Acta medica Indonesiana最新文献

{"title":"Acute Respiratory Distress Syndrome and Corticosteroids: Reconciling Conflicting Evidence.","authors":"Telila Mesfin Tadesse, Olifan Getachew Wakjira","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute respiratory distress syndrome (ARDS) is a life-threatening form of acute inflammatory lung injury in which loss of alveolar-capillary membrane integrity produces protein-rich pulmonary edema, refractory hypoxemia, and reduced lung compliance, typically within 6-72 hours of a precipitating insult. The 2012 Berlin criteria defined ARDS by acute onset within one week of a known insult, bilateral opacities not fully explained by effusion, atelectasis, or cardiac failure, and a PaO₂/FiO₂ ratio of 300 mmHg or less with a minimum PEEP of 5 cmH₂O. The 2023 global definition expands this framework by accepting SpO₂/FiO₂ of 315 or less when SpO₂ is 97% or below, including patients supported with high-flow nasal oxygen at 30 L/min or more, permitting thoracic ultrasonography as an alternative imaging modality, and waiving the PEEP requirement in resource-limited settings. These revisions are particularly relevant to practice in low- and middle-income countries, where arterial blood gas analysis and mechanical ventilation may be unavailable. Management remains anchored in lung-protective ventilation, conservative fluid strategy, and prone positioning. Glucocorticoids remain the most contested pharmacological intervention: evidence from dexamethasone trials in ARDS and in COVID-19 suggests benefit in selected populations, yet questions persist regarding optimal agent, dose, timing relative to symptom onset, duration, the influence of ARDS subphenotypes, and the risk of secondary infection and neuromuscular weakness. This narrative review summarizes the pathophysiology, evolving diagnostic criteria, imaging findings, and current evidence on corticosteroid therapy, and considers how hyperinflammatory and hypoinflammatory subphenotypes may guide future trial design and individualized treatment.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"470-478"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126421","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":"Plasma Galectin-3 as a Predictor of Cardiac Dysfunction in Patients Undergoing Doxorubicin Chemotherapy: A Prospective Cohort Study.","authors":"Mohammad Bhukkar Adil Sjam, Eka Ginanjar, Andhika Rachman, Kuntjoro Harimurti","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Doxorubicin is widely used in chemotherapy in oncology. However, it is associated with dose-dependent cardiotoxicity. Thus, early detection of cardiac dysfunction is crucial to preventing heart failure. This study aimed to evaluate plasma Galectin-3 levels, a biomarker of fibrosis and inflammation, as a predictive biomarker of cardiac dysfunction in cancer patients receiving doxorubicin chemotherapy.</p><p><strong>Methods: </strong>This observational prospective cohort study was conducted from June 2024 to February 2025 at the Integrated Cardiac Service of Cipto Mangunkusumo National General Hospital (RSCM) and Dharmais Cancer Hospital in Jakarta. Fifty-five patients completed plasma Galectin-3 and echocardiographic assessments at three time points: pre-chemotherapy, post-chemotherapy cycle 2, and post-cycle 4. Cardiac dysfunction was defined by a decrease in LVEF ≥ 10% or a GLS reduction ≥ 15%.</p><p><strong>Results: </strong>No cardiac dysfunction was observed pre-chemotherapy, but 34.5% and 50.9% of patients developed dysfunction after cycles 2 and 4, respectively. Galectin-3 levels increased significantly post-cycle 4 (mean: 46.89 ± 18.34 ng/mL; p < 0.05). Receiver operating characteristic analysis showed that post-cycle 4 Galectin-3 levels predicted cardiac dysfunction with an area under the curve of 0.767 (95% CI: 0.638-0.897; p = 0.001), 92.9% sensitivity, and 59.3% specificity at a cut-off of ≥ 37.28 ng/mL. Significant correlations were observed between Galectin-3 and GLS (r = 0.54; p = 0.00) but not LVEF.</p><p><strong>Conclusion: </strong>Plasma Galectin-3 levels, particularly after chemotherapy cycle 4, are sensitive biomarkers for detecting cardiac dysfunction in patients receiving doxorubicin. Integrating Galectin-3 with GLS may provide better detection of subclinical cardiotoxicity. Additionally, monitoring Galectin-3 levels may help identify high-risk patients requiring cardioprotective strategies.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"354-361"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126203","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":"Metabolic Imprinting and Intergenerational Cardiometabolic Risk in Human Populations: Implications for Preconception and Maternal Health.","authors":"Herry Herman, Davin Takaryanto","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The global rise in obesity and type 2 diabetes has been too rapid to be explained by genetic change alone, which points to developmental and environmental contributions to cardiometabolic risk. Metabolic conditions during sensitive windows, particularly preconception, pregnancy, and early postnatal life, appear to shape long-term metabolic regulation and disease susceptibility. In