Journal of the Canadian Association of Gastroenterology最新文献_第7页

Measuring the Impact of Patient Engagement in Health Research: An Exploratory Study Using Multiple Survey Tools 衡量患者参与健康研究的影响：使用多种调查工具的探索性研究

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-12-02 DOI: 10.1093/jcag/gwad045

D. Marshall, Nitya Suryaprakash, Stirling Bryan, K. Barker, Gail Mackean, S. Zelinsky, Tamara L. McCarron, Maria J. Santana, Paul Moayyedi, Danielle C Lavallee

{"title":"Measuring the Impact of Patient Engagement in Health Research: An Exploratory Study Using Multiple Survey Tools","authors":"D. Marshall, Nitya Suryaprakash, Stirling Bryan, K. Barker, Gail Mackean, S. Zelinsky, Tamara L. McCarron, Maria J. Santana, Paul Moayyedi, Danielle C Lavallee","doi":"10.1093/jcag/gwad045","DOIUrl":"https://doi.org/10.1093/jcag/gwad045","url":null,"abstract":"\u0000 \u0000 \u0000 Studies report various ways in which patients are involved in research design and conduct. Limited studies explore the influence of patient engagement (PE) at each research stage in qualitative research from the perspectives of all stakeholders.\u0000 \u0000 \u0000 \u0000 We established two small research groups, a Patient Researcher-Led Group and an Academic Researcher-Led Group. We recruited patient research partners (PRP; n = 5), researchers (n = 5), and clinicians (n = 4) to design and conduct qualitative research aimed at identifying candidate attributes related to patient preferences for tapering biologic treatments in inflammatory bowel disease. We administered surveys before starting, two months into, and post-project work. The surveys contained items from three PE evaluation tools. We assessed the two groups regarding the influence and impact each stakeholder had during the different research stages.\u0000 \u0000 \u0000 \u0000 PRPs had a moderate or a great deal of influence on the critical research activities across the research stages. They indicated moderate/very/extremely meaningful engagement and agreed/strongly agreed impact of PE. PRPs helped operationalize the research question; design the study and approach; develop study materials; recruit participants; and collect and interpret the data.\u0000 \u0000 \u0000 \u0000 The three tools together provide deeper insight into the influence of PE at each research stage. Lessons learnt from this study suggest that PE can impact many aspects of research including the design, process, and approach in the context of qualitative research, increasing the patient-centeredness of the study. More comprehensive validated tools are required that work with a more diverse subject pool and in other contexts.\u0000","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"14 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138607126","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}

引用次数: 0

Beyond Eosinophilic Esophagitis: Eosinophils in Gastrointestinal Disease-New Insights, "New" Diseases. 超越嗜酸性粒细胞食管炎：胃肠道疾病中的嗜酸性粒细胞--新见解、"新 "疾病。

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-11-24 eCollection Date: 2023-12-01 DOI: 10.1093/jcag/gwad046

