Journal of Interdisciplinary Medicine最新文献

{"title":"Malaria and HIV Infection among Febrile Patients in a Large Area of Southwestern Nigeria","authors":"Oyetunde T. Oyeyemi, E. Etim","doi":"10.2478/jim-2020-0011","DOIUrl":"https://doi.org/10.2478/jim-2020-0011","url":null,"abstract":"Abstract Background: Malaria and HIV/AIDS are two major diseases that represent serious public health threats in Nigeria. They have been ascribed diseases of poverty, and therefore their distribution is expected to be overlapping. Aim: The aim of this study was to determine the prevalence of malaria parasites and HIV among febrile patients in the Ikeja area of Lagos State, Nigeria. Materials and Methods: The study was conducted on 300 patients attending medical consultation and referred to blood screening for malaria parasites at Reddington Hospital, Lagos State. Malaria parasites were identified microscopically, and HIV screening was carried out using rapid diagnostic tests (RDT). Results: The prevalence of malaria and HIV was 98.7% and 3.7%, respectively. All HIV-positive individuals were also infected by malaria parasites. Mean parasitemia was significantly higher in HIV-positive individuals (16,507.9 ± 2,280.7 P/μL) than in HIV-negative subjects (3,252.505 ± 236.3 P/μL) (p <0.05). Conclusions: Our results suggest that HIV-infected individuals are more susceptible to infection with malaria parasites. Prompt HIV management is necessary in malaria-endemic areas to reduce disease severity in case of coinfection with HIV.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124266331","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":"Ultrasound-Guided Core-Needle Biopsy of Suspicious Breast Lesions","authors":"K. Lőrincz, Z. Pap, S. Mocan, Csanád-Endre Lőrincz, B. Baróti","doi":"10.2478/jim-2020-0010","DOIUrl":"https://doi.org/10.2478/jim-2020-0010","url":null,"abstract":"Abstract Background: Breast cancer is the female cancer with the highest mortality. While early detection is a public health priority in Western European countries, a screening program in our country has yet to be implemented. The best diagnostic accuracy is achieved through the use of triple assessment: clinical examination, imaging, and core-needle biopsy where indicated. Prognosis is influenced by clinical, histological, and biological factors, and therapy is most effective when individually tailored. Aim of the study: To analyze the clinical, histological, and immunohistochemical characteristics of the biopsied nodules and summarize our experience from the last three years. Material and Methods: We retrospectively analyzed data from 137 patients who underwent core-needle biopsy between 2017 and 2019. Imaging score was assigned based on ultrasound examination or mammography. Clinical and pathological parameters were recorded, followed by statistical processing of the data. Results: The mean age of the patients was 58 ± 14 years, lesions had a mean size of 22.83 ± 14.10 mm. Most nodules (n = 63, 47.01%) were located in the upper-outer quadrant, and bilateral presence was found in 4 (3.08%) cases. We found a significant positive correlation between lesion size and the patients’ age (Spearman r = 0.356; 95% CI 0.186, 0.506; p = 0.000). The malignancy rates within the Breast Imaging Reporting and Data System (BI-RADS) categories were as follows: 0% for „4a”, 31.58% for „4b”, 71.42% for „4c”, and 97.72% for „5”. Most malignancies (n = 73, 78.35%) were represented by invasive ductal carcinoma of no special type, 58.43% (n = 52) were grade 2, 89.13% (n = 82) were estrogen receptor positive, and Luminal B-like type was the most common (n = 63, 78.75%). Conclusions: The mean size of tumors was larger than the average size at discovery described in the literature. In our region, age and tumor size are positively correlated. Preoperative histological results may indicate the reliability of the imaging risk stratification system. Most cases can benefit from adjuvant endocrine therapy.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132119472","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":"Effects of Pirfenidone on Echocardiographic Parameters of Left Ventricular Structure and Function in Patients with Idiopathic Pulmonary Fibrosis","authors":"Shehab Al-Ansari, A. Borowski, Ali Fuad, Omar Alawadhi, Haris Riaz, Vikram Sharma, Nauman A. Khan, B. Southern, W. Tang","doi":"10.2478/jim-2020-0009","DOIUrl":"https://doi.org/10.2478/jim-2020-0009","url":null,"abstract":"Abstract Aim: Pirfenidone is a novel anti-fibrotic agent utilized in the treatment of idiopathic pulmonary fibrosis (IPF). It has been implicated in mitigating myocardial fibrosis and left ventricular (LV) systolic and diastolic dysfunction in animal models. However, its impact on LV mechanics in humans remains unknown. The aim of this study was to retrospectively evaluate the effects of pirfenidone on echocardiographic parameters of LV function and structure in patients with IPF. Methods: A total of 124 patients with IPF were included in this study: 64 patients treated with pirfenidone (treatment