Skin health and disease最新文献

{"title":"Risk factors for actinic keratosis, non-melanoma skin cancer and cutaneous malignant melanoma in persons with and without Parkinson's disease: A cross-sectional study.","authors":"Esther Azizi, Hana Feuerman, Idit Peleg, Felix Pavlotsky, Zvi Segal, Bernice Oberman, Nirit Lev, Emmilia Hodak, Ruth Djaldetti, Sharon Hassin-Baer, Rivka Inzelberg","doi":"10.1002/ski2.464","DOIUrl":"https://doi.org/10.1002/ski2.464","url":null,"abstract":"<p><strong>Background: </strong>An epidemiological link between Parkinson's disease (PD) and cutaneous malignant melanoma (CMM) has been widely reported. The role of CMM risk factors in this association is unclear.</p><p><strong>Objectives: </strong>To compare rates of risk factors for skin tumours, specifically actinic keratosis (AK), non-melanoma skin cancer (NMSC) and CMM, between persons with and without PD.</p><p><strong>Methods: </strong>In this cross-sectional observational study, patients attending tertiary PD clinics and community controls were interviewed for background/medical data and underwent dermatological examination. Logistic regression models assessed risk factors for skin tumours and their interactions with PD status.</p><p><strong>Results: </strong>Included were 141 persons with PD and 155 controls; mean age 71.7 and 72.6 years, respectively. In both groups, the majority were males of Ashkenazi origin. Altogether, AK, basal cell carcinoma, squamous cell carcinoma and CMM were recorded in 76 (53.9%) persons with PD and 92 (59.3%) controls (NS). CMM prevalence predominated in PD patients. In the PD group, prolonged sun exposure (<i>p</i> = 0.007), freckles (<i>p</i> < 0.001) and solar lentigines (<i>p</i> = 0.008) were associated with skin tumours. In the control group, dysplastic atypical moles were negatively associated with skin tumours (<i>p</i> = 0.017). Logistic regression of the whole cohort showed that older age (<i>p</i> < 0.001), fair complexion (<i>p</i> = 0.04) and prolonged sun exposure (<i>p</i> = 0.01) were associated with skin tumours, but PD status was not independently associated, and no interactions were found between PD status and CMM risk factors.</p><p><strong>Conclusions: </strong>Periodic dermatological screening of PD populations is mandatory, especially for carriers of major phenotypic risk factors or presenting with AK, NMSC or CMM.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e464"},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775319","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":"Associations between dietary and supplemental vitamin A intake and melanoma and non-melanoma skin cancer.","authors":"Vaishali Mittal, Jodi Y So, Shufeng Li, Susan M Swetter, Eleni Linos, Linda Van Horn, Marian L Neuhouser, Marcia L Stefanick, Jean Y Tang","doi":"10.1002/ski2.462","DOIUrl":"https://doi.org/10.1002/ski2.462","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous melanoma (CM) and non-melanoma skin cancer (NMSC) are rising in postmenopausal women. Although high doses of oral vitamin A reduce NMSC risk in high-risk patients, the role of vitamin A in preventing skin cancer in this group remains unexplored.</p><p><strong>Objectives: </strong>To determine the association between total (dietary and supplemental) vitamin A and risk of CM and NMSC in postmenopausal women.</p><p><strong>Methods: </strong>This retrospective cohort study included 52 877 White women from the Women's Health Initiative cohort, spanning from 1993 to 2019. Exposures were intake of total vitamin A, retinol and provitamin A carotenoids. Cox proportional hazard models estimated hazard ratios for overall CM incidence, whereas logistic regression determined odds ratios (ORs) for melanoma subtypes and NMSC.</p><p><strong>Results: </strong>1154 cases of CM and 9085 cases of NMSC were identified over an average follow-up period of 17.8 years (SD 6.7). No associations were identified between total vitamin A intake and melanoma risk. Higher dietary vitamin A intake was associated with higher risk of NMSC (OR of 3rd vs. 1st tertile of dietary intake = 1.12, 95% confidence interval [CI] [1.06, 1.18]), as was dietary beta-cryptoxanthin, a provitamin A carotenoid (OR of 3rd vs. 1st tertile of dietary intake = 1.22, 95% CI [1.15, 1.29]); these results were consistent across both age- and fully adjusted regression models.</p><p><strong>Conclusions: </strong>Total vitamin A intake was not associated with lower risk of CM or NMSC. Dietary vitamin A and beta-cryptoxanthin intake were associated with a slightly higher risk of NMSC in postmenopausal women.