Cancer Urology最新文献

{"title":"Neoadjuvant chemotherapy and radical cystectomy in patients with bladder cancer","authors":"O. Karyakin, N. Vorobyov, I. Zaborskiy, A. Muradyan, K. Safiullin, I. A. Taraki, G. Demyashkin, S. A. Ivanov, A. Kaprin","doi":"10.17650/1726-9776-2022-18-3-92-98","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-92-98","url":null,"abstract":"Background. Bladder cancer is the ninth most common malignant neoplasm worldwide. Hidden metastases at the time of diagnosis are the main reason muscle-invasive bladder cancer has poor prognosis. Even after radical cystectomy, muscleinvasive bladder cancer mostly progresses within 2 years with a recurrence rate of over 50 %. At stages II–IV of the disease, drug treatment is indicated before radical cystectomy. The main goal of neoadjuvant chemotherapy is to affect micrometastases, which may be present at the beginning of disease development. The response to ongoing chemotherapy can serve as a predictor of long-term survival.Aim. To increase effectiveness of bladder cancer treatment.Materials and methods. A total of 231 patients with bladder cancer were included in the study. The main contingent consisted of men over 60 years old with locally advanced tumors at stage Т2–Т4. Drug therapy was carried out in neoadjuvant mode before surgical treatment. Standard regimens were used: cisplatin + gemcitabine and MVAC (methotrexate, vinblastine, adriamycin, cisplatin). After four courses of neoadjuvant chemotherapy, the results were evaluated. With complete normalization of a patient’s condition, the issue of surgical treatment – radical cystectomy with one of the types of urinary diversion – was decided.Results and conclusion. The follow-up period for patients after treatment was 62 months. In patients who underwent neoadjuvant chemotherapy, the median overall survival was 44.9 months, in patients without neoadjuvant treatment – 36.8 months with improvement in recurrence-free survival from 32.5 to 39.8 months (p = 0.08). Overall survival after neoadjuvant chemotherapy improved by 8.1 months (p = 0.09).","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115758187","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":"Cardiovascular safety of hormone therapy for prostate cancer","authors":"D. Andreev, A. Zavyalov","doi":"10.17650/1726-9776-2022-18-3-85-91","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-85-91","url":null,"abstract":"Background. As of 2019, prostate cancer (PCa) is the second most common malignancy in men living in Russia (15.7 % of all cancer cases detected in 2019). Cardiovascular diseases, in particular atherosclerosis, are believed to be the second most frequent cause of death in PCa patients.Aim. To evaluate cardiovascular safety of hormone therapy for PCa on the example of gonadotropin releasing hormone (GnRH) agonists and antagonists (leuprolide and degarelix), second-generation antiandrogens (enzalutamide), and steroidogenesis inhibitors (abiraterone).Materials and methods. We analyzed the results of original studies assessing cardiovascular safety of hormone therapy in PCa patients published in 2020–2021 and indexed in PubMed. The results of other meta-analyses and systematic reviews were not included.The search for publications was performed using the PubMed database and the Google system. The following key words were used for searching: prostate cancer, cardiovascular risks, cardiovascular safety, outcomes, atherosclerosis, etc. We analyzed studies published between January 2020 and January 2022. Articles in English and Russian were selected manually; no filters were applied.Results. We examined the results of the latest and most relevant original studies assessing cardiovascular safety of key innovative hormone therapies for PCa. The majority of recent studies were based on routine clinical practice; they were registered in highly specialized cancer registers.Hormone therapy is associated with cardiotoxicity, which increases the risk of non-cancer related death in PCa patients. New, sometimes conflicting evidence is being constantly accumulated. This evidence suggests that the GnRH antagonist (degarelix) has a better cardiovascular safety profile than the GnRH agonist (leuprolide); enzalutamide is safer than abiraterone. Further search for prognostic biomarkers in PCa patients is needed.Conclusion. More high-quality studies analyzing adverse cardiovascular events in PCa patients conducted in routine clinical practice and registered in the online databases are the next stage to identify benefits of one antitumor drug over another. This will help to choose optimal hormone therapy algorithms for PCa patients and, therefore, increase their overall survival.