Pulmonary Therapy最新文献

{"title":"A Review of Analgesic and Anaesthetic Approaches in Local Anaesthetic (Medical) Thoracoscopy.","authors":"Jasandra Sutanto, Duneesha DeFonseka, Bernard Duysinx, Valentina Pinelli, Elizabeth Turnbull, Avinash Aujayeb","doi":"10.1007/s41030-026-00373-y","DOIUrl":"10.1007/s41030-026-00373-y","url":null,"abstract":"<p><p>Pleural disease is a subspecialist area of respiratory medicine, requiring diagnostic and therapeutic interventions. The most invasive pleural procedure is local anaesthetic thoracoscopy (LAT) used in the context of unexplained exudative pleural effusions. LAT can be exquisitely painful because of instrumentation of the parietal pleura which carries all nociceptive nerve endings. The optimal anaesthetic and analgesic requirement for LAT is not known, and recommendations are based on expert opinions and small usually single-centre studies. We provide a narrative description of existing literature, show the potential application of regional nerve blocks for LAT and provide practice points.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"805-818"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472440","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":"Respiratory Support in Pediatric Critical and Near-Fatal Asthma: A Narrative Review.","authors":"Long Xiang, Herng Lee Tan, Andrew Miller, Alexandre T Rotta, Jan Hau Lee","doi":"10.1007/s41030-026-00374-x","DOIUrl":"10.1007/s41030-026-00374-x","url":null,"abstract":"<p><p>Pediatric asthma remains a leading cause of emergency department visits and hospitalizations worldwide. Patients with critical asthma represents a subset of patients requiring respiratory support beyond standard pharmacologic therapy. Management of respiratory support in these patients has evolved dramatically, with intubation rates decreasing from 6.9% to 3.4% between 2009 and 2019 while noninvasive ventilation use doubled and high-flow nasal cannula utilization increased from 11% to 52%. This narrative review examines current evidence and practical considerations for respiratory support strategies across the spectrum of pediatric critical asthma care. The pathophysiology of critical asthma creates unique challenges fundamentally different from other causes of respiratory failure. Dynamic hyperinflation from progressive air trapping and intrinsic positive end-expiratory pressure (PEEP) development represents the cornerstone derangement, requiring ventilation strategies that seems divergent from those utilized in acute respiratory distress syndrome. High-flow nasal cannula provides benefit primarily through dead space washout and gas conditioning, while noninvasive ventilation offers comprehensive support by augmenting ventilation and offsetting intrinsic PEEP effects. When mechanical ventilation becomes necessary, controlled hypoventilation with acceptance of hypercapnia while maintaining pH > 7.20 has dramatically reduced mortality compared with historical approaches targeting normocapnia. Pressure-controlled ventilation may offer physiologic advantages over volume-controlled modes by providing more uniform gas distribution in airways with varying degrees of obstruction. A structured three-phase ventilation approach emphasizes initial hyperinflation clearance, followed by acidosis resolution, then careful weaning with attention to dynamic hyperinflation monitoring. Current survival rates exceed 96% for children reaching medical care, representing substantial improvement from historical mortality rates of 20-30%. Optimal respiratory support in critical asthma requires understanding that mechanical ventilation strategies in asthma differs from other respiratory failure etiologies, with dynamic hyperinflation management taking precedence over traditional lung-protective strategies. Future research priorities include developing severity prediction tools, optimizing noninvasive protocols, and investigating personalized approaches on the basis of emerging understanding of asthma phenotypes and endotypes.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"819-840"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148449020","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":"Sarcoidosis: A Clinical Trials Perspective.","authors":"Juan J Zapata-Huizi, Manuela Herrera-Tamayo, Josmar J Ríos-Poveda, Eli N Pérez-Rodas, Fernanda Hernández-González, Jacobo Sellares","doi":"10.1007/s41030-026-00372-z","DOIUrl":"10.1007/s41030-026-00372-z","url":null,"abstract":"<p><p>Sarcoidosis is a systemic granulomatous disorder of unclear origin, most commonly impacting the lungs and mediastinal lymph nodes. Respiratory manifestations occur in most patients and are the main contributors to disease-related morbidity and mortality. Despite decades of clinical experience, the evidence base for treatment has historically been limited, with corticosteroids serving as first-line therapy largely on the basis of observational data and expert consensus rather than robust randomized controlled trials. This comprehensive review examines the current landscape of clinical trials for pulmonary sarcoidosis, with particular emphasis on landmark studies that have shaped contemporary treatment paradigms. Finally, we propose a vision for the future of pulmonary sarcoidosis treatment, emphasizing the need for personalized medicine approaches, validated biomarkers, and international collaborative trials. As our understanding of sarcoidosis pathophysiology deepens and new therapeutic targets emerge, the prospect of disease-modifying treatments that go beyond symptom management becomes increasingly attainable.