Middle East Fertility Society Journal最新文献

{"title":"The randomized clinical trial trustworthiness crisis","authors":"Furqan A. Butt, Mohammad Fawzy, Bassel H. Al Wattar, Aurora Bueno-Cavanillas, Khalid S. Khan, Yacoub Khalaf","doi":"10.1186/s43043-023-00161-7","DOIUrl":"https://doi.org/10.1186/s43043-023-00161-7","url":null,"abstract":"The rising number of retracted randomised clinical trials (RCTs) is a concern over their trustworthiness. In today's digital landscape electronic observational data is easily accessible for research purposes. This emerging perspective, in tandem with the growing scrutiny of RCT credibility, may steer some researchers towards favouring non-randomized studies. It is crucial to emphasize the ongoing need for robust RCTs, shedding light on the areas within trial design that require enhancements and addressing existing gaps in trial execution. Evidence-based medicine pivots on the nexus between empirical medical research and the theoretical and applied facets of clinical care. Healthcare systems regularly amass patient data, creating a vast reservoir of information. This facilitates large-scale observational studies, which may appear as potential substitutes for RCTs. These large-scale studies inherently possess biases that place them a notch below randomized evidence. Honest errors, data manipulation, lapses in professionalism, and methodological shortcomings tarnish the integrity of RCTs, compromising trust in trials. Research institutions, funding agencies, journal editors and other stakeholders have the responsibility to establish robust frameworks to prevent both deliberate and inadvertent mishandling of RCT design, conduct and analysis. Systematic reviews that collate robust RCTs are invaluable. They amalgamate superior evidence instrumental in improving patient outcomes via informed health policy decisions. For systematic reviews to continue to retain trust, validated integrity assessment tools must be developed and routinely applied. This way it will be possible to prevent false or untrustworthy research from becoming part of the recommendations based on the evidence. High-quality RCTs and their systematic reviews play a crucial role in acquiring valid and reliable evidence that is instrumental in improving patient outcomes. They provide vital information on healthcare effectiveness, and their trustworthiness is key to evidence-based medicine.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"27 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078179","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":"An insight into the associated factors with recurrent endometriomas after surgical excision","authors":"Faezeh Fashkhami, Ali Beykian","doi":"10.1186/s43043-023-00163-5","DOIUrl":"https://doi.org/10.1186/s43043-023-00163-5","url":null,"abstract":"Atwa et al.’s study shed light on endometrioma management and factors affecting recurrence. However, the exclusion of open ovarian surgery patients and the potential impact of laparoscopic surgery on ovarian reserve and outcomes warrant consideration. Including both surgical approaches in future studies would enable a comprehensive assessment of their effectiveness and influence on endometrioma recurrence, enhancing our understanding of surgical excision outcomes.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"20 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139080311","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":"Association between ambient particulate matter and semen quality parameters: a systematic review and meta-analysis","authors":"Seyed Sobhan Bahreiny, Mohammad-Navid Bastani, Mohammad Reza Dabbagh, Hamid Ghorbani, Mojtaba Aghaei, Mehdi Zahedian, Reza Mohammadpour Fard","doi":"10.1186/s43043-023-00162-6","DOIUrl":"https://doi.org/10.1186/s43043-023-00162-6","url":null,"abstract":"The adverse consequences of ambient particulate matter (PM) on human health have been extensively studied. However, the association between PM2.5 and PM10 μm, two common sizes of particulate matter, and semen quality remains a subject of debate. This systematic review and meta-analysis aim to investigate the relationship between ambient PM2.5 and PM10 μm exposure and semen quality parameters. A systematic literature search was conducted using electronic databases to identify relevant studies investigating the association between (PM2.5 μm and PM10 μm) exposure and semen quality, covering the period from January 2000 to April 2023. Standard mean difference (SMD) was used to calculate pooled effect estimates with 95% confidence intervals (CIs). Furthermore, meta-regression and subgroup analyses provided additional insight into potential factors contributing to heterogeneity. The meta-analysis included a comprehensive review of nine studies with a total of 6264 participants. The findings demonstrated a significant negative correlation between ambient exposure to PM2.5 μm and PM10 μm and various parameters related to semen quality. The analysis revealed that PM2.5 exposure was linked