{"title":"Comparison of 7th and 8th American Joint Committee on Cancer Tumor-Node-Metastasis staging in infiltrating ductal carcinoma of the breast: A retrospective study","authors":"Princy Soman, A. Hemalatha, S. Nadipanna, K. Raju","doi":"10.4103/jrcr.jrcr_30_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_30_22","url":null,"abstract":"Context: The American Joint Committee on Cancer (AJCC) staging system is a very important prognostic factor for treating patients with carcinoma breast. There has been a recent change in the staging of breast cancer, from the 7th edition to 8th edition AJCC. Hence, the present study aimed to analyze the stage migration from 7th to 8th edition AJCC staging in infiltrating ductal carcinoma (IDC) and comparison of each staging system with the Nottingham prognostic index (NPI) prognostic scoring system. Aims: The aim is to evaluate the stage migration between the 7th and 8th edition AJCC in IDC of the breast and compare both staging systems with the NPI prognostic scoring system. Settings and Design: In this retrospective study, we collected the clinical and pathological data from 56 IDC cases from January 2019 to June 2021 presenting at our institute. We restaged all the cases as per the prognostic staging system (8th AJCC) and calculated the survival status with NPI as long-term (5-year survival status) follow-up of the cases was not possible. Statistics: Categorical data were represented in the form of frequencies and proportions. Chi-square test or Fischer's exact test (for 2 × 2 tables only) was used as a test of significance for qualitative data. Continuous data were represented as mean and standard deviation. P value was calculated. Results: In this study, majority of the cases were in grade 1 and in Stage II. Among 16 cases in Stage II A, 7 (43.8%) showed down staging and 3 (18.8%) showed up staging, while 12 (70.6%)/17 cases in Stage II B showed down staging. When compared with NPI both 6th and 7th AJCC showed statistical significance. Conclusion: Stage migration (upstaging and down staging) was seen in the 8th edition AJCC when compared to the 7th edition AJCC. Both the staging system correlated with the NPI prognostic index. However, long-term follow-up of these patients must be done to look into the efficacy of the 8th AJCC staging system before changing the treatment protocol.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"48 1","pages":"138 - 143"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76905454","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}
P. Negi, P. Kingsley, J. Jacob, J. Sachdeva, C. Jomi
{"title":"Metabolic syndrome and breast cancer: Is there a cause-and-effect relationship?","authors":"P. Negi, P. Kingsley, J. Jacob, J. Sachdeva, C. Jomi","doi":"10.4103/jrcr.jrcr_43_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_43_22","url":null,"abstract":"Background: Metabolic syndrome (MetS) has an important role in the development as well as the progression of breast cancer (BC). This syndrome is defined as having three or more central obesity, hypertension, insulin resistance, low low-density lipoprotein cholesterol, and high triglycerides (TGs). Multiple studies have demonstrated that early recognition of MetS may have a positive impact on decreasing BC incidence. We compared the prevalence of MetS in newly diagnosed carcinoma breast patients with controls in the general population and thereby provide insight into its role as an emerging risk factor for BC. Patients and Methods: A prospective, case–control study was conducted at Christian Medical College and Hospital, Ludhiana, between September 2018 and October 2019. One hundred and four subjects each of BC and age-matched controls were enrolled. The measurement of waist circumference (WC), blood pressure (BP), fasting blood glucose levels, and lipid profile was performed for women with newly diagnosed BC and controls. Results: MetS was significantly more prevalent among BC (65.4%) compared to controls (30.8%). On assessing each component of MetS, it was evident that the prevalence of WC and BP, as well as the metabolic parameters, namely fasting blood sugar, TGs, and high-density lipoprotein cholesterol, was higher in Group A as compared to Group B. The majority of the women with BC and MetS were postmenopausal. The majority (66.2%) of BC patients with MetS were receptor positive. Conclusions: This study unveils a hidden link between MetS and BC, and hence, BC awareness programs should stress the need for lifestyle changes and healthy living to nip this evil in the bud. Opportunistic screening should be undertaken for women presenting to the medical facility with MetS. Future studies are required to design effective strategies to raise the possibility of MetS as an established risk factor in BC.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"13 1","pages":"144 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86998208","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}
S. Bose, Shyam Sharma, Debojyoti Manna, Linkon Biswas, Suman Ghorai
