Postgraduate medicine最新文献

{"title":"Non-hemolytic acute transfusion reactions: the impact of patient and blood product characteristics.","authors":"Abdulkerim Yıldız, Gökhan Evren, Bilge Zihar, Samet Yaman","doi":"10.1080/00325481.2024.2396797","DOIUrl":"10.1080/00325481.2024.2396797","url":null,"abstract":"<p><strong>Background: </strong>Non-hemolytic acute transfusion reactions (ATRs) are generally not fatal, but they can cause serious increases in workload and costs as a result of blood product wastage.</p><p><strong>Methods: </strong>A retrospective analysis was made of the data of the 7-year period between January 2016 and December 2022 to identify the possible associations between patient and product characteristics and the development of ATRs.</p><p><strong>Results: </strong>A total of 113,666 blood products were transfused during the study period. There were 146 ATRs with an estimated rate of 1.28 per 1000 blood products administered. The most common ATR was mild allergic reactions (<i>n</i> = 84, 57.6%). No statistically significant relationship was found in blood group distribution between patients who had and did not develop ATR (<i>p</i> = 0.797). Febrile Non-hemolytic Transfusion Reaction (FNHTR) was more common in patients receiving erythrocyte suspension (ES) transfusion, and Fresh Frozen Plasma (FFP) was mostly used in those with mild allergic reactions (<i>p</i> < 0.001). Patient age was determined as > 60 years in those who developed FNHTR or 'others,' and < 60 years in patients with mild allergic reactions (<i>p</i> = 0.046).</p><p><strong>Conclusion: </strong>The results of the current study demonstrated that regardless of blood group, the probability of developing FNHTR is high when ES is transfused in elderly patients, and the probability of developing mild allergic reaction is high when FFP is used. While recognizing that ATRs are difficult to prevent, it can be emphasized that prediction and management may become easier if clinicians keep these possibilities in mind when making transfusion decisions.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"726-730"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082990","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":"National survey on peritonsillar abscess treatment and attitudes toward quinsy tonsillectomy.","authors":"Raviv Allon, Elchanan Zloczower, Maxim Chebotaryov, Sapir Pinhas, Yonatan Lahav, Yael Shapira-Galitz","doi":"10.1080/00325481.2024.2399497","DOIUrl":"10.1080/00325481.2024.2399497","url":null,"abstract":"<p><strong>Objectives: </strong>Peritonsillar abscess (PTA) is a common deep neck infection traditionally managed with conservative measures. Quinsy Tonsillectomy (QT) is recognized as a definitive treatment but remains variably utilized. We aimed to investigate PTA management strategies and attitudes toward QT among otolaryngologists.</p><p><strong>Methods: </strong>An anonymous questionnaire was distributed to members of the local national Society of Otolaryngology, evaluating treatment strategies based on patient characteristics and clinical scenario.</p><p><strong>Results: </strong>A total of 108 otolaryngologists responded (response rate: 30.8%). Participants preferred to treat PTA patients as inpatients (89%) and predominantly offered incision and drainage (I&D) as the first (90.7%) and subsequent (98.1%) treatment plan. QT was favored as a primary treatment only in 1.9% of responders. QT adoption increased with multiple I&D failures, reaching 95.3% after four attempts. In patients with recurrent PTA or tonsillitis, 84.2% preferred I&D follows by interval elective tonsillectomy, while 15% considered QT. The most common reason (72.2%) to avoid QT was the perception of a high perioperative risk.</p><p><strong>Conclusion: </strong>I&D was favored for initial PTA treatment. QT is considered after multiple failed I&D attempts, and its use is limited as a primary treatment, mainly due to concerns regarding perioperative risk.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"757-763"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116642","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":"Exploring the role of affective temperaments: predicting major depressive disorder in the context of borderline personality disorder.","authors":"Yaşan Bilge Şair, İrem Saraçoğlu","doi":"10.1080/00325481.2024.2402210","DOIUrl":"10.1080/00325481.2024.2402210","url":null,"abstract":"<p><strong>Purpose: </strong>Major depressive disorder (MDD) is a complex condition believed to arise from a multifaceted interplay of genetic, environmental, and biological factors. In the pursuit of understanding its etiology, two elements that warrant investigation are borderline personality disorder (BPD) and affective temperaments. We aim to gain deeper insights into the mechanisms underlying this debilitating mental health condition.</p><p><strong>Method: </strong>The dataset comprises individuals who sought assistance from psychiatry outpatient clinics for diverse reasons during the period spanning from 2018 to 2022. These individuals underwent SCID-II assessments to diagnose borderline personality disorder (BPD) and also completed the TEMPS-A temperament tests.