Acta Gastroenterologica Latinoamericana最新文献

{"title":"[[Confounders and Effect Modifiers]].","authors":"Rodolfo Pizarro, Leandro Barbagelata","doi":"10.52787/agl.v55i4.560","DOIUrl":"10.52787/agl.v55i4.560","url":null,"abstract":"","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"270-275"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laryngopharyngeal Reflux: Historical Perspectives, Current Diagnostics and Therapies, and Remaining Challenges.","authors":"Callie Cuff, Rena Yadlapati","doi":"10.52787/agl.v55i4.555","DOIUrl":"10.52787/agl.v55i4.555","url":null,"abstract":"<p><p>The concept of laryngopharyngeal reflux has evolved since it was first used to describe the retrograde flow of gastric contents into the upper airway leading to upper airway symptoms. Decades of cross-disciplinary research have led to our current understanding of this process, which emphasizes differentiating laryngopharyngeal reflux disease (characterized by symptoms with objective evidence of reflux) from laryngopharyngeal symptoms (which can occur with or without pathological reflux). It is essential to recognize this distinction for effective management because laryngopharyngeal reflux disease may respond to anti-reflux therapy, whereas the management of laryngopharyngeal symptoms depends on the clinical entity or entities contributing to them. This review summarizes the historical development of the laryngopharyngeal reflux concept, outlines current diagnostic and therapeutic approaches for laryngopharyngeal reflux disease, and highlights ongoing challenges and opportunities for future research. We conclude that continued interdisciplinary collaboration is essential for improving both evidence-based diagnoses and effective treatment outcomes.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"292-302"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Severe Hyponatremia as a Marker of Malignancy in Patients with Liver Cirrhosis. Clinical Implications and Prognostic Relevance in Two Cases].","authors":"Jonatan Nicolás Domínguez, María José Cáceres, Liria Martínez Rejtman, Matías Zanetti, Rubén Guillermo Fernández, Mariano Arguello","doi":"10.52787/agl.v55i4.480","DOIUrl":"10.52787/agl.v55i4.480","url":null,"abstract":"<p><p>Severe hyponatremia is a common complication (21.6%) in patients with decompensated cirrhosis. It can sometimes manifest as a paraneoplastic syndrome, which may precede the diagnosis of cancer in 5% of cases. It can be associated with lung cancer (25 - 45%), colorectal cancer, breast cancer, or lymphomas. Hyponatremia reflects the complexity of the interactions between liver disease and oncological processes. In decompensated cirrhotic patients, hyponatremia is usually caused by the kidney´s inability to excrete free water, resulting in dilution of blood sodium. However, in the context of cancer, factors such as ectopic antidiuretic hormone secretion by tumors can exacerbate this condition. This inappropriate antidiuretic hormone secretion can lead to additional water retention, worsening the hyponatremia in these patients. We present two clinical cases that illustrate this relationship: a patient with liver metastases and a patient with pulmonary nodules, both with compensated cirrhosis as a chronic disease, who were admitted with severe hyponatremia. The management of these patients requires a multidisciplinary approach, searching for occult neoplasms and carefully normalizing sodium levels to prevent neurological complications. Early identification of hyponatremia is crucial due to its prognostic impact.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"386-391"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Intestinal Bacterial Overgrowth and Intestinal Methanogen Overgrowth: Are They Overdiagnosed?","authors":"Anokhi S Kholwadwala, Eamonn M M Quigley","doi":"10.52787/agl.v55i4.570","DOIUrl":"https://doi.org/10.52787/agl.v55i4.570","url":null,"abstract":"<p><p>Small intestinal bacterial overgrowth was originally described as a cause of maldigestion and malabsorption, and its diagnosis was based on the culture of aspirates from the upper small intestine. The application of hydrogen breath tests to assess suspected small intestinal bacterial overgrowth increased the frequency of this diagnosis dramatically, and expanded its clinical context from maldigestion to include a number of non-specific gastrointestinal complaints and even some systemic ills. However, a critical review of recent literature suggests that reliance on breath tests, particularly those using lactulose as the substrate, has led to overdiagnosis of small intestinal bacterial overgrowth. Many aspects of the current concept of its diagnosis are contentious and unresolved. These include diagnostic thresholds, response to antibiotic therapy, as well as the roles of methane, hydrogen sulfide, and other gases emanating from bacterial fermentation in the gastrointestinal tract. We discuss these issues, paying particular attention to the concept of intestinal methanogen overgrowth and exploring the role of methanogens and methane in gastrointestinal homeostasis. We advocate a critical and cautious approach to the diagnosis of small intestinal bacterial overgrowth and intestinal methanogen overgrowth, and that antibiotics are prescribed are with great care. We also look forward to the application of modern molecular microbiology to the study of the small intestinal microbiome and metabolome, including a more complete understanding of methane biology.