JNCI Cancer Spectrum最新文献

{"title":"Screening for comprehensive social needs in patients with cancer: a narrative review.","authors":"Isabel Arana, Raymond Liu, Lawrence Kushi, Erin Hahn, Meera Ragavan","doi":"10.1093/jncics/pkaf012","DOIUrl":"https://doi.org/10.1093/jncics/pkaf012","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer who report social needs have worse quality of life, lower healthcare access, and suboptimal health outcomes. However, screening for social needs does not happen systematically and successful screening tools, strategies, and workflows have seldom been described. The downstream effects of screening including resource navigation have also not been well characterized. This objective of this narrative review was to fill these gaps.</p><p><strong>Methods: </strong>Two investigators searched Pubmed and Embase for studies that implemented a patient-facing social screening tool among patients with cancer between 2008-2023 using search terms including \"social screening,\" \"social needs,\" and \"cancer.\"</p><p><strong>Results: </strong>We identified 19 articles that met study inclusion criteria. The most common tool used was the validated Health Leads Social Toolkit. Most often, screening tools were administered electronically, sent directly to patients, and captured needs at a single time point during a patient's diagnosis. Screening response rates ranged between 10-60%. Less than half of the studies described downstream resource navigation for patients who screened positive for social needs Only one study evaluated the impact of screening on clinical outcomes and quality of life. Screening for patients who do not speak English or who belong to historically racial, ethnic, and gender minority groups was limited.</p><p><strong>Conclusions: </strong>Screening for social needs has been shown to be feasible across delivery systems with numerous validated tools available. However, gaps remain in generalizability to diverse patient populations. Future work must identify how screening workflows can be successfully incorporated into routine clinical workflows.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052429","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":"Duration of aromatase inhibitor use and long-term cardiovascular risk in breast cancer survivors.","authors":"Yuhan Huang, Marilyn L Kwan, Susan R Heckbert, Nicholas L Smith, Megan Othus, Cecile A Laurent, Janise M Roh, Eileen Rillamas-Sun, Valerie S Lee, Tatjana Kolevska, Richard K Cheng, Carlos Irribarren, Mai Nguyen-Huynh, Dawn L Hershman, Lawrence H Kushi, Heather Greenlee","doi":"10.1093/jncics/pkaf009","DOIUrl":"10.1093/jncics/pkaf009","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on duration of aromatase inhibitor (AI) and cardiovascular disease (CVD) risk in breast cancer (BC) survivors. We examined risk of CVD and mortality associated with duration of AI use in postmenopausal women with early-stage hormone receptor-positive BC.</p><p><strong>Methods: </strong>Postmenopausal women diagnosed with hormone receptor-positive BC (n = 5,853) who used an AI were included. Cause-specific hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between AI use duration (short-term: >0 and <2 years; intermediate-term: ≥2 and <5 years; long-term: ≥5 years) and CVD and mortality outcomes. The landmark method was used to avoid immortal time bias; the selected landmark was 6 years after BC diagnosis.</p><p><strong>Results: </strong>Anastrozole was the AI predominantly prescribed (95.4%). Over a median follow-up of 3 years for women who survived 6 years after BC diagnosis, a lower risk of stroke was observed in intermediate-term AI users (HR = 0.60, 95% CI: 0.37-0.96) and long-term AI users (HR = 0.51, 95% CI: 0.30-0.85), than in short-term AI users. The longer duration of AI use was also associated with lower risk of all-cause mortality and non-CVD-related mortality. In addition, long-term AI users were at 37% lower risk of CVD-related mortality than short-term AI users. No significant differences were observed in risks of major adverse cardiovascular events, ischemic heart disease, and heart failure across the three groups.</p><p><strong>Conclusion: </strong>Among postmenopausal women with early-stage hormone receptor-positive BC who survived to 6 years after BC diagnosis, longer duration of AI use was not associated with elevated CVD risk.