</p><p><strong>Results: </strong>The mean years of schooling was lower in the MDD group (<i>p</i> = 0.014). Two groups are compared in terms of affective temperament. Depressive (<i>p</i> < 0.0001), cyclothymic (<i>p</i> < 0.0001), anxious (<i>p</i> = 0.001), and irritable (<i>p</i> < 0.0001) temperament scores were statistically higher in the MDD group. Apart from the scale scores, the prevalence of affective temperament was evaluated and the same temperaments (depressive (<i>p</i> < 0.0001), cyclothymic (<i>p</i> < 0.0001), anxious (<i>p</i> = 0.001), and irritable (<i>p</i> < 0.0001)) were found to be significantly higher in the MDD group. Diagnosis of BPD is higher in the MDD group (<i>p</i> = 0.002). Binary logistic regression analysis revealed that the presence of cyclothymic temperament and marital status may be predictor factors for the development of MDD (<i>p</i> < 0.0001, CI: 0.001-0.121 and <i>p</i> = 0.002, CI: 1.550-7.172, respectively).</p><p><strong>Conclusion: </strong>Notably, higher scores in cyclothymic temperament and experiencing loneliness have been identified as significantly associated with MDD. Interestingly, in patients with comorbid BPD-MDD, the presence of cyclothymic temperament appears to be a more critical factor than personality traits. This finding underscores the potential role of cyclothymic temperament in contributing to the co-occurrence of BPD and MDD.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"764-769"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305148","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":"Letter regarding 'comparison of two ablation procedures combined with high ligation and foam sclerotherapy and compression therapy for patients with venous leg ulcers'.","authors":"Hamza Zaheer, Muhammad Hammad Zaheer, Muhammad Haris","doi":"10.1080/00325481.2024.2395247","DOIUrl":"10.1080/00325481.2024.2395247","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"691"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057655","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":"The association between frailty biomarkers and 20-year all-cause and cardiovascular mortality among community-dwelling older adults.","authors":"Yonatan Moshkovits, Angela Chetrit, Rachel Dankner","doi":"10.1080/00325481.2024.2374703","DOIUrl":"10.1080/00325481.2024.2374703","url":null,"abstract":"<p><strong>Objectives: </strong>While several biomarkers were previously associated with frailty and mortality, data are still contradicting. We aimed to evaluate the association between novel biomarkers and frailty among community-dwelling older adults to enhance understanding of the pathophysiology of frailty.</p><p><strong>Methods: </strong>Nine hundred and sixty-three older adults were screened during the third phase (1999-2008) of the Israel study on Glucose Intolerance, Obesity, and Hypertension (GOH). Frailty was defined as sedentary individuals, past 10 years hospitalizations, or at least one of the following: body mass index (BMI) <21 kg/m²; albumin <3.2 g/dl; ≥2 major baseline diseases. Biomarkers were evaluated for their association with frailty, all-cause, and cardiovascular mortality.</p><p><strong>Results: </strong>Mean baseline age was 72 ± 7 years, 471 (49%) were women, and 195 (20%) were classified as frail. Median follow-up for cardiovascular and all-cause mortality was 11 and 13 years, with 179 (18.6%) and 466 (48.4%) deaths recorded, respectively. Multivariable logistic regression showed greater odds for frailty with lower quartile of alanine aminotransferase (ALT) (OR = 1.8, 95%CI: 1.2-2.8, <i>p</i> = 0.01), and for each 5 µmol/L increment in homocysteine levels (OR = 1.3, 95%CI: 1.1-1.5, <i>p</i> = 0.001). Multivariate Cox regression showed greater all-cause and cardiovascular mortality risk for individuals with low ALT (HR = 1.6, 95%CI: 1.3-2.0, <i>p</i> < 0.001 and HR = 1.5, 95% CI: 1.0-2.2, <i>p</i> = 0.03, respectively), and high homocysteine (HR = 1.1, 95%CI: 1.1-1.3, <i>p</i> = 0.003 and HR = 1.2, 95%CI: 1.0-1.3, <i>p</i> = 0.04, respectively). Homocysteine association with mortality was more pronounced in those with baseline ischemic heart disease (IHD) compared with subjects free of IHD (P for interaction = 0.01).</p><p><strong>Conclusions: </strong>Lower ALT and higher homocysteine were associated with frailty, all-cause and cardiovascular mortality. These available and low-cost biomarkers underscore the nutritional and metabolic aspects of frailty when screening high-risk older adults, especially those with IHD, and may be considered as preferable screening biomarkers to be tested among these individuals for frailty and mortality risk.