Iranian Journal of Pathology最新文献

{"title":"Clinicopathological Features of Frontal Fibrosing Alopecia (FFA) in 26 females: A Retrospective Study.","authors":"Maryam Khalili, Nafise Esmaeilpour, Simin Shamsi-Meymandi, Rezvan Amiri, Fatemeh Gheisoori, Mahin Aflatoonian","doi":"10.30699/IJP.2024.2014122.3194","DOIUrl":"10.30699/IJP.2024.2014122.3194","url":null,"abstract":"<p><strong>Background & objective: </strong>FFA usually has a gradual subtle course and might be overlooked by physicians or misdiagnosed with other types of hair loss including androgenetic alopecia, traction alopecia, and other types of patterned alopecia. In this study, we described clinicopathological features of patients with FFA referring for skin biopsy.</p><p><strong>Methods: </strong>This is a retrospective cross-sectional study on 26 patients with a diagnosis of FFA based on clinicopathological features. Firstly, the demographic and clinical features of patients were extracted from an electronic database. Then, skin biopsy specimens were reviewed regarding the presence or absence of hair follicles, site and severity of infiltrations, and presence of fibrosis.</p><p><strong>Results: </strong>Most of the patients were over fifty years of age (57.7%) with a mean age of 50.73 ± 10.03 years. Frontal region involvement was observed in all of the cases. Eyebrow hair loss was observed in 38.5% of cases. The most frequent clinical findings were the absence of vellus hairs in frontotemporal regions (96.2%) and perifollicular erythema (92.3%). The most common pathological features were involvement of the vellus hairs (84.6%), replacement of follicular epithelium with fibrous sheath (80.8%), and destruction of sebaceous glands (69.2%). Peri-infundibular and peri-bulbar interface changes were observed in 50% and 61.5% of skin biopsies, respectively. Perifollicular fibrosis was demonstrated in half of the skin biopsies.</p><p><strong>Conclusion: </strong>FFA is most commonly observed in females after the 5th decade of life. The absence of vellus hairs and the replacement of follicular epithelium with fibrous sheath are the most common clinical and pathological features of the disease, respectively.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 3","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839638","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":"Do Fibroblast Growth Factor Receptor (FGFR) 2 and 3 Proteins Play a Role in Prognosis of Invasive Urothelial Bladder Carcinoma?","authors":"Shereen Fathy Mahmoud, Nanis Shawky Holah, Alshimaa Mahmoud Alhanafy, Marwa Mohammed Serag El-Edien","doi":"10.30699/IJP.2024.2012115.3180","DOIUrl":"10.30699/IJP.2024.2012115.3180","url":null,"abstract":"<p><strong>Background & objective: </strong>Bladder carcinoma ranks second in prevalence among males in Egypt. As a family of tyrosine kinases, fibroblast growth factor receptor (FGFR) dysregulation has been linked to some malignancies in humans. The aim of this study is to analyze the clinicopathological data of patients while investigating FGFR2 and FGFR3 immunohistochemical expression in invasive urothelial bladder carcinoma.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 60 invasive urothelial carcinoma (UC) cases in the Pathology department, Faculty of Medicine, Menoufia University, from 2009 to 2020. All biopsies were stained for FGFR2 and FGFR3 antibodies. Complete clinical data were available for 44 patients treated and followed in clinical oncology and nuclear medicine departments.</p><p><strong>Results: </strong>Advanced stage and high grade are significantly correlated with FGFR2 positivity (<i>P</i>=0.048 and 0.044, respectively). Cases presented with Perineural invasion showed a higher percentage of FGFR2 (<i>P</i>=0.023). There is a significant indirect linear correlation between FGFR3 expression and lymph node positivity (r= -0.265, <i>P</i>=0.041).</p><p><strong>Conclusion: </strong>A high FGFR2 expression could be associated with poor prognostic parameters, while high FGFR3 expression would be associated with good prognostic parameters. These findings might highlight the importance of FGFR-targeted therapy as a FGFR2 antagonist and FGFR3 agonist for the treatment of urothelial carcinoma patients.