This Medical News article is an interview with Cornelius A. James, MD, of the University of Michigan Medical School about his recent research examining the use of digital health technologies, including patient portals, among older US adults and how it relates to his own experience in the clinic.
{"title":"Study Finds Most Older Adults Use Digital Health Technologies, Plus Some Surprises","authors":"Roy Perlis, Kate Schweitzer","doi":"10.1001/jama.2024.28224","DOIUrl":"https://doi.org/10.1001/jama.2024.28224","url":null,"abstract":"This Medical News article is an interview with Cornelius A. James, MD, of the University of Michigan Medical School about his recent research examining the use of digital health technologies, including patient portals, among older US adults and how it relates to his own experience in the clinic.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143258639","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}
In this narrative medicine essay, the memories of joyfully preparing meals with her parents that must shift to learning how to prepare low-glycemic foods fills a medical student’s mind when a patient during clinic learns they must stop their weekly indulgence.
{"title":"Little Parcels of Joy","authors":"Felicia Y. Ho","doi":"10.1001/jama.2024.28801","DOIUrl":"https://doi.org/10.1001/jama.2024.28801","url":null,"abstract":"In this narrative medicine essay, the memories of joyfully preparing meals with her parents that must shift to learning how to prepare low-glycemic foods fills a medical student’s mind when a patient during clinic learns they must stop their weekly indulgence.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192136","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}
James Agolia, Allen Green, David A. Spain, Jeff Choi
This Viewpoint discusses the importance of standardized metrics of academic and clinical performance among medical students applying for residency in light of many examinations and classes now being graded pass-fail.
{"title":"Diminishing Objectivity in the Residency Application Process","authors":"James Agolia, Allen Green, David A. Spain, Jeff Choi","doi":"10.1001/jama.2024.28397","DOIUrl":"https://doi.org/10.1001/jama.2024.28397","url":null,"abstract":"This Viewpoint discusses the importance of standardized metrics of academic and clinical performance among medical students applying for residency in light of many examinations and classes now being graded pass-fail.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143192135","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}
This Viewpoint explores how FDA approval of intranasal naloxone and nicotine replacement therapy as over-the-counter drugs adversely affects Medicare patients because the treatments are no longer covered and urges policymakers to address this coverage gap.
{"title":"Eliminating the Medicare Coverage Gap for Intranasal Naloxone and Nicotine Replacement Therapy","authors":"Robert A. Kleinman, Brian S. Barnett","doi":"10.1001/jama.2024.28394","DOIUrl":"https://doi.org/10.1001/jama.2024.28394","url":null,"abstract":"This Viewpoint explores how FDA approval of intranasal naloxone and nicotine replacement therapy as over-the-counter drugs adversely affects Medicare patients because the treatments are no longer covered and urges policymakers to address this coverage gap.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125210","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}
Krishna Pandya, Andrew M. Davis, Michaela R. Anderson
This JAMA Clinical Guidelines Synopsis summarizes the American Thoracic Society’s 2023 guidelines on pulmonary rehabilitation for adults with chronic respiratory disease.
{"title":"Pulmonary Rehabilitation for Adults With Chronic Respiratory Disease","authors":"Krishna Pandya, Andrew M. Davis, Michaela R. Anderson","doi":"10.1001/jama.2024.24883","DOIUrl":"https://doi.org/10.1001/jama.2024.24883","url":null,"abstract":"This JAMA Clinical Guidelines Synopsis summarizes the American Thoracic Society’s 2023 guidelines on pulmonary rehabilitation for adults with chronic respiratory disease.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125212","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}
Peter Hanlon, Elaine Butterly, Lili Wei, Heather Wightman, Saleh Ali M. Almazam, Khalid Alsallumi, Jamie Crowther, Ryan McChrystal, Heidi Rennison, Katherine Hughes, Jim Lewsey, Robert Lindsay, Stuart McGurnaghan, John Petrie, Laurie A. Tomlinson, Sarah Wild, Amanda Adler, Naveed Sattar, David M. Phillippo, Sofia Dias, Nicky J. Welton, David A. McAllister
ImportanceSodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase 4 (DPP4) inhibitors improve hyperglycemia, and SGLT2 inhibitors and GLP-1 receptor agonists reduce the risk of major adverse cardiovascular events (MACEs) among individuals with type 2 diabetes. It is not clear whether efficacy varies by age or sex.ObjectiveTo assess whether age or sex are associated with differences in the efficacy of SGLT2 inhibitors, GLP-1 receptor agonists, and DPP4 inhibitors.Data Sources and Study SelectionThe MEDLINE and Embase databases and US and Chinese clinical trial registries were searched for articles published from inception to November 2022; in August 2024, the search was updated to capture the trial results. Two reviewers screened for randomized clinical trials of SGLT2 inhibitors, GLP-1 receptor agonists, or DPP4 inhibitors vs a placebo or active comparator in adults with type 2 diabetes.Data Extraction and SynthesisIndividual participant data and aggregate data were used to estimate age × treatment interactions and sex × treatment interactions in multilevel network meta-regression models.Main Outcome and MeasuresHemoglobin A<jats:sub>1c</jats:sub> (HbA<jats:sub>1c</jats:sub>) and MACEs.ResultsOf the 601 eligible trials identified (592 trials with 309 503 participants reported HbA<jats:sub>1c</jats:sub>; mean age, 58.9 [SD, 10.8] years; 42.3% were female and 23 trials with 168 489 participants reported MACEs; mean age, 64.0 [SD, 8.6] years; 35.3% were female), individual participant data were obtained for 103 trials (103 reported HbA<jats:sub>1c</jats:sub> and 6 reported MACEs). The use of SGLT2 inhibitors (vs placebo) was associated with less HbA<jats:sub>1c</jats:sub> lowering with increasing age for monotherapy (absolute reduction [AR], 0.24% [95% credible interval {CrI}, 0.10% to 0.38%] per 30-year increment in age), for dual therapy (AR, 0.17% [95% CrI, 0.10% to 0.24%]), and for triple therapy (AR, 0.25% [95% CrI, 0.20% to 0.30%]). The use of GLP-1 receptor agonists was associated with greater HbA<jats:sub>1c</jats:sub> lowering with increasing age for monotherapy (AR, −0.18% [95% CrI, −0.31% to −0.05%] per 30-year increment in age) and for dual therapy (AR, −0.24% [95% CrI, −0.40% to −0.07%]), but not for triple therapy (AR, 0.04% [95% CrI, −0.02% to 0.11%]). The use of DPP4 inhibitors was associated with slightly better HbA<jats:sub>1c</jats:sub> lowering in older people for dual therapy (AR, −0.09% [95% CrI, −0.15% to −0.03%] per 30-year increment in age), but not for monotherapy (AR, −0.08% [95% CrI, −0.18% to 0.01%]) or triple therapy (AR, −0.01% [95% CrI, −0.06% to 0.05%]). The relative reduction in MACEs with use of SGLT2 inhibitors was greater in older vs younger participants per 30-year increment in age (hazard ratio, 0.76 [95% CrI, 0.62 to 0.93]), and the relative reduction in MACEs with use of GLP-1 receptor agonists was less in older vs younger participants (ha
{"title":"Age and Sex Differences in Efficacy of Treatments for Type 2 Diabetes","authors":"Peter Hanlon, Elaine Butterly, Lili Wei, Heather Wightman, Saleh Ali M. Almazam, Khalid Alsallumi, Jamie Crowther, Ryan McChrystal, Heidi Rennison, Katherine Hughes, Jim Lewsey, Robert Lindsay, Stuart McGurnaghan, John Petrie, Laurie A. Tomlinson, Sarah Wild, Amanda Adler, Naveed Sattar, David M. Phillippo, Sofia Dias, Nicky J. Welton, David A. McAllister","doi":"10.1001/jama.2024.27402","DOIUrl":"https://doi.org/10.1001/jama.2024.27402","url":null,"abstract":"ImportanceSodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase 4 (DPP4) inhibitors improve hyperglycemia, and SGLT2 inhibitors and GLP-1 receptor agonists reduce the risk of major adverse cardiovascular events (MACEs) among individuals with type 2 diabetes. It is not clear whether efficacy varies by age or sex.ObjectiveTo assess whether age or sex are associated with differences in the efficacy of SGLT2 inhibitors, GLP-1 receptor agonists, and DPP4 inhibitors.Data Sources and Study SelectionThe MEDLINE and Embase databases and US and Chinese clinical trial registries were searched for articles published from inception to November 2022; in August 2024, the search was updated to capture the trial results. Two reviewers screened for randomized clinical trials of SGLT2 inhibitors, GLP-1 receptor agonists, or DPP4 inhibitors vs a placebo or active comparator in adults with type 2 diabetes.Data Extraction and SynthesisIndividual participant data and aggregate data were used to estimate age × treatment interactions and sex × treatment interactions in multilevel network meta-regression models.Main