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"641-650"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474116","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":"Clinical trial designs of emerging therapies for diabetic kidney disease (DKD).","authors":"Ajay K Singh, Youssef M K Farag, Zihe Zheng, George L Bakris","doi":"10.1080/00325481.2024.2377529","DOIUrl":"10.1080/00325481.2024.2377529","url":null,"abstract":"<p><p>Current evidence for medical therapies for diabetic kidney disease (DKD) is largely based on large-scale clinical trials. These trials, however, often exhibit heterogeneity in participant characteristics and baseline kidney function. These differences may lead to misinterpretation in clinical practice, such that treatment effects from different trials are directly compared and generalized to broader populations beyond the population in which each trial was conducted. This is particularly relevant if comparisons on efficacy and safety are made when the underlying study populations are distinctly different. Indeed, key clinical trials evaluating sodium-glucose transport protein-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonist (nsMRA), and glucagon-like peptide-1 receptor agonist (GLP-1RA) differed in recruitment requirements (inclusion/exclusion criteria), resulting in differences in the severity of the underlying kidney disease as well as risk factor profiles. Moreover, these trials defined their primary and secondary outcomes differently. Collectively, these factors lead to distinct study populations with different baseline risks for DKD progression in the placebo arm in each clinical trial. Consequently, a direct head-to-head comparison of the treatment effect between treatments using relative risk measures from placebo-controlled clinical trials alone is not recommended. In addition, healthcare professionals should be equipped to understand the specific target population of clinical trials to avoid over-generalization when drawing conclusions from these trials.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"585-593"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753641","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 frailty status and falling in older adults with hip fracture: a cross-sectional study.","authors":"Lan Jiang, Lili Yang, Ziyuan Hong, Xuewei Yao","doi":"10.1080/00325481.2024.2384827","DOIUrl":"10.1080/00325481.2024.2384827","url":null,"abstract":"<p><strong>Objectives: </strong>There is limited research on the relationship between frailty status and falls in hip fractures in older participants. This study aimed to investigate the relationship between frailty and falls in older adults who had experienced a hip fracture.</p><p><strong>Methods: </strong>From June 2023 to January 2024, the study population comprised 253 hip fracture patients aged 60 years and over. They were admitted to the orthopedic department of a tertiary care hospital. We excluded participants with incomplete information. The 5-item FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, and Loss of Weight) was used to assess frailty status and the patient's self-reported falls. We analyzed the relationship between frailty and falls in older hip fracture patients using logistic regression models, subgroup analyses, and stratified analyses.</p><p><strong>Results: </strong>Finally, 174 older participants with hip fractures were identified in this study, where 155 (89.1%) had falls. Among 155 falls, 39 (78.0%) were in the robust group, 65 (91.5%) were in the pre-frail group, and 51 (96.2%) were in the frail group. An analysis revealed that among more than 60 years old hip fracture patients, each additional point in frailty score was significantly linked to a higher likelihood of experiencing a fall (OR: 1.97, 95% CI: 1.10-3.52, <i>p</i> < 0.05). While frailty appeared as a categorical variable, this association was stronger with an OR of 2.68 (95% CI: 0.71-10.21) in the pre-frailty group and 7.95 (95% CI: 1.11-57.08), compared to the robust group (p for trend < 0.005). In subgroup analyses, an interaction was observed between frailty and falling according to sex. In stratified analyses, the relationship between frailty status and fall significantly differed between the male and female groups (male OR: 1.49, 95% CI: 0.71 -3.13; female OR: 7.54, 95% CI: 1.13 - 50.32, p for interaction = 0.035).</p><p><strong>Conclusions: </strong>The study revealed a notable correlation between frailty and falls, with gender and frailty showing an interaction impact on the increased occurrence of falls. Therefore, further research across diverse disease populations is needed to explore the link between frailty status and falls. Large-scale prospective studies are necessary to clarify the causality of this relationship.</p><p><strong>Clinical trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR2300073031).</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"651-658"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753642","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":"A new perspective on OSAS cases with the Baveno classification.","authors":"Handan Inonu Koseoglu, Gökhan Aykun, Asiye Kanbay, Ahmet Cemal Pazarli, Halil İbrahim Yakar, Osman Demir","doi":"10.1080/00325481.2024.2379759","DOIUrl":"10.1080/00325481.2024.2379759","url":null,"abstract":"<p><strong>Objective/background: </strong>Since the apnea-hypopnea index (AHI), which is used in the diagnosis and grading of OSAS, does not adequately reflect the clinical perspective of the disease, the Baveno classification of OSA was developed, which allows multicomponent evaluation of OSAS patients. The aim of our study was to evaluate the application of the Baveno classification in clinical practice.</p><p><strong>Patients/methods: </strong>A prospective study was performed on patients diagnosed with OSAS between January 2021 and June 2022. Patients were divided into 4 groups according to Baveno classification (Groups A-D) and three groups as mild, moderate, and severe OSAS according to AHI.