{"title":"Possible role of the collagen type I alpha 1–platelet-derived growth factor beta chain fusion gene in the development of dermatofibrosarcoma protuberans with fibrosarcomatous transformation","authors":"Fuminori Katsumata MD, Koji Kamiya MD, PhD, Hitomi Miyauchi BEng, Hirofumi Okada MD, Atsuko Sato MD, PhD, Takeo Maekawa MD, PhD, Mayumi Komine MD, PhD, Mamitaro Ohtsuki MD, PhD","doi":"10.1002/cia2.12297","DOIUrl":"10.1002/cia2.12297","url":null,"abstract":"<p>Dermatofibrosarcoma protuberans with fibrosarcomatous transformation (DFSP-FS) is a rare variant, with higher rates of recurrence and metastasis than DFSP. Detection of the collagen type I alpha 1 (COL1A1)–platelet-derived growth factor beta chain (PDGFB) fusion gene is useful for the diagnosis of DFSP. In this letter, we report a case of DFSP-FS, focusing on the expression of the COL1A1-PDGFB fusion gene in the lesions. Increased expression of the COL1A1-PDGFB fusion gene may be associated with fibrosarcomatous changes during the pathogenesis of DFSP.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43550088","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":"Severity and intractableness of skin infections caused by Panton–Valentine leukocidin-positive methicillin-resistant Staphylococcus aureus","authors":"Tamihiro Kawakami MD, PhD, Kae Yokoyama MD, Takaharu Ikeda MD, PhD, Hiroshi Kaneko MD, PhD, Yuji Watanabe PhD, Hidemasa Nakaminami MD, PhD","doi":"10.1002/cia2.12294","DOIUrl":"10.1002/cia2.12294","url":null,"abstract":"<p>Cases of skin infections caused by Panton–Valentine leukocidin (PVL)-positive methicillin-resistant <i>Staphylococcus aureus</i> (MRSA), particularly USA300 clone, have been increasing in Japan. We report that clinical findings of 5 patients with PVL-positive MRSA and compared to those of four patients with PVL-negative MRSA. Severities of patients with PVL-positive MRSA were significantly higher than those of patients with PVL-negative MRSA. Average durations of antimicrobial therapy for patients with PVL-positive MRSA were 3.4-fold longer than those for patients with PVL-negative MRSA. Our data suggest that PVL-positive MRSA should be deal with a causative agent for intractable skin infections in Japan likewise other countries.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12294","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41820687","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":"A case of extensive alopecia areata following Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine with favorable outcome","authors":"Yoshihiro Matsuda MD, Yoshio Kawakami MD, PhD, Masaya Kawamoto MD, Yoji Hirai MD, PhD, Shin Morizane MD, PhD","doi":"10.1002/cia2.12292","DOIUrl":"10.1002/cia2.12292","url":null,"abstract":"<p>The coronavirus disease 2019 (COVID-19) pandemic has an enormous impact on dermatological practice. There are many articles describing COVID-19-related and COVID-19 vaccine-related hair loss, such as telogen effluvium (TE), alopecia areata (AA), friction alopecia and anagen effluvium,<span><sup>1</sup></span> although their clinical outcomes have been poorly documented. We report a case of extensive AA following administration of the Pfzer-BioNTech BNT162b2 mRNA COVID-19 vaccine with favorable outcome.</p><p>A 37-year-old woman with no significant medical history except for childhood atopic dermatitis, developed persistent low-grade fever (37.2°C) on day +13 after the first dose of BNT162b2 mRNA vaccine (all date numbers refer to the first dose). Subsequently, the patient noticed coin-sized hair loss on day +22, and it became widespread within 1 week. Laboratory examinations performed at a nearby clinic on day +31 showed increased serum C-reactive protein (3.53 mg/dl) and decreased white blood cells (3000/μl) with 54.0% of neutrophils, 2.4% of eosinophils, and 34.8% of lymphocytes, whereas serological tests for syphilis were negative, and serum thyroid function tests, antinuclear antibody, immunoglobulin E, and thymus activation-regulated chemokine levels were all within normal ranges. She received the second dose BNT162b2 mRNA vaccine on day +32. The persistent low-grade fever spontaneously resolved on day +34 although the hair loss continued to aggravate. She presented to our hospital on day +73 for further evaluation. Physical examination revealed widespread alopecia with a severity of alopecia tool (SALT) II score of 80 (Figure 1A), whereas her eyebrows, eyelashes, and body hair were intact. Trichoscopy showed tapering hairs, broken hairs, black dots, and increase in vacant follicular ostia (Figure 1B). Histological findings of a skin biopsy revealed perifollicular lymphocytic infiltrate and increased number of telogen hairs (Figure 1C–E). Results of direct immunofluorescence studies were negative. We treated the patient with topical betamethasone butyrate propionate lotion. On day +120, the patient showed a sign of hair regrowth. The patient's hair mostly recovered leaving only one oval bald patch on day +310, and SALT II score decreased to 5 (Figure 1F).