Cancer prevention research (Philadelphia, Pa.)最新文献

{"title":"Prevention Before Therapy in Pancreatic Ductal Adenocarcinoma: The Clinical, Economic, and Human Case for Weighting Resources Upstream.","authors":"Guido Eibl, O Joe Hines, Enrique Rozengurt","doi":"10.1158/1940-6207.CAPR-26-0197","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0197","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is projected to become the second-leading cause of US cancer death by 2030, and survival is dominated by stage at diagnosis: roughly 44% at five years for localized disease versus about 3% with distant metastases. Only about 15% of cases are detected while localized, surgery reaches a minority of patients, and no validated screening test exists for average-risk adults. This topical review examines the biologic, clinical, economic, psychological, equity, and therapeutic evidence bearing on where scarce resources should be directed. The long interval between initiating mutation and invasive disease provides a mechanistic rationale for prevention and interception, and the modifiable exposures of obesity, tobacco, type 2 diabetes, and alcohol act largely within that window. We consider innovations that extend prevention beyond lifestyle advice-incretin-based weight management, risk stratification anchored in new-onset diabetes and biomarkers, and immunoprevention-together with early-onset disease, implementation and policy, and the barriers and evidentiary limits that temper these arguments. We propose a three-tier framework of primary prevention, early detection in high-risk groups, and therapy, and argue that research, policy, and clinical investment should be weighted upstream, because every case prevented spares the cost, capacity, and suffering that the downstream tiers must otherwise absorb.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229217","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":"Elucidating the Contexts That Enable or Constrain Normalization of Guideline-Based LDCT Lung Cancer Screening Processes in U.S. Primary Care.","authors":"Elochukwu Ezenwankwo, Camden Jones, Julie A Barta, Robert J Volk, Jan M Eberth","doi":"10.1158/1940-6207.CAPR-26-0174","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0174","url":null,"abstract":"<p><p>Routine primary care encounters offer a major opportunity to reach a large population of individuals eligible for lung cancer screening (LCS) in the U.S., potentially representing up to one-third of all primary care visits each year. This article, the first in a two-part integrative review, synthesizes evidence on the contextual factors that enable or constrain the normalization of guideline-based LCS processes in U.S. primary care. Seven electronic databases were searched in February 2025 (updated in December 2025) to identify relevant studies. The findings reported here draw on 146 studies integrated using thematic synthesis. Four main themes emerged: (1) leadership and policy decisions shaping LCS priorities; (2) alignment of guideline-concordant LCS processes with primary care capacity; (3) frontline adaptations and workarounds sustaining routine LCS delivery; and (4) reframing organizational norms to institutionalize guideline-concordant LCS in primary care. Our review revealed limited health system-level investment in formal screening governance and integrated clinical informatics infrastructure. Normalization required continuous negotiation among providers to reconcile persistent misalignments between guideline demands and primary care capacity. Notably, frontline providers and staff relied heavily on pragmatic adjustments and workarounds, enabling screening to continue through labor-intensive and often fragile processes. Providers operated within and sometimes perpetuated entrenched clinical heuristics and paternalistic traditions while navigating heavy documentation burdens and structural inequities that continued to position LCS as optional, controversial, or administratively burdensome. LCS implementation remains largely provider-driven in contemporary U.S. primary care. Normalization will require deliberate and sustained leadership and policy reform, alongside investments in workforce capacity and data infrastructure.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149225475","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":"SGLT2-mediated glucose uptake defines early metabolic reprogramming in lung adenocarcinoma.","authors":"Katherine A Ortmeyer, Kelly Anne McGovern, Lydia Chen, Kevin Guo, Jeffrey Huang, Michael Brown, Ryan Krouse, Jake Mlakar, Paul Zhang, Sunil Singhal","doi":"10.1158/1940-6207.CAPR-26-0170","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0170","url":null,"abstract":"<p><p>The metabolic reprogramming taking place during early lung adenocarcinoma (LUAD) progression remain poorly understood. While early-stage LUAD frequently demonstrates low 18F-2-fluorodeoxyglucose (18FDG) uptake on positron emission tomography (PET), it is unclear whether this reflects metabolic quiescence or alternative glucose utilization pathways. We hypothesized that early lesions are metabolically