</p><p><strong>Results: </strong>A total of 378 patients (70% male, mean age 48.68 ± 11.81 years) were included in the study. The patients had mild (n: 75; 20%), moderate (n: 88; 23%), and severe (n: 215; 57%) OSAS. According to Baveno classification, patients were included in Groups A (n: 90; 24%), B (n: 105 (28%), C (n: 65; 17%), and D (n: 118; 31%). The mean AHIs of the Baveno groups were similar (<i>p</i> = 0.116). Oxygen desaturation index (ODI) was higher in Groups B and D compared to Group A. The duration of T90 desaturation was longer in Groups C and D compared to Groups A and B (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The Baveno classification divided our OSAS cases into equivalent groups. One out of every four patients with mild OSAS was in Group D. This data was noteworthy in that the Baveno classification allows for the identification of symptomatic and comorbid patients with mild OSAS according to AHI and for the application of more effective treatments to these patients. Patients with comorbidities experienced oxygen desaturation for a longer period of time at night, and oxygenation deteriorated in patients with prominent symptoms. Baveno classification was found to be a more reasonable and easily applicable approach in clinical practice.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"659-665"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592478","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":"Uric acid and cardiovascular diseases: a reappraisal.","authors":"Akruti Patel Prabhakar, Angel Lopez-Candales","doi":"10.1080/00325481.2024.2377952","DOIUrl":"10.1080/00325481.2024.2377952","url":null,"abstract":"<p><p>Serum uric acid (SUA) has garnered an increased interest in recent years as an important determinant of cardiovascular disease. Uric acid, a degradation product of purine metabolism, is affected by several inheritable and acquired factors, such as genetic mutation, metabolic syndrome, chronic kidney disease, and medication interactions. Even though elevated SUA have been commonly associated with the development of gout, it has significant impact in the development of hypertension, metabolic syndrome, and cardiovascular disease. Uric acid, in both crystalline and soluble forms, plays a key role in the induction of inflammatory cascade and development of atherosclerotic diseases. This concise reappraisal emphasizes key features about the complex and challenging role of uric acid in the development and progression of atherosclerosis and cardiovascular disease. It explores the pathogenesis and historical significance of uric acid, highlights the complex interplay between uric acid and components of metabolic syndrome, focuses on the pro-inflammatory and pro-atherogenic effects of uric acid, as well as discusses the role of urate lowering therapies in mitigating the risk of cardiovascular disease while providing the latest evidence to the healthcare professionals focusing on the clinical importance of SUA levels with regards to cardiovascular disease.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"615-623"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556303","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":"The impact of palliative care on the frailty-stroke continuum: from theoretical concepts to practical aspects.","authors":"Ioan-Alexandru Chirap-Mitulschi, Sabina Antoniu, Thomas Gabriel Schreiner","doi":"10.1080/00325481.2024.2374701","DOIUrl":"10.1080/00325481.2024.2374701","url":null,"abstract":"<p><p>With a constant increase in prevalence and incidence worldwide, stroke remains a public health issue in the 21^st century. Additionally, population aging inevitably leads to increased vulnerability in the general population, a clinical state known as frailty. While there are adequate guidelines on the treatment of stroke in the acute setting, there are a lot of gaps regarding the chronic management of stroke patients, particularly the frail ones. From the therapeutic point of view, palliative care could be the key to offering complex and individualized treatment to these frail chronic stroke patients. In the context of the heterogeneous data and incomplete therapeutic guidelines, this article provides a new and original perspective on the topic, aiming to increase awareness and understanding and improve palliative care management in stroke patients. Based on current knowledge, the authors describe a new concept called the frailty-stroke continuum and offer a detailed explanation of the intricate stroke-frailty connection in the first part. After understanding the role of palliative care in managing this kind of patients, the authors discuss the most relevant practical aspects aiming to offer an individualized framework for daily clinical practice. The novel approach consists of developing a four-step scale for characterizing frail stroke patients, with the final aim of providing personalized treatment and correctly evaluating prognosis. By pointing out the limitations of current guidelines and the challenges of new research directions, this article opens the pathway for the better evaluation of frail stroke patients, offering a better perception of patients' prognosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":" ","pages":"624-632"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494712","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}