Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru最新文献

{"title":"[Esophageal perforation in children treated with covered biliary stents: report of three cases in a fourth level hospital in Medellín, Colombia].","authors":"Daniela Londoño-Cañas, Álvaro Gómez Vanegas, Mónica Contreras, Catalina Ortiz, Diana Sánchez, Santiago Sánchez, Gabriel Mosquera-Klinger","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Esophageal perforation is a severe digestive tract injury with serious complications and high mortality, representing a diagnostic challenge in the pediatric population due to the nonspecific nature of symptoms. Causes include external trauma, caustic ingestion, foreign body impaction, and iatrogenic injuries. We describe three pediatric patients with esophageal perforation of different etiologies successfully managed by endoscopic placement of fully covered metallic biliary stents, combined with broad-spectrum antibiotic therapy and nutritional support. Two cases were secondary to impacted foreign bodies (a plastic fragment and a coin), and one was due to caustic ingestion. In all cases, complete closure of the esophageal defect was achieved without the need for surgery, with resolution of the leak and favorable clinical outcomes. The use of covered biliary stents is an effective and safe alternative for the management of benign esophageal perforations in selected children, allowing defect closure and avoiding high-morbidity surgical interventions.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593660","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":"[PANCCO Clinical Practice Guideline Update for the treatment of ulcerative colitis in adults].","authors":"Paulina Núñez Figueroa, Abel Sánchez Orozco, Ignacio Alfaro Pérez, María Teresa Andara Ramírez, Domingo Balderramo, Sócrates Bautista, Federico Cassella, Luis Alberto Cervera Caballero, Jorge Luis De León Rendón, Juan De Lucas Ocaña, Eduardo García Vilela, Maria Luisa Jara Alba, Melvin Linares Serrano, Manuel Alejandro Martínez-Vázquez, Sergio Daniel Morínigo Bogado, Ruben Muñoz Camacho, Viviana Parra-Izquierdo, Johana Pérez Baldíoceda, Fabián Eduardo Puentes-Manosalva, Ximena Rodríguez Olaso, Rogério Saad-Hossne, Mariastella Serrano, Miosotis Suarez, Elizabeth Umaña Solis, Rodrigo Pardo-Turriago, Sandra Yuseff, Tatiana Lozano, Fabián Juliao-Baños","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To update the recommendations of the Pan American Crohn's and Colitis Organisation (PANCCO) for the treatment of moderate-to-severe ulcerative colitis (UC) in adults, incorporating recent evidence on new biologics, small molecules, subcutaneous formulations and appendectomy. The PAHO rapid GRADE methods were applied. PANCCO adapted the Colombian guideline 2025 for upadacitinib, tofacitinib, ozanimod and the switch to subcutaneous formulations, and developed de novo recommendations for etrasimod, guselkumab, risankizumab, ustekinumab, mirikizumab, filgotinib and appendectomy. The search was carried out in MEDLINE, Embase, Cochrane and Epistemonikos through February 2026, with quality appraised with ROBIS, AMSTAR-2, RoB 2.0 and ICEMAN; strength of recommendations was established using GRADE. Recommendations were issued for nine clinical questions. In moderate-to-severe UC, upadacitinib, tofacitinib, filgotinib, ustekinumab, mirikizumab, risankizumab and guselkumab are recommended; ozanimod and etrasimod are conditionally suggested, considering the cardiovascular profile. In patients with response to intravenous induction, switching to subcutaneous vedolizumab or subcutaneous infliximab is suggested. In UC refractory to advanced therapies, laparoscopic appendectomy is conditionally suggested as an adjuvant strategy. This third update expands the therapeutic armamentarium for moderate-to-severe UC in Latin America. Treatment choice should be individualized according to prior therapy, comorbidities, cardiovascular and thrombotic risk, availability and patient preferences.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"221-233"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593688","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":"Antimicrobial resistance profile in Helicobacter pylori isolates from Costa Rica.","authors":"Tábata Elizondo-Álvarez, Erick González-Quesada, Thais Castillo-Morales, Christian Campos-Núñez, Vanessa Ramírez-Mayorga, Silvia Molina-Castro","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Helicobacter pylori infection relates to multiple gastric diseases, and its eradication is becoming more challenging due to antimicrobial resistance to commonly used antibiotics, especially clarithromycin. The aim of this study is to describe the antimicrobial susceptibility profiles of H. pylori isolates from Costa Rican patients.</p><p><strong>Materials and methods: </strong>Antimicrobial susceptibility was assessed for 14 H. pylori isolates using the E-test method for amoxicillin, clarithromycin, levofloxacin, metronidazole, tetracycline, and rifampicin. Due to its importance, the point mutations A2143G and A2144G related to clarithromycin resistance were also studied using PCR-RFLP.