{"title":"A prediction rule for disease outcome in patients with undifferentiated arthritis using magnetic resonance imaging of the wrists and finger joints and serologic autoantibodies.","authors":"Mami Tamai, Atsushi Kawakami, Masataka Uetani, Shoichiro Takao, Kazuhiko Arima, Naoki Iwamoto, Keita Fujikawa, Toshiyuki Aramaki, Shin-Ya Kawashiri, Kunihiro Ichinose, Makoto Kamachi, Hideki Nakamura, Tomoki Origuchi, Hiroaki Ida, Kiyoshi Aoyagi, Katsumi Eguchi","doi":"10.1002/art.24711","DOIUrl":"https://doi.org/10.1002/art.24711","url":null,"abstract":"OBJECTIVE\u0000To evaluate whether magnetic resonance imaging (MRI) of the wrists and finger joints and an analysis of serologic autoantibodies are clinically meaningful for the subsequent development of rheumatoid arthritis (RA) in patients with undifferentiated arthritis (UA).\u0000\u0000\u0000METHODS\u0000A total of 129 patients with UA, a disease status formally confirmed by a rheumatologist over a period of at least 1 year, were included. Gadolinium-diethylenetriamine-enhanced MRI of both wrists and finger joints and serologic variables were examined upon admission to our Early Arthritis Clinic at Nagasaki University. After a prospective followup of 1 year, a predictive value for the development of RA was determined for each patient.\u0000\u0000\u0000RESULTS\u0000The subjects were evaluated for their positive or negative status with respect to 3 objective measures at study entry: anti-cyclic citrullinated peptide (anti-CCP) antibodies and/or IgM-rheumatoid factor, MRI-proven symmetric synovitis, and MRI-proven bone edema and/or bone erosion. The patients who were positive for at least 2 of these measures progressed to RA at 1 year with a 79.7% positive predictive value (PPV), 63.0% negative predictive value, 75.9% specificity, 68.0% sensitivity, and 71.3% accuracy. Furthermore, in 22 UA patients positive for both anti-CCP antibodies and MRI-proven bone edema who were considered to have progressed to RA at 1 year, the PPV was increased to 100%. A close correlation was found between the present rule and that established in the Leiden Early Arthritis Cohort.\u0000\u0000\u0000CONCLUSION\u0000MRI-proven early joint damage in conjunction with serologic autoantibodies is efficient in predicting progression from UA to RA. This method can be used to identify patients who would benefit from early treatment with disease-modifying antirheumatic drugs.","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"772-8"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24711","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28205393","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":"Normalizing memory recall in fibromyalgia with rehearsal: a distraction-counteracting effect.","authors":"Frank Leavitt, Robert S Katz","doi":"10.1002/art.24559","DOIUrl":"https://doi.org/10.1002/art.24559","url":null,"abstract":"<p><strong>Objective: </strong>To examine the impact of distraction on the retention of rehearsed information in patients with fibromyalgia syndrome (FMS).</p><p><strong>Methods: </strong>Data refer to the neurocognitive examination of 134 patients (91 with FMS and 43 control subjects) presenting with memory loss. Four neurocognitive measures free of distraction, along with 2 measures with added distraction, were completed. Differences in the retention of rehearsed and unrehearsed information with a source of distraction present were calculated.</p><p><strong>Results: </strong>Patients with FMS showed normal cognitive functioning on verbal memory tests free of distraction. Adding a source of distraction caused unrefreshed information to be lost at a disproportionate rate in patients with FMS. Over 87% of patients with FMS scored in the impaired range on a task of unrehearsed verbal memory. Adding a source of distraction to well-rehearsed information produced a normal rate of recall in FMS.</p><p><strong>Conclusion: </strong>Rehearsal mechanisms are intact in patients with FMS and play beneficial roles in managing interference from a source of distraction. In the absence of rehearsal, a source of distraction added to unrefreshed information signals a remarkable level of cognitive deficit in FMS that goes undetected by conventionally relied-upon neurocognitive measures. We present a theory to promote understanding of the cognitive deficit of people with FMS based on reduced speed of lexical activation and poor recall after distraction.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"740-4"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24559","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28205396","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}
Jennifer M Polinski, Penny E Mohr, Lorraine Johnson