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"276-291"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence of Anxiety and Depression in Patients with Inflammatory Bowel Disease: Association with Disease Activity and its Impact on Quality of Life].","authors":"Camila María Briz, Federico Ignacio Cassella, Pablo Martín Perez, Santiago Marzullo, Luis Viola","doi":"10.52787/agl.v55i4.557","DOIUrl":"10.52787/agl.v55i4.557","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory bowel diseases are chronic conditions whose digestive and extradigestive symptoms affect patients' quality of life. Multiple observational studies have also reported a significantly higher prevalence of psychiatric disorders, particularly anxiety and depression, in inflammatory bowel disease patients compared to the general population.</p><p><strong>Objectives: </strong>To evaluate the prevalence of symptoms suggestive of anxiety and/or depression in inflammatory bowel disease patients, as well as their association with disease activity and quality of life.</p><p><strong>Materials and methods: </strong>Patients over 18 years of age who attended the inflammatory bowel disease clinics of the Gastroenterology and Hepatology Service of the Güemes Hospital and the Centro Integral de Gastroenterología, in the Autonomous City of Buenos Aires, Argentina, from May 2023 to April 2025 were evaluated. The HADS (Hospital Anxiety and Depresión Scale) and CCVEII-9 (Shortened quality of life questionnaire in inflammatory bowel disease) questionnaires were administered, alongside the collection of clinical data and fecal calprotectin as a marker of inflammatory activity.</p><p><strong>Results: </strong>Ninety-nine patients with inflammatory bowel disease aged 18 years or older were included. Symptoms suggestive of anxiety were observed in 62.6% and depression in 19% of patients. No significant associations were found between psychiatric symptoms and calprotectin levels. However, the presence of anxiety or depression was associated with lower quality of life. Moderate negative correlations were observed for anxiety and strong negative correlations for depression between the scores of the two questionnaires.</p><p><strong>Conclusion: </strong>More than half of inflammatory bowel disease patients present symptoms of anxiety and depression, significantly affecting their quality of life, although no relationship with inflammatory activity was observed. These findings emphasize the importance of screening and specifically treating psychiatric disorders in this population to improve overall wellbeing.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"341-349"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Atypical Neurofibromatous Neoplasm with Uncertain Biological Potential (ANNUBP) Mimicking a Solid Pseudopapillary Tumor Pancreatic ANNUBP.","authors":"Santiago Bustince, Nicolás H Dreifuss, Marcelo F Amante, Lucas McCormack, Pablo Capitanich","doi":"10.52787/agl.v55i4.481","DOIUrl":"10.52787/agl.v55i4.481","url":null,"abstract":"<p><p>Atypical neurofibromatous neoplasms of uncertain biological potential have recently been added as a subset of lesions that have the potential to transform into malignant peripheral nerve sheath tumors in patients with neurofibromatosis type 1. Only a few cases of atypical neurofibromatous neoplasms of uncertain biological potential , have been reported in the literature. Here we present the first case of this type of neoplasm located in the pancreas in a 30-year-old woman with neurofibromatosis type 1. The mass was discovered incidentally on imaging studies. Computed tomography and magnetic resonance imaging showed a 3 x 2 cm solidcystic mass in the head of the pancreas, suggestive of a pseudopapillary solid tumor. Following an inconclusive endoscopic ultrasound-guided biopsy, a pancreaticoduodenectomy was performed. The patient had an uneventful postoperative recovery. Histopathological and immunohistochemical analysis confirmed the diagnosis of atypical neurofibromatous neoplasms of uncertain biological potential. To our knowledge, this is the first report of this type of tumor located in the pancreas. They are often difficult to differentiate from other solid and solid-cystic tumors of the pancreas based on imaging studies. Imaging techniques such as magnetic resonance imaging and positron emission tomography along with computed tomography, combined with histopathology, and a history of type 1 neurofibromatosis are essential for an accurate diagnosis. Current treatment consists of radical surgical removal of the tumor, due to the risk of malignant transformation. This case highlights the importance of considering atypical neurofibromatous neoplasms of uncertain biological potential as a differential diagnosis in patients with neurofibromatosis type 1 and a pancreatic mass. Further studies are needed to improve preoperative diagnostic strategies and evaluate longterm prognosis after surgical resection.