{"title":"A prospective study to determine the safety and efficacy of contralateral submandibular gland-sparing radiation therapy for oral cavity and oropharyngeal carcinoma","authors":"S. Bose, Shyam Sharma, Debojyoti Manna, Linkon Biswas, Suman Ghorai","doi":"10.4103/jrcr.jrcr_39_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_39_22","url":null,"abstract":"Background and Aim: The submandibular glands (SMGs) contribute 95% of daily salivary flow. Thus, SMG-sparing intensity-modulated radiation therapy (IMRT) may maximize patient-related xerostomia outcomes. However, sparing the SMG is technically quite challenging due to its small size and proximity with suspected disease harboring target lymph node groups. In this study, we assessed the effects of the contralateral SMG (cSMG)-sparing radiation therapy on the treatment outcome and on the xerostomia and other toxicities. Materials and Methods: Patients with squamous cell carcinoma of oral cavity and oropharynx with only unilateral neck node involvement were given cSMG-sparing IMRT either as definitive or postsurgery adjuvant therapy depending on the scenario. During radiotherapy, patients were followed up weekly and after completion of radiation at 6 weeks, 3 months, and at 6 months for assessment of treatment response and evaluation of xerostomia and other toxicities. Results: The mean dose to the cSMG was 33.68 Gy. Immediately after radiotherapy, 25.7% of patients had Grade 2 acute xerostomia which on subsequent follow-up on 3 and 6 months reduced to only 2.9%. In patients, who received postoperative radiotherapy with or without chemotherapy, no incidence of recurrence was noted in the entire follow-up period. About 57.1% of patients who received definitive concurrent chemoradiotherapy showed complete response after 6 months. Conclusion: In well-lateralized oropharyngeal and oral cavity carcinoma, cSMG-sparing IMRT can limit the incidence of xerostomia without compromising tumor control.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"32 1","pages":"128 - 133"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79301223","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}
Aashita, Rajiv Sharma, Vikas K Yadav, Pragyat Thakur
{"title":"Ovarian clear cell carcinoma with bilateral breast metastasis","authors":"Aashita, Rajiv Sharma, Vikas K Yadav, Pragyat Thakur","doi":"10.4103/jrcr.jrcr_38_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_38_22","url":null,"abstract":"Clear cell carcinoma of ovary (CCCO) is a rare subtype of epithelial ovarian tumors that is associated with poorer prognosis due to relative chemoresistance and higher chances of recurrence. Metastasis to the breast is extremely rare. Here, we report a case of ovarian cancer with metastasis to bilateral breasts. A 46-year-old female presented with pain abdomen and mild distension. Examination revealed pelvic mass and bilateral breast lumps. Staging laparotomy and fine-needle aspiration cytology from bilateral breast lumps were done. Histopathology revealed CCCO with metastasis to bilateral breasts. Due to the rarity of CCCO, there are no standard guidelines for management. The patient should be subjected to maximum cytoreduction and chemotherapy. Metastasis to the breast from ovary can occur either due to retrograde lymphatic or hematogenous spread that confers a worse prognosis. Hence, in a patient with breast mass especially with a history of malignancy, breast metastasis should be differentiated from primary breast cancer.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"26 1","pages":"150 - 152"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89580346","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}
Lanisha Sequeira, S. Shankar, Sandesh Rao, D. Fernandes, T. Jacob, H. Krishnaraj
{"title":"Study of comparison of acute toxicities between sequential intensity-modulated radiation therapy and simultaneous integrated boost intensity-modulated radiation therapy in head-and-neck cancers","authors":"Lanisha Sequeira, S. Shankar, Sandesh Rao, D. Fernandes, T. Jacob, H. Krishnaraj","doi":"10.4103/jrcr.jrcr_48_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_48_22","url":null,"abstract":"Purpose: The purpose of this study is to assess and compare the acute toxicities between sequential intensity-modulated radiation therapy and simultaneous integrated boost (SIB) intensity-modulated radiation therapy in head-and-neck cancers using Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Materials and Methods: Patients with histologically proven squamous cell carcinoma of head and neck at the department of radiotherapy (RT), from December 2018 to July 2020, were taken up for this study. Patients were divided into sequential intensity-modulated RT (IMRT) arm and SIB-IMRT arm. Patients treated with sequential IMRT were treated so as to receive a total dose of 70 Gy in 35 fractions, 2 Gy/fractions, 5 fractions per week – 70 Gy in 35 fractions to the primary tumor, 66 Gy in 33 fractions to high-risk clinical target volume (CTV1), 60 Gy in 30 fractions to high-risk CTV2 and 50 Gy in 25 fractions to elective nodes/low-risk CTV3. Patients treated with SIB-IMRT were treated so as to receive a total dose of 66 Gy in 30 fractions – 2.2 Gy/fraction to gross tumor volume/PTV 66, 60 Gy in 30 fractions – 2.0 Gy/fraction to high-risk nodes (PTV 60), 54 Gy in 30 fractions – 1.8 Gy/fraction to elective nodes (PTV 54), respectively. Patients received concurrent chemotherapy with weekly injections cisplatin (35mg/m2) or injection carboplatin (AUC 2). Toxicities were assessed using CTCAE v 4.03. Results: Higher grades of radiation-induced dermatitis and mucositis were observed in patients in SIB-IMRT. No patients experienced Grade 4 toxicity. The results confirm that irradiation according to our SIB-IMRT protocol is a treatment option with acceptable toxicity. Conclusion: SIB-IMRT is feasible, although associated with increased rates of skin and mucosal toxicity.