</p><p><strong>Results: </strong>Resistance to clarithromycin (29%), levofloxacin (29%), metronidazole (29%), and rifampicin (7%) was found in the studied isolates. These included three isolates with multidrug resistance. A2143G mutation was detected in one isolate and A2144G was detected in two isolates, and the presence of mutations correlated significantly with phenotypic resistance to clarithromycin (r=0.8321, p=0.0071).</p><p><strong>Conclusions: </strong>Antibiotic resistance was high in the studied isolates from Costa Rica. The number of isolates is small, but the results highlight the need for further studies to assess the antibiotic resistance as a growing problem in the country. H. pylori culture and phenotypic tests are difficult, but molecular testing can be used as a quick and cheap option to monitor clarithromycin resistance.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"123-130"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593745","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":"[Dual therapy vs bismuth quadruple therapy in recurrent H. pylori: multicenter randomized trial].","authors":"Rodrigo Castaño-Llano, William Otero, William Valencia, Martha Agudelo, David Restrepo, Camilo Díaz, Iordana Mejia-Kambourova, Daniela Palacio, Óscar Álvarez","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With increasing antibiotic resistance, treatment of H. pylori infection has gradually become a challenge for clinicians.</p><p><strong>Objectives: </strong>To compare the efficacy and safety of dual therapy plus bismuth (DTB) with quadruple therapy with bismuth (DBT) for the treatment of H. pylori in patients with at least one previous eradication therapy failure. The primary objective was eradication of H. pylori at 6 weeks after treatment.</p><p><strong>Materials and methods: </strong>Randomized, open-label, superiority clinical trial evaluating H. pylori eradication in patients with at least one prior treatment failure. Participants were randomly assigned to receive a 14-day course of bismuth-based dual therapy (TDB: esomeprazole 40mg three times daily, amoxicillin 1g three times daily, and bismuth subsalicylate 262mg four times daily) or bismuth-based quadruple therapy (TQB: esomeprazole 40mg three times daily, amoxicillin 1g three times daily, doxycycline 100mg twice daily, and bismuth subsalicylate 262mg four times daily).</p><p><strong>Results: </strong>A total of 267 of 283 subjects were randomized; 11 were excluded due to exclusion criteria and 5 declined participations. Eradication rates by intention-to-treat and per-protocol analyses were 90.1% (119/131; 95% CI: 84.7-94.7%) and 95.8% (113/118; 95% CI: 90.5-98.2%) for TDB, and 78.7% (107/136; 95% CI: 71.1-84.7%) and 84.7% (94/111; 95% CI: 76.8-90.2%) for TQB. Superiority of TDB was confirmed (p=0.001 in ITT; p=0.04 in PP). Adverse events occurred in 30.5% (33/131) of TDB patients and 44.1% (60/136) of TQB patients (p=0.001).</p><p><strong>Conclusions: </strong>Bismuth-based dual therapy is a superior alternative to classical bismuth quadruple therapy for the treatment of patients with at least one failed therapy for H. pylori, as it provides greater eradication with superior safety and compliance.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"115-122"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593627","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":"[Frequency of anorectal disorders in patients with chronic constipation, according to the London classification, in private care centers in Lima - Peru].","authors":"Sergio Angeles Hinojosa, Milagros Ticona Alegre, Jesús Aguilar Huisa, Carmen Alurralde Miranda, Edith Rosas, Cristian León Rabanal, Jorge Espinoza-Ríos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chronic constipation is a frequent gastrointestinal disorder that significantly impairs quality of life and has a multifactorial etiology. High-resolution anorectal manometry (HR-ARM) allows for an objective evaluation of anorectal function. In Peru, evidence regarding its findings in the adult population is scarce.</p><p><strong>Objective: </strong>To describe the findings obtained through high-resolution anorectal manometry in adults with primary chronic constipation, according to the London Classification, in three private institutions in Lima, Peru.</p><p><strong>Materials and methods: </strong>A retrospective descriptive study was conducted in three private institutions in Lima between January 2020 and December 2024. Reports of manometry from patients over 18 years old with a diagnosis of functional chronic constipation and normal colonoscopy findings were included. Data were analyzed using STATA v.18, applying descriptive statistics and the Chi-square test.