Cardiorenal Medicine最新文献

{"title":"Nonlinear Relationship between Early Postoperative Pulse Pressure Variation and Acute Kidney Injury Risk in Older Cardiac Surgical Patients.","authors":"Xiaodan Gong, Yang Yu, Biyu Wei, Fei Xu, Yonghui Zhang, Chenghui Zhou","doi":"10.1159/000551279","DOIUrl":"10.1159/000551279","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) frequently complicates the postoperative course of older patients in surgical intensive care units (ICUs), contributing to increased mortality and prolonged hospital stays. Traditional AKI diagnostic methods, relying on changes in serum creatinine and urine output, often result in delayed detection. Pulse pressure variation (PPV), a dynamic hemodynamic parameter derived from arterial waveform analysis, reflects preload responsiveness and can provide early, complementary information on circulatory status and end-organ perfusion. Although both elevated and diminished PPV levels have been associated with adverse outcomes, the specific nature of the association between early postoperative PPV and AKI risk remains uncertain. This study investigated the relationship between PPV during the first 12 and 24 h after ICU admission and the development of AKI, with a focus on potential nonlinear associations and optimal PPV thresholds.</p><p><strong>Methods: </strong>This retrospective cohort analysis utilized data from the MIMIC-IV and MIMIC-III databases. We included patients aged 60 years and older who underwent cardiothoracic surgery and had available PPV measurements within the first 24 h following ICU admission. The primary dataset was derived from MIMIC-IV, while MIMIC-III served as an external validation cohort. The main outcome was postoperative AKI, as identified by KDIGO criteria. Logistic regression models adjusted for relevant clinical covariates were used to assess associations between PPV at 12 and 24 h (PPV<sub>12</sub>h and PPV<sub>24</sub>h) and AKI. Nonlinear associations were examined using restricted cubic spline (RCS) modeling. Discriminative ability was assessed using area under the receiver operating characteristic curve (AUC), with DeLong's test used to compare model performance.</p><p><strong>Results: </strong>Of the 5,445 patients included, 2,574 (47.3%) developed AKI after surgery. Those with AKI were generally older and had more comorbidities and higher illness severity scores. In multivariable analyses incorporating RCS terms, a U-shaped relationship was identified between PPV<sub>12</sub>h and AKI (p for nonlinearity = 0.0224). The lowest predicted risk was observed at a PPV<sub>12</sub>h of 0.144, corresponding to a 39.4% relative reduction in AKI risk. This association was independently validated in a separate cohort (n = 897), where a PPV<sub>12</sub>h of 0.142 was associated with a 59.8% risk reduction. In contrast, PPV<sub>12</sub>h provided better predictive value than PPV<sub>24</sub>h, which showed no significant association with AKI. The inclusion of PPV<sub>12</sub>h significantly enhanced the discrimination of predictive models.</p><p><strong>Conclusion: </strong>Early postoperative PPV demonstrates a U-shaped correlation with AKI risk in older patients undergoing cardiothoracic surgery, with both low and high values associated with higher incidence. A PPV<sub>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"434-448"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Humanin Improves the Prognostic Accuracy of Cardiovascular Risk Models in Chronic Hemodialysis Patients.","authors":"Davide Bolignano, Marta Greco, Sara Pugliese, Anila Duni, Pierangela Presta, Antonietta Errante, Efthymios Pappas, Lampros Lakkas, Roberta Misiti, Katerina K Naka, Daniela Patrizia Foti, Michele Andreucci, Giuseppe Coppolino, Evangelia Dounousi","doi":"10.1159/000551517","DOIUrl":"10.1159/000551517","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular morbidity and mortality (CVMM) remain highly prevalent among end-stage kidney disease (ESKD) patients undergoing chronic hemodialysis (HD). Nevertheless, risk prediction in this setting is limited by the complexity of factors involved and the individual patients' characteristics. In this study, we evaluated whether circulating levels of Humanin, a micropeptide reflecting mitochondrial dysfunction, could refine CVMM prediction when included in established risk models for CVMM in ESKD-HD.