Archives of pathology & laboratory medicine最新文献

{"title":"Finding Missing Calcifications: How Deep to Cut?","authors":"Lester J Layfield, Magda Esebua, Meghan White, Robert Schmidt","doi":"10.5858/arpa.2024-0079-OA","DOIUrl":"10.5858/arpa.2024-0079-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Mammographic identification of microcalcifications may result in biopsy because many calcifications serve as markers for breast pathology. Absence of these calcifications in histologic sections may indicate that an area of concern has not been adequately sampled.</p><p><strong>Objective.—: </strong>To determine the optimal cutting protocols to identify mammary calcifications.</p><p><strong>Design.—: </strong>Our standard protocol for breast biopsies with suspected mircocalcifications is to cut 2 levels separated by 30 μm and if no microcalcifications are detected, an additional 10 levels are obtained. An electronic search of surgical pathology records was performed for cases with microcalcifications identified between January 1, 2022, and March 30, 2023. For each case, slides designated by the radiologist as containing microcalcifications were retrieved. The level at which microcalcifications were first detected was recorded.</p><p><strong>Results.—: </strong>The search revealed 431 specimens meeting the search criteria, of which 415 contained microcalcifications. The probability of finding microcalcifications in the initial level was 0.629, and the probability of detecting microcalcifications in the first 4 levels was 0.905. Four hundred three of 415 microcalcifications documented by mammographic imaging (97%) were detected histologically in the first 6 levels.</p><p><strong>Conclusions.—: </strong>A 6-level approach appears optimal for the detection of microcalcifications. This study may have implications for other specimen types where a strong suspicion exists for a pathologic lesion, but examination reveals no lesions in the initial sections. Protocols using 6-level-deep cuts may represent optimal sampling.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"483-485"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735972","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":"Conservative Lymph Node Sampling Is Clinically Appropriate in Intestinal Resections Related to Nonneoplastic Inflammatory Bowel Disease: A Single Institution Experience.","authors":"Chen Mayer, Tom Z Liang, Saman Karimi, Yujie Zhang, Tatianna Larman, Lysandra Voltaggio","doi":"10.5858/arpa.2024-0184-OA","DOIUrl":"10.5858/arpa.2024-0184-OA","url":null,"abstract":"<p><strong>Context.—: </strong>In this era of health care challenges, efficient resource use is crucial. Patients with inflammatory bowel disease (IBD) may undergo surgery owing to treatment-refractory disease or strictures. Unlike colorectal cancer resections, there are no guidelines for lymph node retrieval in nonmalignant IBD resections.</p><p><strong>Objective.—: </strong>To assess the usefulness and cost-effectiveness of extensive lymph node examination in nonmalignant IBD resections.</p><p><strong>Design.—: </strong>A retrospective analysis of 354 cases from 2011 to 2018 was conducted. Resections for suspected malignancy or lesions grossly suggestive of carcinoma were excluded. Patient data, resection type, lymph node count, and follow-up information were collected.</p><p><strong>Results.—: </strong>Results showed 51% (180) of cases had 12 or more examined lymph nodes. Only 1 case (0.3%) revealed microscopic invasive carcinoma associated with stricture without metastasis to 26 examined lymph nodes. No metastatic disease was found among the 4972 evaluated lymph nodes. Estimated total savings were at least $19 812, with approximately 10.4 minutes saved on microscopic evaluation. During a mean 5.7-year follow-up, no patients developed metastatic disease from an intestinal primary tumor. Among the 20 deceased patients, cause of death was available for 14 patients (70%), of whom 11 (55%) died of nonneoplastic causes and 3 (15%) of nonintestinal malignancies.</p><p><strong>Conclusions.—: </strong>While lymph node assessment is crucial in IBD-associated colorectal carcinoma, a colorectal cancer protocol-type lymph node search is unnecessary without clinical or gross pathologic suspicion. A conservative approach to lymph node sampling optimizes resources without compromising patient care.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"486-488"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142030","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":"Pathologic and Molecular Features of Perihilar Cholangiocarcinoma Based on U-P Point Division.","authors":"Ying Xiao, Qijia Zhang, Canhong Xiang, Jianghui Yang, Bowen Li, Hongfang Yin","doi":"10.5858/arpa.2023-0547-OA","DOIUrl":"10.5858/arpa.2023-0547-OA","url":null,"abstract":"<p><strong>Context.