{"title":"Impact of Medicare Part D on access to and cost sharing for specialty biologic medications for beneficiaries with rheumatoid arthritis.","authors":"Jennifer M Polinski, Penny E Mohr, Lorraine Johnson","doi":"10.1002/art.24560","DOIUrl":"https://doi.org/10.1002/art.24560","url":null,"abstract":"<p><strong>Objective: </strong>Many worry that the use of specialty tiering for biologic disease-modifying antirheumatic drugs (DMARDs) by Medicare Part D plans imposes a heavy financial burden on beneficiaries with rheumatoid arthritis (RA). To date, no one has examined the cost-sharing structures for biologic DMARDs in Part D plans or the resulting cost burden for patients.</p><p><strong>Methods: </strong>We followed 14,929 vulnerable, low-income patients with RA who were enrolled in the Medicare Replacement Drug Demonstration (MRDD) in 2005. As the MRDD population transitioned into Part D in 2006, we examined correlates of Part D enrollment and compared the cost-sharing provisions for biologic DMARDs in the Medicare Advantage and stand-alone plans. We simulated the out-of-pocket costs of beneficiaries under 3 cost-sharing scenarios.</p><p><strong>Results: </strong>Eighty-one percent of MRDD beneficiaries with RA enrolled in Part D. Enrollment predictors were female sex (odds ratio [OR] 1.48, 95% confidence interval [95% CI] 1.32-1.67), prior MRDD benefit use (OR 2.29, 95% CI 2.04-2.58), other self-reported drug coverage (OR 1.53, 95% CI 1.36-1.71), and receiving an MRDD subsidy (OR 2.00, 95% CI 1.74-2.30). Compared with stand-alone plans, Medicare Advantage plans had lower deductibles, lower premiums, and fewer prior authorization, step therapy, and quantity limit restrictions. However, approximately 75% of all plans used coinsurance as the preferred form of cost sharing. Out-of-pocket costs exceeded $4,000 annually in all cost-sharing scenarios.</p><p><strong>Conclusion: </strong>Most MRDD beneficiaries with RA enrolled in Part D. Although plans assume some costs for biologic DMARDs, the majority of costs are shifted to beneficiaries and to Medicare. Such cost shifting may place these medications out of the beneficiary's financial reach and expose Medicare to high financial liability.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"745-54"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24560","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28206491","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}
Amanda Hall, Chris Maher, Jane Latimer, Manuela Ferreira
{"title":"The effectiveness of Tai Chi for chronic musculoskeletal pain conditions: a systematic review and meta-analysis.","authors":"Amanda Hall, Chris Maher, Jane Latimer, Manuela Ferreira","doi":"10.1002/art.24515","DOIUrl":"https://doi.org/10.1002/art.24515","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether Tai Chi improves pain, disability, physical performance, and/or health-related quality of life (HRQOL) in people with chronic musculoskeletal pain.</p><p><strong>Methods: </strong>Eight databases were searched for randomized controlled trials (RCTs). Two independent reviewers rated trial quality and extracted trial data. Effect sizes and 95% confidence intervals were calculated for individual trials, and pooled effect sizes were calculated using a random-effects model.</p><p><strong>Results: </strong>Seven RCTs were selected for inclusion in the review. Of these, 6 studied people with chronic arthritis and 1 studied people with chronic tension headaches. The trials were typically small and of low methodologic quality. The pooled effect size for arthritic populations on a 0-100 scale was 10.1 (range 6.3-13.9) points for pain reduction, and was 9.6 (range 5.2-14.0) points for disability reduction. Additionally, physical performance and HRQOL outcomes favored the Tai Chi intervention, but of these outcomes, only the level of tension and satisfaction with general health were statistically significant.</p><p><strong>Conclusion: </strong>The available data on the effect of Tai Chi are sparse and derived principally from low-quality studies. These data suggest that Tai Chi has a small positive effect on pain and disability in people with arthritis. The extent to which it benefits other forms of musculoskeletal pain is unclear.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"717-24"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24515","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28205399","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}
Marius Henriksen, Hans Lund, Robin Christensen, Anders Jespersen, Lene Dreyer, Robert M Bennett, Bente Danneskiold-Samsøe, Henning Bliddal
{"title":"Relationships between the fibromyalgia impact questionnaire, tender point count, and muscle strength in female patients with fibromyalgia: a cohort study.","authors":"Marius Henriksen, Hans Lund, Robin Christensen, Anders Jespersen, Lene Dreyer, Robert M Bennett, Bente Danneskiold-Samsøe, Henning Bliddal","doi":"10.1002/art.24512","DOIUrl":"https://doi.org/10.1002/art.24512","url":null,"abstract":"<p><strong>Objective: </strong>To test the hypothesis that fibromyalgia (FM) patients with reduced lower extremity strength are more symptomatic and tender than FM patients with normal muscle strength.