Turkish Journal of Pathology最新文献

{"title":"Analysis of the Relationship Between EGFR Mutations and PD-L1, ALK, and ROS1 Alterations in Patients with Non- Small-Cell Lung Cancer: The Most Extensive Study Conducted in Iran.","authors":"Sepideh Hadimaleki, Roham Sarmadian, Abolfazl Gilani, Parisa Mehrasa, Ali Esfahani, Mortaza Raeisi, Yousef Roosta, Amir Vahedi","doi":"10.5146/tjpath.2025.13827","DOIUrl":"https://doi.org/10.5146/tjpath.2025.13827","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer, the second most common type of cancer, is the leading cause of cancer-related mortality, with non-small-cell lung carcinoma (NSCLC) being the most prevalent subtype. The presence of EGFR mutations in NSCLC influences tumor behavior and treatment response. The prevalence of EGFR mutation in Iranian patients is limited. This study investigated the frequency of EGFR mutation and its association with PD-L1, ALK, and ROS1 expression in patients with NSCLC from Northwest Iran.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 647 cases of NSCLC from April 2018 to August 2024 at Imam Reza Hospital in Tabriz, Iran. Histologic diagnoses were confirmed, and patient data were collected. EGFR mutation testing targeted exons 18-21 using Sanger sequencing and Real-Time PCR. ALK and ROS1 rearrangements were assessed using fluorescence in situ hybridization (FISH), while PD-L1 expression was evaluated through immunohistochemistry (IHC). The statistical analysis was performed using SPSS version 27.0.</p><p><strong>Results: </strong>The cohort comprised 430 males and 217 females, with a median age of 62 years (IQR: 54-70). EGFR mutations were identified in 171 (26.4%) cases, more frequently in females (33.6% vs. 22.8%; p = 0.003). The most common mutation was exon 19 deletion (56.7%), followed by L858R (21.6%). No significant association was found between EGFR mutations and ALK (p = 0.126) or PD-L1 expressions ( p = 0.29). ROS1 mutations were not detected.</p><p><strong>Conclusion: </strong>This study confirmed the mutual exclusivity of EGFR and ALK mutations and found no significant association with PD-L1. Comprehensive EGFR testing remains crucial to guide targeted therapies. Broader studies are needed to include diverse populations and additional clinical factors to improve personalized treatment.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050697","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":"Tumor Budding as an Independent Prognostic Histopathological Marker in Oral Squamous Cell Carcinoma - An Indian Tertiary Care Center Experience.","authors":"Anand Vijaya Narayanan, Krishnapriya Umashankar, Sithara Aravind, Sangeetha K Nayanar, Sandeep Vijay","doi":"10.5146/tjpath.2025.13761","DOIUrl":"10.5146/tjpath.2025.13761","url":null,"abstract":"<p><strong>Objective: </strong>Oral squamous cell carcinoma is the most common head and neck malignancy reported worldwide. Tumor budding represents a histopathological feature characterized by the presence of isolated single/small clusters of cancer cells dispersed within the stroma at the invasive tumor front. Its prognostic significance has not been studied much in lip and oral squamous cell carcinomas in India. The aim of this study was to investigate the prognostic role of tumor budding in a large single-center retrospective cohort of 333 patients with oral squamous cell carcinoma at a tertiary cancer center in North Kerala, India.</p><p><strong>Material and methods: </strong>The primary resection slides of 333 patients with oral squamous cell carcinoma from 2018 to 2020 were retrieved from the pathology archives and were evaluated by two independent pathologists for tumor budding and other histopathological parameters. The survival data were collected from the patient files.</p><p><strong>Results: </strong>We found a significant association between tumor budding and other known histopathological prognosticators using Chi-square analysis. Univariate logistic analysis showed tumor budding, depth of invasion ( > 10 mm), worst pattern of invasion 5, and perineural invasion were significantly associated with locoregional recurrence/distant metastasis. Multivariate logistic regression analysis identified tumor budding as an independent prognostic marker for locoregional recurrence/distant metastasis. Univariate cox proportionality analysis showed that tumor budding, depth of invasion ( > 10 mm), worst pattern of invasion 5, pathological T4 stage, and perineural invasion were associated with decreased overall survival and poor disease-free survival in patients with oral squamous cell carcinoma. Multivariate cox proportionality analysis showed tumor budding as the only independent predictor for decreased overall survival and poor disease-free survival.</p><p><strong>Conclusion: </strong>Based on this study, we can conclude that tumor budding is a simple and a reliable independent prognosticator that facilitates personalized management in patients with oral squamous cell carcinoma.