</p><p><strong>Results: </strong>A total of 122 patients were evaluated (81.2% women). According to the London Classification, the most frequent findings were anal normotension with hypocontractility (62.3%), normal expulsion with abnormal coordination (43.4%), and preserved anorectal inhibitory reflex (97.5%). Regarding rectal sensitivity, hyposensitivity was the most common finding (38.5%), followed by normal parameters (37.8%). Analysis by age and sex showed significant differences in resting anal pressure (p=0.045), desire to defecate (p=0.048), and rectal urgency (p=0.007).</p><p><strong>Conclusions: </strong>The most frequent manometric findings in patients with primary chronic constipation were anal hypocontractility, impaired anorectal coordination, and rectal hyposensitivity. These results highlight differences according to age and sex, underscoring the importance of incorporating the London Classification to achieve a more accurate diagnosis and personalized clinical management.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"144-151"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593703","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":"Mixed Neuroendocrine-NonNeuroendocrine Neoplasm of the Sigmoid colon: the first case reported in Perú.","authors":"Manuel Moreno Gonzales, Paul Pilco Castañeda, Juan Chirinos Vega, Jaime Montes Gil, Luana Mesones Duffoó, Giulia Corigliano Mazzi, Aranza Pujazón Madueño, Nelson Cuevas Muñoz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Mixed Neuroendocrine-NonNeuroendocrine Neoplasms (MiNENs) are rare and aggressive entities, with scarce reports worldwide, especially from Latin America. We describe the first documented case of sigmoid MiNEN in Perú in a 77-year-old woman with a history of hypertension, diabetes, and osteoporosis who presented with left lower quadrant pain and abdominal distension. Colonoscopy revealed polyps, one of which was histologically consistent with a large-cell neuroendocrine carcinoma (NEC) and a high-grade tubular adenoma, each accounting for ≥30% of the lesion, fulfilling MiNEN criteria. Immunohistochemistry confirmed the diagnosis with an Antigen Kiel 67 [Ki-67] index of 70%. Positron Emission Computed Tomography (PET/CT) demonstrated focal uptake without nodal involvement. The patient underwent laparoscopic radical sigmoidectomy with colorectal anastomosis; histopathology confirmed submucosal invasion and metastasis in 5/14 lymph nodes. She was subsequently started on adjuvant carboplatin/etoposide chemotherapy and remains under oncological follow-up. This case underscores the diagnostic and therapeutic challenges of colorectal MiNENs, highlights the role of PET/CT as well as multidisciplinary management, and emphasizes the importance of considering radical resection even after endoscopic removal, given the high risk of recurrence and aggressive biological behavior.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"209-214"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593803","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":"[Myelofibrosis as a cause of non-cirrhotic portal hypertension].","authors":"Juan José Quiroz-Leyva, Edgar Fermín Yan-Quiroz, José Richard Tenazoa-Villalobos","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Primary myelofibrosis is a chronic myeloproliferative neoplasm characterised by extramedullary hematopoiesis. Portal hypertension represents a significant cause of mortality in these patients. Diagnosis of portal hypertension is typically based on clinical manifestations and is often confirmed by upper gastrointestinal endoscopy, which allows for the identification of oesophageal varices and facilitates endoscopic intervention. Management options include general supportive measures, chemotherapy, splenectomy, and radiation therapy. This report describes a 53-year-old woman with a history of myelofibrosis who presented with abdominal pain and anaemia. Upper gastrointestinal video endoscopy revealed oesophageal varices, and subsequent confirmation of portal hypertension prompted a percutaneous liver biopsy, which demonstrated myelofibrosis. After appropriate management, the patient had a favourable clinical outcome.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593695","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":"[Primary hepatic actinomycosis mimicking a malignant liver tumor: Case report and review of the Latin American literature].","authors":"Doyler Cubas-Garcia, Judith Sanchez-Zavaleta, Gilbert Román-Hernández, María Del Carmen Kapsoli-Sanchez, Nelson Urbina-Rojas","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatic actinomycosis is a rare infection caused by Actinomyces spp. It is characterized by nonspecific clinical presentation and imaging findings that may mimic hepatic neoplasms. We report the case of a 43-year-old man presenting with a three-month history of right upper quadrant pain and weight loss. Magnetic resonance imaging revealed an infiltrative hepatic mass involving segments