Pleura and Peritoneum最新文献

{"title":"Pharmacokinetics and toxicity of carboplatin used for hyperthermic intraperitoneal chemotherapy (HIPEC) in treatment of epithelial ovarian cancer.","authors":"Mette Schou Mikkelsen,&nbsp;Jan Blaakaer,&nbsp;Lone Kjeld Petersen,&nbsp;Luise Gram Schleiss,&nbsp;Lene Hjerrild Iversen","doi":"10.1515/pp-2020-0137","DOIUrl":"https://doi.org/10.1515/pp-2020-0137","url":null,"abstract":"<p><strong>Objectives: </strong>Carboplatin is frequently used in various doses for hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of epithelial ovarian cancer (EOC) although its pharmacokinetics, including focus on the perfusion time, has not been evaluated when used in modern era cytoreductive surgery (CRS). The aim was to evaluate the pharmacokinetics and hematological toxicity of carboplatin used for HIPEC with a perfusion time of 90 min.</p><p><strong>Methods: </strong>Fifteen patients with stage III-IV primary EOC received CRS and 90 min of HIPEC with carboplatin at dose 800 mg/m². For the pharmacokinetic analysis, perfusate and blood samples were obtained during HIPEC and up to 48 h after HIPEC (blood only). Hematological toxicity within 30 days was graded according to Common Terminology Criteria for Adverse Events. Severe toxicity (grades 3-5) is reported.</p><p><strong>Results: </strong>Mean maximum concentration of carboplatin was 12 times higher in perfusate than plasma (mean CmaxPF=348 µg/mL (range: 279-595 µg/mL) versus mean CmaxPL=29 µg/mL (range: 21-39 µg/mL)). Mean terminal half-life of carboplatin in perfusate was 104 min (range: 63-190 min) and mean intraperitoneal-to-plasma area under the concentration-time curve (AUC) ratio was 12.3 (range: 7.4-17.2). Two patients (13%) had grade 3 neutropenia within 30 days. No grade 4-5 hematological toxicities were identified.</p><p><strong>Conclusions: </strong>Carboplatin has a favorable pharmacokinetic profile for 90 min HIPEC administration, and the hematological toxicity was acceptable at dose 800 mg/m². Large interindividual differences were found in the pharmacokinetic parameters, making risk of systemic exposure difficult to predict.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 4","pages":"20200137"},"PeriodicalIF":1.8,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25363731","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":"Practice patterns, attitudes, and knowledge among clinicians regarding hyperthermic intraperitoneal chemotherapy and pressurized intraperitoneal aerosol chemotherapy: a national survey by Indian society of peritoneal surface malignancies (ISPSM).","authors":"Sampige Prasanna Somashekhar,&nbsp;Kumar C Rohit,&nbsp;S V S Deo,&nbsp;Kyatsandra Rajagopal Ashwin","doi":"10.1515/pp-2020-0120","DOIUrl":"https://doi.org/10.1515/pp-2020-0120","url":null,"abstract":"<p><strong>Objectives: </strong>Perception of cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and pressurized intraperitoneal aerosol chemotherapy (PIPAC) for treating peritoneal surface malignancies (PSM) differ widely among physicians.</p><p><strong>Methods: </strong>This on-site survey performed during a major oncology congress in 2019 evaluated the current opinion, perceptions, knowledge and practice of HIPEC and PIPAC among oncologists in India.</p><p><strong>Results: </strong>There were 147 respondents (gynecologists (30%), surgical oncologists and gastrointestinal surgeons (64%), and medical oncologists (6%)). Whereas most respondents considered CRS and HIPEC an appropriate therapeutic option, 25% would not recommend CRS and HIPEC. The main barriers to referral to an expert center were inaccessibility to such a center (37.8%), non-inclusion of CRS and HIPEC in clinical practice guidelines (32.4%), and a high morbidity/mortality (21.6%). Variations were found in the various practice patterns of CRS/HIPEC like eligibility criteria, HIPEC protocols and safety measures. Although PIPAC awareness as a novel therapeutic option was high, only a limited number of centers offered PIPAC, mainly because of non-access to technology and missing training opportunities (76.2%).</p><p><strong>Conclusions: </strong>Lack of widespread acceptance, poor accessibility and low utilization presents a significant challenge for HIPEC and PIPAC in India. There is a need to raise the awareness of curative and palliative therapeutic options for PSM. This might be achieved by the creation of expert centers, specialized training curricula and of a new sub-speciality in oncology.