{"title":"Exploring the effects of high protein versus high fat snacks on satiety, gut hormones and insulin secretion in women with overweight and obesity: A randomized clinical trial","authors":"Nahla Al-Bayyari , Maysoon Alhameedy , Razan Omoush , Hadeel Ghazzawi","doi":"10.1016/j.obpill.2025.100212","DOIUrl":"10.1016/j.obpill.2025.100212","url":null,"abstract":"<div><h3>Background</h3><div>Nuts generally blunt the postprandial increases in glucose levels and increase satiety, while yogurt studies yield inconclusive results regarding post-meal hunger. This study investigated the effects of high-protein, and high-fat snacks, specifically Greek yogurt, and peanuts, on satiety, gut hormones, and insulin secretion in women with overweight and obesity. The hypothesis posited that peanuts would exhibit a more beneficial impact on satiety, gut hormones, and insulin levels compared to Greek yogurt.</div></div><div><h3>Methods</h3><div>The two-arm parallel randomized trial involved fifty participants aged 30–40 years with a BMI between 25 and 35 kg/m<sup>2</sup>, randomly divided into peanut (n = 25) and Greek yogurt (n = 25) groups. After three days of adhering to 1200 Kcal diet, appetite sensations were gauged using a visual analog scale (VAS) upon arrival, and at 30- and 60-min post-snack. Pre- and post-snacking, plasma levels of cholecystokinin (CCK), Peptide Tyrosine-Tyrosine (PYY), Glucagon Like Peptide-1 (GLP-1), Ghrelin (GHRL), and insulin were analyzed.</div></div><div><h3>Results</h3><div>Revealed that Greek yogurt induced a statistically significant increase in satiety 30 min after consumption and markedly elevated postprandial insulin levels compared to peanuts. Moreover, notable intergroup differences in postprandial insulin concentrations were observed in the Greek yogurt group. The peanut group had no significant alterations in PYY, GLP-1, CCK or GHRL levels. Pre-snacking, GHRL levels exhibited a positive association with abdominal circumference, weight, and fat mass, while CCK levels displayed a negative association with abdominal circumference, weight, and fat mass.</div></div><div><h3>Conclusion</h3><div>Greek yogurt may enhance satiety and thus has the potential to positively influence body weight in individuals with overweight and/or obesity. Further research is required to elucidate appetite control mechanisms.</div></div><div><h3>Trial registration</h3><div>The study was registered on <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> (No. NCT 04518930).</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100212"},"PeriodicalIF":0.0,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227026","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}
Obesity PillarsPub Date : 2025-09-16DOI: 10.1016/j.obpill.2025.100210
{"title":"Letters to the editor regarding the “Nutritional priorities to support GLP-1 therapy for obesity: A joint advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and the Obesity Society”","authors":"","doi":"10.1016/j.obpill.2025.100210","DOIUrl":"10.1016/j.obpill.2025.100210","url":null,"abstract":"","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105017","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 impact of ultra-processed foods on pediatric health","authors":"Venkata Sushma Chamarthi , Pallavi Shirsat , Kunal Sonavane , Saketh Parsi , Usha Ravi , Harikrishna Choudary Ponnam , Shagun Bindlish , Evan P. Nadler , Rahul Kashyap , Sarah Ro","doi":"10.1016/j.obpill.2025.100203","DOIUrl":"10.1016/j.obpill.2025.100203","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultra-processed foods (UPFs) have become increasingly incorporated into pediatric diets, accounting for approximately 67 % of the total energy consumption in United States (US) children. Manufactured through industrial processing and enriched with excess sugars, unhealthy fats, and sodium, while lacking essential nutrients, UPFs present a substantial public health concern. We aimed to conduct a comprehensive review of the impact of UPFs on pediatric health.</div></div><div><h3>Methods</h3><div>We reviewed the effects of UPF on pediatric health using data from observational studies, systematic reviews, and policy reports. Our review explored the social, environmental, and economic drivers of UPF consumption, associated health consequences, and proposed mitigation strategies. We also examined National Health and Nutrition Examination Survey (NHANES) data, the 2025 US Dietary Guidelines Advisory Committee’s (USDA) report, and the Make America Healthy Again (MAHA) commission findings.</div></div><div><h3>Results</h3><div>UPF intake has dramatically increased during early childhood, with toddlers and school-aged children obtaining 47 % and 59.4 % of their daily calories, respectively, from UPFs. Higher consumption is linked to pediatric obesity, cardiometabolic risks such as insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), mental health concerns, and gut microbiome disruption. Early-life exposure to UPFs can establish unhealthy dietary patterns that persist into adulthood, raising the risk of chronic disease. Greater UPF consumption is often observed among lower-income families, highlighting a key health disparity.</div></div><div><h3>Conclusion</h3><div>UPF consumption is a modifiable risk factor for non-communicable diseases in children. Addressing it requires urgent, coordinated action at multiple levels. Strategies include UPF and sugar-sweetened beverage screening during well-child visits, policy restrictions on food marketing, clearer nutrition labeling, healthier school meals, and personalized family-centered dietary counseling. Clinicians need standardized tools and training to counsel families effectively. Policy initiatives should prioritize prevention-focused measures to protect children's health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100203"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048595","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}