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e462"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775355","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":"Vitiligo: From mechanisms of disease to treatable pathways.","authors":"Gaurav N Pathak, Isabella J Tan, Ge Bai, Jimmy Dhillon, Babar K Rao","doi":"10.1002/ski2.460","DOIUrl":"https://doi.org/10.1002/ski2.460","url":null,"abstract":"<p><p>Vitiligo is a chronic autoimmune-mediated disease characterised by the loss of pigmentary melanocytes in the epidermis. Vitiligo is associated with loss of functional epithelium and significant reductions in quality of life with limited long-term treatment options, highlighting a continued unmet clinical need. A comprehensive understanding of the pathophysiology and newly investigated treatment pathways may guide multimodal treatment strategies and identify future drug targets. The pathology of vitiligo is multifactorial; however, environmental insults in genetically susceptible populations may lead to disease development. Autoreactive CD8+ T-cells that target melanocytes and release inflammatory mediators, including interferon-γ and interleukins 2, 6, 15, 17 and 33 among others, have been identified in vitiligo pathogenesis. Treatment modalities for vitiligo revolve around six broad disease concepts, including procedural modalities (tissue and cellular grafting), phototherapy, stem cells, anti-inflammatories, genetic polymorphisms and antioxidants/vitamins/herbals. Genetic polymorphisms, such as catalase gene variations and toll-like receptor polymorphisms, along with stem cell targets such as melanocytes derived from stem cells, have been implicated in vitiligo onset and possible treatment. Novel JAK-STAT inhibitors have been recently investigated for vitiligo, whereas topical corticosteroids and calcineurin inhibitors continue to be used. Vitamin D, vitamin E, zinc, copper, piperine, pseudo catalase and other vitamins/herbals may improve vitiligo outcomes primarily through antioxidant supplementation pathways. Future studies should investigate alternative drug pathways and targets implicated in vitiligo in large patient cohorts, as well as treatments that target suspected causative immune cells, including memory T-cells, which may provide long-lasting disease-free remission.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e460"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775416","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":"Hip dips technique: Filling lateral depressions with hyaluronic acid of large particles.","authors":"Luciana Lourenco, Helena Medeiros, Luísa Ferreira, Natasha Favoretto Dias de Oliveira, Roberta Lopes, Rosa Sigrist","doi":"10.1002/ski2.461","DOIUrl":"https://doi.org/10.1002/ski2.461","url":null,"abstract":"<p><strong>Introduction: </strong>Hip dips, often referred to as the pronounced trochanteric depression, can be caused by athletic muscular definition or the ageing process. This depression might impact the desirable contour of the buttocks in some female patients.</p><p><strong>Patients and methods: </strong>A technique is described for female patients exhibiting moderate to severe degrees of lateral trochanteric depression. This technique utilizes a specific marking, a well-thought-out plan and a designated product. Eleven patients were selected to use this technique to improve their trochanteric depression and enhance their buttocks contour without undergoing surgery. The product used was Sofiderm Subskin, which was applied at the intermediate subcutaneous layer.</p><p><strong>Results: </strong>The authors report favourable aesthetic results with the proposed technique, and the patients expressed high satisfaction levels.</p><p><strong>Discussion: </strong>Though safe for injection, the lateral gluteal depression can still be challenging to expand. The product chosen has both a high G prime and a large molecular size, contributing to its resistance to deformation.</p><p><strong>Conclusion: </strong>The hip dips technique using hyaluronic acid for the augmentation of lateral depression has shown to be minimally invasive; it provides quick results without significant risks or downtime.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e461"},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775382","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":"A case of Mycoplasma pneumoniae-induced rash and mucositis with recent influenza vaccination.","authors":"Vani Agarwal, Georgie Gamble, Alexander Amphlett, Neil P Patel","doi":"10.1002/ski2.459","DOIUrl":"https://doi.org/10.1002/ski2.459","url":null,"abstract":"<p><p>A 33-year-old female presented with coryzal symptoms, facial swelling, severe haemorrhagic stomatitis, blistering oral mucositis, conjunctival injection and a sparse targetoid rash on the back and face, requiring admission to hospital. She had received the seasonal influenza vaccination 3 days prior to feeling unwell. Differential diagnosis included erythema multiforme major (EMM) secondary to the influenza vaccine or Mycoplasma pneumoniae-induced rash and mucositis (MIRM). Oropharyngeal swabs were negative on PCR for cutaneous viruses and <i>Mycoplasma pneumoniae</i> (MP). A skin biopsy from a targetoid lesion on the body showed full thickness epidermal necrosis with epidermal-dermal clefting, numerous civatte bodies and a moderate perivascular