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"8 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127749839","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":"New lenvatinib and pembrolizumab combination for metastatic renal cell carcinoma in 1st line drug treatment: comparative effectiveness and safety","authors":"B. Alekseev, I. Shevchuk","doi":"10.17650/1726-9776-2022-18-3-51-59","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-51-59","url":null,"abstract":"Currently, combination immunotarget therapy is the treatment standard for patients with disseminated carcinoma of the renal parenchyma. Simultaneous inhibition of immune checkpoints of programmed cell death 1 (PD-1)/PD-L1 and VEGF/VEGFR signal transduction showed synergistic antitumor effect both in preclinical models and clinical practice.The article presents the results of phase III CLEAR (NCT02811861) trial.In the phase III CLEAR (NCT02811861) trial, 1069 patients with renal cell carcinoma with clear-cell component who previously did not receive systemic antitumor therapy were randomized 1:1:1 in groups of lenvatinib (20 mg/day per os) + pembrolizumab (200 mg intravenously once in 21 days), combination lenvatinib (18 mg/day per os) + everolimus (5 mg/day per os), and sunitinib (50 mg/day per os for 4 weeks with 2-week interval). The groups included 355, 357, and 357 patients respectively. Primary endpoint was progression-free survival (PFS) controlled by expertise of an independent central committee per the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v.1.1). Additionally, patient overall survival (OS) and drug therapy tolerability were evaluated.Median PFS for lenvatinib with pembrolizumab was significantly higher than for sunitinib (23.9 months vs. 9.2 months; progression hazard ratio (HR) 0.39; 95 % confidence interval (CI) 0.32–0.49; p <0.001). Similar advantage in PFS was observed for lenvatinib with everolimus compared to sunitinib (median PFS 14.7 months vs. 9.2 months; HR 0.65; 95 % CI 0.53–0.8; p <0.001). OS also was higher for lenvatinib and pembrolizumab combination compared to sunitinib (death HR 0.66; 95 % CI 0.49–0.88; p = 0.005). No advantages in OS of lenvatinib and everolimus compared to sunitinib were detected (death HR 1.15; 95 % CI 0.88–1.5; p = 0.3). Frequency of grade III and higher adverse events among patients receiving lenvatinib + pembrolizumab, lenvatinib + everolimus, and sunitinib were 82.4, 83.1, and 71.8 %, respectively.Pembrolizumab + lenvatinib combination showed high effectiveness in 1st line treatment of renal cell carcinoma compared to sunitinib per PFS and OS values.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"8 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124598104","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 quality of life of patients with solitary renal cancer metastases in bones before and after surgical treatment in combination with targeted therapy and without it","authors":"S. V. Kostritskiy, V. Shirokorad, B. Alekseev, D. Semenov, A. Kalpinskiy, Y. Korneva","doi":"10.17650/1726-9776-2022-18-3-41-50","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-41-50","url":null,"abstract":"Background. Currently, treatment tactics for oligometastatic renal cancer are a debatable topic due to relatively localized process and high risk of skeletal-related events (SRE). Therefore, the effect of treatment on quality of life of these patients is an important subject.Aim. To evaluate quality of life of patients with solitary renal cancer metastases in the bones before and after surgical treatment in combination with targeted therapy and without it.Materials and methods. The study included 64 patients with solitary bone metastases and symptoms of SRE. The patients underwent surgical treatment due to solitary bone metastases of renal cancer in combination with targeted therapy (1st group; n = 25) and without targeted therapy (2nd group; n = 39). The effects of surgical treatment on patients’ condition were evaluated using the EORTC-QLQ-C30 questionnaire.Results. In the 1st group, no statistically significant differences were shown for 8 of 30 indicators of the EORTC-QLQ-C30 questionnaire: restrictions in daily activities, dyspnea, appetite loss, nausea, vomiting, fatigue, tension, financial difficulties. The rest of the indicators showed statistically significant shift toward improvement. In the 2nd group, 7 of 30 indicators did not show statistically significant differences: restrictions in daily activities, dyspnea, sleep disorders, appetite loss, diarrhea, tension, financial difficulties. The rest of the questionnaire points also showed improvement (especially in decreased pain syndrome). In patients of the 2nd group before and after surgery, need for rest, fatigue, appetite loss and restrictions in performing work were more pronounced than in the 1st group. Additionally, after surgery patients of this group required more time in the chair and had more frequent diarrhea, while prior to surgery they complained more of nausea and fatigue. The last 2 parameters evaluating overall quality of life were higher in the 1st group before and after surgery which shows better baseline condition of these patients which was not affected by the treatment.Conclusion. Therefore, surgical treatment of renal cancer bone metastases both in combination with targeted therapy and without it significantly improves quality of life according to the results of quality of life evaluation using the EORTC-QLQ-C30 questionnaire in patients of the studied groups.