Gynecologic Oncology Reports最新文献

{"title":"Immunotherapy-associated capillary leak syndrome in endometrial cancer: a case report and review of the literature","authors":"Katherine Lambert ,&nbsp;Quinn Kistenfeger ,&nbsp;Julia Chalif ,&nbsp;Jason M. Prosek ,&nbsp;Floor Backes","doi":"10.1016/j.gore.2025.101955","DOIUrl":"10.1016/j.gore.2025.101955","url":null,"abstract":"<div><h3>Background</h3><div>Capillary leak syndrome is a rare immune-adverse related event. There are only 3 reported cases of capillary leak syndrome in patients receiving pembrolizumab, all of which are patients with non-gynecologic squamous cell carcinomas. Here, we present a case report of capillary leak syndrome in a patient with recurrent endometrial carcinoma receiving pembrolizumab.</div></div><div><h3>Methods</h3><div>This is a case report and review of relevant literature. Patient consent was obtained prior to initiation of the report and submission to the journal.</div></div><div><h3>Objectives</h3><div>We describe a 65-year-old female with recurrent mismatch repair deficient (dMMR) FIGO grade 2 endometrioid adenocarcinoma on pembrolizumab maintenance therapy, who presented to the hospital with fatigue, lower extremity vasculitis, anasarca, and fevers of unknown origin. She was found to have hypoalbuminemia and hyponatremia. A broad workup was performed, which was overall unrevealing. She was diagnosed with capillary leak syndrome as a diagnosis of exclusion. The patient was treated with corticosteroids and IVIG with resolution of her symptoms. The patient is not currently on any maintenance therapy and there are no plans to resume pembrolizumab.</div></div><div><h3>Conclusion</h3><div>Our case is the first reported case of capillary leak syndrome secondary to pembrolizumab in a patient with a gynecologic malignancy. Capillary leak syndrome is a diagnosis of exclusion and is treated via immunosuppression with agents such as corticosteroids and IVIG. Expanded awareness of this immune-related adverse event is vital to prompt recognition and treatment.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101955"},"PeriodicalIF":1.3,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105396","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":"Long-term disease-free survival after bilateral video-assisted thoracoscopic resection of multiple pulmonary metastases from endometrial stromal sarcoma: An 8-year follow-up case report","authors":"Eitetsu Koh ,&nbsp;Yasuo Sekine ,&nbsp;Tadao Nakazawa ,&nbsp;Kenzo Hiroshima","doi":"10.1016/j.gore.2025.101954","DOIUrl":"10.1016/j.gore.2025.101954","url":null,"abstract":"<div><h3>Background</h3><div>Low-grade endometrial stromal sarcoma (LG-ESS) is a rare uterine malignancy prone to late recurrence and distant metastasis, most commonly to the lungs. Bilateral multiple pulmonary metastases are exceedingly uncommon, and optimal management remains unclear.</div></div><div><h3>Case presentation</h3><div>A 51-year-old woman underwent total abdominal hysterectomy for LG-ESS at age 43. Eight years later, routine chest radiography revealed multiple bilateral pulmonary nodules. Computed tomography showed three well-circumscribed nodules (7–9 mm) in the left S4, left S8, and right S8 segments. Positron emission tomography showed minimal fluorodeoxyglucose uptake. Bilateral video-assisted thoracoscopic wedge resections were performed, achieving complete removal of all lesions. Histopathology confirmed metastatic LG-ESS (CD10/ER/PR positive). The patient received oral medroxyprogesterone acetate for five years. The therapy was discontinued following subarachnoid hemorrhage due to a ruptured posterior-circulation intracranial aneurysm and treated by surgical clipping; she has no residual neurological deficits. She remains disease-free a total of eight years after metastasectomy.</div></div><div><h3>Conclusion</h3><div>Complete resection of bilateral multiple pulmonary metastases from LG-ESS, combined with hormonal therapy, can achieve durable long-term disease control in carefully selected patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101954"},"PeriodicalIF":1.3,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105395","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":"Navigating dual risks: Ovarian cancer prevention and cardiovascular health in patients with hereditary cancer syndromes","authors":"Laura Keenahan ,&nbsp;Muhammad Danyal Ahsan ,&nbsp;Alicia Mecklai ,&nbsp;Melissa K. Frey","doi":"10.1016/j.gore.2025.101940","DOIUrl":"10.1016/j.gore.2025.101940","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101940"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105466","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":"Neoadjuvant chemoimmunotherapy in HPV-associated vulvar and vaginal squamous cell carcinoma with PD-L1 CPS < 1:Dual pCR evidence","authors":"Enyu Tang ,&nbsp;Jia Zeng ,&nbsp;Yangchun Sun","doi":"10.1016/j.gore.2025.101952","DOIUrl":"10.1016/j.gore.2025.101952","url":null,"abstract":"<div><h3>Background</h3><div>While surgery and radiotherapy remain primary treatments for HPV-associated vulvar/vaginal squamous cell carcinoma (SCC), the significant complications and impaired quality of life underscore the need for alternative approaches. We report two cases achieving pathological complete response (pCR) with neoadjuvant chemoimmunotherapy.