ASTRAKHAN MEDICAL JOURNAL最新文献

{"title":"Analysis of morphometric parameters of children’s kidneys according to ultrasound data","authors":"B. T. Kurtusunov, I. A. Usmanov, M. N. Trizno","doi":"10.17021/1992-6499-2023-4-43-49","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-43-49","url":null,"abstract":"Objective. To identify the features of morphometric indicators of children’s kidneys according to ultrasound data, depending on height and age.Materials and methods. Morphometric indicators of the kidneys of children, according to ultrasound examination protocols of 280 male and female children aged 0 to 16 years.Results. The study revealed that in all studied groups of children, the length of the left kidney was greater than the right. The most intensive increase in length occurs at heights of 60–90 cm and 150–170 cm. When analyzing gender differences in kidney growth in length, it was found that in both girls and boys the first “jump” in kidney growth is observed when the length of children is from 60 to 90 cm, and both buds grow at the same rate. The second “jump” in the increase in kidney length occurs at heights of 130–160 cm and 140– 170 cm. These changes in kidney length coincide with the intensive growth of the child in the first three years of life, and then with the onset and course of puberty. Based on the data obtained, it was revealed that the most significant increase in kidney parameters occurs in the first year of life. Thus, by the year of life, the length and width of the kidney increased by 20 %, and thickness by 10 %. By the 4th year of life, with average height (100 cm), length and width increased by another 20 %, and thickness by 32 % from the original.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158119","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":"The use of prognostic scales to assess the effectiveness of the use of anti-cytokine drugs in patients with moderate and severe course of a new coronavirus infection","authors":"S. V. Nagumanov, A. T. Abdrashitova, E. A. Popov","doi":"10.17021/1992-6499-2023-4-67-75","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-67-75","url":null,"abstract":"The aim. To analyze the effectiveness of the use of anti-cytokine drugs (tocilizumab, olokizumab and sarilumab) in a single-center retrospective cohort study based on the prediction of clinical outcomes using prognostic scales, with a single administration in patients with moderate to severe course of a new coronavirus infection.Materials and methods. The retrospective cohort study included three groups of patients with single administration of tocilizumab (65 patients), olokizumab (56 patients) and sarilumab (26 patients). All patients were treated in a repurposed infectious diseases hospital for patients with COVID-19 on the basis of Аlexandro-Mariinskaya Regional Clinical Hospital in the period January- August 2021. Upon admission to the hospital and 2 days after administration of the drug, patients were predicted the severity of the course and outcome using prognostic scales: 4C Mortality Score, COVID-GRAM, SHOCS-COVID.Results. A comparative analysis of the effectiveness of the use of anti-cytokine drugs using the 4C Mortality Score scale revealed a further deterioration in the prognosis of clinical outcome in the groups receiving tocilizumab (p = 0,002) and sarilumab (p = 0,031). When using the COVID-GRAM predictive scale, further deterioration of the prognosis was also noted in the tocilizumab (p = 0,004) and olokizumab (p = 0,005) groups. The SHOCS-COVID scale showed a further deterioration in the prognosis in the tocilizumab group (p = 0,001).Conclusion. The use of drugs based on monoclonal antibodies against IL-6 and its receptors in patients with moderate to severe COVID-19 did not reveal significant positive dynamics in changing the prognosis of clinical outcome 2 days after administration of these drugs.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158943","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":"Influence of 60-day administration of tartrazine and infliction of a defect in the tibia on the histological structure and morphometric parameters of the rat’s thyroid gland","authors":"V. N. Morozov, V. I. Luzin","doi":"10.17021/1992-6499-2023-4-58-66","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-58-66","url":null,"abstract":"Aim: to study the histological structure and histomorphometric parameters of the thyroid gland in rats in the period after the completion of the 60-day administration of tartrazine and the creation of a through defect in the tibiae.Material and methods. One hundred and fifty white male rats were divided into five groups: groups T1 and T2 - 60 days of exposure to tartrazine at a dosage of 750 and 1500 mg/kg; group K+D – 60-day administration of saline solution and infliction of a defect in the tibiae; groups T1+D and T2+D – 60-day exposure to tartrazine at a dosage of 750 and 1500 mg/kg and causing a defect in the tibia. The histological structure and histomorphometric parameters of the thyroid gland were studied on days 3, 10, 15, 24 and 45.Results. In the T1+D and T2+D groups, mainly small follicles, lined with cuboidal shaped cells, and in some of them - a flat or columnar shaped cells were detected in the center of the gland from days 3 to 15. Many thyrocytes had a vacuolated cytoplasm and an intensely stained nucleus. The