Jacc: Cardiooncology最新文献

{"title":"Diversity in Cardio-Oncology Clinical Trials","authors":"Yehoda M. Martei MD, MSCE , Henrietta A. Afari MD , Carmen E. Guerra MD, MSCE","doi":"10.1016/j.jaccao.2024.03.012","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.03.012","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 3","pages":"Pages 386-389"},"PeriodicalIF":11.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001509/pdfft?md5=4807a8294ac3e0ce5c95a1032b1ef6a6&pid=1-s2.0-S2666087324001509-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Cardio-Oncology Care Among Patients With Prostate Cancer∗","authors":"Edward Christopher Dee MD , Fumiko Chino MD , Michelle N. Johnson MD, MPH","doi":"10.1016/j.jaccao.2024.05.005","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.05.005","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 3","pages":"Pages 402-404"},"PeriodicalIF":11.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001571/pdfft?md5=30bf04d0f85704d3bf0ed0f4cc5e9fb8&pid=1-s2.0-S2666087324001571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community Engagement to Advance Equitable Cardio-Oncology Care","authors":"Vanessa B. Sheppard PhD , Arnethea L. Sutton PhD , Shiva Salehian MD, PhD , Anika L. Hines PhD, MPH , Karen Patricia Williams PhD , Megan C. Edmonds PhD, MPH , Alisa Brewer MSPH , Marcie S. Wright PhD , Avirup Guha MBBS, MPH","doi":"10.1016/j.jaccao.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.05.002","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 3","pages":"Pages 381-385"},"PeriodicalIF":11.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324001534/pdfft?md5=21be19efe90859347b39768c83d568d3&pid=1-s2.0-S2666087324001534-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141423406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neighborhood Walkability Is Associated With Lower Burden of Cardiovascular Risk Factors Among Cancer Patients","authors":"Nwabunie Nwana PhD, MPH, MBA ,&nbsp;Omar Mohamed Makram MBBCh ,&nbsp;Juan C. Nicolas BS ,&nbsp;Alan Pan MS ,&nbsp;Rakesh Gullapelli BS, MS ,&nbsp;Tarang Parekh PhD, MBBS ,&nbsp;Zulqarnain Javed PhD, MBBS, MPH ,&nbsp;Anoop Titus MD ,&nbsp;Sadeer Al-Kindi MD ,&nbsp;Jian Guan MD, PhD ,&nbsp;Kai Sun MD, MS ,&nbsp;Stephen L. Jones MD, MSHI ,&nbsp;Jay E. Maddock PhD ,&nbsp;Jenny Chang MD ,&nbsp;Khurram Nasir MD, MPH, MSc","doi":"10.1016/j.jaccao.2024.03.009","DOIUrl":"10.1016/j.jaccao.2024.03.009","url":null,"abstract":"<div><h3>Background</h3><p>Modifiable cardiovascular risk factors constitute a significant cause of cardiovascular disease and mortality among patients with cancer. Recent studies suggest a potential link between neighborhood walkability and favorable cardiovascular risk factor profiles in the general population.</p></div><div><h3>Objectives</h3><p>This study aimed to investigate whether neighborhood walkability is correlated with favorable cardiovascular risk factor profiles among patients with a history of cancer.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional study using data from the Houston Methodist Learning Health System Outpatient Registry (2016-2022) comprising 1,171,768 adults aged 18 years and older. Neighborhood walkability was determined using the 2019 Walk Score and divided into 4 categories. Patients with a history of cancer were identified through International Classification of Diseases-10th Revision-Clinical Modification codes (C00-C96). We examined the prevalence and association between modifiable cardiovascular risk factors (hypertension, diabetes, smoking, dyslipidemia, and obesity) and neighborhood walkability categories in cancer patients.</p></div><div><h3>Results</h3><p>The study included 121,109 patients with a history of cancer; 56.7% were female patients, and 68.8% were non-Hispanic Whites, with a mean age of 67.3 years. The prevalence of modifiable cardiovascular risk factors was lower among participants residing in the most walkable neighborhoods compared with those in the least walkable neighborhoods (76.7% and 86.0%, respectively). Patients with a history of cancer living in very walkable neighborhoods were 16% less likely to have any risk factor compared with car-dependent–all errands neighborhoods (adjusted OR: 0.84, 95% CI: 0.78-0.92). Sensitivity analyses considering the timing of events yielded similar results.