Progress in cardiovascular diseases最新文献

{"title":"Learning from the roundtable on obesity solutions experiences: A 10-year anniversary point of view.","authors":"Nicolaas P Pronk, William H Dietz, Christina D Economos, Ihuoma Eneli, Ross Arena","doi":"10.1016/j.pcad.2025.01.003","DOIUrl":"10.1016/j.pcad.2025.01.003","url":null,"abstract":"<p><p>The Roundtable on Obesity Solutions (ROOS), established in 2014, is a unique organization of multisectoral voices addressing the public health challenge of obesity. The ROOS brings together practitioners, researchers, funders, companies, health systems, government agencies, and the lived experience to dialogue and guide the national conversation about the multilevel challenges and opportunities related to obesity. This paper presents insights and key learnings from a symposium developed to celebrating the 10th Anniversary of the ROOS. The first six years (2014-2019) of the ROOS marked a period in which dialogue was initiated, multi-sectoral perspectives were captured, and important viewpoints were deliberated and published. In 2020, the ROOS engaged in a strategic planning process enabled by systems science that ultimately resulted in the creation of a roadmap focused on drivers and solutions of obesity. This roadmap generated an agenda focused on upstream social and structural drivers of obesity with an emphasis on the integration of equity, gaps, strategies, and the lived experience. Three main priorities identified in this roadmap included structural racism, social norms, and health communications. Based on this work, the ROOS has had significant impact in the areas of equity, weight stigma, and the lived experience. Much work remains. To date, obesity solutions available for prevention and treatment have been vastly underutilized. Future directions should: 1) include increasing access to effective prevention and treatment options; 2) a focus on how best to implement new technologies in obesity prevention and care; 3) addressing issues of equity, literacy, and stigma that remain unresolved; and 4) leveraging the influence of regional cultures, policies, and social norms. We hope that insights gained over the previous 10 years will inspire another decade of impact for the ROOS.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026217","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":"Association between Activity Quotient and cause-specific mortality - A prospective cohort study of 0.5 million participants in Asia.","authors":"Jackson Pui Man Wai, Chi Pang Wen, Min Kuang Tsai, Chien Hua Chen, Jun-Han Lee, Ta-Wei David Chu, Hong Yi Chiou, Christopher Wen, Atefe R Tari, Ulrik Wisløff, Javaid Nauman","doi":"10.1016/j.pcad.2025.01.004","DOIUrl":"10.1016/j.pcad.2025.01.004","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity (PA) is important for reducing the risk of chronic diseases and improving overall health. Activity Quotient (AQ) is a novel metric that translates heart rate during PA into a weekly score, providing an objective measure of an individual's PA. We prospectively examined the association of AQ with cancer and cardiovascular (CVD) mortality outcomes, the two major causes of death, in a Taiwanese population.</p><p><strong>Methods: </strong>A cohort of 515,608 healthy adults (52 % women) enrolled in a standard medical screening program was followed for mortality outcomes. The weekly AQ score of each participant was estimated based on self-reported PA intensity and weekly duration, and placed into six categories (0, ≤50, 51-99,100-149, 150-199, or ≥ 200 AQ per week). We used multivariable Cox proportional hazard models adjusted for potential confounders to estimate the hazard ratios (HR) and 95 % confidence intervals (CI).</p><p><strong>Results: </strong>Higher weekly AQ scores were associated with lower risks of CVD, cancer, and all-cause mortalities. Compared with inactive individuals, HRs (CI) for the association of AQ scores of ≤50, 50-99, 100-149, 150-199, and ≥ 200 were 0.93 (0.89-0.97), 0.91 (0.85-0.96), 0.84 (0.77-0.91), 0.84 (0.74-0.96), and 0.81 (0.73-0.90) with cancer mortality; and 0.88 (0.83-0.93), 0.86 (0.80-0.93), 0.81 (0.73-0.90), 0.71 (0.60-0.85), and 0.73 (0.64-0.84) with CVD mortality, respectively. Subgroup analyses showed that meeting 50 AQ a week was associated with lower risk of disease specific mortality risk across age groups and among individuals with known risk factors. Higher weekly AQ scores were also associated with longer life expectancy, with the highest gains observed among those achieving 150-199 weekly AQ.</p><p><strong>Conclusion: </strong>Our findings show that AQ may be an objective tool for assessing and tracking PA and predicting mortality risks. Encouraging individuals to achieve ≥50 AQ a week could have substantial public health benefits, including lower mortality from major chronic diseases as well as prolonged health- and life expectancy.