Mediastinum (Hong Kong, China)最新文献

{"title":"Anterior chest wall lifting methods for mediastinal approach-literature review.","authors":"Hiroyuki Shiono","doi":"10.21037/med-21-43","DOIUrl":"https://doi.org/10.21037/med-21-43","url":null,"abstract":"<p><strong>Background and objective: </strong>For the purpose of facilitating a wide view and working space during surgery such as a thymectomy procedure, as well as that for treatment of anterior mediastinal lesions, anterior chest wall lifting began to be employed. In this article, previous reports of various kinds of chest wall lifting methods are reviewed.</p><p><strong>Methods: </strong>The present study focused on procedures used for anterior chest wall lifting in a review of related studies primarily available in English. A search of the PubMed database was conducted in 1st March 2016. The first description about lifting method was reported in 1988.</p><p><strong>Key comments and findings: </strong>Although objective evaluation regarding the effectiveness of lifting is difficult, in view of a balance among safety, reliability, and minimal invasiveness, surgeons may consider chest wall lifting as an optional method.</p><p><strong>Conclusions: </strong>Anterior chest wall lifting began to be employed for enlarging the working space long before the advent of endoscopic surgery. Some originally developed retractors were used in transcervical thymectomy procedures. After general acceptance of transsternal extended thymectomy for myasthenia gravis, these transcervical approaches remained an important option along with anterior chest wall lifting. Thoracoscopic surgery for the treatment of anterior mediastinal lesions was introduced in the 1990s. Particularly in cases of surgery in the supine position, various creative methods and devices of lifting the sternum body, the anterior part of the rib, or the xiphoid process were reported.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":" ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/9a/med-06-24.PMC9385877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40376846","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":"Good's syndrome and COVID-19: case report and literature review.","authors":"Lawek Berzenji, Suresh Krishan Yogeswaran, Annemiek Snoeckx, Paul E Van Schil, Reinier Wener, Jeroen M H Hendriks","doi":"10.21037/med-22-12","DOIUrl":"10.21037/med-22-12","url":null,"abstract":"<p><strong>Background: </strong>Good's syndrome (GS) is an adult-onset acquired immunodeficiency, in which patients present with thymoma and hypogammaglobulinemia (HGG). GS is characterized by low to absent peripheral B cells and impaired T-cell mediated immunity, often resulting in various (opportunistic) infections and concurrent autoimmune disorders. In this case report, we present a case of a patient with GS and coronavirus disease 2019 (COVID-19) infection after surgical removal of a thymoma. The simultaneous occurence of these two entities is extremely rare.</p><p><strong>Case description: </strong>A 55-year-old man presented with oral lichen planus and cutaneous lesions. Additional symptoms included a weight loss of 5 kilograms in the last six months. Computed tomography (CT) and positron emission tomography (PET) of the chest showed a large anterior mediastinal mass with a maximum diameter of 10 centimetres. A core needle biopsy was performed, which led to a pathological diagnosis of thymoma type AB. In addition to these earlier findings, laboratory analysis revealed HGG. The combination of a thymoma and HGG led to a diagnosis of GS. Induction chemotherapy with cisplatin-etoposide was started, however, the patient developed COVID-19 after 2 cycles. Treatment with remdesivir was initiated and, subsequently, a thymectomy via sternotomy was performed. Final pathology confirmed a thymoma type AB of 14 centimetres, fully encapsulated, and without invasion. Resection margins were negative and the tumour was classified as pT1aN0, R0 resection. The patient has received immunoglobulin treatments every 4 weeks for his GS and has not developed any new infections since the start of this therapy.</p><p><strong>Conclusions: </strong>Patients with GS are prone to developing (pulmonary) infections. Clinicians should be aware of the possible clinical effects of COVID-19 infections in this patient population.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":"7 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2022-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/0b/med-07-5.PMC10011861.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131144","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":"Home-deliverable antitumoral treatments in the age of COVID-19: the Portsmouth experience and a narrative review.","authors":"Hiba Mechahougui,&nbsp;Harliana Yusof,&nbsp;Nathalie Baudoux,&nbsp;Shyamika Acharige,&nbsp;Alex Friedlaender","doi":"10.21037/med-21-26","DOIUrl":"https://doi.org/10.21037/med-21-26","url":null,"abstract":"<p><strong>Background and objective: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, risks and priorities of oncologic care have required a thorough reassessment. The chance that fragile patients have exposure to infection during frequent hospital visits is an additional consideration for all therapeutic decisions. Patients with cancer, particularly those with lung cancer, have a greater chance of developing a severe form of COVID-19. Their increased risk is due to the immunosuppression associated with the chemotherapy itself, the underlying pulmonary compromise, which often accompanies lung malignancy or their general poor health. Oncology societies have given precise recommendations on the treatment modalities to be favoured, such as giving up specific palliative or adjuvant treatments, preferring shorter and less cytopenic therapies. In this review, we discussed how some of these curative treatments could be given by administering them at home. In this narrative review, we aim to see if it is safe and feasible to deliver home-administered oncologic intravenous treatments.