Acta Oncologica最新文献

{"title":"Factors associated with participation in a proton therapy clinical trial: a cross-sectional survey of Danish patients with head and neck cancer.","authors":"Anne Wilhøft Kristensen, Kenneth Jensen, Annesofie L Jensen, Susanne O Dalton, Jesper Eriksen, Jeppe Friborg, Cai Grau","doi":"10.2340/1651-226X.2025.43912","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43912","url":null,"abstract":"<p><strong>Background and purpose: </strong>Participation in proton therapy (PT) trials may be affected by structural, clinical, and individual factors, potentially excluding certain patient groups. Such disparities can lead to unequal access to potential research benefits and may limit the generalisability of trial findings. This study aimed to identify factors associated with participation in a Danish randomised controlled trial (RCT) comparing proton versus photon radiotherapy for head and neck cancer.</p><p><strong>Patients and methods: </strong>This national cross-sectional study invited patients with pharyngeal and laryngeal cancer, referred for curative-intent radiotherapy at seven Danish radiotherapy clinics between 2022 and 2025, to complete a survey. Respondents were categorised based on enrollment status in a national RCT comparing proton versus photon radiotherapy. Clinical, demographic, psychosocial, and lifestyle data were collected and linked to clinical registry data. Multiple logistic regression was used to assess exposure variables associated with trial participation.</p><p><strong>Results: </strong>Of 304 respondents, 120 (39%) were enrolled in the RCT. Female gender, older age, greater geographical distance to the PT centre, mobility limitations, lower self-rated health status, and lower ability to actively engage with healthcare providers (Health Literacy Questionnaire scale 6) were significantly associated with lower odds of participation. No significant associations were observed for income, education, marital status, or anxiety.</p><p><strong>Interpretation: </strong>The findings indicate that demographic, geographical, functional, and communication--related factors may limit participation in PT trials. This highlights the need for interventions that enhance the delivery of trial information, strengthen communication between patients and healthcare professionals, and support informed clinical trial decision-making.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"879-888"},"PeriodicalIF":2.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599085","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":"Acquired angioedema and rituximab-induced acute thrombocytopenia in splenic marginal zone lymphoma.","authors":"Odd Terje Brustugun, Erik Waage Nielsen","doi":"10.2340/1651-226X.2025.43897","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43897","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"868-871"},"PeriodicalIF":2.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590225","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":"A comprehensive national audit of radiotherapy retreatment numbers, sites and indications.","authors":"Morten Nielsen, Mai-Britt Linaa, Vibeke Nordmark Hansen, Laura Patricia Kaplan, Mikkel Drøgemüller Lund, Martin Skovmos Nielsen, Wiviann Ottoson, Cécile Peucelle, Laura Ann Rechner, Heidi S Rønde, Tine Schytte, Weronika Maria Szejniuk, Rebecca Jean Tobin, Lone Hoffmann, Ane Appelt","doi":"10.2340/1651-226X.2025.43825","DOIUrl":"https://doi.org/10.2340/1651-226X.2025.43825","url":null,"abstract":"<p><strong>Background and purpose: </strong>Reirradiation has seen increased interest and clinical use; however, robust data on patient numbers and treatment indications are missing. As a precursor to a prospective national reirradiation registry, a comprehensive national audit of reirradiation was performed.</p><p><strong>Patients/materials and methods: </strong>Radiotherapy retreatment courses in 2023 were audited by all (eight) radiotherapy centres in Denmark. Six centres extended the evaluation to include 2021-22, and three of these also evaluated preceding years. Reirradiation was defined according to the ESTRO/EORTC consensus (i.e. treatment volume overlap or cumulative dose toxicity risk) using 3 months threshold between the primary and reirradiation courses. Reirradiation courses were further stratified into curative/ablative and palliative treatments by prescription dose.</p><p><strong>Results: </strong>The total number of radiotherapy patients at Danish centres in 2023 was 17,424. Of these, 3,163 received retreatment, including 1,471 reirradiation courses (1,035 palliative; 436 curative/ablative). From 2014 to 2023, absolute numbers for both retreatment and reirradiation increased. We found large variation in prescription doses and fractionation schedules used for reirradiation. Widely used palliative prescriptions were 8Gy/1 fraction (F), 20Gy/4F and 30Gy/10F; stereotactic prescriptions of 20Gy/1F or 27Gy/3F in brain and 45Gy/3F in lung; and a variety of curative treatments schedules. Palliative reirradiations were primarily thoracic (29%), spine (25%), and abdominal/pelvic (22%) and curative/ablative reirradiations were primarily breast (29%) and lung stereotactic (23%).