Arthritis Care & Research最新文献

{"title":"Real-World Effectiveness and Safety of Secukinumab in Giant Cell Arteritis: An Italian Multicenter Cohort Study.","authors":"Luca Iorio, Federica Davanzo, Caterina Ricordi, Milena Bond, Ruggiero Mascolo, Jacopo Mora, Alessandro Tomelleri, Angelo Fassio, Francesca Cuzzocrea, Sara Monti, Edoardo Conticini, Fabiola Atzeni, Paolo Delvino, Carlotta Nannini, Augusta Ortolan, Francesco Pollastri, Ester Vivaldelli, Chiara Marvisi, Paola Toniati, Antonio Brucato, Alessandra Milanesi, Francesca Regola, Enrico Tombetti, Lorenzo Dagna, Roberta Ramonda, Christian Dejaco, Luca Quartuccio, Carlo Salvarani, Roberto Padoan","doi":"10.1002/acr.80167","DOIUrl":"10.1002/acr.80167","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the real-world effectiveness and safety of secukinumab in patients with giant cell arteritis (GCA).</p><p><strong>Methods: </strong>This multicenter retrospective study included patients with GCA who received secukinumab at 14 Italian centers with at least six months of follow-up. Outcomes included clinical, complete, and glucocorticoid (GC)-free remission, GC dose reduction, drug retention rate, and adverse events.</p><p><strong>Results: </strong>Thirty-six patients were included (66.7% women); median age at secukinumab initiation was 74 (interquartile range [IQR] 70-80) years. Overall, 32 of 36 patients (88.9%) had previously relapsed and 26 of 36 (72.2%) had received tocilizumab. Clinical remission was observed in 85.2%, 80.6%, and 83.3% at 3, 6, and 12 months, respectively. Complete remission occurred in 55.6%, 52.8%, and 63.3%, whereas GC-free remission increased progressively, reaching 14.8%, 27.8%, and 40.0% at 3, 6, and 12 months, respectively (P = 0.012). Median daily GC dose decreased from 8.7 (IQR 4.0-21.2) mg at baseline to 0 (0-5.0) mg at 12 months (P < 0.001); GCs were discontinued in 12 of 28 patients (42.9%). The 12-month retention rate was 77.0%. Adverse events occurred in 20 of 36 patients (55.6%); infections occurred in 18 of 36 patients (50.0%), accounting for 21 infectious episodes.</p><p><strong>Conclusion: </strong>In this multicenter, real-world cohort of patients with GCA, including those with relapsing disease and previous biologic exposure, secukinumab was associated with high observed remission rates, progressive GC dose reduction, and increasing GC-free remission. Although the phase III GCAptAIN trial did not meet its primary endpoint, these findings suggest that interleukin-17A inhibition may warrant further evaluation in patients with GCA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining Difficult-to-Treat Rheumatoid Arthritis in Routine Care: Comparative Performance of Published Criteria and Description of Early and Late Difficult-to-Treat Rheumatoid Arthritis Phenotypes.","authors":"Rahaf Zyad Attar, Mohammad Movahedi, Angela Cesta, Pooneh Akhavan, Carter Thorne, Janet Pope, Timothy Kwok, Arthur Lau, Reza Mirza, Elliott Hepworth, Andrew Chow, Bindee Kuriya, Sibel Zehra Aydin","doi":"10.1002/acr.80161","DOIUrl":"10.1002/acr.80161","url":null,"abstract":"<p><strong>Objective: </strong>Despite advances in treat-to-target strategies, a subset of patients with rheumatoid arthritis (RA) remains refractory to multiple therapies and is classified as having difficult-to-treat RA (D2T-RA). Although EULAR has proposed classification criteria for D2T-RA, these patients remain variably identified in real-world practice because of heterogeneous applications. We aimed to compare the preformance of published applications of the EULAR D2T-RA criteria in a real-world RA cohort and to determine weather the timing of D2T-RA development could distinguish early from late D2T-RA phenotypes.</p><p><strong>Methods: </strong>Using data from the Ontario Best Practices Research Initiative, a longitudinal real-world RA registry, we evaluated four literature-derived adaptations of the EULAR D2T-RA definition among patients initiating their first advanced therapy. These definitions differed in disease activity requirements, follow-up duration, and treatment count thresholds. We assessed prevalence, agreement between definitions, and explored different temporal anchors for classifying early versus late D2T-RA.