European journal of breast health最新文献

{"title":"A Comparative Study of Drainage of Breast Abscesses by Conventional Incision and Drainage vs Ultrasound-Guided Needle Aspiration/Re-Aspiration in A Tertiary Health Care Centre","authors":"Varsha Madhavanarayanan Totadri, Rishwanth Vetri, Surabhi Sainath","doi":"10.4274/ejbh.galenos.2024.2024-3-2","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2024.2024-3-2","url":null,"abstract":"","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710473","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":"Treatment Changes in Breast Cancer Management and De-Escalation of Breast Surgery.","authors":"Tolga Ozmen,&nbsp;Vahit Ozmen","doi":"10.4274/ejbh.galenos.2023.2023-6-2","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-6-2","url":null,"abstract":"<p><p>A better understanding of tumor biology and new drugs have led to significant changes in the management of breast cancer (BC). Radical mastectomy, which had been the treatment for BC for more than a century, was based on the hypothesis that BC is a local-regional disease. In the 1970s, Fisher's studies showed that cancer cells could reach the systemic circulation without passage through the regional lymphatic system. Multidisciplinary treatment of BC, which was now considered a systemic disease, was started and radical mastectomy was replaced by breast-conserving surgery (BCS)+, axillary dissection (AD), systemic chemotherapy, hormonotherapy, and radiotherapy in early-stage BC. Modified radical mastectomy, chemotherapy, and radiotherapy were applied as a treatment for locally advanced BC. However, later clinical studies demonstrated that the breast can be preserved in those who respond well to neo-adjuvant chemotherapy (NAC). In the early 1990s, sentinel lymph node biopsy (SLNB) in early-stage BC (cN0) was performed using blue dye and radioisotope markers. It was shown that AD may be avoided in SLN-negative patients, and SLNB has been a standard intervention in cN0 patients. In this way, the very serious complications of AD, especially lymphedema, were avoided. BC has been shown to be a heterogeneous disease and the tumor may be divided into four different molecular subtypes. Thus, optimal treatment differed from patient to patient (one size fits all was inappropriate), individualized treatments have emerged and over-treatment was avoided. The prolongation of life expectancy and the decrease in recurrence led to an increase in the rate of BCS, an acceptable cosmetic result with oncoplastic surgery, and a better quality of life. The increase in the rate of complete response to NAC with new and targeted agents and especially in human epidermal growth factor receptor-2+ and triple-negative patients with a poor prognosis has led to the use of NAC regardless of cN0. The complete disappearance of the tumor after NAC has been reported by some studies, suggesting that breast surgery may not be needed. However, other studies have shown that vacuum biopsies performed on the tumor bed have a high rate of false negativity. Therefore, it is difficult to suggest that there is no need for lumpectomy, which is cheaper and safer today. The false negativity rate of SLNB is high in patients with cN1 at the time of diagnosis and cN0 after NAC (approximately 13%). In order to reduce this rate to ≤5%, clinical studies have recommended the use of the dual method, marking the positive lymph node before chemotherapy and removing 3-4 nodules with SLN. In summary, a better understanding of tumor biology and new drugs have changed the management of BC and de-escalate the role of surgical treatment.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320639/pdf/ejbh-19-186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164018","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":"Current Challenges and Perspectives in Breast Cancer in Elderly Women: The Senologic International Society (SIS) Survey.","authors":"Louise Scheer,&nbsp;Massimo Lodi,&nbsp;Tolga Özmen,&nbsp;Khalid Alghamdi,&nbsp;Stanley Anyanwu,&nbsp;Joshi Birendra,&nbsp;Mohsen Boubnider,&nbsp;Mauricio Costa,&nbsp;Darius Dian,&nbsp;Elisabeth Elder,&nbsp;Luiz Henrique Gebrim,&nbsp;Xiaojing Guo,&nbsp;Damien Heitz,&nbsp;Shigeru Imoto,&nbsp;Lydia Ioannidou-Mouzaka,&nbsp;Cary Kaufman,&nbsp;Hong Liu,&nbsp;Mamadou Mbodj,&nbsp;Esther Meka,&nbsp;Alexander Mundinger,&nbsp;Jorge Novelli,&nbsp;Daniel Ojuka,&nbsp;Ruben Orda,&nbsp;Valerijus Ostapenko,&nbsp;Tadeusz Pieńkowski,&nbsp;Paula Podolski,&nbsp;Thomas Vogel,&nbsp;Jian Yin,&nbsp;Vahit Özmen,&nbsp;Schlomo Schneebaum,&nbsp;Carole Mathelin","doi":"10.4274/ejbh.galenos.2023.2023-5-1","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-5-1","url":null,"abstract":"<p><strong>Objective: </strong>Mammographic screening and management of breast cancer (BC) in elderly women are controversial and continue to be an important health problem. To investigate, through members of the Senologic International Society (SIS), the current global practices in BC in elderly women, highlighting topics of debate and suggesting perspectives.