Innovative Practice in Breast Health最新文献

{"title":"Advancements in managing pure ductal carcinoma in situ: An 18-year artificial intelligence-aided analysis of 998 patients","authors":"Jonathan Sabah ,&nbsp;Charmène Cruchet ,&nbsp;Mousselim Gharbi ,&nbsp;Marie-Pierre Chenard ,&nbsp;Antoine Simoulin ,&nbsp;Nicolas Thiebaut ,&nbsp;Karl Neuberger ,&nbsp;Sébastien Molière ,&nbsp;Carole Mathelin","doi":"10.1016/j.ibreh.2024.100022","DOIUrl":"10.1016/j.ibreh.2024.100022","url":null,"abstract":"<div><h3>Introduction</h3><div>The integration of artificial intelligence (AI) in oncological diseases has opened new avenues for early cancer detection, accurate risk assessments, and personalized treatment protocols. The objective of our study was to describe the shift in the treatment indications and prognosis of ductal carcinoma in situ (DCIS) in a prospective cohort of 998 patients managed over 18 years at a single University Hospital in France.</div></div><div><h3>Methods</h3><div>This analysis included all patients managed for DCIS at the University Hospitals of Strasbourg between January 14, 2002, and December 18, 2019, from the prospective SENOMETRY cohort, which initially included 9599 patients with both in situ and invasive breast cancer. Data were analyzed using Onconum, an AI-based natural language processing tool, to extract structured information from medical records.</div></div><div><h3>Results</h3><div>The incidence of DCIS remained stable at 65 new cases per year. The mean age at diagnosis increased from 55 years in 2002 to 61 years in 2019. There was a significant rise in high-grade DCIS (DIN3) cases from 25% to 35%. The re-excision rate decreased from 57% in 2002 to 18% in 2019. Most DCIS cases were managed with breast-conserving surgeries (682), while total mastectomies accounted for 385 cases. Sentinel lymph node biopsy was performed in 39% of cases, primarily in high-grade and multifocal DCIS. Specific mortality was 0%, with a recurrence rate of 2.2%, predominantly invasive and occurring earlier in high-grade DCIS. Discussion: Over 18 years, there has been a notable shift in the clinicopathological characteristics of DCIS, with an increase in patient age at diagnosis and higher histopathological grades. Therapeutic management evolved significantly, with reduced surgical margins and fewer adjuvant treatments, while maintaining low and stable recurrence rates. AI significantly enhanced data extraction and analysis efficiency, contributing to better clinical decision-making.</div></div><div><h3>Conclusion</h3><div>The study confirms the possibility of therapeutic de-escalation in DCIS, supported by AI-driven data analysis, allowing individualized treatment approaches and leading to optimized patient outcomes.</div></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"5 ","pages":"Article 100022"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746642","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 critical analysis of the potential of formal education programs in breast cancer management in Iran: A Qualitative Content Analysis","authors":"Koosha Rokhzadi ,&nbsp;Saeed Khani ,&nbsp;Kamal Khaleghpanah ,&nbsp;Hossein Daneshmehr ,&nbsp;Kaveh Haji-Allahverdipoor","doi":"10.1016/j.ibreh.2024.100023","DOIUrl":"10.1016/j.ibreh.2024.100023","url":null,"abstract":"<div><h3>Background</h3><div>Education serves as the cornerstone for acquiring essential life skills, yet the conventional structure of academic programs often fails to bridge the gap between theoretical knowledge and its practical application, particularly evident in developing nations. This discrepancy extends to healthcare, notably concerning the challenge of breast cancer on a global scale.</div></div><div><h3>Objectives</h3><div>This study aims to explore the potential of formal biology programs within public education systems to address breast cancer prognosis through qualitative content analysis.</div></div><div><h3>Methods</h3><div>This investigation incorporates qualitative methodologies to elucidate the potential implications of such programs. qualitative content analysis method was conducted by comprehensive examination of formal general Biology programs within the public education sphere worldwide has been undertaken, explicitly emphasizing their relevance to breast cancer prognosis initiatives. Additionally, documentary research and literature reviews have been employed to augment the analytical framework of this study.</div></div><div><h3>Results</h3><div>The analysis uncovers a significant void in current educational frameworks regarding breast cancer awareness and self-examination. With projections indicating a surge in breast cancer cases by 2040, the imperative to address this educational gap becomes increasingly urgent. Integrating breast cancer education into formal schooling emerges as a promising avenue to empower individuals with vital self-healthcare knowledge and early detection skills.