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973999","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":"Global longitudinal strain as an early marker of cardiac damage after cardiotoxic medications, a state of the art review.","authors":"Andrea Sartorio, Luca Cristin, Chiara Dal Pont, Afshin Farzaneh-Far, Simone Romano","doi":"10.1016/j.pcad.2025.01.001","DOIUrl":"10.1016/j.pcad.2025.01.001","url":null,"abstract":"<p><p>Ejection fraction (EF) is the principal parameter used clinically to assess cardiac function and provides prognostic information. However, significant myocardial damage can be present despite preserved EF. Recently, the measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel early marker of cardiac dysfunction. Cardiotoxicity is a frequent side effect of several drugs most notably those used in the treatment of cancer. Although oncology drugs remain the best known cardiotoxic medications, many other drugs can potentially affect LV function. The early recognition of LV dysfunction due to cardiotoxicity is important and of increasing clinical relevance particularly with the rapid pace of development of new drugs. The aim of our review is to provide an overview of the current literature regarding utility of GLS to assess drug-induced myocardial damage. We propose that GLS is a sensitive early marker of myocardial dysfunction associated with the use of certain medications with high risk of cardiotoxicity. Thus, the use of this technique can potentially alert the clinician to myocardial toxicity before reductions in EF are seen.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974002","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":"Cigarette smoke extract induces p38-mediated expression and ROS/rho-mediated translocation of alpha 2C adrenoceptor in human microvascular smooth muscle cells.","authors":"Manal M Fardoun, Ayah Matar, Maha Khachab, Ali H Dakroub, Ali H Eid","doi":"10.1016/j.pcad.2025.01.002","DOIUrl":"10.1016/j.pcad.2025.01.002","url":null,"abstract":"<p><p>Raynaud's phenomenon (RP) is a vascular disease characterized by exaggerated vasoconstriction in response to stressors, mainly cold and emotional stress. This vasoconstriction is mediated solely by alpha 2C-adrenoceptors (α_2C-AR) expressed in vascular smooth muscle cells of dermal arterioles. Several factors, among which is cigarette smoking, are associated with aggravated symptoms of and increased risk for RP. Evidence shows that cigarette smoking induces the production of reactive oxygen species (ROS), which is a major driver of RP pathogenesis. However, the exact mechanism by which smoking contributes to RP or α_2C-AR remains unclear. Here, we show that cigarette smoke extract (CSE) upregulates the expression of α_2C-AR in a concentration- and time-dependent manner in VSMCs extracted from human dermal arterioles. This increase is associated with the activation of p38 MAPK, as pretreatment with SB-202190, a p38 specific inhibitor, attenuated CSE-induced α_2C-AR expression. Furthermore, our results show that CSE induces ROS production followed by increased RhoA activation. We also show that CSE induces translocation of vascular α_2C-AR to the plasma membrane, and that this mobilization is attenuated by inhibiting ROS via N-acetylcysteine or apocynin. Similarly, inhibition of Rho kinase via H- 11522 abolished CSE-induced α_2C-AR translocation. Collectively, these results indicate that CSE activates two different signaling pathways to induce the expression and the translocation of α_2C-AR. While CSE activates a p38-dependent mechanism to increase α_2C-AR expression, it initiates the receptor's spatial and functional rescue via a ROS/RhoA signaling pathway. These results provide mechanistic insight into the effect of cigarette smoking on RP, and further reinforce that smoking avoidance/cessation is critical to manage this disease, especially in the absence of a definitive drug for RP.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967587","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":"Anti-consumption agents: Tirzepatide and semaglutide for treating obesity-related diseases and addictions, and improving life expectancy.","authors":"James H O'Keefe, W Grant Franco, Evan L O'Keefe","doi":"10.1016/j.pcad.2024.12.010","DOIUrl":"10.1016/j.pcad.2024.12.010","url":null,"abstract":"<p><p>American culture encourages overconsumption, fueled by ubiquitous availability and pervasive marketing of ultra-processed foods and other addictive substances. This chronic overindulgence has contributed to rising rates of obesity, type 2 diabetes (T2D), substance abuse, mental health disorders and premature mortality. Glucose-like peptide-1 agonists (GLP-1RAs) affect the brain's reward pathway that mediates addiction to foods and various other substances. Evolving data suggest that tirzepatide and semaglutide may be the first effective \"anti-consumption\" agents with potential applications in reducing food cravings, obesity, alcohol consumption, nicotine