Endokrynologia Polska最新文献

{"title":"The associations between skeletal muscle mass to visceral fat area ratio (SVR) with bone mineral density (BMD) and 10-year probability of fracture risk in Chinese patients with type 2 diabetes mellitus (T2DM): a cross-sectional study.","authors":"Yuning Guo, Renxuan Li, Na Xu, Yan Wang, Wentong Jiang, Jianxia Wei, Xiaolian Zhou, Yanwei Liang, Lei Zhu, Yanman Zhou, Jin Xu","doi":"10.5603/ep.102613","DOIUrl":"https://doi.org/10.5603/ep.102613","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with type 2 diabetes mellitus (T2DM) have a higher risk of fracture, higher visceral fat, and lower muscle mass. The combined effect of skeletal muscle mass and visceral fat area [skeletal muscle mass to visceral fat area ratio (SVR)] on bone mineral density (BMD) and fracture risk in T2DM patients is still unknown.</p><p><strong>Materials and methods: </strong>A cross-sectional study was performed on 422 patients. The associations between SVR with BMD and the 10-year probability of fractures [included major osteoporotic fracture (MOF), and hip fracture (HF)] were analyzed using R studio 4.2.3. Generalized additive models (GAMs) were used to identify the associations between SVR and BMD and fracture risk.</p><p><strong>Results: </strong>There was a lower SVR in patients with osteoporosis/osteopenia than in controls. SVR was an independent determinant for BMD and MOF and HF, and SVR was positively associated with BMD and negatively associated with 10-year fracture risk in non-elderly men or elderly women with T2DM. SVR had an approximately positive linear association with BMD in elderly males and females, and it had an N-shaped curve association with BMD in non-elderly males. In addition, the associations between SVR and MOF/HF were negative linear in females and elderly men, and non-linear in non-elderly men.</p><p><strong>Conclusion: </strong>Our study provided a novel viewpoint on the relationship between SVR and BMD/fracture risk. Relatively high SVR is a protective factor for bone in T2DM patients, but the osteoprotective effect of SVR was mediated by age and gender, and it persisted only in non-elderly men and elderly women with T2DM.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 2","pages":"202-211"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060744","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":"Gut-thyroid axis: investigating the causality between the gut microbiota and autoimmune thyroid disease based on a Mendelian randomization study.","authors":"Ting Zheng, Xin Li, Hongyu Xiang","doi":"10.5603/ep.102030","DOIUrl":"https://doi.org/10.5603/ep.102030","url":null,"abstract":"<p><strong>Introduction: </strong>Current studies have identified a close connection between the gut microbiota (GM) and autoimmune thyroid disease (AITD), indicating that the dysregulation of the GM could play a crucial bridging role in AITD. However, the causality between them has not been definitively defined.</p><p><strong>Material and methods: </strong>We utilized the summary statistics of GM from the largest available meta-analysis of genome-wide association studies conducted by the MiBioGen consortium. The data on AITD were derived from the Genome-Wide Association Study (GWAS) database. We investigated the causality between GM and AITD through various analytical methods in a bidirectional Mendelian randomization (MR) analysis. This encompassed methods like inverse variance weighted, MR-Egger, weighted median, weighted mode, and simple mode.</p><p><strong>Results: </strong>Our findings revealed a protective effect of genus Methanobrevibacter [odds ratio (OR) = 0.791, p = 0.044], order Rhodospirillales(OR = 0.775, p = 0.019) on Graves' disease (GD). However, the family Clostridiales vadin BB60 group (OR = 1.222, p = 0.038), genus Anaerofilum (OR = 1.243, p = 0.038), genus Barnesiella (OR = 1.405, p = 0.021), genus Intestinibacter (OR = 1.777, p = 0.000), and order NB1n (OR = 1.270, p = 0.003) were identified as risk factors for GD. In addition, family Alcaligenaceae (OR = 0.691, p= 0.004), family Rhodospirillaceae (OR = 0.813, p = 0.013), genus Butyrivibrio (OR = 0.877, p = 0.019), genus Prevotella 7 (OR = 0.835, p = 0.026), genus Ruminococcaceae UCG011 (OR = 0.883, p = 0.032), genus Ruminococcaceae UCG013 (OR = 0.797, p = 0.048), and order Lactobacillales (OR = 0.759, p = 0.009) had a protective effect on Hashimoto's thyroiditis (HT). Genus Intestinimonas (OR = 1.247, p = 0.010) was a risk factor for HT. Based on the findings from the reverse MR analysis, AITD did not exert a significant causal influence on the GM. There waere no observed remarkable instrumental variables of heterogeneity or horizontal pleiotropy.</p><p><strong>Conclusion: </strong>Our study offered evidence of causal relationship between certain GM and AITD using two-sample MR analysis. This may provide novel perspectives on diagnosis and latent therapeutic targets for AITD.