OTO Open最新文献

{"title":"Emerging Medications in Facial Nerve Recovery: A Systematic Review and Meta-Analysis.","authors":"Kimberly Chan, Cheng Ma, Bao Y Sciscent, Andreacarola Urso, Neerav Goyal, Jessyka G Lighthall","doi":"10.1002/oto2.70275","DOIUrl":"10.1002/oto2.70275","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the literature for medical therapies that promote facial nerve regeneration and recovery.</p><p><strong>Data sources: </strong>PubMed/Medline, Embase, and SCOPUS databases were searched for English-language studies published from inception through May 2025.</p><p><strong>Review methods: </strong>Human studies evaluating the efficacy of medical therapy on facial nerve regeneration using validated facial nerve grading scales were included.</p><p><strong>Results: </strong>Nine studies were included in qualitative analysis, and 6 were included in a meta-analysis. Treatments included nimodipine (n = 6), pentoxifylline (n = 1), co-enzyme Q10 (n = 1), and extracellular vesicles (n = 1). All studies used HB score, and recovery was defined as HB score ≤3. Recovery was observed in 94% (95% CI:[90%, 97%]) of patients treated with nimodipine and 84% (95% CI: [70%, 97%]) of control patients; this was not statistically significant (OR 2.26, 95% CI: [0.97, 5.26]). Nimodipine significantly decreased HB score by 1.66 (95% CI: [0.81, 2.52]) before and after treatment. Pentoxifylline and extracellular vesicles demonstrated some efficacy, while co-enzyme Q10 was not efficacious.</p><p><strong>Conclusion: </strong>Nimodipine improved HB score but was not significantly associated with recovery to HB score ≤3 compared to controls. Pentoxifylline and extracellular vesicles may have some efficacy, but co-enzyme Q10 is not effective. Further research is required to uncover additional treatments.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70275"},"PeriodicalIF":1.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352893","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":"Vietnamese Translation and Validation of Nasal Obstruction Symptom Evaluation (NOSE) Scale: A Prospective Cohort Study.","authors":"Minh P Hoang, Hien T T Doan, Vien T C Than, Minh H N Phan","doi":"10.1002/oto2.70279","DOIUrl":"10.1002/oto2.70279","url":null,"abstract":"<p><strong>Objective: </strong>The Nasal Obstruction Symptom Evaluation (NOSE) scale is a validated disease-specific patient-reported outcome measure for assessing health-related quality of life in nasal obstruction. This study aimed to translate, culturally adapt, and validate the Vietnamese version of the NOSE questionnaire.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Methods: </strong>Using a standardized forward-backward translation protocol, the Vietnamese NOSE (VN-NOSE) was developed and psychometrically validated in 143 participants (101 patients with nasal obstruction and 42 healthy controls). Among symptomatic patients, 47 undergoing endoscopic septoplasty with inferior turbinoplasty completed assessments preoperatively and at 1 week, 3 weeks, and 3 months postoperatively. Internal consistency, test-retest reliability, construct validity, discriminant validity, responsiveness, and the minimal clinically important difference (MCID) were evaluated. Correlations with a visual analogue scale (VAS), a 6-point Likert scale, and peak nasal inspiratory flow (PNIF) were analyzed.</p><p><strong>Results: </strong>The VN-NOSE showed excellent internal consistency (Cronbach's <i>α</i> = 0.95) and test-retest reliability (intraclass correlation coefficient = 0.993). A strong correlation was observed with the VAS, but not with PNIF. Postoperative NOSE scores improved significantly over time (<i>P</i> < .01), with a large effect size at 3 months (Cohen's <i>d</i> = 2.17). The VN-NOSE effectively discriminated between patients and controls. The MCID, estimated using both distribution- and anchor-based methods, was approximately 15 points.</p><p><strong>Conclusion: </strong>The VN-NOSE is a reliable, valid, and responsive instrument for clinical and research use in Vietnamese patients with nasal obstruction, with an MCID of 15 points.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70279"},"PeriodicalIF":1.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352987","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":"Transgender Women's Voice Outcome After Laryngochondroplasty-A Systematic Literature Review.","authors":"Eiman Abu Bandora, Hen Chaushu, Michal Icht, Narin N Carmel Neiderman, Yotam Lior, Noa Diamant, Roni Vass, Yuval Nachalon, Yael Oestreicher-Kedem","doi":"10.1002/oto2.70264","DOIUrl":"10.1002/oto2.70264","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the literature on voice outcomes following laryngochondroplasty (LCP).</p><p><strong>Data sources: </strong>PubMed, Scopus, and Embase.