</p></div><div><h3>Conclusions</h3><p>Our findings demonstrate an association between neighborhood walkability and the burden of modifiable cardiovascular risk factors among patients with a medical history of cancer. Investments in walkable neighborhoods may present a viable opportunity for mitigating the growing burden of modifiable cardiovascular risk factors among patients with a history of cancer.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 3","pages":"Pages 421-435"},"PeriodicalIF":11.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266608732400142X/pdfft?md5=3257a5008f47f69cc27e95e157045d48&pid=1-s2.0-S266608732400142X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141038103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intracardiac Ultrasound and Mapping Integration-Guided Endomyocardial Biopsy for the Diagnosis of Myocardial Melanoma Metastasis","authors":"Jerry Fan MD ,&nbsp;Christopher Perez MD ,&nbsp;Robert J. Widmer MD ,&nbsp;Vinh Nguyen MD ,&nbsp;Gang Zhou MD ,&nbsp;Laith Wahab DO ,&nbsp;Javier E. Banchs MD","doi":"10.1016/j.jaccao.2024.01.008","DOIUrl":"10.1016/j.jaccao.2024.01.008","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 325-328"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000516/pdfft?md5=7117bed6a8825499079fe1b0bbb7ea40&pid=1-s2.0-S2666087324000516-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Preexisting Heart Failure on Treatment and Outcomes in Older Patients With Hodgkin Lymphoma","authors":"Jenica N. Upshaw MD ,&nbsp;Jason Nelson MPH ,&nbsp;Benjamin Sweigart MA ,&nbsp;Angie Mae Rodday PhD ,&nbsp;Anita J. Kumar MD ,&nbsp;Marvin A. Konstam MD ,&nbsp;John B. Wong MD ,&nbsp;Bonnie Ky MD, MSCE ,&nbsp;Samuel Karmiy MD ,&nbsp;Jonathan W. Friedberg MD ,&nbsp;Andrew M. Evens DO ,&nbsp;David M. Kent MD ,&nbsp;Susan K. Parsons MD","doi":"10.1016/j.jaccao.2024.02.003","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.02.003","url":null,"abstract":"<div><h3>Background</h3><p>Older patients with Hodgkin lymphoma (HL) often have comorbid cardiovascular disease; however, the impact of pre-existing heart failure (HF) on the management and outcomes of HL is unknown.</p></div><div><h3>Objectives</h3><p>The aim of this study was to assess the prevalence of pre-existing HF in older patients with HL and its impact on treatment and outcomes.</p></div><div><h3>Methods</h3><p>Linked Surveillance, Epidemiology, and End Results (SEER) and Medicare data from 1999 to 2016 were used to identify patients 65 years and older with newly diagnosed HL. Pre-existing HF, comorbidities, and cancer treatment were ascertained from billing codes and cause-specific mortality from SEER. The associations between pre-existing HF and cancer treatment were estimated using multivariable logistic regression. Cause-specific Cox proportional hazards models adjusted for comorbidities and cancer treatment were used to estimate the association between pre-existing HF and cause-specific mortality.</p></div><div><h3>Results</h3><p>Among 3,348 patients (mean age 76 ± 7 years, 48.6% women) with newly diagnosed HL, pre-existing HF was present in 437 (13.1%). Pre-existing HF was associated with a lower likelihood of using anthracycline-based chemotherapy regimens (OR: 0.42; 95% CI: 0.29-0.60) and a higher likelihood of lymphoma mortality (HR: 1.25; 95% CI: 1.06-1.46) and cardiovascular mortality (HR: 2.57; 95% CI: 1.96-3.36) in models adjusted for comorbidities. One-year lymphoma mortality cumulative incidence was 37.4% (95% CI: 35.5%-39.5%) with pre-existing HF and 26.3% (95% CI: 25.0%-27.6%) without pre-existing HF. The cardioprotective medications dexrazoxane and liposomal doxorubicin were used in only 4.2% of patients.