</p><p><strong>Methods: </strong>A total of 840 FM patients and 122 healthy subjects were evaluated between 1998 and 2005. All of the patients completed version 1 of the Fibromyalgia Impact Questionnaire (FIQ) and were assessed for tender points and knee muscle strength. All subjects underwent bilateral isokinetic knee muscle strength testing in flexion and extension. Normative knee muscle strength values were calculated from the healthy subjects, and the FM cohort was divided in 2 groups: 1) patients with normal muscle strength and 2) patients with low muscle strength (2 SDs below normal). The clinical characteristics of these 2 groups were compared.</p><p><strong>Results: </strong>Significantly reduced knee muscle strength was found in 52% of the patients. There were no clinically significant differences between patients with low versus normal muscle strength. There were no clinically significant correlations between total FIQ score, tender point count, and muscle strength. Only 4.6% of the FIQ scores and 5.1% of the tender point counts were explained by muscle strength.</p><p><strong>Conclusion: </strong>Significantly reduced knee muscle strength was found in more than half of the patients. Patients with subnormal muscle strength were not more symptomatic or tender than patients with normal muscle strength. There were no clinically significant correlations between FIQ, tender point count, and muscle strength; therefore, reduced knee muscle strength appears to be a common objective abnormality in FM that is independent of measurements of disease activity. The implication of this finding in regard to the clinical assessment of FM needs further study.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"732-9"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24512","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28205829","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}
Tracy Li, Ginger Smith Carls, Pantelis Panopalis, Sara Wang, Teresa B Gibson, Ron Z Goetzel
{"title":"Long-term medical costs and resource utilization in systemic lupus erythematosus and lupus nephritis: a five-year analysis of a large medicaid population.","authors":"Tracy Li, Ginger Smith Carls, Pantelis Panopalis, Sara Wang, Teresa B Gibson, Ron Z Goetzel","doi":"10.1002/art.24545","DOIUrl":"https://doi.org/10.1002/art.24545","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the long-term direct medical costs and health care utilization for patients with systemic lupus erythematosus (SLE) and a subset of SLE patients with nephritis.</p><p><strong>Methods: </strong>Patients with newly active SLE were found in the MarketScan Medicaid Database (1999-2005), which includes all inpatient, outpatient, emergency department, and pharmaceutical claims for more than 10 million Medicaid beneficiaries. The date a patient became newly active was defined as the earliest observed SLE diagnosis code, with a 6-month clean period prior to the diagnosis. This method identified 2,298 patients with a consecutive followup of 5 years. A reference group of patients without SLE was constructed using propensity score matching. Nephritis was assessed based on diagnosis and procedure codes involving the kidney.</p><p><strong>Results: </strong>Mean annual medical costs for SLE patients totaled $16,089 at year 1, which is significantly greater (by $6,831) than that for reference patients. Costs decreased slightly at year 2 but then increased yearly at an average rate of 16% through year 5, to $23,860. SLE patients without nephritis (n = 1,809) had costs $967-3,756 higher than the reference patients. SLE patients with nephritis (n = 489) had costs $13,228-34,907 greater than the reference group. Inpatient visits for the nephritis subgroup were 0.6-1.0 per capita, which are approximately twice the rate for all SLE patients and 3 to 4 times higher than the reference group.</p><p><strong>Conclusion: </strong>SLE is a costly condition to treat. Medical expenses incurred by SLE patients increase steadily over time, particularly for patients with nephritis.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"755-63"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24545","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28205394","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}
X Baraliakos, J Listing, M Rudwaleit, J Sieper, J Braun
{"title":"Development of a radiographic scoring tool for ankylosing spondylitis only based on bone formation: addition of the thoracic spine improves sensitivity to change.","authors":"X Baraliakos, J Listing, M Rudwaleit, J Sieper, J Braun","doi":"10.1002/art.24425","DOIUrl":"https://doi.org/10.1002/art.24425","url":null,"abstract":"<p><strong>Objective: </strong>The modified Stokes Ankylosing Spondylitis Spinal Score (mSASSS) quantifies radiographic changes in the cervical spine (C-spine) and the lumbar spine (L-spine), but not in the thoracic spine (T-spine). Our objective was to study the contribution of the lower part of the T-spine to structural damage in patients with ankylosing spondylitis (AS).</p><p><strong>Methods: </strong>Radiographs of 80 AS patients obtained at baseline and after 2 years were scored by 2 readers using the mSASSS. In addition, changes in the lower T-spine (T10-T12) were quantified. On this basis, a new scoring tool was developed: the Radiographic Ankylosing Spondylitis Spinal Score (RASSS). The RASSS includes 2 changes: no scoring of erosions in order to confine the scoring to new bone formation, and no scoring of squaring in the C-spine for anatomic and feasibility reasons.