</p><p><strong>Review methods: </strong>A systematic review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published in English between January 1990 and January 27, 2026, evaluating voice quality after LCP, were eligible. Included study designs were randomized controlled clinical trials, cohort studies, case-control studies, and case series. Extracted data encompassed study design, sample size, surgical technique, voice assessment methods, and reported outcomes.</p><p><strong>Results: </strong>Of 344 articles identified, 126 duplicates were removed, and 162 articles were excluded by screening title and abstract. The full texts of the remaining 44 articles were reviewed, and 20 met the eligibility criteria, representing a cohort of 760 patients. Most studies relied on subjective or qualitative voice assessments; only two incorporated objective acoustic analyses. Postoperative voice changes were reported in 98 of 777 patients (12.6%), more in patients operated via the transcervical approach (13%), than via the transvestibular approach (5.2%). Fewer reports of voice changes were found when utilizing the transcervical technique with vocal fold localization than without (2.8% vs 29.6%, respectively). More reports of voice changes were found in studies from lead authors affiliated with Otolaryngology-Head and Neck Surgery departments than in those affiliated with plastic surgery departments (15.3% vs 9.9%, respectively).</p><p><strong>Conclusions: </strong>Voice changes may occur following LCP, and the surgical approach may affect the risk. Larger prospective studies using standardized and objective voice measures are needed to confirm these findings.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70264"},"PeriodicalIF":1.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13313092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352982","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":"Evaluation of an Esophageal‑Protective Lithium Coin‑Cell Battery Within Current Management Paradigms.","authors":"Kris R Jatana, Keith Rhoades, Toby Litovitz, Jackson Moore, Aaron A Cadotte, Jamie Mueller, Mariya Dytso, Ian N Jacobs","doi":"10.1002/oto2.70266","DOIUrl":"10.1002/oto2.70266","url":null,"abstract":"<p><strong>Objective: </strong>To assess the first lithium coin-cell battery (CCB) technology on the consumer market with ingestion burn protection claims in context of medical management practices.</p><p><strong>Study design: </strong>Cadaveric porcine esophageal model.</p><p><strong>Setting: </strong>Tertiary care children's hospital research institute and third-party laboratory.</p><p><strong>Methods: </strong>Anterior-posterior X-ray imaging was performed. Using in vitro porcine tissue segments, traditional CCBs and protective CCBs were assessed for visible appearance and surface pH over 60 minutes; another group was assessed for 24 hours. A separate experiment evaluated existing protocols to administer honey/sucralfate and perform 0.25% acetic acid irrigation.</p><p><strong>Results: </strong>All protective CCBs demonstrated diagnostic double-ring/halo sign on X-ray. Traditional CCBs demonstrated diffusely highly alkaline pH of 13 and significant tissue necrosis. For protective CCBs, regions of tissue pH increased to 12-13; however, substantially reduced tissue injury without obvious necrosis was noted. At 24 hours, protective CCBs compared to traditional CCBs maintained reduced visible tissue injury at both positive and negative poles. Honey, sucralfate or 0.25% acetic acid irrigations effectively neutralized pH.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study in the medical literature to assess recently marketed protective CCBs. X-ray diagnosis, preremoval honey/sucralfate use, emergent removal for esophageal lodgment, postremoval 0.25% acetic acid esophageal irrigation <i>practices should not change</i>. While protective CCBs showed substantial reduction of injury severity, the highly alkaline pH at negative pole still warrants neutralization treatments and further study. Widespread adoption of advanced technologies for child safety across the battery, electronics, and consumer goods industries could prevent severe injuries or deaths.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70266"},"PeriodicalIF":1.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13288368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318342","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":"Intermediate Volume Glossectomy Defects Reconstruction: Flap Versus Primary Closure.","authors":"Jidapa Pradit, Wisarut Samuckkeethum","doi":"10.1002/oto2.70270","DOIUrl":"10.1002/oto2.70270","url":null,"abstract":"<p><strong>Objective: </strong>To compare quality-of-life (QoL) outcomes between flap reconstruction and primary closure following intermediate-volume (partial to hemi-) glossectomy in patients with oral tongue carcinoma.</p><p><strong>Study design: </strong>Retro-prospective cross-sectional study.</p><p><strong>Setting: </strong>Department of Otolaryngology-Head and Neck Surgery, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.