British Heart Journal最新文献

{"title":"A retrospective review of empiric acyclovir prescribing practices for suspected viral central nervous system infections: A single-centre study.","authors":"JeongMin Marie Kim, Cesilia Nishi, Jennifer Mina Grant","doi":"10.3138/jammi-2022-0031","DOIUrl":"10.3138/jammi-2022-0031","url":null,"abstract":"<p><strong>Background: </strong>Acyclovir has an important role in the treatment of viral central nervous system (CNS) infection, especially herpes simplex virus (HSV)-1 encephalitis. It is therefore used broadly as empiric therapy for many patients who present to the hospital with symptoms of a possible neurologic infection. We sought to review our practices in acyclovir prescribing, deprescribing, and associated investigations for the clinical syndromes it treats.</p><p><strong>Methods: </strong>Through a retrospective chart review, we identified patients prescribed acyclovir for a possible CNS infection upon admission to Vancouver General Hospital between January 1, 2019, and December 31, 2019. Patient demographics, signs, symptoms, and comorbidities were taken from admission consultation notes or discharge summaries; their investigations, including laboratory tests and imaging, were also recorded. The primary purpose was to describe the appropriateness of empiric acyclovir use in suspected meningoencephalitis cases.</p><p><strong>Results: </strong>Among the 108 patients treated with acyclovir, 94 patients had an indication for starting empiric treatment for encephalitis or meningitis. There was suspicion and workup for encephalitis alone in 76 patients. Among discharge diagnoses, the most common was delirium of a different identified source (18 cases), followed by unknown/other (15 cases). There were seven patients whose CSF viral PCR test was positive for HSV or varicella-zoster virus (VZV); three of them had HSV-1 encephalitis. There were two total adverse events recorded attributed to acyclovir; both cases were of mild acute kidney injury.</p><p><strong>Conclusion: </strong>We found that in many patients, acyclovir was not necessary or could have been stopped earlier, avoiding toxicity and drug costs.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"87 1","pages":"125-133"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86327760","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":"Cortical Morphology in Cannabis Use Disorder: Implications for Transcranial Direct Current Stimulation Treatment.","authors":"Ghazaleh Soleimani, Farzad Towhidkhah, Mehrdad Saviz, Hamed Ekhtiari","doi":"10.32598/bcn.2021.3400.1","DOIUrl":"10.32598/bcn.2021.3400.1","url":null,"abstract":"<p><strong>Introduction: </strong>Transcranial direct current stimulation (tDCS) has been studied as an adjunctive treatment option for substance use disorders (SUDs). Alterations in brain structure following SUD may change tDCS-induced electric field (EF) and subsequent responses; however, group-level differences between healthy controls (HC) and participants with SUDs in terms of EF and its association with cortical architecture have not yet been modeled quantitatively. This study provides a methodology for group-level analysis of computational head models to investigate the influence of cortical morphology metrics on EFs.</p><p><strong>Methods: </strong>Whole-brain surface-based morphology was conducted, and cortical thickness, volume, and surface area were compared between participants with cannabis use disorders (CUD) (n=20) and age-matched HC (n=22). Meanwhile, EFs were simulated for bilateral tDCS over the dorsolateral prefrontal cortex. The effects of structural alterations on EF distribution were investigated based on individualized computational head models.</p><p><strong>Results: </strong>Regarding EF, no significant difference was found within the prefrontal cortex; however, EFs were significantly different in left-postcentral and right-superior temporal gyrus (P<0.05) with higher levels of variance in CUD compared to HC [F_{(39, 43)}=5.31, P<0.0001, C=0.95]. Significant differences were observed in cortical area (caudal anterior cingulate and rostral middle frontal), thickness (lateral orbitofrontal), and volume (paracentral and fusiform) between the two groups.</p><p><strong>Conclusion: </strong>Brain morphology and tDCS-induced EFs may be changed following CUD; however, differences between CUD and HCs in EFs do not always overlap with brain areas that show structural alterations. To sufficiently modulate stimulation targets, whether individuals with CUD need different stimulation doses based on tDCS target location should be checked.