to reduced semen volume (SMD = −0.028; 95% CI −0.055 to −0.01), total sperm count (SMD = −0.027; 95% CI −0.052 to -0.02), sperm motility (SMD = −0.156; 95% CI −0.26 to -0.04), and progressive motility (SMD = −0.194; 95% CI −0.38 to −0.01). Likewise, exposure to PM10 was associated with decreased sperm concentration (SMD = −0.036; 95% CI −0.06 to −0.01) and sperm motility (SMD = −0.93; 95% CI −0.15 to −0.02). This systematic review and meta-analysis demonstrate a consistent negative association between ambient PM10 and PM2.5 μm exposure and semen quality parameters. The findings suggest that increased levels of ambient particulate matter may have an adverse influence on sperm count and motility. The results highlight the importance of addressing environmental air pollution as a potential risk factor for male reproductive health.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"12 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139078178","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":"Inflammatory perspectives of polycystic ovary syndrome: role of specific mediators and markers","authors":"Rajen Dey, Koushik Bhattacharya, Asim Kumar Basak, Nimisha Paul, Raktima Bandyopadhyay, Gargi Ray Chaudhuri, Mahuya Patra Purkait, Aniruddha Bhattacharjee, Chaitali Bose, Nandini Shukla, Rama Bhaduri, Soumya Sinha Roy, Alak Kumar Syamal","doi":"10.1186/s43043-023-00158-2","DOIUrl":"https://doi.org/10.1186/s43043-023-00158-2","url":null,"abstract":"Polycystic ovary syndrome (PCOS) is indeed one of the most common gynecological endocrine disorders, affecting a significant number of females in their reproductive age. While the exact cause of PCOS is not fully understood, several factors are believed to contribute to its onset. The relationship between polycystic ovary syndrome (PCOS) and low-grade chronic inflammation is complex and not fully understood. While there is evidence to suggest an association between PCOS and inflammation, the exact cause and causal nature of this relationship are still under investigation. Several inflammatory markers, including IL-6 (interleukin-6), TNF-α (tumor necrosis factor-alpha), IL-17 (interleukin-17), CRP (C-reactive protein), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio), have been studied about PCOS. These markers are substances produced by the immune system in response to inflammation. Increased levels of IL-17, IL-1, and IL-8 were correlated with PCO. CRP to albumin ratio can be employed as a precise bio-marker for PCOS. The neutrophil-to-lymphocyte ratio (NLR) indicates poor cardiovascular health and metabolic syndrome (MS) and can be considered a negative regulator for FSH which indirectly stimulates testosterone production. Platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) are also recently found to be associated with PCOS. The literature explaining the underlying mechanisms with specific inflammatory markers and how inflammation relates to PCOS will be highlighted in this review article. It will also discuss the roles of inflammation and the association of different inflammatory markers in the pathogenesis of PCOS, which may usher in a new era in the treatment approach for PCOS.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"37 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138577270","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":"Worldwide sperm quality variations between 2000 and 2020: a scoping review","authors":"Noor Mohammad Alqurna, Zina Mahdi Al-Alami","doi":"10.1186/s43043-023-00159-1","DOIUrl":"https://doi.org/10.1186/s43043-023-00159-1","url":null,"abstract":"There is a scarcity of research on male infertility and semen quality worldwide, notably in the Middle East and North Africa (MENA) region. This lack includes temporal comparisons of seminal parameters over decades. The aim of this scoping review is to summarize the articles, published between January 1, 2000, and December 31, 2020, which discuss and describe human semen quality and/or sperm quality in different countries, and/or their alternating patterns through time. The search was done on PubMed, using the following keywords: (((semen[Title/Abstract]) OR (SFA[Title/Abstract])) OR (sperm[Title/Abstract])) AND (country name[Title/Abstract]) with 195 world countries put in the “country name” field one by one along with other filters. The abstracts that fulfilled the inclusion criteria were read thoroughly and summarized. In conclusion, although some semen parameters appear to be stable, semen quality has deteriorated over time. Therefore, various countries must conduct research to characterize their semen quality and its altering patterns throughout time to reach a thorough conclusion.