American journal of clinical pathology最新文献

{"title":"Evaluation of enterochromaffin-like cell hyperplasia can help categorize patients with Helicobacter-negative atrophic gastritis.","authors":"Feidi Chen, Raul S Gonzalez","doi":"10.1093/ajcp/aqae159","DOIUrl":"10.1093/ajcp/aqae159","url":null,"abstract":"<p><strong>Objectives: </strong>Atrophic gastritis (AG) is characterized by atrophy of gastric glands-in particular, oxyntic glands-in the setting of chronic inflammation; it is often autoimmune. The diagnosis is confirmed by immunohistochemistry (IHC) for gastrin (to confirm biopsy site), and pathologists often use IHC for neuroendocrine markers to evaluate for enterochromaffin-like cell hyperplasia (ECL-H). The utility of neuroendocrine staining is unclear, and we undertook this study to determine whether ECL pattern provided any additional information in cases of Helicobacter-negative AG.</p><p><strong>Methods: </strong>We reviewed clinicopathologic findings in 184 cases from 184 patients with histologic AG and no evidence of Helicobacter infection. Using neuroendocrine IHC markers, cases were divided into 3 groups: Group 1 showed complete ECL-H (both qualitative and quantitative criteria met), group 2 showed focal ECL-H (qualitative but not quantitative criteria met), and group 3 showed no ECL-H (neither criteria met).</p><p><strong>Results: </strong>Group 1 patients were more likely to have positive autoantibody serologies (73%, P = .0007 vs group 2) and higher mean gastrin levels (700 pg/mL, P = .017 vs group 3), and only these patients developed gastric neuroendocrine tumors. Group 2 patients were more likely to take proton pump inhibitors (64%, P = .0002 vs group 1). Group 3 patients were more likely to be male (70%, P = .008 vs group 1) and to have microcytic anemia (44%, P = .022 vs group 2) and less likely to have intestinal metaplasia (50%, P = .044 vs group 1).</p><p><strong>Conclusions: </strong>Stratification based on degree of ECL-H is not necessary for diagnosis of AG but does lead to statistically significant clinical and pathologic differences among groups.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"601-609"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the potential for iodinated radiocontrast agents to interfere with ADAMTS13 activity testing via fluorescence resonance energy transfer methodology.","authors":"Jeremy W Jacobs, Melissa S Stuart, Julie I Tange, Rachel R Leger, Aneel A Ashrani, Dong Chen, Rajiv K Pruthi, Meera Sridharan, Jansen N Seheult","doi":"10.1093/ajcp/aqae160","DOIUrl":"10.1093/ajcp/aqae160","url":null,"abstract":"<p><strong>Objectives: </strong>Fluorescence resonance energy transfer (FRET)-based ADAMTS13 activity assays are critical for the diagnosis of thrombotic thrombocytopenic purpura. However, these assays are susceptible to interference. As iodide has been suggested to interfere in laboratory testing via fluorophore quenching or promotion, we aimed to determine whether iodinated contrast (Omnipaque) interferes with the ATS-13 ADAMTS13 Activity Assay 2.0.</p><p><strong>Methods: </strong>We evaluated the excitation, emission, and absorbance spectrum of Omnipaque alone and spiked in patient plasma with known ADAMTS13 activity and ADAMTS13 activity on Omnipaque alone, an abnormal control of patient plasma previously observed to display elevated baseline relative fluorescent units, and variable concentrations of patient plasma with known ADAMTS13 activity spiked with Omnipaque.</p><p><strong>Results: </strong>No atypical fluorescent peaks were observed on any sample (Omnipaque alone or spiked in plasma) between 250 and 700 nm. There was no difference in the mean ADAMTS13 activity among the various concentrations of plasma spiked with Omnipaque or plasma spiked with saline.</p><p><strong>Conclusions: </strong>Iodinated contrast does not appear to interfere-either via spectral overlap of the fluorophore or through physiologic inhibition of the ADAMTS13 enzyme-with ADAMTS13 activity FRET-based assays based on the findings from this in vitro analysis. Delaying sample collection for ADAMTS13 activity testing from suspected patients with thrombotic thrombocytopenic purpura following administration of iodinated radiocontrast agents is not necessary, and recent contrast administration should not yield erroneous ADAMTS13 activity results.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"610-617"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TRPS1 is a useful marker in differentiating metastatic breast carcinoma from pancreatic adenocarcinoma in fine-needle aspiration specimens.","authors":"Bahadir Yildiz, Jerome Jean-Gilles, Ellen J Giampoli, Sierra Kovar-Peltz, Qi Yang, Hiroshi Miyamoto, Ying Wang","doi":"10.1093/ajcp/aqae155","DOIUrl":"10.1093/ajcp/aqae155","url":null,"abstract":"<p><strong>Objectives: </strong>Distinction of metastatic breast carcinoma (BC) to the pancreas from primary pancreatic adenocarcinoma (PAC) is essential but challenging. Breast carcinoma shares similar morphology and exhibits an overlapping immunohistochemistry (IHC) profile with PAC. We investigated the utility of recently reported trichorhinophalangeal syndrome type 1 (TRPS1) IHC in differentiating metastatic BC from PAC in fine-needle aspiration (FNA) specimens.