Obesity PillarsPub Date : 2025-09-09DOI: 10.1016/j.obpill.2025.100207
Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez
{"title":"The impact of disordered eating and eating behavior on weight loss after sleeve gastrectomy in Egyptian adolescents","authors":"Mohey Elbanna , Amany Falah , Ahmed Magdy Hafez","doi":"10.1016/j.obpill.2025.100207","DOIUrl":"10.1016/j.obpill.2025.100207","url":null,"abstract":"<div><h3>Background</h3><div>Bariatric surgery is the most effective treatment for obesity in Adolescents. However, disordered eating is frequent in this population. Several studies found that disordered eating affects weight loss after bariatric surgery. The aim of this study was to find out the impact of disordered eating on weight loss in Egyptian adolescents two years after sleeve gastrectomy.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study conducted at Ain Shams University Hospitals from March 2020 to March 2024. It included 47 adolescents with obesity who underwent laparoscopic sleeve gastrectomy (LSG) two years before. Their age was 16.2 ± 0.67 years (range 14.5 – 17.8 years old). Their body mass indices were above 99th percentile for age and sex with or without comorbidities. They had a mean BMI of 39.9 kg/m² (range: 36.9 – 54.3 kg/m²). Patients with psychiatric illnesses and eating disorders were excluded. Patients were recruited after completion of two years of follow up for weight loss. Weight loss was evaluated by total weight loss % (TWL%). Disordered eating was detected by the Arabic version of EDE-Q v.6.0, and a global score of > 2.5 was considered positive. TWL% was correlated with EDE-Q score.</div></div><div><h3>Results</h3><div>After two years, the mean TWL% was 27.5% ± 7.7%. Nineteen patients (40.4%) had EDE-Q score more than 2.5. The EDE-Q positive patients had a mean %TWL of 25.7% ± 4.8%, while EDE-Q negative patients had a mean %TWL of 30.5% ± 6.2%. The difference is statistically significant.</div></div><div><h3>Conclusion</h3><div>We conclude that the outcome of sleeve gastrectomy in adolescents is affected by their eating behavior as soon as the restrictive effect of the operations subsides.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100207"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105018","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}
Obesity PillarsPub Date : 2025-09-08DOI: 10.1016/j.obpill.2025.100209
Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones
{"title":"Dietary supplement considerations during glucagon-like Peptide-1 receptor agonist treatment: A narrative review","authors":"Brittany V.B. Johnson, Mary Milstead, Rachel Kreider, Rachel Jones","doi":"10.1016/j.obpill.2025.100209","DOIUrl":"10.1016/j.obpill.2025.100209","url":null,"abstract":"<div><h3>Background</h3><div>Recent advancements with Glucagon-like Peptide-1 Receptor Agonists (GLP-1RA) result in approximately 15 % or more weight reduction. Scientific research addressing specific nutritional concerns with GLP-1RA are still emerging. While some guidelines currently exist for nutritional considerations, they are largely focused on side effect management and providing basic dietary guidance during GLP-1RA.</div></div><div><h3>Methods</h3><div>This narrative review aims to provide practical evidence-based considerations for dietary supplementation to help optimize health outcomes while using GLP-1RA. We reviewed available literature of dietary supplementation interventions among individuals with obesity, weight loss clinical trials, and adiposity-related complications to help guide clinicians on potentially advantageous supplementation.</div></div><div><h3>Results</h3><div>Robust data from meta-analyses provides justification for a variety of dietary supplements that can support the unintended consequences of GLP-1RA treatments. Multivitamins are recommended to address micronutrient insufficiencies as determined by individual deficiencies and suboptimal intake. Protein supplements can help individuals meet daily protein intake recommendations of 1.2–2.0 g/kg/d. When combined with resistance training, whey protein can help preserve lean body mass during weight loss, with additional strength benefits from creatine monohydrate and β-Hydroxy β-Methylbutyrate supplementation. Antioxidants and anti-inflammatory nutrients can mitigate oxidative stress and inflammation. Fiber and probiotics can improve bowel regularity and mitigate side effects.</div></div><div><h3>Conclusion</h3><div>Healthcare providers play an active role in supporting their patients with comprehensive obesity treatment. Guidance should focus on improving their long-term health and potentially mitigating unintended consequences. Optimizing nutrient intakes with therapeutic doses of dietary supplements may enhance outcomes when used alongside GLP-1RA, such as increasing nutrient status, retaining lean mass, reducing oxidative stress and inflammation, and improving gastrointestinal health.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100209"},"PeriodicalIF":0.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048594","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}
