Urologic Oncology-seminars and Original Investigations最新文献

{"title":"Comparison of adjuvant and neoadjuvant therapies for muscle invasive bladder cancer: A network meta-analysis.","authors":"Fausto Petrelli, Lorenzo Dottorini, Antonio Ghidini, Francesca Ceresoli, Domenico Taglialatela, Giada Parsani, Ivano Vavassori","doi":"10.1016/j.urolonc.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.014","url":null,"abstract":"<p><p>Muscle-invasive bladder cancer (MIBC) is a highly aggressive disease requiring multimodal treatment. While neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC) is standard, many patients experience recurrence, highlighting the need for improved perioperative strategies. The role of immune checkpoint inhibitors (ICIs) in both neoadjuvant and adjuvant settings is promising, but the optimal approach remains unclear. This network meta-analysis (NMA) evaluates and ranks different perioperative treatments to identify the most effective strategy. We conducted a systematic review and NMA of 12 randomized controlled trials (RCTs) published between 1995 and 2024, including 5,026 patients with MIBC. Treatments analyzed included NAC ± immunotherapy, adjuvant immunotherapy, perioperative regimens, and dose-dense MVAC chemotherapy. Overall survival (OS) was the primary outcome. A Bayesian statistical model ranked treatments using SUCRA scores. The most effective strategy was NAC followed by surgery and adjuvant nivolumab (SUCRA: 99%, HR 0.43, 95% CrI 0.24-0.74). Perioperative durvalumab-based regimens (SUCRA: 82%) and dose-dense MVAC (SUCRA: 78%) also demonstrated significant benefit. Moderate heterogeneity (I² = 46%) was observed. These findings support integrating chemotherapy and immunotherapy into MIBC treatment. Adjuvant nivolumab after NAC and surgery appears most effective, while perioperative immunotherapy shows promise. Further trials are needed to refine treatment sequencing and optimize patient selection.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line sunitinib for metastatic renal cell carcinoma, a 15-year single institution real-world evidence study.","authors":"Mohammad Haman, Johanne Ahrenfeldt, Iben Lyskjær, Niels Fristrup","doi":"10.1016/j.urolonc.2025.08.002","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.002","url":null,"abstract":"<p><strong>Background: </strong>With the introduction of immuno-oncology (IO) tyrosine kinase inhibitor (TKI) combination therapy, sunitinib has become a rarely used drug because of its inferiority demonstrated in a number of randomized clinical trials (RCTs). However, limited studies has investigated the long-term outcomes of first-line sunitinib for mRCC. This study represents the first retrospective Danish real-world evidence (RWE) study evaluating the effect of sunitinib in first line in mRCC patients, PATIENTS AND METHODS: This study included a total of 268 patients over a 15 year period. Clinical data from patients treated with sunitinib for mRCC from 01-01-2010 to 30-05-2024 were extracted from a mRCC registry at the Department of Clinical Oncology, Aarhus University Hospital, Denmark. Patient data was collected through medical record review. The data was managed in RedCap. Median overall survival (mOS) and progression-free survival (mPFS) were estimated using the Kaplan-Meier (KM) method. A multivariate Cox proportional hazards regression analysis was conducted for the entire cohort. All statistical analyses were conducted in R version 4.3.3.</p><p><strong>Results: </strong>For all patients, mPFS was 8.43 months (95% CI: 6.47-11.23) and mOS was 18.60 months (95% CI: 14.73-22.80). In the favorable risk group (IMDC = 0), mPFS reached 26.26 months (95% CI: 16.52-43.67) and mOS 57.73 months (95% CI: 38.62-75.31).</p><p><strong>Conclusions: </strong>When compared to other RWEs, our PFS and OS for all patients fell within the spectrum of previously published results. IMDC risk group was identified as the most significant factor for PFS and OS. PFS and OS for IMDC favorable-risk patients were among the highest reported in existing RWE studies. Importantly, we found sunitinib monotherapy to be an effective treatment in IMDC favorable-risk patients, comparable to published IO-TKI results, supporting its use, especially seen in relation to price.