addiction, recreational drug use, and even uncontrollable shopping behaviors. Tirzepatide and semaglutide, unlike prior weight-loss drugs, are effective and relatively safe/well-tolerated medications that are associated with reduced risks for myocardial infarction, stroke, cardiovascular death, heart failure, progressive kidney and liver disease, obstructive sleep apnea, debilitating osteoarthritis, polycystic ovarian syndrome, neurodegenerative disease and premature mortality. Observational studies show that GLP-1RAs are associated with spontaneous nonvolitional reductions in use of alcohol, nicotine, and recreational drugs. Because obesity and substance abuse are so prevalent in the United States, GLP-1RA drugs may be uniquely helpful in addressing overconsumption and addiction issues thereby improving overall health and life expectancy.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916442","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":"Survival of the fittest? Peak oxygen uptake and all-cause mortality among older adults in Norway.","authors":"Atefe R Tari, Daniel E Brissach, Emma M L Ingeström, Javaid Nauman, Tristan Tyrell, Carl Foster, Kimberley Radtke, John P Porcari, Stian Lydersen, Leonard A Kaminsky, Jonathan Myers, Tara L Walker, Jeff S Coombes, Dorthe Stensvold, Ulrik Wisløff","doi":"10.1016/j.pcad.2024.11.004","DOIUrl":"10.1016/j.pcad.2024.11.004","url":null,"abstract":"<p><strong>Objective: </strong>To determine the cardiorespiratory fitness (CRF) levels needed to avoid the Grim Reaper (Death) among older adults. We hypothesized that an above average peak oxygen uptake (VO_2peak) is needed for 70-77-year-old men and women to delay the encounter with Death.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>General population of older adults in Norway.</p><p><strong>Participants: </strong>788 women and 777 men aged 70-77 years.</p><p><strong>Intervention: </strong>Clinical assessments, including a test of VO_2peak. Participants were categorised based on their baseline VO_2peak and changes after 1 year. This study explored associations between VO_2peak and 5-year all-cause mortality using Cox proportional hazard models.</p><p><strong>Main outcome measure: </strong>All-cause mortality.</p><p><strong>Results: </strong>Death caught up with 5.3 % of men and 3.7 % of women. Compared to unfit men and women, fewer men (Hazard Ratio [HR]: 0.34, 95 % Confidence Interval [CI] 0.15-0.78) and women (HR: 0.41, 95 % CI 0.17-0.98) classified as moderately fit encountered Death with no additional risk reduction among those classified as being more fit. It appears to be easier for the Grim Reaper to claim those in poorer physical condition, specifically VO_2peak levels <26.5 mL/kg/min for men and 22.2 mL/kg/min for women (corresponding to ≥85 % of the observed age- and sex-specific average).</p><p><strong>Conclusion: </strong>The Grim Reaper typically targets individuals with VO_2peak levels <26.5 mL/kg/min/ and <22.2 mL/kg/min when chasing male and female souls aged 70-77 years, respectively, reflecting his penchant for limited CRF. These data underscore the importance of maintaining or enhancing CRF throughout life, providing clear targets for clinicians in assessing patient CRF levels.</p><p><strong>Trial registration: </strong>ClinicalTrials.govNCT01666340.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788296","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":"Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.","authors":"Evan L O'Keefe, James H O'Keefe, Hussam Abuissa, Mark Metzinger, Ellen Murray, Grant Franco, Carl J Lavie, William S Harris","doi":"10.1016/j.pcad.2024.11.003","DOIUrl":"10.1016/j.pcad.2024.11.003","url":null,"abstract":"<p><strong>Objective: </strong>Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF.</p><p><strong>Patients and methods: </strong>A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone. We summarized findings from randomized clinical trials (RCTs), epidemiology studies, and meta-analyses evaluating effects/associations of DHA + EPA on risk of AF. Also, vagal tone was explored as a mediator between omega-3 and risk of AF.</p><p><strong>Results: </strong>Meta-analyses of 8 RCTs and 17 prospective cohort studies comprised of 83,112 and 54,799 individuals, respectively, investigated the link between omega-3 intake and incident AF. The RCTs reported that treatment with DHA and/or EPA was associated with a 24 % increased relative risk of AF (absolute risk 4.0 % vs 3.3 %; relative risk [RR] 1.24, 95 % confidence interval [CI] 1.11-1.38, p = 0.0002). This was dose-dependent; DHA + EPA doses of ∼1000 mg/d increased AF risk ∼12 %, whereas 1800 to 4000 mg/d increased AF risk by ∼50 %. In contrast, observational studies focused on DHA + EPA blood levels or dietary intake have generally reported that higher omega-3 levels/consumption are associated with lower AF risk. Maximal AF risk reduction. (12 %) occurred at ∼650 mg/d of dietary DHA + EPA. Other studies have indicated that omega-3 fatty acids can dose-dependently increase vagal tone, which could explain the biphasic relationship between DHA + EPA and AF risk. Experimental studies show that low-level vagal stimulation decreases risk of AF, whereas high-level vagal stimulation increases risk of AF.