Cancer and clinical oncology最新文献

{"title":"Utilization of Hypofractionated and Conventional Breast Radiotherapy in the State of Utah","authors":"Brandi R Page, T. Belnap, R. Christopher Bowen, D. K. Gaffney, W. Sause","doi":"10.5539/CCO.V2N2P34","DOIUrl":"https://doi.org/10.5539/CCO.V2N2P34","url":null,"abstract":"Efficacy of hypofractionated (HF) radiotherapy (RT) in breast cancer has recently been established by randomized trials. We report patterns of care in Utah to identify how patient, tumor, and treatment characteristics may influence prescription patterns. Data from 1,588 patients from nine facilities with 18 providers were retrospectively collected. Conventionally fractionated (CF) RT was defined as >19 fractions with fractions 200cGy. Partial breast irradiation (PBI) was defined as external beam RT to 3850cGy in 10 fractions. Patients considered eligible for HF were >45 years with breast separation <25 cm and tumor size <2cm with negative nodes and margins. Analysis utilized Wilcoxon Rank Sum Tests and logistic regression. Of all patients, 83.2% received CF, 12% received HF, and 4.7% received PBI. Based on recent published guidelines, 53.5% of patients were eligible for HF. There were no significant differences with respect to laterality, tissue separation, or medical comorbidities. Calculated odds ratios (OR) for increased use of HF included age (OR 1.05, p<0.001) and lower cancer stage (OR 3.75, p=0.002). Use of HF strongly correlated with increased age, number of miles traveled to clinic (47.8 vs. 21), lower grade, less aggressive surgery, and less chemotherapy. HF RT utilization is increasing over time but only in a segment of eligible patients. We report on changes in practice patterns after recent publication of randomized trial data in an effort to bring awareness to underutilization of HF, and intend to track how this changes over time.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"34"},"PeriodicalIF":0.0,"publicationDate":"2013-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70721580","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":"Normal Human Cells Acquiring Proliferative Advantage to Hyperplasia-Like Growth-Morphology: Aberrant Progeny Cells Associated With Endopolyploid and Haploid Divisions","authors":"K. Walen","doi":"10.5539/CCO.V2N2P19","DOIUrl":"https://doi.org/10.5539/CCO.V2N2P19","url":null,"abstract":"Today, cancer-patients can seek individual genomic tailored therapy, but at   escalating costs. However, cancer-incidence reduction would reduce such health-cost. The essence of this report is a cell-culture experimental approach for the production of genetically unstable cells from normal cells which with accumulation of “mutations” might reveal early, neoplastic-like pathology. Summarily the experimental focus was on: 1) establishment of a simple nutritional method (amino acid deprivation) for young-cell-response with depoly-ploidization of endopolyploid cells to diploid CIN-cells, 2) a first time observation of a fast growing new, small cell-type, appearing time-correlated with haploid segregations in normal, fibroblast metaphases  and 3) growth characteristics of the progeny cells in 1) and 2) which from their young-cell derivation, could be growth-extended in cultural passages. This would hypothetically model early tumorigenic progression from normal cells. These studies revealed gain of proliferative advantage (GPA), multilayered, changed patterns of growth, focal 3-D cell-heaps with cell polarity change, and star-like mitotic forms. Comparatively, these developments were typical of hyperplasias. The transiency of the originating genome reductive mechanisms may have prevented earlier detections. It is discussed that present growth-changes were responses to homozygous-caused loss of heterozygosity (LOH) of putative pro-proliferation genetics, whereas leukemic and some solid tumor cells showed hemizygous-caused LOH in near-haploid clonal proliferations. The practical outcome is an experimentally simple, nutrition-based model system for SNP-based haplo-karyotyping of the two aberrant cell-types with GPA, which is a cancer, fundamental trait. Never before have cellular mechanism been shown to initiate in normal, human cells, neoplastic-like proliferative responses.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"19"},"PeriodicalIF":0.0,"publicationDate":"2013-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N2P19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70721648","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":"Plasma CA 19-9 in Advanced Non-Small Cell Lung Cancer","authors":"A. Abdallah, M. Wahba, A. Bastawisy, R. Gaafar","doi":"10.5539/CCO.V2N2P11","DOIUrl":"https://doi.org/10.5539/CCO.V2N2P11","url":null,"abstract":"Background: Lung cancer is the leading cause of cancer death worldwide however no serum marker is routinely recommended till now. Patients and Methods: This is a prospective case control study including two groups of adults, Group I: Includes healthy volunteers as controls. Group II: Includes patients with advanced non-small cell lung cancer (NSCLC). Plasma CA19-9 levels were measured at baseline by ELISA before first line chemotherapy. Primary end point was comparison between the levels of CA19-9 in patients and controls. Secondary endpoint was correlation between CA19-9 level and clinical response (CR), progression free survival (PFS) and overall survival (OS) in advanced NSCLC. Results: 34 healthy adults and 35 patients with advanced NSCLC were included and followed up during the period from October 2009 to February 2013 with median follow up of 10.5 months. The mean and median pre-treatment plasma CA 19-9 concentrations of NSCLC patients were 240.7 and 231U/ml respectively. There was statistically significant difference between the patient and control groups (p < 0.001). No significant correlations were found between CA19-9 levels and CR, PFS and OS p-values: 0.5, 0.3 and 0.6 respectively Conclusion: Plasma CA19-9 is a reliable marker for advanced NSCLC.