heterogeneous colloid partially filled or was practically absent in the follicles cavity, anemia of the capillaries between them was determined. Singly areas of the organ parenchyma with a significant accumulation of lymphocytes were detected. Histomorphometric study showed a decrease in the internal diameter of the follicles, lumen-epithelial index and nucleo-cytoplasmic ratio and the raise in the height of the follicular epithelium and the area of the cytoplasm of follicular cells.Conclusion. Sixty-day administration of tartrazine to rats and artificial traumatic bone injury leads, in comparison with the data of control groups, to a more pronounced change in the histological picture and morphometric data of the thyroid gland. The intensity and duration of changes are dosedependent: in the T1+D group, most of the qualitative and quantitative changes are smoothed out by 45 days, and in the T2+D group, many of them remain, and the body does not adapt to them.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139157625","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":"Effect of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly-Pro on the level of pro- and anti-inflammatory cytokines in conditions of stress-induced depression","authors":"A. Yasenyavskaya","doi":"10.17021/1992-6499-2023-4-103-110","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-103-110","url":null,"abstract":"Depression, being a heterogeneous disorder, is one of the most pressing problems in medicine, due to its high prevalence and the development of severe consequences, both medical and social. Currently, there is an urgent need to study the pathophysiological pathways that determine the development of depression in order to identify targets for the development of innovative multi-targeted drugs.Objective: to study the effect of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly-Pro on the level of pro- and anti-inflammatory cytokines in conditions of stress-induced depression.Materials and methods. The experiment was carried out on non-linear male rats 6 months old. age, in the amount of 50 individuals. A depressive-like state was modeled by providing constant sensory contact in rats and daily confrontations for 20 days, forming submissive and aggressive types of behavior.Results. It has been established that His-Phe-Arg-Trp-Pro-Gly-Pro in conditions of stress-induced depression helps restore the cytokine profile, reducing the level of proinflammatory cytokines (IL-1β, IL-6) and increasing the level of anti-inflammatory cytokines (IL-4 , IL-10).Conclusion. The results obtained allow us to consider stress-induced depression as an immune-mediated condition, which determines the need to develop new therapeutic and preventive methods taking into account immunological etiological and pathogenetic mechanisms. Analysis of key cytokines of neuroimmune interactions (IL-1β, IL-4, IL-6, IL-10) in animals exposed to a stress factor that induces the development of depression under the influence of the neuropeptide compound His-Phe-Arg-Trp-Pro-Gly- Pro showed that one of the ways to realize the action of this substance with a neuropeptide structure is to restore cytokine regulation.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139157619","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":"Diagnosis of acute myocardial infarction before surgery: high-sensitivity troponin T or amino-terminal fragment of pro-brain natriuretic peptide type B?","authors":"O. V. Petrova, D. K. Tverdokhlebova, S. Shashin","doi":"10.17021/1992-6499-2023-4-76-87","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-76-87","url":null,"abstract":"Currently, there are data in the literature about the importance of the aminoterminal fragment of pro-brain natriuretic peptide type B in the diagnosis of patients with acute myocardial infarction.The aim. To study preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B and high-sensitivity troponin T in patients with acute myocardial infarction and to assess the significance of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with this pathology.Materials and methods. We retrospectively analyzed 50 medical records of patients diagnosed with acute myocardial infarction.The results. Study of preoperative levels of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction showed that the values of aminoterminal fragment of pro-brain natriuretic peptide type B at hospital admission ranged from 127 to 600 pg/ml; correlated with left ventricular ejection fraction (r =-0,42, p < 0,05), severity of acute heart failure (r =+0,57, p < 0,05), and outcome of acute myocardial infarction (r =+0,45, p < 0,05). Assessment of the value of aminoterminal fragment of pro-brain natriuretic peptide type B in patients with acute myocardial infarction on the basis of comparison with high-sensitivity troponin T revealed no advantages of its use in this pathology as a marker of acute cardiomyocyte damage: aminoterminal fragment of pro-brain natriuretic peptide type B has less diagnostic and prognostic value than high-sensitivity troponin T. Diagnosis of acute myocardial infarction before surgery: highly sensitive troponin T or aminoterminal fragment of pro-brain natriuretic peptide type B?","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158292","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":"Research of the application