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"785-804"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405593","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":"COPD Biologics: Right Patient, Right Pathway, Right Time.","authors":"Lydia J Finney, Francesca M Conway, Dheeraj K Sethi","doi":"10.1007/s41030-026-00370-1","DOIUrl":"10.1007/s41030-026-00370-1","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease that is entering a new era in precision medicine. Advances in disease endotyping have challenged the traditional view of COPD as a uniformly neutrophilic disorder and revealed biologically distinct subgroups in whom targeted immunomodulation may be effective. Reproducible signatures of type 2 (T2) inflammation and epithelial-derived alarmin activation have emerged as actionable pathways, reshaping therapeutic development in COPD. This narrative review synthesises mechanistic insights and clinical trial evidence for biologic therapies targeting key T2 cytokines such as interleukin-5 (IL-5) IL-4/IL-13 and upstream epithelial alarmins, including interleukin-33 (IL-33) and thymic stromal lymphopoietin (TSLP). We examine why earlier approaches targeting neutrophilic inflammation failed, and how biomarker-driven trial design has enabled success in selected populations. Across these programmes, therapeutic efficacy has depended not only on the pathway targeted but also on patient selection, disease stage and timing of intervention. We propose that the future of biologics in COPD lies in integrating biomarkers, treatable traits and longitudinal phenotyping to align the right patient with the right pathway at the right time, closing persistent treatment gaps in this common, overlooked and burdensome disease.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"763-783"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353280","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":"Destroyed Lungs and Surgical Management.","authors":"Lihui Yu, Jingyu Chen","doi":"10.1007/s41030-026-00369-8","DOIUrl":"10.1007/s41030-026-00369-8","url":null,"abstract":"<p><p>Destroyed lung is a radiographic and clinical end-stage condition of chronic pulmonary infection, characterized by irreversible parenchymal destruction and major functional impairment. Medical treatment may control active infection, but established structural damage is usually irreversible. Pneumonectomy remains the conventional surgical option for selected patients with unilateral destroyed lung, although it is associated with considerable perioperative risk. Lung transplantation may be considered only in highly selected patients with end-stage disease, bilateral involvement, severe functional compromise, or failure of conventional resection-based strategies. However, it should not be regarded as a routine substitute for pneumonectomy. This narrative review summarizes the major etiologies, clinical manifestations, and surgical approaches to destroyed lung, with particular attention to the selective role, indications, technical challenges, and limitations of lung transplantation in this setting.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"749-762"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284193","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":"Summary of Research: Dupilumab for Chronic Obstructive Pulmonary Disease with Type 2 Inflammation: A Pooled Analysis of Two Phase 3, Randomised, Double-Blind, Placebo-Controlled Trials.","authors":"Surya P Bhatt, Klaus F Rabe, Nicola A Hanania, Claus F Vogelmeier, Mona Bafadhel, Stephanie A Christenson, Alberto Papi, Dave Singh, Linda Walsh, Tonya Winders, Ashish Bansal, Lacey B Robinson","doi":"10.1007/s41030-026-00361-2","DOIUrl":"10.1007/s41030-026-00361-2","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a progressive lung disease that is usually caused by long-term exposure to harmful substances, such as cigarette smoke, which can lead to inflammation in the airways. Dupilumab is a drug that works by blocking the activity of interleukins 4 and 13, and helping to reduce type 2 inflammation in various organs, such as the lungs, sinuses, and skin. This summary of research provides an overview of the previously published article on the results of two phase 3 studies of patients with COPD and type 2 inflammation who were treated with either dupilumab or placebo for up to 52 weeks. Dupilumab reduced exacerbations and symptom severity, improved lung function and quality of life in these patients, and was well tolerated. These studies provide evidence that dupilumab is a safe and effective treatment option for patients with COPD who also show signs of type 2 inflammation. ClinicalTrials.gov Identifiers: BOREAS: NCT03930732; NOTUS: NCT04456673.