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 2","pages":"153-164"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045102","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":"Advances in imaging examination of bone density and bone quality.","authors":"Junyan Li, BiYan She, MingLi He, Chuyue Yuan, Na Li","doi":"10.5603/ep.100805","DOIUrl":"10.5603/ep.100805","url":null,"abstract":"<p><p>Bone mineral density is the primary basis for the diagnosis of osteoporosis. Bone mineral density measurement methods include dual-energy X-ray (DXA) and quantitative computed tomography (QCT). Based on traditional bone density detection equipment, the newly developed imaging detection technology can further detect the microstructures and geometric features of bones, providing important reference for exploring the pathophysiological changes, sensitive clinical diagnosis, and disease monitoring of osteoporosis.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 1","pages":"29-39"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607357","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":"How to use properly the POL-RISK algorithm developed for 10-year prediction of osteoporotic fractures in daily practice.","authors":"Wojciech Pluskiewicz, Piotr Adamczyk, Bogna Drozdzowska","doi":"10.5603/ep.103617","DOIUrl":"10.5603/ep.103617","url":null,"abstract":"<p><strong>Introduction: </strong>Osteoporosis is one of the most common diseases in elderly subjects. Accurate assessment of fracture risk is essential in the management of osteoporotic patients. The aim of the study was to present the optimal manner of using a method designed for fracture risk prediction, e.g. POL-RISK, in daily practice.</p><p><strong>Material and methods: </strong>Methods for fracture prediction were presented, especially those which allow easy and quick online assessment. In addition to true medical aspect, e.g. the ability to accurately detect high fracture risk patients who need therapy, the economic aspects were also presented. Due to the enormous number of osteoporotic patients the therapy should be indicated mainly in patients with high fracture risk. The optimal threshold of fracture risk for the initiation of reimbursed therapy should be established as a compromise of prior established medical threshold and economic aspects. The expected endpoint is the reduction of new fractures noted in longitudinal observation.</p><p><strong>Conclusion: </strong>Implementation of the described scenario should enable the development of the optimal model of care in osteoporotic subjects. Broad use of fracture risk thresholds to initiate reimbursed therapy, encompassing both true medical and economic aspects, should result in the reduction of osteoporotic fractures and decrease overall osteoporosis-related costs to the healthcare system.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 1","pages":"82-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607384","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":"Metastatic follicular thyroid carcinoma with excellent response to radioiodine therapy.","authors":"Andreia Martins Fernandes, Ana Rita Elvas, Leandro Augusto Silva, Bernardo Marques, Eugénia Rovira, Fernando Jc Rodrigues","doi":"10.5603/ep.104971","DOIUrl":"10.5603/ep.104971","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 3","pages":"341-342"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531883","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":"Age, gender, and BMI in presentation of primary hyperparathyroidism: a single-center experience.","authors":"Katarina Mlekus Kozamernik, Gaj Vidmar, Mojca Jensterle Sever, Luka Lezaic, Marko Hocevar, Soncka Jazbinsek, Katarina Remec, Andrej Janez, Tomaz Kocjan","doi":"10.5603/ep.103968","DOIUrl":"https://doi.org/10.5603/ep.103968","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT) is a relatively common disease with considerable heterogeneity. We aimed to assess the impact of age, gender, and body mass index (BMI) on the presentation of PHPT.</p><p><strong>Material and methods: </strong>We retrospectively analyzed the baseline biochemical status, symptoms, renal manifestations, and bone mineral density (BMD) of patients diagnosed with PHPT at the national tertiary endocrine referral clinic from January 2004 to December 2016.</p><p><strong>Results: </strong>We included 415 patients (333 women [41 premenopausal, 292 postmenopausal] and 82 men) with PHPT, aged 64 years on average [standard deviation (SD)13, range 19-89 years], with an average BMI of 28.4 (SD 6.0, range 11.2-51.1 kg/m²). Older age was statisticallysignificantly associated with milder biochemical presentation - lower total and corrected calcium (standardized regression coefficient β = -0.17, p < 0.001 and β = -0.12, p = 0.018). In comparison with premenopausal women, postmenopausal women [estimated odds ratio (OR) = 8.6, 95% confidence interval (CI): 3.9-20.8; p < 0.001] and men (OR = 5.9, 95% CI: 2.5-15.6; p < 0.001) were more likely to suffer from skeletal manifestations of PHPT. Renal manifestations were less likely among postmenopausal than premenopausal women (OR = 0.4, 95% CI: 0.2-0.8; p = 0.014). BMI was negatively associated with skeletal and renal manifestations (OR = 0.94 per unit change, p = 0.002) and symptomatic presentation (OR = 0.96 per unit change, p = 0.012).