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"392-397"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevalence of Rumination Syndrome: Experience in Three Countries of the Working Group on Brain-Gut Disorders of the Latin American Society of Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN)].","authors":"Carlos Alberto Velasco-Benítez, Estefanía Rodríguez-López, Daniela Alejandra Velasco-Suárez, Claudia Jimena Ortiz-Rivera, Edgar Játiva-Mariño, Ada Ruth Dionicio Avendaño, Arony Martínez","doi":"10.52787/agl.v55i4.526","DOIUrl":"10.52787/agl.v55i4.526","url":null,"abstract":"<p><strong>Introduction: </strong>According to Rome IV diagnostic criteria, the worldwide prevalence of rumination syndrome is 1.0%.</p><p><strong>Objectives: </strong>Identify the prevalence and possible associations of rumination syndrome in preschoolers, school-children, and adolescents from Colombia, Mexico, and Ecuador according to Rome IV criteria.</p><p><strong>Materials and methods: </strong>Prospective, observational, cross-sectional and descriptive study conducted in three Latin American countries. We included children and adolescents between 5 and 18 years of age from the Functional International Digestive Epidemiological Research Survey - FINDERS Group database, who answered the Rome IV Pediatric Digestive Symptom Questionnaire in Spanish. Sociodemographic, family, clinical, and nutritional variables were analyzed. The statistical analysis included measures of central tendency and dispersion for univariate description of the variables. Subsequently, bivariate analyses were performed using the chi-square or Fisher's exact tests, and odds ratios (OR) were calculated with their respective 95% confidence intervals. A p-value of p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 10.089 children (mean age 12.7 ± 3.1 years; 55.6% female; 52.1% mixed race) were included in the study. Rumination syndrome was diagnosed in 0.8% of the children. An overlap of rumination with other functional disorders was observed in 3.4% of cases. The following variables were associated with rumination: female gender (OR = 2.10; 95% C: 1.24 - 3.66; p = 0.0032) and overlap with other functional disorders such as constipation and aerophagia (p = 0.000).</p><p><strong>Conclusion: </strong>The prevalence of rumination syndrome among preschoolers, schoolchildren and adolescents in three Latin American countries is similar to that reported worldwide. Bivariate analysis showed an association with female sex and overlap with other functional disorders.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"332-340"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Use of Los Angeles Classification in Erosive Esophagitis: analysis of inter-observer and intra-observer agreement].","authors":"Anahí Ayelén de Los Rios, Juan Ignacio Olmos, José María Sanguinetti, Andrés Wonaga, Lorena Bortot, Esteban González Ballerga","doi":"10.52787/agl.v55i4.559","DOIUrl":"10.52787/agl.v55i4.559","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal reflux disease is a com-mon condition with a prevalence of 10 to 20% in Western countries. The Los Angeles Classification is the standard endoscopic system for categorizing erosive esophagitis.</p><p><strong>Objectives: </strong>To evaluate intra- and inter-observer agreement among resident physicians and gastroenterology specialists in classifying the severity of reflux-related erosive esopha-gitis using the Los Angeles Classification.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted with 59 participants (25 specialists and 34 residents) who clas-sified 40 endoscopic images according to the Los Angeles Classification (10 images were duplicated). Inter-observ-er agreement was analyzed using Fleiss's kappa index and intra-observer agreement using Cohen's kappa.</p><p><strong>Results: </strong>Inter-observer agreement was moderate among specialists (κ = 0.425, IC95% 0.39 - 0.46) and acceptable among residents (κ = 0.297, IC95% 0.26-0.33), and the dif-ference was statistically significant (p < 0.001). Over-all intra-observer agreement was moderate (κ = 0.525, IC95% 0.47 - 0.58).