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"227 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130537802","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":"Preventive sutures in nonischemic laparoscopic partial nephrectomy. Description of S.P. Botkin City Clinical Hospital technique","authors":"A. Seregin, A. Seregin, K. Kolontarev, I. V. Seregin, A. I. Makhmadaliev, O. Loran","doi":"10.17650/1726-9776-2022-18-3-35-40","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-35-40","url":null,"abstract":"Background. Radical removal of the tumor while maximizing sparing of the renal function are the main goals of the partial nephrectomy. Shortening of the warm ischemia time is one of the best ways to achieve good functional results of the surgery. Aim. To present our technique of non-ischemic laparoscopic kidney resection with preventive suturing around the tumor.Materials and methods. Before tumor resection, sutures are placed around tumor spaced by 1 cm with moderate tension. Enucleoresection is performed between tumor and preplaced sutures in visually healthy plane. 30 patients underwent this technique.Results. Median tumor size was 3.6 (1.5–7.2) cm. All patients had negative surgical margin. Warm ischemia was needed in 8 (26.7 %) patients with a median time of 9 minutes. Median operative time was 115 (65–185) minutes. There were no intra or postoperative complications. Trifecta was achieved in all patients (100 %).Conclusion. This technique allows to perform the surgery in non-ischemic fashion, decrease bleeding and improve visualization of the resection field and achieve superior oncologic and functional results.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122812022","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":"Transperitoneal laparoscopic and robot-assisted resection of anterior and posterior kidney tumors","authors":"B. Guliev, B. Komyakov, K. Yakubov","doi":"10.17650/1726-9776-2022-18-3-17-24","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-17-24","url":null,"abstract":"Background. Laparoscopic and robot-assisted resection of the posterior kidney tumors can be performed through retroperitoneal and transperitoneal accesses. Supporters of retroperitoneal partial nephrectomy point to better results for neoplasms in this location. However, most surgeons use transperitoneal access.Aim. To perform comparative analysis of the results of laparoscopic and robot-assisted partial resection of anterior and posterior renal neoplasms.Materials and methods. The results of transperitoneal minimally invasive partial nephrectomy in 156 patients (86 (55.1 %) men and 70 (44.9 %) women) were analyzed. Anterior tumors (1st group) were diagnosed in 96 (61.5 %), posterior (2nd group) in 60 (38.5 %) patients. In the 1st group, mean tumor size was 3.4 ± 1.6 cm; in the 2nd group, 3.2 ± 1.4 cm. In the 1st group, laparoscopic partial nephrectomy was performed in 70 (72.9 %), robot-assisted in 26 (27.1 %) patients; in the 2nd group in 40 (66.7 %) and 20 (33.3 %) patients, respectively. Comparative analysis of operating time, warm ischemia time, complications and glomerular filtration rate was performed.Results. No conversions into nephrectomy or open interventions were performed. Time of laparoscopic partial nephrectomy in the 1st group was shorter than in the 2nd: 108.6 min versus 120.5 min (р >0.05). In robot-assisted partial nephrectomy it was 90.5 and 112.6 min (р >0.05), respectively. For laparoscopic partial nephrectomy, mean warm ischemia time in the 1st group was 15.0 min, in the 2nd group it was 17.5 min (р >0.05); in robot-assisted operation it was 13.2 and 16.0 min (р >0.05), respectively. Blood loss volume was lower in the 1st group compared to the 2nd: 125 ml versus 230 ml (р <0.05). In all patients, renal cell carcinoma was diagnosed; Т1а tumors were predominant (in the 1st and 2nd group, 87.5 and 88.3 %, respectively; р >0.05). Postoperative complications in transperitoneal resection of anterior tumors were observed less frequently: 16.7 % versus 20.0 % (р >0.05). Grade I complications per the Clavien classification in the 1st and 2nd group were observed in 8 (8.3 %) and 6 (10.0 %) patients, grade II in 6 (6.3 %) and 5 (8.3 %) patients, grade III in 2 (2.1 %) and 1 (1.7 %) patients. After resection, urinary leakage through the drain was observed in 2 (2.1 %) patients of the 1st group and 1 (1.7 %) patient of the 2nd group; they underwent drainage of the upper urinary tract using a stent. Blood transfusion in the postoperative period was performed in 2 patients from each group (2.1 and 3.3 %, respectively). In the 1st group, glomerular filtration rate before and after surgery was 68 and 56 ml/min/1.73 m2, in the 2nd group 70.2 and 58.2 ml/min/1.73 m2, respectively; no significant difference was observed (р >0.05).Conclusion. Transperitoneal access allows to safely perform minimally invasive resection of the anterior and posterior kidney tumors with results comparable to the perioperative results of retroperitoneal partial nephr","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121348891","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":"Techniques of surgical hemostasis and sealing after laparoscopic partial