group) and 60 patients not taking pirfenidone (control group), who had serial pretreatment/baseline and posttreatment/follow-up echocardiograms done within a time frame of four years. Changes in the means of parameters of LV function (systolic, diastolic, and global longitudinal strain) and LV structure (mass and volume indices) were compared between the treatment and control groups. This was followed by a subgroup analysis that included only 88 patients (47 treated, 41 controls) with echocardiographic evidence of myocardial dysfunction at baseline (defined as an ejection fraction of ≤45, or diastolic dysfunction stage 1 or more) in addition to a known clinical diagnosis of congestive heart failure. To account for potential confounders, a secondary adjusted analysis by way of 1:1 propensity score matching (PSM) was carried out. This yielded a sample consisting of 62 patients with 56 patients in the subgroup cohort. Results: Patients in the treatment group were significantly younger (69.4 vs. 77 years, p<0.001) and had relatively lower forced vital capacity (69.9% vs. 80.6%, p = 0.005) in comparison to the control group. However, after PSM, the age demographics were comparable between both groups (72.18 vs. 72.15, p = 0.9). In the primary unadjusted analysis, there was no statistically significant change in any of the mean parameters of LV function and structure after pirfenidone administration when compared to the control group. Furthermore, no significant differences were noted in the subgroup cohort. Such findings were re-demonstrated after a secondary analysis with PSM. Conclusion: From an echocardiographic perspective, pirfenidone had no significant effects on LV structure and function in patients with IPF, even in patients with more overt cardiac dysfunction.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129493003","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":"Acute Drug-Induced Cholestatic Syndrome in Basedow Graves’ Disease","authors":"Robert Aurelian Tiucă, A. Boeriu, R. Georgescu, I. Pașcanu","doi":"10.2478/jim-2020-0006","DOIUrl":"https://doi.org/10.2478/jim-2020-0006","url":null,"abstract":"Abstract Introduction: Graves’ disease (GD), an autoimmune disorder caused by high levels of auto-antibodies against the thyroid-stimulating hormone receptor, is considered the most common cause of thyrotoxicosis, characterized by features such as goiter, ophthalmopathy and dermopathy. In our country, the administration of antithyroid drugs (ATD) is the first line of treatment in this disease. Side effects are rare but some of them, such as agranulocytosis or liver damage, may become serious. Case presentation: We report the case of a 20-year-old female patient who was diagnosed with GD after being previously diagnosed with viral hepatitis A. Treatment was initiated with methimazole 30 mg/day, and three weeks later she developed intense hepatic cytolysis and cholestatic syndrome, therefore the ATD was stopped. A suspicion of autoimmune liver disease was raised, and a liver biopsy was performed in order to establish the diagnosis. The next therapeutic option for hyperthyroidism was radioactive iodine (RAI). Three months following RAI, the patient presented severe hypothyroidism, thereupon treatment with levothyroxine was initiated. Conclusions: Although severe acute liver injury is rare, mild liver dysfunction is quite common in patients with GD. The overproduction of thyroid hormones, or the treatment with ATD through immune mediated processes or drug reactions, represent possible mechanisms responsible for liver damage.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129911731","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":"Epicardial Fat Volume as a New Imaging-Based Feature Associated with Risk of Recurrence after Pulmonary Veins Ablation in Atrial Fibrillation","authors":"E. Blîndu, S. Korodi, L. Bordi, I. Kovács, I. Benedek","doi":"10.2478/jim-2020-0012","DOIUrl":"https://doi.org/10.2478/jim-2020-0012","url":null,"abstract":"Abstract Background: Atrial fibrillation (AF), a common arrhythmia in clinical practice, is associated with a high rate of complications and an increased risk for thromboembolic events. Pulmonary vein ablation is a new therapeutic option to cure AF; however, it remains associated with a high rate of recurrence. In this study we aimed to identify the clinical characteristics and imaging-based features that may predict the risk of recurrence after pulmonary veins ablation in atrial fibrillation. Materials and method: Twenty-four patients with paroxysmal and persistent AF, who underwent radiofrequency catheter ablation and a 12-month follow-up were included in the study. Group 1 included 8 patients with AF recurrence, and group 2 included 16 patients with no AF recurrence. In all cases, cardiovascular risk factors, ejection fraction, left atrial diameter, atrial volumes, and epicardial fat volume were analyzed. Results: CT analysis revealed that patients with AF recurrence presented a significantly larger mean index of left atrial volume (59.57 ± 8.52 mL/m2 vs. 49.99 ± 10.88 mL/m2, p = 0.04), right atrial volume (58.94 ± 8.37 mL/m2 vs. 43.21 ± 6.4 mL/m2, p<0.0001), and indexed bi-atrial volume (118.5 ± 15.82 mL/m2 vs. 93.19 ± 16.42 mL/m2, p = 0.005). At the same time, CT analysis of the epicardial adipose tissue volume indicated that patients with AF recurrence have a larger amount of epicardial fat than those without AF recurrence (176.4 ± 100.8 mL vs. 109.8 ± 40.73 mL, p = 0.02). Conclusion: Left atrial diameter, indexed atrial volumes, and epicardial fat volume may be used as factors to identify patients at risk for developing recurrence after pulmonary vein ablation.