Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia最新文献

{"title":"Comparison of perceived versus actual care complexity in HIV-positive patients receiving antiretroviral treatment: The STRATPATIENT study.","authors":"Cristina Galindo García, Enrique Contreras-Macías, Gema Araceli Naranjo-Pérez, Ramón Morillo-Verdugo","doi":"10.37201/req/014.2025","DOIUrl":"https://doi.org/10.37201/req/014.2025","url":null,"abstract":"<p><strong>Introduction: </strong>HIV is now considered a chronic disease due to advances in antiretroviral therapy (ART), which have improved survival but have also increased both comorbidities and polypharmacy. This underscores the need for personalized care strategies such as the Capacity-Motivation-Opportunity (CMO) model and patient stratification tools. This study aimed to identify the discrepancy between patient-perceived and actual care complexity in HIV-positive patients on ART, as assessed by a stratification tool.</p><p><strong>Methods: </strong>A retrospective, observational study at Valme Hospital (April-June 2024) included HIV-positive patients aged over 18 years on stable ART, excluding clinical trial participants. Data collected included age, sex, route of HIV acquisition, viral load, CD4 count, AIDS stage, comorbidities, polypharmacy and the Medication Regimen Complexity Index (MRCI). Perceived complexity was assessed using a visual analogue scale, whereas complexity according to the stratification tool was calculated with the variables of the CMO model.</p><p><strong>Results: </strong>A total of 411 participants with a median age of 55 years were included, of whom 72.5 % had comorbidities, primarily cardiovascular. The median MRCI score was 8, with 85.4 % of patients were classified at stratification level 3, while 74.9 % reported low perceived healthcare complexity. Concordance between stratification and perceived complexity was weak. Significant associations were observed between perceived complexity and AIDS stage, extensive polypharmacy, and stratification levels.</p><p><strong>Conclusion: </strong>This study emphasises integrating objective assessments and patient perspectives to improve healthcare evaluation and patient-centered care.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164348","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":"Conjunctival and cutaneous Kaposi's Sarcoma as the first manifestation of HIV infection.","authors":"Raúl Parra-Fariñas, Carlota Insua, Lucía Buznego, Paula Runza, Carlos Armiñanzas, Manuel Gutierrez-Cuadra, Sara Marcos-González, Francisco Arnaiz de Las Revillas","doi":"10.37201/req/013.2025","DOIUrl":"https://doi.org/10.37201/req/013.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164351","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":"Evolution of postsurgical mediastinis after major heart surgery (mhs) in the last 12 years: are we improving?","authors":"María Jesús Pérez-Granda, Emilio Bouza, José María Barrio-Gutiérrez, Marina Machado, Agustín Estevez, Gregorio Cuerpo, Javier Hortal, Patricia Muñoz, Ángel González-Pinto, Maricela Valerio","doi":"10.37201/req/041.2025","DOIUrl":"https://doi.org/10.37201/req/041.2025","url":null,"abstract":"<p><strong>Background: </strong>Postsurgical mediastinitis (PSM) is a serious and potentially life-threatening complication of Major Heart Surgery (MHS). Data on the evolution of the incidence of PSM after MHS in large series of operated patients in recent years are scarce. The aim of our study was to evaluate the trend of incidence, microbial etiology, and associated mortality of PSM at a referral MHS unit in the last 12 years.</p><p><strong>Material and methods: </strong>The study was conducted at a tertiary hospital in Madrid, Spain. We carried out a retrospective and cross-sectional study that included all patients who underwent CCM and developed MPQ between January 2012 and December 2023 at our institution. It was conducted at a tertiary hospital in Madrid, Spain. We carried out a retrospective and cross-sectional study that included all patients who underwent CCM and developed MPQ between January 2012 and December 2023 at our institution.</p><p><strong>Results: </strong>During the 12-year study period, a total of 5,584 patients underwent MHS at our institution. The incidence rate of PSM varied yearly between 1.16 and 2.34 episodes/100 surgical procedures. Overall, the 89 patients with PSM were analyzed (92 different episodes). Their median age was 67 years (IQR 56-75) and most of them were male (63%). Their median Euroscore was 7 (IQR 5-9.5). Main type of heart surgery in patients with PSM was: coronary artery bypass graft in 37% and valve replacement in 32.6%. The more frequent causative microorganisms were: Gram-positive bacteria (59.0%), Gram-negative bacteria (32.4%), fungi (7.6%) and others (1%). Overall, 22 patients died (24.7%).