</div></div><div><h3>Cases</h3><div>Two biopsy-confirmed HPV-associated vulvar/vaginal SCC cases with inguinal lymph node metastases (both PD-L1 CPS &lt; 1) received three cycles of neoadjuvant camrelizumab plus nab-paclitaxel/cisplatin. Subsequent imaging demonstrated marked tumor regression, permitting urethra-preserving resection. Histopathological analysis confirmed pCR, with no recurrence at 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>Neoadjuvant chemoimmunotherapy may be an effective treatment for HPV-associated vulvar/vaginal SCC, potentially independent of PD-L1 CPS status, while improving post-treatment quality of life compared to conventional therapies.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101952"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045021","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":"An unusual pelvic mass","authors":"Marie-Véronique Poirier,&nbsp;Vikram B. Chakravarthy,&nbsp;Floor Backes","doi":"10.1016/j.gore.2025.101948","DOIUrl":"10.1016/j.gore.2025.101948","url":null,"abstract":"<div><h3>Background</h3><div>The differential diagnosis for a solid pelvic mass is broad and includes non-gynecologic masses such as retroperitoneal schwannoma. Theses benign nerve-sheath tumors can be mistaken for adnexal masses or cause non-specific bulk symptoms, which may lead patients to present to their Ob/Gyn or ultimately be referred to gynecologic oncologists for evaluation and possible resection.</div></div><div><h3>Cases</h3><div>We discuss two cases of pelvic schwannoma: a 79-year-old woman who initially presented with a two-year history of left lower extremity cramping, paresthesia, and back pain, and a 40-year-old woman with right-sided flank pain and worsening dysmenorrhea, who presented with initial concern for adnexal mass.</div></div><div><h3>Conclusion</h3><div>The differential diagnosis for a smooth, fixed, pre-sacral or sidewall mass on pelvic exam includes pelvic schwannoma. These nerve sheath tumors are typically benign; however, can cause a variety of symptoms due to regional mass effect and may significantly impact quality of life. Associated symptoms, if present, may be non-specific or difficult to localize (i.e. pelvic pain/fullness, urinary symptoms, constipation, and radiculopathy), which can lead to a delay in diagnosis if a comprehensive pelvic exam is not performed or if suspicion for an etiology of non-gynecologic origin is not considered. Recommended workup includes pelvic MRI followed by CT-guided biopsy. Management is guided by the patient’s symptoms; if surgery is warranted, a minimally invasive, interdisciplinary approach is strongly preferred.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101948"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019717","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":"Human epidermal growth factor receptor-2, nectin-4, and trophoblast cell surface antigen-2 expression in endometrial carcinosarcoma","authors":"Shih-Yao Lin ,&nbsp;Chung-Ting Chang ,&nbsp;Ren-Chin Wu ,&nbsp;Chiung-Ru Lai ,&nbsp;Yi-Jen Chen","doi":"10.1016/j.gore.2025.101951","DOIUrl":"10.1016/j.gore.2025.101951","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the immunohistochemical expression of human epidermal growth factor receptor-2 (HER2), nectin-4, and trophoblast cell surface antigen-2 (TROP2) in endometrial carcinosarcoma (ECS), with particular attention to compartment-specific expression patterns and potential therapeutic implications.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 56 ECS cases and performed immunohistochemistry for HER2, nectin-4, and TROP2 on representative tumor sections. Expression levels were semi-quantitatively scored and compared between the carcinomatous and sarcomatous components. Associations with clinicopathological features were also assessed.</div></div><div><h3>Results</h3><div>HER2 overexpression (3+) was identified in 4 cases (7.1 %), with an additional 6 cases (10.7 %) showing equivocal (2+) staining. HER2 2+/3+ expression was significantly associated with serous carcinoma differentiation (31.0 % vs. 3.7 %, <em>P</em> = 0.012) and was largely confined to the carcinomatous component (<em>P</em> &lt; 0.001). Nectin-4 was expressed in 39.3 % of cases, predominantly weak in intensity, with significantly higher expression in the carcinomatous than in the sarcomatous component (<em>P</em> &lt; 0.001). TROP2 expression was observed in 62.5 % of cases, also confined to the carcinomatous component, with no strong expression detected. No significant correlations were found between marker expression and other clinicopathological variables beyond serous differentiation.