of elements of sports games in the process of therapeutic physical education activities","authors":"A. V. Dorontsev, L. N. Porubayko, N. Zinchuk, Yu. A. Lyamina","doi":"10.17021/1992-6499-2023-4-35-42","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-35-42","url":null,"abstract":"Recent studies have shown that the use of elements of team sports in physical education classes in a special medical group “B” (therapeutic physical education) remains one of the promising areas and, at the same time, a rather complex methodological problem, caused in many cases by concomitant diseases of students. When discussing the features and advantages of various team sports in the mode of practical exercises in therapeutic physical culture in universities, it is necessary to pay attention to the differentiated use of elements of sports games in accordance with the existing pathology.Purpose. Determine the most effective complexes of physical activity using elements of team sports.Materials and methods. The material for the work was the results of a current medical examination, motor tasks that make it possible to determine the level of development of physical qualities, and data from a functional test. The research was conducted at the departments of physical education of Astrakhan State Medical University and Kuban State Medical University and Astrakhan State University in the 2021/22 academic year. Based on functional tests, the level of physical fitness of those involved was analyzed, and hemodynamics were determined during physical activity classes using elements of team sports. The work used standard methods of mathematical analysis.Results. A reliable correlation was revealed between the use of elements of team sports and the level of increase in the regulatoryadaptive potential of the cardiovascular system, reduction of BMI, elements of team sports were identified that are advisable to recommend for the appropriate medical group. During the work, data were obtained on the effectiveness of using elements of sports games for students assigned to medical group “B”.Conclusions. It is advisable to use elements of basketball in the form of developing coordination abilities, mastering techniques of ball possession with changing parameters in space and time interval. In our opinion, this format allows you to vary the intensity of physical activity in accordance with the level of functional and physical fitness of students. In the same group, it is possible to use elements of volleyball and the game of volleyball itself according to simplified rules. The individual duration of rest breaks should allow the cardiorespiratory system to be restored to background levels.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159181","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":"Nasal cavity microbiota features among people who have had COVID-19","authors":"V. A. Romanov, I. V. Dukhanina, A. V. Afanas'ev, M. Y. Gul'neva, N. V. Semechkin","doi":"10.17021/1992-6499-2023-4-97-102","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-97-102","url":null,"abstract":"The new coronavirus infection of 2019 is accompanied by damage to a number of organs, tissues, systems of the human body, including the microbiome. However, some aspects of the influence of this infection on the state of the microbiota of individual biotopes in individuals vaccinated with the Gam-COVIDVac vaccine require further research.Purpose: to study the characteristics of the nasal microbiota in vaccinated Gam-COVID-Vac and non-vaccinated individuals who have had COVID-19.Materials and methods: 60 people aged 18 to 23 years old were examined, divided into 3 equal groups: group 1 – vaccinated, sick after vaccination, group 2 – not vaccinated, recovered, group 3 (control) – not sick and not vaccinated. In all examined persons, muconasal secretions from the nasal cavity were examined using conventional bacteriological methods.Results. In the group of unvaccinated and recovered patients, the coronavirus infection caused a significant change in the composition of the nasal cavity microbiota in the form of a significant increase in the number of opportunistic microorganisms (S. aureus, E. coli, Streptococcus spp;) relative to similar indicators in the control group (who had not recovered from the disease and were not vaccinated). In vaccinated and recovering individuals compared with the control group, the changes are unreliable.Conclusion: Transmission of COVID-19 in individuals vaccinated with the Gam-COVID-Vac vaccine does not lead to changes in the nasal microbiota. Significant changes in the microbiota with an increase in the number of opportunistic microorganisms were found in unvaccinated individuals who underwent COVID-19.