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 1","pages":"81-88"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306997","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":"Proven Cutaneous Mucormycosis in a COVID-19 Patient: A Case Report and Literature Review.","authors":"Arezoo Salami Khaneshan, Mahsa Falahatinejad, Mahsa Abdorahimi, Mohammadreza Salehi, Farzad Aala, Alireza Abdollahi, Hana Saffar, Sadegh Khodavaisy","doi":"10.30699/IJP.2024.2006768.3143","DOIUrl":"10.30699/IJP.2024.2006768.3143","url":null,"abstract":"<p><p>There has been a rise in COVID-19-associated mucormycosis (CAM) cases, particularly in low-income countries. We describe a case of primary cutaneous mucormycosis after recovering from COVID-19 in a kidney transplant recipient who had a known case of diabetes mellitus. The patient developed cutaneous ulcers due to Rhizopus oryzae in the right hand. She did not recall any trauma or injury at the affected site. Based on the appearance of the wound we suspected that healthcare-associated mucormycosis could be the causative agent. Due to the initial misdiagnosis as a bacterial infection, the appropriate treatment was delayed, and the lesions progressed rapidly to necrotic ulcers with jagged margins that deteriorated during hospitalization. She underwent consecutive surgical interventions and received broad-spectrum antifungal therapy. Finally, the patient deceased after 32 days of hospital stay. We reviewed the previous case reports of cutaneous mucormycosis occurring in COVID-19 patients and described patient characteristics, predisposing factors, location of ulcers, clinical presentation, management, and outcome. This report and existing published literature indicate a poor outcome for cutaneous mucormycosis in COVID-19 patients and the importance of early diagnosis, aggressive multidisciplinary management, and regular follow-up as a life-saving measure, especially in immunocompromised patients.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 2","pages":"259-268"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907841","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":"Clinicopathological Profile of Primary Extra Nodal Lymphoma from a Tertiary Care Center in South India.","authors":"Nischitha N Suvarna, Vidya Monappa","doi":"10.30699/IJP.2024.2018132.3229","DOIUrl":"10.30699/IJP.2024.2018132.3229","url":null,"abstract":"<p><strong>Background & objective: </strong>Primary extranodal lymphoma (pENL) is a malignant lymphoid neoplasm that presents with the main bulk of disease at an extranodal site. The incidence of primary pENL has risen sharply in recent years due to the advent of better diagnostic modalities. Diagnosing pENL can be challenging due to its morphological overlap with other tumors native to the site of origin. This study aims to establish the anatomic distribution, clinical presentations, possible etiologic correlations, and histological subtypes of pENL in a tertiary care center located in South India.</p><p><strong>Methods: </strong>This is a retrospective study of 109 patients with pENL (69 males, 40 females, M: F = 1.7:1) over 5 years (October 2012 to September 2017). The tumors were reclassified according to WHO classification of Haematolymphoid tumors, 5th edition, 2022.</p><p><strong>Results: </strong>pENL constituted 109/481 cases (22.6%) of all NHL cases, with the highest incidence in 7th decade. The gastrointestinal tract (39%) was the predominant site involved, followed by head and neck (26%). Diffuse large B cell lymphoma (DLBCL) was the most common histomorphological variant followed by Follicular lymphoma (FL). The majority of the patients were immunocompetent (89%) and presented with stage IV disease (31.1%) at diagnosis.</p><p><strong>Conclusion: </strong>This study presents an overview of the diverse distribution patterns of both common and rare pENL within a tertiary care center. The accurate diagnosis of pENL necessitates the elimination of secondary extranodal involvement. It is important to note that the accurate diagnosis of pENL requires careful evaluation and exclusion of other possible causes.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 2","pages":"250-258"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11304468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907912","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":"Diagnostic Approach to Adult Erythroderma: A Rare Case of Sezary Syndrome.","authors":"Quri Meihaerani Savitri, Fitria Rettobyan, Linda Astari, Amira Suryani Rahmatika, Muhammad Noor Diansyah, Putu Niken Ayu Amrita, Pradana Zaky Romadhon, Sipirianus Ugroseno Yudho Bintoro, Ami Ashariati, Merlyna Savitri","doi":"10.30699/ijp.2024.2022723.3258","DOIUrl":"10.30699/ijp.2024.2022723.3258","url":null,"abstract":"<p><strong>Background & objective: </strong>Sezary Syndrome is an uncommon leukemic variant of Cutaneous T-cell Lymphoma (CTCL), comprising only 5% of all CTCL cases. The rarity of this syndrome emphasizes the critical need to comprehend its distinct clinical presentation, diagnosis, and treatment.