</p></div><div><h3>Conclusions</h3><p>Pre-existing HF in older patients with newly diagnosed HL is common and associated with higher 1-year mortality. Strategies are needed to improve lymphoma and cardiovascular outcomes in this high-risk population.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 200-213"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000565/pdfft?md5=72b9cb7a80806c60cb007d3d69f7a74d&pid=1-s2.0-S2666087324000565-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anthracyclines in Older Adults With Hodgkin Lymphoma","authors":"Gabriel Aleixo MD ,&nbsp;Michael P. Lavelle MD ,&nbsp;Ramy Sedhom MD","doi":"10.1016/j.jaccao.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.03.003","url":null,"abstract":"","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 214-216"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000644/pdfft?md5=a6aadf742331a6a3849ab8557b9c79ba&pid=1-s2.0-S2666087324000644-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Tafamidis on Renal Function in Patients With Transthyretin Amyloid Cardiomyopathy in ATTR-ACT","authors":"Brett W. Sperry MD ,&nbsp;Marla B. Sultan MD ,&nbsp;Balarama Gundapaneni MS ,&nbsp;Sandi See Tai MD ,&nbsp;Ronald M. Witteles MD","doi":"10.1016/j.jaccao.2024.02.007","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.02.007","url":null,"abstract":"<div><h3>Background</h3><p>Chronic kidney disease (CKD) is common among patients with amyloid cardiomyopathy. Tafamidis was approved for the treatment of transthyretin amyloid cardiomyopathy (ATTR-CM) based on findings from ATTR-ACT (Safety and Efficacy of Tafamidis in Patients With Transthyretin Cardiomyopathy).</p></div><div><h3>Objectives</h3><p>This post hoc analysis evaluated changes in renal function among patients with ATTR-CM in ATTR-ACT.</p></div><div><h3>Methods</h3><p>Patients were randomized to receive tafamidis (20 mg and 80 mg pooled) or placebo for 30 months. The change from baseline in the estimated glomerular filtration rate (eGFR) was compared over time. A composite endpoint of all-cause death, dialysis, kidney transplant, or ≥30% decline in eGFR from baseline was analyzed based on the time to first event.</p></div><div><h3>Results</h3><p>The mean baseline eGFR was 57.5 ± 17.3 and 55.6 ± 16.8 mL/min/1.73 m² in the tafamidis (n = 264) and placebo (n = 177) groups, respectively. At 30 months, patients treated with tafamidis had a significantly smaller decline in eGFR compared with placebo (least squares mean difference = 3.99 mL/min/1.73 m²; 95% CI: 1.31-6.68; <em>P =</em> 0.004). In patients who completed ATTR-ACT, improvement in CKD staging was more common with tafamidis vs placebo treatment (17.7% vs 7.2%; OR: 2.75; 95% CI: 1.10-6.90; <em>P =</em> 0.034). A lower proportion of tafamidis-treated patients reached the composite renal endpoint (crude rates 34.5% vs 44.1%; HR: 0.73, 95% CI: 0.54-0.99; <em>P =</em> 0.040).</p></div><div><h3>Conclusions</h3><p>Renal function deteriorates over time in patients with ATTR-CM, and tafamidis treatment was associated with a reduction in this deterioration, and a higher incidence of improved eGFR and CKD staging over 30 months compared with placebo. (Safety and Efficacy of Tafamidis in Patients With Transthyretin Cardiomyopathy [ATTR-ACT] <span>NCT01994889</span><svg><path></path></svg>)</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 300-306"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000607/pdfft?md5=977a59e3d9d0544dc735375b45242858&pid=1-s2.0-S2666087324000607-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cardioprotective and Anticancer Effects of SGLT2 Inhibitors","authors":"Mohamed S. Dabour MS ,&nbsp;Mina Y. George MS, PhD ,&nbsp;Mary R. Daniel PharmD ,&nbsp;Anne H. Blaes MD, MS ,&nbsp;Beshay N. Zordoky MS, PhD","doi":"10.1016/j.jaccao.2024.01.007","DOIUrl":"10.1016/j.jaccao.2024.01.007","url":null,"abstract":"<div><p>Sodium-glucose cotransporter-2 (SGLT2) inhibitors, originally approved for type 2 diabetes mellitus, have demonstrated efficacy in reducing cardiovascular events, particularly heart failure, in patients with and without diabetes. An intriguing research area involves exploring the potential application of SGLT2 inhibitors