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200120"},"PeriodicalIF":1.8,"publicationDate":"2020-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38752204","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":"Rebound hypothermia after cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) and cardiac arrest in immediate postoperative period: a report of two cases and review of literature.","authors":"Sohan Lal Solanki,&nbsp;Mrida A K Jhingan,&nbsp;Avanish P Saklani","doi":"10.1515/pp-2020-0126","DOIUrl":"https://doi.org/10.1515/pp-2020-0126","url":null,"abstract":"<p><strong>Objectives: </strong>Cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS-HIPEC) for peritoneal malignancies are complex surgeries marked with hemodynamic perturbations, temperature fluctuations, blood loss and metabolic disturbances in the intra-operative and post-operative period. In this report, we highlighted perioperative factors which may have led to cardiac arrest in immediate postoperative period and subsequent successful resuscitation in two patients with high volume peritoneal cancers who underwent CRS-HIPEC.</p><p><strong>Case presentation: </strong>Both patients had a similar clinical course, characterized by massive blood and fluid loss, metabolic derangement, hemodynamic instability, long duration of surgery, post HIPEC rebound hypothermia and hypokalemia which need to be anticipated.</p><p><strong>Conclusions: </strong>We reviewed the literature related to postoperative hypothermia and other major complications after CRS-HIPEC and correlated the available literature with our findings.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200126"},"PeriodicalIF":1.8,"publicationDate":"2020-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38752205","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":"Technique of neuromonitoring during pelvic peritonectomy.","authors":"Antonio Macrì,&nbsp;Giorgio Badessi,&nbsp;Carmelo Mazzeo,&nbsp;Marica Galati,&nbsp;Eugenio Cucinotta,&nbsp;Vincenzo Rizzo","doi":"10.1515/pp-2020-0132","DOIUrl":"https://doi.org/10.1515/pp-2020-0132","url":null,"abstract":"<p><strong>Objectives: </strong>Pelvic peritonectomy can induce anorectal and urogenital dysfunctions. To reduce this type of complications during the procedure, we propose to use intraoperative neuromonitoring (IONM).</p><p><strong>Content: </strong>Stimulation with a bipolar probe allows the identification of the obturator and ilioinguinal and pudendal nerves. At the end of the cytoreductive surgery, the motor and somatosensory evoked potentials must be evaluated to confirm the preservation of pelvic innervation.</p><p><strong>Summary: </strong>The use of IONM during pelvic peritonectomy is technically feasible, and it can help to preserve pelvic nerves.</p><p><strong>Outlook: </strong>Obviously, its definitive value remains to be elucidated.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200132"},"PeriodicalIF":1.8,"publicationDate":"2020-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39087844","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":"Peritoneal pseudomyxoma after incomplete appendectomy.","authors":"Dahbia Djelil,&nbsp;Anthony Dohan,&nbsp;Marc Pocard","doi":"10.1515/pp-2020-0119","DOIUrl":"https://doi.org/10.1515/pp-2020-0119","url":null,"abstract":"A41-year-oldwomanwas referredbecauseof abdominalpain, reporting on an appendectomy 24 years ago. At that time, she developed a postoperative intra-abdominal abscess and was told that the tip of the appendix had been left in the abdomen. Seventeenyears later, aCT-scan showeda6cmcystic tumorat the caecum base (Figure 1A). The treatment was conservative. The abdominal CT-scan now showed a 15 cm large tumor (Figure 1B). A low-grade pseudomyxomaperitonei (PMP)with a Peritoneal Cancer Index (PCI) of 6/39 was diagnosed. A 59-year-old man presented with abdominal pain nine years after a laparoscopic appendectomy. He reported on an intra-abdominal abscess eight months postoperatively, requiring radiological drainage. A low-grade PMP (PCI 12) was diagnosed, andanappendix tip remnant identified (Figure 1C). A PMP can arise from an appendiceal tip remnant. A history of appendectomy does not exclude an appendiceal origin of PMP.","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200119"},"PeriodicalIF":1.8,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38752203","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 delay in time to adjuvant chemotherapy after HIPEC and its impact on oncological outcome in advanced epithelial ovarian cancer.","authors":"S P Somashekhar,&nbsp;Y Ramya,&nbsp;K R Ashwin,&nbsp;S Z Shabber,&nbsp;V K Ahuja,&nbsp;R Amit,&nbsp;K C Rohit","doi":"10.1515/pp-2020-0103","DOIUrl":"https://doi.org/10.1515/pp-2020-0103","url":null,"abstract":"<p><strong>Obejectives: </strong>Optimal cytoreductive surgery (CRS), followed by adjuvant chemotherapy, is a major predictor of oncological outcome in patients with advanced epithelial ovarian carcinoma (EOC). It is not clear if a delayed start of adjuvant chemotherapy negatively impacts on the oncological outcome.</p><p><strong>Methods: </strong>Prospective registry study on 75 patients treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC). Adjuvant chemotherapy was started within 42 days in 41 patients (55%), later on in 34 patients (45%). Multivariate analyses of preoperative factors were done on survival outcome. Outcomes were recurrence-free survival (RFS) and overall survival (OS).