</p><p><strong>Interpretation: </strong>This is the first comprehensive national audit of reirradiation, demonstrating an increasing number of patients being treated, using a wide variety of dose prescriptions and fractionation schedules.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"872-878"},"PeriodicalIF":2.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590224","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":"Risk factors for early mortality and impaired quality of life in oral cavity cancer - head and neck cancer register study.","authors":"Teija Nieminen, Morag Tolvi, Tuija Ylä-Kotola, Lasse Lehtonen, Antti Mäkitie, Taru Ilmarinen","doi":"10.2340/1651-226X.2025.43469","DOIUrl":"10.2340/1651-226X.2025.43469","url":null,"abstract":"<p><strong>Background and purpose: </strong>Treatment of locoregionally advanced oral cavity cancer (OCC) is associated with treatment-related complications, functional deficits, and even early mortality. High-quality register data could help in choosing between curative and non-curative intent treatment options.</p><p><strong>Materials and methods: </strong>The Helsinki Head and Neck Cancer Register (HHNCR) is linked with the EORTC QLQ-H&N35 questionnaire automatically sent to all patients at diagnosis and predetermined intervals. We analyzed pretreatment data of all patients diagnosed with OCC during 2018-2023, focusing on risk factors for early mortality and impaired health-related quality of life after curative-intent treatment.</p><p><strong>Results: </strong>Of 597 patients, 556 (93%) were treated with curative intent. Thirty-nine (7.0%) patients died within 6 months after diagnosis. The independent risk-factors for 6-month mortality identified in multivariable analysis were T3 stage (OR 8.3 [2.6-26.5], p < 0.001), T4 stage (OR 8.2 [2.5-26.8], p < 0.001), N3 stage (OR 10.6 [3.2-35.1], p < 0.001), and Adult Comorbidity Evaluation (ACE)-27 score 2-3 (OR 5.5 [2.4-12.5], p < 0.001). These risk-factors were used to create a predictive risk score for early death. Younger, healthier patients had significantly higher EORTC QLQ-H&N35 response rates compared with older patients with comorbidities. Six months after diagnosis, patients with a stage III-IV tumor had significantly higher scores in 15 of 18 items, compared with patients with a stage I-II tumor.</p><p><strong>Interpretation: </strong>Early mortality was associated with advanced tumor (T) and nodal (N) stage, and increased pretreatment comorbidity (ACE-27) scores. The strongest predictor for impaired quality of life was locoregionally advanced disease.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"859-867"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551686","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":"The risk of myelodysplastic syndrome and acute myeloid leukemia by metformin use and type 2 diabetes status - a Danish nation-wide cohort study.","authors":"Umar Aziz","doi":"10.2340/1651-226X.2025.44082","DOIUrl":"10.2340/1651-226X.2025.44082","url":null,"abstract":"","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"857-858"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537683","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":"CYP2D6 genotype and outcome in tamoxifen treated early breast cancer.","authors":"Linda Thorén, Jonatan D Lindh, Espen Molden, Marianne Kristiansen Kringen, Jonas Bergh, Erik Eliasson, Sara Margolin","doi":"10.2340/1651-226X.2025.43208","DOIUrl":"10.2340/1651-226X.2025.43208","url":null,"abstract":"<p><strong>Background and purpose: </strong>The clinical significance of individual CYP2D6 activity for the outcome of tamoxifen treatment in early breast cancer is unclear. Our previous investigation in patients diagnosed over the period 1998-2000 indicated an association between reduced CYP2D6 activity and poor outcome in premenopausal women. The aim of this study was to investigate the association between CYP2D6 genotype and clinical outcome in a larger tamoxifen treated cohort.</p><p><strong>Patients/material and methods: </strong>Swedish breast cancer patients who initiated adjuvant tamoxifen treatment over the period 2006-2014 constituted the full study cohort. Clinical information was collected from medical records. Data on endocrine treatment, use of CYP2D6 inhibitors was retrieved from the Swedish Prescribed Drug Register. CYP2D6 was genotyped and translated into predicted metabolic activity. The association between CYP2D6 activity and clinical outcome was analyzed using Cox regression, controlling for potential confounding variables. Subgroup analyses were performed based on menopausal status, tamoxifen treatment for at least 1 year and as single endocrine treatment, HER2-status and tamoxifen monotherapy.