</p><p>The hair loss in this patient occurred following a febrile condition after the first dose of BNT162b2 mRNA vaccine, and we initially considered the patient as TE. However, initial onset with coin-sized hair loss and the presence of an oval bald patch in the late phase were rather characteristic for AA.</p><p>A review of the literature including the present case identified 17 cases of AA associated with COVID-19 vaccines.<span><sup>2-7</sup></span> Six cases had a previous history of AA. Types of vaccines prior to the development of AA included BNT162b2 mRNA in 11 cases, AZD1222/ChAdOx1 viral vector in three cases, and mRNA-1273 in three cases. In eight cases, AA appeared after the ","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48824335","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":"Skin Beautification with an ImmunatuRNA® Complex: A Natural Complex Based on Yeast RNA and Marine Derivatives on the Human Skin Immunity and Microbiome Composition","authors":"V. Neymann","doi":"10.37191/mapsci-2582-6549-3(2)-039","DOIUrl":"https://doi.org/10.37191/mapsci-2582-6549-3(2)-039","url":null,"abstract":"The skin is the largest organ of human body implicated in vital physiological and immunological processes, including protection against injury, infections, and environmental exposures. Nevertheless, a number of negative external and internal factors, including increased pollution along with modern lifestyle can significantly influence on the skin immunity, promote aging and reduce regenerative capabilities. Cosmetic formulations based on natural ingredients, including plant and marine/algae extracts, and microbial-derived bio-actives may help to maintain healthy skin condition and protect its beautiful appearance.\u0000\u0000The ImmunatuRNA®* (*The trademark ImmunatuRNA® is a registered trademark in the European Union EUTM 018365297 and Great Britain UK00003630172. Any reference to the registration of the ImmunatuRNA® trademark applies to the designated territories), a signature complex (VRFD SA/VERDILAB Switzerland) based on the Natural RNA molecules obtained from yeasts, with added marine exopolysaccharides and natural hyaluronic acid with potential benefits for antibacterial and antiradical defense and maintaining skin detox homeostasis. Therefore, the main aim of this study is to experimentally assess the ImmunatuRNA® complex capabilities to enhance natural skin antioxidant defenses and protection against oxidative stress, by using human fibroblast cell culture. Additionally, this study will investigate the effects of the skincare products with added ImmunatuRNA® complex on the skin microbiome composition in the group of healthy adults with various skin types. The results obtained from the in vitro studies consistently demonstrated that treatment with an ImmunatuRNA® complex protects human fibroblasts against exposure to pro-oxidants, while at the same time enhances anti-oxidative defenses of these cells, demonstrated as reduced formation of free radicals and upregulation of SIRT-1 protein. Furthermore, the cosmetic intervention carried on the group of 10 healthy human volunteers with different skin types (oily, dry, combined, normal) aged between 23 and 65 years old demonstrated that using interchangeably of two cosmetic products-a Natural Moisturizer Probiotic Cream and Natural Detox Replenishing Face Mask containing the ImmunatuRNA® complex, for 4-weeks led to favorable changes in the composition of skin microbiome observed as a reduction of relative abundance of adverse microorganisms, previously linked to the skin inflammation and infections, such as Citrobacter koseri, Bacillus spp., Enterococcus spp., Alcaligenes spp., Pantoea spp. and Staphylococcus aureus. Based on following results, the use of skincare products containing the ImmunatuRNA® complex can help maintain a healthy skin microbiome while possibly preventing against infections and negative environmental exposures, in particularly against oxidative stress in healthy adults with all types of skin with age range 23-65 years old.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82509793","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}