</p><p><strong>Methods: </strong>By narrative review, we looked for all the articles written in English describing home delivery chemotherapy or immunotherapy programs since 2019 that emerged or evolved during the COVID-19 pandemic. We added real-life data regarding the initiation of home immunotherapy in Portsmouth.</p><p><strong>Key content and findings: </strong>There is a growing body of evidence supporting the safety and feasibility of home-administered chemotherapy and immunotherapy treatments.</p><p><strong>Conclusions: </strong>Home-administered chemotherapy and immunotherapy treatments are safe and feasible despite financial challenges, particularly about reimbursement by insurance companies and the loss of earnings for hospitals. Home treatments also require the careful selection of eligible patients and the training and organisation of specialised teams capable of managing the expected complications. It would be interesting to assess the risk-reduction in terms of infections and potential survival gains obtained by these programmes during the COVID pandemic.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":" ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/10/c5/med-06-12.PMC9272088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40614312","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":"Thymic tumors: impact of the TNM for medical oncologists: extended abstract","authors":"N. Girard","doi":"10.21037/med-21-56","DOIUrl":"https://doi.org/10.21037/med-21-56","url":null,"abstract":"© Mediastinum. All rights reserved. Mediastinum 2022;6:17 | https://dx.doi.org/10.21037/med-21-56 Thymic tumors are rare thoracic malignancies that require comprehensive assessment and multidisciplinary management; these may be aggressive and difficult to treat (1). In the past decade, the scientific community has been increasingly interested in that field, with the creation of many dedicated working groups, including the International Thymic Malignancy Interest Group (ITMIG, www. itmig.org), or local organizations, such as the RYTHMIC (Réseau tumeurs THYMiques et Cancer; www.rythmic. org) network in France. At the 2021 ITMIG virtual annual meeting, a discussion focused on the impact of the 8 TNM classification for medical oncologists. A key point in thymic tumors is that there is no formal clinical staging system, as stage grouping include pathological findings, especially for early stage tumors, and the treatment strategy is then primarily based on whether the tumor may be resected upfront or not, as complete resection represents the most significant prognostic factor on disease-free and overall survival (2,3). Correlation between clinical and final stage is better in advanced stages, given the identification at imaging of vessel invasion, enlarged lymph nodes, pleural/pericardial lesions, or even systemic metastases (4). The management of patients with TETs is based on multidisciplinary expertise that is mandatory at all stages of the disease (1). The assessment of resectability is mostly based on the radiologist and the surgeon expertise, but may be complex, even if the 8th TNM staging provides a definition of resectable anatomical structures (stage IIIA). Ultimately, stage IV disease does not mean that the tumor is not amenable to complete surgical resection, especially in the setting of localized pleural implants (5,6). Multidisciplinary tumor board (MTB) is then recommended at any stage of the disease. In France, RYTHMIC is a nationwide network dedicated to thymic tumors, which was recognized by the French National Cancer Institute, in 2012. The treatment of all patients with TET is discussed on a real-time basis at a national MTB, which is organized twice a month basis using a web-based system. Decisionmaking is based on consensual recommendations, that were originally established based on available evidence, and are updated and approved each year by all members of the network (1). Similar thymoma-dedicated networks are now being implemented in France and in other European countries, such as Spain and Italy (the TYME collaborative group) (7,8). EURACAN is a European Reference Network that helps gathering expertise and organizing initiatives across European countries and expert centers. In Masaoka-Koga stage III/IVA tumors (classified as stage IIIA/IIIB/IVA in the 8 TNM proposed system), complete resection is usually not achievable upfront. A biopsy is performed, followed by primary/induction chemotherapy, in a curative-intent setting with","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45041455","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 clinical fallout of organizational resilience in oncology during the pandemic.","authors":"Alfredo Addeo,&nbsp;Giuseppe L Banna","doi":"10.21037/med-21-34","DOIUrl":"https://doi.org/10.21037/med-21-34","url":null,"abstract":"","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":" ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/7a/med-06-11.PMC9272089.