Cardio-oncology最新文献

{"title":"Management of primary central nervous system lymphoma and coexisting heart failure with reduced ejection fraction: a narrative review.","authors":"Vanessa M Barrionuevo-Villacis, Mauricio X Davila","doi":"10.1186/s40959-025-00374-x","DOIUrl":"10.1186/s40959-025-00374-x","url":null,"abstract":"<p><strong>Background: </strong>Patients with primary central nervous system lymphoma (PCNSL) often require high-dose methotrexate (HD-MTX)-based regimens for effective disease control. However, the coexistence of heart failure with a reduced ejection fraction (HFrEF) poses significant challenges due to the increased risk of treatment-related cardiotoxicity and the potential exacerbation of cardiac dysfunction from fluid overload.</p><p><strong>Main body: </strong>This review explores current PCNSL treatment modalities and their implications for patients with HFrEF. These findings emphasize the importance of multidisciplinary care, the cardiovascular risks associated with HD-MTX and adjunct therapies, and the strategies available to mitigate these risks.</p><p><strong>Conclusion: </strong>Managing PCNSL in patients with HFrEF requires individualized therapy, vigilant monitoring, and strong collaboration between oncology and cardiology teams. Emerging therapies may reduce cardiotoxicity, but further evidence is needed to guide their safe use in this vulnerable population.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"77"},"PeriodicalIF":3.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944644","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":"Revolutionizing cardiac fibrosis treatment: the potential of personalized CAR T-cell therapy.","authors":"Soroush Taherkhani, Maryam Honardoost, Negar Dokhani, Atousa Janzadeh","doi":"10.1186/s40959-025-00367-w","DOIUrl":"10.1186/s40959-025-00367-w","url":null,"abstract":"<p><p>Cardiac fibrosis, a condition characterized by the deposition of excess collagen in the cardiac tissue, is a major complication of various cardiovascular diseases, including myocardial infarction, hypertension, and different types of cardiomyopathies. CAR T-cell therapy, a form of immunotherapy that involves the genetic modification of T cells to recognize and target specific antigens, has shown promise in the treatment of various cancers and autoimmune diseases. The rationale behind using CAR T-cell therapy to treat cardiac fibrosis lies in the fact that fibrosis is often driven by the activation of pro-fibrotic immune cells, such as myofibroblasts. By targeting these pro-fibrotic cells with CAR T-cells, it may be possible to reduce the severity of cardiac fibrosis. Enhancing CAR T-cell therapy through innovative nanoparticle delivery systems provides a comprehensive approach to treating cardiac fibrosis, with experimental evidence indicating potential in reducing fibrosis and improving cardiac function. Despite these benefits, significant challenges such as cardiotoxicity and cardiovascular complications remain. Therefore, this review explores the molecular mechanisms underlying cardiac fibrosis and the effects of CAR T-cell therapy on the heart, elucidating both its antifibrotic properties and associated cardiotoxic effects based on findings from recent studies.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"76"},"PeriodicalIF":3.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944596","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":"Cardiac function surveillance practices and outcomes in patients with HER2-positive breast cancer treated with trastuzumab: a retrospective cohort study across a safety-net and tertiary care setting.","authors":"Le Huang, Pratyusha Manthena, Malcolm Su, Alvin Chandra, Navid Sadeghi","doi":"10.1186/s40959-025-00376-9","DOIUrl":"10.1186/s40959-025-00376-9","url":null,"abstract":"<p><strong>Background: </strong>Anti-HER2 receptor monoclonal antibodies like trastuzumab are the mainstay of treatment in HER2-positive breast cancer but can result in cancer therapy-related cardiac dysfunction (CTRCD). Guidelines recommend cardiac surveillance prior to anti-HER2 therapy initiation, every 3 months during therapy, and within 1 year after therapy completion. Resource limitations in safety-net settings without cardio-oncology programs may impact cardiac surveillance and treatment patterns and contribute to disparities in cardiovascular health among patients with cancer. We aimed to characterize and compare patterns of cardiac surveillance and short-term cardiovascular outcomes among patients with breast cancer receiving trastuzumab in a safety-net versus a tertiary care system.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on women diagnosed with stage I-III HER2-positive breast cancer between 2018 and 2020 in a safety-net and a tertiary care system. Clinical data from transthoracic echocardiograms, multigated acquisition scans, and cardiac magnetic resonance imaging one year out from trastuzumab initiation were collected. CTRCD was defined by decrements in left ventricular ejection fraction, global longitudinal strain changes, and symptoms of heart failure. Demographics and referral patterns were also assessed.