</p><p><strong>Conclusion: </strong>Older patients with PHPT presented with a biochemically less florid disease. Postmenopausal women and men with PHPT were more likely to suffer from skeletal manifestations of PHPT than premenopausal women. Patients with higher BMI had fewer skeletal and renal manifestations of PHPT and were less likely to be symptomatic.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 4","pages":"450-456"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983785","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":"Association between stress hyperglycemia ratio and mortality in critically ill patients across different glucose metabolic status and diabetes mellitus subtypes.","authors":"Chong Zhang, Weiru Liang, Bin Su, Kun Hu, Wei Su, Yi Chen, Tingting Guo, Meng Ning, Fengkui Zhang, Yingwu Liu","doi":"10.5603/ep.105797","DOIUrl":"10.5603/ep.105797","url":null,"abstract":"<p><strong>Introduction: </strong>No study has specifically investigated the correlation between stress hyperglycemia ratio (SHR) and mortality in critically ill patients across different glucose metabolic status and diabetes mellitus (DM) subtypes.</p><p><strong>Material and methods: </strong>Analysis was conducted using the Medical Information Mart for Intensive Care-IV 2.2 database.</p><p><strong>Result: </strong>In this study, a total of 73,181 intensive care unit (ICU) patients were included, among whom 33,683 critically ill patients were included in the final analysis. Logistic model analysis revealed that the SHR was associated with elevated mortality rates in the ICU and in-hospital among patients with type 2 diabetes mellitus (T2DM) and those in the ICU with different glucose metabolism status, particularly in individuals with prediabetes mellitus (Pre-DM) and normal glucose regulation (NGR). In the Cox proportional hazards model, SHR was linked to an increased risk of one-year mortality, particularly among critically ill patients with Pre-DM. Mediation analysis revealed that the high SHR could account for 14.0% and 11.3% of the increased risk of ICU death and in-hospital mortality associated with DM, respectively.</p><p><strong>Conclusion: </strong>SHR is correlated with both short-term and long-term mortality in critically ill patients across various glucose metabolism status, particularly evident in those with NGR and Pre-DM. Moreover, SHR demonstrates an elevated risk of short-term and long-term mortality in critically ill patients with T2DM. Additionally, SHR plays a mediating role in the association between DM and mortality.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"552-561"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139384","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":"Disorders of the iron economy in females with Hashimoto's thyroiditis.","authors":"Marcin Gierach, Roman Junik","doi":"10.5603/ep.105209","DOIUrl":"10.5603/ep.105209","url":null,"abstract":"<p><strong>Introduction: </strong>Hashimoto's thyroiditis (HT) is the most common organ-specific autoimmune disorder. It is a chronic lymphocytic infiltration into the thyroid gland and is characterized by the production of anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibodies (TgAb). HT is a polygenic disease with an incompletely defined etiopathogenesis. It affects 0.3-1.5/1000 subjects/year and is 4-10 times more frequent in women than in men (3.5-5/1000 subjects/year in women versus 0.6-1.0/1000 subjects in men).</p><p><strong>Material and methods: </strong>The study group included 482 females of childbearing age (18-45 years). The group was divided into 3 subgroups: (147 - healthy individuals, 152 - hypothyreosis, 183 - HT). All patients were recruited in a 24-months period from the Cardiometabolic Center Gierach-Med in Bydgoszcz, Poland, and the Department of Endocrinology and Diabetology Collegium Medicum University of Nicolaus Copernicus in Bydgoszcz, Poland, and provided verbal consent to participate in the study.</p><p><strong>Results: </strong>We noticed that a lower level of ferritin was connected with a higher level of thyroid-stimulating hormone (TSH) in each of the subgroups. Additionally, we marked the correlation between ferritin and TSH and anti-thyroid antibodies (TPOAb and TgAb). There was a strong, negative correlation between TSH and ferritin level in all the study groups. Moreover, there was a weak, negative correlation between anti-TPO, anti-TG, and ferritin level in females with HT.</p><p><strong>Conclusions: </strong>To sum up, we believe that hypothyroidism, especially in the course of Hashimoto's disease, leads to an increased risk of iron and ferritin deficiency and requires monitoring of these parameters.