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40614313","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":"Clinical and laboratory features heralding the appearance of thymoma: extended abstract","authors":"M. Ashraghi, M. Leite","doi":"10.21037/med-21-59","DOIUrl":"https://doi.org/10.21037/med-21-59","url":null,"abstract":"","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46292567","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 case report of a giant middle mediastinal leiomyosarcoma.","authors":"Stéphane Collaud,&nbsp;Clemens Aigner","doi":"10.21037/med-21-44","DOIUrl":"https://doi.org/10.21037/med-21-44","url":null,"abstract":"<p><p>Primary mediastinal leiomyosarcomas are extremely rare soft tissue tumors, accounting for less than 15% of all primary mediastinal sarcomas. Middle mediastinal tumors are very rare, with a prevalence of 0.1% in healthy individuals. Usually, mediastinal leiomyosarcoma originates and involves mediastinal structures such as oesophagus, heart or great vessels. Here we report the rare case of a giant middle mediastinal leiomyosarcoma without involvement of any surrounding structures in a 70 years old female. Main related symptoms were cough and increasing dyspnea. Imaging work-up showed an 11-cm giant middle mediastinal tumor located in the subcarinal space and compressing the oesophagus. Cytopathologic examination of endobronchial ultrasound-guided transbronchial needle aspiration diagnosed leiomyosarcoma. The tumor was completely removed through a right posterolateral thoracotomy in the fifth intercostal space. None of the surrounding structures were involved by the tumor intraoperatively. The patient underwent adjuvant chemoradiation as advised by the sarcoma tumor board (5 cycles of dacarbazine and doxorubicin followed by 60 Gy). At last follow-up, no evidence of recurrence was seen on imaging ten months after surgery. This rare case confirms that giant middle mediastinal leiomyosarcoma may not involve surrounding mediastinal structure and that resection can be completely and safely done without the need for resection of neighboring structures. The relevant literature on the subject is reviewed here.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":"6 ","pages":"38"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/5f/med-06-38.PMC9792857.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455443","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":"Surgical indications for mediastinal cysts-a narrative review.","authors":"Paola Barrios,&nbsp;Diego Avella Patino","doi":"10.21037/med-22-27","DOIUrl":"https://doi.org/10.21037/med-22-27","url":null,"abstract":"<p><strong>Background and objective: </strong>Whether and when surgical intervention is indicated for mediastinal cysts is a matter of some debate. While most mediastinal cysts are found incidentally, the anatomic location, clinical presentation, and symptoms, as well as the potential for malignancy, are important considerations that inform decisions related to whether to intervene surgically. The objective of this review is to summarize the current literature regarding the criteria for surgical excision of mediastinal cysts and provide a framework for the clinician and surgeon to arrive at a decision regarding the appropriateness of surgical intervention of mediastinal cysts.</p><p><strong>Methods: </strong>A review of the published literature in the last 45 years (1977-2022) was conducted through PubMed, MeSh and Google Scholar. We included retrospective reviews, meta-analyses, and case studies published in the English language. A single author identified eligible studies, and those identified were reviewed by the team until consensus was met. Pediatric literature was excluded from this review.</p><p><strong>Key content and findings: </strong>The current literature predominantly contains case studies, small retrospective studies, and meta-analyses describing mediastinal cysts. In the anterior mediastinum, multiloculated thymic cysts should be resected to rule out thymic malignancy. Intralesional fat, smooth borders, and a more midline location are features suggestive of a benign process, while asymmetric cystic wall thickening has been associated with malignancy. Both esophageal and bronchogenic cysts should be excised, taking into account the risk of complications (up to a 45% risk) of infection, rupture, or compression, as well as the rare risk of associated malignancy. Simple thymic and small pericardial cysts can be observed and followed with serial radiographic tools and should be resected if they increase in size, compress surrounding structures, or lead the patient to develop symptoms.</p><p><strong>Conclusions: </strong>Since mediastinal cysts are rare and often asymptomatic, there are no formal guidelines outlining when surgical intervention should be undertaken. Based on our review of the literature, surgical intervention should be pursued if the patient's symptoms correlate with radiographic findings of a mediastinal cyst, there is compression of the surrounding structures, and concern of malignancy is present.