</p><p><strong>Methods: </strong>Eighty-three chronic HD patients (mean age 67 ± 12 years; 74.7% male) were enrolled in a 24-month prospective multicenter study. CVMM (fatal or non-fatal CV events requiring hospitalization) occurred in 33 patients (39.7%). The performances of an internal prognostic model based on cohort-related risk predictors and four externally generated and validated risk scores (AROii-2, jDOPPS, You et al., and Zhang et al.) were compared before and after the inclusion of Humanin.</p><p><strong>Results: </strong>Humanin displayed a curvilinear association with CVMM, with both low (<462 pg/mL) and high (>778 pg/mL) levels linked to an increased risk. CVMM was best predicted by the internal model (AUC 0.671; R2 0.13), followed by the Zhang (0.669; 0.12), AROii-2 (0.632; 0.05), You (0.628; 0.07), and jDOPPS (0.610; 0.03) scores. All models were well calibrated. Humanin inclusion remarkably improved discrimination (ΔAUC spanning from 0.083 to 0.109), calibration, explained variance (R2 gain from 9 to 15%), and reclassification (Net Reclassification Improvement: 8-27.9%; Integrated Discrimination Index: 4.4-7.3%) of all models considered.</p><p><strong>Conclusions: </strong>Integration of Humanin significantly enhances the predictive accuracy of CVMM risk models in HD patients, supporting its potential role as an additive biomarker in this high-risk population.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"179-189"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney Transplant Outcomes in Patients with and without Type II Diabetes Mellitus.","authors":"Jan H N Lindeman, Rutger J Ploeg, Edward Sharples, Ian P Alwayn, Frederieke J Bemelman, Stefan P Berger, Maarten H L Christiaans, Cynthia Konijn, Aiko P J de Vries, Jacqueline van de Wetering, Arjan D van Zuilen, James P Hunter, Dorothea P Touwen, Esther Bastiaannet, Alexander F M Schaapherder","doi":"10.1159/000551839","DOIUrl":"10.1159/000551839","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to estimate the impact of type II diabetes (DM-II) on kidney transplant outcomes and graft utility.</p><p><strong>Methods: </strong>A nationwide, registry-based study compares outcomes for all primary kidney transplantations performed between 2000 and 2022 in the Netherlands in DM-II patients (761 deceased and 364 living donor procedures) with nondiabetic controls.</p><p><strong>Results: </strong>Short-term (≤90 days) transplant outcomes for living donor procedures were similar for DM-II and nondiabetic controls. Deceased donor transplantations in DM-II patients were associated with an increased incidence of delayed graft function (p < 0.0002), and a doubling of 90-day mortality (HR: 2.19 [95% CI: 1.49-3.23], p < 0.0001). Evaluation of long-term graft survival, with death as competing risk, indicated an equal (sub-distribution hazard rate [sHR] 0.95 [0.74-1.23]), respectively, compromised (sHR 1.91 [1.37-2.65]; p < 0.001) survival for grafts from deceased or living donors. DM-II profoundly impacted recipient survival (HR for death, respectively, 1.63 [1.45-1.82] and 1.81 [1.51-2.17]; p < 0.001) for recipients of a deceased or living donor graft (nondiabetic recipient is reference), with cardiovascular event and infection as dominant causes of death. The compromised recipient survival profoundly impacted the utility of kidney transplantations (p < 0.001).</p><p><strong>Conclusions: </strong>Despite excellent graft survival, the efficacy of kidney transplantations in DM-II patients is compromised by reduced recipient survival. Cause of death distribution suggests a role for immunosuppressive regimens in the excess mortality observed. A shift in focus from optimized transplant to optimized patient survival is warranted for DM-II patients. Moreover, the conflict between increasing incidences of DM-II, a lower transplant utility, but persistent donor organ shortages, calls for development of novel organ allocation strategies.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"237-247"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Replacement Therapy in Cardiovascular-Kidney-Metabolic Syndrome: Challenges for Dialytic Therapies and Kidney Transplantation.","authors":"Mahtab Mashayekhi, Jasjot Bhullar, Zohreh Gholizadeh Ghozloujeh, Sayna Norouzi, Khalil Pathan, Amir Abdipour","doi":"10.1159/000552830","DOIUrl":"10.1159/000552830","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular-kidney-metabolic (CKM) syndrome integrates the strong interrelationship among cardiovascular disease, chronic kidney disease (CKD), and metabolic risk factors such as obesity and diabetes.