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"745-748"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309245","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":"Incidence of New Malignancies in Severe Asthma: Comparison of Real-World Patients Treated with Benralizumab, Other Biologics, or Non-biologics.","authors":"Eileen O Dareng, Trung N Tran, Hannah Urbanski, Ryan Finch, Ulrika Emerath, Yulia Kurdyukova, Maria L Jison, Lila Bahadori, Andrew Menzies-Gow, Eileen Wang, Elisabeth H Bel, Luis Perez de Llano, Benjamin Emmanuel, Lynda Olinger","doi":"10.1007/s41030-026-00379-6","DOIUrl":"10.1007/s41030-026-00379-6","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical trials report no increased malignancy risk with benralizumab in severe asthma; however, trial populations are highly selective. To better define real-world safety, malignancy risk was compared among patients treated with benralizumab, other (non-benralizumab) biologics, or non-biologic therapies.</p><p><strong>Methods: </strong>Data from adults with severe asthma accrued to the International Severe Asthma Registry (ISAR) and a United States severe asthma registry (CHRONICLE) between 1 November 2017, and 31 December 2023, were analyzed. Cohorts were defined by exposure to benralizumab, other asthma biologics, and non-exposure to biologic therapies. First new-onset malignancies were assessed. Incidence per 1000 person-years (PY) and adjusted incidence rate ratios (aIRR) were estimated with an inverse probability-weighted Poisson model, with propensity scores incorporating demographics, comorbidities, baseline asthma medication, systemic steroid use, and relevant medical history, with residual adjustment for age, sex, body mass index, region, and smoking.</p><p><strong>Results: </strong>Among 12,493 patients, 43,434.8 PY were accrued (benralizumab, 7749.1 PY; other biologics, 21,054.1 PY; non-biologics, 14,631.6 PY), with a median (range) follow-up of 3.3 (0-6.2) years across cohorts. Seventy-five patients reported new malignancies: benralizumab, 17 (0.7%); other biologics, 34 (0.6%); and non-biologics, 24 (0.5%). Weighted, fully adjusted incidence rates were 1.3 versus 1.1 per 1000 PY for benralizumab versus other biologics (aIRR 1.2, 95% CI 0.79-1.81) and 1.8 versus 1.7 per 1000 PY for benralizumab versus non-biologics (aIRR 1.1, 95% CI 0.70-1.59).</p><p><strong>Conclusions: </strong>This large observational study with up to 6 years of follow-up found no increased malignancy risk with benralizumab versus other therapies in patients with severe asthma.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"937-953"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850782","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":"Immunometabolic Modulation in Obese Asthma: How GLP-1 Receptor Agonists Could Influence Systemic and Pulmonary Immune Phenotypes.","authors":"Helen O'Brien, Adam J Byrne, Alessandro N Franciosi, Marcus W Butler","doi":"10.1007/s41030-026-00380-z","DOIUrl":"10.1007/s41030-026-00380-z","url":null,"abstract":"<p><p>Obesity-associated asthma is an increasingly prevalent and clinically challenging phenotype, characterized by poorer response to conventional asthma therapies, greater disease burden, and a distinct immunometabolic profile that sets it apart from classical eosinophilic asthma. Given the growing interest in therapies targeting the treatment of obesity, understanding the underlying biological mechanisms that drive inflammatory processes in this cohort is essential. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as transformative agents in the management of obesity and type 2 diabetes mellitus (T2DM), with a growing basis of evidence that their utility may extend beyond these indications and exert potent anti-inflammatory effects. In late 2025, the World Health Organization endorsed GLP-1RAs for obesity management, reframing how we contextualize care for patients living with obesity. In this review, we examine the immunopathological mechanisms underpinning obesity-associated asthma, and explore the biology of GLP-1 receptor signaling and the emerging preclinical and observational evidence supporting a direct role for GLP-1RAs in modulating pulmonary inflammation, airway remodeling, and immune cell activation. This could have important implications on future therapeutic directions. Key questions remain regarding whether any respiratory benefits are weight loss dependent or driven by direct immunomodulatory effects, and how GLP-1RAs should be positioned within treatment algorithms. Future prospective trials will be essential to define which patients derive the greatest benefit from these agents. GLP-1RAs represent a compelling and novel therapeutic avenue in obesity-associated asthma and potentially across the broader spectrum of chronic inflammatory airway disease.