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"31-41"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650765","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":"Role of PD-L1 in the Pathogenesis of Pre-Eclampsia and Its Association with Adverse Fetal Outcomes.","authors":"Sonal Tripathi, Kachnar Varma, Vatsala Misra","doi":"10.5146/tjpath.2025.13658","DOIUrl":"10.5146/tjpath.2025.13658","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia is a pregnancy-specific disorder characterized by impaired maternal-fetal immune tolerance. The maternal immune system plays a crucial role in maintaining pregnancy, and its dysfunction is believed to contribute to preeclampsia. Immune checkpoint molecules such as programmed cell death protein 1 (PD-1) and its ligand, programmed death ligand 1 (PD-L1), may play a key role in this process. This study evaluated PD-L1 expression in the placentae of patients with pre-eclampsia (PE) and eclampsia (EC). We also compared PD-L1 expression with histomorphological features and fetal outcomes.</p><p><strong>Material and methods: </strong>A prospective case-control study was conducted, including fifty pre-eclampsia cases, twenty-five eclampsia cases, and twenty-five normal pregnancy controls. Detailed clinicopathological data, histomorphological features of the placenta, and fetal outcomes were collected. PD-L1 expression was assessed using immunohistochemistry, with a semi-quantitative scoring system. The relationship between PD-L1 expression, histopathological scores, and fetal outcomes was also evaluated.</p><p><strong>Results: </strong>In this study, a lower expression of PD-L1 was observed in pre-eclampsia and eclampsia as compared to a normal pregnancy. Adverse fetal outcomes were associated with lower PD-L1 expression and with reduced placental weight and high histopathological scores ( > 5).</p><p><strong>Conclusion: </strong>Lower PD-L1 expression was observed in pre-eclampsia and eclampsia compared to normal pregnancies. Reduced PD-L1 expression correlated with histomorphological changes in the placenta and adverse fetal outcomes.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112301","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":"Carcinoma Cuniculatum Masquerading as Eumycetoma: An Unacquainted Entity Posing a Diagnostic Dilemma.","authors":"Pooja Sharma, Pragya Jain, Ankur Garg, Sonal Sharma","doi":"10.5146/tjpath.2024.13373","DOIUrl":"10.5146/tjpath.2024.13373","url":null,"abstract":"<p><p>Carcinoma cuniculatum (CC) is a rare and distinct clinicopathological variant of well-differentiated squamous cell carcinoma. It is a rare and slow-growing tumor with a peculiar infiltrative growth pattern resembling rabbit burrows (cuniculi). It usually occurs over the plantar aspect of the foot but can also occur at other sites like the oral cavity and genitals. The pathogenesis is unknown, with various hypotheses of trauma as proposed by different authors. It is essential to be aware of this entity as it commonly mimics benign and other low-grade squamous cell carcinoma (SCC). Diagnosis of CC can be challenging and requires repeated histological evaluation and clinical correlation. Herein, we present a case report of CC of the plantar and dorsal aspect of the foot in a 60-year-old male with a history of multiple chronic non-healing ulcers, which was clinically suspected as eumycetoma and remained inconclusive on numerous biopsies.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"65-69"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564798","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":"Role of HEG1 and Claudin-4 Immunohistochemistry in the Differential Diagnosis of Lung Adenocarcinoma from Malignant Mesothelioma in Pleural Effusion Cytology.","authors":"Aziza E Abdelrahman, Fatma A Elbadry, Taiseer R Ibrahim, Mohamed Ali Alabiad, Mohamed Awad","doi":"10.5146/tjpath.2025.13801","DOIUrl":"10.5146/tjpath.2025.13801","url":null,"abstract":"<p><strong>Objective: </strong>Cytological examination of pleural effusion is minimally invasive and low risk but faces challenges due to the lack of architectural features, low cell counts, and overlapping characteristics among reactive mesothelial cells (RMCs), carcinoma cells, and malignant epithelioid mesothelioma (MPM) cells. The aim of this was study to detect the diagnostic accuracy of the expression of HEG1 and Claudin-4 in distinguishing malignant mesothelioma from lung adenocarcinoma in pleural effusion.</p><p><strong>Material and methods: </strong>The present study was carried out on 84 cases of pleural effusion. Sixty-four representative cell blocks of the studied malignant cases and twenty control cases were stained with HEG1 and Claudin-4 immunostaining, and the results were recorded.