</p><p><strong>Summary: </strong>Renal replacement therapy (RRT) is considered an essential component of management in advanced CKD. Kidney failure has unique therapeutic and prognostic challenges, particularly with the coexistence of heart failure, ischemic heart disease, and metabolic syndrome. In this review, we aim to evaluate challenges and therapeutic considerations in dialytic therapies and kidney transplantation in patients with CKM syndrome.</p><p><strong>Key messages: </strong>Patients with CKM syndrome undergoing RRT represent a complex and vulnerable population requiring multidisciplinary and individualized management approaches. Optimization of cardiovascular and metabolic risk factors is essential to improve outcomes in dialysis and kidney transplantation settings.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"357-366"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148162018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Heart Failure Therapy in Chronic Kidney Disease: Converging Evidence and Ongoing Controversies.","authors":"Faeq Husain-Syed, Claudio Ronco, Adam T Whaley-Connell","doi":"10.1159/000551254","DOIUrl":"10.1159/000551254","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"134-137"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13068377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A State-of-the-Art Review Exploring the Cardiovascular Outcomes of Renin-Angiotensin Inhibitors in Acute Kidney Injury.","authors":"Farah Yasmin, Sharjeel Ahmad, Adina Jabeen, Abdul Moeed, Muhammad Sohaib Asghar, Afsana Ansari Shaik, Mohammed Mahmmoud Fadelallah Eljack, M Chadi Alraies","doi":"10.1159/000551326","DOIUrl":"10.1159/000551326","url":null,"abstract":"<p><strong>Background: </strong>Renin-angiotensin system (RAS) inhibitors, including ACE inhibitors, ARBs, and angiotensin receptor-neprilysin inhibitors (ARNIs), are essential in managing cardiovascular and renal diseases.</p><p><strong>Summary: </strong>The purpose of this narrative review was to comprehensively evaluate the cardiovascular outcomes associated with the use of RAS inhibitors in patients who have experienced acute kidney injury (AKI). The study highlighted cardiovascular complications of AKI, role of renin-angiotensin inhibitors for cardioprotection post-AKI, reviewed clinical considerations for RAS inhibitor use post-AKI to prevent cardiovascular complications, and discussed mechanistic basis of RAS inhibitors in post-AKI cardioprotection as well as cardiovascular safety concerns of RAS inhibitors post-AKI.</p><p><strong>Key messages: </strong>By highlighting areas for future research, this review intended to stimulate further studies that will ultimately enhance patient care and outcomes.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"201-209"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Sarcopenia and All-Cause and Cardiovascular Mortality Risk among Middle-Aged and Older Adults across Stages 0-3 of Cardiovascular-Kidney-Metabolic Syndrome: Evidence from NHANES and CHARLS.","authors":"Yan Chen, Yujun Liu, Shiqi Liu, Yafeng Mu, Zhihai Feng","doi":"10.1159/000550891","DOIUrl":"10.1159/000550891","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia has been proved to be associated with cardiovascular diseases (CVD), chronic kidney disease, and metabolic disorders, but the relationship between sarcopenia and all-cause and cardiovascular mortality risk among middle-aged and older adults across stages 0-3 of cardiovascular-kidney-metabolic (CKM) syndrome remains unclear. This study aimed to investigate the relationship between sarcopenia and all-cause and cardiovascular mortality risk among middle-aged and older adults across stages 0-3 of CKM syndrome based on Nutrition Examination Survey (NHANES) 2011-2018 and the China Health and Retirement Longitudinal Study (CHARLS) 2011-2020.</p><p><strong>Methods: </strong>Multivariable Cox regression analysis was performed to analyze the association of sarcopenia with all-cause and CVD mortality. Restricted cubic spline (RCS) analysis was conducted to explore the non-linear relationship between body mass index (BMI)-adjusted muscle mass (appendicular skeletal muscle mass divided by BMI, ASMI) and all-cause and CVD mortality, and machine learning (ML) models were developed for mortality risk prediction. The CHARLS database was utilized as validation to enhance the stability of the results.