</p><p><strong>Methods: </strong>Seventy patients undergoing partial to hemi-glossectomy were included and grouped by reconstruction method (flap reconstruction vs primary closure). QoL was assessed at 6 to 12 months posttreatment using the EORTC QLQ-H&N35 questionnaire. Multivariable linear regression was performed adjusting for age, stage group, neck dissection, and adjuvant therapy. Effect sizes were calculated to evaluate clinical relevance.</p><p><strong>Results: </strong>Baseline demographic and clinicopathologic characteristics were comparable between groups. Operative time was significantly longer in the flap group. Flap reconstruction was associated with significantly better QoL, including lower overall HN35 scores (40.89 ± 3.39 vs 44.74 ± 5.26; <i>P</i> < .01), and improved swallowing and speech domains (both <i>P</i> < .01). In multivariable analysis, flap reconstruction remained independently associated with better overall QoL (adjusted <i>β</i>, -5.23; 95% CI, -7.09 to -3.37; <i>P</i> < .001), swallowing (adjusted <i>β</i>, -2.18; <i>P</i> < .001), and speech (adjusted <i>β</i>, -1.65; <i>P</i> < .001). Effect size analysis demonstrated large to very large effects. Wound complications were more frequent in the flap group (14.3% vs 0%; <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Flap reconstruction was associated with improved QoL at 6 to 12 months, particularly in swallowing and speech, but with longer operative time and higher wound complication rates. Prospective studies are warranted to confirm these findings.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70270"},"PeriodicalIF":1.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295969","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":"Extended Paramedian Forehead Flap for Nasal and Upper Lip Defect Reconstruction: A Case Report.","authors":"Abdullah A Adil, Christie C Cheng, Michael J Brenner","doi":"10.1002/oto2.70271","DOIUrl":"10.1002/oto2.70271","url":null,"abstract":"","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70271"},"PeriodicalIF":1.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295872","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":"Inappropriate Appeal Denials for Head and Neck Cancer Surgery in Medicare Advantage Plans.","authors":"Jeffrey R Bellinger, Cameron B Fattahi, Ericka L Erickson, Nolan B Seim, Vinay K Rathi, Lauren E Miller","doi":"10.1002/oto2.70268","DOIUrl":"10.1002/oto2.70268","url":null,"abstract":"<p><p>Medicare Advantage (MA) plans use prior authorization to manage utilization, with denied services appealable through a five-level process. Independent review entities (IREs) adjudicate second-level appeals, determining whether initial plan denials were appropriate. This study assessed whether MA plan denials for head and neck cancer surgery are overturned by IREs at higher rates than denials for other services. We analyzed IRE determinations from January 2020 to December 2024, categorizing appeals as head and neck cancer surgery, surgical oncology, all surgery, or all healthcare services. Among 94 head and neck cancer surgery appeals, 11 denials (11.7%) were favorable/partially favorable. This rate was similar to surgical oncology (9.3%; <i>P</i> = .45) but significantly higher than all surgical services (5.6%; <i>P</i> < .001) and all healthcare services (4.5%; <i>P</i> < .001). The most common denial rationale was inadequate documentation. MA plan denials for head and neck oncologic surgery are overturned by IREs at higher rates compared to general healthcare services, which may represent a barrier to time-sensitive cancer care.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70268"},"PeriodicalIF":1.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295966","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":"An Open-Source, Three-Dimensionally Printed, Motorized (\"Breathing\") Nasotracheoscopy Simulator.","authors":"Anthony M Saad, David Herz, Mal Mehari, Andrey Filimonov, Kenneth Yan, Rachel Kaye","doi":"10.1002/oto2.70269","DOIUrl":"10.1002/oto2.70269","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the face and content validity of a novel, 3D-printed nasotracheoscopy simulator with a motorized, moving larynx using expert feedback from board-certified otolaryngologists.</p><p><strong>Study design: </strong>Device development and validation study.</p><p><strong>Setting: </strong>An academic institution.</p><p><strong>Methods: </strong>An anatomically accurate airway model was created from a de-identified normal patient CT scan using open-source segmentation software. Negative impressions of the turbinates and nasopharynx were 3D printed in PLA and cast in silicone for realistic soft tissue. A custom-coded Arduino-controlled servo motor was integrated to simulate laryngeal motion. Ten board-certified otolaryngologists performed flexible nasotracheoscopy on the model and completed a survey assessing face validity, content validity, and general impressions using a 5-point Likert scale. Descriptive statistics summarized responses.