A. Awan, Muhammad Tariq Nadeem, Bushra Babar, Ammara Iftikhar, Abdul Wahab, Abdul Quddus
{"title":"Validation of “TOPRS” Score to Predict Outcome in Paediatric Patients in a Tertiary Care Hospital of Pakistan","authors":"A. Awan, Muhammad Tariq Nadeem, Bushra Babar, Ammara Iftikhar, Abdul Wahab, Abdul Quddus","doi":"10.51253/pafmj.v73i6.8107","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8107","url":null,"abstract":"Objective: To validate a clinical scoring system for defining the severity of ailment that will assist in developing strategies for management prioritisation. Study Design: Cross-sectional analytical study. Place and Duration of Study: Paediatric Department, Combined Military Hospital Lahore, Pakistan, form Jan 2020 to Jul 2021. Methodology: The paediatric patients who reported to the Medical Reception Centre and were admitted to an Inpatient Facility were enrolled. Demographic profile, temperature, oxygen saturation, pulse, respiratory rate, seizures, and sensorium labelled as “TOPRS” score was recorded with “0 – Normal” and “1 – Abnormal” and scores calculated for each patient with the incorporation of systemic inflammatory response and advanced paediatric life support criteria. Results: A total of 300 paediatric patients with an age range of 1-18 years (mean: 3.86±5.43) were included. Of 300 patients, 237(79%) were discharged after improvement, and the mortality rate was 63(21%). A significant association with the mortality rate was deciphered with temperature, oxygen saturation, and respiratory rate variables. In contrast, pulse rate, sensorium, and seizures were concluded to have an insignificant association. Score “0” mortality was associated with the 4.4% mortality, whereas score “5” enumerated an 80% death rate. Conclusion: The TOPRS clinical scoring system has significant value in the diagnosis of mortality and morbidity of paediatric patients and, hence, can assist in early recognition and triage of patients, consequently aiding in the provision of prioritisation protocols and management in a befitting manner.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 96","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137656","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}
Nosheen Sadiq, Ammara Iftikhar, Myra Tahir, Rashid Mahmood, A. Awan, Muhammad Uzair
{"title":"Diagnostic Accuracy of Lung Ultrasound in Diagnosis of Pneumonia in Children using Chest X-RAY as Gold Standard","authors":"Nosheen Sadiq, Ammara Iftikhar, Myra Tahir, Rashid Mahmood, A. Awan, Muhammad Uzair","doi":"10.51253/pafmj.v73i6.8785","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8785","url":null,"abstract":"Objective: To determine the diagnostic accuracy of lung ultrasound (LUS) in the diagnosis of pneumonia in children using chest x-ray as the gold standard. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Radiology, Combined Military Hospital, Sialkot Pakistan, from Feb to Aug 2021 Methodology: All patients underwent clinical examination, chest radiograph (anterior-posterior view), lung ultrasound and blood sample analysis in the first 24 hours after admission. A pre-specified hospital radiologist carried out a lung ultrasound. The examination was performed with the patient sitting upright or supine. The presence of pneumonia on x-ray and USG were recorded. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of lung ultrasound in the diagnosis of pneumonia by taking chest x-ray as the gold standard was calculated in all the study participants. Results: In this study, 262 patients with clinical features of pneumonia were enrolled. The mean age of the study participants was 3.27±2.344 years. Sensitivity (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV), accuracy and frequency of lung ultrasonography (US) vs chest radiography (CR) in diagnosing pneumonia was 95.28%, 87.5%, 99.59%, 36.84%, 95.04% and 96.95% respectively. Conclusion: Lung ultrasound emerged as a sensitive diagnostic tool to diagnose pneumonia in children. Sensitivity, specificity, positive predictive value, and negative predictive value all favoured the use of this modality to diagnose pneumonia in paediatric patients.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139404","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}
Ahsan Ahmad Ghauri, Muhammad Usman Munir, Z. Haroon, Muhammad Younas, Muhammad Anwar, S. Kirmani