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115661498","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":"Immunosuppressive Medication and Non-Rejection-Related Complications Following Heart Transplantation","authors":"Dumitru Costel, D. Ghiga, S. Voidăzan, Alexandra Groșan, Dan Ş. Sîmpălean, A. Sin","doi":"10.2478/jim-2020-0015","DOIUrl":"https://doi.org/10.2478/jim-2020-0015","url":null,"abstract":"Abstract Background: Although the clinical evolution of a patient with heart failure is initially improved by transplantation, a number of potential complications may occur in the post-transplant period, which may be directly related to the effects of chronic immunosuppression. The purpose of this study was to analyze the occurrence and frequency of post-transplant complications related to immunosuppressive treatment in the Institute of Cardiovascular Diseases and Transplantation of Târgu Mureș, Romania. Material and methods: This is a descriptive study including 53 patients out of a total of 71 patients who underwent cardiac transplantation between 2000 and 2017 in the Institute of Cardiovascular Disease and Cardiac Transplantation in Târgu Mureș, Romania. Data were collected from the patient files and included demographic, clinical and laboratory data, as well as information about post-transplant complications related to immunosuppressive treatment. Results: The mean age of patients undergoing heart transplantation was 40.72 ± 14.07 years, the majority of patients being male (84.91%) and living in an urban environment (56.60%). The average length of hospital stay was 33.6 days. From the total number of patients, 7 (13.2%) presented post-transplantation bacterial infections, while antibodies indicating the presence or history of B hepatitis, toxoplasma, and cytomegalovirus infection were identified with a relatively high incidence in the study population. Conclusions: Infections following surgery are probably the most common post-transplant pathology, the primary reason being the administration of immunosuppressive medication.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115421963","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":"Proper Surgical Treatment of Small and Medium Size Umbilical Hernias. A Single Surgeon Experience","authors":"E. Élthes, D. Sala, R. Neagoe, János Székely, M. Dénes","doi":"10.2478/jim-2020-0007","DOIUrl":"https://doi.org/10.2478/jim-2020-0007","url":null,"abstract":"Abstract Introduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results. Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias. Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed. Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group. Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130794612","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 Healthcare in 2020 – Alarming Realities in Romania","authors":"R. Hodaș","doi":"10.2478/jim-2020-0014","DOIUrl":"https://doi.org/10.2478/jim-2020-0014","url":null,"abstract":"DOI: 10.2478/jim-2020-0014 The unprecedented progress recorded over the last decades in the field of prevention and management of cardiovascular disease (CVD) has led to a significant reduction of premature cardiovascular (CV) mortality across Europe.1 Despite this progress, a new reality is emerging and generates serious concerns for public health policies. The burden of CVD presents alarming inequalities among different European regions, remaining disproportionately larger in lowand middle-income countries (LMICs) compared to high-income countries (HICs). Moreover, economic constraints at local level involve substantial disparities in availability of CV care and services, with dramatic effects on the healthcare benefits of CV patients in LMICs.2 The recently published map of “ESC Cardiovascular Realities 2019”, a map of ESC member countries based on monitoring CV health expenditure, infrastructure, and workforce across European countries, raised alarming signs for healthcare systems regarding the social and economic burden of CVD in different regions of Europe.3 From this point of view, Romania presents a concerning reality in all points of interest highlighted by the ESC’s call to action: insufficient control of risk factors and harmful behaviors, increased burden of CVD, and disparities in availability of CV care. Extensively investigated, the important influence of potentially reversible well-established risk factors in the determination and progression of