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2013-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N2P11","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70721502","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":"Psychosocial Distress in Caregivers of Patients with a Metastatic Solid Tumor in Routine Care: A Survey in a Community Based Oncology Group Practice in Germany","authors":"S. Feiten, V. Friesenhahn, J. Heymanns, K. Kleboth, H. Köppler, U. Mergenthaler, J. Thomalla, C. V. Roye, R. Weide","doi":"10.5539/CCO.V2N2P1","DOIUrl":"https://doi.org/10.5539/CCO.V2N2P1","url":null,"abstract":"Introduction: Psychosocial distress in caregivers of cancer patients is highly prevalent, particularly in advanced stages. Little data is available concerning extent and main issues of caregivers’ distress from patients who receive their treatment in an oncology group practice. Methods: Standardized cross-sectional survey was administered to caregivers and patients with a metastatic solid tumor who were treated in a community based oncology group practice. Patients provided information concerning their caregivers and level of distress. Caregivers assessed level and main issues of distress. The extent of distress was evaluated using the Distress Thermometer (DT), main issues of distress were evaluated by the Hospital Anxiety and Depression Scale (HADS-D). Results: 200 patients (35% male) with a median age of 68 (38 – 93) were interviewed. DT mean score was 4.7, with 35% scoring above cut-off (> 5). 90% named one or more caregiver, 1.3 were named in mean (0 – 4). 137 caregivers (42% male) with a median age of 61.5 (25 – 86) were interviewed. DT mean score was 5.4, with 48% scoring above cut-off (> 5). According to HADS-D 20% were anxious (cut-off >= 11) and 15% depressed (cut-off >= 9) in a clinical sense. With regard to the distress level of caregivers and patients, gender was not found to be a confounding variable although female patients showed higher distress levels than male patients. Conclusion: Caregivers are screened as highly distressed, sometimes even more than the patients themselves. A significant proportion seems to be anxious and depressed and therefore should be offered help.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2013-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N2P1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70721443","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":"Thymidine Kinase 1: A Universal Marker for Cancer","authors":"M. Alegre, R. Robison, K. O’Neill","doi":"10.5539/CCO.V2N1P159","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P159","url":null,"abstract":"Thymidine Kinase 1 (TK1) is traditionally a serum biomarker which is elevated in the early stages of malignancies. TK1 is a DNA repair enzyme which is typically associated with proliferation. In serum, TK1 is elevated in a stage-like manner and increases as the disease advances. As a well-characterized serum biomarker, relatively little work has been done to establish it as a tumor biomarker. However, tumor TK1 reflects many of the same trends that can be seen with serum TK1. Specifically, tumor TK1 is an early event in tumor progression and increases with grade and stage. This study seeks to demonstrate that, similar to serum TK1, tumor TK1 is a valuable indicator of malignancy in the most common types of cancer in men. In this study we used a highly specific monoclonal antibody to TK1 to histologically stain 10 different types of carcinoma tissue and corresponding normal tissue. We found that TK1 is a good marker for malignancy and is significantly overexpressed in cancers compared to normal controls in lung, colon, prostate, esophagus, stomach, liver, and kidney tissues. Slight differences were found in the staining pattern among various types of lung cancer although virtually all types showed significantly higher TK1 staining compared to normal tissue. Additionally, TK1 expression in prostate carcinoma was significantly higher than from normal tissue, and correlated with an increase in stage. Overall, it is clear that TK1 is a valuable cancer marker in a wide variety of solid tumors and may be considered a universal cancer marker.