</p><p><strong>Results: </strong>There was no difference in RFS after early introduction (median 35 months) vs. late introduction of chemotherapy (median 32 months), p = 0.17. Median OS in patients with late introduction of chemotherapy was 46 months and was not yet reached in early introduction group.</p><p><strong>Conclusions: </strong>In this exploratory study in a small group of women with advanced EOC, starting adjuvant chemotherapy more than 6 weeks after CRS and HIPEC did not deteriorate significantly RFS or OS. Well-designed clinical studies are still needed to evaluate the interplay of HIPEC and the point of time of postoperative adjuvant chemotherapy in this indication.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200103"},"PeriodicalIF":1.8,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38752201","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":"Impact of insurance status on overall survival after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).","authors":"Ravi J Chokshi,&nbsp;Jin K Kim,&nbsp;Jimmy Patel,&nbsp;Joseph B Oliver,&nbsp;Omar Mahmoud","doi":"10.1515/pp-2020-0105","DOIUrl":"https://doi.org/10.1515/pp-2020-0105","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of insurance status on oncological outcome in patients undergoing cytoreduction and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is poorly understood.</p><p><strong>Methods: </strong>Retrospective study on 31 patients having undergone 36 CRS-HIPEC at a single institution (safety-net hospital) between 2012 and 2018. Patients were categorized as insured or underinsured. Demographics and perioperative events were compared. Primary outcome was overall survival (OS).</p><p><strong>Results: </strong>A total of 20 patients were underinsured and 11 were insured. There were less gynecologic malignancies in the underinsured (p=0.02). On univariate analysis, factors linked to poor survival included gastrointestinal (p=0.01) and gynecologic malignancies (p=0.046), treatment with neoadjuvant chemotherapy (p=0.03), CC1 (p=0.02), abdominal wall resection (p=0.01) and Clavien-Dindo 3-4 (p=0.01). Treatment with neoadjuvant chemotherapy and abdominal wall resections, but not insurance status, were independently associated with OS (p=0.01, p=0.02 respectively). However, at the end of follow-up, six patients were alive in the insured group vs. zero in the underinsured group.</p><p><strong>Conclusions: </strong>In this small, exploratory study, there was no statistical difference in OS between insured and underinsured patients after CRS-HIPEC. However, long-term survivors were observed only in the insured group.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 3","pages":"20200105"},"PeriodicalIF":1.8,"publicationDate":"2020-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0105","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38752202","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":"\"Peritoneal failure\": A new concept to explain negative results of randomized trials evaluating intraperitoneal therapies.","authors":"Marc Pocard, Marc A Reymond","doi":"10.1515/pp-2020-0117","DOIUrl":"10.1515/pp-2020-0117","url":null,"abstract":"Prof. Jimmy So recently presented the results of the Extensive Peritoneal Lavage after curative gastrectomy for gastric cancer (EXPEL) study at the Gastrointestinal Cancers Symposium 2020 (ASCO GI) in San Francisco [1]. The EXPEL trial is a prospective randomized, high-quality surgical study evaluating the potential benefit of peritoneal lavage after surgical resection of the stomach. The trial involved 800 patients from 22 hospitals from Korea, China, Japan, Malaysia, and Singapore. Patients with cT3, T4 stomach cancer undergoing curative resection were randomized to surgery alone (control group, n = 402 patients) or surgery followed by lavage of the peritoneal cavity with 10 L of saline solution (test group, n = 398 patients). There was no difference in the 3-year cumulative incidence of recurrence between the two groups. The rate of adverse events was higher in the test group (RR= 1.58, P = 0.019). The EXPEL study is not the first study failing to show a benefit of intraperitoneal therapies. Since 2018, the community of peritoneal surgeons is collecting negative results with hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer, both in the prophylactic and in the therapeutic setting [2, 3]. Positive results talk louder than negative studies. They are more appealing to physicians and get broader coverage. But does that mean that peritoneal surgeons should be discouraged from pursuing a fruitless path? Or might these negative studies give them valuable insights into where to look next? Many comments have been made regarding the failure of the French PRODIGE 7 randomized controlled trial examining an additional benefit of HIPEC over cytoreductive surgery alone in patients with peritoneal metastasis of colon cancer [4–6]. The PRODIGE 7 trial showed a