</p><p><strong>Results: </strong>A total of 235 patients were included (93 safety-net, 142 tertiary care). The safety-net population was 23% Black, 60% Hispanic, and 69% uninsured, while the tertiary care population was 64% White and 3.5% uninsured (p < 0.001). Baseline cardiac surveillance was obtained in 84% of safety-net patients and 89% of tertiary care patients, with mean surveillance interval of approximately 3 months. Only 54% of patients at each site obtained cardiac surveillance post-trastuzumab. CTRCD occurred in 12% of patients in the safety-net system and 19% in the tertiary care system, with most cases being asymptomatic (p = 0.143). High-risk patients were more likely to be referred to cardiology/cardio-oncology in the tertiary care system compared to the safety-net system (67% vs. 6.7%, p < 0.001).</p><p><strong>Conclusions: </strong>While our data shows similar frequency of cardiac surveillance based on left ventricular ejection fraction at our safety-net and tertiary care center, the utilization of various imaging modalities and cardiology/cardio-oncology services were significantly different between the two institutions. These differences may result in underdiagnosis of CTRCD in vulnerable populations and contribute to inferior long-term cardiovascular outcomes.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"74"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944593","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":"Integrative speckle-tracking echocardiography for the early detection and prediction of cancer therapy-related cardiac dysfunction.","authors":"Shuo Qiu, Yuxin Zhang, Ying Hou, Songhao Chen, Huihui Yu, Han Li, Lianbi Zhao, Xiaofang Zhang, Xi Zhang, Jiahan Liu, Changyang Xing, Yunyou Duan, Lijun Yuan","doi":"10.1186/s40959-025-00371-0","DOIUrl":"10.1186/s40959-025-00371-0","url":null,"abstract":"","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"73"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944599","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":"Take charge during treatment: a protocol for a pilot study to evaluate the impact of exercise on cardiovascular biomarkers among black and white breast cancer patients undergoing treatment.","authors":"Natalia Do Couto, Mary Hidde, Georgios Grigoriadis, Rodney Sparapani, Matt Durand, Michael Widlansky, Courtney Jankowski, Madeline Berendt, Bethany Canales, Sarah Golus, Laura E Norwood Toro, Purushottam Laud, Amanda Kong, Kent Hoskins, David Lewandowski, Shane A Phillips, David D Gutterman, Alison J Kriegel, Kirsten M M Beyer, Andreas M Beyer, Melinda Stolley","doi":"10.1186/s40959-025-00378-7","DOIUrl":"10.1186/s40959-025-00378-7","url":null,"abstract":"<p><p>Cardiotoxicity is a significant challenge associated with common first-line breast cancer (BC) anti-neoplastic (CTx) treatments including anthracyclines (AC) and targeted immunotherapies, such as anti-Her-2 therapy. Non-Hispanic black/African American (NHB) women are at higher risk for CTx induced cardiotoxicity compared to Non-Hispanic White (NHW) women. To date, most study efforts to mitigate cardiotoxicity target large vessels and cardiac damage. However, impaired microvascular function may also be implicated. Further, although exercise interventions reduce systemic inflammation and cardiovascular risk, few cardio-oncology studies examine the effect of exercise on CTx cardiotoxicity, and none have quantified microvascular endothelial function. An additional gap is the paucity of studies focused on racial disparities. The Discovery and Elimination of Cardio-Oncology Disparities for Equity in the Heartland (DECODE Heartland) Center addresses these gaps with three overarching goals to: (1) Test the feasibility and efficacy of the Take Charge during Treatment (TCT) exercise intervention designed to mitigate the adverse effects of CTx; (2) Quantify differences on exercise capacity and quality of life (QoL), endothelial function and molecular differences in inflammation in NHB versus NHW BC patients before and following CTx; and (3) Examine the influence of socio-ecological factors (individual, interpersonal, systemic, environmental) on inflammation, microvascular endothelial function, QoL in response to the exercise intervention. NHB and NHW women diagnosed with non-metastatic BC, scheduled to receive AC and/or anti-Her2 therapy, will be recruited and randomized to participate in the TCT intervention or usual care. TCT is a virtual exercise program with weekly coaching sessions, six of which include supervised exercise. Assessments include surveys, dual X-ray absorptiometry, flow-mediated dilation, pulse wave velocity and analysis, VO₂ peak cycling test, fat biopsy, venous puncture blood draw, geocoding of patient addresses, and measurement of neighborhood characteristics. Assessments will be captured prior to treatment, post-intervention (16-20 weeks), and at follow-up/study completion (12-18 months post-diagnosis). This study reflects a first step in a research trajectory to identify upstream determinants of disparities and discern how behavioral strategies can assist diverse BC survivors to move through treatment toward better health, including reduced rates of cardiotoxicity following anti-cancer treatment.