The journal of allergy and clinical immunology. Global最新文献

{"title":"Aims and scope","authors":"","doi":"10.1016/S2772-8293(25)00137-7","DOIUrl":"10.1016/S2772-8293(25)00137-7","url":null,"abstract":"","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100536"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757301","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":"Long-term outcomes of dupilumab therapy in severe asthma: A retrospective, multicenter, real-world study","authors":"Carlo Mümmler MD ,&nbsp;Alexandra Lenoir MD ,&nbsp;Jeremias Götschke MD ,&nbsp;Michael Gerckens MD ,&nbsp;Merle Kaiser MD ,&nbsp;Moritz Kayser MD ,&nbsp;Nora Drick MD ,&nbsp;Hendrik Suhling MD ,&nbsp;Leonie Biener MD ,&nbsp;Carmen Pizarro MD ,&nbsp;Dirk Skowasch MD ,&nbsp;Nikolaus Kneidinger MD, PhD ,&nbsp;Jürgen Behr MD ,&nbsp;Katrin Milger MD","doi":"10.1016/j.jacig.2025.100533","DOIUrl":"10.1016/j.jacig.2025.100533","url":null,"abstract":"<div><h3>Background</h3><div>Dupilumab is an IL-4Rα antibody approved for treatment of severe asthma. Real-world data on the continuation and cessation patterns of dupilumab and long-term treatment efficacy are scarce.</div></div><div><h3>Objective</h3><div>We sought to analyze real-world, long-term treatment outcomes and to evaluate trajectories of patients continuing or discontinuing dupilumab therapy over a 3-year period.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective, real-world cohort study included patients with severe asthma who started dupilumab before March 2021. Data on asthma control, medication, lung function, and annualized exacerbation rates were collected at baseline and 3, 12, and 36 months after initiation of dupilumab therapy. Asthma remission was assessed at 12 months and 36 months after dupilumab initiation.</div></div><div><h3>Results</h3><div>Of 160 included patients, 95 patients (59%) continued dupilumab therapy for 36 months; 65 patients (41%) discontinued therapy after a median time of therapy of 8 months. Patients who continued dupilumab for 36 months had significant reductions in annual exacerbations (−1; <em>P</em> &lt; .0001) and oral corticosteroid dose (−5.5 mg/day; <em>P</em> &lt; .001) as well as significant improvements in asthma control (asthma control test +5; <em>P</em> &lt; .0001) and lung function (percent predicted of FEV₁ +7%; <em>P</em> &lt; .001) compared with baseline. Of patients who continued dupilumab, 30% achieved remission at 12 months, and 26% achieved remission at 36 months. Of the 65 patients who discontinued therapy, 55 switched to another antibody, and 10 did not receive further antibody treatment.</div></div><div><h3>Conclusions</h3><div>Dupilumab represents an effective long-term treatment option for patients with severe asthma, with sustained treatment effects up to 36 months. Importantly, a relevant proportion of patients achieved remission in this pretreated population.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100533"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780046","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":"Global trends and modifiable risk factors for atopic dermatitis incidence: Insights from GBD 2021","authors":"Yi Xiao MD ,&nbsp;Yuxuan Chen MPH ,&nbsp;Xu Yao MD ,&nbsp;Xiang Chen PhD ,&nbsp;Juan Su MD ,&nbsp;Minxue Shen PhD","doi":"10.1016/j.jacig.2025.100532","DOIUrl":"10.1016/j.jacig.2025.100532","url":null,"abstract":"<div><h3>Background</h3><div>Global patterns in atopic dermatitis (AD) incidence and their associations with modifiable risk factors remain unclear.</div></div><div><h3>Objective</h3><div>We sought to analyze global trends in AD incidence and identify associated socioeconomic, environmental, and lifestyle factors contributing to its global disparities and epidemics.</div></div><div><h3>Methods</h3><div>Data on AD in 204 countries and territories from 1990 to 2021 were extracted from the Global Burden of Diseases Study 2021. Age-standardized incidence rates (ASIRs) were calculated by sex and region. Socioeconomic development was measured by the Sociodemographic Index, a composite indicator of income, education, and fertility. Modifiable risk factors—including high body mass index, low physical activity, air pollution, and unhealthy diets—were quantified using summary exposure values, reflecting the population-level exposure to each risk. Dietary risks included diet high in sugar-sweetened beverages, processed meat, and sodium, and low intake of whole grains. Relationships between ASIRs and summary exposure values were independently assessed using restricted cubic spline regression.