Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes最新文献

{"title":"Breast Biopsy Marker: Is Bigger Better?","authors":"Mona El Khoury, Lilia Maria Sanchez, Benoit Mesurolle","doi":"10.1177/08465371211034400","DOIUrl":"https://doi.org/10.1177/08465371211034400","url":null,"abstract":"Mammographically-detected cancers and cancers that underwent neoadjuvant therapy are small and may be challenging to localize pre-operatively unless a marker is left during the biopsy that helps in their detection and subsequent localization prior to surgery especially if complete response is achieved after neoadjuvant chemotherapy. Since their initial introduction in 1990s, more and more, larger markers with a 3D shape are used such as Ultracor Twirl (Nitinol ring shaped) or Hologic Professional Tumark (known to expand into different shapes upon deployment) and hygroscopic sonographically detectable markers such as HydroMark with an expansile hydrogel component that absorbs the surrounding fluid allowing long-term visibility. The main disadvantage reported in breast tissue markers is their possible dislodgment especially if deployed under stereotactic guidance. To our best knowledge, no study has highlighted any difficulties related to these markers, more specifically their size, during pathologic analysis. In fact, when the excised specimen is submitted to the pathology suite, a specimen radiograph is obtained to identify the biopsy marker used as a landmark for the targeted lesion before painting all the surfaces of the specimen with India ink to help define the margins. Subsequently, the marker and radioactive seed, if used for localization, are withdrawn to allow serial sectioning across the specimen and hence, margin assessment. If not carefully done, manipulating the lumpectomy specimen to extrude the marker, can lead to fragmentation of the specimen hence difficulty assessing the margins. This risk is likely higher in case of small ill-defined lesions especially, those altered by neoadjuvant chemotherapy and when a large marker is embedded. One of our patients, recently underwent breast conservative surgery for a 0.5 cm invasive lobular carcinoma after which, re-operation to achieve negative margins was mandatory since initial assessment of the margins was extremely difficult due to fragmentation while retrieving the Ultracor Twirl marker deployed after the biopsy. Good sonographic visibility of a large biopsy marker eases pre-operative localization at the risk of shattering the tumor into pieces at retrieval, hence suboptimal margin assessment. Since these markers are more and more used, meticulous handling of the specimen in pathology, is mandatory.","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"275"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211034400","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39287355","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":"Addressing Radiology Burnout During the COVID-19 Pandemic.","authors":"Nanxi Zha","doi":"10.1177/08465371211036971","DOIUrl":"https://doi.org/10.1177/08465371211036971","url":null,"abstract":"","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"273"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39315035","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":"Which Aspects of the CanMEDS Competencies are Most Valued in Radiologists? Perspectives of Trainees From Other Specialties.","authors":"Stefanie Y Lee,&nbsp;Namita Sharma,&nbsp;Yoan K Kagoma,&nbsp;P Andrea Lum","doi":"10.1177/08465371211008649","DOIUrl":"https://doi.org/10.1177/08465371211008649","url":null,"abstract":"<p><strong>Purpose: </strong>Radiologists work primarily in collaboration with other healthcare professionals. As such, these stakeholder perspectives are of value to the development and assessment of educational outcomes during the transition to competency-based medical education. Our aim in this study was to determine which aspects of the Royal College CanMEDS competencies for diagnostic radiology are considered most important by future referring physicians.</p><p><strong>Methods: </strong>Institutional ethics approval was obtained. After pilot testing, an anonymous online survey was sent to all residents and clinical fellows at our university. Open-ended questions asked respondents to describe the aspects of radiologist service they felt were most important. Thematic analysis of the free-text responses was performed using a grounded theory approach. The resulting themes were mapped to the 2015 CanMEDS Key Competencies.</p><p><strong>Results: </strong>115 completed surveys were received from residents and fellows from essentially all specialties and years of training (out of 928 invited). Major themes were 1) timeliness and accessibility of service, 2) quality of reporting, and 3) acting as a valued team member. The competencies identified as important by resident physicians were largely consistent with the CanMEDS framework, although not all key competencies were covered in the responses.