</p><p><strong>Conclusion: </strong>The incidence of PSM has remained stable and below 2.5% in the last 12 years in our institution, but it continues to be an entity associated with high morbidity and mortality and long hospital stays.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164396","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":"[Impact of increasing the frequency of meetings in which the Antimicrobial Stewardship Programme team conducted prospective audit and feedback on antimicrobial consumption].","authors":"María Inmaculada Zas-García, José Manuel Fernández-Carreira, Jorge Rodríguez-Prida, Ana Blanco-Suárez, Marcos Álvarez-Pérez, Jesús Rubio-Sanz, Elsa Castelo-Alvárez, Daniel González-Fernández, Tania Rubio-Alfonso","doi":"10.37201/req/022.2025","DOIUrl":"https://doi.org/10.37201/req/022.2025","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate how antimicrobial consumption was influenced by increasing the frequency of meetings in which the Antimicrobial Stewardship Program (ASP) team conducted prospective audit and feedback (PAF).</p><p><strong>Materials and methods: </strong>Retrospective cohort study comparing consumption in DDD per 1000 beds-day and DDD per 1000 admissions across groups of anti-infectives, antibacterial groups, agents against methicillin-susceptible <i>Staphylococcus aureus</i> (anti-MSSA agents)/agents against methicillin-resistant <i>Staphylococcus aureus</i> (anti-MRSA agents), antibiotics targeting sensitive Gram-negative bacteria/antibiotics targeting resistant Gram-negative bacteria and antimicrobial agents, during two comparative periods of ASP activity (2 weekly meetings in 2023 versus 1 weekly meeting in 2022).</p><p><strong>Results: </strong>Comparing 2023 to 2022: antibacterials for systemic use consumption increased in DDD per 1000 beds-day (+0.13%) and decreased in DDD per 1000 admissions (-3.55 %); consumption in DDD per 1000 beds-day and DDD per 1000 admissions increased for penicillins, glycopeptides and aminoglycosides while it decreased for cephalosporins and carbapenems, quinolones use increased per beds-days but decreased per admissions; regarding anti-MSSA and anti-MRSA agents, consumption of cefazolin, cloxacillin, vancomycin and daptomycin increased in DDD per 1000 beds-day and DDD per 1000 admissions, linezolid consumption increased per beds-day but decreased per admissions; for antibiotics targeting sensitive Gram-negative bacteria and antibiotics targeting resistant Gram-negative bacteria, consumption of amoxicillin-clavulanate, piperacillin-tazobactam, aminoglycosides, ceftazidime, cefepime and polymyxins increased per DDD/1000 bed-days and DDD per 1000 admissions, carbapenems consumption decreased per bed-days and admissions.</p><p><strong>Conclusion: </strong>The increase in the frequency of meetings seems to be related to better use of antimicrobials in our center.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164331","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":"[Early diagnosis of a case of septic arthritis thanks to the BioFire^® joint infection panel].","authors":"José Carlos De Gracia-Díaz, Ana Madueño, Sara Díaz-Martín, María Lecuona-Fernández","doi":"10.37201/req/023.2025","DOIUrl":"https://doi.org/10.37201/req/023.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164281","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":"[Ability of midregional proadrenomedullin (MR-proADM) to predict poor clinical outcome and stratify prognosis in adult patients seen for suspected infection in the Emergency Department].","authors":"Elena de Rafael-González, Javier Cabañas-Morafraile, Laura Serrano-Martín, Agustín Julián-Jiménez, María Torres-Fernández, Elia Chaves-Prieto, Laura Morell-Jurado, William Esneider López-Forero, María Francisca Calafell-Mas, Álvaro Thomas-Balaguer Cordero, María Remedios Asensio-Nieto, Isabel Nieto-Rojas, Rafael Rubio-Díaz, Eva Heredero-Gálvez, María Carmen Lorenzo-Lozano, Raúl Canabal-Berlanga","doi":"10.37201/req/031.2025","DOIUrl":"https://doi.org/10.37201/req/031.2025","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze and compare the accuracy of midregional proadrenomedullin (MR-proADM) to predict poor clinical outcome (understood as progression to septic shock or admission to the Critical Care Unit -CCU-) and 30-day mortality in adult patients seen for suspected infection in the Emergency Department (ED). We also compared their performance with other biomarkers (C-reactive protein -CRP-, procalcitonin -PCT-, lactate and leukocyte count) and clinical scales widely used in routine practice (qSOFA, SRIS, NEWS-2).