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"159"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P159","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70721158","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":"Intravascular Large B-cell Lymphoma Transformed from a Mantle Cell Lymphoma: A Case Report and Literature Review","authors":"Long Yang, B. Harrison, M. Perle, M. Singh, Z. Pei, J. Melamed, Peng Lee, S. Ibrahim, R. Wieczorek","doi":"10.5539/CCO.V2N1P151","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P151","url":null,"abstract":"Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal diffuse large B-cell lymphoma (NHL) characterized by the presence of neoplastic lymphocytes only in the lumina of small vessels and capillaries. Although studies have shown an association of IVLBCL with other lymphomas, its relationship with mantle cell lymphoma has not been reported. Here we report a rare case of a 76 year-old male with intravascular transformation of mantle cell lymphoma in the adrenal glands. Histopathological examination of the adrenal mass biopsy revealed two cell populations within the fibrovascular tissue – a diffuse and infiltrative small lymphoid cell population and an unexpected large neoplastic cell population. Immunohistochemistry (IHC) for the small lymphoid cells are positive for CD5, CD20, and cyclin D1, with the t(11;14)(q13;q32) chromosomal rearrangement on cytogenetic analysis by interphase fluorescence in situ hybridization (FISH), characteristic for mantle cell lymphoma. The large cells are positive for CD5, CD20 and CD79a and negative for cyclin D1 on IHC, demonstrating exclusive localization within small capillaries by CD34 staining, evident of IVLBCL. In addition, FISH analysis revealed that the large cells also have the t(11;14)(q13;q32) mantle cell lymphoma rearrangement. To our knowledge, the present study provides the first reported case of IVLBCL transformation from mantle cell lymphoma and supports the hypothesis that IVLBCL may arise by transformation from other lymphomas.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"151"},"PeriodicalIF":0.0,"publicationDate":"2013-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70720891","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 Transdifferentiation of Mediastinal Germ Cell Tumor into a Myeloid Neoplasm in the Bone Marrow-Report of a Case and Short Review of a Diagnostic Pitfall","authors":"L. Cichon, J. Gaede, T. Sporn, C. Rehder, A. Lagoo","doi":"10.5539/CCO.V2N1P143","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P143","url":null,"abstract":"We present the case of a young male with a mediastinal non-seminomatous germ cell tumor who developed a severe thrombocytopenia, one year after initial diagnosis and surgical treatment and chemotherapy. Bone marrow morphology suggested myelodysplastic syndrome (refractory cytopenia with multilineage dysplasia). Cytogenetics of bone marrow showed near tetraploid karyotype, raising concerns about the diagnosis of MDS. The patient died within one month due to refractory disease and autopsy revealed a highly invasive germ cell tumor in the mediastinum and chest wall which showed the same cytogenetic abnormality seen in the bone marrow. The bone marrow collected at autopsy showed features compatible with acute myeloid leukemia. The implications of this transdifferentiation of a mediastinal germ cell tumor into an apparent hematological malignancy for correct diagnosis and appropriate treatment are discussed.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"143"},"PeriodicalIF":0.0,"publicationDate":"2013-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70720771","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":"ECF with Infusional Fluorouracil for 5 Days in Locally Advanced and Metastatic Gastric Cancer, Is It Better than the Standard?","authors":"A. Ibrahim, Adel Gabr, Ahmed A. Hefny","doi":"10.5539/CCO.V2N1P136","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P136","url":null,"abstract":"The ECF (Epirubcin/Cisplatin/5-fluorouracil) first therapy in metastatic gastric is the optimal therapeutic option but its complexity limits its utility in many communities. We investigated a more convenient modification of the standard approach, \"5 days CIV 5-fluorouracil 1000mg/m 2 \". A total of 115 patients with advanced and metastatic adenocarcinoma of the stomach and gastroesophageal cancer were reviewed retrospectively to compare the efficacy of modified ECF N=41 with the reference protocols FAM N=32 and ELF N=42. The overall response rate was 36.5% with ECF, 16.6% with ELF, and 15.6% with FAM, with significant differences p=0.001. No one achieved a complete tumor regression. However, 4 patients with locally advanced stomach were able to have total gastrectomy in ECF arm only with p=0.000. Hematologic toxicities were more common in ECF p= 0.01. On the other hand, there was no significant difference in progression free survival or overall survival between the three regimens. Modified ECF showed significant overall response than FAM and FLF. However survival benefit is very small. So we recommend using this regimen as neoadjuvant treatment.