active but preferentially utilize sodium-glucose cotransporter 2 (SGLT2), a non-canonical glucose transporter with low 18FDG affinity. This study investigates metabolic activity in early-stage LUAD and glucose transporter expression patterns across the adenocarcinoma spectrum. LDH, SGLT2 and GLUT1 expression were evaluated by immunohistochemistry in human lung cancers and compared with normal lung and benign inflammation. Expression levels were correlated with structural and radiologic features including tumor size, invasion, histology, radiographic features and PET avidity. Glycolysis was elevated in premalignant and early LUAD as indicated by LDH expression. SGLT2 was highly expressed in preinvasive and minimally invasive LUAD compared to normal lung and invasive tumors. Conversely, GLUT1 was upregulated in invasive, high-grade tumors. Radiographically, SGLT2 expression was associated with subsolid nodules and low PET avidity, while GLUT1 expression was higher in nodules with a solid component and high 18FDG avidity. Notably, SGLT2 was not elevated in inflammatory lesions compared to normal lung, unlike GLUT1, which was frequently upregulated in inflammation. Early lung adenocarcinoma lesions exhibit aerobic glycolysis despite low FDG avidity and preferentially utilize SGLT2-mediated glucose uptake. These findings highlight a distinct metabolic profile in early LUAD and underscore the need for alternative imaging modalities to enhance the detection of early lesions.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186698","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":"The Association Between Metabolic Syndrome and Lung Cancer: A Systematic Review and Meta-analyses.","authors":"Rebecca Mattson, Mary Barger, Arjan van der Star, Sai Tejasri Yerramsetti, Uduak Z George","doi":"10.1158/1940-6207.CAPR-26-0019","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0019","url":null,"abstract":"<p><p>Lung cancer has a 29% survival rate, with nearly half detected at Stage 4. Survival increases to 65% with early-stage diagnosis, yet only 28.1% are diagnosed early. Cardiovascular and respiratory comorbidities coexist with LC and may affect detection and prognosis. Metabolic syndrome (MetS), characterized by central adiposity, hypertension, dysglycemia, hypertriglyceridemia, and low high-density lipoprotein cholesterol, has been associated with LC incidence and mortality. We estimated associations between MetS and LC incidence and mortality and examined study-level heterogeneity. Following PRISMA 2020, we searched CINAHL, Web of Science, and PubMed (2000-March 2025) for adult (≥18 years) studies reporting quantitative associations between MetS and LC outcomes. Two reviewers independently screened studies and extracted design, population, MetS definitions, outcomes, effect estimates, and covariates. Random-effects meta-analyses and sensitivity analyses were conducted. Study quality was assessed using NHLBI tools; funnel plots and Egger's test evaluated small-study effects. Of 163 full-text articles, 11 contributed to the incidence analysis and four to the mortality analysis. MetS was associated with higher LC incidence (pooled hazard ratio [HR] = 1.18; 95% CI: 1.04-1.33; p = .010). Among good-quality studies with thorough smoking adjustment, the HR was 1.15 (95% CI: 1.04-1.28). LC mortality was not significantly associated with MetS. Although pooled findings indicate higher LC incidence among individuals with MetS, variation in smoking adjustment precludes causal inference. Future prospective cohorts across diverse populations and settings should use standardized MetS definitions and detailed smoking histories and assess whether MetS can provide a meaningful window for LC screening and early intervention.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129505","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":"Occupation and Lymphoma Risk by Cell of Origin: A Nationwide Matched Case-Control Study in Thailand.","authors":"Chatchai Ekpanyaskul, Suleeporn Sangrajung, Qing Lan, Nathaniel Rothman","doi":"10.1158/1940-6207.CAPR-26-0137","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0137","url":null,"abstract":"<p><p>Lymphoma constitutes a substantial and increasing burden of hematologic malignancy in Thailand and globally, while its etiology remains incompletely characterized. Occupational factors have been implicated in lymphomagenesis; however, evidence from developing countries remains limited, particularly with respect to lymphoma heterogeneity by cell of origin. A matched case-control study was conducted to examine associations between occupational categories and lymphoma risk within a cell-of-origin framework. Occupational categories were defined a priori based on epidemiological evidence and occupational carcinogen classifications of the International Agency for Research on Cancer. The analysis included 592 matched case-control pairs and used conditional logistic regression to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). Diffuse large B-cell lymphoma was the most frequent histological subtype. Agricultural occupations, including agricultural