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052425","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":"Cancer risk in carriers of TP53 germline variants grouped into different functional categories.","authors":"Lucas John Müntnich, Christina M Dutzmann, Anika Großhennig, Valentina Härter, Myriam Keymling, Angela Mastronuzzi, Emilie Montellier, Juliane Nees, Natalie E Palmaers, Judith Penkert, Stefan M Pfister, Tim Ripperger, Sarah Schott, Farina Silchmüller, Pierre Hainaut, Christian P Kratz","doi":"10.1093/jncics/pkaf008","DOIUrl":"https://doi.org/10.1093/jncics/pkaf008","url":null,"abstract":"<p><p>Li-Fraumeni syndrome is a cancer predisposition syndrome caused by pathogenic TP53 germline variants and associated with a high lifelong cancer risk. We analysed the German LFS registry that contains data on 304 individuals. Cancer phenotypes were correlated with variants grouped according to their ability to transactivate target genes in a yeast assay using a traditional (non-functional, partially-functional) and a novel (clusters A, B, C) classification of variants into different groups. Partially-functional and cluster B or C variants were enriched in patients not meeting clinical testing criteria. Time to first malignancy was longer in carriers of partially-functional variants (Hazard Ratio [HR] = 0.38; 95% CI, 0.22 to 0.66). Variants grouped within clusters B (HR = 0.45; 95% CI, 0.28 to 0.71) or C (HR = 0.34; 95% CI, 0.19 to 0.62) were associated with later cancer onset than NULL variants. These findings can be used to risk-stratify patients and inform care.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052421","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":"Tumor localization strategies of multi-cancer early detection tests: a quantitative assessment.","authors":"Christopher Tyson, Kevin H Li, Xiting Cao, James M O'Brien, Elliot K Fishman, Elizabeth K O'Donnell, Carlos Duran, Vijay Parthasarathy, Seema P Rego, Omair A Choudhry, Tomasz M Beer","doi":"10.1093/jncics/pkaf011","DOIUrl":"https://doi.org/10.1093/jncics/pkaf011","url":null,"abstract":"<p><strong>Background: </strong>Multi-cancer early detection (MCED) tests may expand cancer screening. Characterizing diagnostic resolution approaches following positive MCED tests is critical. Two trials employed distinct resolution approaches: a molecular signal to predict tissue of origin (TOO) and an imaging-based diagnostic strategy. This modeling study characterizes diagnostic journeys and impact in a hypothetical population of average risk MCED eligible patients.</p><p><strong>Methods: </strong>A mathematical expression for diagnostic burden was derived using positive predictive value (PPV), molecular TOO localization accuracy, and numbers of procedures associated with each diagnostic outcome. Imaging-based and molecular TOO-informed strategies were compared. Excess lifetime cancer risk due to futile radiation exposure was estimated using organ-specific diagnostic imaging radiation doses.</p><p><strong>Results: </strong>Across all PPVs and localization performances, a molecular TOO strategy resulted in a higher diagnostic burden: 3.6 procedures [SD 0.445] vs 2.6 procedures [SD 0.100] for the imaging strategy. Estimated diagnostic burden was higher for molecular TOO in 95.5% of all PPV and TOO accuracy combinations; ≥79% PPV and 90% accuracy would be required for a molecular TOO-informed strategy to be less burdensome than imaging. The maximum rate of excess cancer incidence from radiation exposure for MCED false positive results (individuals aged 50-84) was 64.6/100,000 (annual testing, 99% specificity), 48.5/100,000 (biennial testing, 98.5% specificity), and 64.6/100,000 (biennial testing, 98% specificity).</p><p><strong>Conclusions: </strong>An imaging-based diagnostic strategy is more efficient than a molecular TOO-informed approach across almost all PPV and TOO accuracy combinations. The use of an imaging-based approach for cancer localization can be efficient and low-risk compared to a molecular-informed approach.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032964","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":"Abdominal visceral and subcutaneous adipose tissue associations with postmenopausal breast cancer incidence.","authors":"Jennifer W Bea, Heather M Ochs-Balcom, Celina I Valencia, Zhao Chen, Robert M Blew, Kimberly E Lind, Bette J Caan, Denise J Roe, Thomas E Rohan, Katherine W Reeves, JoAnn E Manson, Tarah Ballinger, Kerryn W Reding, Shawna Follis, Shelby G Ziller, Andrew O Odegaard","doi":"10.1093/jncics/pkaf007","DOIUrl":"https://doi.org/10.1093/jncics/pkaf007","url":null,"abstract":"<p><strong>Background: </strong>Obesity, classified by body mass index (BMI), is associated with higher postmenopausal breast cancer (BCa) risk. Yet, the associations between abdominal visceral (VAT) and subcutaneous adipose tissue (SAT) with BCa are unclear.</p><p><strong>Methods: </strong>We assessed BCa associations with abdominal VAT and SAT in a prospective cohort of postmenopausal women without a history of cancer and with 27 years follow-up (N = 9950), during which all new cancers were adjudicated. Dual-energy X-ray absorptiometry scans assessed adiposity at baseline, year 3, and year 6. Competing risks multivariable sub-hazard ratios (SHR), with adjustments for sociodemographic, behavioral, reproductive, and anthropometric characteristics, were estimated for baseline and time-dependent associations between VAT, SAT, and incident BCa.