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"1 1","pages":"116 - 121"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74942133","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}
T. Jacob, Sandesh Rao, D. Fernandes, Lanisha Sequeira, HKrishna Raj
{"title":"Study to evaluate the acute toxicities and response to concurrent chemoradiotherapy with weekly cisplatin versus cisplatin and paclitaxel in locally advanced head-and-neck cancer","authors":"T. Jacob, Sandesh Rao, D. Fernandes, Lanisha Sequeira, HKrishna Raj","doi":"10.4103/jrcr.jrcr_47_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_47_22","url":null,"abstract":"Objective: The objective of this study is to assess the acute toxicities and locoregional response rates in patients with locally advanced head-and-neck squamous cell carcinomas with intensity-modulated radiotherapy (IMRT) and weekly cisplatin versus weekly cisplatin and paclitaxel. Methodology: Fifty-four patients with histologically proven squamous cell carcinoma of the head and neck at the department of radiotherapy, at our hospital, were taken up for this study. Patients were allotted to the study and control arm and results were analyzed. All patients were treated with IMRT 70 Gy along with weekly injection cisplatin 35 mg/m2 (control arm) versus IMRT 70 Gy along with weekly injection paclitaxel 30 mg/m2 and injection cisplatin 20 mg/m2 (study arm). The toxicity profile was assessed weekly during treatment and then monthly for 3 months postchemoradiotherapy with Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. The immediate locoregional response rates were assessed clinically postchemoradiotherapy and then monthly for 3 months after concurrent chemoradiotherapy. Results: In this study, oropharyngeal cancer dominated with 52% of patients in the study arm and 47% in the control arm. Most of the patients were in Stage IV a (69%). Toxicities were observed more in the study arm with 59% of patients with Grade 3 mucositis and 52% of patients with Grade 3 dermatitis. Eighty-one percent of patients in the study arm and 70% of patients in the control arm had Grade 3 dysphagia. Grade 2 leukocytopenia was seen in 44% of patients in the study arm and 19% in the control arm. Complete and partial responses at the end of follow-up were 70% and 30% in the study arm and 48% and 52% in the control arm, respectively. Conclusion: Concurrent chemoradiotherapy with injection cisplatin and paclitaxel in locally advanced squamous cell carcinoma of the head and neck has a higher complete response rate with manageable toxicities.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"136 1","pages":"122 - 127"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76445506","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":"Changes in glucose metabolism of the brain after immunochemotherapy in patients with diffuse large B-Cell lymphoma on fluorodeoxyglucose positron emission tomography/computed tomography","authors":"Ogun Bulbul, S. Göksel, Demet Nak","doi":"10.4103/jrcr.jrcr_37_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_37_22","url":null,"abstract":"Objective: Mild cognitive impairment seen after chemotherapy is called chemo brain. Neuropsychological tests mainly diagnose chemo brain, but morphological or functional imaging modalities may also contribute to the diagnosis. This study aimed to examine the change in brain fluorodeoxyglucose (FDG) uptake after immunochemotherapy in patients with diffuse large B-cell lymphoma (DLBCL). Materials and Methods: FDG positron emission tomography/computed tomography images performed for both staging and treatment response evaluation of patients treated with R-CHOP for DLBCL were retrospectively analyzed. It was investigated whether the FDG uptake of the brain decreased after the treatment. Results: There was no significant decrease in FDG uptake in the brain regions of 40 patients treated with R-CHOP compared to pretreatment. There was no significant change in brain FDG uptake after treatment between Ann Arbor Stage 1 or Stage 2 patients and Ann Arbor Stage 3 or Stage 4 patients compared to pretreatment. There was no significant change in brain FDG uptake after treatment compared to pretreatment between patients with Deauville score (DS) 1–3 and patients with DS 4 or 5 according to treatment responses. Patients with the most hypermetabolic lesion SUVmax >30.5 had significantly decreased posttreatment SUVmean in the right basal ganglia, left and right central regions, left cingulate and paracingulate cortices, right striatum, left and right frontal cortices, left occipital cortex, left and right parietal cortices, left and right precunei, and right temporal cortex. Conclusion: FDG uptake decreased in many brain regions after R-CHOP in patients with DLBCL whose lesions showed high FDG uptake.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"87 1","pages":"134 - 137"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75184935","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}