infiltrate of lymphocytes and plasma cells in the papillary dermis. She was successfully treated with oral prednisolone and azithromycin. Following discharge from hospital, the paired serological testing for MP returned positive, confirming a diagnosis of MIRM. Our case highlights the difficulties in detecting MP as two diagnostic methods yielded different results, and so we advocate performing both MP PCR and serology to maximise the yield and speed of diagnosis. Secondly, our case highlights the clinical challenge in differentiating MIRM from EMM or Stevens-Johnson syndrome, particularly if there is a potential drug trigger (in our case the influenza vaccine), as all these conditions can feature a severe mucositis with often indistinguishable histological findings. Correct diagnosis of MIRM is important for appropriate and timely administration of anti-MP antibiotic therapy to facilitate recovery and minimise complications.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e459"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775275","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":"Bridging the gap in dermatology and psychiatry: A scientific rationale.","authors":"Isabella J Tan, Shaunt Mehdikhani, Amy S Pappert, Paul F Weber","doi":"10.1002/ski2.456","DOIUrl":"https://doi.org/10.1002/ski2.456","url":null,"abstract":"","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e456"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775358","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":"Gender differences in melanoma awareness, diagnosis and treatment: Patient-reported data from a multicentre survey in Switzerland.","authors":"Johanna Mangana, Cristina Lamos, Berna C Özdemir, Heinz Läubli, Linda Morgan, Lara V Maul, David König, Florentia Dimitriou, Sandra Kaiser, Janine Landolt, Anastasia Musiari, Nadine Pasche, Beat Siegenthaler, Reinhard Dummer, Valerio Del Prete","doi":"10.1002/ski2.442","DOIUrl":"https://doi.org/10.1002/ski2.442","url":null,"abstract":"<p><p>There is a need to understand the journey of patients with melanoma, including any associated gender differences, to identify aspects in the patient journey that could be improved. We used data collected from an online survey completed by adults with stage III or IV melanoma at three Swiss melanoma centres to understand patients' perceptions of their healthcare journeys from melanoma diagnosis to treatment and the relevance of treatment attributes (Figure 1). We identified that there is a need to improve communication about the testing process and gender differences in terms on information needs, relevance of treatment attributes and attitudes towards psychological support.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e442"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775380","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 tumour necrotic factor-α, interleukin-17 and interleukin-22 on the expression of filaggerin-2 and hornerin: Analysis of a three-dimensional psoriatic skin model.","authors":"Teruhiko Makino, Megumi Mizawa, Keita Takemoto, Seiji Yamamoto, Tadamichi Shimizu","doi":"10.1002/ski2.440","DOIUrl":"https://doi.org/10.1002/ski2.440","url":null,"abstract":"<p><strong>Background: </strong>Filaggrin-2 (FLG2) and hornerin (HRNR) are members of the S100 fused-type protein family, which share many properties with filaggrin (FLG). A previous study demonstrated that the expression of FLG2 was significantly decreased in psoriatic skin relative to that in normal skin. In contrast, the HRNR expression in psoriatic skin varied among studies.</p><p><strong>Objectives: </strong>We aimed to investigate the effect of tumour necrosis factor-α (TNF-α), IL-17A and IL-22 on the expression of FLG2 and HRNR using a three-dimensional psoriatic skin model.</p><p><strong>Methods: </strong>In the present study, we generated a 3D psoriatic skin model that was stimulated with TNF-α, IL-17A and IL-22 for 3D skin equivalents. Using this model, we examined the altered expression of FLG2 and HRNR by quantitative reverse transcription polymerase chain reaction and immunostaining.</p><p><strong>Results: </strong>In the 3D psoriatic skin model, the expression of FLG2 and HRNR was significantly reduced compared with that in the 3D control skin. FLG2 expression was significantly decreased by stimulation with TNF-α, IL-17A and IL-22. In contrast, the expression of HRNR was markedly increased by stimulation with IL-22, although it was slightly decreased by TNF-α or IL-17A compared to the 3D control skin.</p><p><strong>Conclusion: </strong>TNF-α, IL-17A and IL-22 have different effects on FLG2 and HRNR expression and epidermal structure formation. Furthermore, FLG2 and HRNR may play different roles in barrier formation and the pathogenesis of psoriasis.