</p><p><strong>Results: </strong>Participants averaged 63.3 ± 7.4 years of age and a BMI of 28.20 ± 5.72 kg/m2 at baseline. The models included 738 incident BCa cases (N = 593 invasive; N = 145 in situ). Baseline VAT and SAT area were associated with significantly increased BCa risk, by 36% and 19% respectively. Increasing VAT/SAT ratio was associated with an 8% increase in incident BCa. Time-dependent models produced similar results. VAT and VAT/SAT associated BCa risk was highest for African American/Black women, though not significantly different from other groups. Quartiles (Q) of VAT/SAT were also explored; the SHR for Q4 compared to Q1 was 1.49 (95% CI: 1.18, 1.87).</p><p><strong>Conclusion: </strong>Higher abdominal VAT and SAT are associated with an increased risk of postmenopausal BCa, and VAT/SAT may provide a distinctive risk estimate. Potential racial and ethnic differences require replication in a larger sample.(NCT00000611).</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028923","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":"Parental loss at age 0-21 and daughters' breast cancer and tumor characteristics.","authors":"Corinna Keeler, Nickilou Y Krigbaum, Barbara Cohn, Piera Cirillo","doi":"10.1093/jncics/pkaf004","DOIUrl":"https://doi.org/10.1093/jncics/pkaf004","url":null,"abstract":"<p><strong>Background: </strong>Adverse events in childhood are linked to cancer risk across the life course, but evidence is lacking regarding parental death during childhood and breast cancer (BrCa) characteristics. We investigated whether parental loss in childhood defines women at higher risk of BrCa incidence and aggressive disease.</p><p><strong>Methods: </strong>The Child Health and Development Studies (CHDS) comprises over 15,000 families who enrolled during mothers' pregnancies between 1959-1967; family members were followed for cancer incidence and cause-specific mortality. We constructed an analytical cohort of all live-born CHDS daughters (N = 9,169), linked to their parents' cause and date of death. We estimated adjusted hazard ratios of incident BrCa, stage at diagnosis, and tumor hormone receptor expression for parental loss in Cox models adjusted for race, maternal BrCa, and paternal age. Generalized linear models estimated associations between breast density and parental loss among a subsample CHDS daughters (N = 610) with available mammography.</p><p><strong>Results: </strong>137 CHDS daughters were diagnosed with BrCa by age 52, and 654 daughters lost one or both parents at age ≤21. Loss of both parents was associated with BrCa incidence [aHR(95%CI)=4.69(1.68,13.04)], late-stage at diagnosis [aHR(95%CI)=9.47(1.38,64.84)], and HER2-positive, PR-negative, and ER-negative tumors. Loss of mother or father was associated with HER2-positive tumors. Breast density in the premenopause window was associated with loss of mother or both parents.</p><p><strong>Conclusion: </strong>Death of one or both parents during childhood was strongly associated with BrCa and aggressive disease. Parental death during childhood could be added to medical histories to indicate counseling regarding prevention and early detection of BrCa.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005554","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":"Utilizing proton therapy to reduce health-care disparities among patients with breast cancers.","authors":"Kristin Hsieh, Jehee Isabelle Choi, Anthony Nehlsen, Jana Fox, Richard Bakst, Julie Bloom, Irini Yacoub, Arpit M Chhabra, Audrey Saitta, Manjeet Chadha, Sheryl Green, Deborah Marshall, Charles B Simone","doi":"10.1093/jncics/pkaf003","DOIUrl":"https://doi.org/10.1093/jncics/pkaf003","url":null,"abstract":"","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":"9 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491894","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":"Sex differences in melanoma survival-a GEM study.","authors":"Tharani Murali, Matthew Schwartz, Adam Z Reynolds, Li Luo, Grace Ridgeway, Klaus J Busam, Anne E Cust, Hoda Anton-Culver, Richard P Gallagher, Roberto Zanetti, Stefano Rosso, Lidia Sacchetto, Colin B Begg, Irene Orlow, Nancy E Thomas, Marianne Berwick","doi":"10.1093/jncics/pkaf005","DOIUrl":"10.1093/jncics/pkaf005","url":null,"abstract":"<p><p>Sex differences in melanoma are prominent, with female having a significant survival advantage. However, it is unclear why we see this survival advantage. Here, we investigate the relationship between sex, clinicopathologic variables, and melanoma specific survival in 1753 single primary melanomas from patients in the GEM (Genes, Environment, and Melanoma) study. Using Cox proportional hazard models and formal mediation analysis, the effect of sex on survival is explained largely by differences in the clinicopathologic features of tumors at diagnosis. Specifically, we find evidence that 86.5% of the effect of sex on melanoma survival is mediated by differences in age at diagnosis, Breslow thickness, ulceration, mitoses, and site (hazard ratio [HR] = 1.85, P < .001). This analysis indicates that the female survival advantage in melanoma is not primarily due to a direct effect of sex (HR = 1.19, P = .42) but is largely a result of an indirect effect of sex mediated by clinicopathologic features.