62) and desmin were also enriched, without evidence of increased autophagocytosis. Whole-tissue analyses revealed upregulation of cardiomyopathy-associated biomarkers and downregulation of mitochondrial proteins, suggesting impaired energy metabolism contributing to congestive heart failure.</p><p><strong>Conclusion: </strong>In GSD15, storage of abnormal glycogen in cardiomyocytes is associated with enrichment of specific proteins involved in glycogen metabolism, contributing to dysregulation of glycogen turnover. This dysregulation results in polyglucosan accumulation, disruption of sarcomeric and mitochondrial architecture, and progressive fibrosis. No disease-modifying therapy currently exists for GSD15; future strategies based on substrate reduction, enhancement of autophagy, or gene therapy require further investigation.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"3181-3195"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985087","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":"Correction to: \"Ersodetug for Refractory Hypoglycemia Due to Malignant Insulin-Secreting Tumors\".","authors":"","doi":"10.1210/clinem/dgag360","DOIUrl":"10.1210/clinem/dgag360","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"e2448"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877114","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":"Longitudinal circulating procollagen-markers PRO-C1 and PRO-C2 reflect pubertal growth spurt in healthy adolescents.","authors":"Li Juel Mortensen, Yi He, Martin Blomberg Jensen, Jørgen Holm Petersen, Hanne Frederiksen, Stine Agergaard Holmboe, Anne-Christine Bay-Jensen, Anders Juul","doi":"10.1210/clinem/dgag203","DOIUrl":"10.1210/clinem/dgag203","url":null,"abstract":"<p><strong>Introduction: </strong>Epiphyseal growth plate development is stimulated by GH and IGF-I. Serum IGF-I is applied as an efficacy and safety marker, monitoring growth in short GH-treated children. However, IGF-I offers poor guidance to clinicians, especially in children without growth hormone deficiency. Thus, novel biomarkers reflecting endogenous and GH-induced linear growth are needed. We evaluated the association between linear growth during pubertal transition and circulating levels of procollagen type I and II (PRO-C1 and PRO-C2, respectively).</p><p><strong>Methods: </strong>We included 1700 serum samples from 213 healthy children and adolescents (51% female), ages 5-16 years, from the prospective longitudinal Copenhagen Puberty Study, followed between 2006 and 2014. We assessed peak height velocity (PHV), pubertal development, serum IGF-I, sex steroids (LC-MS/MS), and PRO-C1 and PRO-C2 (immunoassays). Additionally, PRO-C1 and PRO-C2 were determined in short children born small for gestational age before and after 12 months of GH treatment.</p><p><strong>Results: </strong>Age-, sex-, and puberty-related reference intervals for PRO-C1 and PRO-C2 concentrations were established. PRO-C1 and PRO-C2 increased significantly with age and pubertal development (Tanner breast stage 1-3, P < .0001; Tanner genital stage 1-4, P < .001). During growth spurt, PRO-C1 and PRO-C2 were associated with increased height SD score (SDS) and height velocity, both reached peak concentrations at the time of PHV, earlier than IGF-I and sex-steroids, followed by a rapid decline. In GH-treated prepubertal children, PRO-C1 increased from 0.70 to 3.78 SDS (P < .0001) and PRO-C2 from -2.07 to 0.69 SDS (P = .0055).</p><p><strong>Conclusion: </strong>We present longitudinal changes in PRO-C1 and PRO-C2 in normal and disordered growth, suggesting PRO-C1 and PRO-C2 as potential biomarkers of endogenous and GH-induced linear growth.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"3250-3261"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937255","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":"Correction to: \"A systematic review supporting the Endocrine Society clinical practice guidelines on central precocious puberty\".","authors":"","doi":"10.1210/clinem/dgag320","DOIUrl":"10.1210/clinem/dgag320","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":"e2452"},"PeriodicalIF":5.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709449","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":"Waist circumference outperforms cardiometabolic indices for identifying hypogonadism in Klinefelter Syndrome.","authors":"Andrea Graziani, Matteo Nardin, Giuseppe Grande, Riccardo Maria Pollis, Andrea Delbarba, Antonella Di Mambro, Riccardo Selice, Carlo Cappelli, Gian Paolo Fadini, Alberto Ferlin","doi":"10.1210/clinem/dgag426","DOIUrl":"https://doi.org/10.1210/clinem/dgag426","url":null,"abstract":"<p><strong>Context: </strong>Klinefelter syndrome (KS) is characterized by primary hypogonadism and increased cardiometabolic risk. The utility of cardiometabolic indices remains unclear.