Outcome and MeasuresHemoglobin A<jats:sub>1c</jats:sub> (HbA<jats:sub>1c</jats:sub>) and MACEs.ResultsOf the 601 eligible trials identified (592 trials with 309 503 participants reported HbA<jats:sub>1c</jats:sub>; mean age, 58.9 [SD, 10.8] years; 42.3% were female and 23 trials with 168 489 participants reported MACEs; mean age, 64.0 [SD, 8.6] years; 35.3% were female), individual participant data were obtained for 103 trials (103 reported HbA<jats:sub>1c</jats:sub> and 6 reported MACEs). The use of SGLT2 inhibitors (vs placebo) was associated with less HbA<jats:sub>1c</jats:sub> lowering with increasing age for monotherapy (absolute reduction [AR], 0.24% [95% credible interval {CrI}, 0.10% to 0.38%] per 30-year increment in age), for dual therapy (AR, 0.17% [95% CrI, 0.10% to 0.24%]), and for triple therapy (AR, 0.25% [95% CrI, 0.20% to 0.30%]). The use of GLP-1 receptor agonists was associated with greater HbA<jats:sub>1c</jats:sub> lowering with increasing age for monotherapy (AR, −0.18% [95% CrI, −0.31% to −0.05%] per 30-year increment in age) and for dual therapy (AR, −0.24% [95% CrI, −0.40% to −0.07%]), but not for triple therapy (AR, 0.04% [95% CrI, −0.02% to 0.11%]). The use of DPP4 inhibitors was associated with slightly better HbA<jats:sub>1c</jats:sub> lowering in older people for dual therapy (AR, −0.09% [95% CrI, −0.15% to −0.03%] per 30-year increment in age), but not for monotherapy (AR, −0.08% [95% CrI, −0.18% to 0.01%]) or triple therapy (AR, −0.01% [95% CrI, −0.06% to 0.05%]). The relative reduction in MACEs with use of SGLT2 inhibitors was greater in older vs younger participants per 30-year increment in age (hazard ratio, 0.76 [95% CrI, 0.62 to 0.93]), and the relative reduction in MACEs with use of GLP-1 receptor agonists was less in older vs younger participants (ha","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077290","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}
Nirmish Singla, Aditya Bagrodia, Ezra Baraban, Christian D. Fankhauser, Yasser M. A. Ged
ImportanceTesticular cancer is the most common solid malignancy among males aged 15 to 40 years in the US, with approximately 10 000 new cases diagnosed each year. Between 90% and 95% of testicular cancers are germ cell tumors (GCTs).ObservationsThe mean age at diagnosis for testicular cancer is 33 years. GCTs are categorized as seminomas and nonseminomatous GCTs (NSGCTs) based on their embryonic origins and path of differentiation. Risk factors include cryptorchidism, family history of testicular cancer, gonadal dysgenesis, infertility, cannabis use, and genetic conditions such as Klinefelter syndrome. The most common presenting symptom of testicular cancer is a painless testicular mass. History, physical examination, scrotal ultrasound, laboratory assessment of GCT-associated serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase), and prompt referral to a urologist are indicated when testicular cancer is suspected. Early diagnosis and treatment, starting with a radical inguinal orchiectomy, are important to optimize outcomes. At diagnosis, GCT is stage I (localized to the testicle) in 70% to 75% of patients, stage II (metastatic only to the retroperitoneal lymph nodes) in 20%, and stage III (widely metastatic) in 10%. Treatment of GCTs is guided by histology, clinical staging, and risk classification, with 5-year survival rates of 99%, 92%, and 85% for those diagnosed at stages I, II, and III, respectively. Optimal treatment often involves a multidisciplinary team at high-volume, experienced medical centers and may include surveillance (serum tumor markers [α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase] and imaging of the chest, abdomen, and pelvis), surgery (retroperitoneal lymph node dissection), chemotherapy, and/or radiation. Treatment decisions should consider long-term survivorship concerns, including body image, fertility, hypogonadism, mental health, financial cost, adherence to follow-up, and late adverse effects of therapy such as cardiovascular disease, secondary malignancies, and potential psychosocial effects such as anxiety, depression, and social isolation.Conclusions and RelevanceTesticular cancer is the most common solid malignancy in young men in the US, and 90% to 95% are GCTs. Patients with testicular GCT have a 5-year survival rate of 99%, 92%, and 85% for stages I, II, and III, respectively. Prompt diagnosis and treatment are important to optimize outcomes, and treatment decisions should balance oncologic control with survivorship concerns to minimize long-term adverse effects of treatment.
