JACC advances最新文献

{"title":"Cardiologists' Perceptions of Cardiogenetic Testing and Management","authors":"W.H. Wilson Tang MD ,&nbsp;Quan M. Bui MD ,&nbsp;Allison L. Cirino MS, CGC ,&nbsp;Lisa Dellefave-Castillo MS, CGC ,&nbsp;Brendan J. Floyd MD, PhD, MEd ,&nbsp;Alejandra Guerchicoff PhD ,&nbsp;Marianna Guerchicoff MD ,&nbsp;Amit V. Khera MD, MSc ,&nbsp;Joshua W. Knowles MD, PhD ,&nbsp;Kristen Lafayette MPP ,&nbsp;Andrew P. Landstrom MD, PhD ,&nbsp;Daria W. Ma MS, LCGC, MSHS ,&nbsp;Ana Morales MS, CGC ,&nbsp;Kate M. Orland MS, CGC ,&nbsp;Daniel E. Pineda-Alvarez MD ,&nbsp;Siddharth K. Prakash MD, PhD ,&nbsp;Paul Theriot BSBA ,&nbsp;Melissa Dempsey MS, CGC","doi":"10.1016/j.jacadv.2025.101910","DOIUrl":"10.1016/j.jacadv.2025.101910","url":null,"abstract":"<div><h3>Background</h3><div>Cardiogenetic testing has become clinically relevant as genetic insights increasingly contribute to the understanding and management of cardiovascular diseases of genetic origin. However, utilization of cardiogenetic testing remains variable and underutilized.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to assess cardiologists' perceptions of cardiogenetic testing and identify relevant barriers, facilitators, educational needs, and clinical applications.</div></div><div><h3>Methods</h3><div>We surveyed 161 cardiologists using the American College of Cardiology CardioSurve Panel between March and April 2024.</div></div><div><h3>Results</h3><div>Among respondents, 80% reported that they have directly ordered or facilitated a referral for cardiogenetic testing for their patients. Generally, cardiologists from our testing group felt confident identifying and referring patients for testing, but only 40% confidently ordering tests and only 31% were confident interpreting results. A substantial portion of respondents (40%) had not received any training in cardiogenetic testing. Furthermore, 76% of those who had never ordered testing did not receive relevant education in cardiogenetic testing. The majority (59%) had access to genetic counselors though this was limited for those less familiar with testing. Common barriers included perceived high cardiogenetic testing costs (60%), limited access to genetic counselors (59%), and lack of confidence in interpreting results (43%). Respondents had substantial variability in perceived insurance coverage. Guidelines and resources from professional societies were top educational tools, whereas most cardiologists (91%) expressed interest in further education in patient selection, testing procedures, and results interpretation.</div></div><div><h3>Conclusions</h3><div>The survey suggest that improved access to genetic counselors and professionals, clearer guidelines, and expanded education could boost cardiogenetic testing adoption and integration into cardiovascular care.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101910"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548384","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":"Changes in Coronary Physiology by μFR Measurement After DREAMS-3G-Scaffold Implantation","authors":"Hector M. Garcia-Garcia MD, PhD ,&nbsp;Ryan L. Wallace MD ,&nbsp;Adrian Wlodarczak MD ,&nbsp;René J. van der Schaaf MD ,&nbsp;Jan Torzewski MD ,&nbsp;Bert Ferdinande MD ,&nbsp;Javier Escaned MD ,&nbsp;Juan F. Iglesias MD ,&nbsp;Michael Haude MD ,&nbsp;Ron Waksman MD","doi":"10.1016/j.jacadv.2025.101944","DOIUrl":"10.1016/j.jacadv.2025.101944","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101944"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548385","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":"Impact of Sex and Age on Trends of Mortality From Infective Endocarditis in High-Income Countries","authors":"Makoto Hibino MD, MPH, PhD ,&nbsp;Hiroki A. Ueyama MD ,&nbsp;Raj Verma ,&nbsp;Hwee Teoh PhD ,&nbsp;Bobby Yanagawa MD, PhD ,&nbsp;Deepak L. Bhatt MD, MPH, MBA ,&nbsp;Subodh Verma MD, PhD","doi":"10.1016/j.jacadv.2025.101900","DOIUrl":"10.1016/j.jacadv.2025.101900","url":null,"abstract":"<div><h3>Background</h3><div>Characteristics of infective endocarditis vary by age and sex.</div></div><div><h3>Objectives</h3><div>The aim of the study was to identify how age and sex impact mortality due to infective endocarditis in high-income countries.