</p><p><strong>Objective: </strong>To evaluate whether anthropometric and cardiometabolic indices provide incremental value beyond age for identifying hypogonadism in men with KS.</p><p><strong>Design and setting: </strong>Retrospective cross-sectional cohort study at a tertiary referral center.</p><p><strong>Patients: </strong>580 patients with KS were evaluated. Analyses assessing biochemical hypogonadism were restricted to untreated patients with available calculated free testosterone (cFT) concentrations (n = 328).</p><p><strong>Main outcome measures: </strong>Biochemical androgen deficiency was defined as cFT <0.220 nmol/L. Discriminative performance and incremental value of WC, LAP, TyG, and HOMA-IR were assessed using logistic regression, ROC analyses, reclassification analyses, decision curve analysis (DCA), and bootstrap validation.</p><p><strong>Results: </strong>Among untreated patients, 64.9% had biochemical hypogonadism. WC showed the highest discriminative ability (AUC 0.747) and slightly greater discrimination than cardiometabolic indices including LAP (AUC 0.704), HOMA-IR (AUC 0.681), and TyG index (AUC 0.612). In multivariable analyses adjusted for age, WC remained independently associated with hypogonadism (OR 1.05 per cm; p < 0.001). Age alone yielded an AUC of 0.744, which increased to 0.796 after addition of WC (p = 0.007), whereas addition of LAP resulted in only modest improvement (AUC 0.758). Addition of WC improved reclassification beyond age. DCA demonstrated consistent gains in clinical net benefit with inclusion of WC, whereas composite cardiometabolic indices provided limited additional utility.</p><p><strong>Conclusions: </strong>In KS, WC provides incremental value beyond age for identifying hypogonadism, whereas composite cardiometabolic indices offer limited additional discriminatory value. These findings suggest that simple anthropometric assessment may support endocrine-metabolic stratification in KS.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187783","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":"Genotype-phenotype correlation in partial combined 17α-hydroxylase/17,20-lyase deficiency: functional characterization of CYP17A1 variants in ten 46,XY patients.","authors":"Yaqing Cao, Lin Lu, Ming Li, Anli Tong, Shi Chen, Wei Zhang, Chenjie Guo, Chuang Wang, Xi Wang, Jiangfeng Mao, Xueyan Wu, Min Nie","doi":"10.1210/clinem/dgag363","DOIUrl":"https://doi.org/10.1210/clinem/dgag363","url":null,"abstract":"<p><strong>Background: </strong>Partial combined 17α-hydroxylase/17,20-lyase deficiency (PC-17OHD) is a rare 17OHD subtype with residual 17α-hydroxylase and 17,20-lyase activities. In 46,XY individuals, genital virilization is highly variable, and genotype-phenotype correlations remain poorly defined.</p><p><strong>Objective: </strong>To characterize the clinical and endocrine spectrum of 46,XY PC-17OHD, functionally validate uncharacterized CYP17A1 variants, and establish genotype-phenotype correlations.</p><p><strong>Methods: </strong>We enrolled ten 46,XY PC-17OHD patients from 9 families. Clinical phenotypes were characterized, and long-read CYP17A1 sequencing was performed. Splicing effects and enzyme activities were evaluated by minigene assays and HEK293T functional studies, respectively. Variants were classified according to ACMG guidelines.</p><p><strong>Results: </strong>All patients presented with the triad of elevated mineralocorticoid precursors, generalized androgen suppression, and preserved cortisol levels. Median age at diagnosis was 17.5 years, with hypertension in 30% (3/10) and hypokalemia in 20% (2/10). Ten distinct variants were identified, including 2 novel splice-site variants (c.666+2T>C, c.1243+2T>G). Haplotype analysis revealed a shared identical haplotype among 5 patients carrying the c.1263G>A allele, indicating a Chinese founder effect. Four uncharacterized variants showed residual 17α-hydroxylase/17,20-lyase activities: p.Trp499Ter (11%/6.3%), p.Ala448Val (22.5%/14.2%), p.Leu433Ser (25.9%/21.7%), and c.666+2T>C (28.9%/22.6%). Notably, 2 patients with identical genotypes (c.985_987delinsAA/c.1263G>A) exhibited drastically divergent phenotypes-hypospadias (raised male) vs complete female external genitalia (raised female)-indicating that genotype alone cannot accurately predict clinical phenotypes in PC-17OHD.</p><p><strong>Conclusions: </strong>Residual CYP17A1 activity largely determines genital masculinization, while marked phenotypic heterogeneity among patients with identical genotypes indicates that genotype alone cannot fully predict clinical manifestations. These findings improve molecular diagnosis and individualized care for this disorder.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":5.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187757","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}