</p><p><strong>Case presentation: </strong>A 51-year-old man was admitted with itchy, persistent, and extensive erythematous patches, ulcers, lumps, lymphadenopathy, alopecia, and nail dystrophy that had been present for eight months. Laboratory findings showed elevated LDH and 𝛽2-microglobulin. Peripheral blood smear analysis confirmed the presence of Sezary cells, while imaging revealed multiple lymph node enlargements. Skin biopsy and immunohistochemistry suggested cutaneous T-cell lymphoma (CTCL), while immunophenotyping verified a diagnosis of Sezary syndrome . The patient underwent fluid therapy, systemic antibiotics, topical antibiotics, phototherapy, and chemotherapy. Tenofovir was given due to the hepatitis B co-infection. Despite the improvement when discharged from the hospital, the patient's health eventually deteriorated, which led to death at home.</p><p><strong>Conclusion: </strong>This patient presented with Sezary Syndrome, exhibiting atypical dermatologic manifestations that must be differentiated from other causes of erythroderma. This case highlights the importance of a comprehensive diagnostic approach, including clinical evaluation, laboratory tests, imaging, and biopsies. Sezary Syndrome is an inherently aggressive malignancy, characterized by a poor response to treatment and a low 5-year survival rate.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"460-466"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543944","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":"International Academy of Cytology Yokohama System for Reporting Breast Cytology and the ACR Breast Imaging Reporting and Data System (BIRADS): Are they Concordant?","authors":"Alka Yadav, Aparna Singh, Sonali Madaan, Mukta Pujani, Sujata Raychaudhuri, Charu Agarwal, Varsha Chauhan, Dipti Sidam, Jyoti Rajpoot, Garima Dhull, Cherry Bansal","doi":"10.30699/ijp.2024.2028955.3300","DOIUrl":"10.30699/ijp.2024.2028955.3300","url":null,"abstract":"<p><strong>Background & objective: </strong>Breast cancer is the leading cause of cancer deaths among women worldwide. Fine needle aspiration cytology (FNAC) and breast sonography have played a pivotal role in the characterization of a breast lump. The main objective of this study was to analyze the correlation between the International Academy of Cytology (IAC) Yokohama for Reporting Breast Fine Needle Aspiration Biopsies (FNAB) and breast imaging reporting and data system (BIRADS) for sonography along with histopathological correlation.</p><p><strong>Methods: </strong>A total of 135 FNAC specimens were categorized according to the IAC Yokohama system and BIRADS reporting system and their correlation with histopathology wherever possible to calculate the risk of malignancy (ROM).</p><p><strong>Results: </strong>According to IAC Yokohama categorization, the cases in categories I, II, III, IV, and V were 1,78,8,6 and 42, respectively. Akin to cytology, most of the cases were assigned BIRADS score two followed by score 6, with the Pearson's correlation coefficient between the IAC Yokohama system for reporting breast cytology and BIRADS scoring system of 1.957 with a P-value < 0.001 (strong correlation). The sensitivity, specificity, PPV, NPV, and DA of FNAC with category III assumed as malignant were 98.9%, 85%, 76.1%, 99.3%, and 89.5%, respectively. Histopathological correlation was available for 90 cases. The ROM for categories II, III, IV, and V was 5.6%,37.5%,100%, and 100%, respectively.</p><p><strong>Conclusion: </strong>IAC Yokohama system of reporting breast cytopathology and BIRADS serves as a common language of communication between pathologists and clinicians and aid in better stratification of the lesions. Both FNAC (minimally invasive) and ultrasound (non-invasive imaging technique) are diagnostic tools that complement each other for patient diagnosis and management.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"400-407"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543959","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":"Oral Mucosal Melanoma and Sinonasal Amelanotic Melanoma: A Summary of Two Unusual Cases.","authors":"Krishnendu Mondal, Rupali Mandal","doi":"10.30699/ijp.2024.2014328.3199","DOIUrl":"10.30699/ijp.2024.2014328.3199","url":null,"abstract":"","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 4","pages":"4474-4476"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543962","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":"COVID-19 Impact on Pathology Education Program in Iran.","authors":"Shabnam Mashhadi, Alireza Abdollahi, Fereshteh Ameli, Fatemeh Nili","doi":"10.30699/IJP.2024.2004823.3130","DOIUrl":"10.30699/IJP.2024.2004823.3130","url":null,"abstract":"<p><strong>Background & objective: </strong>The coronavirus disease brought worldwide uncertainty, and Iran was affected by it as well as many other countries in the world. Halting face-to-face education due to social distancing and resident re-employment in clinical wards leads to defective education. The aim of this survey was to evaluate the advantages and disadvantages of modifications made in pathology residency education in Iran.