</div></div><div><h3>Methods</h3><div>The World Health Organization mortality database was analyzed to determine trends in mortality from infective endocarditis in the United Kingdom, Germany, France, Italy, Japan, Australia, the United States, and Canada between 2000 and 2021. Age-standardized and age-specific (≤49, 50-64, 65-79, and ≥80 years) mortality rates per 100,000 persons in either sex were calculated and compared using the male-to-female ratio. Trends were analyzed using joinpoint regression.</div></div><div><h3>Results</h3><div>During the most recent observation year, there were widespread differences in the age-standardized mortality rates (per 100,000) across the 8 countries (from 0.40 [95% CI: 0.38-0.42] in Japan to 1.29 [95% CI: 1.23-1.35] in France), with increasing trends in all except for Japan (decreasing trend) and the United States (constant trend). Age-standardized mortality was male-dominant in all countries (mean ratios ranging from 1.16 in Japan to 1.70 in France). The between-sex differences tended to be less pronounced with increasing age. The ratios of age-specific mortality rates between sexes remained stable or showed a progression toward male dominance across all age groups. Among those ≤49 years, mortality rates increased significantly in females in the United Kingdom, Australia, and the United States, and in both sexes in Canada.</div></div><div><h3>Conclusions</h3><div>Mortality rate from infective endocarditis is increasing in most countries, with varying patterns and degrees of changes observed in relation to sex and age. This underscores the crucial need to identify the root causes at the individual country level.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101900"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548381","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":"Prolonged Edoxaban in Patients With Low Body Weight and Cancer-Associated Isolated Distal Deep Vein Thrombosis","authors":"Tomoyuki Nagai MD ,&nbsp;Naohiko Nakanishi MD ,&nbsp;Yugo Yamashita MD ,&nbsp;Takeshi Morimoto MPH, MD ,&nbsp;Nao Muraoka MD ,&nbsp;Michihisa Umetsu MD ,&nbsp;Yuji Nishimoto MD ,&nbsp;Takuma Takada MD ,&nbsp;Yoshito Ogihara MD ,&nbsp;Tatsuya Nishikawa MD ,&nbsp;Nobutaka Ikeda MD ,&nbsp;Kazunori Otsui MD ,&nbsp;Daisuke Sueta MD ,&nbsp;Yukari Tsubata MD ,&nbsp;Masaaki Shoji MD ,&nbsp;Ayumi Shikama MD ,&nbsp;Yutaka Hosoi MD ,&nbsp;Yasuhiro Tanabe MD ,&nbsp;Ryuki Chatani MD ,&nbsp;Kengo Tsukahara MD ,&nbsp;Satoaki Matoba MD","doi":"10.1016/j.jacadv.2025.101956","DOIUrl":"10.1016/j.jacadv.2025.101956","url":null,"abstract":"<div><h3>Background</h3><div>The ONCO DVT study revealed that 12-month edoxaban treatment for cancer-associated isolated distal deep vein thrombosis (IDDVT) was superior to 3-month edoxaban treatment. However, the influence of body weight on efficacy and safety remains unknown.</div></div><div><h3>Objectives</h3><div>We compared 12-month and 3-month edoxaban treatments in patients with low body weight and cancer-associated IDDVT.</div></div><div><h3>Methods</h3><div>In this prespecified subgroup analysis of the ONCO DVT study, we divided patients by body weight with a 60 kg cutoff. The primary endpoint was symptomatic recurrent venous thromboembolism or venous thromboembolism-related death at 12 months.</div></div><div><h3>Results</h3><div>Of the 601 participants, 426 had low body weight, 99% receiving a reduced dose of edoxaban. The 1-year primary endpoint rate was significantly lower in the 12-month edoxaban group than in the 3-month group in both the low body weight (1.0% vs 6.2%, <em>P</em> = 0.003; OR: 0.15; 95% CI: 0.02-0.55) and the non-low body weight (1.0% vs 10.0%, <em>P</em> = 0.005; OR: 0.10; 95% CI: 0.01-0.54) subgroups. The 1-year major bleeding rate was not different between the 12-month and 3-month groups in the low body weight subgroup (7.0% vs 8.4%, <em>P</em> = 0.57), whereas in the non-low body weight subgroup, it was significantly higher in the 12-month edoxaban group than in the 3-month edoxaban group (14.7% vs 3.8%, <em>P</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>Twelve-month edoxaban treatment in cancer-associated IDDVT was superior to 3-month edoxaban treatment in terms of thrombotic events without increased bleeding risk among patients with low body weight but with increased bleeding risk among patients with non-low body weight.