</p><p><strong>Results: </strong>A total of 1,103 patients were included. A total of 761 patients received tamoxifen as monotherapy. A total of 42% were premenopausal. Median follow-up was 11.4 years. No significant association was found between CYP2D6 activity and recurrence (adjusted hazard ratio [aHR] 1.18, 95% CI 0.92; 1.52) or breast cancer mortality (aHR 1.41, 95%CI 0.93; 2.13) in the full cohort, or in the subgroup with tamoxifen monotherapy (aHR 1.39, CI 0.99; 1.96 and 1.88, CI 0.98; 3.60 respectively).</p><p><strong>Interpretation: </strong>No association was noted between reduced CYP2D6 activity and poorer outcome in this early breast cancer cohort, with patients generally at lower risk of recurrence, reflecting the role of adjuvant tamoxifen in current clinical practice.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"848-856"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537681","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":"Incidence of myocardial ischemia during treatment with capecitabine: a cohort study with Holter recording and cardiac biomarkers.","authors":"Anne Dyhl-Polk, Morten Schou, Kirsten K Vistisen, Anne-Sophie Sillesen, Stig E Bojesen, Jens Faber, Merete Vaage-Nilsen, Dorte L Nielsen","doi":"10.2340/1651-226X.2025.43089","DOIUrl":"10.2340/1651-226X.2025.43089","url":null,"abstract":"<p><strong>Background and purpose: </strong>Treatment with fluoropyrimidines can lead to cardiotoxicity. For 5-fluorouracil, silent myocardial ischemia and effort-related myocardial ischemia have been demonstrated. We investigated the incidence of myocardial ischemia and clinical cardiotoxicity during treatment with capecitabine, a pro-drug of 5-fluorouracil.</p><p><strong>Patients and methods: </strong>We included patients with breast- or colorectal cancer, who received first-time treatment with capecitabine. Holter recording, clinical evaluation, 12-lead electrocardiogram, and measurement of plasma cardiac troponin I and copeptin were performed before and during treatment.</p><p><strong>Results: </strong>A total of 42 patients with breast cancer and 39 with colorectal cancer were included. Seven patients (9%) experienced clinical cardiotoxicity; five with unstable angina, one with dyspnoea, ST elevations and anterolateral hypokinesia, and one with cardiac arrest. Six patients (8%) had myocardial ischemia on Holter recording during treatment. Among these were two with clinical cardiotoxicity, and four (5.0%) with silent myocardial ischemia. More patients had myocardial ischemia on Holter recording during treatment compared to before, but the difference was not statistically significant (1st cycle: p = 0.22, 3rd/4th cycle: p = 0.50). Plasma copeptin increased during 1st cycle (p = 0.004), while cardiac troponin I remained unchanged (p = 0.92). More patients had non-sustained ventricular tachycardia during 1st cycle of treatment than before (p = 0.020).</p><p><strong>Interpretation: </strong>Treatment with capecitabine was associated with an incidence of myocardial ischemia of 8%, an incidence of clinical cardiotoxicity of 9%, and an increase in plasma copeptin and the frequency of non-sustained ventricular tachycardia episodes. Increases in cardiac troponin I were rare. The incidence of myocardial ischemia was lower than previously reported for 5-fluorouracil.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"837-847"},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144537682","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":"Prostate cancer incidence and mortality among immigrants in Finland between 2000 and 2017 - a register-based cohort study.","authors":"Katja M Mustonen, Maarit H Lamminmäki, Tytti M Sarkeala, Sirpa H Heinävaara","doi":"10.2340/1651-226X.2025.43328","DOIUrl":"10.2340/1651-226X.2025.43328","url":null,"abstract":"<p><strong>Background and purpose: </strong>Prostate cancer impacts millions of men worldwide each year, and its significance will continue to rise as populations age. Literature demonstrates differences in cancer burden between immigrant groups and non-immigrants across the world. Despite its prevalence, little research has focused primarily on prostate cancer among immigrants.</p><p><strong>Patients/material and methods: </strong>We utilized individual-level data on all immigrant men who had lived in Finland for over a year between 1973 and 2017 and aggregate data on Finnish-born men to determine immigrants' incidence of and mortality from prostate cancer in relation to the men born in Finland. This gave us a study population of 162,844 non-Western and 56,127 Western immigrant men. Cases and deaths from the study period (2000-2017) were analyzed with the multivariate Poisson regression model for the groups, non-Western and Western immigrants separately.</p><p><strong>Results and interpretation: </strong>Non-Western men had a relative risk (RR) of 0.663 (95% confidence interval [CI] 0.609-0.722) for cases and 0.803 (0.646-0.997) for deaths. Western men had RRs of 0.876 (0.784-0.978) and 0.78 (0.567-1.072), respectively. A longer duration of residence and a younger age at immigration increased the risk for prostate cancer. Compared to the men born in Finland, both immigrant groups showed a lower risk of prostate cancer. Non-Western men may have also had a lower risk of death from it. Prostate cancer mortality in non-Western immigrants appears to be high compared to its incidence. While uncertain, this implication is concerning enough to warrant further research into the topic.