this narrative review, we synthesise human cohort studies, natural experiments, and experimental models, and we translate the resulting evidence into clinical and public health practice. Across human cohorts, maternal metabolic disturbances such as gestational diabetes and obesity are consistently associated with higher offspring risk of obesity, insulin resistance, and impaired glucose regulation, with adjusted estimates commonly between 1.4- and 2.0-fold. Epigenome-wide studies report differential DNA methylation in insulin-signalling, adipogenic, and energy-homeostasis pathways, lending biological plausibility, and experimental models show that transient early perturbations can durably alter metabolic physiology even after diet is later normalised. We read these converging findings as metabolic imprinting: relatively stable but potentially modifiable regulatory states, rather than deterministic germline inheritance. Set against current guidance from the ADA, FIGO, WHO, USPSTF, and ACOG, the evidence supports concrete actions across the reproductive life course, including preconception screening and weight optimisation, gestational diabetes screening and glycaemic management, appropriate gestational weight gain, and postpartum and offspring follow-up. Preconception and maternal metabolic health therefore emerge as practical, high-value targets for reducing the long-term cardiometabolic burden.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"458-464"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126396","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 Relationship Between Serum Interleukin-31 Levels and Chronic Kidney Disease-Associated Pruritus in Patients Undergoing Hemodialysis.","authors":"I Gede Yasa Asmara, Lili Legiawati, Alvina Widhani, Pringgodigdo Nugroho, Arif Mansjoer, Hamzah Shatri, Imam Subekti, Maruhum Bonar Hasiholan Marbun","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease-associated pruritus (CKD-aP) has been linked to immune dysregulation, including elevated interleukin-31 (IL-31) levels. However, the limited research on serum IL-31 levels in patients with CKD-aP has yielded inconsistent findings due to heterogeneous patient populations and varied assessment methods. This study elucidated the relationship between serum IL-31 levels, CKD-aP, and its severity in patients undergoing routine hemodialysis (HD).</p><p><strong>Methods: </strong>This cross-sectional observational study included patients undergoing HD at Dr. Cipto Mangunkusumo Hospital between April and May 2024. Pruritus was assessed using the visual analog scale (VAS) and 5-D itch scale. Serum IL-31 levels were measured using enzyme-linked immunosorbent assay. Bivariate and multivariate analyses were performed.</p><p><strong>Results: </strong>Among 70 participants (54.3% male; median age, 52.5 years; median HD vintage, 57 months), 35 experienced CKD-aP. The median VAS and 5-D itch scale scores were 5.3 and 13, respectively, indicating moderate itching severity. Patients with CKD-aP had significantly higher serum IL-31 levels than those without CKD-aP (p = 0.05). Receiver operating characteristic analysis showed modest discriminatory ability (area under the curve = 0.64), with a sensitivity of 51.4% and specificity of 74.3% at a cut-off of 173 pg/mL. A significant association was observed between serum IL-31 levels and CKD-aP (p = 0.03). However, no significant correlation was found between IL-31 levels and pruritus severity as measured by the VAS (p = 0.79) or 5-D itch scale (p = 0.44).</p><p><strong>Conclusion: </strong>Serum IL-31 levels were higher in patients with CKD-aP, suggesting its potential association with pruritus. However, its modest diagnostic performance and lack of correlation with itch severity indicate that IL-31 is unlikely to serve as a standalone clinical biomarker and may have a limited role as an adjunctive or exploratory marker.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"344-353"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126193","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":"Multiple Cavitary Lung Lesions in ANCA-Negative Small Vessel Vasculitis: A Case Report.","authors":"Anshari Saifuddin Hasibuan, Rizqi Najla Humaira, Sukamto Koesnoe, Evy Yunihastuti, Alvina Widhani, Suzy Maria, Bramantya Wicaksana, Cleopas Martin Rumende, Pringgodigdo Nugroho","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Multiple cavitary lung lesions present a diagnostic challenge, with a broad differential diagnosis, including infectious, malignant, and autoimmune etiologies. ANCA-associated vasculitis (AAV), particularly in its seronegative form, is a rare yet important cause that is frequently overlooked, as pulmonary involvement is uncommon and its manifestations can closely mimic infection or malignancy. We report a case of a 30-year-old male who presented with a three-week history of dyspnea and hemoptysis, and a background of membranoproliferative glomerulonephritis confirmed by renal biopsy three months prior, consistent with pauci-immune glomerulonephritis. Chest radiography and contrast-enhanced CT revealed multiple bilateral cavitary lung lesions with air-fluid levels, micronodules, and centrilobular