</p><p><strong>Results: </strong>Positive membranous HEG1 immunoexpression was found in 95% of RMCs in benign effusions. Also, positive membranous HEG1 immunoexpression was found in 96% of cases of MPM, and only 2.6% of lung adenocarcinoma cases. There was a statistically significant difference between benign effusion with RMCs and lung adenocarcinoma immunoreactivity. There was a highly statistically significant difference between HEG1 immunoexpression in MPM and lung adenocarcinoma. On the other hand, all cases of benign effusions and all MPM cases had negative Claudin-4 immunoexpression while positive membranous Claudin-4 immunoexpression was found in 94.9% of lung adenocarcinoma cases. There was a statistically significant difference in immunoexpression of Claudin-4 between benign effusion and lung adenocarcinoma. There was a statistically significant difference in the immunoexpression of Claudin-4 between MPM and lung adenocarcinoma.</p><p><strong>Conclusion: </strong>HEG1 and Claudin-4 IHC staining is extremely valuable in the differential diagnosis between reactive or malignant mesothelial cells and adenocarcinoma in pleural effusion.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":"42-50"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650374","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":"Inflammation-Associated Long Non-Coding RNAs (lncRNAs) in Chronic Viral Hepatitis- Associated Hepatocellular Carcinoma.","authors":"Burcin Pehlivanoglu, Anil Aysal, Cihan Agalar, Tufan Egeli, Mucahit Ozbilgin, Tarkan Unek, Ilkay Tugba Unek, Ilhan Oztop, Safiye Aktas, Ozgul Sagol","doi":"10.5146/tjpath.2024.13593","DOIUrl":"10.5146/tjpath.2024.13593","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify the expression profile and prognostic significance of inflammation-associated lncRNAs in chronic viral hepatitis (CVH) and CVH-associated hepatocellular carcinoma (CVH-HCC).</p><p><strong>Material and methods: </strong>In the first step, lncRNA expression analysis was performed by real-time polymerase chain reaction (RT-PCR) using an array panel of 84 inflammation-associated lncRNAs in 48 formalin-fixed paraffin-embedded (FFPE) tissue samples (12 CVH-HCC, 12 peritumoral cirrhotic parenchyma, 12 nontumoral cirrhotic CVH parenchyma, 12 normal liver samples). In the second step, 7 lncRNAs (DLEU2, HOTAIR, LINC00635, LINC00662, RP11-549J18.1, SNHG16 and XIST) were chosen for RT-PCR assay testing in 72 samples (24 CVH-HCC, 24 peritumoral cirrhotic parenchyma, 24 nontumoral cirrhotic CVH parenchyma samples).</p><p><strong>Results: </strong>Fifty-six inflammation-associated lncRNAs were significantly up-regulated in the peritumoral cirrhotic parenchyma compared to the normal liver. Expression of 71 lncRNAs was significantly higher in peritumoral cirrhotic parenchyma compared to cirrhotic CVH parenchyma. DLEU2 and SNHG16 were up-regulated both in the tumor and peritumoral cirrhotic parenchyma compared to cirrhotic CVH parenchyma. Expression of LINC00662 was significantly higher in CVH-HCC than in cirrhotic CVH parenchyma. Expression of XIST was also increased in both tumor and peritumoral parenchyma samples, albeit without statistical significance. No significant association was found between lncRNA expressions and survival.</p><p><strong>Conclusion: </strong>Inflammation-associated lncRNAs DLEU2, SNHG16, LINC00662, and XIST are candidate diagnostic biomarkers in CVH-HCC. More evidence is needed to prove their utility as prognostic markers.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":"1-8"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477246","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":"Cytohistological Correlation of Thyroid Cases with Emphasis on Papillary Thyroid Carcinoma and Analysis of the Causes of Diagnostic Errors on Cytology.","authors":"Soundarya Soundarya, S Mary Theresa-Sylvia, Banushree Chandrasekhar Srinivasamurthy","doi":"10.5146/tjpath.2025.13787","DOIUrl":"10.5146/tjpath.2025.13787","url":null,"abstract":"<p><strong>Objective: </strong>Fine needle aspiration cytology is the first line of investigation for thyroid lesions. Despite standard reporting formats, the diagnostic accuracy varies across institutions. In this study, we have reviewed our discordant cases on cytology and histopathology and analyzed the diagnostic errors.</p><p><strong>Material and methods: </strong>The thyroid cases with discrepant cytology and histopathology reports for a period of five years were analyzed for diagnostic errors. The papillary thyroid carcinoma (PTC) cases were studied in detail for all diagnostic parameters. Nuclear scoring was used to improve the detection of PTC.</p><p><strong>Results: </strong>Of the 166 cases, 18 (10%) had discrepant diagnoses. The sensitivity was 65.62% (CI 46.81-81.43%), specificity 94.78%, positive predictive value 75%, negative predictive value 92.03%, positive likelihood ratio 12.56, negative likelihood ratio 0.36, false positive rate 5.2%, false negative rate 34.3% and accuracy 89.16%. False negative (malignant cases diagnosed as benign) was due to inadequate/wrong site sampling, benign clusters/ cyst macrophages, marginal flares, thin colloid, larger fragments of calcification, and subtle nuclear features. An interesting flower head-like structure was observed in PTC cases. Nuclear scoring on false negative cases improved our diagnostic accuracy. False positivity was due to vigorous aspiration and over-interpretation of nuclear features.