</p><p><strong>Materials and methods: </strong>The questionnaire was sent to the SIS network and included 55 questions on definitions of an elderly woman, BC epidemiology, screening, clinical and pathological characteristics, therapeutic management in elderly women, onco-geriatric assessment and perspectives.</p><p><strong>Results: </strong>Twenty-eight respondents from 21 countries and six continents, representing a population of 2.86 billion, completed and submitted the survey. Most respondents considered women 70 years and older to be elderly. In most countries, BC was often diagnosed at an advanced stage compared to younger women, and age-related mortality was high. For this reason, participants recommended that personalized screening be continued in elderly women with a long life expectancy.In addition, this survey highlighted that geriatric frailty assessment tools and comprehensive geriatric evaluations needed to be used more and should be developed to avoid undertreatment. Similarly, multidisciplinary meetings dedicated to elderly women with BC should be encouraged to avoid under- and over-treatment and to increase their participation in clinical trials.</p><p><strong>Conclusion: </strong>Due to increased life expectancy, BC in elderly women will become a more important field in public health. Therefore, screening, personalized treatment, and comprehensive geriatric assessment should be the cornerstones of future practice to avoid the current excess of age-related mortality. This survey described, through members of the SIS, a global picture of current international practices in BC in elderly women.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320638/pdf/ejbh-19-201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861656","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":"Role of Reassurance and Proper Mechanical Support Advice on Quality of Life and Pain Relief in Patients of the Mastalgia-A Prospective Follow-up Study at A Tertiary Care Center in a Developing Country.","authors":"Harendra Pankaj,&nbsp;Priyanka Rai,&nbsp;Amarjot Singh,&nbsp;Sunil Singh,&nbsp;Rohit Srivastava,&nbsp;Rudramani","doi":"10.4274/ejbh.galenos.2023.2023-3-9","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-3-9","url":null,"abstract":"<p><strong>Objective: </strong>To study the effect of reassurance and proper mechanical support on quality of life (QOL) and visual analogue score (VAS) pain assessment in patients with mastalgia at a range of follow-ups.</p><p><strong>Materials and methods: </strong>A prospective follow-up study was conducted among women aged 15-45 years, complaining of breast pain without any abnormality detected clinically and radiologically. After consent to participate and enrollment, all the study participants were counseled and reassured about the non-neoplastic nature of the disease and about wearing proper mechanical support/Bra; this was repeated at each follow-up. VAS was used to assess the pain intensity perceived by the woman at each follow-up, post intervention. The Short Form-36 (SF-36) scale was used to evaluate health related QOL (HRQOL).</p><p><strong>Results: </strong>Among 80 patients, 31.2% were wearing a Bra of fabric other than cotton, 21.2% were wearing a loose fit mechanical support/Brassiere, while 10% were not wearing any mechanical support at baseline. The overall mean VAS score was significantly reduced with each follow-up, indicating decreased perception of breast pain over time. There was a significant difference between the mean SF-36 score between base line and after three months (<i>p</i><0.0001). Mean scores in all domains of the SF-36 increased. The greatest reduction in mean VAS score was seen in 26-35 years age group and women with a body mass index <18.5 kg/m².</p><p><strong>Conclusion: </strong>Reassurance and wearing proper mechanical support/Bra are effective for improving QOL and alleviating breast pain/mastalgia. These simple processes should be used for the management of mastalgia.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320641/pdf/ejbh-19-210.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861658","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":"Risk Factors Associated With Sentinel Lymph Node Metastasis in Clinically Node-Negative Breast Cancer.","authors":"Hussain Adnan Abdulla,&nbsp;Ahmed Zuhair Salman,&nbsp;Sarah Jawad Alaraibi,&nbsp;Khaled Nazzal,&nbsp;Sara Abdulameer Ahmed,&nbsp;Sayed Ali Almahari,&nbsp;Ali Dhaif","doi":"10.4274/ejbh.galenos.2023.2023-3-5","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-3-5","url":null,"abstract":"<p><strong>Objective: </strong>Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in clinically node negative breast cancer. If predictive factors for sentinel lymph node (SLN) metastasis could be identified, it would allow selection of candidates for SLNB and omit axillary surgery in those with the lowest risk of axillary lymph node involvement. The aim of this study was to determine risk factors associated with SLN metastasis in breast cancer patients in Bahrain.