</div></div><div><h3>Conclusions</h3><div>HER2, nectin-4, and TROP2 are preferentially expressed in the carcinomatous component of ECS. HER2-targeted antibody–drug conjugates may be a promising therapeutic strategy for ECS with serous carcinoma differentiation. Further investigation is warranted to determine the clinical relevance of targeting nectin-4 and TROP2 in ECS.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101951"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105397","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":"Adverse events beyond the RUBY trial: reporting immunotherapy-associated myocarditis, myositis, and myasthenia gravis in a real-world endometrial cancer case","authors":"Yasmin Abozenah ,&nbsp;Blair McNamara ,&nbsp;Michelle Greenman ,&nbsp;Emily Daigle ,&nbsp;John Paul Mikhaiel ,&nbsp;Daniel DiCapua ,&nbsp;Jennifer Kwan ,&nbsp;Masoud Azodi ,&nbsp;Gary Altwerger","doi":"10.1016/j.gore.2025.101950","DOIUrl":"10.1016/j.gore.2025.101950","url":null,"abstract":"<div><h3>Objectives</h3><div>To report a rare case of immune checkpoint inhibitor (ICI)-associated myocarditis, myositis, and myasthenia gravis (MMM syndrome) in a patient with advanced endometrial cancer treated with dostarlimab, highlighting the diagnostic and therapeutic challenges, in addition to the importance of biomarker-informed treatment selection.</div></div><div><h3>Methods</h3><div>We report the case of a 75-year-old woman with unresectable stage IIIC2 endometrial adenocarcinoma and mismatch repair (MMR) deficiency treated with carboplatin and paclitaxel, followed by dostarlimab. After initiation of dostarlimab, the patient presented with neuromuscular and cardiac symptoms, leading to the diagnosis of myocarditis, myositis, myasthenia gravis (MMM) syndrome requiring hospitalization. A multidisciplinary care including neurologic, cardiac, and critical care management was required.</div></div><div><h3>Results</h3><div>The patient developed MMM syndrome 81 days after starting dostarlimab, presenting with bilateral ptosis, dysphagia, diplopia and respiratory compromise. Evaluation revealed elevated troponins, elevated creatine kinase, and a positive acetylcholine receptor antibody. Cardiac MRI confirmed myocarditis. Management included high-dose steroids, mycophenolate, IVIG, abatacept, and tofacitinib, with initial stabilization.</div></div><div><h3>Conclusions</h3><div>MMM syndrome is a rare but life-threatening complication of ICI therapy. Early recognition and multidisciplinary management are crucial. This case underscores the importance of weighing the risks and benefits of initiating immunotherapy and utilizing biomarker-driven clinical decisions.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101950"},"PeriodicalIF":1.3,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045020","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":"Diagnosis and treatment of a mixed ovarian malignant germ cell tumor with glioblastoma transformation","authors":"M.A. Sylvester ,&nbsp;D. Spinosa ,&nbsp;A. Encarnacion ,&nbsp;A. Berning ,&nbsp;J. Alldredge","doi":"10.1016/j.gore.2025.101945","DOIUrl":"10.1016/j.gore.2025.101945","url":null,"abstract":"<div><h3>Objectives</h3><div>Mixed malignant germ cell tumors of the ovary consist of two or more germ cell components, and are a rare but aggressive gynecologic malignancy which typically affect women in early reproductive years. Very few cases of mixed malignant germ cell tumors with glioblastoma component are reported in the literature, and little is known about the most appropriate chemotherapy regimen and long-term outcomes for these rare tumor presentations.</div></div><div><h3>Methods</h3><div>Presented here is the case of a 44-year-old female patient diagnosed with a stage III mixed malignant germ cell tumor of the ovary consisting of immature teratoma (95%) and yolk sac tumor (5%), with concurrent transformation of mature neural tissue to glioblastoma. The patient underwent primary staging surgery with evidence of gliomatosis peritonei on final pathology.</div></div><div><h3>Results</h3><div>In collaboration with neuro-oncology, the decision was made to not alter adjuvant treatment plan on account of the glioblastoma component of this case, so the patient underwent adjuvant chemotherapy with four cycles of bleomycin, etoposide, and cisplatin (BEP) and has been followed for 2.5 years from completion with no evidence of recurrence.</div></div><div><h3>Conclusions</h3><div>The case presented here discusses the rare presentation of mixed malignant germ cell tumor of the ovary with concurrent glioblastoma transformation and gliomatosis peritonei. While long-term outcomes cannot be concluded based on this case, excellent treatment response has been seen at 2.5 years, suggesting that traditional BEP therapy regiment should be considered for similar cases.