Obesity PillarsPub Date : 2025-09-02DOI: 10.1016/j.obpill.2025.100208
Ola Faleh, Zaynab Alourfi
{"title":"The relationship between obesity and serum calcium level in a sample of Syrian people a cross sectional study","authors":"Ola Faleh, Zaynab Alourfi","doi":"10.1016/j.obpill.2025.100208","DOIUrl":"10.1016/j.obpill.2025.100208","url":null,"abstract":"<div><h3>Introduction</h3><div>Calcium is one of the most important elements in the human body playing a crucial role in various physiological functions. Its serum levels might be influenced by multiple factors. Obesity is a prevalent disease worldwide, and many studies have explored the relationship between obesity and serum calcium levels. This study aimed to investigate the association between Body Mass Index (BMI) and serum calcium.</div></div><div><h3>Material and method</h3><div>This cross-sectional study conducted at the National University Hospital between 2023 and 2024 involved 206 participants. Serum calcium levels were measured. A fasting morning blood sample was collected from each subject, and all tests were performed at The National University Hospital.</div></div><div><h3>Result</h3><div>The analysis showed no significant association between BMI and serum calcium levels, nor between age and serum calcium. However, after adjusting for age, the relationship between BMI and serum calcium strengthened and reached statistical significance, revealing an inverse correlation. This suggests that age acted as a partial confounding variable in the initial assessment.</div></div><div><h3>Conclusion</h3><div>While the initial findings of this cross-sectional study initially revealed no significant relationship between body mass index (BMI) and serum calcium, after adjusting for age, an inverse relationship was found between BMI and serum calcium, with higher BMI associated with lower serum calcium levels.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100208"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988583","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}
Obesity PillarsPub Date : 2025-08-29DOI: 10.1016/j.obpill.2025.100206
Nora Struckmeyer , Torben Biester , Chantal Weiner , Evelin Sadeghian , Cathrin Guntermann , Laura Galuschka , Kisa von Stuelpnagel , Jantje Weiskorn , Kerstin Kapitzke , Karin Lange , Thomas Danne , Rebecca Toenne , Felix Reschke
{"title":"Evaluating the long-term effectiveness of a structured telehealth obesity program in children and adolescents: A retrospective matched-control study","authors":"Nora Struckmeyer , Torben Biester , Chantal Weiner , Evelin Sadeghian , Cathrin Guntermann , Laura Galuschka , Kisa von Stuelpnagel , Jantje Weiskorn , Kerstin Kapitzke , Karin Lange , Thomas Danne , Rebecca Toenne , Felix Reschke","doi":"10.1016/j.obpill.2025.100206","DOIUrl":"10.1016/j.obpill.2025.100206","url":null,"abstract":"<div><h3>Background</h3><div>Childhood obesity is a growing global health crisis, driven by poor diet, reduced physical activity, and psychosocial distress. The COVID-19 pandemic amplified these factors, contributing to rising BMI and impaired health-related quality of life (HrQoL). Telehealth offers a promising, scalable modality to deliver multimodal obesity care. This study evaluated the long-term effectiveness of a structured pediatric telehealth intervention compared to historical in-person treatment.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data from 237 children and adolescents with obesity treated at a single academic center. Between 2020 and 2022, 117 participants received a 12-month structured lifestyle intervention via telehealth. A historical cohort (n = 120; 2017–2019) received the same intervention in person. Clinical outcomes were assessed at baseline and after 12 months; the telehealth group was additionally followed up at 24 and 36 months. Primary outcome was change in BMI standard deviation score (BMI SDS). Secondary outcomes included physical fitness (6-min walk test), insulin resistance (HOMA index), lipid profile, dietary behavior (K-FFL), eating regulation (K-FEV), and HrQoL (KINDL-R).</div></div><div><h3>Results</h3><div>Both groups achieved significant reductions in BMI SDS after 12 months, with sustained improvements in the telehealth group through 36 months (Δ = −0.18; p < 0.05). Physical performance and HOMA index improved in both cohorts. Telehealth participants showed greater improvements in healthy dietary behavior, cognitive appetite regulation, and Health-related quality of life HrQoL, especially in emotional and family domains. No adverse events occurred; adherence exceeded 85 %.</div></div><div><h3>Conclusion</h3><div>A structured telehealth lifestyle intervention is safe, effective, and sustainable for pediatric obesity management. These findings support telehealth as a clinically viable and sustainable model for pediatric obesity care, recognizing that both weight reduction and weight stabilization may contribute to improved long-term outcomes.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100206"},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988586","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}
Obesity PillarsPub Date : 2025-08-28DOI: 10.1016/j.obpill.2025.100205
Angela Fitch , Linda Gigliotti , Harold Edward Bays