</p><p><strong>Materials and methods: </strong>Patients with clinically node-negative breast cancer who underwent SLNB at a single institution between 2016 and 2022 were identified from the pathology database. Patients who had failure of localization of SLN, those with bilateral cancers and those treated for a local recurrence were excluded.</p><p><strong>Results: </strong>A total of 160 breast cancer patients were retrospectively analyzed. Of these, 64.4% had a negative SLNB and 21.9% of all cases underwent axillary dissection. The following parameters emerged as predictors of SLN metastasis in univariate analysis: age; tumour grade; ER status; presence of lymphovascular invasion (LVI) and tumor size. On multivariate analysis, age was not independently associated with the incidence of SLN metastasis.</p><p><strong>Conclusion: </strong>This study showed that high tumour grades, presence of LVI and large tumour size were all risk factors related to axillary metastasis after SLNB in breast cancer. In the elderly, the incidence of SLN metastasis appeared to be relatively low, providing an opportunity to de-escalate axillary surgery in these patients. These findings may allow for the development of a nomogram to estimate the risk of SLN metastasis.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320640/pdf/ejbh-19-229.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861659","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":"Breast Hematoma: A Rare Complication of Anticoagulant and Antiplatelet Use and Review of the Literature.","authors":"Emrah Dağtekin,&nbsp;Sebahattin Çelik","doi":"10.4274/ejbh.galenos.2023.2023-3-8","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-3-8","url":null,"abstract":"<p><p>Oral anticoagulants and anti-platelet therapies are used for treatment and especially prophylaxis in clinical situations where there is a risk of thromboembolism or when thromboembolic events occur. The presented case was a patient who was hospitalized due to cellulitis in the leg, and was diagnosed with heart failure, obesity and chronic obstructive pulmonary disease. She was started on prophylactic oral anticoagulants for deep vein thrombosis and pulmonary emboli and subsequently developed spontaneous breast hematoma. The usual sites of such bleeding are the skin, gastrointestinal tract, genitourinary tract, central nervous system, retroperitoneum, muscle, and the site of recent surgical procedures or trauma while breast hematomas are usually of traumatic origin. Spontaneous bleeding into the breast after anticoagulant use is rare. While using anticoagulants, it should be kept in mind that, rarely, bleeding may occur in the breast. We advise that intervention in such cases is unnecessary, no matter how large the breast hematoma is, and that new anti-coagulant drugs may be safer.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320636/pdf/ejbh-19-257.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861660","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":"Advances in Artificial Intelligence and the Potential Impact on Oncoplastic Breast Surgery.","authors":"Çağrı Akalın","doi":"10.4274/ejbh.galenos.2023.2023-3-4","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-3-4","url":null,"abstract":"","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320632/pdf/ejbh-19-261.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164022","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":"Ductal Carcinoma <i>In Situ</i> Arising in Sentinel Axillary Lymph Nodes Excised From Patients With Breast Carcinoma - A Potential Diagnostic Pitfall. Report of Two Cases.","authors":"Aysel Bayram,&nbsp;Ali Yılmaz Altay,&nbsp;Sidar Bağbudar,&nbsp;Semen Önder,&nbsp;Mustafa Tükenmez,&nbsp;Ekrem Yavuz","doi":"10.4274/ejbh.galenos.2023.2023-2-4","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-2-4","url":null,"abstract":"<p><p>We present two cases of ductal carcinoma <i>in situ</i> (DCIS) that arose in axillary lymph nodes excised as the sentinel lymph node from two patients with breast carcinoma. The patient ages were 72 and 36 years and both patients underwent mastectomy and axillary lymph node dissection. In addition to DCIS in the sentinel lymph node, the first patient had a wide DCIS and microinvasion in the ipsilateral breast and a micrometastasis in another sentinel lymph node. The second patient was operated on after neoadjuvant chemotherapy and had DCIS and a small focus of invasion, in addition to invasive and <i>in situ</i> ductal carcinoma in the lymph node having signs of chemotherapy-induced regression. The presence of DCIS was confirmed by use of the immunohistochemical method with antibodies against myoepithelial cells. As a potential source of cellular origin, DCIS was accompanied by benign epithelial cell clusters in the lymph node in both cases. Morphologic and immunohistochemical features were similar in breast and lymph node neoplasms. We conclude that DCIS may rarely develop from benign epithelial inclusions in the axillary lymph node and is a potential diagnostic pitfall in cases having ipsilateral breast carcinoma.