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101945"},"PeriodicalIF":1.3,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019716","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":"Unusual metastatic pattern of endometrial carcinoma with distal foot involvement","authors":"Tessel Speelman ,&nbsp;Suzanne Otten ,&nbsp;Meta Tjeenk Willink ,&nbsp;Jasper Helthuis ,&nbsp;Natascha M. de Lange ,&nbsp;Harm H. de Haan ,&nbsp;Arnold-Jan Kruse","doi":"10.1016/j.gore.2025.101938","DOIUrl":"10.1016/j.gore.2025.101938","url":null,"abstract":"<div><h3>Introduction</h3><div>Endometrial carcinoma typically metastasizes to the lungs, liver, and bones of the axial skeleton. Metastatic spread to the bones of the foot is exceedingly rare and may present with nonspecific musculoskeletal symptoms, often mimicking infection. Recognizing such atypical metastatic patterns is essential for timely diagnosis and management, particularly in patients with high-risk disease.</div></div><div><h3>Case report</h3><div>A 62-year-old woman with FIGO stage IIIB endometrioid adenocarcinoma, previously treated with surgery and radiotherapy, presented with progressive pain and swelling of the right foot. Initial clinical evaluation suggested cellulitis, and empiric antibiotics were started. Symptoms persisted, prompting further investigation. MRI demonstrated diffuse marrow abnormalities and cortical disruption in multiple tarsal bones, raising suspicion for malignancy. Biopsy confirmed metastatic endometrioid adenocarcinoma. FDG PET-CT revealed intense uptake in the foot lesion, as well as additional FDG-avid lesions in the right femur, fibula, metatarsal, and a pulmonary nodule, consistent with widespread metastatic disease.</div></div><div><h3>Conclusion</h3><div>Metastases to the bones of the foot from endometrial carcinoma are rare and can mimic infection. This case highlights the importance of maintaining a high index of suspicion for unusual metastatic patterns in patients with persistent musculoskeletal symptoms and a history of high-risk endometrial cancer. Timely imaging and histologic confirmation are critical for accurate diagnosis and appropriate management, especially as such presentations often indicate advanced systemic disease.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101938"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010244","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":"Peutz-Jeghers syndrome in gynecological cancers: bibliometric trends, clinical insights, and future directions","authors":"Tianhui Niu,&nbsp;Jinghui Jia,&nbsp;Zhang Lei,&nbsp;Hongfang Wang,&nbsp;Guoqing Cai","doi":"10.1016/j.gore.2025.101941","DOIUrl":"10.1016/j.gore.2025.101941","url":null,"abstract":"<div><h3>Background</h3><div>Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder caused by germline mutations in the STK11 tumor suppressor gene. It is characterized by mucocutaneous pigmentation, gastrointestinal polyposis, and a significantly elevated risk of various malignancies. While the association between PJS and gastrointestinal cancers is well established, its relationship with gynecological malignancies, particularly gastric-type endocervical adenocarcinoma (G-EAC), remains poorly understood. The rarity and clinical heterogeneity of PJS have hindered the development of evidence-based guidelines, especially for gynecological tumors</div></div><div><h3>Methods</h3><div>We conducted a comprehensive bibliometric analysis of 96 English-language publications from 2010 to 2024 to map global research trends on PJS-related gynecological cancers, identifying key topics and tracing the evolution of knowledge in this field. This was complemented by a retrospective case series analysis of PJS patients diagnosed with G-EAC, integrating clinical, imaging, and pathological data to characterize their disease features.</div></div><div><h3>Results</h3><div>The bibliometric analysis revealed a growing research focus on STK11 molecular pathogenesis and improved surveillance strategies for PJS. Our case series of 10 PJS patients with G-EAC underscores the early onset and aggressive nature of this malignancy—all cases were HPV-negative. Clinical presentation often included watery vaginal discharge and pelvic pain, with imaging showing cervical masses and pelvic effusions. Pathological review confirmed G-EAC in six patients and atypical lobular endocervical glandular hyperplasia (aLEGH) in others, highlighting the need for heightened vigilance in monitoring PJS patients.</div></div><div><h3>Conclusion</h3><div>These findings emphasize the urgent need for individualized, multidisciplinary screening and management strategies for PJS-associated gynecological cancers. Improved awareness of PJS-related G-EAC is crucial for early detection. Integration of genetic counseling, advanced imaging, and molecular diagnostics into routine care for PJS patients will help optimize outcomes in this high-risk population</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"61 ","pages":"Article 101941"},"PeriodicalIF":1.3,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145003907","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}