</p><p><strong>Conclusions: </strong>This study illustrates how CanMEDS roles and competencies may be exemplified in a concrete and specialty-specific manner from the perspective of key stakeholders. Our survey results provide further insight into specific objectives for teaching and assessing these competencies in radiology residency training, with the ultimate goal of improving patient care through strengthened communication and working relationships.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"30-37"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211008649","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38916407","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":"Current Status of Contrast Enhanced Mammography: A Comprehensive Review.","authors":"Anat Kornecki","doi":"10.1177/08465371211029047","DOIUrl":"https://doi.org/10.1177/08465371211029047","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this article is to provide a detailed and updated review of the physics, techniques, indications, limitations, reporting, implementation and management of contrast enhanced mammography.</p><p><strong>Background: </strong>Contrast enhanced mammography (CEM), is an emerging iodine-based modified dual energy mammography technique. In addition to having the same advantages as standard full-field digital mammography (FFDM), CEM provides information regarding tumor enhancement, relying on tumor angiogenesis, similar to dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). This article reviews current literature on CEM and highlights considerations that are critical to the successful use of this modality.</p><p><strong>Conclusion: </strong>Multiple studies point to the advantage of using CEM in the diagnostic setting of breast imaging, which approaches that of DCE-MRI.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"141-156"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39394814","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":"Neuroimaging Findings of Hospitalized Covid-19 Patients: A Canadian Retrospective Observational Study.","authors":"Vibeeshan Jegatheeswaran,&nbsp;Michael W K Chan,&nbsp;Sumon Chakrabarti,&nbsp;Adrian Fawcett,&nbsp;Yingming Amy Chen","doi":"10.1177/08465371211002815","DOIUrl":"https://doi.org/10.1177/08465371211002815","url":null,"abstract":"<p><strong>Purpose: </strong>Coronavirus disease (COVID-19) has been associated with neurologic sequelae and neuroimaging abnormalities in several case series previously. In this study, the neuroimaging findings and clinical course of adult patients admitted with COVID-19 to a tertiary care hospital network in Canada were characterized.</p><p><strong>Methods: </strong>This is a retrospective observational study conducted at a tertiary hospital network in Ontario, Canada. All adult patients with PCR-confirmed COVID-19 admitted from February 1, 2020 to July 22, 2020 who received neuroimaging related to their COVID-19 admission were included. CT and MR images were reviewed and categorized by fellowship-trained neuroradiologists. Demographic and clinical data were collected and correlated with imaging findings.</p><p><strong>Results: </strong>We identified 422 patients admitted with COVID-19 during the study period. 103 (24.4%) met the inclusion criteria and were included: 30 ICU patients (29.1%) and 73 non-ICU patients (70.9%). A total of 198 neuroimaging studies were performed: 177 CTs and 21 MRIs. 17 out of 103 imaged patients (16.8%) had acute abnormalities on neuroimaging: 10 had macrohemorrhages (58.8%), 9 had acute ischemia (52.9%), 4 had SWI abnormalities (23.5%), and 1 had asymmetric sulcal effacement suggesting possible focal encephalitis (5.8%). ICU patients were more likely to have positive neuroimaging findings, more specifically acute ischemia and macrohemorrhages (<i>P</i> < 0.05). Macrohemorrhages were associated with increased mortality (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Macrohemorrhages, acute ischemia and SWI abnormalities were the main neuroimaging abnormalities in our cohort of hospitalized COVID-19 patients. Acute ischemia and hemorrhage were associated with worse clinical status.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"179-186"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211002815","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38895558","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":"Arteries of the Lower Limb-Embryology, Variations, and Clinical Significance.","authors":"Emmad Qazi,&nbsp;Joerg Wilting,&nbsp;Neeral R Patel,&nbsp;Abdullah O Alenezi,&nbsp;Sean A Kennedy,&nbsp;Kong T Tan,&nbsp;Arash Jaberi,&nbsp;Sebastian Mafeld","doi":"10.1177/08465371211003860","DOIUrl":"https://doi.org/10.1177/08465371211003860","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this article is to review the embryology of the lower limb arterial anatomy along with common variants and their clinical relevance.</p><p><strong>Design: </strong>Embryologic variations of the lower limb arterial system may be explained by i.) persistence of primordial arterial segments, ii.) abnormal fusion, iii.) segmental hypoplasia/absence, or a combination of both. Persistent sciatic artery, corona mortis, and popliteal entrapment syndrome will also be discussed with associated symptoms, and potential complications.