Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery最新文献

{"title":"Evaluating safety and outcomes of concurrent cholecystectomy in revisional and conversion bariatric surgery: an Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program case cohort analysis of 72,189 patients.","authors":"Thomas H Shin, Valentin Mocanu, Donovan Hui, Leighton Matthews, Juan S Barajas-Gamboa, Melissa Wills, Cullen Carter, Peter Hallowell, Bruce Schirmer, Jerry Dang","doi":"10.1016/j.soard.2025.05.017","DOIUrl":"10.1016/j.soard.2025.05.017","url":null,"abstract":"<p><strong>Background: </strong>Symptomatic cholelithiasis in altered foregut anatomy can have significant clinical repercussions and modify risk-benefit calculations surrounding a concurrent cholecystectomy (CC) at time of bariatric surgery.</p><p><strong>Objectives: </strong>To characterize trends in CC during revisional and conversion bariatric surgery and evaluate its subsequent risk profile.</p><p><strong>Setting: </strong>Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database from 2020 to 2022 was used to identify 72,189 adult laparoscopic bariatric revisions (16,335 cases, 22.6%) and conversions (55,854 cases, 77.4%) METHODS: Multivariable logistic regressions were completed to calculate odds of 30-day postoperative complications, reintervention, reoperation, and conversion to open surgery associated with CC. Sensitivity analyses identified drivers of complication rates and differences in complication risk by conversion type.</p><p><strong>Results: </strong>Multivariable analysis showed significantly increased odds of 30-day complications (odds ratio [OR] 1.45, P = .022) in revisions and conversions with CC, but not reinterventions, readmission, or conversion to open. Cases with CC had significantly higher incidences of postoperative hemorrhage (2.37% versus 1.59%, P = .008), cardiac events (.32% versus .13%, P = .021), and acute kidney injury (.32% versus .13%, P = .024). Selecting for the most performed conversions in 2020-2022 MBSAQIP, multivariable analyses reveal significantly increased odds of 30-day serious complications in adjustable gastric band (AGB) to Roux-en-Y gastric bypass (RYGB; OR 2.62, P = .038). Odds of 30-day serious complications in other leading sleeve gastrectomy and AGB conversions did not reach statistical significance.</p><p><strong>Conclusions: </strong>While CC significantly increases odds of 30-day complications, risks and benefits of CC at time of revisions and conversions must be weighed carefully, particularly in AGB to RYGB conversions and clinical contexts with elevated risk of bleeding, cardiac events, and renal injury.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337393","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":"Paired Editorial: Efficacy of combined sleeve gastrectomy and Nissen fundoplication for weight loss and prevention of postoperative gastroesophageal reflux disease in patients with obesity: a systematic review and meta-analysis.","authors":"Ruth Lopez-Gonzalez, Alyssa Ritchie, Ricard Corcelles","doi":"10.1016/j.soard.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.009","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201230","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":"Effect of laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass on esophageal motility and gastroesophageal reflux at more than 5 years in patients with severe obesity.","authors":"Julian Süsstrunk, Anne C Meyer-Gerspach, Ralph Peterli, Suzanne M Edwards, Alissa Jell, Markus Trochsler, Mark Fox, Bettina K Wölnerhanssen, Jennifer C Myers","doi":"10.1016/j.soard.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>The effect of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on postoperative esophageal motility and its clinical significance is poorly understood.</p><p><strong>Objectives: </strong>To investigate the effect of SG and RYGB on esophageal motility and distal esophageal acid exposure time at least 5 years after surgery.</p><p><strong>Setting: </strong>Prospective clinical study conducted in 2 academic hospitals in Switzerland.</p><p><strong>Methods: </strong>Patients who underwent SG and RYGB were invited at least 5 years after surgery to undergo upper endoscopy, high-resolution manometry (HRM) and wireless pH measurement. Primary outcome was presence of esophageal motility disorders. Exploratory outcomes included presence of esophagitis, Barrett's esophagus, esophageal acid exposure, and validated symptom questionnaires.