</p><p><strong>Methods: </strong>This online survey was conducted on all pathology residents in Iran. An online 30-item questionnaire was developed and used in this study.</p><p><strong>Results: </strong>Sixty residents (88.3% female) participated in this survey. The majority (70%) of the residents were over 30 years old. Fifty percent of the responders reported that their personal life was influenced by the pandemic. Skyroom and Adobe Connect were the most common platforms for online education with overall satisfaction of 65%. The webinars were considered suitable by 51.7% of the responders. Concerns at work were reported by 48.3% of the residents, while 78.3% reported being exposed to the disease and 55% reported being infected. Concerns about transmission of the disease to family members were reported by 90% of the responders.</p><p><strong>Conclusion: </strong>This study showed that the pathology residency modifications were successful in providing education. However, their social and educational life characteristics might affect their satisfaction with online education.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 3","pages":"272-276"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839735","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":"Serum C-reactive Protein Levels about Insulin Resistance and Beta Cell Function in Iranian Women with Subclinical Hypothyroidism.","authors":"Amirali Ayatollahi, Zohre Moosavi, Hossein Ayatollahi","doi":"10.30699/IJP.2024.2015823.3213","DOIUrl":"10.30699/IJP.2024.2015823.3213","url":null,"abstract":"<p><strong>Background & objective: </strong>Subclinical hypothyroidism (SCH), is defined as an asymptomatic state characterized by a normal serum concentration of free thyroxine and elevated serum concentration of TSH. This study aims to investigate the complex interplay between hyperinsulinism, insulin resistance, beta cell function, and low-grade chronic inflammation in Iranian women with SCH.</p><p><strong>Methods: </strong>Eighty women with SCH and 80 healthy women as controls matched to the patient group for sex, age, and body mass index (BMI), were enrolled in this prospective cross-sectional study. TSH, free T3, free T4, highly sensitive C-reactive protein (hs-CRP), fasting insulin, fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, Triglyceride, HOMA-IR index, Beta cell function (HOMA-B index) and insulin sensitivity were determined.</p><p><strong>Results: </strong>Hs-CRP was not statistically different between the SCH patients and the control group (3.7±3.2 Vs 3.6±4.0, <i>P</i>>0.05). Total cholesterol and LDL-cholesterol were significantly higher; however, triglyceride and HDL-cholesterol were not statistically different in patients with SCH as compared with the control group. Fasting insulin levels and HOMA-IR and Beta cell function (HOMA-B) were significantly higher in SCH women compared to the control group. A positive correlation between HOMA-IR and HOMA-B with TSH levels was found (r=0.324, r=0.191, <i>P</i><0.05 respectively). A positive correlation between insulin levels and hs-CRP (r=0.22, <i>P</i><0.05), also between insulin levels and TSH (r=0.312, <i>P</i><0.05) and LDL- LDL-cholesterol was obtained (r=0.27, <i>P</i><0.05).</p><p><strong>Conclusion: </strong>Iranian women with SCH may exhibit elevated atherogenic parameters (hyperinsulinemia, LDL-cholesterol, and total cholesterol), HOMA-IR, and HOMA-B.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 3","pages":"326-331"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839855","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":"Sclerosing Microcystic Adenocarcinoma of the Base of Tongue with Signet Ring-Like Cell Component: A Rare Case.","authors":"Parisa Mokhles, Alireza Sadeghipour, Maryam Kadivar, Nasrin Shayanfar, Zahra Keshtpour Amlashi, Pegah Alizade Pahlavan, Ashkan Shafiei","doi":"10.30699/IJP.2023.1989943.3068","DOIUrl":"10.30699/IJP.2023.1989943.3068","url":null,"abstract":"<p><p>Sclerosing microcystic adenocarcinoma (SMA) is an uncommon neoplasm of the oral cavity, with only 14 reported cases documented in the literature. We present a case of SMA in a 65-year-old woman with a history of high-grade lymphoma who developed clear cell changes in the deep muscular layer of the tongue. Currently, the diagnosis of SMA relies on careful morphological evaluation and the exclusion of other potential differential diagnoses.</p>","PeriodicalId":38900,"journal":{"name":"Iranian Journal of Pathology","volume":"19 1","pages":"107-113"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307063","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}