nephrectomy","authors":"A. Nosov, E. Mamizhev, N. A. Shchekuteev, D. P. Semeyko, P. Lushina, D. Rumyantseva, M. Berkut","doi":"10.17650/1726-9776-2022-18-3-27-34","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-27-34","url":null,"abstract":"Background. The kidney cancer treatment remains cornerstone problem in our country for healthcare. Survival results of partial nephrectomy as a radical nephrectomy are similar in groups of patients with the same morphological features and was confirmed by previously results: “indications for nephron-sparing treatment of kidney cancer is determined with the degree of resectability, assessed subjectively by surgeon and his experience, ambitions and technical capabilities. It does not depend on oncological prognostic factors”. This thesis is actual due to oncological preoperative factors and limited only by tumor size. Therefore, development of technical capabilities, techniques and skills expand our capabilities in organ-preserving treatment.Aim. To evaluate the effectiveness and safety of bipolar coagulation with fibrin glue in comparison with the standard technique of surgical suture to the area of non-ischemic partial nephrectomy.Materials and methods. This is prospective trial which had included the results of treatment of 121 patients who received partial-nephrectomy for localized kidney cancer from 2015 to 2017 at the N.N. Petrov National Medical Research Center of Oncology. Two variants of hemostasis were used in the work: standard surgical (surgical suture) and electrohemostasis with an additional hemostatic component (fibrin glue). Among the selected patients, there were no patients with a single kidney and a pronounced violation of the excretory function of the organ.Results. The groups were comparable in terms of tumor size (р = 0.09), morphometric characteristics according to the R.E.N.A.L. scale (p = 0.07), no differences were found in clinical and morphological staging. The use of electrohemostasis with a hemostatic glue component did not significantly affect at the excretory function of the kidney, assessed on the 3rd and 10th days after laparoscopic non-ischemic resection, which indirectly confirms the functional safety of the tested technique (р >0.05). The groups did not differ significantly in terms of the blood loss, hemotransfusions (р = 0.067), and none of delayed bleeding was found which indicates the reliability of electrohemostasis using an adhesive composition.Conclusion. We proposed a patent “Method of surgical hemostasis in laparoscopic partial nephrectomy” RU2654402C1 by combining bipolar coagulation in the 90 W-effect 7–8 mode and hemostatic fibrin glue (SURGIFLO, PERCLOT). Used adhesive compositions complement the achieved electrohemostasis, and also provide sealing of the area of the resected kidney tissue.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114553820","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":"Review of the article “Transperitoneal laparoscopic and robot-assisted resection of anterior and posterior kidney tumors”","authors":"D. Perlin","doi":"10.17650/1726-9776-2022-18-3-25-26","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-3-25-26","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124729187","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":"Resolution of the expert council “Modern options for the treatment of urothelial cancer”","authors":"A. Editorial","doi":"10.17650/1726-9776-2022-18-2-226-228","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-2-226-228","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131274847","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":"Hereditary leiomyomatosis and renal cell cancer: a case report","authors":"M. Filippova, D. Mikhaylenko, I. Samoylenko, Y. Sergeev, N. A. Kozlov, I. Fainstein, E. Alekseeva","doi":"10.17650/1726-9776-2022-18-2-211-216","DOIUrl":"https://doi.org/10.17650/1726-9776-2022-18-2-211-216","url":null,"abstract":"This article presents a case report of hereditary leiomyomatosis and renal cell cancer (HLRCC) with new mutation in a 25-year-old female patient admitted to the clinic for diagnosis and treatment due to multiple skin and uterus leiomyomas. The patient has a history of surgery to remove adrenal pheochromocytoma and papillary kidney cancer. Clinical and laboratory examination as well as medical genetic counseling of the patient were performed. We have detected the heterozygous c.395_399del (p.L132*) germline nonsense mutation in exon 4 of the FH gene using polymerase chain reaction/Sanger sequencing of exons 1–10 of this gene and confirmed the diagnosis of HLRCC. The mutation c.395_399del in a patient with HLRCC was described for the first time. The identical mutation was also found in the mother and sister of the patient. Based on the obtained results, medical genetic counseling was carried out in this family, recommendations were given for further oncological monitoring. The case report could be useful for geneticists, oncologists and other specialists to interpretate the clinical heterogeneity of HLRCC and improve the genetic diagnosis of this rare hereditary oncological syndrome.","PeriodicalId":216890,"journal":{"name":"Cancer Urology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133964720","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}