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"830-836"},"PeriodicalIF":2.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144525972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to choose optimal adjuvant therapies for high-risk hormone receptor-positive, HER2-negative breast cancer after chemotherapy?","authors":"Peeter Karihtala","doi":"10.2340/1651-226X.2025.43645","DOIUrl":"10.2340/1651-226X.2025.43645","url":null,"abstract":"<p><strong>Background and purpose: </strong>The prognosis for hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer has significantly improved over the past few decades. However, a substantial number of patients still face an elevated risk of recurrence. Due to the high prevalence and cumulative mortality of HR+/HER2- breast cancer, it poses a global health challenge.</p><p><strong>Material and methods: </strong>This is a narrative review on the post-chemotherapy treatment options in patients with HR+/HER2- breast cancer.</p><p><strong>Results: </strong>Endocrine therapy remains the cornerstone of adjuvant treatment, with extended durations of tamoxifen and aromatase inhibitors demonstrating survival benefits. Several novel post-chemotherapy adjuvant treatments have recently been introduced for high-risk patients, and now most patients with HR+/HER2- breast cancer are eligible for non-endocrine adjuvant therapies. Bisphosphonates help to reduce bone recurrence and enhance overall survival in postmenopausal women, though the evidence remains somewhat inconsistent. CDK4/6 inhibitors abemaciclib and ribociclib have also emerged as adjuvant therapies, while the poly ADP ribose polymerase (PARP) inhibitor olaparib provides clinically meaningful benefits for patients with germline BRCA1/2 mutations.</p><p><strong>Interpretation: </strong>Optimal patient selection for these often toxic treatments remains partially unclear and is the focus of intensive research. In the near future, monitoring ctDNA may enable treatment de-escalation for selected high-risk patients. The rise of perioperative immunological therapies, new CDK4-specific inhibitors, and targeted endocrine treatments can lead to a notably favorable prognosis for many previously high-risk HR+/HER2- breast cancers. Future research should prioritize predictive biomarkers and personalized approaches to optimize treatment efficacy, ensure more equal access to treatments, and minimize overtreatment.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"815-829"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes and the role of surgery in gestational trophoblastic neoplasia: a population-based cohort study.","authors":"Agnes Larsson, Emelie Wallin, Mats Nilsson, Ulrika Joneborg","doi":"10.2340/1651-226X.2025.43274","DOIUrl":"10.2340/1651-226X.2025.43274","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cure rates of gestational trophoblastic neoplasia (GTN) are excellent, however the surgical interventions in disease management are not well described. The primary aim of this study was to investigate the incidence and types of surgical procedures used for management of GTN and to report treatment outcomes in a population-based cohort. The secondary aim was to assess the impact of hysterectomy on time to human chorionic gonadotropin (hCG)-normalisation in low-risk GTN.</p><p><strong>Material and methods: </strong>Medical records of all patients treated for GTN at Karolinska University Hospital, Stockholm, Sweden between 1994 and 2020 were screened for treatment outcomes, types of surgical procedures and complications. Regression models were used to assess if hysterectomy affected time to complete remission in low-risk GTN.</p><p><strong>Results and interpretation: </strong>Over the 27-year study period, 185 patients with GTN were included. The primary complete remission rate was 98.4% and relapse rate 3.2%. Sixty-four patients (34.6%) underwent at least one surgical procedure; 39/154 (25.3%) of low-risk patients, 17/23 (73.9%) of high-risk patients and all (100%) patients with placental site or epithelioid trophoblastic tumour. No severe complications (Clavien-Dindo ≥3) were observed. Seven of 74 procedures (9.5%) were complicated by bleeding >1,000 mL or surgical site infection. Therapeutic hysterectomy significantly shortened time to hCG-normalisation in the low-risk group (48 vs 74 days, p = 0.002). This population-based study confirms the excellent cure rates and low relapse rates for GTN. Surgery plays an important role in the management of GTN with low risk of complications. Hysterectomy shortens time to hCG normalisation.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"807-814"},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}