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"18 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138568067","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":"Enhancing endometrial pathology detection: chromohysteroscopy vs. conventional hysteroscopy in infertility evaluation","authors":"Sangam Jha, Shalini Singh, Jafeesha B. Singh","doi":"10.1186/s43043-023-00157-3","DOIUrl":"https://doi.org/10.1186/s43043-023-00157-3","url":null,"abstract":"Endometrial pathology is a recognized contributor to infertility and recurrent implantation failure, but its detection during hysteroscopy, particularly in the absence of visible lesions, is challenging. Chromohysteroscopy, involving the use of methylene blue dye, has shown promise in improving diagnostic accuracy. This interventional cross-sectional study compared the diagnostic accuracy of chromohysteroscopy and conventional hysteroscopy, using histopathology as the gold standard. A total of 100 consenting infertility patients were included, in a sequential step, hysteroscopy followed by chromohysteroscopy using methylene blue dye was performed to enhance the detection of subtle endometrial pathologies. Among the 100 women who underwent diagnostic hysteroscopy, 76 exhibited normal findings, while 24 had abnormal findings. During chromohysteroscopy, 62 cases displayed a light staining pattern, and 38 cases exhibited dark staining. Histopathological analysis of biopsy tissue from the dark-stained areas revealed endometrial pathology in 84.2% (32/38) and normal endometrium in 15.8% (6/38) cases. In contrast, biopsies from the light-stained areas indicated abnormal endometrium in only 3.23% (2/62) cases, with the remaining 96.77% having a normal histology. Chromohysteroscopy demonstrated a significantly higher diagnostic accuracy (92%) for endometrial pathology compared to conventional hysteroscopy (58%). Notably, chromohysteroscopy’s sensitivity was 94.12%, and its specificity was 90.9%. The staining patterns observed during chromohysteroscopy correlated well with histological findings, highlighting its effectiveness in identifying structurally damaged endometrium. Chromohysteroscopy emerges as a valuable diagnostic tool for assessing endometrial pathology, especially in infertility cases. This technique offers superior accuracy compared to conventional hysteroscopy, providing clinicians with a more precise means of diagnosis and potential targeted treatments.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538002","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 narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19","authors":"Azra Allahveisi, Parivash Afradiasbagharani, Mahshid Bazrafkan, Raheleh Kafaeinezhad, Elham Hosseini","doi":"10.1186/s43043-023-00156-4","DOIUrl":"https://doi.org/10.1186/s43043-023-00156-4","url":null,"abstract":"Although COVID-19 infection has dropped across the world and SARS-CoV-2 vaccines have been developed, global concerns remain about the disease’s long-term health consequences. The purpose of this research was to review the consequences of SARS-CoV-2 on male health, particularly the reproductive system and the pathogenic mechanisms affecting male infertility. Improving knowledge on these issues may help in considering to which extent some of the remaining concerns should be addressed. The primary target of this disease is the pulmonary system, but reproductive organs may be targeted by the virus. To enter host cells, the virus utilizes both ACE2 and TMPRSS2, which are differentially expressed in the spermatogonial stem, Leydig, and Sertoli cells, thereby providing possible testicular vulnerability. COVID-19-related stress and psychological distress may also affect aspects of male reproductive health. Since some pathological effects of COVID-19 infection and dysregulations are linked to infertility, more attention is needed to determine whether such dysregulations regress following infection decline.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"7 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538017","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":"Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study","authors":"Mustafa Sahin, Suleyman Guven, Hidayet Sal, Emine Seda Guvendag Guven","doi":"10.1186/s43043-023-00154-6","DOIUrl":"https://doi.org/10.1186/s43043-023-00154-6","url":null,"abstract":"Abstract Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material and methods This case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D. Conclusion In the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"13 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346512","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":"Assessment of Cdx2 polymorphism in Iranian women with polycystic ovary syndrome","authors":"Behdis Khansari, Hashem Nayeri, Maryam Ostadsharif","doi":"10.1186/s43043-023-00155-5","DOIUrl":"https://doi.org/10.1186/s43043-023-00155-5","url":null,"abstract":"Abstract Background Women’s fertility is affected by polycystic ovarian syndrome (PCOS) as an endocrine disorder with characteristic symptoms such as insulin resistance, polycystic ovaries, menstrual irregularities, and obesity. In polycystic ovarian syndrome, the vitamin D endocrine system is regulated by the vitamin D receptor (VDR) associated with type II diabetes, endocrine dysfunctions, and insulin