—: </strong>The Japanese Society of Hepato-Biliary-Pancreatic Surgery guidelines propose a classification scheme that differs from the Union for International Cancer Control (UICC) system, in which the anatomic U-P point is the boundary between intrahepatic cholangiocarcinoma and perihilar cholangiocarcinoma (PCC).</p><p><strong>Objective.—: </strong>To investigate whether this classification system improves clinicopathologic and genomic differentiation.</p><p><strong>Design.—: </strong>Fifty-eight PCC cases defined by the UICC system were collected and classified into intrahepatic PCC (IPCC) and extrahepatic PCC (EPCC) categories using U-P point division. They were analyzed by next-generation sequencing using a panel that targeted 425 cancer-related genes.</p><p><strong>Results.—: </strong>The IPCC group exhibited a significantly larger tumor size compared with the EPCC group (4.67 ± 2.44 cm versus 2.50 ± 0.91 cm, P = .002). The mutation frequency of the KRAS proto-oncogene, GTPase (KRAS) Q61 was also significantly higher in the IPCC group than in the EPCC group (16.7% versus 0.0%, P = .03). There were no statistically significant differences in other pathologic features or genomic characteristics, including tumor mutation burden and microsatellite instability. Significant differences in gene mutation rates, such as phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA; 0.0% versus 15.8%, P = .01) and tumor protein p53 (TP53; 34.5% versus 63.2%, P = .04), were observed between PCC and adjacent biliary tract cancers.</p><p><strong>Conclusions.—: </strong>This study offers valuable insight into the clinicopathologic and genomic features of PCC. It is proposed that the U-P point division may have limited potential to refine the characterization of PCC regarding these features, and that the UICC classification system can readily demonstrate the molecular specificity of PCC.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"439-447"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876947","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":"Cervical Cancer Screening by Human Papillomavirus Testing of Vulvar Swabs.","authors":"Tommy Richard Sun-Wing Tong","doi":"10.5858/arpa.2024-0406-LE","DOIUrl":"https://doi.org/10.5858/arpa.2024-0406-LE","url":null,"abstract":"","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":"149 5","pages":"395"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065339","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 Anatomic Pathology Hospitalist Model : A Novel Approach to Frozen Section Practice in a Tertiary Care Center.","authors":"Ellen E Chapel, David B Chapel, L Priya Kunju, John A Hamilton, Jeffrey L Myers, Liron Pantanowitz","doi":"10.5858/arpa.2024-0056-OA","DOIUrl":"10.5858/arpa.2024-0056-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Challenges to staffing a high-quality frozen section service include consolidation of health systems and pathology practices, off-campus relocation of some pathology offices, growing numbers of stand-alone surgery centers, and subspecialization among pathologists and surgeons. To address these challenges, we developed a novel anatomic pathology hospitalist model with explicit emphasis in frozen section.</p><p><strong>Objective.—: </strong>To evaluate our anatomic pathology hospitalist program's impact on (1) frozen section staffing, (2) frozen-permanent diagnostic concordance, and (3) turnaround time.</p><p><strong>Design.—: </strong>Frozen section staffing and performance data were collected for the 28-month period spanning July 1, 2021, to October 31, 2023. Outcomes were compared between hospitalists, nonhospitalists, and fellows.</p><p><strong>Results.—: </strong>Hospitalists performed more frozen sections per month than nonhospitalists (median, 87 versus 17, respectively; P = .002). After implementation, nonhospitalists' average frozen section staffing obligation fell from 3.7 (30%) of 12.3 total service days per month to 2.8 (22%) of 12.6 total service days per month (P = .005), compared with hospitalists' average of 9.5 frozen section days (69%) of 13.7 total service days per month. Frozen-permanent concordance was marginally but significantly higher for hospitalists (4701 of 4744 blocks, 99.1%) than nonhospitalists (7259 of 7362 blocks, 98.6%; P = .02). Concordance did not correlate with pathologists' academic rank or subspecialization. Turnaround times were comparable for hospitalists, nonhospitalists, and fellows across multiple metrics.</p><p><strong>Conclusions.—: </strong>Our anatomic pathology hospitalists significantly reduced the frozen section obligations of nonhospitalist faculty, with a small but significant increase in frozen-permanent concordance and no substantial change in turnaround time.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"469-475"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142303216","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":"Neuropathologic Features and Underlying Medical Disease States of Spontaneous Subdural Hematomas in Adults: A Hospital Autopsy Case Series From a Single Tertiary Center.","authors":"Annie A Wu, Kevin Y Zhang, Tara Srinivas, Joshua D Materi, Thomas Zaikos, Christopher J VandenBussche, Cheng-Ying Ho","doi":"10.5858/arpa.2024-0003-OA","DOIUrl":"10.5858/arpa.2024-0003-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Spontaneous (nontraumatic) subdural hematomas (SDHs) have been reported yet have not been well studied.