{"title":"Evaluation of Key Performance Indicators in the Pre-analytical Phase of Testing in a Clinical Chemistry Laboratory of a Reference Institute","authors":"Ahsan Ahmad Ghauri, Muhammad Usman Munir, Z. Haroon, Muhammad Younas, Muhammad Anwar, S. Kirmani","doi":"10.51253/pafmj.v73i6.8556","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8556","url":null,"abstract":"Objectives: To check the performance in the pre-analytical phase of testing in the clinical chemistry laboratory of a reference institute using five key performance indicators and to compare these indicators between the morning and night shifts to ascertain the most probable source of pre-analytical errors. Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Apr to Sep 2021. Methodology: Defined key performance indicators (KPIs) were observed for a period of six months. The frequency and percentage of each KPI were calculated. Defects per Million were calculated for deriving Six Sigma (σ) values. KPIs were alsocompared between the morning and night shifts. Results: A total of 272,731 samples were observed in which 2306(0.84%) were found haemolysed (σ=3.5), 604 samples (0.22%) were not received in the Department due to various pre-analytic reasons (σ=4.0), 260 samples (0.09 %) were found having insufficient sample volume for analysis (σ=4.5), 181(0.06%) samples were found having improper/ wrong labelling or bar code errors (σ=4.5) and 161(0.05%) samples were delivered in wrong tubes (σ=4.5). KPI-1, KPI-2, and KPI-3 were found to be significantly higher during the night shift than the morning shift. Conclusion: Haemolysed samples and lost-not-received samples were the main causes of pre-analytical errors Key performance indicators aided as an instrument to screen and improve process execution in the laboratory.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" June","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136887","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}
Fayyaz Ahmed Orfi, Shafqat Hussain, Shafaan Orfi, Ali Arslan Munir, Sumbal Rana, Nida Maryam
{"title":"An Experience in Managing an open Fracture Shaft of the Femur Due to a Gunshot with Intramedullary Interlocking Nailing","authors":"Fayyaz Ahmed Orfi, Shafqat Hussain, Shafaan Orfi, Ali Arslan Munir, Sumbal Rana, Nida Maryam","doi":"10.51253/pafmj.v73i6.8538","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8538","url":null,"abstract":"Objective: To evaluate functional outcomes and complications in gunshot femur shaft fractures treated with intramedullary nailing primarily. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Orthopaedic Combined Military Hospital, Nowshera, Combined Military Hospital Sialkot, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2016 to Dec 2021. Methodology: A total number of 53 cases of open fracture of the femur shaft due to gunshot were included in the study. After initial wound debridement, an X-ray was taken, and fractures were classified according to the Gustilo–Anderson classification. All fractures were fixed with titanium I/M I/L Nail in static mode by the same orthopaedic surgeon. Rehabilitation was instituted immediately after the operation, and the outcome was assessed in regards to infection, range of motion at the knee, full weight bearing and radiological union achieved. Results: Thirty-four (64.15%) patients had Type-1 fractures of the femur shaft, and 19(35.8%) patients had Type-2 fractures. Fracture union was observed in 47(88.67%) patients after three months and 6(11.32%) over the next five months. Complications were wound infections 5(9.44%), leg length discrepancy 4(7.53%), and non-union 2(3.77%) at six months. In these two cases, bone grafting was done, and union was achieved. Conclusion: Primary intramedullary (IM) is the preferred mode of treatment of Type 1 and 2 shafts of femur fractures if early good debridement is done. It avoids secondary procedures, has fewer complications and helps in early mobilization.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138814","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}
Taimur Azam Khan, Syed Qasim Ali Shah, Mirza Hamid Beg, Osama Abdul Mateen, Muhammad Huzaifa Sharif, Syed Rafat Ali Hashmi
{"title":"A Comparison of Glide Scope Video Laryngoscopy to Direct Laryngoscopy for Nasotracheal Intubation","authors":"Taimur Azam Khan, Syed Qasim Ali Shah, Mirza Hamid Beg, Osama Abdul Mateen, Muhammad Huzaifa Sharif, Syed Rafat Ali Hashmi","doi":"10.51253/pafmj.v73i6.10056","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.10056","url":null,"abstract":"Objective: To compare the ease of intubation using glide scope video laryngoscope versus direct laryngoscopy for nasotracheal intubation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, Aug 2022 to Feb 2023. Methodology: Patients of either gender with age greater than 18 years with American Society of Anesthesiologists (ASA) Grade I or Grade II planned for elective dental or maxillofacial procedures requiring nasotracheal intubation were included. A total of 60 patients were included, with 30 patients in each