</p><p><strong>Conclusion: </strong>Higher consumption of dietary omega-3 is associated with decreased AF risk. In contrast, pharmaceutical dosing of omega-3 increases AF in a dose-dependent manner, which may be mediated by vagal tone.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776025","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 outcomes among giant cell myocarditis compared with cardiac sarcoidosis: A propensity score-matched analysis.","authors":"Vikash Jaiswal, Muhammad Hanif, Yusra Mashkoor, Aanchal Sawhney, Tushar Kumar, Juveriya Yasmeen, F N U Sundas, Jishanth Mattumpuram, Adrija Hajra, Carl J Lavie, Dhrubajyoti Bandyopadhyay","doi":"10.1016/j.pcad.2024.11.002","DOIUrl":"10.1016/j.pcad.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Giant cell myocarditis (GCM) and cardiac sarcoidosis (CS) are rare inflammatory diseases of the myocardium with poor prognosis. Cardiovascular disease outcomes among both diseases have not been well studied with limited literature.</p><p><strong>Objective: </strong>This study aims to investigate the cardiovascular outcomes among patients with GCM and CS.</p><p><strong>Method: </strong>We queried the TriNeTX Global Collaborative Network for adult patients with giant cell myocarditis and cardiac sarcoidosis between January 2000 to May 2023 and created two groups: one with giant cell myocarditis and second with cardiac sarcoidosis. Both the groups were followed for 6 months and 12 months.</p><p><strong>Result: </strong>After propensity score matched analysis (PSM), among the 4804 patients (2402 patients in each group), the mean age of patients was 57.1 and 57.6 years in GCM and CS groups, respectively. PSM analysis showed that primary outcome i.e., all-cause mortality was significantly higher in GCM group both after 6 months [relative risk (RR) 2.33, 95 % confidence interval (CI): 1.64-3.30, p < 0.01] and 1 year follow up [RR, 1.54 (95 % CI: 1.20-1.98), p < 0.01] as compared with CS group. However, secondary outcomes i.e., heart failure (HF) at 6 month (RR 0.66, 95 % CI: 0.52-0.85, p < 0.01), and at 1 year (RR 0.60, 95 % CI: 0.49-0.73, p < 0.01), ventricular tachycardia (VT) at 6 months (RR 0.34, 95 % CI: 0.25-0.46, p < 0.01), and at 1 year (RR 0.32, 95 % CI: 0.25-0.41, p < 0.01), atrioventricular (AV) node block at 6 month (RR 0.45, 95 % CI: 0.33-0.61, p < 0.01), and at 1 year (RR 0.43, 95 % CI: 0.34-0.55, p < 0.01), and atrial flutter and fibrillation (AF) at 6 months (RR 0.67, 95 % CI: 0.48-0.94, p = 0.02), and at 1 year (RR 0.59, 95 % CI: 0.45-0.76, p < 0.01) were found significantly lower in GCM group as compared to CS group. On the other hand, heart transplant incidence was comparable between both the groups.</p><p><strong>Conclusion: </strong>These findings suggest that GCM patients have high risk of mortality and lower risk of HF, VT, AV node block, and AF when compared with CS.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669616","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":"Innovations in cardiac computed tomography: Imaging in coronary artery disease.","authors":"Venkat Sanjay Manubolu, Keishi Ichikawa, Matthew J Budoff","doi":"10.1016/j.pcad.2024.05.005","DOIUrl":"10.1016/j.pcad.2024.05.005","url":null,"abstract":"<p><p>Coronary computed tomography angiography (CCTA) has emerged as a pivotal tool in the non-invasive evaluation of coronary artery disease (CAD). Recent advancements in imaging techniques, quantitative plaque assessment methods, assessment of coronary physiology, and perivascular coronary inflammation have propelled CCTA to the forefront of CAD management, enabling precise risk stratification, disease monitoring, and evaluation of treatment response. However, challenges persist, including the need for cardiovascular outcomes data for therapy modifications based on CCTA findings and the lack of standardized quantitative plaque assessment techniques to establish universal guidelines for treatment strategies. This review explores the current utilization of CCTA in clinical practice, highlighting its clinical impact and discussing challenges and opportunities for future development. By addressing these nuances, CCTA holds promise for revolutionizing coronary imaging and improving CAD management in the years to come. Ultimately, the goal is to provide precise risk stratification, optimize medical therapy, and improve cardiovascular outcomes while ensuring cost-effectiveness for healthcare systems.</p>","PeriodicalId":94178,"journal":{"name":"Progress in cardiovascular diseases","volume":" ","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961357","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}