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320633/pdf/ejbh-19-253.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861655","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":"Management and Outcomes of Metastatic and Recurrent Malignant Phyllodes Tumors of the Breast: A Systematic Literature Review.","authors":"Elaheh Samii,&nbsp;Yannick Hurni,&nbsp;Daniela Huber","doi":"10.4274/ejbh.galenos.2023.2023-3-2","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-3-2","url":null,"abstract":"<p><p>To summarize the evidence on the current management and outcomes for metastatic and recurrent malignant phyllodes tumors (MPTs) of the breast. A systematic literature review of all cases of metastatic or recurrent MPTs of the breast published between 2010 and 2021 was performed. In total, 66 patients from 63 articles were included. Fifty-two (78.8%) had distant metastatic disease (DMD subgroup), and 21 (31.8%) showed locoregional recurrent/progressive disease (LRPR subgroup). Locoregional recurrences in patients with no distant metastases were treated with surgical excision in all cases. Radiotherapy was administered in 8/21 cases (38.1%) and was combined with chemotherapy in 2/21 cases (9.5%). Metastatic disease was managed through metastases surgical excision, chemotherapy, radiotherapy, or a combination of these three in 84.6% of cases, while the remaining patients received no oncological treatments. Chemotherapy was proposed in 75.0% of cases. Anthracycline and alkylating agent-based combination regimens were most frequently administered. The median survival time was 24 (2.0-152.0) months, and 72.0 (2.5-98.5) months in the DMD and LRPR subgroups, respectively. Management of recurrent or metastatic MPTs is challenging. Surgery is the fundamental approach, but the use of adjuvant radio- and chemo-therapy remains controversial due to the lack of scientific evidence. Further studies and international registers are needed to implement new and more efficient treatment strategies.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320634/pdf/ejbh-19-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9861654","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":"Knowledge About Early Diagnosis of Breast Cancer, and Breast Cancer Risks Among Syrian Immigrants and Turkish Citizens: A Comparative, Cross-Sectional Study.","authors":"Hatice Serap Koçak,&nbsp;Ecem Çiçek Gümüş","doi":"10.4274/ejbh.galenos.2023.2023-1-6","DOIUrl":"https://doi.org/10.4274/ejbh.galenos.2023.2023-1-6","url":null,"abstract":"<p><strong>Objective: </strong>Cancer affects people regardless of being native or immigrants from developing countries. The most common form of cancer amongst displaced and immigrant women is breast cancer. This study provided a cultural comparison of early diagnosis, screening and breast cancer risks among Syrian immigrants and Turkish citizens in Turkey.</p><p><strong>Materials and methods: </strong>The study was performed with a descriptive, comparative and cross-sectional design with 589 women (Turkish=302, Syrian=287). A Personal Information Form and Breast Cancer Risk Assessment Form were used for data collection.</p><p><strong>Results: </strong>The knowledge of Syrian immigrant women and behavior regarding breast self-examination, clinical breast examination, and screening with a mammogram were significantly lower than those of Turkish women (<i>p</i><0.05). In addition, Syrian women's information about general breast cancer early diagnosis and screening was poorer. However, the mean breast cancer risk score was higher in Turkish women (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>The data highlighted the importance of understanding locally specific barriers to breast cancer screening among immigrants and developing national programs to increase cancer education as a means of prevention.</p>","PeriodicalId":11885,"journal":{"name":"European journal of breast health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10320631/pdf/ejbh-19-222.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164020","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}