</p><p><strong>Results: </strong>A total of 113 patients (49 SG and 64 RYGB) underwent HRM and pH monitoring 7 ± 1.6 years after bariatric-metabolic surgery. Integrated-relaxation-pressure was 4.3 ± 3.9 mm Hg after SG and 4.2 ± 3.8 mm Hg after RYGB (P = .89). Average distal contractile integral was 2931 ± 2102 mm Hg-cm-s after SG and 3530 ± 3454 mm Hg-cm-s after RYGB (P = .29). After 100-mL rapid drinking challenge, a hypercontractile or spastic contraction was seen in 37.5% after RYGB and 16.3% after SG (P = .01). Mean esophageal acid exposure time was 11.4 ± 7.9% after SG and 1.3 ± 2.1 after RYGB (P < .0001). Esophagitis was present in 67.3% after SG and 28.1% after RYGB (P < .0001).</p><p><strong>Conclusions: </strong>Esophageal motility is similar for patients after SG and RYGB and clinically significant motility disorders of the esophagus are rare at long term follow-up. SG leads to significantly more reflux esophagitis, acid reflux and symptoms than RYGB and therefore, endoscopic surveillance should be considered.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236353","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":"Evaluating outcomes after metabolic/bariatric surgery among middle Eastern and North African patients in Michigan.","authors":"Ahmad M Hider, Sarah Petersen, Arthur M Carlin, Jonathan Finks, Oliver A Varban, Nabeel R Obeid","doi":"10.1016/j.soard.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>The Middle Eastern and North African (MENA) population of the United States consists of 3.8 million citizens. This study compares health care outcomes for MENA patients undergoing metabolic and bariatric surgery (MBS) in Michigan to those of non-MENA patients statewide.</p><p><strong>Objectives: </strong>To compare outcomes of MBS between MENA and non-MENA patients in Michigan and identify disparities in surgery rates.</p><p><strong>Setting: </strong>Michigan Bariatric Surgery Collaborative (MBSC), Ann Arbor, MI.</p><p><strong>Methods: </strong>This retrospective cohort study used data from the MBSC database from 2017 to 2024. The cohort consisted of self-identified MENA patients (n = 799), approximately 1.5% of the MBSC total patient cohort. Data collected included demographic information, co-morbidities, type of bariatric procedure performed, adverse events at 30 days and at 1-year postoperative, including weight loss and changes in co-morbid status.</p><p><strong>Results: </strong>Compared to non-MENA patients, MENA patients were more likely to be males (25.8% vs. 18.5%; P < .0001), present at younger ages (age < 30 years: 21.8% vs. 11.0%, P < .0001), have lower initial body mass index (BMI) (45.1 vs 47.4, P < .001), be active smokers (12.6% vs 8.5%; P < .0001), and undergo sleeve gastrectomy (84.7% vs 80.1%; P = .0011). There were no differences in 30-day complications (5.9% vs. 5.7%, P = .5056), although MENA patients had lower rates of emergency department visits (6.3% vs 7.1%, P = .0139) and healthcare utilization (8.6% vs 10.0%, P = .0117). Overall, there were no differences in weight loss outcomes or rates of comorbidity improvement at 1 year following MBS among MENA patients undergoing gastric bypass specifically, the percent total weight loss at 1 year was lower than non-MENA patients (30.2% vs 33.4%, P = .0168).</p><p><strong>Conclusion: </strong>MENA individuals tend to pursue MBS at a younger age and with a lower BMI. Bariatric surgery appears equally safe and similarly effective in this patient population.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287694","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":"Role of bariatric surgery in patients with advanced heart failure.","authors":"Darae Kim, In-Cheol Kim, Jong-Chan Youn, Jin-Jin Kim, Mi-Hyang Jung, Jin-Oh Choi, Daniel Seong Kyu Kim, Mason Lee, Evan P Kransdorf, David H Chang, Michelle M Kittleson, Michele Hamilton, Jignesh K Patel, Fardad Esmailian, Jon A Kobashigawa","doi":"10.1016/j.soard.2025.05.013","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.013","url":null,"abstract":"<p><strong>Background: </strong>Although bariatric surgery (BaS) is an important treatment option to treat obesity in general, the safety and efficacy of BaS in patients with advanced heart failure (HF) are not well known.</p><p><strong>Objectives: </strong>To describe the trajectory of patients with advanced HF who underwent BaS and cardiac replacement therapy.</p><p><strong>Setting: </strong>Single-tertiary academic hospital.