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"75"},"PeriodicalIF":3.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944611","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":"Challenges and opportunities for improving cardiovascular health in women with breast cancer: a review.","authors":"Sana Ali, Kerri A Mullen","doi":"10.1186/s40959-025-00362-1","DOIUrl":"10.1186/s40959-025-00362-1","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors are at a high risk of developing cardiovascular disease (CVD) owing to cancer treatment. Breast cancer and CVD share common risk factors, necessitating CVD risk assessment along with cancer screening. This review aimed to explore the challenges and opportunities associated with promoting cardiovascular health in women with breast cancer.</p><p><strong>Main text: </strong>Cardio-oncology is a rapidly developing discipline that focuses on identifying, monitoring, and managing CVD in cancer patients. Preventing and managing CVD in patients with breast cancer involves evaluating risk factors, initiating cardioprotective medications, and implementing cardio-oncology rehabilitation. Major barriers to cardio-oncology prevention and management include inadequate programs, sex/gender-specific issues, financial constraints, underutilization of cardiac rehabilitation (CR), determination of the appropriate time to begin CR, physical limitations, psychological issues, and social and racial disparities.</p><p><strong>Conclusion: </strong>A preventive cardio-oncology approach; early identification of cardiotoxicity, CVD risk factors, anxiety, and depression; individualized CR programs; early CR referrals; home/community and virtual CR models; dedicated funding, resources, and personnel; a multidisciplinary team approach; and culturally tailored cardio-oncology care can be beneficial for addressing CVD health challenges and disparities in women with breast cancer.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"72"},"PeriodicalIF":3.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811852","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":"Arrhythmias, conduction disorders and sudden cardiac death in cancer patients and survivors: expert opinion of the working groups on cardio-oncology and on electrophysiology of the hellenic cardiac society.","authors":"Kalliopi Keramida, Ourania Kariki, Eleni Angelopoulou, Ioannis Kalafatis, Christos Lafaras, Konstantinos P Letsas, Helena Michalopoulou, Athanasios Saplaouras, Konstantinos Tampakis, Dorothea Tsekoura, George Andrikopoulos","doi":"10.1186/s40959-025-00363-0","DOIUrl":"10.1186/s40959-025-00363-0","url":null,"abstract":"<p><p>Advances in cancer therapeutics have significantly improved patient survival; however, cardiotoxic effects-including arrhythmias-have emerged as a growing clinical concern. This expert opinion, developed by the Working Groups on Cardio-Oncology and Electrophysiology of the Hellenic Cardiological Society, aims to raise awareness of the increasing burden of arrhythmias in cancer patients and survivors. This document explores the multifactorial etiology of arrhythmias in this population, including patient-related factors, the direct effects of malignancy, and the arrhythmogenic potential of therapies such as classical chemotherapy, targeted agents, immunotherapy, hormonal treatments, and radiotherapy. Additionally, the often-overlooked contributors-such as autonomic dysfunction and drug-drug interactions- are discussed and emphasis is put on specific diagnostic and management challenges. It provides practical insights into the spectrum of arrhythmias and conduction disorders, including atrial fibrillation, QTc prolongation, and sudden cardiac death, while underscoring the importance of comprehensive cardiologic assessment throughout the cancer care continuum.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"71"},"PeriodicalIF":3.2,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728315","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":"The cardio-oncology multidisciplinary team: beyond the basics.","authors":"Joshua D Bennetts, Trent D Williams, Craig J Beavers, Heather N Moore, Cameron Robson, Thomas Warner, Susan Dent, Aaron L Sverdlov, Doan T M Ngo","doi":"10.1186/s40959-025-00369-8","DOIUrl":"10.1186/s40959-025-00369-8","url":null,"abstract":"<p><p>A cardio-oncology multidisciplinary team is essential for the successful delivery of patient-centred care. The roles of oncologists, haematologists, and cardiologists have been clearly articulated in literature pertaining to the creation of cardio-oncology clinics. However, the involvement of other key team members, such as pharmacists, nurses and nurse practitioners, social workers, psychologists and other allied health professionals has been less well-defined. In this review we aim to define the role of pharmacists and nurses as part of a multidisciplinary cardio-oncology team. We also discuss models of care and opportunities to expand the delivery of cardio-oncology services to further enhance outcomes for individuals with cancer, and highlight the challenges experienced by those living in regional, rural, and remote communities.