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted hotspot profiling reveals a functionally relevant mutation in bladder cancer.","authors":"Md Naiem Hossain, Depro Das, Munshi Akid Mostofa, Md Ismail Hosen, Yearul Kabir","doi":"10.1016/j.urolonc.2025.08.013","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.013","url":null,"abstract":"<p><strong>Background: </strong>Understanding the mutational landscape is critical for elucidating the molecular mechanisms driving cancer progression. This study aimed to profile somatic mutations in bladder cancer patients (N=7) from Bangladesh to provide insights into the genetic alterations underlying this malignancy.</p><p><strong>Methods: </strong>We performed targeted sequencing of 50 oncogenes and tumor suppressor genes using the Ion AmpliSeq Cancer Hotspot Panel v2 on tumor and matched blood samples from seven bladder cancer patients. Somatic variants were identified with GATK Mutect2, annotated with ANNOVAR, and analyzed using maftools. Molecular subtypes were defined through NMF clustering, ssGSEA, and immune deconvolution on TCGA data. Structural and functional impacts of deleterious mutations were assessed through protein modeling, docking, molecular dynamics simulations, and survival analysis.</p><p><strong>Results: </strong>Analysis of somatic variants revealed the presence of frameshift indels (insertions-deletions) and missense SNVs (msSNVs), while T > C and C > T transitions were highly prevalent among the SNVs. The genes that were highly mutated in this series included ATM, APC, STK11, TP53, KIT, MET, ERBB4, RET, KDR, and PIK3CA in each sample. Among these genes, the tumor suppressor gene STK11 was found to be highly deleterious due to a mutation involving phenylalanine to serine substitution at the 255th amino acid position of the STK11 protein. Further, we investigated the effect of somatic mutations in the STK11 gene using different bioinformatics tools. 3D structure analyses and molecular dynamics simulation showed that the mutation occurred within the protein's kinase domain, contributing to the destabilization of the protein's structure; lowered the affinity for ATP binding, and affected the catalytic properties, which may ultimately lead to the loss of its tumor suppressive function. Additionally, mutational signature-based stratification identified 2 molecular subtypes with basal and luminal characteristics. Integrative transcriptomic analysis was performed to characterize these 2 subtypes using publicly available transcriptomic dataset. Despite a lower tumor mutational burden, the basal subtype was significantly associated with immune infiltration within the tumor microenvironment and displayed aggressive and metastatic disease traits.</p><p><strong>Conclusion: </strong>Our study highlights STK11 as a key deleterious mutation in Bangladeshi bladder cancer patients, suggesting its potential role in tumor progression and patient prognosis.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Featured SUO fellow: Daniel S. Roberson, MD","authors":"Daniel S. Roberson","doi":"10.1016/j.urolonc.2025.08.001","DOIUrl":"10.1016/j.urolonc.2025.08.001","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Page 585"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cover 2 - Masthead","authors":"","doi":"10.1016/S1078-1439(25)00327-8","DOIUrl":"10.1016/S1078-1439(25)00327-8","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Page IFC"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An overview of molecular testing in genitourinary malignancies","authors":"Sinchita Roy-Chowdhuri M.D. Ph.D.","doi":"10.1016/j.urolonc.2025.06.013","DOIUrl":"10.1016/j.urolonc.2025.06.013","url":null,"abstract":"","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":"43 10","pages":"Page 533"},"PeriodicalIF":2.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revisiting BCG: The potential of rescue BCG therapy for BCG-unresponsive non-muscle-invasive bladder cancer.","authors":"Ketty Bai, Srinath-Reddi Pingle, Rainjade Chung, Benjamin I Joffe, Caroline Laplaca, G Joel Decastro, James M McKiernan, Christopher B Anderson, Andrew T Lenis","doi":"10.1016/j.urolonc.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.007","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of Rescue BCG in the treatment of BCG-unresponsive nonmuscle-invasive bladder cancer (NMIBC), in order to inform clinical decision-making especially when access to alternative therapies is limited.