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139159819","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":"Predictors of late spontaneous miscarriages depending on the phenotype of abortion","authors":"T. V. Rachenkova, Y. Dudareva","doi":"10.17021/1992-6499-2023-4-88-96","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-88-96","url":null,"abstract":"The aim. Assessment of risk factors for late miscarriages depending on the clinical phenotype of abortion.Materials and methods. The study included 156 women. The main group consisted of 66 patients with late spontaneous abortion at a gestational age of 12,0–21,6 weeks, 47 of them with miscarriage on the background of isthmic-cervical insufficiency or premature rupture of amniotic fluid, 19 with late miscarriage against the background of blood discharge. Control group – 90 patients whose pregnancy ended in term delivery.Results. Analysis of the prevalence of extragenital pathology revealed a high incidence of anemia (31,8 %; p = 0,000), obesity (12,12 %, p = 0,013), and gastrointestinal diseases (12,12 %; p = 0,004) in women with late miscarriage. When analyzing gynecological pathology, it was revealed that surgical treatment of the cervix was 9,6 times more common in patients of the main group compared to the control group (10,6 and 1,1 %; p = 0,008; OR = 10,68 CI 1,28–89,04), the frequency of abnormalities in the development of the uterus – 7,5 times more often in the group with bleeding compared to the group of patients with isthmic-cervical insufficiency (15,8 and 2.1 %; p = 0,035; OR = 8,63 CI 0,84–88,97). Significant risk factors for late miscarriages are preterm birth (18,2 %, p = 0,000), non-developing pregnancy (18,2 %; p = 0,026), medical abortions (42,6 %; p = 0,003). When analyzing the course of pregnancy, prognostically unfavorable markers of miscarriage were identified: the threat of termination of a real pregnancy (53,0 %; p = 0,000), isthmic-cervical insufficiency (19,1 %: p = 0,000) and violations of the vaginal biocenosis (71,2 %, p = 0,000).Conclusion. Thus, the presence of extragenital pathology, aggravated obstetric anamnesis and complicated course of pregnancy is typical for patients with late spontaneous abortions, which requires monitoring of this category of patients at the stage of preconception preparation, treatment of extragenital pathology, as well as timely prevention, diagnosis and treatment of complications at different stages of pregnancy.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139157876","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":"Features of cytomegalovirus infection in severely premature newborns","authors":"O. V. Lebedeva, N. Pimenova, E. Kashirskaya, T. A. Berezhnova, E. Polyanina, T. A. Gasanova","doi":"10.17021/1992-6499-2023-4-50-57","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-50-57","url":null,"abstract":"Cytomegalovirus infection of newborns is one of the serious medical and social problems of neonatology and is often the cause of disability and mortality of the child population.The purpose of the work was to study the incidence and clinical characteristics of cytomegalovirus infection in very premature newborns.  Materials and methods. Data from 384 medical records of premature infants with a gestational age of less than 32 weeks were analyzed.Results. The variants of the clinical course of the disease are described, the results of laboratory studies are presented, as well as the methods of therapy used. Clinical cases with fatal outcome demonstrated. The results of the study showed that the postnatal form of the disease was 3 times more common than congenital and often occurred under the “mask” of another severe pathology, which made early diagnosis difficult. For timely diagnosis and treatment of cytomegalovirus infection in severely premature newborns, regular polymerase chain reaction examination is recommended.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139158423","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":"Problems of antibacterial therapy of hospital infections in the post-pandemic period of COVID-19 and ways to solve them","authors":"A. A. Galitsky, S. D. Mitrokhin, A. S. Shkoda, O. E. Orlova, S. Bochkareva, I. A. Kiseleva, M. Anurova, A. V. Aleshkin","doi":"10.17021/1992-6499-2023-4-25-34","DOIUrl":"https://doi.org/10.17021/1992-6499-2023-4-25-34","url":null,"abstract":"Due to the coronavirus pandemic in Russia, a significant increase in the emergence of strains of microorganisms with multiple drug resistance was noted.Objective: improvement of the effectiveness of prophylactic and therapeutic measures aimed at prevention of hospital pathogens circulation in the intensive care unit by using bacteriophages active against multidrug-resistant strains of Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii.Materials and methods. The study was conducted on the basis of the Intensive Care Unit No. 2 of L.A. Vorohobov City Clinical Hospital No. 67 of Moscow Healthcare Department. Personalized selection of bacteriophages was carried out on the basis of G.N. Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology. The study included two groups of patients, a total of 20 people, who were on prolonged mechanical ventilation in the intensive care unit.Results. No toxic and allergic reactions were detected from the patients in all cases of bacteriophages application. Pathological changes of blood biochemical parameters were not observed in connection with the use of bacteriophages. Complete eradication of pathogens occurred in 60 % of cases.Conclusion. The effectiveness of treatment of various nosological forms of HAIs caused by MDR strains of hospital pathogens increased by 30%, and the effectiveness of the starting antibiotic therapy regimen was 70% and more as a result of the use of personalized phage therapy.","PeriodicalId":269283,"journal":{"name":"ASTRAKHAN MEDICAL JOURNAL","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139160377","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}