workers, gardeners, and livestock handlers, were associated with increased overall lymphoma risk after adjustment for potential confounders (AOR = 1.41; 95% CI: 1.04-1.90). In prespecified subgroup analyses by cell of origin, associations were observed for B-cell-derived malignancies, including combined B-cell non-Hodgkin lymphoma and Hodgkin lymphoma (AOR = 1.50; 95% CI: 1.04-2.15) and B-cell non-Hodgkin lymphoma alone (AOR = 1.63; 95% CI: 1.09-2.43). Longer duration of agricultural work and initiation of agricultural work during childhood were also associated with increased lymphoma risk. These findings provide epidemiological evidence of an association between agricultural occupation and lymphoma, with similar associations observed in analyses of B-cell-derived malignancies. The results support further investigation of specific agricultural exposures and may inform occupational cancer surveillance and prevention in agricultural populations.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129461","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":"Molecular Cancer Signal Origin Minimizes Diagnostic Burden: Letter.","authors":"Elliot K Fishman, James M O'Brien, Christopher Tyson, Xiting Cao, Kevin H Li, Omair A Choudhry, Tomasz M Beer","doi":"10.1158/1940-6207.CAPR-26-0145","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0145","url":null,"abstract":"","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"19 10","pages":"601"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119433","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":"Assessing Levels of Evidence for Cancer Screening: A Focus on Testicular Self-examination.","authors":"Kamalie Thomas, Ashley Malvita, Michael J Rovito","doi":"10.1158/1940-6207.CAPR-26-0125","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0125","url":null,"abstract":"<p><p>Testicular cancer is the most common malignancy among men 15 to 45 years of age, with 5-year relative survival exceeding 95% when all stages are combined. Early detection may reduce treatment intensity, preserve fertility, and protect quality of life. Testicular self-examination (TSE) has historically been recommended as a secondary prevention strategy; however, the US Preventive Services Task Force issues a D recommendation against routine TSE, citing insufficient evidence of mortality benefit and potential harms. The National Cancer Institute Physician Data Query (PDQ) levels-of-evidence framework offers a complementary approach, grading certainty of effects while decoupling evidence assessment from prescriptive policy. This article contrasts the 2 frameworks, examines the available evidence for TSE, and considers whether elements of the PDQ approach could usefully inform guidance for low-incidence, high-survivability cancers. We argue that current evidence does not support a strong recommendation for or against routine TSE, but that mortality-only frameworks may understate outcomes that matter to patients, including treatment burden, fertility, and psychosocial function, and that more transparent communication of uncertainty would better support shared decision-making.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"19 10","pages":"559-563"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119512","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 Screening Adherence in the United States by Smoking and Vaping Status, 2023.","authors":"Karin A Kasza, Liane M Schneller-Najm, Christine E Sheffer, Rodney C Haring, Ken Batai, Kathryn M Glaser, Maansi Bansal-Travers, Whitney E Mendel, Nicolas F Schlecht, Elisa M Rodriguez, Christina R Crabtree-Ide, Andrew Hyland, Richard J O'Connor","doi":"10.1158/1940-6207.CAPR-26-0033","DOIUrl":"10.1158/1940-6207.CAPR-26-0033","url":null,"abstract":"<p><p>Early detection of cancer saves lives and reduces healthcare costs. In the United States, adherence to cancer screening recommendations is associated with many structural and individual-level factors. People who smoke cigarettes are less likely to engage in cancer screening. E-cigarette use (vaping) has become popular in the United States. We evaluated whether vaping is associated with cancer screening. Data from the 2023 National Health Interview Survey were used to identify adults who met criteria to receive preventative cancer screening for colorectal (N = 14,561), breast (N = 6,572), cervical (N = 8,637), or prostate (N = 3,556) cancer. Nationally representative cancer screening adherence rates were determined for each cancer site, by smoking and vaping status. Multivariable logistic regression analyses were used to examine differences in screening adherence, controlling for social determinants of health. Smoking was associated with lower cancer screening adherence across all sites [colorectal, males: adjusted odds ratio (AOR) = 0.66, 95% confidence interval (CI), 0.55-0.79; colorectal, females: AOR = 0.60, 95% CI, 0.50-0.73; breast: AOR = 0.45, 95% CI, 0.36-0.56; cervical: AOR = 0.77, 95% CI, 0.64-0.93; and prostate: AOR = 0.56, 95% CI, 0.42-0.74]. Among males who smoke, current vaping (vs. never or former vaping) may signal greater engagement in colorectal and prostate cancer screening, a finding not observed among males who formerly smoked. Among females who smoke, vaping seems unrelated to engagement in breast cancer screening or cervical cancer screening. However, among females who formerly smoked, current vaping (vs. never or former vaping) may signal lower engagement in breast cancer screening. Smoking remains a robust target for improving cancer screening adherence across multiple cancer sites whereas vaping may signal emerging differences in cancer screening adherence.