Nicholas J Talley, Grace L Burns, Emily C Hoedt, Kerith Duncanson, Simon Keely

{"title":"Beyond Eosinophilic Esophagitis: Eosinophils in Gastrointestinal Disease-New Insights, \"New\" Diseases.","authors":"Nicholas J Talley, Grace L Burns, Emily C Hoedt, Kerith Duncanson, Simon Keely","doi":"10.1093/jcag/gwad046","DOIUrl":"https://doi.org/10.1093/jcag/gwad046","url":null,"abstract":"<p><p>Functional dyspepsia (FD) is a highly prevalent disorder. Upper endoscopy is normal, and according to the Rome IV criteria, there is no established pathology. Data accumulated over the last 15 years has challenged the notion FD is free of relevant pathology, and in particular, increased duodenal eosinophils have been observed. Intestinal eosinophils play important roles in microbial defence, immune regulation, tissue regeneration and remodelling, and maintaining tissue homeostasis and metabolism; degranulation of eosinophils releases toxic granule products (e.g., major basic protein, eosinophil-derived neurotoxin) which can damage nerves. Normal cut-offs for eosinophil infiltration into the duodenum histologically are less than five eosinophils per high power field (<25 per five high power fields). In clinical practice there is evidence that pathologically increased intestinal eosinophils may often be overlooked. In a meta-analysis duodenal eosinophils were significantly increased in FD although there was substantial heterogeneity; degranulation of duodenal eosinophils was also significantly higher in FD without significant heterogeneity. In addition, increased duodenal permeability, systemic immune activation, and an altered mucosa-associated duodenal microbiome have been identified that may help explain why symptoms arise, often occur after food with exposure to food antigens, and typically fluctuate. Several potentially reversible risk factors for FD have now been identified. We evaluate the current evidence linking duodenal microinflammation and immune activation with FD and disorders of gut-brain interactions that overlap with FD. We propose a two-hit disease model for eosinophilic functional dyspepsia (EoFD) with management implications.</p>","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"6 6","pages":"199-211"},"PeriodicalIF":0.0,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138803894","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}

引用次数: 0

Correction to: The 2023 Impact of Inflammatory Bowel Disease in Canada: Executive Summary 更正:2023年加拿大炎症性肠病的影响:执行摘要

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-11-13 DOI: 10.1093/jcag/gwad038

引用次数: 0

The Impact of COVID-19 on Health Anxiety and Perceived Stress Among Persons with IBD: A Population-representative Study COVID-19对IBD患者健康焦虑和感知压力的影响:一项具有人群代表性的研究

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-11-12 DOI: 10.1093/jcag/gwad047

Seth R Shaffer, Gia L Jackson, Sydney Chochinov, Casandra Dolovich, Lesley A Graff, Renée El-Gabalawy, Souradet Yuh-Nan Shaw, Harminder Singh, Charles N Bernstein

{"title":"The Impact of COVID-19 on Health Anxiety and Perceived Stress Among Persons with IBD: A Population-representative Study","authors":"Seth R Shaffer, Gia L Jackson, Sydney Chochinov, Casandra Dolovich, Lesley A Graff, Renée El-Gabalawy, Souradet Yuh-Nan Shaw, Harminder Singh, Charles N Bernstein","doi":"10.1093/jcag/gwad047","DOIUrl":"https://doi.org/10.1093/jcag/gwad047","url":null,"abstract":"Abstract Background The Corona Virus Immune Disease-2019 (COVID-19) pandemic has broadly impacted the mental health of individuals worldwide, especially with restrictions including social distancing and quarantining. Persons with IBD are at increased risk of mental health disorders. The aim was to understand how the COVID-19 pandemic affected adults with a chronic health issue, inflammatory bowel disease (IBD), using a population-based sample. Methods A survey study in Manitoba was conducted during the second COVID-19 wave in autumn 2020. We assessed proportions of health anxiety and perceived stress using validated measures, as well as stressors during the COVID-19 pandemic. We used univariable and multivariable logistic regression analysis to assess predictors of perceived stress and health anxiety. Results A total of 1,384 (47.1%) persons responded, with a mean age of 58.0, and 46.9% had Crohn’s disease. Almost three quarters (73.7%) had increased stress, with 37.7% having increased stress about their IBD, and 33.6% worried about their IBD worsening. 46.0% felt increased stress about accessing their doctor or nurse, and 56.5% felt they had good access to their gastroenterologist. Elevated stress and health anxiety were seen in 63.5% and 17.2% of respondents, respectively. Younger age and being on immune-modifying therapy (IMT) was predictive of increased health anxiety and stress. Longer IBD duration was associated with decreased stress, including those on IMT. Conclusion Persons with IBD reported high rates of stress and health anxiety early in the COVID-19 pandemic, especially among those on IMT. It will be important to determine how this evolved over time and to what extent this impacted on disease course.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"20 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135037974","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}

引用次数: 0

The Role of Tofacitinib in the Treatment of Acute Severe Colitis in Children 托法替尼在治疗儿童急性严重结肠炎中的作用