</p><p><strong>Methods: </strong>From an institutional database, patients who met the criteria of BCG-unresponsive NMIBC between 2002 and 2023 were identified and sorted into 2 cohorts: those who received additional BCG therapy immediately after BCG-unresponsive designation and those who received alternative treatments such as intravesical chemotherapy and radical cystectomy. Primary endpoint was progression-free survival (PFS). Secondary endpoints included high-grade (HG) recurrence-free survival (RFS) and overall survival (OS).</p><p><strong>Results: </strong>A total of 120 patients with BCG-unresponsive NMIBC were evaluated. Of these, 66 received Rescue BCG, and 54 did not. Both cohorts were similar in demographics, although the Rescue BCG cohort had significantly more HG T1 disease. The 1-year PFS for Rescue BCG was 95.3% compared with 84.5% for No Rescue BCG (log rank, P = 0.4). Multivariable analyses showed Rescue BCG significantly reduced disease progression (HR: 0.38, 95% CI, 0.14-0.99) and improved overall survival (HR: 0.18, 95% CI, 0.04-0.79), though no difference in HG recurrence was found. Limitations include retrospective design.</p><p><strong>Conclusion: </strong>Use of rescue BCG was associated with reduced risk of progression and improved overall survival when compared to No Rescue BCG. There was no significant difference in PFS between the No Rescue BCG cohort and in patients who had a HG recurrence within 2 years of being treated with Rescue BCG suggesting that a trial of Rescue BCG does not compromise overall oncologic outcomes.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory bowel disease vs. adverse in-hospital outcomes after radical prostatectomy.","authors":"Calogero Catanzaro, Natali Rodriguez Peñaranda, Andrea Marmiroli, Mattia Longoni, Quynh Chi Le, Fabian Falkenbach, Michele Nicolazzini, Jordan A Goyal, Lorenzo Bianchi, Pietro Piazza, Angelo Mottaran, Fred Saad, Shahrokh F Shariat, Salvatore Micali, Gennaro Musi, Alberto Briganti, Felix K H Chun, Markus Graefen, Alessandro Volpe, Riccardo Schiavina, Pierre I Karakiewicz","doi":"10.1016/j.urolonc.2025.07.032","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.07.032","url":null,"abstract":"<p><strong>Introduction: </strong>The effect of inflammatory bowel disease (IBD) on adverse in-hospital outcomes after radical prostatectomy (RP) for nonmetastatic prostate cancer (PCa) is not well known.</p><p><strong>Materials and methods: </strong>Descriptive analyses, propensity score matching and multivariable logistic regression models were used within the National Inpatient Sample (2000-2019) RP patients, after stratification according to Crohn's disease (CD) vs. ulcerative colitis (UC) vs. no-IBD, and RP type (minimally invasive [MIRP] vs. open [ORP]).</p><p><strong>Results: </strong>Of 251,334 RP patients, 486 (0.2%) had CD vs. 446 (0.2%) UC. In CD patients vs. no-IBD counterparts, MIRP (n = 223) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.64, P < 0.01) and postoperative (OR:1.73, P < 0.01) complications. Conversely, in CD patients vs. no-IBD counterparts, ORP (n = 263) independently predicted higher rates of adverse in-hospital outcomes in 5/15 categories, including also overall (OR:1.37, P < 0.05), and postoperative (OR:1.44, P < 0.05) complications. In UC patients vs. no-IBD counterparts, MIRP (n = 218) independently predicted higher rates of adverse in-hospital outcomes in only 1/15 categories, namely prolonged length of stay (OR:1.64, P < 0.001). Conversely, in UC patients vs. no-IBD counterparts, ORP (n = 228) independently predicted higher rates of adverse in-hospital outcomes in 3/15 categories, including overall (OR:1.49, P < 0.05) and intraoperative (OR:2.31, P < 0.01) complications.</p><p><strong>Conclusion: </strong>In the current analysis, direct comparisons with no-IBD patients showed worse in-hospital outcomes for both CD and UC patients, with adverse in-hospital outcomes indirectly appearing more severe in CD than in UC patients. In both subgroups, MIRP was associated with fewer adverse outcomes than ORP, based on comparison with no-IBD patients.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiomic biomarkers associated with immune checkpoint blockade response for advanced renal cell carcinoma.","authors":"Stephen W Reese, Daniel Barbakoff, Burcin Agridag Ucpinar, Andrea Knezevic, Kelly Fitzgerald, Lennert Eismann, Yousef Mazaheri Tehrani, Juan Sebastian, Sari Khaleel, Yash S Khandwala, Mark Dawidek, Robert J Motzer, Martin H Voss, Paul Russo, Oguz Akin, Ritesh R Kotecha, A Ari Hakimi","doi":"10.1016/j.urolonc.2025.08.012","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.012","url":null,"abstract":"<p><strong>Purpose: </strong>Immune checkpoint blockade (ICB) has transformed outcomes for patients with metastatic renal cell carcinoma (mRCC) and has impacted the timing and use of cytoreductive nephrectomy (CN). As ICB responses vary, we evaluated whether radiographic and radiomic biomarkers were associated with clinical and pathological outcomes.