{"title":"Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions","authors":"Angela Fitch , Linda Gigliotti , Harold Edward Bays","doi":"10.1016/j.obpill.2025.100205","DOIUrl":"10.1016/j.obpill.2025.100205","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a heterogeneous systemic chronic disease associated with excess adiposity and a complex etiology and is increasing in prevalence worldwide. Initially used to treat type 2 diabetes mellitus, glucagon-like peptide-1 (GLP-1) based therapies are now widely prescribed for individuals with overweight and obesity as an adjunct to a reduced-calorie diet and increased physical activity. However, despite their impressive weight reduction capabilities, many patients on GLP-1 based therapies do not receive appropriate nutrition advice and struggle to maintain their weight reduction.</div></div><div><h3>Methods</h3><div>This narrative review explores and summarizes existing literature on the challenges associated with nutrition intake in people with obesity taking GLP-1 based therapies and practical applications of nutrition and lifestyle interventions for the management of these individuals to ensure their best long-term health outcomes.</div></div><div><h3>Results</h3><div>Delivering optimal nutrition management to people with obesity treated with GLP-1 based therapies presents healthcare providers with many challenges including addressing the impact of obesity and weight reduction on body composition (particularly muscle mass loss and risk of sarcopenic obesity), and poor nutrition. Physicians should work with dietitians and other healthcare providers to deliver comprehensive lifestyle counselling that is patient-centered, aligning with the needs and preferences of the individual. This should include advice on: timely and appropriate nutrition that centers on adequate macronutrient, micronutrient and fluid intake, particularly increased protein intake alongside resistance training for the preservation of muscle mass; mental health; sleep hygiene, physical activity; and medication adherence and persistence. Evidence-based nutrition guidelines can also provide an important framework for healthcare professionals, helping to ensure nutrition advice is consistent and based on rigorous scientific research.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the importance of ensuring that patients treated with GLP-1 based therapies are closely monitored and provided with comprehensive nutrition and lifestyle support to ensure they achieve the best long-term health outcomes.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145105016","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}
Obesity PillarsPub Date : 2025-08-27DOI: 10.1016/j.obpill.2025.100204
Zoobia W. Chaudhry , Marci Laudenslager , Kimberly A. Gudzune , Selvi Rajagopal
{"title":"Developing and implementing an obesity medicine fellowship program: Experience at a U.S. academic medical center","authors":"Zoobia W. Chaudhry , Marci Laudenslager , Kimberly A. Gudzune , Selvi Rajagopal","doi":"10.1016/j.obpill.2025.100204","DOIUrl":"10.1016/j.obpill.2025.100204","url":null,"abstract":"<div><h3>Background</h3><div>Obesity is a prevalent and complex chronic disease yet physicians’ training in obesity care is often inadequate. Fellowship training in obesity medicine is now available at multiple academic medical centers; however, there has been limited description and evaluation of these programs to date. Therefore, this article describes our curriculum development process and fellowship program implementation experience at a U.S. academic medical center.</div></div><div><h3>Methods</h3><div>This was a structured, multi-phase curriculum development study guided by established obesity medicine competencies and certification standards. We used a six-step approach to curriculum development to guide our design with content informed by the Obesity Medicine Education Collaborative competencies, American Board of Obesity Medicine (ABOM) content outline, and Accreditation Council for Graduate Medical Education - International Obesity Medicine Fellowship program requirements. We utilized several tools of instruction as well as modes of assessing learners. Feedback from fellows and faculty was used to iteratively refine the program over the initial 3 years.</div></div><div><h3>Results</h3><div>We identified 19 content domains key for obesity medicine. Within each domain, we created instructional components including didactic e-lectures, directed readings, reflective assignments, role play activities, and clinical experiences. We developed evaluation tools to determine trainee progress including knowledge check assessments, mini-clinical evaluation exercises (mini-CEXs), and structured feedback. Early outcomes indicate that trainees achieve competence in obesity care, engage in meaningful scholarly activity, and benefit from professional development opportunities. All graduating fellows have successfully achieved ABOM certification. Feedback has informed fellowship refinements, particularly improvements in rotation timing and duration as well as additional subspecialty elective options.</div></div><div><h3>Conclusion</h3><div>This obesity medicine fellowship curriculum provides a structured, multidisciplinary program and graduates have achieved competency in obesity care. Obesity medicine fellowship training holds promise in advancing the field through innovative education and leadership development.</div></div>","PeriodicalId":100977,"journal":{"name":"Obesity Pillars","volume":"16 ","pages":"Article 100204"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925170","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}