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":"6 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/bb/med-06-31.PMC9792824.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454259","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":"An asymptomatic giant AB thymoma in a patient with Down syndrome: a case report.","authors":"Elisa Sicolo,&nbsp;Vittorio Aprile,&nbsp;Tommaso Ferrarello,&nbsp;Diana Bacchin,&nbsp;Maria Giovanna Mastromarino,&nbsp;Greta Alì,&nbsp;Marcello Carlo Ambrogi,&nbsp;Marco Lucchi,&nbsp;Stylianos Korasidis","doi":"10.21037/med-22-8","DOIUrl":"https://doi.org/10.21037/med-22-8","url":null,"abstract":"<p><strong>Background: </strong>Mediastinal mass management may represent a real challenge for all the physicians who deal with it. Mediastinum, in fact, contains different vital structures which are often involved by growing neoplasms with increasing severity. Therefore, up to 60% of the patients with mediastinal mass are symptomatic, according to the structure involved. Different neoplasms may arise essentially from all mediastinal organs, whereas thymic epithelial tumors and lymphomas represent more than 90% of mediastinal tumors.</p><p><strong>Case description: </strong>We report the first case described of a giant asymptomatic mediastinal mass in a 43-year-old male affected by Down syndrome (DS), turned out to be a thymoma, treated exclusively and successfully with radical surgery. Despite the absence of any symptoms, the giant thymoma infiltrated the diaphragm, the pericardium, the upper lobe of the left lung together with the left phrenic nerve resulting in the compression of heart and great vessels.</p><p><strong>Conclusions: </strong>To date, this is the first description of a thymic malignancy in a patient with DS, that usually is characterized by a low-incidence of solid tumor except for germ-cells ones. Surgery has been extremely challenging, due the clinical condition of the patient together with the tumor features; nevertheless, oncological radicality criteria were completely fulfilled. After four years from surgery, the patient is alive and still disease-free, highlighting the importance of radical surgery.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":"6 ","pages":"39"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/80/26/med-06-39.PMC9792865.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10455444","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":"Giant tumors of the posterior mediastinum: a narrative review of surgical treatment.","authors":"Sevki Mustafa Demiroz,&nbsp;Muhammet Sayan,&nbsp;Ali Celik","doi":"10.21037/med-21-39","DOIUrl":"https://doi.org/10.21037/med-21-39","url":null,"abstract":"<p><strong>Background and objective: </strong>The posterior mediastinum is a potential space along the paravertebral sulci or between the posterior aspect of the pericardium and the vertebrae. This compartment is classically the most frequent location site of neurogenic tumors. Whereas neurofibroma and schwannoma are neurogenic tumors that commonly arise from peripheral nerves, sympathetic nerves are the origin of ganglioneuroma, neuroblastoma, ganglioneuroblastoma, and neuroectodermal cells closely associated with autonomic nerves are the origin of paragangliomas and pheochromocytomas. Additionally, tumors from the esophagus, tumors of mesenchymal origin, lymphoma, ectopic goiter, and diseases with lymph node hyperplasia may also settle on this compartment. The objectives are to identify term \"giant posterior mediastinal tumor\" and the etiology, clinical features, diagnostic methods, pathological types, surgical methods applied, and technical details of these methods for the treatment of these tumors.</p><p><strong>Methods: </strong>In this review, the term \"giant tumor\" was used to define tumors larger than 10 cm settled in the posterior mediastinum. PubMed database was searched with keywords \"posterior mediastinum, giant mass\" or \"posterior mediastinum, tumor, giant\" limited to English language and full-text available studies published between years 1984-2021.</p><p><strong>Key content and findings: </strong>As a result of the literature review with the relevant terms, 23 case reports were found in accordance with the inclusion criteria. We detected the most common giant posterior mediastinum tumors were neurogenic origin (schwannoma, ganglioneuroma, ganglioneuroblastoma, triton tumor) in that review. The most common surgical approach was posterolateral thoracotomy. Treatment response to surgical total excision was good in most of cases.</p><p><strong>Conclusions: </strong>The definitive diagnosis and treatment of giant posterior mediastinal tumors is made by surgical excision. Diagnostic procedures and subsequent surgical planning may vary depending on the origin and localization. Adjuvant treatment and follow-up should be conducted on the histopathological features.</p>","PeriodicalId":74139,"journal":{"name":"Mediastinum (Hong Kong, China)","volume":"6 ","pages":"36"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/d9/med-06-36.PMC9792830.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10454263","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}