Aashita, Rajiv Sharma, Vikas K Yadav, A. Kapoor, Nisha Singh
{"title":"Pigmented dermatofibrosarcoma protuberans: A case report and review of literature","authors":"Aashita, Rajiv Sharma, Vikas K Yadav, A. Kapoor, Nisha Singh","doi":"10.4103/jrcr.jrcr_33_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_33_22","url":null,"abstract":"Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous sarcoma. Bednar tumor (BT) or pigmented DFSP is a rarely reported variant of it. The only differentiating feature between them is the presence of melanocytes on histopathological examination. We report a case of a 23-year-old female who presented with a recurrent lump in the right thigh that on histopathological evaluation was diagnosed as BT. Less than hundred cases of BT have been recorded to date, with only five cases originating from the thigh. Clinicopathological features of recurrent cases have been compared as local recurrence is less commonly reported.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"30 1","pages":"156 - 159"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87006522","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}
ShahidRashid Sofi, Tauseef Tali, WA Kitab, M. Sofi, M. Lone, A. Najmi, N. Dar
{"title":"Hypofractionated reirradiation by conformal radiotherapy techniques in recurrent anaplastic astrocytoma and glioblastoma multiforme: An observational study at a Tertiary Care Center in North India","authors":"ShahidRashid Sofi, Tauseef Tali, WA Kitab, M. Sofi, M. Lone, A. Najmi, N. Dar","doi":"10.4103/jrcr.jrcr_10_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_10_22","url":null,"abstract":"Aim and Objectives: The aims and objectives of the study were to assess the progression-free survival (PFS) and overall survival, local tumor control rate (response rate), effect on the quality of life, and treatment-related toxicities in all patients diagnosed with recurrent high-grade gliomas (HGGs). Methodology: The present study was conducted between September 2017 and July 2019 in the Department of Radiation Oncology, Sheri Kashmir Institute of Medical Sciences and included a total of 22 patients. The study included recurrent HGGs (Grade III/IV) Operated Cases of Grade III and Grade IV. Results: The majority of our patients were between the age group of 40–60 years (45.5%). There were 12 males (54.5%) and 10 females (45.5%). GBM was the most common diagnosis in 13 (59.1) patients and 9 (40.9%) were anaplastic astrocytoma. Sixteen patients were diagnosed as recurrent HGG radiologically. Sixteen (72.7%) patients achieved partial response and 6 (27.3%) achieved stable disease. The median PFS was 2.8 months and the median overall survival was 4.2 months. Conclusion: Reirradiation is one of the treatment options for recurrent HGGs and conformal intensity-modulated radiotherapy can be effective treatment modality for recurrent high-grade brain tumors with only mild side effects. Although survival is better in patients with good performance status and young age.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"25 1","pages":"33 - 36"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72671089","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}
Sujata Sarkar, I. Bashir, R. Yotham, Ritesh Sharma
{"title":"A rare case of mantle cell lymphoma of nasopharynx and larynx with synchronous presentation treated with volumetric modulated arc technique radiotherapy","authors":"Sujata Sarkar, I. Bashir, R. Yotham, Ritesh Sharma","doi":"10.4103/jrcr.jrcr_11_22","DOIUrl":"https://doi.org/10.4103/jrcr.jrcr_11_22","url":null,"abstract":"Mantle cell lymphoma (MCL) or mature peripheral B-cell lymphoid neoplasm is a type of non-Hodgkin's lymphoma. It is more common in elderly males. It is very rare, accounting for less than 1% of head and neck malignancies. MCL is usually positive for CD20, CD5, CD43, cyclin D1 and negative for CD10, CD23, and BCL6. It is a very aggressive neoplasm, and hence, patients often present in advanced stage. Due to its rare incidence and short clinical course, there are limited data on standard treatment protocols. Even with the present treatment protocols, only 30% of patients achieve complete response. Here, we present a case of synchronous presentation of MCL of the nasopharynx and larynx in a 69-year-old male. We aim to discuss the investigations and treatment done with volumetric modulated arc technique radiotherapy that led to complete response.","PeriodicalId":16923,"journal":{"name":"Journal of Radiation and Cancer Research","volume":"311 1","pages":"49 - 51"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79989093","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}