</p><p><strong>Conclusion: </strong>Knowledge of these variations is essential for surgical and endovascular management as failure to recognize them can result in complications.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"259-270"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211003860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38905403","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":"Evaluation of Low-Dose Multidetector Computed Tomography Whole Gastroenterography With Oral Administration of Contrast Agents.","authors":"Yong Guo,&nbsp;Qing-Jun Wang,&nbsp;Li-Jing Shi,&nbsp;Ying-Ying Hu,&nbsp;Wen-Ping Li","doi":"10.1177/0846537119897143","DOIUrl":"https://doi.org/10.1177/0846537119897143","url":null,"abstract":"Purpose: To evaluate the degree of gastric, enteric, colonic, and rectal filling in multidetector computed tomography (MDCT) whole gastroenterography. Methods: In this prospective study involving 124 patients, 78 and 46 patients underwent MDCT whole gastroenterography using positive and neutral oral contrast agents, respectively. The degree of filling of the stomach, small and large bowel, was qualitatively analyzed by experienced radiologists using a 3-point scoring system. Results: The majority of patients received a score of ≥2 for small intestine filling using both positive and neutral contrast agents (90.5% and 78.2%, respectively), and <9% of the patients had a score of 0. The highest score for the degree of filling in the small intestine was observed in the ileum, followed by the duodenum and jejunum. There was a significant difference in the degree of filling achieved with positive and neutral contrast agents in the duodenum (P = .013) and jejunum (P = .047). More than 74% of cases had an optimal filling of the stomach, whereas >80% of the cases had an optimal filling of the colorectal segments. Only ≤5.1% had a score of 0 for the analyzed segments of the colorectum. Positive and neutral contrast agents were associated with similar degree of filling in the stomach and colon segments without a significant difference in the extent of contrast agent filling (P > .05). Conclusions: Multidetector computed tomography whole gastroenterography was found to be a simple, safe, noninvasive, painless, and effective modality for the diagnosis of stomach and bowel complications in clinical settings.","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"410-417"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537119897143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37651384","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":"Competency-Based Medical Education in Radiology: A Survey of Medical Student Perceptions.","authors":"Joseph Yang,&nbsp;Danny Jomaa,&nbsp;Omar Islam,&nbsp;Benedetto Mussari,&nbsp;Corinne Laverty,&nbsp;Benjamin Yin Ming Kwan","doi":"10.1177/0846537119893663","DOIUrl":"https://doi.org/10.1177/0846537119893663","url":null,"abstract":"<p><strong>Purpose: </strong>Implementing competency-based medical education in diagnostic radiology residencies will change the paradigm of learning and assessment for residents. The objective of this study is to evaluate medical student perceptions of competency-based medical education in diagnostic radiology programs and how this may affect their decision to pursue a career in diagnostic radiology.</p><p><strong>Methods: </strong>First-, second-, and third-year medical students at a Canadian university were invited to complete a 14-question survey containing a mix of multiple choice, yes/no, Likert scale, and open-ended questions. This aimed to collect information on students' understanding and perceptions of competency-based medical education and how the transition to competency-based medical education would factor into their decision to enter a career in diagnostic radiology.</p><p><strong>Results: </strong>The survey was distributed to 300 medical students and received 63 responses (21%). Thirty-seven percent of students had an interest in pursuing diagnostic radiology that ranged from interested to committed and 46% reported an understanding of competency-based medical education and its learning approach. The implementation of competency-based medical education in diagnostic radiology programs was reported to be a positive factor by 70% of students and almost all reported that breaking down residency into measurable milestones and required case exposure was beneficial.</p><p><strong>Conclusions: </strong>This study demonstrates that medical students perceive competency-based medical education to be a beneficial change to diagnostic radiology residency programs. The changes accompanying the transition to competency-based medical education were favored by students and factored into their residency decision-making.