Medicine international最新文献

{"title":"Bladder malakoplakia mimicking a bladder tumor: A case report and brief review of the literature.","authors":"Rawa Bapir, Ismaeel Aghaways, Hadeel A Yasseen, Ahmed H Ahmed, Farman M Faraj, Bryar Othman Muhammed, Twana Omer Saeed, Pavel W Baqi, Marwan N Hassan, Fahmi H Kakamad","doi":"10.3892/mi.2025.292","DOIUrl":"10.3892/mi.2025.292","url":null,"abstract":"<p><p>Malakoplakia is a rare granulomatous inflammatory disease that primarily affects the genitourinary tract and is often associated with coliform infections. In rare cases, it can mimic tumors; however, to date, to the best of our knowledge, no case of malakoplakia due to <i>Morganella morganii</i> mimicking as a tumor has been reported. The present study describes the case of a patient with bladder malakoplakia caused by <i>Morganella morganii</i>, mimicking a bladder tumor. A 78-year-old male patient presented with complaints of dysuria, urinary frequency, urgency and incontinence. Upon a urinalysis, a marked number of pus cells were observed, and an abdominal ultrasound revealed bladder wall thickening. Flexible cystoscopy revealed a tight urethra and multiple sessile masses in the bladder. A urine culture revealed infection with <i>Morganella morganii</i>, and the patient was treated with antibiotics. Following transurethral resection of the masses, histopathological analysis revealed von Hansemann cells and Michaelis-Gutmann bodies, confirming the diagnosis of malakoplakia. Immunohistochemistry was negative for AE1/AE3 and S100, but positive for CD68. In addition, 10 cases in the literature were reviewed; all patients in these cases were elderly or adults, apart from one case. Of note, 6 cases had <i>Escherichia coli</i> infection, and 1 case also had <i>Pseudomonas aeruginosa</i> infection. A total of 6 cases underwent mass resection, while 4 cases were managed conservatively; one of these experienced recurrence. On the whole, the present study demonstrates that bladder malakoplakia can also arise from infection with <i>Morganella morganii</i> and mimic a tumor; thus, it should be considered in the differential diagnosis of bladder inflammation or masses.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"6 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12746052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866714","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":"Multiple relapses of mantle cell lymphoma as different extranodal lesions: A case report.","authors":"Masahiro Manabe, Daisuke Aohara, Daiki Mukai, Satoru Nanno, Ki-Ryang Koh","doi":"10.3892/mi.2025.284","DOIUrl":"10.3892/mi.2025.284","url":null,"abstract":"<p><p>Mantle cell lymphoma (MCL) usually affects the lymph nodes; however, extranodal involvement is also common, particularly in Waldeyer's ring and the gastrointestinal tract, spleen and bone marrow. Other organs that may be affected include the skin, endocrine glands, lungs and central nervous system, with these sites most commonly affected by relapsing disease. However, in rare, extranodal MCL has arisen in the ocular adnexa, soft tissue and heart. The present study reports the case of a 75-year-old male patient, who experienced repeated relapses of MCL, involving ocular adnexa, soft-tissue and cardiac lesions, which are rare. The aim of the present case report was to demonstrate that clinicians should be aware of the various extranodal sites at which MCL can arise, and monitor patients carefully during and after treatment.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"85"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12635513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590012","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":"Psammoma bodies in a benign thyroid gland: A case report and brief review of the literature.","authors":"Ari M Abdullah, Hadeel A Yasseen, Rawa M Ali, Shaho F Ahmed, Abdulwahid M Salih, Imad J Habibullah, Twana Omer Saeed, Shko H Hassan, Harun Amanj Ahmed, Fahmi H Kakamad","doi":"10.3892/mi.2025.282","DOIUrl":"10.3892/mi.2025.282","url":null,"abstract":"<p><p>Psammoma bodies (PBs) are round, layered calcified structures usually associated with papillary thyroid cancer and may be observed in 40-50% of cases, but may rarely occur in benign thyroid disease. The present study describes a rare case of PBs being found in a benign thyroid gland. In addition, a brief review of the literature is presented. A 28-year-old female patient presented with a 3-month history of weight loss, poor appetite and generalized weakness. Her thyroid was firm and mildly enlarged. Thyroid function was within normal limits (thyroid-stimulating hormone, 0.85 µIU/ml; free T4, 20.1 pmol/l; thyroglobulin, 6.15 ng/ml). An ultrasound demonstrated bilateral TI-RADS-3 nodules measuring 25x21x19 mm (right) and 17x15x13 mm (left). A total thyroidectomy revealed thyroid follicular nodular disease with focal lymphocytic thyroiditis and PBs, but no malignancy. In the literature, 4 cases of PBs or psammomatous calcifications linked to benign conditions were identified, 2 males and 2 females. Half of the cases involved the thyroid-region lesions and half were pediatric (2/4). All cases underwent surgical excision, and fine-needle aspiration was diagnostic in only 1 case (25%). A computed tomography scan was used in 2 cases (50%). A histological analysis confirmed PBs or psammomatous calcifications in every case, and all patients had favorable outcomes with no recurrence upon follow-up. When PBs are detected without tumor cells, submitting the entire thyroid tissue for histology is recommended to rule out microscopic carcinoma. PBs can arise in benign thyroid follicular nodular disease, mimicking malignancy on imaging and cytology, accurate diagnosis requires comprehensive histopathological evaluation.