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-11-06 DOI: 10.1093/jcag/gwad042

Guillermo Alejandro Costaguta, Chloé Girard, Véronique Groleau, Kelly Grzywacz, Martha Heather Dirks, Colette Deslandres

{"title":"The Role of Tofacitinib in the Treatment of Acute Severe Colitis in Children","authors":"Guillermo Alejandro Costaguta, Chloé Girard, Véronique Groleau, Kelly Grzywacz, Martha Heather Dirks, Colette Deslandres","doi":"10.1093/jcag/gwad042","DOIUrl":"https://doi.org/10.1093/jcag/gwad042","url":null,"abstract":"Abstract Objectives Acute severe colitis (ASC) occurs in up to 15 percent of children with ulcerative colitis, with a high index of morbidity and mortality. Treatment includes high-dose steroids, infliximab, and salvage therapies. Unfortunately, up to 20 percent of patients may need an urgent colectomy due to treatment failure. We report our experience using tofacitinib for the treatment of six patients. Methods A retrospective review of our medical electronic records was conducted. We included every patient with ASC and treatment failure, in whom tofacitinib was used as a salvage therapy. Response, complications, and disease course were noted. Results Six patients were included with Pediatric Ulcerative Colitis Activity Index (PUCAI) scores ranging from 65 to 85 on admission, and 35 to 85 before tofacitinib was started (P 0.07). Median response time was 72 h. A median decrease of 40 points in PUCAI was noted (P 0.00001). Mean length of stay was 18 days with discharge 9 days after tofacitinib introduction. Haemoglobin, albumin, fecal calprotectin, and CRP improved after tofacitinib (P 0.02, P 0.02, P 0.025, and P 0.01, respectively). The mean follow-up was 8.5 months, four patients achieved complete remission and only one had a recrudescence of symptoms (P 0.01). One patient had a systemic Epstein-Barr virus infection prior to tofacitinib therapy, which resolved with rituximab treatment. No other complications were noted. Conclusions Tofacitinib response is rapid and impressive in children suffering from ASC, and the safety profile appears comparable to or better than other available treatments. In the future, tofacitinib should be integrated into pediatric protocols.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"288 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135685222","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}

引用次数: 0

Correction to: The 2023 Impact of Inflammatory Bowel Disease in Canada: Epidemiology of IBD 2023年加拿大炎症性肠病的影响:IBD的流行病学

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-11-01 DOI: 10.1093/jcag/gwad043

引用次数: 0

An Update On Anti-TNF Biosimilar Switching—Real-World Clinical Effectiveness and Safety 抗肿瘤坏死因子生物仿制药转换的最新进展-现实世界的临床有效性和安全性

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-10-25 DOI: 10.1093/jcag/gwad027

Susanna Meade, Elizabeth Squirell, Thomas Tam Hoang, James Chow, Gregory Rosenfeld

{"title":"An Update On Anti-TNF Biosimilar Switching—Real-World Clinical Effectiveness and Safety","authors":"Susanna Meade, Elizabeth Squirell, Thomas Tam Hoang, James Chow, Gregory Rosenfeld","doi":"10.1093/jcag/gwad027","DOIUrl":"https://doi.org/10.1093/jcag/gwad027","url":null,"abstract":"Abstract Background Biological medications for inflammatory bowel disease (IBD) account for a significant burden on provincial budgets. In an effort to curb these rising costs, nationwide switching to biosimilars is expected to be complete in Canada before the end of 2023. Biosimilar products do not require the same rigor for licensing as the originator and therefore there has been appropriate scepticism as to how biosimilars will perform in real-world practice. Methods We have performed a systematic review including real-world observational studies of adult patients with IBD. The primary outcome was clinical effectiveness and/or safety in patients who had switched from originator to biosimilar anti-TNF. Secondary outcomes included loss of response (LOR), treatment persistence or cessation and immunogenicity. Results We included 43 studies (7,462 patients [70 percent Crohn’s disease: 30 percent ulcerative colitis]; 32 infliximab studies, and 11 adalimumab studies). For infliximab, 75 percent patients were in clinical remission at the time of switch and 75 percent maintained clinical remission beyond 12 months, compared to 78 percent of patients who continued originator. For adalimumab, 86 percent patients were in remission at the time of switch with 82 percent maintaining remission at 6 months follow-up. Injection site pain was higher in patients who switched to a citrate containing adalimumab biosimilar, compared with those who continued originator. All other outcomes (LOR, treatment cessation or persistence and serious adverse events) were similar to patients who continued originator (in comparator cohorts or the available literature). Conclusion Whilst ongoing vigilance is required, these data are reassuring to both patients and clinicians and will significantly help to reduce health-care costs across Canada.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"35 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134973491","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}