</p><p><strong>Results: </strong>Over an average follow-up of 5.11 years, NHANES recorded 85 all-cause deaths and 12 CVD deaths. After the full adjustment, sarcopenia was significantly associated with all-cause mortality (weighted hazard ratio [HR] = 3.428, 95% confidence interval [CI] 1.484-7.915, p = 0.004) and CVD mortality (weighted HR = 1.070, 95% CI 1.009-1.570, p = 0.049). RCS analysis revealed a nonlinear negative relationship between ASMI and CVD mortality (p for nonlinear = 0.009). ML models demonstrated better predictive performance, with random forest (area under the curve = 0.766) achieving the highest accuracy. In the CHARLS cohort, sarcopenia significantly increases all-cause mortality (HR = 2.519, 95% CI 1.402-4.527, p < 0.001), and subgroup analysis reported consistent results with the main analysis.</p><p><strong>Conclusion: </strong>Sarcopenia was significantly associated with all-cause mortality and with CVD mortality in fully adjusted models, though the latter association was modest, and exhibits good predictive performance for mortality among middle-aged and older individuals within CKM stages 0-3.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"138-152"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing Cardiac Surgery-Associated Acute Kidney Injury with the 4-B Approach: Biomarkers, Bundles, Blood Purification, and Blockage of the Complement Cascade.","authors":"Maria Gabriela Guimarães, Thiago Reis, Irene L Noronha, Paulo Novis Rocha, Claudio Ronco","doi":"10.1159/000551447","DOIUrl":"10.1159/000551447","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"154-158"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tubular Biomarkers N-Acetyl-ß-D-Glucosaminidase, Kidney-Injury-Molecule 1 and Neutrophil Gelatinase-Associated Lipocalin: Long-Term Follow-Up in a Chest Pain Cohort.","authors":"Andreas Leonhard Schober, Julia Bindig, Michael Philipp Schober, Alexander Daniel Schober, Ute Hubauer, Andreas Luchner, Lars Siegfried Maier, Carsten Jungbauer","doi":"10.1159/000552700","DOIUrl":"10.1159/000552700","url":null,"abstract":"<p><strong>Introduction: </strong>The goal of the current study was to evaluate the prognostic value of the potential cardiorenal biomarkers kidney injury molecule-1 (u-KIM-1), N-acteyl-ß-D-glucosaminidase (NAG) and urinary neutrophil gelatinase-associated lipocalin (u-NGAL) regarding mortality and major adverse cardiac events (MACEs) in patients presenting with acute chest pain in the emergency department.</p><p><strong>Methods: </strong>The study cohort consisted of 294 patients who presented themselves with acute chest pain in the emergency department of the university hospital Regensburg. The urinary concentrations of NAG, KIM-1, and NGAL were measured alongside troponin I and NT-proBNP. The patients were followed for 60 months regarding the primary endpoints mortality of any cause and MACEs, consisting of mortality, stroke, congestive heart failure and acute coronary syndrome with the necessity of PCI was gathered (MACE).</p><p><strong>Results: </strong>Fifty four patients died during the follow-up and 97 suffered from MACE. Regarding ROC-analysis NAG as well as u-KIM-1 showed promising predictive values (all-cause mortality: AUC_NAG 0.821, AUC_KIM-1 0.745, MACE: AUC_NAG 0.778, AUC_KIM-1 0.692). u-NGAL showed less promising AUCs regarding mortality (AUC 0.69) as well as MACE (AUC 0.66). According to the Kaplan-Meier analysis, patients with concentrations of urinary N-acetyl-β-D-glucosaminidase, u-KIM-1 or u-NGAL > median showed a significant worse outcome regarding MACE as well as all-cause mortality (each p < 0.05). Furthermore, Cox-regression analysis revealed NAG as independent predictor beside NT-proBNP and older age for mortality due to any cause and MACE (each p < 0.001), opposite to u-KIM-1, hypertension and diabetes (each p = n.s.).</p><p><strong>Conclusion: </strong>Urinary N-acetyl-ß-D-glucosaminidase and, to a lesser extent, kidney injury molecule-1 showed significant value in prediction MACEs and mortality due to any cause in patients with acute chest pain. But the clinical usability is still not certain and further studies are required.</p>","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"334-346"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13363111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in Cardiorenal Medicine: The Year 2025 in Review.","authors":"Amir Kazory, Claudio Ronco","doi":"10.1159/000551756","DOIUrl":"10.1159/000551756","url":null,"abstract":"","PeriodicalId":9584,"journal":{"name":"Cardiorenal Medicine","volume":" ","pages":"210-219"},"PeriodicalIF":3.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}