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"102 1","pages":"647-662"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11016884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85981103","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":"Socioeconomic status and entrepreneurial networking responses to the COVID-19 crisis.","authors":"Leif Brändle, Helen Signer, Andreas Kuckertz","doi":"10.1007/s11573-022-01120-w","DOIUrl":"10.1007/s11573-022-01120-w","url":null,"abstract":"<p><p>Networks play a vital role for entrepreneurs in overcoming crises. The most vulnerable to crises are those from lower socioeconomic backgrounds. However, we know less about the role of socioeconomic status in entrepreneurial networking. This study investigates whom entrepreneurs call in case of emergency. We develop hypotheses on how entrepreneurs' socioeconomic status influences models of networking agency in situations of economic threat. The results of a pre-registered randomized experiment in the COVID-19 context conducted with 122 entrepreneurs from the US indicate that entrepreneurs in higher socioeconomic status positions activate contacts to serve their own goals (i.e., independent networking agency) when facing an economic threat. In contrast, and counter-intuitively, entrepreneurs of lower socioeconomic status are more likely to support others when facing an economic threat (i.e., interdependent networking agency). Exploring the evolving network structure, our explorative post-hoc analyses suggest that entrepreneurs activate closer networks (i.e., higher density and stronger ties) under threat. The study discusses the implications of these findings for the theory of entrepreneurial networking in general and network responses to crises in particular.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"97 1","pages":"111-147"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86358999","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":"Cardiac microstructural alterations measured by echocardiography identify sex-specific risk for heart failure.","authors":"Alan Kwan, Emmanuella Demosthenes, Gerran Salto, David Ouyang, Trevor Nguyen, Chike C Nwabuo, Eric Luong, Amy Hoang, Ewa Osypiuk, Plamen Stantchev, Elizabeth H Kim, Pranoti Hiremath, Debiao Li, Ramachandran Vasan, Vanessa Xanthakis, Susan Cheng","doi":"10.1136/heartjnl-2022-320876","DOIUrl":"10.1136/heartjnl-2022-320876","url":null,"abstract":"<p><strong>Objective: </strong>Established preclinical imaging assessments of heart failure (HF) risk are based on macrostructural cardiac remodelling. Given that microstructural alterations may also influence HF risk, particularly in women, we examined associations between microstructural alterations and incident HF.</p><p><strong>Methods: </strong>We studied N=2511 adult participants (mean age 65.7±8.8 years, 56% women) of the Framingham Offspring Study who were free of cardiovascular disease at baseline. We employed texture analysis of echocardiography to quantify microstructural alteration, based on the high spectrum signal intensity coefficient (HS-SIC). We examined its relations to incident HF in sex-pooled and sex-specific Cox models accounting for traditional HF risk factors and macrostructural alterations.</p><p><strong>Results: </strong>We observed 94 new HF events over 7.4±1.7 years. Individuals with higher HS-SIC had increased risk for incident HF (HR 1.67 per 1-SD in HS-SIC, 95% CI 1.31 to 2.13; p<0.0001). Adjusting for age and antihypertensive medication use, this association was significant in women (p=0.02) but not men (p=0.78). Adjusting for traditional risk factors (including body mass index, total/high-density lipoprotein cholesterol, blood pressure traits, diabetes and smoking) attenuated the association in women (HR 1.30, p=0.07), with mediation of HF risk by the HS-SIC seen for a majority of these risk factors. However, the HS-SIC association with HF in women remained significant after adjusting for relative wall thickness (representing macrostructure alteration) in addition to these risk factors (HR 1.47, p=0.02).</p><p><strong>Conclusions: </strong>Cardiac microstructural alterations are associated with elevated risk for HF, particularly in women. Microstructural alteration may identify sex-specific pathways by which individuals progress from risk factors to clinical HF.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1800-1806"},"PeriodicalIF":0.0,"publicationDate":"2022-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42812280","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":"Aspirin","authors":"","doi":"10.1007/s40278-022-25726-4","DOIUrl":"https://doi.org/10.1007/s40278-022-25726-4","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"1929 1","pages":"102 - 102"},"PeriodicalIF":0.0,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"52671931","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":"Smartphone detection of atrial fibrillation using photoplethysmography: a systematic review and meta-analysis.","authors":"Simrat Gill, Karina V Bunting, Claudio Sartini, Victor Roth Cardoso, Narges Ghoreishi, Hae-Won Uh, John A Williams, Kiliana Suzart-Woischnik, Amitava Banerjee, Folkert W Asselbergs, Mjc Eijkemans, Georgios V Gkoutos, Dipak Kotecha","doi":"10.1136/heartjnl-2021-320417","DOIUrl":"10.1136/heartjnl-2021-320417","url":null,"abstract":"<p><strong>Objectives: </strong>Timely diagnosis of atrial fibrillation (AF) is essential to reduce complications from this increasingly common condition. We sought to assess the diagnostic accuracy of smartphone camera photoplethysmography (PPG) compared with conventional electrocardiogram (ECG) for AF detection.