</p><p><strong>Methods: </strong>We conducted a retrospective study of patients with advanced HF with obesity (body mass index [BMI] >35 kg/m²) between January 2010 and August 2022. Among them, 15 patients underwent BaS, and their clinical trajectories were compared with 62 patients with advanced HF who received orthotopic heart transplant (OHT) or durable mechanical circulatory support without BaS (non-BaS group) during the same period. Key outcomes included BMI reduction, OHT eligibility, and post-OHT survival.</p><p><strong>Results: </strong>Among 15 patients who underwent BaS, 12 underwent sleeve gastrectomy and 3 underwent gastric bypass surgery. After a median duration of 11 (6-14) months from BaS, the mean value of BMI was significantly reduced (39.8 [39.0-42.2] kg/m² versus 31.6 [27.7-35.3] kg/m², P < .001) with no BaS related mortality. In subgroup of OHT patients, post-OHT survival was comparable between the 2 groups.</p><p><strong>Conclusions: </strong>BaS is a safe and effective intervention for BMI reduction in patients with advanced HF. BaS may enhance OHT eligibility without compromising posttransplantation outcomes.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251602","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":"Microbiome and genetic predictors of weight loss 12 months postsleeve gastrectomy: insights from a pilot retrospective cohort study.","authors":"Inti Pedroso, Shreyas V Kumbhare, Shaneeta Johnson, Karthik M Muthukumar, Santosh K Saravanan, Carmel Irudayanathan, Garima Sharma, Lawrence Tabone, Ranjan Sinha, Daniel E Almonacid, Nova Szoka","doi":"10.1016/j.soard.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Gut microbiome and genetic biomarkers are increasingly guiding obesity treatment. Bariatric surgery leads to shifts in gut microbial composition and function, while genome-wide association studies reveal genetic underpinnings of polygenic obesity, informing risk, therapeutic outcomes, and nutrigenomics-based interventions.</p><p><strong>Objectives: </strong>This pilot study aimed to identify gut microbiome and genetic biomarkers associated with weight loss 12 months after sleeve gastrectomy (SG).</p><p><strong>Setting: </strong>Single academic institution university clinic.</p><p><strong>Methods: </strong>Sixty-seven patients 12 months post-SG were enrolled: 34 had successful excess weight loss (EWL ≥50%), while 33 had unsuccessful EWL (EWL <50%). Microbiome and genetic profiles were collected and analyzed using ANOVA and regression methods.</p><p><strong>Results: </strong>The genus Akkermansia was significantly associated with EWL (P = 9.9 × 10^-6). Several microbial pathways, including propionate synthesis and menaquinone (vitamin K2) production, showed nominally significant (P < .05) associations with greater weight loss. No differences emerged in the Firmicutes/Bacteroidetes ratio. Genetic analyses revealed significant correlations between EWL and polygenic scores for dietary needs and metabolic responses, including distinct vitamin D and K requirements, as well as higher LDL cholesterol levels and predisposition for major depression.</p><p><strong>Conclusions: </strong>These findings suggest that both the gut microbiome and genetics may modulate weight loss following bariatric surgery. Integrating microbiome and genetic profiling into bariatric care pathways could enhance personalized obesity treatment. While this pilot, exploratory, and proof-of-concept study has limitations, it supports prior work linking gut microbial pathways to weight loss and suggests new associations. Follow-up studies are warranted to validate these results and further inform precision obesity interventions.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328277","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 frailty on serious complications after bariatric surgery: a comparison between robotic and laparoscopic approach.","authors":"Michelle Chang, Chiu-Hsieh Hsu, Diaa Soliman, Iman Ghaderi","doi":"10.1016/j.soard.2025.04.471","DOIUrl":"https://doi.org/10.1016/j.soard.2025.04.471","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a state of reduced physiologic capacity, and our group has created a bariatric frailty index using 9 variables from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. We found that frailty scores had weakly positive correlations with increasing age and body mass index in bariatric patients.</p><p><strong>Objective: </strong>To examine the effect of frailty and pre-frailty on Clavien-Dindo (CD) ≥III grade complications after bariatric surgery for all adults as well as outcomes of surgical approach using the MBSAQIP database (2016-2019).</p><p><strong>Setting: </strong>Data pooled from American Society for Bariatric Surgery-accredited bariatric surgery centers, United States.