</div></div><div><h3>Conclusion</h3><div>By equipping students with life-saving skills, such proactive educational measures hold promise in mitigating the global burden of breast cancer, potentially reducing both mortality rates and incidence worldwide. Our study, through qualitative content analysis, developed a curriculum to enhance students' understanding of breast cancer. In Iran, updating the \"Health and Hygiene\" textbook to include breast cancer information is crucial. This curriculum aims to improve health literacy and proactive healthcare, ultimately contributing to better health outcomes and the global fight against breast cancer.</div></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"5 ","pages":"Article 100023"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746656","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":"Artificial intelligence for hierarchical tumor masking potential classification in mammograms","authors":"João Mendes ,&nbsp;Nuno C. Garcia ,&nbsp;Nuno Matela","doi":"10.1016/j.ibreh.2024.100014","DOIUrl":"10.1016/j.ibreh.2024.100014","url":null,"abstract":"<div><p>The most commonly detected cancer type worldwide in 2020 was Breast Cancer (BC). Early diagnosis of this disease, aimed through generalized screening programs with mammography, is imperative to improve BC prognosis. Despite its positive impacts, these programs present some pitfalls. The two-dimensional nature of screening mammography often results in tissue overlap, which can obscure the presence of tumors. This phenomenon contributes to false negative results, potentially delaying cancer diagnosis and compromising disease prognosis. This work proposes an Artificial Intelligence (AI) model capable of analyzing current healthy mammograms and predicting their masking potential. This refers to the likelihood of a potential future cancer, if present, being obscured in subsequent screening mammograms. Given that, 3,000 synthetic mammograms, evenly divided into three masking potential classes Low, Medium, and High were used to train a Convolutional Neural Network (CNN). The performance of the CNN was evaluated using a test set comprising 1,000 mammograms from each masking potential class. Besides that, an independent test set comprised of real instead of synthetic mammograms (<em>N</em> = 201) was also used to assess performance. The F1-score, Specificity, and Accuracy values were very high on the synthetic test set, measuring at 0.976, 0.988, and 0.976, respectively, underscor ing the excellent predictive capability of the CNN. Moreover, the results on the independent test set also show a high classification capacity on the Low and High masking classes in terms of Precision and Specificity. A model like the one proposed here can have significant impacts in the future, allowing personal ized screening based on masking risk, potentially reducing the number of false negative results and ultimately improving the outcomes of this disease.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"3 ","pages":"Article 100014"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000149/pdfft?md5=888159d16a33bcf265f9cfbd0275e395&pid=1-s2.0-S2950212824000149-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173640","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":"Systematic review of added immunotherapy in traditional treatment for HER2 positive breast cancer patients","authors":"Rohan Choudhari","doi":"10.1016/j.ibreh.2024.100013","DOIUrl":"10.1016/j.ibreh.2024.100013","url":null,"abstract":"<div><h3>Background</h3><p>Breast Cancer is one of the most prevalent cancers in the UK with a variety of subtypes. One of the more invasive and aggressive subtypes is known as ‘HER 2 positive’, referring to the overexpression of HER 2 receptors on cancer cells. Traditionally, surgical intervention alongside chemotherapy in these invasive subtypes is the preferred and recognised treatment. However, recent literature suggests newer immunotherapeutic agents approved by NICE could be beneficial to treat HER 2 Positive patients as an addition or even a substitute over traditional treatments.</p></div><div><h3>Objective</h3><p>To perform a systematic review of added Immunotherapy in traditional treatment in HER2 Positive Breast Cancer Patients</p></div><div><h3>Methods</h3><p>A literature search was conducted using four medical databases in 2022. These were PubMed, Scopus, EMBASE, and Web of Science. The inclusion criteria included Females aged 18 years and above diagnosed with HER2+ breast cancer using immunotherapy as the intervention comparing it with chemotherapy and looking at pCR and survival rates as the outcome. Exclusion criteria was also present excluding terms like ‘triple negative breast cancer’. The Joanna Briggs Institute (JBI) Checklists were used to assess the risk of bias of studies.</p></div><div><h3>Results</h3><p>After study selection processes, seven studies were used in this review. Five of the studies were randomised controlled trials and two of the studies were follow up studies. The randomised controlled trial results clearly showed a better pCR and survival rate for patients which had two immunotherapeutic agents compared to one, and patients who has chemotherapy alongside immunotherapy, compared to patients who only had immunotherapy.