ground-glass opacities. Extensive infectious workup, including sputum and bronchoalveolar lavage cultures, acid-fast bacilli smear, GeneXpert, and fungal studies, was negative. Cytological examination excluded malignancy. Both p-ANCA and c-ANCA were negative. Based on the 2022 ACR/EULAR classification criteria, a diagnosis of ANCA-negative microscopic polyangiitis (MPA) was established, with a total score of +6 derived from imaging findings consistent with interstitial lung disease and histopathological evidence of pauci-immune glomerulonephritis in a prior renal biopsy. Immunosuppressive therapy with methylprednisolone and mycophenolate sodium was initiated, resulting in complete radiological resolution of all cavitary lesions within two months. This case highlights that cavitary lung lesions may represent a rare pulmonary manifestation of ANCA-negative MPA. A negative ANCA result should not exclude vasculitis when clinical suspicion is high, and tissue biopsy remains essential for definitive diagnosis in atypical presentations.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"450-457"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126373","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":"Geriatric Assessment-Guided Care for Older Adults with Cancer: A Clinical Practice Review.","authors":"Aulia Rizka, Czeresna Heriawan Soejono, Findy Prasetyawaty, Rahmat Cahyanur","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cancer is a growing global health burden among older adults, with incidence rising most rapidly in low- and middle-income countries. Chronological age alone poorly reflects physiological reserve, comorbidity, frailty, and functional status, which together determine how well an older patient tolerates cancer therapy. This clinical practice review summarizes contemporary geriatric oncology approaches based on international consensus guidelines and current literature. Comprehensive geriatric assessment (CGA), evaluating functional status, comorbidity, falls, cognition, mood, nutrition, polypharmacy, and social support, outperforms performance status alone in predicting chemotherapy toxicity, treatment completion, functional decline, and mortality. Beyond prognostication, randomized trials have shown that geriatric assessment-guided management reduces severe chemotherapy toxicity and improves communication about ageing-related concerns without compromising survival, which is the strongest argument for embedding assessment into routine oncology care. Validated brief screening tools such as the Geriatric-8 (G8) can identify patients who warrant full assessment, and chemotherapy toxicity calculators such as the Cancer and Aging Research Group and Chemotherapy Risk Assessment Scale for High-Age Patients scores improve risk estimation and support shared decision-making. Implementation remains the principal barrier in resource-limited settings, where geriatrician availability, clinic time, and reimbursement constrain routine use; pragmatic adaptations include nurse-led or self-administered assessment and stepwise screening pathways. Geriatric assessment-guided multidisciplinary care, adapted to local resources, should be regarded as the standard of care for older adults with cancer rather than an optional refinement, and deserves explicit incorporation into national cancer control planning.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"479-487"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126401","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":"From Biomarkers to Better Outcomes: Precision Medicine in Modern Internal Medicine.","authors":"Laurentius Aswin Pramono","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Internal medicine has traditionally focused on population-based approaches, utilizing diagnostic algorithms and treatment thresholds designed for the \"average\" patient. While beneficial, this one-size-fits-all model often leads to treatment failures. Precision medicine addresses this limitation by tailoring medical care to an individual's unique molecular, genetic, and clinical profile. Driven by advancements in multi-omics platforms, novel biomarkers, artificial intelligence (AI), and pharmacogenomics, precision medicine is transforming modern internal medicine from oncology into routine clinical practice. However, integrating these tools presents significant challenges, including high costs, lack of assay standardization, and the need for enhanced clinician literacy. Addressing these hurdles and ensuring equitable access are essential for translating biomarkers into better patient outcomes.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"323-325"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126423","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":"Thyroid Dysfunction and Its Association with Glycemic Control in Patients with Type 2 Diabetes Mellitus (T2DM): A Systematic Review and Meta-Analysis.","authors":"Calvin Sasongko, Melvin Andrean, Afif Faizi Assaffah","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus (DM) is characterized by metabolic anomalies, such as hyperglycemia, resulting from pancreatic β-cell dysfunction. In this context, thyroid dysfunction is the second most prevalent endocrine disorder after DM, and the interaction with glycemic control in type 2 diabetes mellitus (T2DM) remains a topic of debate. Therefore, this meta-analysis aimed to evaluate the impact of thyroid dysfunction on glycemic control in T2DM patients.