</div></div><div><h3>Results</h3><div>In 2021, 16.0 million new cases of AD were recorded globally, with the highest ASIRs in high-income Asia Pacific (474.8 per 100,000 population) and Western Europe (421.7 per 100,000 population) geographically and higher ASIRs in women. AD incidence strongly increased with socioeconomic development. Among modifiable risk factors, high body mass index, low physical activity, and nitrogen dioxide pollution formed positive associations with AD risk. Diets rich in sugar-sweetened beverages, processed meat, and sodium and diet low in whole grains further increased the risk.</div></div><div><h3>Conclusions</h3><div>Global disparities in AD incidence trends are closely linked to socioeconomic development and modifiable risk factors, including obesity, air pollution, and unhealthy diets. Addressing these factors through targeted public health policies is essential to mitigating the global burden of AD, particularly in industrialized and rapidly developing regions.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100532"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679315","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":"Dupilumab treatment and 3-dimensional bronchial tree changes in asthma-COPD overlap","authors":"Yoshiro Kai MD, PhD ,&nbsp;Yuichi Hishida RT","doi":"10.1016/j.jacig.2025.100530","DOIUrl":"10.1016/j.jacig.2025.100530","url":null,"abstract":"<div><div>Dupilumab treatment might be effective in improving lung function and exercise tolerance in patients with asthma–chronic obstructive pulmonary disease overlap. Three-dimensional bronchial tree visualization is a useful tool when assessing the functional response after treatment in these patients.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100530"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662808","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":"Guideline-based asthma treatment in Asia: Insights from a robust time-in-state model","authors":"Laura Huey Mien Lim MSc ,&nbsp;Yah Ru Juang BSc ,&nbsp;Mei Fong Liew MBBS, MRCP, MMed ,&nbsp;Ming Ren Toh MD ,&nbsp;Gerald Xuan Zhong Ng BSc ,&nbsp;Yvonne Qi Feng Wong BSc ,&nbsp;Juntian Wu MPH ,&nbsp;Wei Qiang See MPH ,&nbsp;Narayanan Ragavendran MBA ,&nbsp;Sean Shao Wei Lam PhD ,&nbsp;Anthony Chau Ang Yii MB, BChir, MA, MRCP ,&nbsp;David Hsien Yung Tan MBBS, MMed, FCFP, MBA ,&nbsp;Zafar Zafari MSc, PhD ,&nbsp;Mariko Siyue Koh MD ,&nbsp;Wenjia Chen PhD","doi":"10.1016/j.jacig.2025.100531","DOIUrl":"10.1016/j.jacig.2025.100531","url":null,"abstract":"<div><h3>Background</h3><div>The landscape of guideline-based asthma treatment in Asia remains unclear.</div></div><div><h3>Objective</h3><div>Leveraging current evidence, we predicted the long-term economic impact of guideline-based asthma treatment in Asian countries, using Singapore as a case study.</div></div><div><h3>Methods</h3><div>We systematically reviewed evidence between 2014 and 2024 on asthma prevalence, adherence to inhaled corticosteroid (ICS) with or without long-acting β-agonist (LABA), and frequency of short-acting β-agonist (SABA) use in Asian asthma populations. We developed a time-in-state model for the joint impact of ICS/ICS-LABA adherence and SABA use on the economic and humanistic burden of uncontrolled asthma during 2024 to 2043. Accordingly, we projected 20-year total direct costs, indirect costs, and quality-adjusted life-years (QALYs) lost associated with uncontrolled asthma in Singapore and assessed the varied impact of guideline-based asthma treatment.</div></div><div><h3>Results</h3><div>Among 28 Asia-based, population-level studies, asthma prevalence was 1% to 12% in adults and 2% to 14% in children. ICS/ICS-LABA adherence, reported in only 3 countries, ranged from 10% to 90%; average SABA use was 2.5 to 6.4 canisters/year. In Singapore, under current trends of ICS/ICS-LABA adherence and SABA use, the 20-year burden of uncontrolled asthma is SGD$2.772 billion in direct costs, SGD$5.670 billion in indirect costs, and 58,872 QALYs lost. Optimizing guideline-based treatment nationwide (ICS/ICS-LABA medication possession ratio = 0.8, SABA use = 1 canister/year) reduces 20-year direct costs, indirect costs, and QALYs lost by 27.7%, 23.8%, and 28.8%, respectively.</div></div><div><h3>Conclusions</h3><div>Population-based evidence on guideline-based asthma treatment in Asia is limited. Population-level modeling of its economic impact, using minimal key evidence, revealed substantial reduction in societal economic and humanistic burden in Asian countries such as Singapore.