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"83"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497691","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":"Lenalidomide-associated pure red cell aplasia during the treatment of POEMS syndrome: A case report and brief review of the literature.","authors":"Minghui Dai, Qiuling Li, Xiaohong Kuang, Jiaxun Wei, Wei Jiang, Lin Zhang, Ling Li, Yan Zou","doi":"10.3892/mi.2025.283","DOIUrl":"10.3892/mi.2025.283","url":null,"abstract":"<p><p>Lenalidomide is widely used in the treatment of hematological malignancies, with bone marrow suppression being one of the most common hematological adverse effects associated with its use. However, lenalidomide-associated pure red cell aplasia (PRCA) remains exceptionally rare. The present study describes a case of PRCA secondary to lenalidomide therapy in a patient with POEMS syndrome. A 61-year-old woman diagnosed with POEMS syndrome received lenalidomide (25 mg/day) in combination with dexamethasone. Following 3 months of treatment, she developed severe anemia accompanied by a markedly reduced absolute reticulocyte count. Bone marrow aspiration and biopsy demonstrated a complete absence of erythroid precursors, establishing the diagnosis of PRCA. After excluding other potential causes, including viral infections, malignancies and alternative drug-related toxicities, lenalidomide was considered the most likely etiology. Lenalidomide was discontinued, and the patient was subsequently treated with cyclosporine and corticosteroids. Her anemia markedly improved after 16 weeks of therapy, with the normalization of the reticulocyte count. No recurrence was observed during 6 months of follow-up. The present study also performed a brief review of the literature, discussing this rare phenomenon.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"84"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497669","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":"Ovarian fibroma torsion mimicking solid malignant tumors of the ovary: A case report and mini-review of the literature.","authors":"Efthymia Thanasa, Anna Thanasa, Emmanouil Xydias, Ioannis-Rafail Antoniou, Apostolos Ziogas, Ioannis Thanasas","doi":"10.3892/mi.2025.280","DOIUrl":"10.3892/mi.2025.280","url":null,"abstract":"<p><p>The present study describes a rare case of torsion of an ovarian fibroma in a woman of reproductive age, where a severe diagnostic dilemma arose in differentiating it from a solid ovarian cancer. A 48-year-old female patient presented to the hospital with a 1-week history of low-grade fever and mild, continuous abdominal pain, accompanied by nausea and a mild sensation of abdominal bloating. The pain, which was not associated with signs of peritoneal irritation, was more pronounced in the right iliac fossa. The levels of inflammatory and tumor markers were found to be slightly elevated. A computed tomography scan and magnetic resonance imaging of the right adnexal region revealed a large heterogeneous mass with cystic-necrotic areas inside, free fluid collection in the pelvis, and multiple slightly enlarged para-aortic and iliac lymph nodes. These imaging findings, combined with the lack of clinical and laboratory improvement following treatment with antibiotics, led to the decision to proceed with a laparotomy, without having ruled out the diagnosis of solid ovarian cancer. Intraoperatively, the torsion of an ovarian fibroma was identified. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. An immunohistochemical examination confirmed the diagnosis of ovarian fibroma. Following an uneventful post-operative course, the patient was discharged from the clinic on the 4th day post-operatively. The present case report highlights an unusual clinical manifestation of ovarian fibroma torsion, which entailed milder symptom intensity and characteristics resembling ovarian malignancy instead. The aim of the present study was to report this uncommon manifestation, explore its differential diagnosis from malignancy and provide a brief review of the current diagnostic and treatment algorithms for clinicians faced with similar cases in their practice. In this manner, it is hoped that the present study may contribute to the improvement of the diagnostic accuracy and treatment efficacy for similar cases.