</p><p><strong>Methods: </strong>A prospective, observational and analytical study was carried out on adult patients who were treated in an ED with the clinical diagnosis of an infectious process. Follow-up was carried out for 30 days. The main outcome was a composite measure that included progression to septic shock or admission to the CCU and 30-day mortality. The predictive ability was analyzed with the area under the curve (AUC) of the receiver operating characteristic (ROC) and the values of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) of MR-proADM, PCR, PCT, lactate, leukocyte count and the clinical scales.</p><p><strong>Results: </strong>214 patients were included, of whom 31 (14.5%) fulfilled the combined variable. The mean age was 68.6 (SD 20.75) years, 55.1% (118) were men. The MR-proADM concentration achieved the best AUC-ROC of 0.920 (95% CI: 0.850-0.989) compared to the other biomarkers and clinical scales. With a cut-off point (Cp) according to the Youden index > 2.105 nmol/L, a Se: 68%, Es: 98% and NPV: 97% were obtained. The NEWS-2 scale ≥ 5 achieves an AUC-ROC of 0.733 (95% CI: 0.630-0.835) with a Se: 87%, Es: 55% and NPV: 96%. The mixed model (MR-proADM ≥2.1 nmol/l + NEWS-2 ≥5) improved the AUC-ROC to 0.849 (95% CI: 0.782-0.915) and Se: 68%, Es: 98%, PPV: 74% and NPV: 88%.</p><p><strong>Conclusion: </strong>In adult patients attended with clinical suspicion of infection in the ED, MR-proADM presents a high ability to predict poor clinical evolution (progression to septic shock or ICU admission) and 30-day mortality and performs better than PCT, lactate, CRP, leukocyte count and the clinical scales qSOFA, SRIS, NEWS-2. The combined model (MR-proADM ≥2.1 nmol/L + NEWS-2 ≥5) improves prediction of both MR-proADM and clinical scales.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164279","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":"[Impact of a dedicated multidisciplinary committee (<i>endocarditis team</i>) on the management and outcome of infective endocarditis in a reference center].","authors":"Javier Iglesias-Varea, Mario Fernández-Ruiz, Laura Domínguez, Jorge Boán, Eduardo Aparicio-Minguijón, Antonio Terrón, María Asunción Pérez-Jacoiste Asín, José María Aguado, Francisco López-Medrano","doi":"10.37201/req/020.2025","DOIUrl":"https://doi.org/10.37201/req/020.2025","url":null,"abstract":"<p><strong>Introduction: </strong>Infective endocarditis (IE) is a complex condition associated with high morbidity and mortality. The creation of multidisciplinary teams (endocarditis team) has been shown to improve its management and prognosis. We analysed the impact of the formal implementation of a multidisciplinary IE committee (coIE) in a tertiary care hospital.</p><p><strong>Methods: </strong>Single-centre quasi-experimental study comparing two periods: before (2010-2015) and after (2017-2021) the implementation of the coIE. The coIE met weekly (and on demand when necessary) to make decisions regarding medical and surgical management in patients with definite or possible IE, following a protocol based on international guidelines.</p><p><strong>Results: </strong>We included 92 and 97 patients in the pre- and post-intervention periods, respectively. Demographic characteristics, predisposing factors, and types of IE were similar. No significant differences were observed in the proportion of patients with surgical indication who underwent surgery (30.2 % vs 39.1 %, respectively; p = 0.317), in-hospital mortality (27.2 % vs 34.0 %; p = 0.308), or one-year mortality (32.6 % vs 45.4 %; p = 0.073). The median (interquartile range) time from diagnosis to surgery decreased in the post-intervention period (11.5 [6.3-25.3] vs 7 [3-10] days; p = 0.026). The diagnosis of embolic events was more frequent in this period (46.7 % vs 58.8 %; p = 0.098).</p><p><strong>Conclusion: </strong>Although we did not observe a significant impact on mortality among patients with definite IE after the implementation of an endocarditis team, we noted a favourable trend in intermediate indicators of healthcare quality.