</p><p><strong>Methods: </strong>This is a systematic review of MEDLINE, EMBASE and Cochrane (1980-December 2020), including any study or abstract, where smartphone PPG was compared with a reference ECG (1, 3 or 12-lead). Random effects meta-analysis was performed to pool sensitivity/specificity and identify publication bias, with study quality assessed using the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies-2) risk of bias tool.</p><p><strong>Results: </strong>28 studies were included (10 full-text publications and 18 abstracts), providing 31 comparisons of smartphone PPG versus ECG for AF detection. 11 404 participants were included (2950 in AF), with most studies being small and based in secondary care. Sensitivity and specificity for AF detection were high, ranging from 81% to 100%, and from 85% to 100%, respectively. 20 comparisons from 17 studies were meta-analysed, including 6891 participants (2299 with AF); the pooled sensitivity was 94% (95% CI 92% to 95%) and specificity 97% (96%-98%), with substantial heterogeneity (p<0.01). Studies were of poor quality overall and none met all the QUADAS-2 criteria, with particular issues regarding selection bias and the potential for publication bias.</p><p><strong>Conclusion: </strong>PPG provides a non-invasive, patient-led screening tool for AF. However, current evidence is limited to small, biased, low-quality studies with unrealistically high sensitivity and specificity. Further studies are needed, preferably independent from manufacturers, in order to advise clinicians on the true value of PPG technology for AF detection.</p>","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1600-1607"},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47546441","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":"Correspondence on 'Hypertensive response to exercise in adult patients with repaired aortic coarctation' by Meijs <i>et al</i>.","authors":"Nejc Pavšič, Polona Kačar, Jure Dolenc, Katja Prokšelj","doi":"10.1136/heartjnl-2022-321349","DOIUrl":"10.1136/heartjnl-2022-321349","url":null,"abstract":"","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43382885","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":"Response to: Correspondence on ‘Hypertensive response to exercise in adult patients with repaired aortic coarctation’ by Pavšič et al","authors":"T. A. Meijs, M. Voskuil","doi":"10.1136/heartjnl-2022-321350","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-321350","url":null,"abstract":"The Authors' reply: We thank Pavšič et al for their remarks regarding our recent article. They raise some important points. First, the definition of a hypertensive response to exercise varies between studies in patients with coarctation of the aorta (CoA), which limits their comparability. We used a cutoff value of 210 mm Hg in men and 190 mm Hg in women for systolic blood pressure (SBP) during peak exercise, since these values correspond to the 90th percentile in both sexes in a healthy population. Although this definition is most widely used, we acknowledge that there are potential drawbacks when extrapolating this definition to a relatively young cohort of patients with CoA. As noted by Pavšič et al, contemporary data indicate that peak exercise SBP increases with age in a pattern similar to resting SBP. Since most patients in our cohort were between 18 and 40 years old, we may have detected an even higher prevalence of a hypertensive response to exercise using ageadjusted cutoff values. However, we believe we should be cautious in comparing patients with CoA with apparently healthy individuals. Patients with CoA represent a very distinct group with a high prevalence of hypertension and signs of a generalised arteriopathy, which are often already present from a young age. At this moment, there is insufficient evidence how this generalised arteriopathy progresses over time. Interestingly, our presented data show a trend towards a lower peak exercise SBP with increasing age, even when corrected for workload (table 2 in original article). This may be partly explained by differences in surgical era. Repair techniques have improved over the last decades, which has most benefited the younger patients in our cohort. Consequently, even the patients with the most severe forms of arteriopathy, who presumably have the highest risk of a hypertensive response to exercise, survive into adulthood in reasonable condition. In contrast, patients >50 years whose exercise tolerance is well enough to undergo exercise stress testing may represent a subgroup with a relatively mild arteriopathy. These era differences are likely to introduce some degree of selection bias, which should be taken into account when interpreting exercise stress testing in patients with CoA. Pavšič et al argue that workloadindexed SBP better reflects an abnormal blood pressure response than SBP alone. Workload may indeed confound the relationship between exercise and SBP, which is why we reported workload in metabolic equivalents (METs) and adjusted for this factor in multivariable analysis. It is plausible to adjust for workload, since there is a nearly linear relationship