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100531"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679314","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":"Asthma increases short-time sickness absence and presenteeism in young adults","authors":"Inger Kull RN, PhD ,&nbsp;Maria Ödling RN, PhD ,&nbsp;Ida Mogensen MD, PhD ,&nbsp;Anne-Sophie Merritt PhD ,&nbsp;Theo Bodin MD, PhD ,&nbsp;Gun Johansson PhD ,&nbsp;Sandra Ekström PhD","doi":"10.1016/j.jacig.2025.100518","DOIUrl":"10.1016/j.jacig.2025.100518","url":null,"abstract":"<div><h3>Background</h3><div>There is limited knowledge on how asthma affects short-term sickness absence and presenteeism among young adults.</div></div><div><h3>Objective</h3><div>Our aim was to investigate associations between asthma and short-term sickness absence and presenteeism among young adults. A secondary aim was to investigate the influence of comorbidity with rhinitis and skill levels in occupations for these associations.</div></div><div><h3>Methods</h3><div>The study included 2029 participants from the population-based Barn/Children Allergy Milieu Stockholm Epidemiology (BAMSE) cohort who answered questions on allergic disease at age 24 years and questions on work-related outcomes in a follow-up at age 28 years. Short-term sickness absence was defined as sickness absence lasting fewer than 14 days. Presenteeism was defined as working despite being unwell. Analyses were performed with multinominal logistic regression (sickness absence) and logistic regression (presenteeism) adjusted for sex, education, employment status, smoking status, and body mass index.</div></div><div><h3>Results</h3><div>The participants with current asthma reported more short-term sickness absence and presenteeism, respectively, than did those without current asthma (eg, 37.2% vs 30.5% reported 2-4 episodes and 8.6% vs 5.7% reported ≥5 episodes in the preceding 12 months [<em>P</em> = .01]). In multivariate analyses, current asthma was associated with frequent sickness absence (relative risk ratio = 1.37 [95% CI = 1.02-1.84 for 2-4 episodes] and relative risk ratio = 1.74 [95% CI = 1.03-2.94 for ≥5 episodes]), as well as higher presenteeism (odds ratio = 1.40 [95% CI = 1.06-1.85]). For the most frequent sickness absence category (≥5 episodes), there was an association for asthma with, but not without, allergic rhinitis and a tendency for a greater association in occupations with low- versus high-skill levels.</div></div><div><h3>Conclusion</h3><div>Asthma is associated with frequent short-term sickness absence and presenteeism among young adults. Optimal treatment and management of asthma may reduce its negative consequences on working life.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100518"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632492","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":"Monoclonal gammopathy in WHIM syndrome can mask hypogammaglobulinemia","authors":"Julia Lew MD ,&nbsp;Adil Adatia MD","doi":"10.1016/j.jacig.2025.100526","DOIUrl":"10.1016/j.jacig.2025.100526","url":null,"abstract":"<div><div>Monoclonal gammopathy can be seen at an early age in patients with warts-hypogammaglobulinemia, infections, and myelokathexis syndrome and can mask the presence of hypogammaglobulinemia.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100526"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632472","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":"Analysis of atmospheric particles washed away by eyewashes in Indonesia: The second report of the Jakarta study","authors":"Tatsuya Mimura MD, PhD ,&nbsp;Willitri A. Sunarya PhD ,&nbsp;Kazuhiro Tsuji PhD ,&nbsp;Eichi Uchio MD, PhD ,&nbsp;Kazumi Fukagawa MD, PhD ,&nbsp;Hiroshi Fujishima MD, PhD","doi":"10.1016/j.jacig.2025.100527","DOIUrl":"10.1016/j.jacig.2025.100527","url":null,"abstract":"<div><h3>Background</h3><div>Airborne particles from pollutants aggravate ocular and nasal symptoms.</div></div><div><h3>Objective</h3><div>We sought to investigate the effectiveness of eyewashing in removing airborne particles from the eyes and improving ocular and nasal symptoms in Jakarta.</div></div><div><h3>Methods</h3><div>Healthy volunteers were divided into car (n = 15) and motorcycle (n = 15) commuters. Both eyes were washed twice with commercial eyewash, then the number of particles in the washing solution was calculated using a microscope connected to a smartphone. Ocular and nasal symptoms before and after the first eyewash were scored using a modified Japanese Allergic Conjunctival Disease Quality-of-Life Questionnaire.</div></div><div><h3>Results</h3><div>The number of particles obtained by eyewashing was significantly higher following the first wash than that following the second wash (36.2 ± 23.2 vs 11.5 ± 10.1, <em>P</em> &lt; .001). However, the number of particles did not significantly differ between motorcycle and car commuters for both the first (36.1 ± 23.5 vs 36.3 ± 22.9) and the second washes (13.1 ± 12.4 vs 9.9 ± 6.5). Eyewashing significantly improved total ocular (3.2 ± 3.6 vs 0.9 ± 1.3, <em>P</em> = .003) and nasal (1.2 ± 1.8 vs 0.3 ± 0.7, <em>P</em> = .017) symptom scores.