</p><p><strong>Objective.—: </strong>To identify the neuropathologic features of acute spontaneous SDHs (ASSDHs) and their associated medical conditions.</p><p><strong>Design.—: </strong>A retrospective study of 235 autopsy cases of SDH was conducted. Review of demographics, underlying medical conditions, and coagulation profile as well as gross and histopathologic examination of the brain and other organs were performed.</p><p><strong>Results.—: </strong>Among the 32 cases of ASSDH, 5 cases (15.6%) had severe hemorrhage and 4 (12.5%) demonstrated brain herniation. Twenty-two cases (68.8%) had concurrent but nonconnecting subarachnoid hemorrhage or intraparenchymal hemorrhage. The most common underlying medical condition was thrombocytopenia (n = 21; 65.6%), followed by immunosuppression (n = 15; 46.9), bloodstream infections or sepsis (n = 12; 37.5%), hypertension (n = 13; 40.6%), and coronary artery disease (n = 12; 37.5%). Many patients with thrombocytopenia or immunosuppression had underlying malignancies, with leukemia being the most common type (n = 11; 34.4%). The use of circulatory devices or hemodialysis was noted in a significant portion of ASSDH cases. In terms of coagulation factors, most of our ASSDH patients had normal prothrombin time and activated partial thromboplastin time, but abnormal platelet count and D-dimer levels.</p><p><strong>Conclusions.—: </strong>ASSDHs can be severe and are often associated with subarachnoid hemorrhage and/or intraparenchymal hemorrhage. The causes of ASSDH are limited to certain underlying medical conditions that ultimately lead to bleeding tendency. Autopsies are helpful in determining the etiology. Given their association with abnormal platelet count, correcting platelet deficiencies is a potential preventive measure for ASSDHs.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"457-463"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790301","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":"Use of Mitotic Activity and the Size of Any Dedifferentiated Component for Risk Assessment in MDM2-Amplified Liposarcoma.","authors":"Hao Wu, Madina Sukhanova, Haiming Tang, Xinyan Lu, Minghao Zhong, Hari Deshpande, Seth M Pollack, William B Laskin, Borislav A Alexiev","doi":"10.5858/arpa.2024-0098-OA","DOIUrl":"10.5858/arpa.2024-0098-OA","url":null,"abstract":"<p><strong>Context.—: </strong>The characteristic molecular signature for both atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma is amplified sequences derived from chromosome 12q13-15, including MDM2 proto-oncogene (MDM2). As the progression of atypical lipomatous tumor/well-differentiated liposarcoma to the more aggressive dedifferentiated liposarcoma has the potential to adversely affect patient outcomes, the extent of the latter component might be important to evaluate.</p><p><strong>Objective.—: </strong>To investigate the correlation between clinicopathologic characteristics, including tumor size, modified Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade, molecular data, and outcomes in 123 surgically resected MDM2-amplified liposarcomas.</p><p><strong>Design.—: </strong>Pathology reports and clinical records were reviewed. A log-rank test was used to compare the survival trends, and univariate logistic regression was performed to identify variables associated with adverse events (distant metastasis and/or death), from which the P value was derived to construct a multivariate regression model.</p><p><strong>Results.—: </strong>In univariate analysis, the largest single dimension of the dedifferentiated component, the percentage of cells with gain of chromosome 12, mitotic count, and the presence of modified FNCLLC grade 3 were associated with adverse events. In multivariate analysis, the largest single dimension of the dedifferentiated component (odds ratio: 1.169; 95% CI: 1.053, 1.299; P = .003), and a higher mitotic count (odds ratio: 1.133; 95% CI: 1.037, 1.237; P = .006) were correlated with adverse events. There was no statistically significant association between current local recurrence status, overall largest tumor dimension, overall tumor volume, MDM2 copy number, or MDM2 to chromosome 12 centromere probe ratio and adverse outcomes.</p><p><strong>Conclusions.—: </strong>Staging dedifferentiated liposarcoma based on the size of the dedifferentiated component better predicts the outcome.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"422-430"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Bottom-Up Liquid Chromatography-Tandem Mass Spectrometry Method for Therapeutic Drug Monitoring of Infliximab: Method Development, Comparison With 2 Enzyme-Linked Immunosorbent Assay Methods, and Evaluation of Anti-Drug Antibody Interference.","authors":"Sang-Mi Kim, Hyeonju Oh, Sung Noh Hong, Mi Jin Kim, Yon Ho Choe, Soo-Youn Lee","doi":"10.5858/arpa.2023-0573-OA","DOIUrl":"10.5858/arpa.2023-0573-OA","url":null,"abstract":"<p><strong>Context.