Tokiko Yoshida MD, Eishin Morita PhD, Yuko Chinuki PhD, Kunie Kohno PhD, Osamu Yamasaki PhD
{"title":"Usefulness of Gly m 4-specific IgE test in the diagnosis of Rosaceae fruit-oral allergy syndrome caused by Betulaceae pollen sensitization","authors":"Tokiko Yoshida MD, Eishin Morita PhD, Yuko Chinuki PhD, Kunie Kohno PhD, Osamu Yamasaki PhD","doi":"10.1002/cia2.12291","DOIUrl":"https://doi.org/10.1002/cia2.12291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pollen-food allergy syndrome (PFAS) is caused by the cross-reaction of the specific IgE to pollen allergens with similar allergens contained in fruits, vegetable, and nuts. The representative allergen responsible for this cross-reaction is pathogenesis-related protein (PR)-10. Specific IgE test using Gly m 4, soybean PR-10, is widely used to diagnose soy allergy. We aimed to investigate whether the Gly m 4-specific IgE test is useful for predicting oral allergy symptoms (OAS) to Rosaceae fruits in PFAS caused by Betulaceae pollen sensitization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-one patients with suspected PFAS were enrolled. Specific IgE levels were measured against alder pollen, apple, peach, pear, and Gly m 4, and correlation between test results and allergic symptoms was assessed to compare the accuracy of these allergen-specific IgE tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 41 patients, 32 were positive for alder pollen-specific IgE. Of those, 16 showed OAS to at least one of apple, peach, and pear (OAS (+) group), and the rest 16 cases showed no symptoms (OAS (−) group). The Gly m 4-specific IgE value was significantly higher in the OAS (+) group (<i>p</i> = .014), and the highest in area under the receiver operating characteristics curve. The cut-off value for detection of the OAS (+) group was 2.65 UA/ml, with a sensitivity of 62.5% and a specificity of 81.3%. Other allergen-specific IgE values were not significantly different between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the subjects sensitized to Betulaceae pollen allergens, the Gly m 4-specific IgE test is useful for predicting OAS of Rosaceae fruits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50142340","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}
Tokiko Yoshida, E. Morita, Y. Chinuki, K. Kohno, O. Yamasaki
{"title":"Usefulness of Gly m 4‐specific IgE test in the diagnosis of Rosaceae fruit‐oral allergy syndrome caused by Betulaceae pollen sensitization","authors":"Tokiko Yoshida, E. Morita, Y. Chinuki, K. Kohno, O. Yamasaki","doi":"10.1002/cia2.12291","DOIUrl":"https://doi.org/10.1002/cia2.12291","url":null,"abstract":"Pollen‐food allergy syndrome (PFAS) is caused by the cross‐reaction of the specific IgE to pollen allergens with similar allergens contained in fruits, vegetable, and nuts. The representative allergen responsible for this cross‐reaction is pathogenesis‐related protein (PR)‐10. Specific IgE test using Gly m 4, soybean PR‐10, is widely used to diagnose soy allergy. We aimed to investigate whether the Gly m 4‐specific IgE test is useful for predicting oral allergy symptoms (OAS) to Rosaceae fruits in PFAS caused by Betulaceae pollen sensitization.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51154560","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":"Two-sided influence of dupilumab on alopecia areata co-existing with severe atopic dermatitis: A case series and literature review","authors":"Masahiro Fukuyama MD, PhD, Misaki Kinoshita-Ise MD, PhD, Yoshiko Mizukawa MD, PhD, Manabu Ohyama MD, PhD","doi":"10.1002/cia2.12289","DOIUrl":"10.1002/cia2.12289","url":null,"abstract":"Alopecia areata (AA) often coexists with atopic dermatitis (AD). Recently, several reports suggested that dupilumab, an interleukin 4 receptor α‐antagonist, administration could be a promising medication not only for severe AD but also for AA concomitant with AD (AD‐AA). At the same time, dupilumab has also been reported to exacerbate AA in AD‐AA cases. Thus, the efficacy of dupilumab on AA in AD‐AA cases remains controversial.