Egyptian Journal of Ear, Nose, Throat and Allied Sciences最新文献

{"title":"Correlation Between Preoperative Adenoid Grading and Intraoperative Findings","authors":"Ali Abd-Alrahman, A. Hassan, Ahmed Samnody","doi":"10.21608/ejentas.2022.113064.1453","DOIUrl":"https://doi.org/10.21608/ejentas.2022.113064.1453","url":null,"abstract":"Introduction: Adenoid hypertrophy is one of the most common causes of nasal obstruction especially in children. Adenoid size could be different comparing preoperative radiological size with the intraoperative findings. Aim and objectives: The purpose of this prospective study was to evaluate and compare between preoperative radiologic grading techniques and intraoperative endoscopic findings. Patients and Methods: 60 patients with symptomatic adenoid hypertrophy such as; nasal obstruction, snoring, mouth breathing and bilateral recurrent otitis media with effusion were randomly included in this study. All patients had adenoidectomy and was diagnosed by x-ray nasopharynx and flexible nasopharyngoscopy. Patients were scheduled for follow-up visit after one week and one month for clinical assessment of any remnant. Results: The mean age of these patients is 8.1 with female predominance (60%). There is correlation detected between the preoperative Xray grading of adenoid tissue and the endoscopic view done by the flexible nasopharyngoscopy. This could be occurred due to cases with mild or moderate sized adenoid tissues appeared larger sized adenoid hypertrophy. This could be explained that the endoscopy has magnification power that show larger size of detected adenoid mass. Conclusion: Adenoid enlargement especially in children is one of most common causes of nasal blockade. Preoperative lateral airway radiograph and intraoperative flexible endoscopic nasopharyngoscopy showed significant correlation in detecting adenoid size.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80506050","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":"Auditory Brainstem Response in Children with Autism Spectrum Disorder: A Case-Control Study","authors":"A. Othman, M. Khaled, A. Gelaney","doi":"10.21608/ejentas.2022.83489.1389","DOIUrl":"https://doi.org/10.21608/ejentas.2022.83489.1389","url":null,"abstract":"Background: Autism spectrum disorder (ASD) is a group of disorders characterized by abnormal social behavior, poor communication, repetitive behaviors and atypical response to sensory information, poor auditory brainstem function in ASD could be correlated to language impairment in (ASD). Aim: The present study aimed to investigate the abnormalities in auditory brain stem response to speech stimuli among ASD children. Patients and Methods: This case-control study was carried out from January 2019 to December 2019. The study included 21 children with autism and 30 children in a normal control group, the mean age of patients and control was comparable, respectively (4.16 ± 1.09, 4.85 ± 1.42) with males predominate in both groups. We used DSM-V-TR criteria, StanfordBinet intelligence scale V and childhood autism rating scale (CARS) for assessments. All children were assessed in the audiology unit as follows, basic audiological evaluation, tympanometry, Click evoked Auditory Brainstem Response to confirm the presence of wave V and Speech Evoked Auditory Brainstem Response (S-ABR). Data were analyzed by IBM SPSS version 20.0, using Chi-Square, Fisher's Exact Test, and the Mann-Whitney U Test. Results: ABR latency of wave V (6.36 ± 0.29) and wave A (7.41 ± 0.29 ) were detected in the patients' group, in comparison to the control group, with a significant delay (p<0.001). ABR latency of wave D in patients with mild to moderate autism was delayed in comparison to patients with severe autism with a significant difference (p= 0.03) ABR latency of wave V, A, C, and O, in patients with severe autism, was delayed in comparison to patients with mild to moderate autism with no significant difference respectively, (p=0.85, p=0.624, P=0.94, p=0.652). ABR latency of wave E and F, in patients with mild to moderate autism, was delayed in comparison to patients with severe autism with no significant difference respectively (p=0.143, p=0.066). Conclusion: (S-ABR) is very promising in the evaluation of children with (ASD) as regards the deficit in cognitive processing, attention, auditory discrimination.