</p><p><strong>Results: </strong>The mean +/- SD change was 0.9 +/- 2.5 units using the mSASSS and 1.6 +/- 2.8 units using the RASSS (P < 0.001). Although the mSASSS identified new syndesmophytes in mean +/- SD 1.4 +/- 2.9 vertebral edges over 2 years, an additional 0.6 +/- 1.2 vertebral edges were seen in the lower T-spine. New syndesmophytes or ankylosis were found in 15 patients (21.4%; 95% confidence interval [95% CI] 13.1-32.4%) in the C-spine/L-spine and in 6 patients (8.6%; 95% CI 3.8-17.2%) in the T-spine alone. The reliability of the RASSS and the agreement between readers was excellent.</p><p><strong>Conclusion: </strong>The lower T-spine improves the sensitivity to change of scoring radiographic progression in AS. The tool developed in this study, the RASSS, showed better face and content validity than the mSASSS and was proven to be superior in the quantification of new bone formation in AS.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"764-71"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28206492","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}
Laura R Thompson, Robert Boudreau, Michael J Hannon, Anne B Newman, Constance R Chu, Mary Jansen, Michael C Nevitt, C Kent Kwoh
{"title":"The knee pain map: reliability of a method to identify knee pain location and pattern.","authors":"Laura R Thompson, Robert Boudreau, Michael J Hannon, Anne B Newman, Constance R Chu, Mary Jansen, Michael C Nevitt, C Kent Kwoh","doi":"10.1002/art.24543","DOIUrl":"https://doi.org/10.1002/art.24543","url":null,"abstract":"<p><strong>Objective: </strong>To describe the location and pattern of knee pain in patients with chronic, frequent knee pain using the Knee Pain Map, and to evaluate the inter- and intrarater reliability of the map.</p><p><strong>Methods: </strong>A cohort of 799 participants from the University of Pittsburgh Osteoarthritis Initiative Clinical Center who had knee pain in the last 12 months were studied. Trained interviewers assessed and recorded participant-reported knee pain patterns into 8 local areas, 4 regional areas, or as diffuse. Inter- and intrarater reliability were assessed using Fleiss' kappa.</p><p><strong>Results: </strong>Participants most often reported localized (69%) followed by regional (14%) or diffuse (10%) knee pain. In those with localized pain, the most commonly reported locations were the medial (56%) and lateral (43%) joint lines. In those with regional pain, the most commonly reported regions were the patella (44%) and medial region (38%). There was excellent interrater reliability for the identification of localized and regional pain patterns (kappa = 0.7-0.9 and 0.7-0.8, respectively). The interrater reliability for specific locations was also excellent (kappa = 0.7-1.0) when the number of participants with pain in a location was >4. For regional pain, the kappa for specific regions varied from 0.7-1.0.</p><p><strong>Conclusion: </strong>The majority of participants could identify the location of their knee pain, and trained interviewers could reliably record those locations. The variation in locations suggests that there are multiple sources of pain in knee OA. Additional studies are needed to determine whether specific knee pain patterns correlate with discrete pathologic findings on radiographs or magnetic resonance images.</p>","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 6","pages":"725-31"},"PeriodicalIF":0.0,"publicationDate":"2009-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24543","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28206490","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":"Inconsistency of response to conscious and unconscious motor imagery in complex regional pain syndrome: Comment on the article by Moseley et al.","authors":"Jane Hall, David Blake, Candida McCabe","doi":"10.1002/art.24160","DOIUrl":"https://doi.org/10.1002/art.24160","url":null,"abstract":"","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 1","pages":"139-40; author reply 140-1"},"PeriodicalIF":0.0,"publicationDate":"2009-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24160","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27928773","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}
L H D van Tuyl, W F Lems, A E Voskuyl, B A C Dijkmans, M Boers, P J S M Kerstens
{"title":"Inclusion of glucocorticoids in recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis: Comment on the article by Saag et al.","authors":"L H D van Tuyl, W F Lems, A E Voskuyl, B A C Dijkmans, M Boers, P J S M Kerstens","doi":"10.1002/art.24231","DOIUrl":"https://doi.org/10.1002/art.24231","url":null,"abstract":"","PeriodicalId":8405,"journal":{"name":"Arthritis and rheumatism","volume":"61 1","pages":"141-2; author reply 141-2"},"PeriodicalIF":0.0,"publicationDate":"2009-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/art.24231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27928777","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}