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164327","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":"Healthcare resource utilization and costs associated with inadequate initial antibiotic treatment of bacteraemia produced by carbapenem-resistant Gram-negative bacilli (CRGNB): a descriptive, observational study in Spanish hospitals.","authors":"José Garnacho-Montero, José María Aguado, Enrique Alemparte, Juan P Horcajada, Francisco López-Medrano, Paula Ramírez, Ariadna Giró-Perafita, Martí Blasco, Borja Suberviola","doi":"10.37201/req/121.2024","DOIUrl":"10.37201/req/121.2024","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem-resistant gram-negative bacilli (CRGNB) are one of the main causes of nosocomial infections, posing a major public health challenge. Blood stream infections (BSI) require special attention because of the higher morbidity and mortality associated.</p><p><strong>Objective: </strong>To assess the impact of initial adequate or inadequate antibiotic treatment on the length of stay (LOS) and healthcare resource utilisation of patients with bloodstream infections (BSI) caused by a Carbapenem-resistant gram-negative bacilli (CRGNB) in the Spanish clinical practice.</p><p><strong>Methods: </strong>A descriptive, observational, retrospective chart review study of patients diagnosed with CRGNB bacteriemia in 6 Spanish public hospitals.</p><p><strong>Results: </strong>The overall median LOS of the total population (n=64) was 26.5 days (Q1: 16 days; Q3: 40 days). The median LOS for the initially adequately treated group was 27 days (Q1: 17; Q3: 50), and 24 days (Q1: 15; Q3: 38) for the initially inadequately treated (t-test p= 0.5031). In the Hospital Ward group (n=44), initially adequately treated patients spent hospitalised a median of 6 days less than the initially inadequately treated patients (18 days [Q1: 12; Q3: 27] vs 24 days [Q1: 15; Q3: 38] respectively, p=0.0269). In the total population analysis, initially adequately treated patients had a lower use of resources (20,895.02 [Q1: 11,543.67 ; Q3: 61,773.17 ]) compared to initially inadequately treated patients (24,444.02 [Q1: 11,571.63 ; Q3: 40,790.64 ).</p><p><strong>Conclusion: </strong>Results suggest that inadequate empirical treatment for BSI caused by CRGNB in the hospital ward could be associated with an increase in the LOS and resource utilization of these patients.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":"38 3","pages":"197-207"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143495133","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":"Cefiderocol-associated chromaturia, a secondary side effect to recognize.","authors":"Victoria Lobo-Antuña, Marta Lobo-Antuña, Margarita Monzón-Torres, Sebastián Ortiz-Zuluaga, Armando Mena-Durán, Carmen Ricart-Olmos","doi":"10.37201/req/019.2025","DOIUrl":"10.37201/req/019.2025","url":null,"abstract":"","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":"38 3","pages":"253-254"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589089","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":"Usefulness of business intelligence to guide antimicrobial treatment decision in infections by infrequent microorganism such as <i>Bordetella bronchiseptica</i>.","authors":"Ángel Rodríguez-Villodres, María Valentina Hoffmann-Álvarez, Pedro Camacho-Martínez, José Antonio Lepe","doi":"10.37201/req/125.2024","DOIUrl":"10.37201/req/125.2024","url":null,"abstract":"<p><p>Human infections by <i>Bordetella bronchiseptica</i> are increasing in recent years. However, due to the lack of clinical susceptibility/resistance breakpoints, antimicrobial treatment is complex. Business Intelligence (BI) is a tool that allows to record and analyze large amounts of data in a very short time. The aim of this study was to analyze a cohort of patients with <i>B. bronchiseptica</i> infections focusing on how BI can help guide empirical antimicrobial therapy Demographic, clinical, and microbiological data about <i>B. bronchiseptica</i> infections were recovered. Then, MIC_50/90 of several antibiotics was automatically calculated through the BI. Thirteen <i>B. bronchiseptica</i> infections were identified. The lowest MICs₉₀ were for carbapenem, aminoglycoside, fluoroquinolones, and tetracyclines. The EUCAST PK-PD (non-species related) breakpoints showed that only piperacillin/tazobactam, imipenem and meropenem would be appropriate treatments to use empirically. In conclusion, BI systems have great potential to optimize the empirical antibiotic treatment in these types of infections.</p>","PeriodicalId":94198,"journal":{"name":"Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia","volume":"38 3","pages":"208-213"},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12095938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627348","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}