</p><p><strong>Methods: </strong>We assessed consecutive patients of PAC (n = 49). Due to limited cases of metastatic BC to the pancreas (n = 3), cases of metastatic BC (n = 23) in various locations, including lymph node, lung, bone, or soft tissue, were included. Immunohistochemistry for TRPS1 was performed by using the cell blocks obtained from FNA. A quantitative score for TRPS1 expression was calculated by multiplying the intensity and the percentage of positive cells. Immunoreactivity scores were assigned as negative, low positive, intermediate positive, or high positive.</p><p><strong>Results: </strong>In 49 PAC cases, 47 (95.9%) exhibited negative while 2 (4.1%) exhibited low positive TRPS1 expression. However, TRPS1 expression was high positive in 23 (88.0%) of 26 metastatic BC cases, including 10 (83.3%) of 12 triple-negative BC (TNBC) and 13 (92.9%) of 14 non-TNBC cases.</p><p><strong>Conclusions: </strong>Our results suggest that TRPS1 IHC represents a highly accurate and reliable method for differentiating metastatic BC from PAC.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"581-585"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analytical performance of a point-of-care CBC hematology analyzer, including a 5-part differential: A prospective study to evaluate a microfluidic flow cytometry-based analyzer in waived settings.","authors":"Jane F Emerson, Hao Wang, Imran N Siddiqi","doi":"10.1093/ajcp/aqae149","DOIUrl":"10.1093/ajcp/aqae149","url":null,"abstract":"<p><strong>Objectives: </strong>A microfluidic flow cytometer-based point-of-care (POC) analyzer was validated against an in-laboratory hematology analyzer (Sysmex XN Automated Hematology System). Concordance on a full complete blood cell count (CBC) with 5-part differential, as performed by operators with no prior clinical laboratory experience, was evaluated.</p><p><strong>Methods: </strong>We prospectively collected 376 venous blood specimens (376) from individuals with self-reported medical conditions and from apparently healthy individuals. Forty-six additional remnant specimens were acquired to ensure coverage of analytic measuring ranges. Parallel testing was performed, with up to 7 hours between testing on the POC and Sysmex XN analyzers.</p><p><strong>Results: </strong>Regression analysis resulted in r values of 0.998 to 0.932 for all parameters of a 5-part differential CBC other than basophils (0.709). The mean percentage bias from the reference method, inclusive of the upper and lower reporting limits, was less than 2% for parameters other than lymphocytes (-6.4%), monocytes (25.9%), eosinophils (12.2%), and basophils (-15%). Overall agreement on abnormal flagging was 93.3%.</p><p><strong>Conclusions: </strong>The Cito CBC microflow cytometer (CytoChip Inc) provides a CBC with a 5-part differential with accuracy, precision, and abnormal flagging equivalent to a moderate-complexity hematology analyzer. It has the key features required of a POC device that can be operated in a waived setting: minimum space requirements, rapid results, single-action measurement (no sample processing or dilution), ease of use, and minimal blood volume.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"531-544"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urothelial carcinoma in situ with \"early papillary formation\" vs \"lateral spread/shoulder lesion\" of prior high-grade noninvasive papillary urothelial carcinoma: A survey of pathologist and urologist interpretations.","authors":"Ankur R Sangoi, Ali Shahabi, Michelle S Hirsch, Chia-Sui Sunny Kao, Mustafa Deebajah, Justine A Barletta, Gladell P Paner, Steven C Smith, David J Grignon, Eva Compérat, Mahul B Amin, Fiona Maclean, Rajal B Shah, Kenneth A Iczkowski, Warick Delprado, Liang Cheng, Chin-Chen Pan, Jesse K McKenney, Jae Y Ro, Francesca Khani, Rodolfo Montironi, Brian D Robinson, Hikmat Al-Ahmadie, Jonathan I Epstein, Kiril Trpkov, Maria Tretiakova, Steven S Shen, Shaheen Alanee, Christopher J Weight, Mahmut Akgul, Sean R Williamson","doi":"10.1093/ajcp/aqae167","DOIUrl":"10.1093/ajcp/aqae167","url":null,"abstract":"<p><strong>Objectives: </strong>Urothelial carcinoma in situ (CIS) with early papillary formation is terminology sometimes used to suggest incipient high-grade papillary urothelial carcinoma (PUC) but may lead to confusion between true CIS and lateral flat spread of PUC.</p><p><strong>Methods: </strong>It remains unclear how pathologists and urologists interpret this scenario, so a survey was circulated to 68 pathologists (group 1 = 28 academic genitourinary pathologists; group 2 = 17 pathologists with a self-reported genitourinary focus; group 3 = 23 pathologists self-reported as not genitourinary specialists) and 32 urologists.