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"352-358"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537119893663","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37681966","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":"The Role of Combined Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced MRI for Differentiating Malignant From Benign Breast Lesions Presenting Washout Curve.","authors":"Sehnaz Tezcan,&nbsp;Funda Ulu Ozturk,&nbsp;Nihal Uslu,&nbsp;Eda Yilmaz Akcay","doi":"10.1177/0846537120907098","DOIUrl":"https://doi.org/10.1177/0846537120907098","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to evaluate the diagnostic performance of combined breast magnetic resonance imaging (MRI) protocol including dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with enhancing lesions that demonstrated washout curve and to determine whether applying apparent diffusion coefficient (ADC) cutoff value could improve the diagnostic value of breast MRI.</p><p><strong>Methods: </strong>The retrospective study included 116 patients with 116 suspicious breast lesions, which showed washout curve on DCE-MRI, who underwent subsequent biopsy. Morphologic characteristics on DCE-MRI and ADC values on DWI were evaluated. Apparent diffusion coefficient values and morphologic features of benign and malignant lesions were compared. Diagnostic values of DCE-MRI and combined MRI, including DCE-MRI and DWI (applying an ADC cutoff value) for distinguishing malignancy from benign lesions, were calculated.</p><p><strong>Results: </strong>Of the 116 breast lesions, 79 were malignant and 37 were benign. The ADC value of malignant tumors (median ADC, 0.72 × 10^-3 mm²/s) was significantly lower than that of benign lesions (median ADC, 1.03 × 10^-3 mm²/s; <i>P</i> < .000). The sensitivity and specificity of an ADC cutoff value of 0.89 × 10^-3 mm²/s were 92% and 95%, respectively. Dynamic contrast-enhanced MRI alone presented 100% sensitivity and 59.4% specificity. Adding an ADC cutoff value of 0.89 × 10^-3 mm²/s provided 100% sensitivity and 81% specificity, which would have prevented biopsy for 21.6% of benign lesions without missing any malignancies.</p><p><strong>Conclusion: </strong>Applying an ADC cutoff value to DCE-MRI provides an improvement in the diagnostic value of breast MRI for differentiating among lesions presenting washout curve.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"460-469"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120907098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37725846","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":"Comparison of Baseline, Bone-Subtracted, and Enhanced Chest Radiographs for Detection of Pneumothorax.","authors":"Fatemeh Homayounieh,&nbsp;Subba R Digumarthy,&nbsp;Jennifer A Febbo,&nbsp;Sherief Garrana,&nbsp;Chayanin Nitiwarangkul,&nbsp;Ramandeep Singh,&nbsp;Ruhani Doda Khera,&nbsp;Matthew Gilman,&nbsp;Mannudeep K Kalra","doi":"10.1177/0846537120908852","DOIUrl":"https://doi.org/10.1177/0846537120908852","url":null,"abstract":"<p><strong>Purpose: </strong>To assess and compare detectability of pneumothorax on unprocessed baseline, single-energy, bone-subtracted, and enhanced frontal chest radiographs (chest X-ray, CXR).</p><p><strong>Method and materials: </strong>Our retrospective institutional review board-approved study included 202 patients (mean age 53 ± 24 years; 132 men, 70 women) who underwent frontal CXR and had trace, moderate, large, or tension pneumothorax. All patients (except those with tension pneumothorax) had concurrent chest computed tomography (CT). Two radiologists reviewed the CXR and chest CT for pneumothorax on baseline CXR (ground truth). All baseline CXR were processed to generate bone-subtracted and enhanced images (ClearRead X-ray). Four radiologists (R1-R4) assessed the baseline, bone-subtracted, and enhanced images and recorded the presence of pneumothorax (side, size, and confidence for detection) for each image type. Area under the curve (AUC) was calculated with receiver operating characteristic analyses to determine the accuracy of pneumothorax detection.</p><p><strong>Results: </strong>Bone-subtracted images (AUC: 0.89-0.97) had the lowest accuracy for detection of pneumothorax compared to the baseline (AUC: 0.94-0.97) and enhanced (AUC: 0.96-0.99) radiographs (<i>P</i> < .01). Most false-positive and false-negative pneumothoraces were detected on the bone-subtracted images and the least numbers on the enhanced radiographs. Highest detection rates and confidence were noted for the enhanced images (empiric AUC for R1-R4 0.96-0.99).</p><p><strong>Conclusion: </strong>Enhanced CXRs are superior to bone-subtracted and unprocessed radiographs for detection of pneumothorax.</p><p><strong>Clinical relevance/application: </strong>Enhanced CXRs improve detection of pneumothorax over unprocessed images; bone-subtracted images must be cautiously reviewed to avoid false negatives.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"519-524"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120908852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37749797","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}