</p></div><div><h3>Discussion</h3><p>It was clear that two immunotherapeutic agents alongside chemotherapy was the most effective treatment for patients also producing the best pCR and survival rates. Limitations of studies included short follow up periods and lack of binding of participants in the trials.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"3 ","pages":"Article 100013"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000137/pdfft?md5=9a619717b77d3b3386df710e4d23607e&pid=1-s2.0-S2950212824000137-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142173641","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":"Ours","authors":"","doi":"10.1016/S2950-2128(24)00021-6","DOIUrl":"10.1016/S2950-2128(24)00021-6","url":null,"abstract":"","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"3 ","pages":"Article 100021"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142743195","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":"Is immediate breast reconstruction surgery safe for elderly women? Assessment of postoperative complications in women aged 70 years and older","authors":"Carlo Arellano ,&nbsp;Caroline Bouche ,&nbsp;Ariane Weyl ,&nbsp;Mony Ung ,&nbsp;Eva Jouve ,&nbsp;Gabrielle Selmes ,&nbsp;Marc Soule-Tholy ,&nbsp;Thomas Meresse ,&nbsp;Carole Massabeau ,&nbsp;Ana Cavillon ,&nbsp;Charlotte Vaysse","doi":"10.1016/j.ibreh.2024.100005","DOIUrl":"10.1016/j.ibreh.2024.100005","url":null,"abstract":"<div><h3>Introduction</h3><p>The rate of immediate breast reconstruction (IBR) in elderly women (EW) is lower than in younger patients because of concerns related to postoperative complications (POC) and their consequences.</p></div><div><h3>Objective</h3><p>We assessed POC 30 days after IBR, readmissions rate within 30 days, and the time to start adjuvant therapy in EW aged ≥ 70 years.</p></div><div><h3>Materials and Methods</h3><p>We conducted an observational, retrospective, single-center study between January 2014 and May 2022 at the University Cancer Institute of Toulouse-Oncopole (IUCT-O), including patients over 70 years old treated with mastectomy and IBR. Patients’ characteristics, medical treatments with the time between therapies and POC were recorded.</p></div><div><h3>Results</h3><p>A total of 125 women aged 70 to 84 years old were included in our study. The rate of IBR was 13.7 %. The rate of major POC was 17.6 % (<em>n</em> = 22), including 9.8 % (<em>n</em> = 11) implant removal. There was significantly more skin necrosis in patients with a history of homolateral radiotherapy (<em>p</em> = 0.016) but less hematoma (<em>p</em> = 0.004). Overweight or obese EW tending to have more than one surgical POC (<em>p</em> = 0.019). EW with nipple-areola complex (NAC) conservation had significantly more skin necrosis (<em>p</em> = 0.01). The median time for initiation of adjuvant chemotherapy (ACT) and hormonal therapy was 5.7 [1.6–11.9] and 4.3 [1.6–78.9] weeks respectively. The median time to initiate adjuvant radiotherapy (ART) when preceded by ACT or not, was 9.2 [5.1–22] and 21.1 [16.9–21.4] weeks respectively.</p></div><div><h3>Conclusion</h3><p>Our study confirms that IBR in women aged ≥ 70 years is safe and does not delay adjuvant therapies.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"2 ","pages":"Article 100005"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000058/pdfft?md5=af050a47b3edea7ab03c602ec38142d9&pid=1-s2.0-S2950212824000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699245","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 prospective study to assess the quality of life (QOL) in breast cancer patients and factors affecting quality of life","authors":"Rakesh Kapoor ,&nbsp;Treshita Dey ,&nbsp;Divya Khosla ,&nbsp;Ishita Laroiya","doi":"10.1016/j.ibreh.2024.100004","DOIUrl":"10.1016/j.ibreh.2024.100004","url":null,"abstract":"<div><h3>Introduction</h3><p>Breast cancer is the most prevalent malignancy among women globally, with an incidence rate of 11.7 %, surpassing lung cancer as the most frequently diagnosed cancer. In India, incidence rates begin to increase in the early thirties, peaking between the ages of 50 and 64. Historically, the female population has harbored significant fear towards this particular cancer due to the social stigma associated with the diagnosis. It not only poses a challenge to their self-image but also affects their sexual function, consequently having a negative impact on their psychological well-being. Recent advancements in treatment delivery techniques have decreased breast cancer mortality and enhanced disease-free survival rates. However, ensuring a good quality of life (QOL) remains a challenge. This study was conducted to assess the QOL of breast cancer patients and the factors influencing it.</p></div><div><h3>Materials</h3><p>Patients with histopathological proven malignancy of breast carcinoma aged above 18 years who were registered in our radiotherapy department were included in this cross-sectional study. Patient related, disease related and treatment related parameters were noted. QOL survey instruments used were EORTC-QLQ-C30 version 3.0, EORTC-QLQ-BR23.