</p><p><strong>Methods: </strong>A systematic literature search was conducted using ScienceDirect, the Cochrane Library, and PubMed up to December 8, 2024, under PRISMA guidelines. Research evaluating the effect of thyroid dysfunction on glycemic control in T2DM was included, with Glycated hemoglobin (HbA1c) levels as the primary outcome measure. Furthermore, research lacking relevant outcome data, full-text availability, or appropriate design was excluded. Data extraction and quality assessment were performed collaboratively, using the STROBE checklist. Meta-analysis was conducted using Review Manager 5.4, with mean difference (MD) and 95% confidence intervals (CI) as the effect size. Random-effects models were used to account for anticipated clinical heterogeneity, assessed by Higgins' I-squared (I²) statistic.</p><p><strong>Results: </strong>The initial search identified 1,397 research studies, with only 3 papers meeting the inclusion criteria. A pooled analysis reported a significant increase in HbA1c levels in T2DM patients with thyroid dysfunction (MD: 1.94, 95% CI: 0.73 - 3.14; p < 0.000001) with high heterogeneity (I² = 98%).</p><p><strong>Conclusion: </strong>Thyroid dysfunction was prevalent in T2DM patients and was associated with poorer glycemic control. Routine thyroid function assessment could also be integrated into T2DM management to optimize metabolic outcomes.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"378-385"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126176","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":"Progression of Secondary to Tertiary Hyperparathyroidism with a Coexisting Parathyroid Adenoma in Stage 3b Chronic Kidney Disease: A Case Report.","authors":"Reniza Puteri Yuliantari, Fauqa Arinil Aulia, Muhamad Robi'ul Fuadi, Ferdy Royland Marpaung, Jongky Hendro Prajitno, Yessy Puspitasari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tertiary hyperparathyroidism arises when prolonged secondary hyperparathyroidism progresses to autonomous parathyroid hormone secretion with persistent hypercalcemia, most often in chronic kidney disease. Diffuse or nodular multiglandular hyperplasia is the expected pathology; a discrete parathyroid adenoma arising within hyperplastic tissue is uncommon and may be overlooked when imaging is negative early in the disease course. A 60-year-old man with stage 3b chronic kidney disease and long-standing secondary hyperparathyroidism presented with recurrent hypercalcemia and severe vomiting. Laboratory evaluation confirmed elevated serum calcium and parathyroid hormone. Initial cervical ultrasonography showed no parathyroid enlargement, but repeat imaging demonstrated a progressively enlarging lesion adjacent to the left thyroid lobe. He underwent subtotal parathyroidectomy with bilateral cervical exploration. Histopathology showed multiglandular hyperplasia of the right parathyroid glands together with a distinct encapsulated adenoma arising within hyperplastic left parathyroid tissue. Serum calcium normalized postoperatively.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 3","pages":"436-441"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149126178","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":"Local Crude House Dust Extracts as a Substitute for Standardized House Dust Mite Extracts in Allergy Diagnostic and Immunotherapy.","authors":"Odhi Anggani, Feri Trihandoko, Almarissa Ajeng Prameshwara","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Allergic diseases are a significant global health issue commonly triggered by house dust mite (HDM) allergens. Standardized HDM extracts are currently widely used in allergen immunotherapy (AIT) and diagnostic tests. However, in several tropical regions, such as Indonesia, these standardized extracts were either expensive, difficult to obtain, or did not represent local allergen exposure. Previous studies examined crude house dust extracts (CHDE) derived from locally collected dust as a possible substitute because they reflected the complex allergenic and other composition of the local environment. Therefore, this study aimed to review the potential of Local Crude House Dust Extracts (LCHDE) as a regionally relevant substitute source of allergens for both diagnostic and therapeutic applications. LCHDE reflects real environmental exposure, including region-specific mite, fungal, and bacterial components, which could better represent local allergen profiles. LCHDE offered a promising, cost-effective, and contextually relevant option for allergy diagnosis in developing regions. However, its application in immunotherapy necessitated rigorous allergen profiling, and regional collaboration was crucial to establish a CHDE suitable for clinical use.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"58 2","pages":"314-322"},"PeriodicalIF":0.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410054","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}