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101956"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548383","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":"Prognostic Value of the Right Ventricular-to-Left Ventricular Volume Ratio in Tricuspid Regurgitation","authors":"Robert S. Zhang MD ,&nbsp;Pablo Villar-Calle MD ,&nbsp;Lily Jin BS ,&nbsp;Rachel Axman MD ,&nbsp;Zachary Falk MD ,&nbsp;Mahniz Reza BA ,&nbsp;Annie Tsay MD, MPH ,&nbsp;Giorgia Falco MD ,&nbsp;Andre Cheng MD ,&nbsp;Shmuel Chen MD, PhD ,&nbsp;Jonathan W. Weinsaft MD ,&nbsp;Jiwon Kim MD","doi":"10.1016/j.jacadv.2025.101922","DOIUrl":"10.1016/j.jacadv.2025.101922","url":null,"abstract":"<div><h3>Background</h3><div>Tricuspid regurgitation (TR) is associated with right ventricular (RV) remodeling; however, conventional RV metrics may not fully reflect the interplay between the right and left ventricles.</div></div><div><h3>Objectives</h3><div>The aim of the study was to examine the prognostic value of the right ventricular-to-left ventricular volume ratio (RV/LV_vol) ratio in TR.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 949 patients with ≥moderate TR who underwent cardiac magnetic resonance imaging between 2005 and 2024. The RV/LV_vol ratio was assessed as a dichotomous variable (normal: &lt;1.27, abnormal: ≥1.27) and by severity strata. Follow-up data, including all-cause mortality, were collected using the Social Security Death Index and electronic medical records.</div></div><div><h3>Results</h3><div>Of the 949 patients, 43.6% had an abnormal RV/LV_vol ratio. Among 528 patients with a normal RV end-diastolic volume index, 178 (33.7%) had an abnormal RV/LV_vol ratio. Over a mean follow-up of 4.8 ± 4.5 years, 236 patients died. An abnormal RV/LV_vol ratio was independently associated with increased mortality after adjusting for covariates (adjusted HR: 1.47, 95% CI: 1.01 to 2.14, <em>P</em> = 0.043). Mortality risk increased with RV/LV_vol ratio severity, with severe ratios conferring the highest risk (adjusted HR: 2.20, 95% CI: 1.31-4.76, <em>P</em> = 0.045). The RV/LV_vol ratio provided significant incremental prognostic value over conventional RV indices, improving global chi-square from 24.7 (age/sex) to 47.1 with RV ejection fraction, 59.3 with RV end-diastolic volume index, and 68.3 with the addition of RV/LV_vol ratio (<em>P</em> = 0.005).</div></div><div><h3>Conclusions</h3><div>The RV/LV_vol ratio is a strong predictor of mortality in advanced TR, capturing ventricular remodeling not identified by conventional metrics.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101922"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548382","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":"Cardiovascular Risk After Concussion","authors":"Ioannis Skalidis MD, PhD ,&nbsp;Panagiotis Antiochos MD","doi":"10.1016/j.jacadv.2025.101949","DOIUrl":"10.1016/j.jacadv.2025.101949","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101949"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535083","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":"Utility of Skin Patch Testing to Investigate Cardiac Implant-Related Hypersensitivity","authors":"Madeline K. Mahowald MD ,&nbsp;John Z. Nan MD ,&nbsp;Ahmed El Shaer MBBS ,&nbsp;Alejandra N. Chavez-Ponce MD ,&nbsp;Julio C. Sartori-Valinotti MD ,&nbsp;Dawn MR. Davis MD ,&nbsp;Mohamad Alkhouli MD","doi":"10.1016/j.jacadv.2025.101911","DOIUrl":"10.1016/j.jacadv.2025.101911","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101911"},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535081","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":"Medical Malpractice Claims for Sports Cardiology Cases Among Young Athletes","authors":"Samantha L. Weller DO ,&nbsp;Masihullah Barat MD ,&nbsp;Zachary Weller MS, MBA ,&nbsp;Francis Phan MD ,&nbsp;Nathaniel Moulson MD ,&nbsp;Timothy W. Churchill MD ,&nbsp;Kimberly G. Harmon MD ,&nbsp;Jonathan A. Drezner MD ,&nbsp;Aaron L. Baggish MD ,&nbsp;Ahmad Masri MD, MS ,&nbsp;Bradley J. Petek MD","doi":"10.1016/j.jacadv.2025.101915","DOIUrl":"10.1016/j.jacadv.2025.101915","url":null,"abstract":"<div><h3>Background</h3><div>Sudden cardiac arrest/death (SCA/D) is the leading medical cause of fatalities among young competitive athletes. Sports participation among athletes with cardiovascular disease has become more frequent, raising concerns regarding the medicolegal risk and adequacy of emergency medical response plans.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to analyze the frequency and characteristics of medical malpractice/negligence claims related to sports cardiology cases among young competitive athletes in the United States.