resistance. Therefore, the current paper deals with the investigation of the connection between Cdx2 VDR gene polymorphism and the biochemical factors in obese PCOS women. Material and methods In the current case–control study, 40 obese women without PCOS and 38 obese women with PCOS were enrolled in May–September 2016. Insulin, IGF1, FBS, and HOMA-IR were examined for the participants along with the allelic and genotypic frequency of Cdx2 polymorphism G/A (rs11568820) from Isfahan Fertility and Infertility Center, Iran. The ASM-PCR (multiplex allele-specific PCR) technique was utilized in this regard. Results The age of PCOS women was less ( P < 0.001) than the controls. In PCOS women, insulin, FBS, and HOMA-IR serum levels were higher than in the control women (all P values 0.05). For GG, AG, AA,A, and G Cdx2 (A/G) genotypic/allelic frequencies were 84.2%, 15.8%, 0%, 7.9%, and 92.1% in cases and 87.5%, 12.5%, 0%, 6.3%, and 93.8% in controls, respectively. HOMA-IR ( P = 0.047 and P = 0.033, respectively) and insulin than those with the AG genotype were in PCOS women with the GG Cdx2 genotype. The highest IGF-1 mean value ( P = 0.020) was found for the AG genotype in PCOS. In our study, a significant relation was found only between PCOS and FBS, in terms of a logistic regression analysis of Cdx2 and parameters. Conclusion In the present study, it was indicated that the GG genotype in PCOS subjects was associated with the IGF-1, HOMA-IR, and insulin. Similarly, no association was found between obese PCOS patients and Cdx 2 in the 1a promoter area of the VDR gene in our study.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"125 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137401","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":"Letrozole plus misoprostol versus misoprostol alone in the induction of anembryonic missed abortion: a randomized controlled trial conducted in Upper Egypt","authors":"Ramy Heshmat Zekry Tadros, Usama Fouda, Sherif Sameh Zaki, Marwa Abdalla","doi":"10.1186/s43043-023-00152-8","DOIUrl":"https://doi.org/10.1186/s43043-023-00152-8","url":null,"abstract":"Abstract Background A missed abortion is a spontaneous abortion in which the embryo or fetus has already died but has remained in the uterus for days or weeks with a closed cervical ostium. Termination of pregnancy could be achieved either by surgical evacuation or medical or expectant management. Letrozole is a third-generation aromatase inhibitor. According to many recent studies, letrozole given for three days before the administration of misoprostol was more effective than misoprostol alone at inducing abortion. Our study compared the efficacy of various letrozole regimens (10 mg/d for three days and a single dose of 20 mg) combined with misoprostol vs. misoprostol alone in inducing abortion. To find the most efficient regimen of letrozole administered before misoprostol to induce an abortion. Methodology This prospective, parallel, three-arm, single-blinded, allocation-concealed randomized controlled trial was conducted in Sohag Teaching Hospital in Upper Egypt. We randomly divided 105 patients with anembryonic missed abortion (up to 63 days gestation) with no history of medical disorders or a history of allergies to misoprostol or letrozole into three equal groups (a single-dose letrozole group, a multiple-dose letrozole group, and a misoprostol-only group). The complete abortion rate, incomplete abortion rate, failure to abort rate, and induction-to-abortion interval were all collected. All statistical calculations were performed using the computer program SPSS (Statistical Package for the Social Science, SPSS Inc., Chicago, IL, USA). Results The complete abortion rate was significantly higher in the single-dose letrozole and multiple-dose letrozole groups than in the misoprostol group ( p values = 0.0455 and 0.001, respectively). On the other hand, there was no significant difference in the complete abortion rate between the single-dose group and the multiple-dose letrozole group ( p -value = 0.1713). The time to complete abortion was significantly shorter in the single-dose and multiple-dose letrozole groups than in the misoprostol group ( p values = 0.0036 and 0.0049, respectively). On the other hand, there was no significant difference in the time to complete abortion between the single-dose letrozole group and the multiple-dose letrozole group ( P = 0.532). Conclusion Single- and multiple-dose letrozole regimens followed by misoprostol had a higher rate and a shorter time to complete abortion than misoprostol alone. Trial registration The trial is registered at gov with the name “letrozole and abortion” and the identifier “NCT05198050”. The date of registration was April 1, 2022, registered prospectively. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&amp;ts=25&amp;sid=S000BPDQ&amp;cx=43mobl .","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"59 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135820116","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}