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e440"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775301","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":"The age-related incidence of male genital lichen sclerosus is triphasic.","authors":"Cherry Choudhary, Ryan Beazley, Encarl Uppal, Georgios Kravvas, Christopher Bunker","doi":"10.1002/ski2.447","DOIUrl":"https://doi.org/10.1002/ski2.447","url":null,"abstract":"<p><strong>Background: </strong>Male genital lichen sclerosus (MGLSc) is a chronic and acquired inflammatory dermatosis associated with substantial sexual dysfunction and urological morbidity and mortality. The age incidence of MGLSc is held to be biphasic, with a peak in infancy and another in adulthood. A recent review has implied two peaks in adulthood (making it triphasic overall); this triphasicity has been our emergent clinical impression from a voluminous practice. Furthermore, a link between MGLSc and smoking has been suggested, but this has not been our clinical impression.</p><p><strong>Objectives: </strong>The primary objective was to clarify the age-specific incidence of adult men with GLSc; the secondary objective was to explore the relationship between MGLSc and smoking.</p><p><strong>Methods: </strong>We retrospectively reviewed the medical notes of 487 adult MGLSc patients from a large specialist male genital dermatology clinic. We abstracted data about the age of diagnosis and smoking history.</p><p><strong>Results: </strong>A biphasic U-shaped age distribution was identified with two clear peaks at the end of the third decade and another in the sixth decade of life (Hartigan's dip-stat = 0.03; <i>p</i> < 0.01). Thirty-six percent of the patients had been smokers at some point in their lives.</p><p><strong>Conclusions: </strong>These findings confirm that MGLSc is biphasic in its adult incidence, confirming an earlier supposition; including the previously well-acknowledged paediatric peak, it is thus triphasic. The smoking data are probably unremarkable compared with the available data for smoking habits from the United Kingdom. These findings indirectly support what is postulated about the likely pathogenesis of MGLSc, that is, urinary micro-incontinence, occlusion and epithelial susceptibility.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e447"},"PeriodicalIF":0.0,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775409","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":"Evaluation of dermatologic diagnostic ability on skin of colour in preclinical medical students.","authors":"Adina Greene, Tara Ghalambor, Scott Penner, Chase Irwin, K Taraszka Hastings","doi":"10.1002/ski2.425","DOIUrl":"https://doi.org/10.1002/ski2.425","url":null,"abstract":"<p><strong>Background: </strong>Various studies have revealed that there is a disproportionately low representation of skin of colour (SOC) in medical school dermatologic curriculum and board study resources.</p><p><strong>Methods: </strong>First-year and second-year medical students were emailed an 18-question survey regarding (1) identifying correct diagnoses of dermatologic conditions on either White skin or SOC and (2) their confidence in identifying dermatologic conditions on SOC.</p><p><strong>Results: </strong>15% of the images of dermatologic conditions included in the institutional preclinical curriculum show images of patients with SOC. Regarding overall scores for diagnosing dermatologic diseases, students performed similarly on both the White image survey (61.73%) and SOC image survey (66.20%) with no statistically significant differences between surveys (<i>p</i> = 0.14). Second-year medical students performed better than first-year medical students overall (<i>p</i> = 0.01) and on White skin image survey scores (<i>p</i> = 0.02) but not on people of colour image survey scores (<i>p</i> = 0.09). Students largely agreed that they were more comfortable identifying dermatologic diagnoses on White skin and that their school could benefit from increased SOC dermatological resources.</p><p><strong>Conclusion: </strong>The overall low scores for the diagnosis of common skin conditions on both the White image and SOC image survey by first- and second-year students are not surprising given the results of a prior study and support the need for re-exposure to dermatology presentations in all skin types during the preclinical curriculum. The low scores support the need for changes in the pre-clinical dermatology curriculum to improve diagnostic ability. Second-year students performed better at diagnosing dermatologic conditions overall and on White skin compared to SOC at the end of their didactic years, possibly due to an underrepresentation of SOC images in institutional and outside educational resources. Attitudes towards school-specific dermatologic SOC education demonstrated a clear desire amongst students for more exposure to dermatologic conditions in various skin colours throughout the curriculum.</p>","PeriodicalId":74804,"journal":{"name":"Skin health and disease","volume":"4 6","pages":"e425"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775304","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}