in cardio-oncology, aiming to mitigate the cardiovascular adverse events associated with anticancer treatments. These inhibitors present a unique dual nature, offering both cardioprotective effects and anticancer properties, conferring a double benefit for cardio-oncology patients. In this review, the authors first examine the established cardioprotective effects of SGLT2 inhibitors in heart failure and subsequently explore the existing body of evidence, including both preclinical and clinical studies, that supports the use of SGLT2 inhibitors in the context of cardio-oncology. The authors further discuss the mechanisms through which SGLT2 inhibitors protect against cardiovascular toxicity secondary to cancer treatment. Finally, they explore the potential anticancer effects of SGLT2 inhibitors along with their proposed mechanisms.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 159-182"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000486/pdfft?md5=ee17dd20ab18a6c1a71d94a7953fddf0&pid=1-s2.0-S2666087324000486-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Electrocardiography to Predict Atrial Fibrillation in Patients With Chronic Lymphocytic Leukemia","authors":"Georgios Christopoulos MD ,&nbsp;Zachi I. Attia PhD ,&nbsp;Sara J. Achenbach MS ,&nbsp;Kari G. Rabe MS ,&nbsp;Timothy G. Call MD ,&nbsp;Wei Ding MD, PhD ,&nbsp;Jose F. Leis MD, PhD ,&nbsp;Eli Muchtar MD ,&nbsp;Saad S. Kenderian MD ,&nbsp;Yucai Wang MD, PhD ,&nbsp;Paul J. Hampel MD ,&nbsp;Amber B. Koehler PA-C ,&nbsp;Neil E. Kay MD ,&nbsp;Prashant Kapoor MD ,&nbsp;Susan L. Slager PhD ,&nbsp;Tait D. Shanafelt MD ,&nbsp;Peter A. Noseworthy MD ,&nbsp;Paul A. Friedman MD ,&nbsp;Joerg Herrmann MD ,&nbsp;Sameer A. Parikh MD","doi":"10.1016/j.jaccao.2024.02.006","DOIUrl":"https://doi.org/10.1016/j.jaccao.2024.02.006","url":null,"abstract":"<div><h3>Background</h3><p>The use of an artificial intelligence electrocardiography (AI-ECG) algorithm has demonstrated its reliability in predicting the risk of atrial fibrillation (AF) within the general population.</p></div><div><h3>Objectives</h3><p>This study aimed to determine the effectiveness of the AI-ECG score in identifying patients with chronic lymphocytic leukemia (CLL) who are at high risk of developing AF.</p></div><div><h3>Methods</h3><p>We estimated the probability of AF based on AI-ECG among patients with CLL extracted from the Mayo Clinic CLL database. Additionally, we computed the Mayo Clinic CLL AF risk score and determined its ability to predict AF.</p></div><div><h3>Results</h3><p>Among 754 newly diagnosed patients with CLL, 71.4% were male (median age = 69 years). The median baseline AI-ECG score was 0.02 (range = 0-0.93), with a value ≥0.1 indicating high risk. Over a median follow-up of 5.8 years, the estimated 10-year cumulative risk of AF was 26.1%. Patients with an AI-ECG score of ≥0.1 had a significantly higher risk of AF (HR: 3.9; 95% CI: 2.6-5.7; <em>P &lt;</em> 0.001). This heightened risk remained significant (HR: 2.5; 95% CI: 1.6-3.9; <em>P &lt;</em> 0.001) even after adjusting for the Mayo CLL AF risk score, heart failure, chronic kidney disease, and CLL therapy. In a second cohort of CLL patients treated with a Bruton tyrosine kinase inhibitor (n = 220), a pretreatment AI-ECG score ≥0.1 showed a nonsignificant increase in the risk of AF (HR: 1.7; 95% CI: 0.8-3.6; <em>P =</em> 0.19).</p></div><div><h3>Conclusions</h3><p>An AI-ECG algorithm, in conjunction with the Mayo CLL AF risk score, can predict the risk of AF in patients with newly diagnosed CLL. Additional studies are needed to determine the role of AI-ECG in predicting AF risk in CLL patients treated with a Bruton tyrosine kinase inhibitor.</p></div>","PeriodicalId":48499,"journal":{"name":"Jacc: Cardiooncology","volume":"6 2","pages":"Pages 251-263"},"PeriodicalIF":11.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666087324000590/pdfft?md5=2b46e3d750db69305ecc22343491ff0a&pid=1-s2.0-S2666087324000590-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140559123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}