remarkable overall survival of around 41months in both groups, and the control group (surgery alone) performed much better than expected. Thus, the additional effect of HIPEC, if any, was too small to be detected with the sample size available. Moreover, the HIPEC effect, if any, was erased by the increased postoperative morbidity in the test group. The reasons for these repeated, unexpected failures of intraperitoneal therapies in clinical trials might differ between trials, but some lessons can be learned for all of them. The first lesson is methodological and might appear self-evident. Medical research does not start with Phase-3 trials. Peritoneal surgeons should first go back to the laboratory to explore new approaches such as advanced drug delivery systems, nanoparticles, carrier solutions, and others. Only a few of these approaches will go successfully through the preclinical development steps and will reach clinical testing in human patients. These new approaches should then be validated step by step in welldesigned Phase-I and (controlled) Phase-II trials. Out of the strategies tested in early-phase clinical trials, only the most promising will make it to Phase-3 trials, wit","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 2","pages":"20200117"},"PeriodicalIF":1.8,"publicationDate":"2020-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073075","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":"Cutaneous port-site recurrence secondary to tumour seeding following implantation of an intraperitoneal chemotherapy access port for gastric cancer.","authors":"Koy Min Chue,&nbsp;Dexter Yak Seng Chan,&nbsp;Jimmy B Y So","doi":"10.1515/pp-2020-0102","DOIUrl":"https://doi.org/10.1515/pp-2020-0102","url":null,"abstract":"<p><p>Intraperitoneal chemotherapy has shown promising results for the treatment of peritoneal carcinomatosis in gastric cancer. However, the implantation of an intraperitoneal chemotherapy port may be associated with catheter-related complications. The authors describe a case of cutaneous port-site recurrence secondary to tumour seeding from an intraperitoneal chemotherapy access port.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 2","pages":"20200102"},"PeriodicalIF":1.8,"publicationDate":"2020-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0102","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073072","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":"Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC)-directed treatment of peritoneal metastasis in end-stage colo-rectal cancer patients.","authors":"Signe Bremholm Ellebæk,&nbsp;Martin Graversen,&nbsp;Sönke Detlefsen,&nbsp;Lars Lundell,&nbsp;Claus W Fristrup,&nbsp;Per Pfeiffer,&nbsp;Michael B Mortensen","doi":"10.1515/pp-2020-0109","DOIUrl":"https://doi.org/10.1515/pp-2020-0109","url":null,"abstract":"<p><strong>Background: </strong>Pressurized IntraPeritoneal Aerosol Chemotherapy (PIPAC) represents a novel approach to intraperitoneal chemotherapy. Hereby results, obtained with PIPAC in patients with advanced peritoneal metastasis (PM) from colorectal cancer (CRC), are presented.</p><p><strong>Methods: </strong>Data from CRC patients (<i>n</i> = 24) included in the prospective PIPAC-OPC1 and PIPAC-OPC2 trials are reported. Oxaliplatin 92 mg/m² was administered at 4-6-week intervals. A CE certified nebulizer was used to aerosolize the chemotherapeutics. Outcome criteria were objective tumor response, survival and adverse events.</p><p><strong>Results: </strong>Retrospective analysis of 74 PIPAC procedures carried out in 24 consecutive patients with PM from CRC included from October 2015 to February 2019. Five patients had still the primary tumor in situ, and 22 patients had received palliative systemic chemotherapy. Nineteen patients completed more than two PIPAC procedures, and objective tumor response according to the histological Peritoneal Regression Grading Score (PRGS) was observed in 67% of the patients, while 21% had stable disease. Four patients (21%) had complete response (mean PRGS = 1 and negative cytology). We recorded a median survival of 37.6 (range 7.3-48.9) months from the time of PM diagnosis, whereas it was 20.5 (range 0.13-34.7) months following the first PIPAC session. Minor postoperative complications were noted, and few were considered causally related to the PIPAC treatment. However, two cases of severe postoperative complications were recorded (urosepsis and iatrogenic bowel perforation).</p><p><strong>Conclusions: </strong>PIPAC with low-dose oxaliplatin can induce objective tumor regression in selected patients with advanced PM from colorectal cancer.</p>","PeriodicalId":20231,"journal":{"name":"Pleura and Peritoneum","volume":"5 2","pages":"20200109"},"PeriodicalIF":1.8,"publicationDate":"2020-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1515/pp-2020-0109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38073073","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}