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"869-884"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888574","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":"Bridging the Knowledge Gap: Transforming COPD Management Through Lessons from Asthma.","authors":"Javier de Miguel-Díez, Francisco Javier Callejas-González, Marina Blanco-Aparicio, Borja G Cosío, Cruz González-Villaescusa, Salud Santos, Carlos Cabrera","doi":"10.1007/s41030-026-00376-9","DOIUrl":"10.1007/s41030-026-00376-9","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in asthma immunopathology and the integration of biologic therapies have reshaped clinical practice, and in turn have impacted diagnosis, phenotyping, monitoring, and care organization. Given the persistent burden of chronic obstructive pulmonary disease (COPD), transferring these strategies may facilitate the implementation of precision medicine in COPD. The BRIDGE project, an educational initiative involving seven pulmonologists, aimed to identify key learnings from asthma that could support the incorporation of immunological insights and biologics into the management of COPD.</p><p><strong>Methods: </strong>The expert panel conducted a structured review of current approaches to severe asthma, including biomarker-guided diagnosis, endotyping, treatment evaluation frameworks, and specialized clinical pathways. Through consensus-based discussions, the group analyzed which elements were adaptable to COPD and proposed recommendations to support their implementation.</p><p><strong>Results: </strong>Experts agreed that several core principles of asthma management could significantly improve COPD care. Comprehensive phenotyping, supported by biomarkers such as blood eosinophils, FeNO, and IgE, along with computed tomography (CT) imaging to characterize mucus plugging and emphysema, was identified as essential. Treatment optimization should shift toward quantifiable therapeutic objectives, emphasizing exacerbations, corticosteroid use, dyspnea, and physical activity. Structured follow-up must rely on objective exacerbation recording, rescue medication use, lung function, and functional capacity. Organizational improvements should mirror the asthma model, including the development of specialized units, decentralization of biologic administration, and enhanced, multidisciplinary coordination. The remaining gaps include the need for standardized CT protocols, consensus definitions of uncontrolled exacerbator phenotypes, and a national registry to generate real-world evidence on biologics.</p><p><strong>Conclusions: </strong>Experience gained from biologic therapy in asthma provides a robust framework for advancing precision medicine in COPD. Adopting rigorous diagnostic, therapeutic, and organizational strategies will facilitate the effective introduction of biologics and improve outcomes for patients with uncontrolled COPD despite conventional therapies.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"733-744"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813994","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":"Advanced Bronchoscopic Approaches to Peripheral Pulmonary Lesions: a Narrative Review of Current and Emerging Techniques.","authors":"Richard Westley, Alberto Fantin, Ernesto Crisafulli, Rakesh Panchal","doi":"10.1007/s41030-026-00377-8","DOIUrl":"10.1007/s41030-026-00377-8","url":null,"abstract":"<p><p>Peripheral pulmonary lesions (PPLs), defined by their location in the outer one-third of the lung, are expected to be identified with increasing frequency following the widespread adoption of lung cancer screening. The majority of PPLs will have a benign aetiology; however, obtaining tissue to exclude malignancy can be challenging, leading to high rates of benign surgical resections or prolonged surveillance imaging. Over the last two decades, there has been rapid advancement in bronchoscopic technologies, with the adoption of radial probe endobronchial ultrasound (RP-EBUS), ultrathin bronchoscopes, electromagnetic navigation bronchoscopy (ENB), virtual bronchoscopic navigation (VBN) and robotic assisted bronchoscopy (RAB). These technologies provide access to lesions that are inaccessible by conventional bronchoscopic approaches, with diagnostic yields comparable to those of CT-guided transthoracic needle biopsy (TTNB). Whilst these advanced technologies offer a lower risk of complications than CT-guided TTNB, they are significantly more expensive. In addition, advances in biopsy techniques, such as transbronchial cryobiopsy, have further enhanced the diagnostic yield for PPLs.Recent data supports the potential for a one-stop 'diagnose and treat' approach, where advanced bronchoscopic platforms are combined with thoracic surgery and rapid onsite evaluation. This offers the potential to locate and diagnose nodules prior to potential resection, thereby reducing benign resections and shortening the diagnostic pathway. The therapeutic potential of these advanced bronchoscopic platforms is an active area of research, with the potential to deliver thermal ablation therapies and intralesional brachytherapy and chemotherapy agents. This narrative review summarises the current evidence base of this rapidly evolving field.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":" ","pages":"853-867"},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876123","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}