CVD provides a strong rationale for giving a higher priority to risk reduction strategies. In HICs, the ongoing modern-day epidemics of obesity and type 2 diabetes, particularly in younger adults, represent the most serious public health challenges which threaten to erode the health gains of recent years.4 In this European context, Romania seems to present inadequate strategies. Besides the negligible decrease in hypertension prevalence, poor strategies for the identification and effective treatment of people with established hypertension contribute to the continuing high rates of myocardial infarction and CV death. Moreover, the daily intake of large quantities of alcohol, insufficient selfreported physical activity, and altered nutritional intake proved to be important CORRESPONDENCE","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"302 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123395564","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":"Incidence of Periodontal Disease among Adolescents","authors":"D. Dicu, A. Lazar, L. Lazăr","doi":"10.2478/jim-2020-0013","DOIUrl":"https://doi.org/10.2478/jim-2020-0013","url":null,"abstract":"Abstract Background: Despite the scarcity of studies regarding periodontal disease in young patients (teenagers and young adults), it seems that this disorder is also affecting the young population. Risk factors for periodontal disease include older age, chronic tobacco use, male gender, habits regarding oral hygiene, educational status, ethnicity, and financial status. Aim: This study aimed to evaluate the periodontal health among adolescents in two high schools in Târgu Mureș that had dental practices. Material and Methods: An online questionnaire consisting of 16 questions was distributed among high schoolers of Târgu Mureș. Data about personal characteristics, oral hygiene habits, family history of periodontal disease, risk factors for periodontal disease, and symptoms of periodontal disease observed by the respondents were collected and analyzed. Results: Out of the 501 teenagers who responded to the online questionnaire, 114 (22.8%) were 18 years old and were mostly females (88.2%). Regarding oral hygiene habits, 75.8% prefer a manual toothbrush over an electric toothbrush, 66.7% brush their teeth twice a day, and 54.1% practice a horizontal method of toothbrushing. Mouthwash was the most used oral hygiene aid (58.3%). Family history of periodontal disease was observed in 21.9% of respondents. As favoring factors, nicotine addiction (23.8%), bruxism (24.4%), interposition of various objects between teeth (48.3%), past or present orthodontic treatments (38.7%) were recorded. Symptoms of gingivitis and periodontitis, such as gingival bleeding (81.4%), redness of gingiva (39.3%), increased gingival volume (44.5%), gingival retraction (22.8%), and halitosis (81%), were present in the responding teenagers. Conclusions: In this study, periodontal disease was affecting mostly adolescent females who are practicing inappropriate methods of toothbrushing with inadequate frequency.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125371090","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":"Disease Burden, Mechanism and Management of Obesity – Where Do We Stand?","authors":"Irfan Sharif Shakoori, Gohar Ashraf, F. Aslam, H. Akram","doi":"10.2478/jim-2020-0008","DOIUrl":"https://doi.org/10.2478/jim-2020-0008","url":null,"abstract":"Abstract The role of increased body mass index in general morbidity and mortality is well documented. This global public health issue continues to represent a major burden and threat to health systems and the population’s wellbeing. Global statistics show that the prevalence of obesity has increased about three times since the mid-1970s, and an upward trend is still observed, not only in developed but also in developing countries. We used several databases, including PubMed, ProQuest, and Google Scholar, to perform a literature search and review on obesity. Keywords such as “obesity”, “overweight”, and “BMI” were used in combination with multiple keywords such as “mechanism”, “factors”, “socio-economic”, “environmental”, “social determinants”, “management”, “treatment”, “non-traditional treatment”, “alternative therapies”, “non-pharmaceutical treatment” etc. and related phrases. According to the literature, the management of obesity is difficult due to the complex nature of this problem in terms of its course, complications, risks, and etiological factors. The role of alternative therapies in obesity management is still unclear, and further research is needed in this area. Recently introduced weight-loss and -management devices can also help in losing excess bodyweight. The present article summarizes relevant information related to obesity, collected from different regions of the world, and discusses diverse interventional approaches to treat obesity.","PeriodicalId":234618,"journal":{"name":"Journal of Interdisciplinary Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129143649","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}