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"136"},"PeriodicalIF":0.0,"publicationDate":"2013-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70720692","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":"Individualized Case–Control Study of Accelerated Partial Breast Irradiation by Multicatheter Intertstitial Brachytherapy in Japanese Patients with Breast Cancer","authors":"Kazuhiko Sato, Y. Mizuno, H. Fuchikami, Masahiro Kato, T. Shimo, Jun Kubota, N. Takeda, Y. Inoue, H. Seto, T. Okawa","doi":"10.5539/CCO.V2N1P127","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P127","url":null,"abstract":"Background: Breast-conserving surgery (BCS) followed by whole-breast irradiation (WBI) are the standard of care for treating early-stage breast cancer. The efficacy of accelerated partial breast irradiation (APBI) has recently been investigated as an alternative to WBI. Although we previously reported that multicatheter brachytherapy in APBI is feasible in Japanese patients, long-term data of several APBI techniques have not yet been obtained. Here we estimated the long-term efficacy of multicatheter brachytherapy in Japanese patients with breast cancer to validate its use an individualized case–control (ICC) analysis. Method: From October 2008 to March 2013, a total of 184 consequent patients with 188 tumors underwent BCS followed by multicatheter brachytherapy. A total of 120 consecutive patients (mean age, 55.1 years) with 122 tumors (pN0) who had at least 1 year of follow-up were enrolled in this analysis. Before lumpectomy, the insertion of applicators and delivery doses were simulated by computed tomography. After confirming the free margins and negative sentinel node metastases by frozen section analysis, the applicators were inserted. APBI therapy was initiated on the same day of surgery on the basis of the dose distribution analysis, at 32 Gy in 8 fractions over 5–6 days with a 2-cm tumor margin coverage. Regarding our prospective follow-up policy in this observational study, all patients had a predefined schedule including clinical examination every 3–4 months and mammography and breast magnetic resonance imaging (MRI) every 12 months. We performed ICC analysis to estimate the number of patients with ipsilateral breast tumor recurrence (IBTR). The 10-year risk of IBTR for each patient when undergoing with WBI was calculated using the web-based decision-making tool IBTR! and was adjusted during the real-time follow-up period using data obtained from an overview by the Early Breast Cancer Trialists’ Collaborative Group. Results: The median follow-up period was 3.1 years (range, 1.1–4.4 years). Most tumors (92.6%) were ?2 cm in diameter, and 89.4% were estrogen receptor-positive. Hormone therapy was administered in 86.7% and adjuvant chemotherapy in 20.0% patients. If all patients received WBI after BCS, we estimated IBTR in this group to be 1.1–2.8. Although 1 IBTR was observed, no tumor bed recurrence was recorded. Conclusions: Although this study involved only a small number of patients and short follow-up period, only 1 IBTR case was recorded, which was within the estimated range of local recurrence. Multicatheter brachytherapy using this technique may offer the same rates of local control as WBI in Japanese patients.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2013-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70720296","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":"Comparative Effectiveness of Adjuvant Chemotherapy in Elderly Colon Cancer Patients","authors":"S. Satram-Hoang, L. Lee, Shui Yu, Faiyaz Momin, Sridhar R Guduru, C. Reyes, E. McKenna","doi":"10.5539/CCO.V2N1P115","DOIUrl":"https://doi.org/10.5539/CCO.V2N1P115","url":null,"abstract":"Introduction: We assessed whether older patients experience the same treatment benefits from adjuvant chemotherapy in a real-world setting as younger patients in clinical trials. Methods: This retrospective cohort analysis used the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database. The analysis included 3,390 patients, >65 years, diagnosed with stage II or III colon cancer between January 1, 2004, and December 31, 2007. Patients were enrolled in Medicare Parts A and B, and had undergone adjuvant treatment with fluorouracil plus leucovorin (5-FU/LV; n=1,368), 5-FU/LV plus oxaliplatin (FOLFOX; n=1,398), capecitabine (CAP; n=507), or CAP plus oxaliplatin (CAPOX; n=117) within 3 months of surgery. Differences in patient demographics and disease characteristics by treatment were assessed by chi-square test and ANOVA or t-test. Cox proportional hazards regression and propensity score-weighted analyses were used to measure the relative risk of death associated with each treatment. Results: Median time from surgical resection to initiation of treatment was similar across cohorts (44-48 days). Mean treatment duration was longer for 5-FU/LV (149 days) and FOLFOX (144 days) than CAP (121 days) and CAPOX (111 days); p<.0001. In the propensity score-adjusted survival models, patients treated with FOLFOX (HR=0.70; 95%CI=0.55-0.90) and CAPOX (HR=0.44; 95%CI=0.20-0.98) had a significantly lower risk of death than 5FU/LV, while risk of death was similar between CAP and 5-FU/LV. Conclusions: Elderly patients with colon cancer have similar benefits from adjuvant chemotherapies in real-world settings as demonstrated in younger patients in clinical trial settings.","PeriodicalId":89904,"journal":{"name":"Cancer and clinical oncology","volume":"2 1","pages":"115"},"PeriodicalIF":0.0,"publicationDate":"2013-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5539/CCO.V2N1P115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70720228","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}