</p><p><strong>Results: </strong>Regarding atypical urothelial lesions that appear mainly flat but contain possible papillae, group 3 was more likely to label this as CIS compared with groups 1 and 2 (35% for group 3 vs 13% for groups 1 and 2), while groups 1 and 2 more often adopted another descriptive diagnosis, such as \"CIS with early papillary features\" (38% for groups 1 and 2 vs 13% for group 3). Among all 3 groups, group 1 was most likely to diagnose concomitant CIS and PUC in the same specimen but in different tissue fragments (58%). Pagetoid spread was reported to favor CIS predominantly by group 1 (61%). Urologists felt that the term lateral spread/shoulder was unclear (75%) and preferred early PUC (44%) or PUC with early growth (44%). Half (53%) of urologists felt that reporting CIS instead of lateral spread of PUC would change management.</p><p><strong>Conclusions: </strong>Documentation of flat lesions lacks consensus among pathologists and may benefit from standardized terminology. Moreover, the distinction between CIS and early or lateral spread of PUC is not always clear to urologists and can influence disease management.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"629-640"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to \"Escalation process of critical values when these cannot be communicated on first attempt: a hospital-wide process improvement project\".","authors":"Jeannette Guarner","doi":"10.1093/ajcp/aqae165","DOIUrl":"10.1093/ajcp/aqae165","url":null,"abstract":"","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"643"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Follow the LINE: A novel case of dilated cardiomyopathy caused by a LINE-1 insertion in the TTN gene.","authors":"Qiliang Ding, Jenna Fine, Frank T Hoffman, Michelle L Kluge, Rhonda K Kuennen, Sarah M Thieke, Nicole L Hoppman, Cherisse A Marcou, Ross A Rowsey, Erik C Thorland, Linnea M Baudhuin, Ann M Moyer, Alessia Buglioni","doi":"10.1093/ajcp/aqae170","DOIUrl":"10.1093/ajcp/aqae170","url":null,"abstract":"<p><strong>Objectives: </strong>Protein-truncating variants in the TTN gene are a well-established cause of dilated cardiomyopathy (DCM). We report a novel case of DCM caused by a mobile element insertion (MEI) in TTN, through which we highlight the key features of MEIs in next-generation sequencing data. Because of the rarity of MEIs, the next-generation sequencing data features associated with these events may be mistaken as noise, potentially leading to missed diagnoses.</p><p><strong>Methods: </strong>Next-generation sequencing gene panel testing for DCM was performed on a 17-year-old male patient presenting with severe left ventricular dilatation and systolic dysfunction. Manta was used for structural variant detection, followed by manual review of NGS data for potential structural variants.</p><p><strong>Results: </strong>Manta detected a potential insertion in TTN. Manual review identified hallmark features consistent with a LINE-1 MEI. This finding was orthogonally confirmed by long-range polymerase chain reaction and gel electrophoresis, which indicated an insertion of approximately 4 to 5 kilobase pairs. The insertion disrupted the reading frame of TTN within an A-band exon, resulting in protein truncation that was classified as likely pathogenic.</p><p><strong>Conclusions: </strong>This case expands the mutational spectrum of TTN protein-truncating variants. It also underscores the importance of recognizing rarer types of pathogenic variants (eg, MEIs) to produce accurate genetic diagnostics.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"511-515"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How I diagnose B-cell lymphoproliferative disorders with plasmacytic differentiation.","authors":"Jonathan H Young, Olga Pozdnyakova","doi":"10.1093/ajcp/aqae163","DOIUrl":"10.1093/ajcp/aqae163","url":null,"abstract":"<p><strong>Objectives: </strong>B-cell lymphomas with plasmacytic differentiation is a broad category that includes small and large B-cell lymphomas. In this review, we focus on the small B-cell lymphomas, which include lymphoplasmacytic lymphoma and marginal zone lymphomas, among others. We aimed to review the diagnostic criteria of each entity and the features that distinguish them from each other.</p><p><strong>Methods: </strong>We discuss the clinical presentation, morphology, immunophenotype, molecular features, and potential pitfalls of diagnosing B-cell lymphomas with plasmacytic differentiation and provide 2 illustrative cases.</p><p><strong>Results: </strong>In some instances, small B-cell lymphomas with plasmacytic differentiation, particularly lymphoplasmacytic lymphoma and certain marginal zone lymphomas, have overlapping morphologic and immunophenotypic features. As a result, differentiating them may be difficult.