</p><p><strong>Conclusion: </strong>Low inter- and intra-observer agreement was observed when using the Los Angeles Classification for esophagitis, with signifi-cant differences when comparing groups with different levels of experience. The development and application of local clinical-endoscopic protocols is recommended to standardize diagnostic and therapeutic criteria, optimize resources, and contribute to the training of gastroenter-ology specialists.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"350-357"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Transaminases on the First Day After Hepatectomy and Prediction of Out-comes in Malignant Disease].","authors":"Lourdes Mollard, Rodrigo A Gasque, Magalí Chahdi-Beltrame, Marcelo E Lenz, Francisco J Mattera, Emilio G Quiñonez","doi":"10.52787/agl.v55i4.547","DOIUrl":"10.52787/agl.v55i4.547","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in oncological liver surgery have improved the radicality of procedures and broadened the criteria for resectability. Transaminases can be indicators of postoperative hepatocellular injury.</p><p><strong>Objectives: </strong>Evaluate the relationship between transaminase levels on the first postoperative day and morbidity and mortality in hepatectomies for malignant disease.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on hepatectomies for malignant disease between March 2015 and February 2023. Demographic, intraoperative, and postoperative variables were evaluated. Optimal transaminase cutoff values and their relationship with complications and mortality were determined using ROC curves and sensitivity and specificity calculations.</p><p><strong>Results: </strong>We performed 273 hepatectomies at our institution, 118 of which were for malignant pathology. We found a statistically significant relationship between elevated transaminase levels on the first postoperative day and the development of morbidity and mortality. The cutoff points for predicting mortality were 856 IU/L for glutamic-oxaloacetic transaminase and 1341 IU/L for glutamic-pyruvic transaminase (AUC: 0,714 and 0,579, respectively), and 530 IU/L and 257 IU/L for predicting the occurrence of complications (AUC: 0,700 and 0,663, respectively). Elevated glutamic-pyruvic transaminase values were associated with postoperative liver failure, with a cutoff point > 856 IU/L (AUC: 0,834).</p><p><strong>Conclusion: </strong>Elevated transaminase values on the first postoperative day are associaed with a higher occurrence of complications, the need for blood products and the use of vasoactive drugs. Elevated glutamic-pyruvic transaminase indicates a higher risk of postoperative liver failure and 90-day mortality. Transaminases are useful prognostic markers in hepatectomies for malignant pathology.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"358-370"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Usefulness of Neuromodulators in Clinical Practice: The Gastroenterologist's Viewpoint].","authors":"Karla Rocío García-Zermeño, Jorge E Aquino-Matus, Joanna Jiménez Pavón, José María Remes-Troche","doi":"10.52787/agl.v55i4.533","DOIUrl":"10.52787/agl.v55i4.533","url":null,"abstract":"<p><p>Neuromodulators have become a fundamental tool in modern gastroenterology, particularly for disorders involving brain-gut interaction. Originally developed for the management of psychiatric disorders, these drugs have demonstrated the ability to modulate visceral pain, intestinal hypersensitivity, and gastrointestinal motility, acting through both central and peripheral mechanisms. The most widely used neuromodulators included tricyclic antidepressants, which are effective in reducing abdominal pain; selective serotonin reuptake inhibitors, which are useful for patients with comorbid anxiety or depression; and serotonin-norepinephrine reuptake inhibitors, which are used for visceral pain with neuropathic features. Other drugs, such as gabapentinoids, mirtazapine, buspirone, and certain antipsychotics, have also shown benefits in specific phenotypes. Drug selection depends on the patient´s clinical profile, comorbidities, tolerability, and risk of adverse effects, particularly for elderly and polymedicated patients. Neuromodulator management is characterized by the use of low initial doses with gradual increases and close patient monitoring. In addition, a multidisciplinary approach integrating non-pharmacological interventions such as cognitive-behavioral therapy, gut-directed hypnotherapy, and mindfulness-based programs, is recommended. This combination enhances clinical effectiveness, reduces stigma, and improves quality of life, consolidating neuromodulators as an essential part of the comprehensive treatment of disorders of brain-gut interaction.</p>","PeriodicalId":35700,"journal":{"name":"Acta Gastroenterologica Latinoamericana","volume":"55 4","pages":"303-316"},"PeriodicalIF":0.0,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12965155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}