group. Recorded variables were time to intubate, glottic grade, use of Magill forceps, first attempt success, failure to intubate and postoperative sore throat. Results: With 60 patients after randomised allocation, 30 were allocated to Group-DL (Direct laryngoscopy) and Group-VL(Video laryngoscopy). The success rate in the first attempt was 27(90%) in Group-DL vs 30 (100%) in Group-VL, and the number of patients who could not be intubated was 1(3.3%) vs 0(0%) in both groups. The glottic grade recorded by the operator under vision, time to intubation, use of Magill forceps and post-operative sore throat in both groups was significant with a p-value of <0.05. Conclusion: Glide scope video laryngoscopy provides a better view of the vocal cords with less time to intubation, greater chances of successful intubation, and fewer post-operative chances of sore throat than direct laryngoscopy.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 90","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138277","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}
Muhammad Shahzad Anwer, Mohsin Hussain, Jehanzeb Ur Rehman, Mehwish Gilani, Syed Mohsin Manzoor, Asif Ali
{"title":"Pattern of Vitamin D Status in Patients with Non-Specific Bone Pains- A Single Centre Study","authors":"Muhammad Shahzad Anwer, Mohsin Hussain, Jehanzeb Ur Rehman, Mehwish Gilani, Syed Mohsin Manzoor, Asif Ali","doi":"10.51253/pafmj.v73i6.9766","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9766","url":null,"abstract":"Objective: To determine the pattern of Vitamin D status in patients presenting with complaints of non-specific bone pains and to correlate the association of sunlight exposure with Vitamin D deficiency/insufficiency Study Design: Cross-sectional study. Place and Duration of Study: Department of Chemical Pathology, CMH, Abbottabad Pakistan, from Aug 2020 to Jul 2021. Methodology: All patients with non-specific bone pain were asked about demographic, clinical and sunlight exposure. Vitamin D assays were performed after history taking. Result: A total of 247 patients were tested for vitamin D levels. 103(41.7%) were male and 144(58.3 %) were females. 56(22.7%) had >60 minutes of daily sunlight exposure, 67(27.1%) had 30 to 60 minutes, and 124(50.2%) had less than 30 minutes of daily sunlight exposure. Vitamin D deficiency was found in 132(53.4%) patients, insufficiency was seen in 74(30.0%) patients and 41(16.6%) patients had normal vitamin D levels. Vitamin D deficiency correlated significantly with low sunlight exposure time. Conclusion: Vitamin D deficiency was seen in 53.4% of patients with non-specific bone pains, while insufficiency was seen in 30.0% of patients. Moreover, our study showed association of Vitamin D deficiency with a decreased duration of sunlight exposure.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139764","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}
Yusra Tayyab, Amir Rashid, Muhammad Javed Yousaf, Adnan Manzar, Asifa Majeed
{"title":"Correlation of Body Mass Index with Inflammatory Markers in Rheumatoid Arthritis Patients","authors":"Yusra Tayyab, Amir Rashid, Muhammad Javed Yousaf, Adnan Manzar, Asifa Majeed","doi":"10.51253/pafmj.v73i6.8576","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8576","url":null,"abstract":"Objective: To study the correlation of body mass index with inflammatory markers among rheumatoid arthritis patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, RawalpindiPakistan, in collaboration with the Rheumatology Department and laboratory of Pak Arab Emirates Military Hospital (PEMH), Rawalpindi Pakistan from Jan 2020 to Jan 2021. Methodology: The study sample was sixty in number and was divided into two groups. Diagnosed Rheumatoid Arthritis (RA) patients on modifying rheumatic Drugs (DMARDs) therapy constituted Group-I. At the same time, Group-II consisted of 30 healthy individuals. BMI, C reactive proteins (CRP) and erythrocyte sedimentation rate (ESR) of both groups were assessed and compared. The correlation of BMI with inflammatory markers was also assessed in both groups. Results: Sixty subjects with a mean age of 44.90±10 years were distributed evenly among two groups. Mean inflammatory markers for ESR and CRP, were 30.70±16.46 and 11.65±12.97, respectively, of Group-I. There was a significant difference in CRP and ESR (p ≤ 0.05) among the two groups. The mean BMI was 25.20±4.65, which was also raised for Group-I. BMI was positively correlated with inflammatory markers in both groups. Group-I showed a more positive correlation of BMI with ESR (r=0.23) than Group-II (r= 0.143). Conclusion: BMI is positively correlated with inflammatory status among RA patients.