引用次数: 0

Emergency Colorectal Surgery in Those with Cirrhosis: A Population-based Study Assessing Practice Patterns, Outcomes and Predictors of Mortality 肝硬化患者的急诊结直肠手术:一项基于人群的研究，评估实践模式、结果和死亡率预测因素

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-10-20 DOI: 10.1093/jcag/gwad040

Lisa Zhang, Kelly Brennan, Jennifer A Flemming, Sulaiman Nanji, Maya Djerboua, Shaila J Merchant, Antonio Caycedo-Marulanda, Sunil V Patel

{"title":"Emergency Colorectal Surgery in Those with Cirrhosis: A Population-based Study Assessing Practice Patterns, Outcomes and Predictors of Mortality","authors":"Lisa Zhang, Kelly Brennan, Jennifer A Flemming, Sulaiman Nanji, Maya Djerboua, Shaila J Merchant, Antonio Caycedo-Marulanda, Sunil V Patel","doi":"10.1093/jcag/gwad040","DOIUrl":"https://doi.org/10.1093/jcag/gwad040","url":null,"abstract":"Abstract Background Those with cirrhosis who require emergency colorectal surgery are at risk for poor outcomes. Although risk predictions models exists, these tools are not specific to colorectal surgery, nor were they developed in a contemporary setting. Thus, the objective of this study was to assess the outcomes in this population and determine whether cirrhosis etiology and/or the Model for End Stage Liver Disease (MELD-Na) is associated with mortality. Methods This population-based study included those with cirrhosis undergoing emergent colorectal surgery between 2009 and 2017. All eligible individuals in Ontario were identified using administrative databases. The primary outcome was 90-day mortality. Results Nine hundred and twenty-seven individuals (57%) (male) were included. The most common cirrhosis etiology was non-alcoholic fatty liver disease (NAFLD) (50%) and alcohol related (32%). Overall 90-day mortality was 32%. Multivariable survival analysis demonstrated those with alcohol-related disease were at increased risk of 90-day mortality (hazards ratio [HR] 1.53, 95% confidence interval [CI] 1.2–2.0 vs. NAFLD [ref]). Surgery for colorectal cancer was associated with better survival (HR 0.27, 95%CI 0.16–0.47). In the subgroup analysis of those with an available MELD-Na score (n = 348/927, 38%), there was a strong association between increasing MELD-Na and mortality (score 20+ HR 6.6, 95%CI 3.9–10.9; score 10–19 HR 1.8, 95%CI 1.1–3.0; score &lt;10 [ref]). Conclusion Individuals with cirrhosis who require emergent colorectal surgery have a high risk of postoperative complications, including mortality. Increasing MELD-Na score is associated with mortality and can be used to risk stratify individuals.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617934","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}

引用次数: 0

Interobserver Reliability of the Paris Classification for Superficial Gastrointestinal Tract Neoplasms: A Systematic Review 浅表胃肠道肿瘤Paris分类的观察者间可靠性:一项系统综述

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-10-10 DOI: 10.1093/jcag/gwad039

Sarang Gupta, Sam Seleq, Nikko Gimpaya, Rishad Khan, Michael A Scaffidi, Rishi Bansal, Samir C Grover