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"69"},"PeriodicalIF":3.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717567","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":"Explainable machine learning for neoplasms diagnosis via electrocardiograms: an externally validated study.","authors":"Juan Miguel Lopez Alcaraz, Wilhelm Haverkamp, Nils Strodthoff","doi":"10.1186/s40959-025-00370-1","DOIUrl":"10.1186/s40959-025-00370-1","url":null,"abstract":"<p><strong>Background: </strong>Neoplasms are a major cause of mortality globally, where early diagnosis is essential for improving outcomes. Current diagnostic methods are often invasive, expensive, and inaccessible in resource-limited settings. This study explores the potential of electrocardiogram (ECG) data, a widely available and non-invasive tool for diagnosing neoplasms through cardiovascular changes linked to neoplastic presence.</p><p><strong>Methods: </strong>A diagnostic pipeline combining tree-based machine learning models with Shapley value analysis for explainability was developed. The model was trained and internally validated on a large dataset and externally validated on an independent cohort to ensure robustness and generalizability. Key ECG features contributing to predictions were identified and analyzed.</p><p><strong>Results: </strong>The model achieved high diagnostic accuracy in both internal testing and external validation cohorts. Shapley value analysis highlighted significant ECG features, including novel predictors. The approach is cost-effective, scalable, and suitable for resource-limited settings, offering insights into cardiovascular changes associated with neoplasms and their therapies.</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of using ECG signals and machine learning for non-invasive neoplasm diagnosis. By providing interpretable insights into cardio-neoplasm interactions, this method addresses gaps in diagnostics and supports integration into broader diagnostic and therapeutic frameworks.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"70"},"PeriodicalIF":3.2,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717566","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":"The incidence of vascular adverse events and usefulness of novel risk assessment tool in Japanese patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors.","authors":"Naoki Watanabe, Tomoiku Takaku, Noriyoshi Iriyama, Eisaku Iwanaga, Yuta Kimura, Maho Ishikawa, Hitomi Nakayama, Eriko Sato, Takayuki Tabayashi, Toru Mitsumori, Tomonori Nakazato, Michihide Tokuhira, Hiroyuki Fujita, Miki Ando, Katsuhiro Miura, Tatsuya Kawaguchi","doi":"10.1186/s40959-025-00366-x","DOIUrl":"10.1186/s40959-025-00366-x","url":null,"abstract":"<p><strong>Background: </strong>Tyrosine kinase inhibitor (TKI) therapy improves the overall survival of patients with chronic myeloid leukemia (CML). However, the risk of vascular adverse events (VAEs) in these patients is reported to be higher than that in healthy individuals, because of both CML itself and the effects of TKIs. Appropriate and effective VAE risk assessment tools for TKI treatment have long been anticipated.</p><p><strong>Methods: </strong>Here, we investigated the usefulness of a newly developed VAE risk assessment tool, the Hisayama score, and presented data on the clinical characteristics of VAEs in Japanese patients with CML based on an analysis of a real-world, large-cohort database.</p><p><strong>Results: </strong>Patients with CML who developed VAEs were evaluated using three VAE risk assessment tools. Forty-four VAEs were reported in 41 out of 626 patients with CML, with three patients developing multiple VAEs during the observation period. There were 16 cases of cerebral infarction, 19 of ischemic heart disease, and nine of peripheral artery occlusive disease, with rates per 1,000 person-years of 3.23, 3.84, and 2.02, respectively. The Framingham and Hisayama scores stratified high-risk patients with VAEs more effectively than the SCORE chart. Smoking and hypertension are prominent risk factors for VAEs.</p><p><strong>Conclusions: </strong>Our results clearly demonstrate that the Hisayama score can be used to evaluate VAE risk in high-risk patients. Selecting appropriate TKIs based on each patient risk, smoking cessation, and blood pressure control may contribute to selecting appropriate TKIs and managing VAE risk.</p>","PeriodicalId":9804,"journal":{"name":"Cardio-oncology","volume":"11 1","pages":"68"},"PeriodicalIF":3.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667285","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}