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"485-489"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139481","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":"Breast neuroendocrine neoplasms - characteristics in contrast-enhanced mammography.","authors":"Agnieszka Niewiadomska, Anna Grażyńska, Violetta Rosiek, Mateusz Winder, Joanna Szczudło-Chraścina, Michał Hrapkowicz, Anna Barczyk-Gutkowska, Aleksandra Kuźbińska, Katarzyna Steinhof-Radwańska","doi":"10.5603/ep.104704","DOIUrl":"10.5603/ep.104704","url":null,"abstract":"<p><strong>Introduction: </strong>Neuroendocrine neoplasms of the breast (Br-NENs) constitute a heterogeneous group of rare tumors, whose number may be underestimated. Our study aims to evaluate and compare the analysis of the radiological features of Br-NEN and carcinomas with neuroendocrine differentiation (NEDBC), which were visualized in contrast-enhanced mammography (CEM) images.</p><p><strong>Material and methods: </strong>The histories of patients who, between 2015 and 2023, underwent CEM and core needle biopsy/postoperative histopathological examination confirming the nature of the lesion were retrospectively analyzed. All CEM images were acquired on two digital mammograms designed for dual-energy CEM acquisition (SenoBright et al., 3000 N. Grandview Blvd., Waukesha, WI, USA and Giotto Class, IMS Giotto, Sagittario, 5, 40037 Sasso Marconi BO, Italy). Two radiologists with at least eight years of experience describing CEM analyzed the studies and classified them into appropriate morphological categories.</p><p><strong>Results: </strong>Ten patients with histopathologically diagnosed Br-NEN and 14 with NEDBC were retrospectively assessed. The mean age of patients at the time of diagnosis of Br-NEN was 56.5 years, and for NEDBC it was 67.4 years. All Br-NEN lesions and 93% of NEDBC lesions were observed as masses on low-energy CEM images. In the Br-NEN group, lesions most often had an oval shape (40%), while NEDBC lesions were irregular (43%) and obscure (43%). Multifocality and multicentricity of the tumor process were observed much more often in the Br-NEN group than in the NEDBC group. In the recombinant images, all lesions from the two groups were enhanced after intravenous administration of the iodinated contrast agent.</p><p><strong>Conclusion: </strong>Br-NEN and NEDBC show similar radiological features on CEM images, differing only in a few aspects.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"403-414"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736315","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":"Elevated thyroglobulin levels in fine-needle aspiration washout fluid from thyroid nodules: a potential marker of benign nature?","authors":"Serhat Uysal, Cem Sulu, Banu Betul Kocaman, Ilkin Muradov, Lala Soltanova, Serdar Sahin, Hande Mefkure Ozkaya, Dildar Konukoglu, Taner Damci, Mustafa Sait Gonen","doi":"10.5603/ep.105584","DOIUrl":"10.5603/ep.105584","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the relationship between thyroglobulin (Tg) levels obtained from thyroid fine-needle aspiration (FNA) and cytopathological results.</p><p><strong>Material and methods: </strong>This cross-sectional study included patients who underwent FNA between January 2023 and August 2024 in accordance with the American College of Radiology Thyroid Imaging Reporting and Data System risk scoring. Patients with pure cystic nodules, non-thyroid malignancy, and major psychiatric disorders that could interfere with compliance during the procedure were excluded from the study. FNA-Tg samples were obtained from the nodules using a 22-gauge needle on the first attempt. FNA-Tg levels were then measured by electrochemiluminescence immunoassay. These levels were compared among different patient groups and classified according to the cytopathological examination results based on the Bethesda System for Reporting Thyroid Cytopathology. Statistical analyses were performed using the Statistical Package for the Social Sciences, version 20.</p><p><strong>Results: </strong>The study included 193 FNA samples in 193 patients. In 148 (76.7%) out of 193 samples the aspirate was diagnostic. Of these, 101 (68.2%) were benign (Bethesda II), 29 (19.6%) were indeterminate (Bethesda III-IV), and 18 (12.2%) were malignant (Bethesda V-VI). FNA-Tg levels were significantly higher in benign nodules compared to malignant ones (p < 0.001). There was no significant difference between concomitant serum Tg levels in patients with benign and malignant nodules (p = 0.614). An FNA-Tg value above 13,262 ng/mL predicted benign cytology with 71.3% sensitivity and 77.8% specificity.</p><p><strong>Conclusions: </strong>FNA-Tg levels may provide valuable insights into FNA cytology and serve as an effective marker for distinguishing benign nodules from those with malignant characteristics.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"397-402"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736318","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}