</p></div><div><h3>Results</h3><p>A total of 160 patients registered in our department from November 2019 to November 2022 were included in this study. The young breast (&lt;45 years) cancer patients showed comparable QOL scores with older patients on most symptomatic and functional scales. The patients with an advanced disease had lowest scores on all functional scales but was not statistically significant. Breast conserving surgery (BCS) correlated very well with better functioning scores in our study though it did not achieve statistical significance. Patients undergoing BCS seemed more confident about their future prospectives and had better sexual enjoyment score. People living in urban area scored higher in both scales.</p></div><div><h3>Conclusion</h3><p>This study indicates that QOL of breast cancer patients is closely linked to clinical and sociodemographic factors. Providing financial and psychological support to patients diagnosed with breast cancer may further enhance their QOL.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"2 ","pages":"Article 100004"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000046/pdfft?md5=6f91e0b3f8c0e4d05ca4f84c4e462d82&pid=1-s2.0-S2950212824000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708386","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":"ours","authors":"","doi":"10.1016/S2950-2128(24)00017-4","DOIUrl":"10.1016/S2950-2128(24)00017-4","url":null,"abstract":"","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"2 ","pages":"Article 100017"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000174/pdfft?md5=cb127cd8a10ee63a88a9fd9740464775&pid=1-s2.0-S2950212824000174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142149514","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":"Non-genetic indications for risk reducing mastectomies: Guidelines of the national college of French gynecologists and obstetricians (CNGOF)","authors":"Carole Mathelin ,&nbsp;Emmanuel Barranger ,&nbsp;Martine Boisserie-Lacroix ,&nbsp;Gérard Boutet ,&nbsp;Susie Brousse ,&nbsp;Nathalie Chabbert-Buffet ,&nbsp;Charles Coutant ,&nbsp;Emile Daraï ,&nbsp;Yann Delpech ,&nbsp;Martha Duraes ,&nbsp;Marc Espié ,&nbsp;Luc Fornecker ,&nbsp;François Golfier ,&nbsp;Pascale Grosclaude ,&nbsp;Anne Sophie Hamy ,&nbsp;Edith Kermarrec ,&nbsp;Vincent Lavoué ,&nbsp;Massimo Lodi ,&nbsp;Élisabeth Luporsi ,&nbsp;Christine M Maugard ,&nbsp;Xavier Fritel","doi":"10.1016/j.ibreh.2024.100003","DOIUrl":"https://doi.org/10.1016/j.ibreh.2024.100003","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the value of performing a risk-reducing mastectomy (RRM) in the absence of a deleterious variant of a breast cancer susceptibility gene, in 4 clinical situations at risk of breast cancer.</p></div><div><h3>Design</h3><p>The French National College of Obstetricians and Gynecologists (CNGOF) Commission of Senology developed these recommendations. A policy of declaration and monitoring of links of interest was applied throughout the process of making the recommendations. Similarly, the development of these recommendations did not benefit from any funding from a company marketing a health product. The Commission of Senology adhered to the AGREE II (Advancing guideline development, reporting and evaluation in healthcare) criteria and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method to assess the quality of the evidence on which the recommendations were based. The potential drawbacks of making recommendations in the presence of poor quality or insufficient evidence were highlighted.</p></div><div><h3>Methods</h3><p>8 questions on 4 topics, focusing on histological, hereditary (except identified genetic abnormality), radiological (of unrecognized cancer), and radiation (history of Hodgkin's lymphoma) risks were considered. For each situation, it was determined whether performing RRM compared with surveillance would decrease the risk of developing breast cancer and/or increase survival.</p></div><div><h3>Results</h3><p>The Commission of Senology synthesis and application of the GRADE method resulted in 11 recommendations, 6 with a high level of evidence (GRADE 1+/-) and 5 with a low level of evidence (GRADE 2+/-).</p></div><div><h3>Conclusion</h3><p>There was significant agreement among the Commission of Senology members on recommendations to improve practices for performing or not performing RRM.</p></div>","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"1 ","pages":"Article 100003"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000034/pdfft?md5=bd623db483b14e079371e70f3ab95ce3&pid=1-s2.0-S2950212824000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141439101","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":"ours","authors":"","doi":"10.1016/S2950-2128(24)00008-3","DOIUrl":"10.1016/S2950-2128(24)00008-3","url":null,"abstract":"","PeriodicalId":100675,"journal":{"name":"Innovative Practice in Breast Health","volume":"1 ","pages":"Article 100008"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2950212824000083/pdfft?md5=5637ba7a3dd5ea7f1368daaf7b216533&pid=1-s2.0-S2950212824000083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961563","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}