{"title":"Testicular Germ Cell Tumors","authors":"Nirmish Singla, Aditya Bagrodia, Ezra Baraban, Christian D. Fankhauser, Yasser M. A. Ged","doi":"10.1001/jama.2024.27122","DOIUrl":"https://doi.org/10.1001/jama.2024.27122","url":null,"abstract":"ImportanceTesticular cancer is the most common solid malignancy among males aged 15 to 40 years in the US, with approximately 10 000 new cases diagnosed each year. Between 90% and 95% of testicular cancers are germ cell tumors (GCTs).ObservationsThe mean age at diagnosis for testicular cancer is 33 years. GCTs are categorized as seminomas and nonseminomatous GCTs (NSGCTs) based on their embryonic origins and path of differentiation. Risk factors include cryptorchidism, family history of testicular cancer, gonadal dysgenesis, infertility, cannabis use, and genetic conditions such as Klinefelter syndrome. The most common presenting symptom of testicular cancer is a painless testicular mass. History, physical examination, scrotal ultrasound, laboratory assessment of GCT-associated serum tumor markers (α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase), and prompt referral to a urologist are indicated when testicular cancer is suspected. Early diagnosis and treatment, starting with a radical inguinal orchiectomy, are important to optimize outcomes. At diagnosis, GCT is stage I (localized to the testicle) in 70% to 75% of patients, stage II (metastatic only to the retroperitoneal lymph nodes) in 20%, and stage III (widely metastatic) in 10%. Treatment of GCTs is guided by histology, clinical staging, and risk classification, with 5-year survival rates of 99%, 92%, and 85% for those diagnosed at stages I, II, and III, respectively. Optimal treatment often involves a multidisciplinary team at high-volume, experienced medical centers and may include surveillance (serum tumor markers [α-fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase] and imaging of the chest, abdomen, and pelvis), surgery (retroperitoneal lymph node dissection), chemotherapy, and/or radiation. Treatment decisions should consider long-term survivorship concerns, including body image, fertility, hypogonadism, mental health, financial cost, adherence to follow-up, and late adverse effects of therapy such as cardiovascular disease, secondary malignancies, and potential psychosocial effects such as anxiety, depression, and social isolation.Conclusions and RelevanceTesticular cancer is the most common solid malignancy in young men in the US, and 90% to 95% are GCTs. Patients with testicular GCT have a 5-year survival rate of 99%, 92%, and 85% for stages I, II, and III, respectively. Prompt diagnosis and treatment are important to optimize outcomes, and treatment decisions should balance oncologic control with survivorship concerns to minimize long-term adverse effects of treatment.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077289","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}
Christopher L. Cai, Aaron S. Kesselheim, Benjamin N. Rome
This cross-sectional study explores US prescription fills, retail spending, and prices of low-dose doxepin for insomnia and the possible cost savings to patients had they used liquid doxepin, a less expensive formulation.
{"title":"Trends in Fills, Spending, and Prices of Doxepin for Insomnia","authors":"Christopher L. Cai, Aaron S. Kesselheim, Benjamin N. Rome","doi":"10.1001/jama.2024.27526","DOIUrl":"https://doi.org/10.1001/jama.2024.27526","url":null,"abstract":"This cross-sectional study explores US prescription fills, retail spending, and prices of low-dose doxepin for insomnia and the possible cost savings to patients had they used liquid doxepin, a less expensive formulation.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077286","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}
Charlotte Albury, Madeleine Tremblett, Paul Aveyard
This JAMA Insights explores effective communication strategies for clinicians who do not specialize in treating obesity in how to introduce conversations about weight loss with their patients and offer them support and treatment.
{"title":"Patient-Clinician Communication About Weight Loss","authors":"Charlotte Albury, Madeleine Tremblett, Paul Aveyard","doi":"10.1001/jama.2024.27850","DOIUrl":"https://doi.org/10.1001/jama.2024.27850","url":null,"abstract":"This JAMA Insights explores effective communication strategies for clinicians who do not specialize in treating obesity in how to introduce conversations about weight loss with their patients and offer them support and treatment.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143077288","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}
In this narrative medicine essay, a primary care physician-psychiatrist offers a prayer to save his son who needs a heart transplant and to comfort the donor family who are still unaware that they will experience a lifetime of pain and loss.
{"title":"Match Day","authors":"Cerrone Cohen","doi":"10.1001/jama.2024.28556","DOIUrl":"https://doi.org/10.1001/jama.2024.28556","url":null,"abstract":"In this narrative medicine essay, a primary care physician-psychiatrist offers a prayer to save his son who needs a heart transplant and to comfort the donor family who are still unaware that they will experience a lifetime of pain and loss.","PeriodicalId":518009,"journal":{"name":"JAMA","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056696","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}
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