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"81"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497749","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":"Dilated cardiomyopathy in Rubinstein-Taybi syndrome: A case report and mini-review of the literature.","authors":"Ahsen Shah, Asad Riaz, Abdul Muhymin Alam Khattak, Hasham Qureshi, Zanib Ejaz, Muhammad Mustafa","doi":"10.3892/mi.2025.281","DOIUrl":"10.3892/mi.2025.281","url":null,"abstract":"<p><p>Rubinstein-Taybi syndrome (RTS) or Broad Thumb-Hallux syndrome, is a rare neurodevelopmental disorder characterized by distinctive physical, cognitive and congenital abnormalities. Mutations in the CREBBP or EP300 genes are implicated, often arising <i>de novo</i>. While cardiac defects are noted in 32.6% of patients with RTS, the association with dilated cardiomyopathy (DCM) remains poorly explored. The present study describes a clinically diagnosed case of a 32-year-old male patient with RTS, manifesting with symptoms of heart failure. The patient, born to a consanguineous marriage, exhibited hallmark features of RTS, including short stature, dysmorphic facial features, intellectual disability and broad thumbs. DCM was confirmed by echocardiography with an ejection fraction of 20%. The patient responded well to diuretics for heart failure and was referred for specialized cardiology and surgical management. Cardiac manifestations in RTS vary from septal defects to complex anomalies, with few reports on DCM. The genetic basis of RTS may contribute to cardiac dysfunction, underscoring the need for multidisciplinary care. The case described herein highlights the necessity of recognizing RTS in adults with unexplained syndromic features and cardiac symptoms. Comprehensive evaluation, including cardiac screening, is essential for improving patient outcomes. Further research is warranted to establish the link between RTS and DCM and to develop diagnostic and therapeutic guidelines.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"82"},"PeriodicalIF":0.0,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496859","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":"Effect of chemotherapy on ovarian function in pre-menopausal women with breast cancer.","authors":"Olaiya Popoola, Mohammad Habeebu, Akeem Adeniji, Olukemi Alegi, Gbenro Olukiran, Uchenna Okoro, Oladimeji Adepoju, Atara Ntekim","doi":"10.3892/mi.2025.279","DOIUrl":"10.3892/mi.2025.279","url":null,"abstract":"<p><p>Chemotherapy has been known to negatively affect ovarian function. This sometimes results in infertility, particularly in young patients who still desire to have children. The effect of chemotherapy on young women with breast cancer has not been extensively studied. The objective of the present study was to determine the effects of chemotherapy on ovarian function/reserve among pre-menopausal female patients with breast cancer. Pre-menopausal females with breast cancer scheduled for chemotherapy were recruited for the study. Blood samples were obtained to determine the plasma concentrations of three hormones, namely estrogen, follicle stimulating hormone and anti-Müllerian hormone. The samples were collected at pre-chemotherapy, at 3 months and then at 6 months post-chemotherapy. The assays were performed using the direct immunoenzymatic colorimetric method. Data from 82 participants were analyzed. The age range of the patients was 32-41 years (mean age, 36.6±4.6 years). There were significant reductions in the plasma concentrations of estrogen and anti-Müllerian hormone, with significant increase in the levels of follicle stimulating hormone. An irregular or the cessation of menstrual flow was observed in some patients who were >30 years of age. There was no significant difference in the effects with different chemotherapeutic regimens for breast cancer. The negative ovarian effects on tested hormones persisted 6 months post-chemotherapy. Overall, the present study demonstrates that chemotherapy for breast cancer has deleterious effects on ovarian function, as reflected by altered plasma levels of estrogen, follicle stimulating hormone and anti-Müllerian hormone. Clinicians should be aware of this and counsel such patients appropriately on fertility issues to ensure a better quality of life for patients who survive breast cancer.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"80"},"PeriodicalIF":0.0,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497709","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":"Management of invasive candidiasis in the ICU: Challenges and advances (Review).","authors":"Wael Ghaly Elmasry, Ahmed Mohamed Abdelbaky, Ahmed Hossameldin Ahmed Awad","doi":"10.3892/mi.2025.278","DOIUrl":"10.3892/mi.2025.278","url":null,"abstract":"<p><p>Invasive candidiasis (IC) is one of the principal causes of morbidity and mortality in critically ill patients, particularly in intensive care units (ICUs). Early diagnosis and prompt treatment are vital for achieving optimal outcomes for patients; however, factors such as delayed diagnosis, antifungal resistance and difficulty in managing critically ill patients make this