{"title":"Interobserver Reliability of the Paris Classification for Superficial Gastrointestinal Tract Neoplasms: A Systematic Review","authors":"Sarang Gupta, Sam Seleq, Nikko Gimpaya, Rishad Khan, Michael A Scaffidi, Rishi Bansal, Samir C Grover","doi":"10.1093/jcag/gwad039","DOIUrl":"https://doi.org/10.1093/jcag/gwad039","url":null,"abstract":"Abstract Background and study aims The Paris classification characterizes the morphology of superficial gastrointestinal tract neoplasms. This system has been shown to predict the risk of submucosal invasion in certain subtypes of lesions. There is limited data that assesses its agreement amongst endoscopists. We performed a systematic review to summarize the available literature on the interobserver reliability (IOR) of the Paris classification. Methods We conducted a search through December 2020 for studies reporting IOR of the Paris classification. Studies were included if they quantitatively evaluated the IOR of the Paris classification with at least five participating endoscopists. Two authors independently screened studies and abstracted data using an a priori-designed data collection form. Evaluation of study quality and risk of bias was performed using an adapted version of the Guidelines for Reporting Reliability and Agreement Studies. Results Of the 1,541 studies retrieved, 5 were included in the review. All studies were observational cohort studies published between 2014 and 2020. The IOR of the Paris classification was moderate amongst all four studies evaluating colorectal neoplasms (range, κ = 0.42 to κ = 0.54) and substantial in one study that evaluated gastric neoplasms (κw = 0.65). An educational intervention was conducted by three studies with variable methodology and no significant change in IOR. Conclusions IOR of the Paris classification is moderate for superficial colonic neoplasms. Further study is needed to determine the reliability of this system for superficial gastric lesions. Standardized training programs are required to investigate the impact of educational intervention on the Paris classification amongst endoscopists.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"215 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136292345","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}

引用次数: 0

How Did COVID-19 Affect Mental Health and Access to Care in Persons With Inflammatory Bowel Disease COVID-19如何影响炎症性肠病患者的心理健康和获得护理

Journal of the Canadian Association of Gastroenterology Pub Date : 2023-10-10 DOI: 10.1093/jcag/gwad033

Seth R Shaffer

{"title":"How Did COVID-19 Affect Mental Health and Access to Care in Persons With Inflammatory Bowel Disease","authors":"Seth R Shaffer","doi":"10.1093/jcag/gwad033","DOIUrl":"https://doi.org/10.1093/jcag/gwad033","url":null,"abstract":"Abstract The coronavirus disease pandemic globally affected public health and the world economy, leading to an increase in mental health symptoms, thought to be due in part to periods of quarantining, restrictions, and other interventions used to curb ongoing transmission of the virus. It is well established that persons with inflammatory bowel disease (IBD) have significantly higher rates of depression and anxiety than the general population and that mental health symptoms can exacerbate disease severity. For persons with IBD, psychological distress was correlated with challenges in accessing medical care. In the early stages of the pandemic, endoscopy suites were closed, leading to fewer colonoscopies, although this rebounded the following year. This likely led to fewer diagnoses of IBD initially as people avoided the health care system, and also a reduction in IBD-related dysplasia being detected during colonoscopy. Many hospitals and health care clinics adjusted by delivering telemedicine for ambulatory care. Persons with IBD had increased stress about accessing both their health care provider and gastroenterologist during the pandemic, although many had increased satisfaction with the level of care they received virtually. Telemedicine is now being used in most clinics in conjunction with in-person care, to help deliver care, and can be cost-effective. Additional research is needed to assess whether heightened levels of mental health symptoms have led to worsening disease activity, and further, if a delay in health care access including colonoscopies and surgeries, or the perceived decreased access to health care professionals for some will have detrimentally affected the disease course for persons with IBD.","PeriodicalId":17263,"journal":{"name":"Journal of the Canadian Association of Gastroenterology","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136292619","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}

引用次数: 0