</p><p><strong>Results: </strong>Among 1,121 patients with RA (mean age 56.0 years; 80.7% female; mean disease duration of 8.4 years), 202 (18%) fulfilled at least one of four D2T-RA definitions. Prevalence varied substantially across definitions, ranging from 5.5% (definition 4) to 11.7% (definition 2). Definitions 1 and 2, which incorporated multiple disease activity measures, identified the largest proportion of patients, whereas definition 4, which is defined solely by initiation of a third advanced therapy, was most restrictive. Overlap between definitions was modest, with only 44% of patients meeting all definitions 1 through 3, whereas definition 4 identified a distinct group with no overlap with the other definitions, suggesting that these classification approaches capture different patient subsets and are not interchangeable. In temporal analyses, anchoring the D2T-RA onset to the initiation of the first advanced therapy, a two-year threshold-selected for its clinical relevance and balanced group sizes-classified approximately 40% of patients as early and approximately 60% as late D2T-RA.</p><p><strong>Conclusion: </strong>The applications of D2T-RA criteria are not interchangeable and vary widely in patient capture. A two-year threshold anchored to the first initiation of advanced therapy offered a clinically balanced early-late D2T-RA framework. Harmonized, multidimensional definitions incorporating disease activity and temporal stratification are needed to improve phenotyping, prognostication, and cross-study comparability.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Phenotypes in Patients With Inflammatory Myopathies: A Latent Class Analysis.","authors":"Mohammad Radaideh, Duaa Husein, Almurtada Razok, Juan Schmukler, Alexander Best, Joshlean Fair, Manuel Lubinus, Yvonne C Lee, Didem Saygin","doi":"10.1002/acr.80164","DOIUrl":"10.1002/acr.80164","url":null,"abstract":"<p><strong>Objective: </strong>Pain is a common and burdensome symptom in patients with idiopathic inflammatory myopathies (IIM). Our aim was to identify pain phenotypes in IIM that may reflect distinct underlying mechanisms.</p><p><strong>Methods: </strong>An anonymous electronic survey of patients with self-reported IIM and pain attributable to myositis was circulated. The survey included questions related to demographics, IIM-related information, pain characteristics, and the Fibromyalgia Survey Questionnaire. Latent class analysis (LCA) was performed using four variables, including distribution, pattern, difference in pain during myositis flare versus now, and disease duration. Class validity was assessed using pain characteristics, fibromyalgia criteria fulfillment, and symptom burden.</p><p><strong>Results: </strong>A total of 426 participants were included. LCA identified four classes: (i) class 1: proximal arm- and leg-predominant pain and lowest persistent pain, (ii) class 2: diffuse axial and proximal limb-predominant pain, (iii) class 3: diffuse axial and distal leg-predominant pain, and (iv) class 4: widespread axial and extremity pain and the highest persistent pain. In post hoc analyses, class 1 primarily included participants with earlier IIM and a lower rate of fibromyalgia. Class 2 and 3 included participants with intermediate fibromyalgia symptom burden, and class 4 included participants with the highest pain intensity and fibromyalgia.</p><p><strong>Conclusion: </strong>In this large international cohort of patients with self-reported IIM and pain, we identified four different pain phenotypes. These phenotypes range from a localized, disease-related nociceptive pattern to a widespread, fibromyalgia-like nociplastic pattern. Our findings highlight the heterogeneity of myositis-related pain and may inform future mechanistic studies and phenotype-directed management strategies.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Risk Factors and Management of Adverse Events in Contemporary Real-World Care of Children with Juvenile Idiopathic Arthritis.","authors":"Bashayer Alnuaimi, Roberta A Berard, Jean-Philippe Proulx-Gauthier, Heinrike Schmeling, Michelle Batthish, Gilles Boire, Adam M Huber, Dax G Rumsey, Jaime Guzman, Gaëlle Chédeville","doi":"10.1002/acr.80162","DOIUrl":"10.1002/acr.80162","url":null,"abstract":"<p><strong>Objective: </strong>We describe the frequency, risk factors, severity, and management of actionable and serious adverse events (AAE and SAE) in children with newly diagnosed Juvenile Idiopathic Arthritis (JIA) in Canada.</p><p><strong>Methods: </strong>We enrolled patients within 3 months of JIA diagnosis in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry, an ongoing prospective registry-based cohort study. At every clinic visit, clinicians reported AAEs since the previous visit, their severity and actions undertaken. We calculated proportion of patients and visits with an event, events rates per 100 patient-years (PY), and used Kaplan-Meir and Cox regression analysis to estimate first AAE risk and assess associated risk factors.