—: </strong>Therapeutic drug monitoring is recommended to optimize infliximab use and improve outcome in chronic inflammatory disorders.</p><p><strong>Objective.—: </strong>To describe a simple and affordable liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to measure infliximab in serum.</p><p><strong>Design.—: </strong>Infliximab was measured using winged stable isotope-labeled peptides as internal standards. Linearity, lower limit of measuring interval, limit of detection, precision, accuracy, carryover, and ion suppression were evaluated. Method comparison against 2 enzyme-linked immunosorbent assay (ELISA) methods (Remsima Monitor and IDKmonitor Infliximab) and anti-drug antibody (ADA) interference were evaluated using clinical specimens from inflammatory bowel disease patients (N = 237).</p><p><strong>Results.—: </strong>Analytical run time and sample preparation time were 5 minutes per sample and 3 hours per batch, respectively. Analytical measurement interval and limit of detection were 0.50 to 50.0 μg/mL (R2 = 0.998) and 0.25 μg/mL, respectively. The intraday and interday imprecision percentage coefficients of variation were less than 6.1%. Accuracy was 94.2% to 98.7%. No significant ion suppression or carryover was observed. Infliximab concentrations measured by LC-MS/MS showed good agreement with those measured by Remsima Monitor (mean percentage difference, 5.7%; 95% CI, -1.2% to 12.6%) but were markedly lower than those measured by IDKmonitor (-32.6%; -35.8% to -29.4%), demonstrating significant bias between ELISAs. Although a good agreement between LC-MS/MS and ELISA was observed for ADA-negative samples (-3.5%; -12.8% to 5.9%), a significant bias was observed for ADA-positive samples (13.6%; 1.7% to 25.6%).</p><p><strong>Conclusions.—: </strong>This simple, fast, and affordable LC-MS/MS method for infliximab quantitation could improve standardization of infliximab quantitation and optimization of infliximab use in patients with high-titer ADA.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"448-456"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749891","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":"Reported Awareness and Use of Pyridoxal-5'-Phosphate Supplementation in Alanine Aminotransferase and Aspartate Aminotransferase Assay Reagents: A Survey by the College of American Pathologists Clinical Chemistry Committee.","authors":"Allison B Chambliss, Rhona J Souers, Jonathan R Genzen, David M Manthei","doi":"10.5858/arpa.2024-0097-CP","DOIUrl":"10.5858/arpa.2024-0097-CP","url":null,"abstract":"<p><strong>Context.—: </strong>Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) assay reagents are available both with and without supplementation with pyridoxal-5'-phosphate (P5P; the active form of vitamin B6), a catalytic cofactor required for their enzymatic reactions. Nonsupplemented assays may miss ALT or AST elevations in patients with vitamin B6 deficiency.</p><p><strong>Objective.—: </strong>To assess awareness and adoption of ALT and AST reagents that are supplemented with P5P.</p><p><strong>Design.—: </strong>A 4-question survey about ALT and AST reagent supplementation with P5P was included in the College of American Pathologists General Chemistry and Therapeutic Drugs (C program) proficiency testing 2023 B mailing.</p><p><strong>Results.—: </strong>Overall, 38% (1651 of 4304) of responding laboratories reported using ALT and/or AST reagent supplemented with P5P. P5P supplementation was more common for nonacademic hospital/medical center laboratories (44%; 713 of 1629) relative to other settings. Of the laboratories that reported not using P5P-supplemented reagents, few (5%; 141 of 2611) cited plans to convert in the future. Despite the availability of P5P-supplemented reagents from several major assay manufacturers, the most common stated barrier for adoption was that the laboratory's reagent manufacturer does not provide P5P-supplemented reagents.</p><p><strong>Conclusions.—: </strong>There is a lack of awareness of the existence and benefits of P5P-supplemented ALT and AST reagents. There is a need for ALT and AST assay manufacturers to clarify and standardize the P5P status of ALT and AST reagents.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":" ","pages":"400-404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763189","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":"In Reply.","authors":"Xiao Li, Hongyu Xie, Xinyu Wang","doi":"10.5858/arpa.2025-0003-LE","DOIUrl":"https://doi.org/10.5858/arpa.2025-0003-LE","url":null,"abstract":"","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":"149 5","pages":"395"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044679","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}