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12289","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43315731","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":"Targeting cytokines and potentiality of JAK–STAT inhibition in systemic sclerosis","authors":"Wah Wah Aung MD, PhD, Yasuhito Hamaguchi MD, PhD, Takashi Matsushita MD, PhD","doi":"10.1002/cia2.12288","DOIUrl":"10.1002/cia2.12288","url":null,"abstract":"<p>Systemic sclerosis (SSc) or scleroderma is an autoimmune disease of unknown etiology, the treatment of which has garnered increased research interest. Associated symptoms range from localized or diffused skin tightening to multiple organ failure, including the lungs, kidneys, heart, and gastrointestinal tract, with considerable morbidity and mortality. Given that several cytokines contribute to the immune pathogenesis of SSc, efforts have been made toward the development of treatments targeting these cytokines to control disease progression. Indeed, anti-cytokine therapy has emerged as a new therapeutic intervention. Recently, the Janus kinase signal transducer and activator of transcription (JAK–STAT) pathway has been investigated as a novel candidate for the fibrogenic pathology of SSc. However, a comprehensive scientific review of the targeted therapy for SSc has been hampered by the rarity and heterogeneous nature of the disease. In this review, we provide an overview of cytokines involved in the innate and adaptive immune pathogenesis of SSc based on recent scientific data. In particular, we focus on targeted anti-cytokine therapy and the emerging role of the JAK–STAT inhibitor, a prospective therapeutic agent for the reversal of disease pathogenesis.</p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12288","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47744722","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":"Hepatitis B and C Co-Infection among HIV-Positive Patients Attending Art at General Hospital Kaltungo, Gombe State, Nigeria","authors":"Danladi Nengak Precious","doi":"10.37191/mapsci-2582-6549-3(2)-038","DOIUrl":"https://doi.org/10.37191/mapsci-2582-6549-3(2)-038","url":null,"abstract":"Background: HBV and HCV infection, have been found to worsen the health of PLWAS, thereby impairing treatments and management. HIV, HBV, and HCV are transmitted through similar routes and hence the presence of infection with any of them could be a risk factor for the others.\u0000\u0000Objective: Determine the prevalence of HBV/HCV co-infection in persons with HIV.\u0000\u0000Method: This was a serological study in persons with HIV. For HBV, the Hepatitis B surface antigen was investigated and the antibodies to HCV for HCV. The study included HIV-positive patients registered with the ART clinic at General Hospital Kaltungo, irrespective of age. Ethical approval was gotten, consent was received from patients, and patient’s information was kept confidential. Prevalence was determined by comparing the total positive test, to the overall study population tested.\u0000\u0000Results: A total of 170 HIV-positive individuals took part in the study. The study had 59 (34.7%) males with mean age (standard deviation) of 40.9 (11.4) years and 111 (65.3%) females, having a Mean (Standard Deviation) of 37.1 (11.0) years.\u0000\u0000The result revealed a statistically significant, high negative association between the viral load values of HIV, HBV and HCV co-infection and marital status (rs=-0.812, rs=-0.812, n=170, p=0.000, at α=0.001 significant level) with a 66% degree of variability. Also, the study observed a high positive, significant association within the viral loads of HIVHBV co-infection and HIVHCV co-infection (rs=-0.762, n=170, p=0.000, at α=0.001 significant level) with a 58% degree of variability using the Spearman correlation.\u0000\u0000Conclusion: Co-infection for HBV was higher than that of HCV. No co-infection with all three viruses was found in this study. This can improve the health and treatment of PLWAS, then screening them for both HBV and HCV, must become a part of the guidelines.","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76485740","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":"Simultaneous infection in a couple by Panton-Valentine leukocidin-positive methicillin-susceptible Staphylococcus aureus related to the USA300 clone","authors":"Takuo Murakami MD, Naohiko Aozasa MD, PhD, Yoshika Suzuki MD, Tomoka Togo MD, Kyohei Miyano MD, PhD, Hiroshi Kaneko, Hidemasa Nakaminami PhD, Yuichiro Tsunemi MD, PhD, Koichiro Nakamura MD, PhD","doi":"10.1002/cia2.12287","DOIUrl":"10.1002/cia2.12287","url":null,"abstract":"<p>We present a case of Panton-Valentine leucocidin-positive methicillin-susceptible <i>Staphylococcus aureus</i> infection in a couple. The isolated bacterium was not methicillin-resistant but was very closely related to the USA300 clone.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15543,"journal":{"name":"Journal of Cutaneous Immunology and Allergy","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cia2.12287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46641553","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}