</p><p><strong>Results: </strong>Among 964 patients followed for 2,046 PY, AAEs occurred in 39.0% of patients (34.9 per 100PY) and SAEs in 3.4% (2.0 per 100PY). Gastrointestinal symptoms linked to non-steroidal anti-inflammatory drugs (NSAID) and methotrexate (MTX) were most common (56.4%). In adjusted analyses, active disease, subcutaneous MTX (HR 3.27, p<0.001), oral MTX (HR 2.08, p<0.001), and NSAID (HR 2.17, p<0.001) were associated with increased AAE risk, while biologic Disease Modifying Anti-Rheumatic Drugs (bDMARDs) were associated with decreased risk (HR 0.46, p<0.001). Forty SAEs occurred, including 16 infections with hospitalization and one malignancy, mostly in patients not receiving bDMARDs. There were no deaths, demyelinating conditions, or opportunistic infections.</p><p><strong>Conclusion: </strong>In this real-practice JIA cohort, AAEs were reported in 2 of 5 patients and most were mild events related to NSAID and MTX. SAEs were rare with no deaths and few major complications.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Interchangeability of Two Different Patient-Reported Global Assessment Measures in an Observational Axial Spondyloarthritis Cohort.","authors":"Connor Vershel, Seokhun Kim, Lianne S Gensler, Matthew A Brown, Michael H Weisman, Mariko L Ishimori, Michael Ward, John D Reveille, Mark C Hwang","doi":"10.1002/acr.80163","DOIUrl":"10.1002/acr.80163","url":null,"abstract":"<p><strong>Objective: </strong>The goal of this study was to determine if patient global assessment (PGA) scores reported by patients with axial spondyloarthritis (AxSpA) before the development of the AxSpA Disease Activity Score (ASDAS) can be used as a substitute for the global item of the ASDAS formula.</p><p><strong>Methods: </strong>Data from the Prospective Study of Outcomes in Ankylosing Spondylitis (PSOAS) observational cohort were analyzed. Patients completed a questionnaire during visits to assess disease activity. Before the development of ASDAS, global disease activity was rated on a numeric scale with the prompt, \"Considering all the ways that your ankylosing spondylitis affects you, rate how you are doing.\" The ASDAS global prompt instead asks, \"How active was your spondylitis on average during the last week?\" We calculated the ASDAS based on the original PGA of the PSOAS cohort (PSOAS-PGA) and the standard ASDAS-PGA. Then, we compared ASDAS disease activity categories between the two values and calculated weighted Cohen's κ coefficients. We also compared the older versus newer global single-item scores with intraclass correlation coefficients (ICCs).</p><p><strong>Results: </strong>A total of 610 unique patient visits were analyzed. The proportion of agreement of ASDAS calculated with the PSOAS-PGA compared to the ASDAS-PGA was 86.7% based on disease activity categories with Cohen's κ coefficient of 0.818. The ICC was calculated using a two-way mixed-effects model and was 0.980, consistent with excellent agreement.</p><p><strong>Conclusion: </strong>Prior measures of PGA used before the validation of ASDAS are a valid substitution for the PGA in the ASDAS based on calculation of a κ coefficient showing excellent agreement.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-rheumatology. The risk related to diagnostic and therapeutic decisions based on purposely incomplete, unvetted examination reports: comment on the article by Zickuhr et al.","authors":"Bruce Rothschild","doi":"10.1002/acr.80158","DOIUrl":"10.1002/acr.80158","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Considerations in ICI-Myositis Research: Immortal Time Bias and Diagnostic Standardization.","authors":"Daming Shao, Deanna Jannat-Khah, Anne R Bass, Pankti Reid","doi":"10.1002/acr.80153","DOIUrl":"https://doi.org/10.1002/acr.80153","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Usual Suspects: A Teenager's Diagnostic Odyssey.","authors":"Rasha M Elrefai, Jessica Nguyen, Dawn Gist, Lisa F Satter, Amanda Grimes, Marietta De Guzman","doi":"10.1002/acr.80160","DOIUrl":"10.1002/acr.80160","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Liver Enzymes Is Not an Impediment to Allopurinol Dose Escalation: An Observational Cohort Study.","authors":"May Shuen Tang, Qai Ven Yap, Peter Pak Moon Cheung, Amelia Santosa, Gim Gee Teng","doi":"10.1002/acr.80157","DOIUrl":"10.1002/acr.80157","url":null,"abstract":"<p><strong>Objective: </strong>Routine liver enzyme monitoring is advocated for while on allopurinol, but supporting guidance is lacking. We assessed the incidence and factors associated with elevated liver enzyme levels in patients with gout commenced on allopurinol.