</div></div><div><h3>Methods</h3><div>A comprehensive retrospective review of medical malpractice/negligence lawsuits from inception to October 2024 was performed using 4 search strategies. Cases involving young competitive athletes aged 12 to 40 years competing at the middle school, high school, competitive club, collegiate, semiprofessional/professional, or national/international level who experienced SCA/D or had a diagnosis associated with SCA/D were included. Medical malpractice/negligence case frequency, location, demographics, allegations, defendant profiles, and case outcomes/awards were identified.</div></div><div><h3>Results</h3><div>A total of 35/586 (6%) cases met inclusion criteria from 1978 to 2022. There was a favorable plaintiff outcome or settlement in 10/35 (29%) cases with known settlements or awards ranging from $600,000 to $24,000,000; a favorable defendant outcome or dismissal in 16/35 (46%) cases; and the case outcome was undisclosed/unknown in 9/35 (26%) cases. The most common primary allegation for lawsuits was a negligent emergency medical response (13/35, 37%) followed by failure to diagnose cardiovascular disease (9/35, 26%).</div></div><div><h3>Conclusions</h3><div>Medical malpractice/negligence claims regarding cardiac cases in young competitive athletes in the United States were rare (&lt;1 case/y), although the financial settlements were significant. This study supports ongoing efforts to improve emergency preparedness and the cardiac emergency medical response for young competitive athletes.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101915"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144517448","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":"Artificial Intelligence–Enabled Electrocardiograms","authors":"Joshua Mayourian MD, PhD,&nbsp;Sunil Ghelani MD,&nbsp;John K. Triedman MD","doi":"10.1016/j.jacadv.2025.101866","DOIUrl":"10.1016/j.jacadv.2025.101866","url":null,"abstract":"","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 7","pages":"Article 101866"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472334","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":"Right Ventricular Myocardial Work Predicts Pulmonary Capillary Wedge Pressure Rise During Exercise in Heart Failure","authors":"Kuan-Chih Huang MD, PhD ,&nbsp;Ting-Tse Lin MD, PhD ,&nbsp;Lung-Chun Lin MD, PhD ,&nbsp;Lian-Yu Lin MD, PhD ,&nbsp;Cho-kai Wu MD, PhD","doi":"10.1016/j.jacadv.2025.101905","DOIUrl":"10.1016/j.jacadv.2025.101905","url":null,"abstract":"<div><h3>Background</h3><div>Symptoms of heart failure with preserved ejection fraction (HFpEF) are closely related to exercise-induced elevation in pulmonary capillary wedge pressure (PCWP). However, the diagnostic role of right ventricular (RV) myocardial work in HFpEF remains unclear.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to evaluate the diagnostic utility of RV myocardial work in HFpEF and their correlation with PCWP during exercise.</div></div><div><h3>Methods</h3><div>Patients with unexplained dyspnea underwent invasive cardiopulmonary exercise tests to identify HFpEF. Echocardiography assessed left and right ventricular parameters. RV myocardial work was calculated using strain rate and pressure curves, matched with electrocardiography data. RV global constructive work, RV global work index, RV global wasted work (RVGWW), and RV global work efficiency (RVGWE) were analyzed.</div></div><div><h3>Results</h3><div>Forty-one patients with adequate data were enrolled, with 21 diagnosed with HFpEF. No significant differences in various echocardiographic parameters were found between HFpEF and non-HFpEF groups, except higher postexercise PCWP and mean pulmonary artery pressure in HFpEF patients. HFpEF patients had higher RVGWW and lower RVGWE. RVGWW and RVGWE demonstrated superior diagnostic performance for HFpEF compared to other echocardiographic parameters, with areas under the receiver operating characteristic curve of 0.85 (95% CI: 0.73-0.97) and 0.83 (95% CI: 0.70-0.96), respectively. RV global constructive work (r = 0.504; <em>P</em> = 0.001) and RVGWW (r = 0.621; <em>P</em> &lt; 0.001) correlated with postexercise ΔPCWP and exercise PCWP, with RVGWW independently associated with both after adjustment for confounding factors.</div></div><div><h3>Conclusions</h3><div>RVGWW is a novel predictive parameter that provides a better explanation of RV performance regarding postexercise ΔPCWP than other standard echocardiographic parameters in HFpEF.</div></div>","PeriodicalId":73527,"journal":{"name":"JACC advances","volume":"4 8","pages":"Article 101905"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144472015","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}