</div></div><div><h3>Conclusions</h3><div>Both motorcycle and car commuters have many particles in their eyes. Eyewashing removes particles from the eye and improves subjective symptoms. Therefore, eyewashing may be effective in improving ocular symptoms in countries with severe air pollution.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 4","pages":"Article 100527"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144672491","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":"Pediatric anaphylaxis in the emergency department: Performances of dynamic tryptase measurement","authors":"Constance Gonzalez MD ,&nbsp;Meng Sun MSc ,&nbsp;Aurélie Morand MD, PhD ,&nbsp;Philippe Minodier MD ,&nbsp;Marc Leone MD, PhD ,&nbsp;Jean-Christophe Dubus MD, PhD ,&nbsp;Joana Vitte MD, PhD ,&nbsp;Moïse Michel PharmD, PhD","doi":"10.1016/j.jacig.2025.100524","DOIUrl":"10.1016/j.jacig.2025.100524","url":null,"abstract":"<div><h3>Background</h3><div>Dynamic measurement of serum acute (sAT) and baseline (sBT) tryptase confirms mast cell degranulation during systemic hypersensitivity reactions, provided timing and interpretation are appropriate. The current consensus formula requires sAT greater than a personalized cutoff value [sAT &gt; (1.2 × sBT) + 2]. Only a few studies have investigated its diagnostic performance in children.</div></div><div><h3>Objective</h3><div>We assessed the diagnostic accuracy of the consensus formula and alternative algorithms for interpreting tryptase levels in pediatric patients with suspected anaphylaxis.</div></div><div><h3>Methods</h3><div>Medical records of suspected anaphylaxis referred to the pediatric emergency department of the University Hospitals of Marseille (France) from 2011 to 2020 were retrospectively reviewed. Clinical and laboratory data, including total tryptase and allergy evaluations, were collected. Anaphylaxis was defined as a sudden-onset, perceived life-threatening systemic reaction at the time of physician assessment. Inclusion criteria were suspected anaphylaxis and at least one tryptase determination. The diagnostic performance of the consensus formula was compared to 5 alternative tryptase interpretation algorithms.</div></div><div><h3>Results</h3><div>Among 315 patients (median age, 7.8 years; 317 emergency department visits), 175 (55%) were categorized as cases. Food-induced anaphylaxis was diagnosed in 82%, and 92 (52.6%) had two or more tryptase determinations. The highest diagnostic performance was achieved by the sAT/sBT ratio. A cutoff for sAT/sBT ratio of &gt;1.74 yielded 66.7% sensitivity, 90.0% specificity, 96.8% positive predictive value, and 24.3% negative predictive value. The retrospective study design was a major limitation.</div></div><div><h3>Conclusion</h3><div>Compared to the current consensus formula, a sAT/sBT ratio above 1.74 may enhance the diagnostic performance of dynamic tryptase measurement in children with suspected anaphylaxis.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100524"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632474","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":"Hyper-IgE syndrome: A rare case report","authors":"Lee Smith PhD ,&nbsp;Ahmed Rafei MD ,&nbsp;Susanna Caminada MD ,&nbsp;Salma Barakat MD ,&nbsp;Sami Medani Abd Elwahab MD ,&nbsp;Damiano Pizzol PhD ,&nbsp;Abdelmounem Eltayeb Abdo PhD","doi":"10.1016/j.jacig.2025.100525","DOIUrl":"10.1016/j.jacig.2025.100525","url":null,"abstract":"<div><div>Hyper-IgE syndrome (HIES) is a rare and sporadic primary immunodeficiency usually characterized by atopic dermatitis, recurrent skin staphylococcal infections, recurrent pulmonary infections, and elevated IgE levels. Due to the rarity of the syndrome and its nonspecific and wide presentation, the diagnosis is difficult and arises with other diagnoses including other types of primitive chronic granulomatous disease or acquired immunodeficiency, severe atopic dermatitis, or cystic fibrosis or chronic respiratory infection as tuberculosis. To date, there is no gold standard management and treatments aim to relieve symptoms and avoid complications. We report on a 30-year-old female with a long-time misdiagnosed HIES.</div></div>","PeriodicalId":75041,"journal":{"name":"The journal of allergy and clinical immunology. Global","volume":"4 3","pages":"Article 100525"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632471","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}