</p><p><strong>Methods: </strong>All adult patients were included. Fourteen variables of the Canadian Study of Health and Aging Frailty Index were mapped onto 9 variables of MBSAQIP to derive a bariatric frailty score (0-9) which were classified as Not frail (0), pre-frail (1-2), and frail (≥3). Logistic regression was performed to evaluate the effects of frailty on CD ≥III grade complications.</p><p><strong>Results: </strong>Most patients undergoing bariatric surgery were pre-frail (56% versus not frail 33.6% vs frail 10.3%). There was a positive association between greater frailty scores and a greater frequency of CD ≥III grade complications in both laparoscopic and robotic cohorts. Regardless of surgical approach or operation, patients who were classified as pre-frail and frail had greater frequency of serious complications compared with patients classified as not frail.</p><p><strong>Conclusions: </strong>Using a bariatric frailty score to identify patients who are pre-frail and frail may assist with prehabilitation before bariatric surgery and assist with decision-making for surgical approach.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251603","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":"Comment on: Diagnosis of gestational diabetes after Roux-en-Y gastric bypass: a comparative analysis of 3 methods.","authors":"Robert L Dubin","doi":"10.1016/j.soard.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.007","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251600","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":"Efficacy and safety of direct oral anticoagulants (DOACs) for postoperative thromboprophylaxis in patients after bariatric surgery: a systematic review and meta-analysis.","authors":"Pedro Bicudo Bregion, Josélio Rodrigues de Oliveira-Filho, Victor Kenzo Ivano, João Caetano Dallegrave Marchesini, Everton Cazzo","doi":"10.1016/j.soard.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.004","url":null,"abstract":"<p><p>Bariatric surgery is effective for achieving substantial weight loss and improving metabolic comorbidities in patients with severe obesity. However, both obesity and bariatric surgery elevate the risk of thromboembolic events. Traditionally, venous thromboembolism (VTE) prophylaxis in individuals who undergo bariatric surgery has relied on heparins, particularly enoxaparin. Concerns regarding pharmacologic limitations linked to the adipose tissue-related impact on the drug's pharmacodynamics in high-BMI patients have led to increased interest in direct oral anticoagulants (DOACs) as a potential alternative. This systematic review and meta-analysis aimed to assess the efficacy and safety of DOACs for thromboprophylaxis in people undergoing bariatric surgery. We systematically searched PubMed, EMBASE, and Cochrane Central for studies evaluating DOAC use for VTE prophylaxis in bariatric surgery patients up to November 2024. Primary outcomes included thrombotic and bleeding event rates (classified as major or minor), with secondary outcomes including the prevalence of allergic reactions. Randomized controlled trials and observational studies were included. Study weights were calculated using the inverse variance method, with statistical analyses performed using R version 4.4.0 (R Foundation for Statistical Computing, Vienna, Austria). Seven studies with a total of 7706 patients were included. The incidence of thrombotic events post-surgery with DOAC use was .23% (95% CI: .14-.39). Major bleeding events were reported at .33% (95% CI: .11-1.03), minor bleeding at 1.27% (95% CI: .45-3.54), and allergic reactions at 1.33% (95% CI: .59-2.98). There was one reported death due to pulmonary embolism. These findings suggest a low incidence of adverse effects with DOAC use in this population. Our meta-analysis supports the use of DOACs as a safe and effective option for thromboprophylaxis in individuals undergoing bariatric surgery. Further research, including direct comparisons with enoxaparin, is needed to establish definitive guidelines for postoperative management.</p>","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287693","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":"Assessing outcomes following magnetic duodenoileal anastomosis with sleeve gastrectomy.","authors":"Tauheed Akram, Benyamin Alam, Amir Reza Akbari","doi":"10.1016/j.soard.2025.05.012","DOIUrl":"https://doi.org/10.1016/j.soard.2025.05.012","url":null,"abstract":"","PeriodicalId":94216,"journal":{"name":"Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268310","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}