</p><p><strong>Prevention relevance: </strong>Early detection of cancer saves lives and reduces healthcare costs. Our nationally representative findings show that cigarette smoking remains a robust target for improving cancer screening adherence across multiple cancer sites. Cessation counseling and screening advisement both present opportunities to cross-promote health behaviors.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"587-599"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378281","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":"Active Surveillance for Atypical Ductal Hyperplasia: Are We Ready for Surgical De-escalation?","authors":"Alison Laws, Tari A King","doi":"10.1158/1940-6207.CAPR-26-0180","DOIUrl":"https://doi.org/10.1158/1940-6207.CAPR-26-0180","url":null,"abstract":"<p><p>Atypical ductal hyperplasia (ADH) remains one of the few benign breast lesions for which surgical excision is routinely recommended because of the risk of underlying carcinoma, most commonly ductal carcinoma in situ (DCIS). However, increasing interest in active surveillance has emerged alongside broader trends toward surgical de-escalation and ongoing prospective trials evaluating observation for low-risk DCIS. In this commentary, we review the challenges of identifying patients with ADH at sufficiently low risk of upgrade and summarize emerging outcome data supporting active monitoring. We discuss the target trial emulation study by Rangel and colleagues, evaluating active monitoring versus surgical excision for selected patients with ADH, as well as novel tools that may further support this approach. Together, these developments suggest a growing role for individualized management strategies in ADH. See related article by Rangel et al., p. 577.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":"19 10","pages":"555-557"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119464","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":"Active Monitoring versus Surgical Excision for Atypical Ductal Hyperplasia.","authors":"Melissa Rangel, Puneet Singh, Nina Tamirisa, Constance T Albarracin, Therese B Bevers, Leora Sarvet, Isabelle Bedrosian, Kerollos Nashat Wanis","doi":"10.1158/1940-6207.CAPR-26-0082","DOIUrl":"10.1158/1940-6207.CAPR-26-0082","url":null,"abstract":"<p><p>The recently published 2-year outcomes of the comparing an operation to monitoring, with or without endocrine therapy (COMET) trial provide evidence for the noninferiority of active monitoring of ductal carcinoma in situ (DCIS), compared with excision. These findings raise questions for the management of atypical ductal hyperplasia (ADH). To assess whether active monitoring is a safe strategy in selected patients with ADH, we used observational data on women diagnosed at an academic comprehensive cancer center and emulated a target trial of surgical excision versus active monitoring. Eligibility criteria were adapted from the COMET trial: age 40 years or older, without concurrent malignancy or a history of ipsilateral breast cancer or DCIS within the prior 5 years, without breast cancer symptoms, with no mass on physical examination or imaging, and without a history of recent endocrine therapy use. We estimated the risk of ipsilateral invasive carcinoma. There were 673 women with low-risk ADH, 238 (35.4%) of whom underwent surgical excision within 6 months. The risk of ipsilateral invasive carcinoma was 2.4% [95% confidence interval (CI), 0.8-4.1%] at 2 years with surgical excision and 0.4% (95% CI, 0-0.9%) with active monitoring (difference: 2.0; 95% CI, 0.3-3.8). At 5 years, the risk was 2.4% (95% CI, 0.8-4.2%) with surgical excision and 1.8% (0.7-3.3%) with active monitoring (difference: 0.5; 95% CI, -1.6 to 2.6). All cancers diagnosed at surgical excision or during follow-up were stage I. These findings provide evidence that active monitoring is safe and does not increase the risk of invasive carcinoma compared with surgical excision in patients with low-risk ADH.</p><p><strong>Prevention relevance: </strong>Surgical excision is commonly performed for ADH of the breast. This study found that women with low-risk ADH had a very low risk of invasive cancer with active monitoring, which was similar to the risk under surgical excision. The findings support omission of surgery in these patients. See related Spotlight, p. 555.</p>","PeriodicalId":72514,"journal":{"name":"Cancer prevention research (Philadelphia, Pa.)","volume":" ","pages":"577-586"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177335","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}