IV, V, and VIII, suggestive of malignancy. Percutaneous biopsy was inconclusive; therefore, an extended right hepatectomy with segmental colectomy was performed. The definitive diagnosis was established by histopathological examination, which demonstrated sulfur granules and filamentous structures consistent with Actinomyces spp. The patient received prolonged antibiotic therapy, with favorable clinical evolution and no evidence of recurrence during follow-up. Hepatic actinomycosis is an entity with limited representation in the Latin American literature and should be considered in the differential diagnosis of atypical liver masses, even in the absence of predisposing factors. Its presentation may mimic hepatic malignancy and lead to unnecessary major surgical interventions. In clinical practice, it is essential to maintain a high index of suspicion for infectious etiologies, particularly when initial biopsies are inconclusive.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"192-197"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593696","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":"Real-world effectiveness and safety of golimumab in ulcerative colitis: multicenter experience from Chile.","authors":"Paulina Núñez, Rodrigo Quera, Karin Herrera, Lilian Flores, Romina Fernández","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>Evidence on golimumab for ulcerative colitis (UC) is scarce in Latin America. We aimed to assess the real-world effectiveness and safety of golimumab in a multicenter Chilean cohort.</p><p><strong>Materials and methods: </strong>We conducted a retrospective, observational study including adult patients with moderate-to-severe UC treated with golimumab under the Chilean government coverage program (July 2019-August 2023). Clinical, biomarker, endoscopic, and histological outcomes were evaluated at weeks 16 and 52. Dose optimization strategies and adverse events (AEs) were recorded.</p><p><strong>Results: </strong>Seventy-nine patients were included (69.6% women; median disease duration 8 years). Most were anti-TNF naïve (94%). At week 16.81% achieved symptomatic remission, 77% biomarker remission, 35% endoscopic remission, and 38% histological remission. At week 52, 43 patients remained on treatment; of these, 93% achieved symptomatic remission, 98% biomarker remission, 63% endoscopic remission, and 42% histological remission. Dose optimization was required in 62% of patients, and early optimization was associated with higher remission stability. Kaplan-Meier analysis showed 75% clinical remission at 24 months. Adverse events were infrequent, with no colectomies reported.</p><p><strong>Conclusions: </strong>In this first Chilean and Latin American multicenter real-world study, golimumab proved effective and safe for moderate UC, achieving high rates of clinical and biomarker remission, particularly with early dose optimization. Despite newer biologics and small molecules, golimumab remains a valid therapeutic option in regions with limited access.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"152-158"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593753","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":"[Endoscopic retrograde cholangiopancreatography transgastric guided by endoscopic ultrasound in a single endoscopic procedure: first case in the Colombian Caribbean region].","authors":"Dagoberto Rafael Duarte Misol, Marco Antonio Medina Ortega, Fernando Luis García Del Risco, Jesús Maria Pérez Orozco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is the standard treatment for biliary tract diseases; however, in patients with Roux-en-Y gastric bypass, it is technically challenging due to altered anatomy. We report the case of a 43 year old woman with a history of gastric bypass who presented with abdominal pain, fever, and jaundice, and was diagnosed with choledocholithiasis complicated by cholangitis. After multidisciplinary evaluation, a single-session endoscopic ultrasound-guided transgastric ERCP (EDGE) was performed. A gastrogastric fistula was created using a Hot Axios lumen-apposing metal stent, which was subsequently dilated and secured to allow safe passage of the duodenoscope. During ERCP, type IV Mirizzi syndrome with an impacted stone was identified; therefore, a biliary stent was placed for drainage and infection control, with planned subsequent lithotripsy. This case highlights that the EDGE technique is an effective and minimally invasive alternative for biliary access in patients with surgically altered anatomy, demonstrating high technical success and an acceptable safety profile, and enabling treatment in a single endoscopic session.</p>","PeriodicalId":35807,"journal":{"name":"Revista de gastroenterologia del Peru : organo oficial de la Sociedad de Gastroenterologia del Peru","volume":"46 2","pages":"198-202"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593636","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}