difficult. The present review describes some of the major challenges involved in the management of IC in ICU settings, including delays in diagnosis, outbreaks of multi-drug-resistant <i>Candida</i> species and high mortality rates. Improvements in innovative diagnostic methods, including rapid molecular testing, as well as developments in antifungal therapy, such as rezafungin and ibrexafungerp, help improve patient outcomes. In addition, antifungal stewardship, prevention and combination therapy enhance the management of this complex infection. The present review also discusses clinical guidelines emphasizing the need for early empirical therapy, species-specific definitive treatment, and proper treatment duration. Continuous research toward new diagnostic procedures, antifungal agents and vaccines is essential to overcoming the challenges posed by IC in critically ill patients.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"79"},"PeriodicalIF":0.0,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497684","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":"Accessory breast granulomatous mastitis: A case report and mini-review of the literature.","authors":"Abdulwahid M Salih, Ari M Abdullah, Lana R A Pshtiwan, Sakar O Arif, Zuhair D Hammood, Shaban L Tofiq, Hiwa O Abdullah, Masty K Ahmed, Harzal Hiwa Fatih, Meer M Abdulkarim, Fahmi H Kakamad","doi":"10.3892/mi.2025.277","DOIUrl":"10.3892/mi.2025.277","url":null,"abstract":"<p><p>Granulomatous mastitis (GM) is a rare inflammatory condition that primarily affects the breasts, and its occurrence in accessory breast tissue is even rarer. The present report describes the case of a patient with GM in the accessory breast. A 43-year-old female patient presented with a 1-month history of pain in the left axilla and breast. An analysis of her medical and surgical history did not reveal any notable findings, but she had a history of four full-term pregnancies and a cumulative lactation period of 4 years. Upon a clinical examination, a palpable, ill-defined, tender mass was noted along with an accessory breast and nipple in the axilla. The diagnosis was chronic mastitis, and she was treated with oral corticosteroids, amoxicillin, cabergoline and analgesics. Her condition initially improved; however, the symptoms recurred 1 year later. A wide local excision of the left axillary tail was performed. The patient experienced marked improvement post-surgery and remained stable, with no recurrence, at the 1-year follow-up. In addition, in the present study, seven recent cases of GM were included for a brief literature review, involving patients aged 23 to 42 years. Of these cases, 6 cases did not have any notable medical histories. A total of 6 patients had a history of pregnancy, with an average lactation duration of 22.7 months. The right breast was affected in 6 cases. Pain and swelling were the most frequent symptoms. A conservative approach, which included antibiotics, corticosteroids and wound dressing was used for 5 patients. In total, 6 patients achieved recovery. On the whole, the present study demonstrates that accessory breast tissue can develop GM. While corticosteroids may provide favorable short-term results, they do not necessarily prevent recurrence, whereas surgical management may provide more durable long-term outcomes.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"78"},"PeriodicalIF":0.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496331","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":"Growth hormone in disease and treatment (Review).","authors":"Saikat Fakir, Md Matiur Rahman Sarker, Madan Sigdel, Nektarios Barabutis","doi":"10.3892/mi.2025.276","DOIUrl":"10.3892/mi.2025.276","url":null,"abstract":"<p><p>Growth hormone (GH) is a peptide hormone produced by the anterior pituitary gland, which regulates growth and development. Abnormal levels of GH have been associated with a diverse variety of disorders affecting life quality and longevity; including dwarfism, acromegaly, gigantism and cancer. Based on the fact that growth hormone-releasing hormone (GHRH) and somatostatin exert opposing effects on the regulation of GH, GHRH antagonists (GHRHAnts) and synthetic somatostatin analogs (SSAs) have been developed to alleviate GH-related illness. The present study provides information on the multifaceted role of GH in human health and disease. Furthermore, it summarizes recent findings on the protective effects of GHRHAnts and FDA-approved SSAs, such as octreotide, lanreotide and pasireotide, in GH-related and endothelium-dependent dysfunctions. Based on the provided bibliography, an emerging body of evidence suggests that GH modulators may represent a promising therapeutic possibility towards blood brain barrier dysregulation, keratitis, direct and indirect lung injury, sepsis, and acute respiratory distress syndrome.</p>","PeriodicalId":74161,"journal":{"name":"Medicine international","volume":"5 6","pages":"77"},"PeriodicalIF":0.0,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497671","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}