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77289785","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":"Inferior Turbinate Hypertrophy Histopathology in Allergic Rhinitis Patients and in Patients with Deviated Nasal Septum","authors":"mohamed El awady, Mohamed Ali","doi":"10.21608/ejentas.2022.141170.1518","DOIUrl":"https://doi.org/10.21608/ejentas.2022.141170.1518","url":null,"abstract":"Background: A common issue in otorhinolaryngology is nasal obstruction based on by inferior turbinate hypertrophy (ITH). Objective: In order for the surgeon to choose the most appropriate surgical procedure, it is important to distinguish between compensatory ITH caused by DNS and ITH caused by allergic rhinitis. Patients and Methods: There were 60 patients in this study, and their ages ranged from 18 to 50. (28 male & 32 female ). Their history, endoscopic examination, and CT scans of their Para nasal sinuses all indicated that they had ITH. There were two groups of patients. Group A: This group, which consisted of 30 patients with compensated ITH brought on by DNS, underwent a skin prick test to weed out any allergic patients. Group B was composed of 30 patients who had bilateral ITH brought on by allergic rhinitis. Under general anesthesia, all patients underwent endoscopic partial inferior turbinectomy with or without septoplasty, being careful to remove all three layers of the turbinate. The Department of Pathology handled the turbinate specimens according to protocol, and slides were made and analyzed histopathologically and microscopically. Results: The bony layer's mean thickness of ITH cases in group A was 6.50 ±1.75mm, whilst its thickness in group B was 2.25 ± 1.25 mm with statistical significant P value =0.001. Conclusion: The bone layer leads to the majority of the compensatory ITH thickness caused by DNS, hence it should be the focus of surgery using the right surgical method.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76679846","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":"Is Deficiency of 25-Hydroxy Vitamin D A Risk Factor for Autism? A Preliminary Study","authors":"Megahed M. Hassan, A. Emam, A. Radwan, Amany Abdelhameed, S. Eldin, Montasser M Mohamed","doi":"10.21608/EJENTAS.2021.44200.1264","DOIUrl":"https://doi.org/10.21608/EJENTAS.2021.44200.1264","url":null,"abstract":"Objective: To investigate the status of 25-hydroxy-vitamin-D [25-(OH)-D] in autistic children and to correlate with their mothers vitamin statuses and autism severity.Methods: In this case-control study, serum 25(OH)-D was measured in autistic children and controls (n=36 each) and in mothers of autistics and control mothers (n=24 each). Comparison and correlation studies were performed.Results: Both autistic children and their mothers have lower 25-(OH)-D compared to their controls with significant differences (P<0.001 for children and P=0.025 for mothers). Vitamin statuses in both autistic children and their mothers showed moderate to strong positive correlation (P<0.001). Moreover, the 25-OH-D showed inverse correlation with the autism severity (P=0.0026).Conclusion: Deficiency of 25(OH)-D is common in autistic children and related to the severity of symptoms. Vitamin D deficiency in children might be maternal-dependent. Deficiency of 25(OH)-D in autistic children and their mothers could be the primary predisposing factor for autism. This may find a common link among the genetic, immunological, anatomical, biochemical and physiological factors putting the puzzles together. Early supplementation of vitamin D could improve autistic manifestations.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86170941","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":"Vocal folds nodules among Egyptian children and adolescents: Behavior aspects","authors":"N. Mahmoud, Ahmad Ezzat, A. M. M. Lotfy, H. Mohammed","doi":"10.21608/ejentas.2020.50574.1283","DOIUrl":"https://doi.org/10.21608/ejentas.2020.50574.1283","url":null,"abstract":"Objective: This study aimed to verify the relationships between voice, and behavior in children and adolescents with and without dysphonia based on parents’ reports and perceptual voice analysis by Phoniatricans.Study Design: This is a case control study.Patients and Methods: The study involved 51 of dysphonic school-age children and adolescents and 62 vocally normal controls aged from 6-18 years. Participants were assessed with auditory perceptual voice analysis, clinical laryngoscopic examination (CLE). Parents of all participants completed the Child Behavior Checklist for ages 6–18 years (CBCL)..Results: Children and adolescents with dysphonia scored higher on Internalizing, Externalizing, Anxiety/depression, Withdrawal/depression, Somatic complaints, Social problems, Attention problems, Rule-breaking, and Aggressive behavior. Children and adolescents with vocal problem scored lower on Activities, Social, School, and thought problems. Correlation analysis between dysphonia severity and CBCL scores demonstrated significant positive correlation in the following scales (Internalizing scale r=0.549; P=0.001, externalizing scale (r=0.370; P= 0.001 and total Behavior scales (r= 0.581; P=0.00), school scale score (r= 0.288; P=0.002), and total Competence indicators (r= 0.230; P= 0.014), withdrawal/depression, social problems, rule-breaking, and aggressive behavior .Conclusion: Vocal fold nodules may be a risk for behavior problems due to the higher scores on behavior problems scales in children and adolescents, especially internalization and externalization aspects and significant positive correlation found between dysphonia severity and CBCL scores. Early interventions of these problems are needed to prevent the persistence of such problems, and reduce its negative impact.