</p><p><strong>Methods: </strong>One hundred and fifty patients with gout and normal baseline serum aminotransferases initiated on allopurinol were followed prospectively over three visits. Raised transaminase levels were defined as mild, moderate, or severe if aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels were raised less than two, two to three, or more than three times above upper normal limits, respectively. Predictors of AST/ALT elevation were assessed using generalized estimating equations.</p><p><strong>Results: </strong>Mean age was 56.6 years, and 95.3% were men. Median follow-up was 33.5 (interquartile range 22.8-53.1) weeks. A total of 32 (21.5%) drank alcohol, 43 (28.9%) were obese, and 11 (7.3%) had metabolic dysfunction-associated steatotic liver disease. Thirty (20.0%) developed raised AST/ALT levels during follow-up, the majority (86.7%) being mild, while none were severe. Allopurinol was maintained or increased in 18 out of 19 patients with raised serum aminotransferase levels at visit 2. Their elevated AST/ALT levels remained stable (27.8%), improved (11.1%), or resolved (33.3%) at subsequent visit. None had worsening AST/ALT levels. Multivariate analysis revealed that alcohol consumption (adjusted odds ratio [OR] 3.52, 95% confidence interval [CI] 1.41-8.79) and statin nonuse (adjusted OR 3.41, 95% CI 1.04-11.17) were independent predictors of raised transaminase levels. Higher allopurinol dose was not associated with development of liver enzyme elevation (P = 0.193).</p><p><strong>Conclusion: </strong>Mild asymptomatic AST/ALT elevation is common among patients with gout and is not influenced by allopurinol dose escalation. Alcohol consumption was an independent risk factor for elevated liver enzyme levels, whereas statin use appeared protective. Allopurinol can be safely escalated despite mild-moderate serum aminotransferase elevation.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Damage Is Associated With Carotid Wall Structural Changes in Systemic Sclerosis: A Capillaroscopy and Ultrasound-Based Observational Study.","authors":"Eugenio Capparelli, Luca Clerici, Francesco Lapia, Giusy C Moltisanti, Eleonora Zaccara, Greta Pellegrino, Daniela Bompane, Francesca Capelli, Letizia Ferrami, Laura Castelnovo, Antonio Tamburello, Maria Sole Chimenti, Paola Faggioli, Antonino Mazzone","doi":"10.1002/acr.80156","DOIUrl":"10.1002/acr.80156","url":null,"abstract":"<p><strong>Objective: </strong>Systemic sclerosis (SSc) is characterized by cardiovascular risk excess not fully explained by traditional factors. Whether the severity of microvascular damage correlates with structural subclinical atherosclerosis remains unclear. We investigated the relationship between nailfold videocapillaroscopy (NVC) abnormalities and carotid ultrasound wall alterations in SSc.</p><p><strong>Methods: </strong>In this cross-sectional study, 165 patients with SSc underwent NVC and carotid ultrasound. NVC patterns were collected, and specific abnormalities were graded semiquantitatively. Carotid intima-media thickness (cIMT) and atherosclerotic plaques (unilateral/bilateral) were evaluated. In patients with scleroderma pattern, associations were explored using univariate and ordinal trend analyses. Multivariable logistic regression models were employed to explore independent predictors of atherosclerosis at the carotid level.</p><p><strong>Results: </strong>Mean bilateral cIMT was 0.83 ± 0.17 mm, with 52.1% of patients exhibiting a cIMT ≥0.9 mm, and 46.7% had carotid plaques (20.6% bilateral). A nonscleroderma pattern was found in 12.7%, whereas early (21.8%), active (30.3%), and late (35.1%) patterns were more prevalent. No associations were found among NVC findings and both cIMT and the plaque at any side. Late pattern (P = 0.021), avascular areas (P = 0.009), and capillary density reduction (P = 0.021) were associated with bilateral plaques. In multivariable models, late NVC pattern was associated with bilateral plaques, whereas no independent association was found for pathologic cIMT and plaque at any side, for which age and systolic blood pressure (SBP) revealed a stronger predictive effect.</p><p><strong>Conclusion: </strong>More severe structural microangiopathy in SSc is associated with bilateral plaques at carotid level. However, traditional risk factors, like age and SBP, remain key determinants of cIMT and plaques at any side.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}