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140313","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":"An Uncommon Clinical Presentation of a Rare Disease-Alkaptonuria: Case Report","authors":"Umar Abdul Ali Qureshi, N. Malik","doi":"10.51253/pafmj.v73i6.9174","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9174","url":null,"abstract":"Palmoplantar pigmentation is a rare clinical presentation of alkaptonuria, a rare inborn error of phenylalanine and tyrosine metabolism. Alkaptonuria occurs owing to a deficiency of an enzyme homogentisic acid oxidase inherited as an autosomal recessive disorder. We report a case of alkaptonuria, which presented with palmoplantar pigment pigmentary nail changes and the involvement of the spine and joints. He was advised of ascorbic acid along with symptomatic management and detailed counselling.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 59","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139568","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}
Mansoor Ejaz, S. Saulat, Syed Saeed Uddin Qadri, Awais Ayub
{"title":"Comparison of Outcomes of Pneumatic Ballistic Lithotripsy, Holmium Laser Lithotripsy, and Combined Electromagnetic with Ultrasonic Lithotripsy during Percutaneous Nephrolithotomy","authors":"Mansoor Ejaz, S. Saulat, Syed Saeed Uddin Qadri, Awais Ayub","doi":"10.51253/pafmj.v73i6.8856","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8856","url":null,"abstract":"Objective: To compare outcomes of combined electromagnetic with ultrasonic lithotripter, pneumatic ballistic lithotripter, and holmium laser lithotripter among patients at a Tertiary Care Hospital. Study Design: Prospective comparartieve study. Place and Duration of Study: Department of Urology at Tabba Kidney Institute, Karachi Pakistan, from May 2020 to Jun 2021. Methodology: Ninety patients were divided into three groups of lithotripsy energies. Group-A (n=30) patients got pneumatic lithotripsy, Group-B (n=30) patients got laser lithotripsy, while Group-C (n=30) patients got trilogy lithotripsy technique. Outcomes such as post-operative pain, post-operative complications, and stone clearance were evaluated in all groups. Results: The overall mean age of the patients was 50.23±9.24 years, ranging from 33-74 years. The majority of the participants were males (n=52,57.8%), and 38(35.6%) of the participants were females. The intra-operative time, severity of post-operative pain, fever and UTI were the same between the three groups. However, the proportion of hematuria (p=0.001) and stone clearance (p=0.025) significantly differed between the three groups. Conclusion: Laser and pneumatic lithotripter were more effective in complete stone clearance than trilogy lithotripter. While laser lithotripter significantly decreases the occurrence of hematuria.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139851","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}
Khan Muhammad Yaqub, Muhammad Saeed, Bilal Yasin, Khalid Ameer, Nusrat Noor
{"title":"The role of Tranexamic acid in the Reduction of Bleeding in Abdominal Aortic Aneurysm Surgery","authors":"Khan Muhammad Yaqub, Muhammad Saeed, Bilal Yasin, Khalid Ameer, Nusrat Noor","doi":"10.51253/pafmj.v73i6.7689","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.7689","url":null,"abstract":"Objective: To determine the effects of Tranexamic acid on intraoperative blood loss. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Oct 2021. Methodology: A total of 96 patients from both genders undergoing elective open abdominal aortic aneurysm surgery under general anaesthesia enrolled in the study after random distribution to Drug and Control Groups. The primary determinant was intraoperative blood loss. Additionally, determining variables were intraoperative and postoperative blood transfusions, thromboembolic episodes, and postoperative mortality rate. Results: A total of 96 patients enrolled in the study, out of which 90(93%) were males, whereas 6(7%) were females, with a mean age of 65.37±7.01 (55–75 years). Of 96 participants, 52(54%) patients were from ASA Class II and 44(46%) were from ASA Class III. There was no significant correlation between surgical time (p-value 0.45), clamping time (p-value 0.34), and intraoperative and postoperative transfusions (p-value 0.56 and 0.28, respectively). However, a statistically significant reduction in intraoperative and postoperative blood loss was recorded (p-value <0.001). Conclusion: Tranexamic acid significantly impacts the reduction of intraoperative and postoperative bleeding in elective open abdominal aortic aneurysm surgeries under general anaesthesia.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140491","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}