</p><p><strong>Conclusions: </strong>In cases where classification is challenging, integration with clinical, radiologic, and laboratory findings may be helpful in arriving at a specific diagnosis. Instances remain, however, in which classification is difficult.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"501-510"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of anatomic and clinical pathology services and infrastructure in Nigeria.","authors":"Jonathan Tucci, Jeremy W Jacobs, Zainab U Ibrahim, Aminu A Yusuf, Ali Bala Umar, Danny A Milner, Quentin Eichbaum","doi":"10.1093/ajcp/aqae156","DOIUrl":"10.1093/ajcp/aqae156","url":null,"abstract":"<p><strong>Objectives: </strong>The paucity of data regarding the availability and extent of diagnostic medical services across sub-Saharan Africa hinders appropriate allocation of resources to improve health care in these regions. We assessed anatomic pathology (AP) and clinical pathology (CP) services in Nigeria, one of the most populous and fastest-growing countries in the world.</p><p><strong>Methods: </strong>Two individual surveys (AP focused and CP focused) were developed by subject matter experts and administered to individuals involved in pathology and laboratory medicine diagnostic services at hospitals and laboratories across Nigeria between June and August 2022 using the American Society for Clinical Pathology email listserv.</p><p><strong>Results: </strong>A total of 75 responses (29 AP and 46 CP) were received from 48 unique laboratories. Twenty-four sites provided AP services and 35 provided CP services. Eleven respondents performed both AP and CP services. Among AP services, basic surgical and cytopathology capabilities were available at most sites; however, the availability of automated technologies (eg, automated sample processing and staining) was more variable. Advanced diagnostic techniques, (eg, immunohistochemistry, human papillomavirus testing, molecular diagnostics) were rarely performed. The most frequently available CP services included hematology, microbiology, and chemistry. Microbiology services appeared to be among the most robust laboratory medicine services, particularly parasitology and bacteriology testing. Similar to AP services, more advanced diagnostic assays, such as flow cytometry, cytogenetics, and molecular testing, were largely unavailable.</p><p><strong>Conclusions: </strong>These findings augment earlier studies and identify gaps that should be prioritized from a policy perspective to improve medical services and the overall health care infrastructure in Nigeria.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"586-600"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Career pathways into the medical laboratory workforce: Education, exposures, and motivations.","authors":"Grace A Guenther, Shahida F Shahrir, Susan M Skillman, Iman Kundu, Edna Garcia, Bianca K Frogner","doi":"10.1093/ajcp/aqae151","DOIUrl":"10.1093/ajcp/aqae151","url":null,"abstract":"<p><strong>Objectives: </strong>The goal of this study was to investigate career pathways into the medical laboratory workforce by examining medical laboratory scientists, medical laboratory technicians, histotechnologists, histotechnicians, cytologists, and phlebotomists.</p><p><strong>Methods: </strong>We collected data through an anonymous online survey (May-June 2023) from a convenience sample of medical laboratory professionals in the United States (N = 1243). We performed descriptive analyses of demographics, current employment characteristics, educational and training history, career exposures, motivations, movement, and outlook (eg, job satisfaction, future career plans).</p><p><strong>Results: </strong>Findings show a diverse range of educational backgrounds and varying career pathways across occupations. A majority of respondents reported hearing about laboratory occupations from friends, family, co-workers, and acquaintances. At least one-third to nearly one-half of respondents had a family member with broader professional health care experience. Respondents viewed their jobs favorably, with at least 75% of respondents answering that they would recommend their occupation or another laboratory occupation.</p><p><strong>Conclusions: </strong>This study found overall positive job experiences and satisfaction, but career pathways into medical laboratory occupations are complex and often unclear. Organizations in the field are undertaking promotional efforts to increase the visibility of these occupations. Future research is needed to monitor and evaluate these efforts.</p>","PeriodicalId":7506,"journal":{"name":"American journal of clinical pathology","volume":" ","pages":"545-580"},"PeriodicalIF":2.3,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142826968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}