between workload and cardiac output during exercise. However, it has not yet been demonstrated that workloadindexed SBP is superior to SBP alone in predicting adverse cardiovascular events. The importance of preventing cardiovascular events in adult patients with CoA was emphasised by our recent study, showing a substant","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1328 - 1329"},"PeriodicalIF":0.0,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41898891","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":"Gender disparities in alcohol septal ablation for hypertrophic obstructive cardiomyopathy","authors":"D. Lawin, T. Lawrenz, K. Marx, N. B. Danielsmeier, M. Poudel, C. Stellbrink","doi":"10.1136/heartjnl-2022-320852","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320852","url":null,"abstract":"Objective Alcohol septal ablation (ASA) improves symptoms in hypertrophic obstructive cardiomyopathy (HOCM). We conducted a large retrospective analysis investigating gender effects on outcome after ASA. Methods and results 1367 ASAs between 2002 and 2020 were analysed. Women (47.2%) were older (66.0 years (IQR 55.0–74.0) vs 54.0 years (IQR 45.0–62.0); p<0.0001) with more severe symptoms. The interventricular septal diameter (IVSD) was higher in men (21.0 mm (IQR 19.0–24.0) vs 20.0 mm (IQR 18.0–23.0); p<0.0001) but the IVSD indexed to body surface area was higher in women (10.9 mm/m2 (IQR 9.7–12.7) vs 10.2 mm/m2 (IQR 9.0–11.7); p<0.0001). Women had lower exercise-induced left ventricular outflow tract gradients (LVOTG) 1–4 days after ASA (55.0 mm Hg (IQR 30.0–109.0) vs 71.0 mm Hg (IQR 37.0–115.0); p=0.0006). There was a trend for lower resting LVOTG 1–4 days after ASA (20.0 mm Hg (IQR 12.0–37.5) vs 22.0 mm Hg (IQR 13.0–40.0); p=0.0062) and lower exercise-induced LVOTG after 6 months in women (34.0 mm Hg (IQR 21.0–70.0) vs 43.5 mm Hg (IQR 25.0–74.8); p=0.0072), but this was not statistically significant after Bonferroni correction. More women developed atrioventricular (AV) block (20.3% vs 13.3%; p=0.0005) and required a pacemaker (17.4% vs 10.4%; p=0.0002) but not a cardioverter defibrillator (9.0% vs 11.6% in men; p=n .s.). However, in multivariable regression models, there was no evidence that sex independently influenced LVOTG and the occurrence of AV block. Conclusion Female patients with HOCM were older and had more advanced disease at the time of ASA. Women had superior short-term haemodynamic response to ASA but more often developed AV block after ASA. These results are important to consider for sex-specific counselling before ASA.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1623 - 1628"},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45340077","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":"Diabetes mellitus and cardiovascular mortality across the spectrum of aortic stenosis","authors":"A. Coisne, D. Montaigne, S. Ninni, N. Lamblin, G. Lemesle, P. Delsart, Alexandre Filiot, Paul Andrey, P. Balaye, L. Butruille, R. Decoin, E. Woitrain, J. Granada, B. Staels, C. Bauters","doi":"10.1136/heartjnl-2022-320897","DOIUrl":"https://doi.org/10.1136/heartjnl-2022-320897","url":null,"abstract":"Objective Current data regarding the impact of diabetes mellitus (DM) on cardiovascular mortality in patients with aortic stenosis (AS) are restricted to severe AS or aortic valve replacement (AVR) trials. We aimed to investigate cardiovascular mortality according to DM across the entire spectrum of outpatients with AS. Methods Between May 2016 and December 2017, patients with mild (peak aortic velocity=2.5–2.9 m/s), moderate (3–3.9 m/s) and severe (≥4 m/s) AS graded by echocardiography were included during outpatient cardiology visits in the Nord-Pas-de-Calais region in France and followed-up for modes of death between May 2018 and August 2020. Results Among 2703 patients, 820 (30.3%) had DM, mean age was 76±10.8 years with 46.6% of women and a relatively high prevalence of underlying cardiovascular diseases. There were 200 cardiovascular deaths prior to AVR during the 2.1 years (IQR 1.4–2.7) follow-up period. In adjusted analyses, DM was significantly associated with cardiovascular mortality (HR=1.40, 95% CI 1.04 to 1.89; p=0.029). In mild or moderate AS, the cardiovascular mortality of patients with diabetes was similar to that of patients without diabetes. In severe AS, DM was associated with higher cardiovascular mortality (HR=2.65, 95% CI 1.50 to 4.68; p=0.001). This was almost exclusively related to a higher risk of death from heart failure (HR=2.61, 95% CI 1.15 to 5.92; p=0.022) and sudden death (HR=3.33, 95% CI 1.28 to 8.67; p=0.014). Conclusion The effect of DM on cardiovascular mortality varied across AS severity. Despite no association between DM and outcomes in patients with mild/moderate AS, DM was strongly associated with death from heart failure and sudden death in patients with severe AS.","PeriodicalId":9311,"journal":{"name":"British Heart Journal","volume":"108 1","pages":"1815 - 1821"},"PeriodicalIF":0.0,"publicationDate":"2022-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47977894","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}