</p><p><strong>Results: </strong>The simulator received high scores for face validity (mean 4.6, SD 0.67), content validity (mean 4.8, SD 0.40), and general impressions (mean 4.83, SD 0.42). All participants agreed that the model accurately represented anatomical landmarks and held educational value. Feedback emphasized its utility for telescopic navigation and anatomical recognition training.</p><p><strong>Conclusions: </strong>This 3D-printed simulator demonstrated strong validity and realism. Its anatomical accuracy, dynamic features, and reproducibility support its use as a training adjunct in procedural training. Future studies will assess its effect on learner performance.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70269"},"PeriodicalIF":1.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295935","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":"Outcomes of Bisphosphonate-Related Osteonecrosis Following Head and Neck Free-Flap Reconstruction.","authors":"Taylor E Freeman, Ericka L Erickson, Nolan B Seim, Matthew O Old, Lauren E Miller","doi":"10.1002/oto2.70258","DOIUrl":"10.1002/oto2.70258","url":null,"abstract":"<p><p>Bisphosphonate-related osteonecrosis of the jaw (BRONJ) can be refractory to conservative management. Definitive segmental resection with microvascular free-flap reconstruction is increasingly used, yet outcomes remain underreported. We conducted a single-institution retrospective review (2014-2022) of patients with BRONJ undergoing free-flap reconstruction. Exposures included inciting medication and smoking history. Primary outcomes were recurrence and orocutaneous fistula. Ten patients met criteria; zoledronic acid was the most common exposure (60%). Reconstructions included fibular (n = 8) and scapular (n = 2) free flaps. Eight patients (80%) did not have recurrence of osteonecrosis after a single operation over the span of follow-up. Two had recurrent osteonecrosis, one of which developed a postoperative fistula requiring reoperation. In our cohort of patients with advanced BRONJ, segmental resection with immediate free-flap reconstruction achieved high single-stage cure with low complication rates.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70258"},"PeriodicalIF":1.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272528","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":"Association Between Cannabis Use and Tinnitus: A Multi-Center Propensity-Score-Matched Cohort Study.","authors":"Oluwatobiloba Ayo-Ajibola, Tyler Jung, Diego Gonzalves, Asher C Park, Matthew E Lin, Ian Kim, Ziva D Cooper, Janet S Choi","doi":"10.1002/oto2.70251","DOIUrl":"10.1002/oto2.70251","url":null,"abstract":"<p><strong>Objective: </strong>There are mixed findings regarding the impact of cannabis use on tinnitus, with different patterns of cannabis use potentially influencing risk in varying ways. This study investigates the association between cannabis-related disorders (CRD) and the risk of developing tinnitus.</p><p><strong>Study design: </strong>Propensity-score-matched cohort study.</p><p><strong>Setting: </strong>TriNetX, a multi-institutional research database.</p><p><strong>Methods: </strong>Adult patients (>18 years) with any CRD and no prior ear-related disorders were matched to a control group of patients without any history of CRD. Patients with CRD were stratified by increasing levels of cannabis use intensity based on the ICD-10 codes (use, abuse, or dependence). Propensity score matching controlled for demographic and related clinical variables, including migraine, nicotine and substance use, and mood disorders. The primary outcome was diagnosed tinnitus at 1, 5, and 10 years, analyzed using Cox regression hazard models (hazard ratios (HR), 95% confidence intervals).</p><p><strong>Results: </strong>After matching (n = 92,077 in each group), tinnitus incidence after 1, 5, and 10 years of CRD diagnosis was 0.7%, 1.8%, and 2.1%, respectively. One-year risk was significantly higher among those with any CRD (HR = 1.30, [95% CI: 1.16-1.45]). Compared to control at 1-year of follow-up, effect size was relatively higher among patients diagnosed with cannabis dependence (use: 1.30 [1.11-1.51]; abuse: 1.42 [1.05-1.90]; dependence: 1.55 [1.02-2.37]). There were no significant trends in tinnitus development at 5 and 10 years of follow-up with any CRD.</p><p><strong>Conclusion: </strong>Cannabis use may elevate the short-term risk of tinnitus, especially among those with more severe use. Further investigation should explore a potential dose-dependent relationship and underlying mechanisms.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70251"},"PeriodicalIF":1.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13270402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148272420","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}