</p><p><strong>Conclusion: </strong>Analysis of our discrepant cases highlighted the importance of multiple passes, sampling all nodules, and ultrasound-guided aspiration to reduce sampling error. Application of nuclear scoring reduced overdiagnosis and missing out on PTC. Tissue fragments and hypercellularity were the major misleading factors in false positive cases.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":"1 1","pages":"51-58"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005482","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":"Exploring Tumor Microenvironment in Breast Cancer: Parameters that can be Assessed with Light Microscopy.","authors":"Seetu Palo","doi":"10.5146/tjpath.2024.13748","DOIUrl":"10.5146/tjpath.2024.13748","url":null,"abstract":"","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591841","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":"A Rare Case of Primary Ovarian Mucinous Carcinoma with Signet-Ring Cells and Literature Review.","authors":"Fatma Gundogdu, Alp Usubutun","doi":"10.5146/tjpath.2024.13669","DOIUrl":"https://doi.org/10.5146/tjpath.2024.13669","url":null,"abstract":"<p><p>The presence of signet-ring cells in the ovary is almost always associated with metastatic mucinous carcinomas known as Krukenberg tumors. Here we report a primary ovarian mucinous carcinoma with signet-ring cells, which is scarcely encountered, and a review of the literature to summarize the clinical and morphological features of these tumors. The patient was a 26-year-old female who had a large multicystic lesion in the right ovary. Macroscopic examination of the cyst revealed a 30 cm-sized multicystic lesion filled with mucinous material. The capsule was intact, and there was no surface involvement. Microscopically, a multicystic mucinous tumor with a predominantly borderline background and three well-demarcated nodules composed of signet ring cells without desmoplastic stroma were noted in the cyst wall. There was only one invasive focus seen. Immunohistochemically, conventional mucinous areas were diffusely positive for Keratin 7 and Keratin 20, and focally positive for PAX8, while negative for CDX2. Signet ring cells were positive for Keratin 20, CDX2, and Keratin 7, while negative for PAX8. In the systemic examinations, no potential primary site was found. The patient has not received any adjuvant treatment and has been followed for six years without disease, which is the longest follow-up time among previously reported cases. Signet ring cells can be present in primary ovarian mucinous carcinomas. The distinction from the more frequently seen metastatic carcinomas needs a complete evaluation of clinicopathological findings. Early-stage primary mucinous carcinomas having localized signet-ring cell nodules seem to have favorable prognosis without adjuvant treatment.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298144","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":"Mucinous Carcinoma of Ovary in a 15-Year-Old Girl, A Rare Case Report and Literature Review.","authors":"Hazwa Karathanathodi Hamza, Nausheen Yaqoob, Khadra Ahmed Galaal, Aref Zribi, Ibrahim Al-Haddabi","doi":"10.5146/tjpath.2024.13496","DOIUrl":"https://doi.org/10.5146/tjpath.2024.13496","url":null,"abstract":"<p><p>Ovarian epithelial tumors are common in adults, and the median patient age at presentation is 55 years. In children, epithelial tumors are rare and mostly benign. Mucinous cystadenocarcinoma is reported in only 11 cases less than 15 years old. This report describes the case of a 15-year-old postmenarchal Omani girl with ovarian mucinous carcinoma. She was admitted with severe epigastric pain and abdomen distension. CT scan showed a huge cystic lesion arising from the left adnexa filling the entire abdominal and pelvic cavity. The patient underwent laparotomy with left ovarian cystectomy and omental biopsy which revealed a 35 x 30 cm left ovarian cyst filled with turbid straw color fluid. Histopathology was reported as mucinous carcinoma. The patient later underwent cytoreductive surgery with left salpingo-oophorectomy, omentectomy, appendicectomy, and lymph node dissection that were negative for malignancy or metastatic disease. During follow-up, she developed a lymphocele in the pelvic cavity that was drained. There were no other significant issues during follow-up, as well as no evidence of recurrence or metastasis. Epithelial tumors of the ovary are rare in young girls, with malignant tumors being exceedingly rare. Fertility-sparing surgery is adopted over radical surgery in these patients, even though the recurrence rates with this treatment protocol are high. All cases should be under follow-up to look for recurrence and timely management.</p>","PeriodicalId":45415,"journal":{"name":"Turkish Journal of Pathology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019083","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}