</p><p><strong>Methods: </strong>This retrospective cohort study included ICB-treated mRCC patients without upfront CN. Clinical and treatment data were collected, and time to next therapy (TTNT) and overall survival (OS) were estimated using Kaplan-Meier analysis. Univariable regression analyses were performed to correlate extracted radiomic features with pathologic outcomes from patients who underwent delayed CN.</p><p><strong>Results: </strong>From 2015 to 2022, 60 mRCC patients met inclusion criteria. Among 43 patients with available imaging data, patients with 3-month radiologic response at both primary and metastatic sites had significantly prolonged TTNT and OS compared to those with progressive disease (PD) at both sites (6-month TTNT 95% vs. 0% and 12-month OS 100% vs. 20%). Primary tumor imaging overestimated pathologically confirmed viable tumor by an average of 622 cm³ (95% CI 285-958 cm³). Imaging contrast enhancement and change in enhancement correlated with pathologic viability (Spearman ρ=0.41 and 0.39, respectively). Radiomic features of energy, run length nonuniformity, busyness, and gray-level nonuniformity identified patients with minimal residual disease with area under the curve (AUC) >0.84.</p><p><strong>Conclusion: </strong>Response patterns in primary and metastatic tumor sites are associated with ICB outcomes. Radiomic features extracted from raw imaging provide an improved surrogate for estimating tumor viability. Efforts to optimize and integrate radiomic data for treatment decision-making are needed.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer-specific mortality in secondary bladder cancer after nephroureterectomy for upper tract urothelial carcinoma.","authors":"Natali Rodriguez Peñaranda, Francesco Di Bello, Andrea Marmiroli, Fabian Falkenbach, Mattia Longoni, Quynh Chi Le, Calogero Catanzaro, Michele Nicolazzini, Mario de Angelis, Jordan A Goyal, Fred Saad, Shahrokh F Shariat, Gennaro Musi, Markus Graefen, Alberto Briganti, Felix K H Chun, Riccardo Schiavina, Carlotta Palumbo, Marco Ticonosco, Stefano Resca, Stefano Puliatti, Salvatore Micali, Pierre I Karakiewicz","doi":"10.1016/j.urolonc.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.urolonc.2025.08.006","url":null,"abstract":"<p><strong>Objective: </strong>To examine differences in cancer-specific mortality (CSM) in nonmetastatic upper tract urothelial carcinoma (UTUC) patients with vs. without secondary bladder cancer (BCa) after radical nephroureterectomy (RNU).</p><p><strong>Methods: </strong>Within the Surveillance, Epidemiology, and End Results database (SEER 2000-2021), T1-T4N0M0 UTUC patients treated with RNU and diagnosed with secondary BCa were identified. A landmark approach was used, requiring the diagnosis of secondary BCa within 18 months of the UTUC diagnosis. Additionally, a minimum follow-up of 18 months after the UTUC diagnosis was required. Subsequently, Kaplan-Meier plots and time-dependent multivariable Cox regression (MCR) models were fitted. Sensitivity analyses were performed in patients with late BCa diagnoses (6 to 18 months after UTUC diagnosis).</p><p><strong>Results: </strong>Of 3,013 eligible UTUC patients who fulfilled the landmark and follow-up criteria, 269 (9.0%) harbored secondary BCa. Ten-year CSM-free survival rates were respectively 60 vs 73% in patients with vs without secondary BCa. In MCR models, secondary BCa independently predicted higher CSM (hazard ratio [HR]: 1.53, p < 0.001). Subgroup analyses by tumor stage confirmed the independent predictor status of secondary BCa in T1-T2 stages (HR: 2.04, p < 0.001), primary renal pelvic (HR: 1.47, p = 0.003) and ureteral (HR: 1.63, p = 0.01) UTUC. Sensitivity analyses confirmed the independent predictor status of secondary BCa also in patients with late secondary BCa (HR: 1.68, p < 0.001).</p><p><strong>Conclusion: </strong>In general, secondary BCa in UTUC patients treated with RNU is associated with higher CSM. This disadvantage primarily affects patients with T1-T2 stage UTUC involving the ureter or renal pelvis.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}