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970890","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":"Rethinking the rise of early-onset gastrointestinal cancers: a call to action.","authors":"Benjamin A Weinberg, Caitlin C Murphy, David R Freyer, K Leigh Greathouse, Jan K Blancato, Elena M Stoffel, Julia L Drewes, Anne Blaes, John M Salsman, Y Nancy You, Hannah Arem, Reetu Mukherji, Priyanka Kanth, Xin Hu, Anne Fabrizio, Marion L Hartley, Marios Giannakis, John L Marshall","doi":"10.1093/jncics/pkaf002","DOIUrl":"10.1093/jncics/pkaf002","url":null,"abstract":"<p><p>Since the early 1990s, there has been a dramatic rise in gastrointestinal cancers diagnosed in patients under age 50 for reasons that remain poorly understood. The most significant change has been the increase in incidence rates of early-onset colorectal cancer, especially rates of left-sided colon and rectal cancers. Increases in gastric, pancreatic, and other gastrointestinal cancer diagnoses have further contributed to this trend. We formed a multidisciplinary Think Tank to develop a strategic, coordinated approach to studying early-onset gastrointestinal cancers. This area of research is challenging given multifactorial etiologies. We focused on epidemiology and the environment, the microbiome, and survivorship as key pillars to structure a research framework. We advocate a comprehensive strategy to (1) use existing biospecimens, especially those collected longitudinally, with correlation to exposures (the exposome); (2) standardize microbiome specimen collection and analyses of blood, tissue, and stool specimens to minimize contamination and biases; (3) prioritize mechanistic studies to evaluate findings from biomarker studies; and (4) explore the unique survivorship needs of this young population. These recommendations build upon prior efforts with the goal of streamlining research into this important field of study while minimizing redundant efforts. We hope that our findings serve as a clarion call to motivate others to discover why young individuals are being diagnosed with gastrointestinal cancers at such an alarming rate and how to best support those who have been diagnosed.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005556","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":"Cancer outcomes and cardiopulmonary toxicities for Black patients with breast cancer treated with proton therapy.","authors":"Gurbani Singh, Sravya Koduri, Manaahil Rao, Meira Kidorf, Sarah Ruff, Akshar Patel, Søren M Bentzen, Elizabeth Nichols, Sarah McAvoy, Melissa A L Vyfhuis","doi":"10.1093/jncics/pkae129","DOIUrl":"10.1093/jncics/pkae129","url":null,"abstract":"<p><strong>Background: </strong>Black women have a 40% higher breast cancer mortality rate than White women and are at a higher risk of acquiring cardiovascular disease. Proton therapy can be used to mitigate cardiac radiation exposure; however, proton therapy remains a scarce resource in the United States. We report on the cardiovascular profiles of patients undergoing proton therapy to determine the potential benefit of the therapy for Black women compared with patients of other races.</p><p><strong>Methods: </strong>We retrospectively analyzed 599 patients with breast cancer who received proton therapy from June 2016 to December 2021 at the Maryland Proton Treatment Center. A variety of sociodemographic, disease, and treatment variables were analyzed using descriptive statistics.</p><p><strong>Results: </strong>With a median follow-up of 26 months (range = 0.47-90 months), Black patients made up 31.6% of the population and presented with higher rates of hypertension (P < .001), cardiopulmonary conditions (P < .001), and a higher median body mass index (P = .015) compared with the other cohort, a trend that persisted at the time of post-proton therapy follow-up. Black women had higher rates of triple-negative disease (P < .001), with subsequent greater receipt of neoadjuvant chemotherapy (P = .039). Pulmonary events were 2.6 times more likely to occur in Black patients than in the non-Black cohort after proton therapy (odds ratio = 2.60, 95% CI = 1.39 to 4.88; P = .003).</p><p><strong>Conclusions: </strong>Black women presenting for proton therapy had higher baseline risks of cardiovascular co-morbidities combined with more aggressive breast cancer biology and a subsequent 2.6-fold increased risk of pulmonary events after proton therapy. Our findings support the use of advanced radiation techniques as a means of sparing important organs at risk, especially in historically marginalized populations.</p>","PeriodicalId":14681,"journal":{"name":"JNCI Cancer Spectrum","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894354","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}