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73632337","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":"Total thyroidectomy: Conventional suture ligation technique versus sutureless techniques, Sohag experince","authors":"Islam A. Amer, A. Saleem, Osama Abd Elraheem","doi":"10.21608/ejentas.2020.48292.1275","DOIUrl":"https://doi.org/10.21608/ejentas.2020.48292.1275","url":null,"abstract":"ABSTRACT Background: The thyroid gland is one of the highly vascular tissues in the body. Hemostasis is one of the important and essential components of the procedure. Nowadays with the widespread use of energy instruments like ultrasonic coagulation (Harmonic Scalpel, Ethicon) and bipolar control (LigaSure, Valleylab) or cutting and hemostasis which integrates new approaches to vessel ligation and division without increase the postoperative complications. In a prospective comparative analysis of open complete thyroidectomy, this work aimed to examine the effect of modern suture ligation procedures using the Harmonic ® process in comparison with conventional suture ligation. Patients and Methods: This was a prospective comparative analysis at Maxillofacial, Head, and Neck Surgery Unite in the General Surgery Department, Faculty of Medicine, Sohag University in Sohag, Egypt. The patients were divided into two groups; the first group included patients operated with the Harmonic ® Focus or Sutureless Thyroidectomy (S technique), and the second group included patients receiving traditional thyroidectomy (C group). Results: Between September 2016 and September 2019 92 patients with thyroid disorder were registered for this research. Fifty patients (54.3 percent) had complete sutureless thyroidectomy and 42 patients (45.6 percent) had conventional complete thyroidectomy, mean sutureless thyroidectomy age was (42.53) years, and typical group age was (45.74) years. Duration of operation: blood loss Intraoperative and postoperative, drain, transient hypocalcemia, general postoperative complications, and hospital stay were considerably lower in the Sutureless Thyroidectomy group. No significant difference between the two groups concerning the laryngeal nerve's recurring function. Conclusion: Sutureless thyroidectomy is the recommended treatment for treating most thyroid disorders, because it has had reduced operation time, reduced clinical complications incidence, and successful operating outcomes. Harmonic Concentration (HF) is a safe, reliable, and time-saving strategy.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76139803","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":"Office-Based Steroid Injection in Benign Vocal Fold Lesions","authors":"M. Baraka, Essam A. Behairy, Hossam El Desouky, Shaimaa F. Mostafa, E. Ezzat","doi":"10.21608/ejentas.2021.86930.1396","DOIUrl":"https://doi.org/10.21608/ejentas.2021.86930.1396","url":null,"abstract":"Background: Benign vocal fold lesions (BVFLs) are usually caused by vocal abuse or misuse. Conservative treatment and micro laryngeal surgery (MLS) are recommended in the treatment. However, conservative measures are usually difficult to perform and some patients are contraindicated for general anesthesia. Objective: This study is designed to assess the practical application, effectiveness, and side effects of office-based steriod injection via a transnasal route. Patients and Methods: This study included 29 patients with BVFLs. Transnasal endoscopic steroid injection (TESI) was performed via operating channel for all patients. Local anesthesia was used to inject betamethasone into Reinke's space at the base of the lesion. Acoustic analysis, including fundamental frequency (F0), jitter, shimmer, noise to a harmonic ratio (NHR), aerodynamic analysis (MPT), auditory perceptual assessment using modified GRBAS scale, videolaryngostroboscopy (VLS) evaluations, and voice handicap index (VHI), was done before and three months after TESI. Results: Three months after injection, the VLS demonstrated that remission in size or lesions improvement was observed in 20 patients, total disappearance in 4 patients, and no improvement in 5 patients. The summation of the modified GRBAS scale also indicated highly significant improvement after TESI (P < 0.01). MPT showed a highly significant increase post-injection. VHI showed a highly significant reduction post-injection. Acoustic analysis revealed significant improvements in F0, jitter, shimmer, and NHR (P <0.05). Conclusion: : Office-based TESI is an effective, safe, easy, and feasible alternative treatment method in some BVFLs.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86405773","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":"Service Implementation by Phoniatricians during a Pandemic Emergency: A Questionnaire-based Survey","authors":"R. Ibrahim, T. Abou-Elsaad","doi":"10.21608/ejentas.2021.82004.1384","DOIUrl":"https://doi.org/10.21608/ejentas.2021.82004.1384","url":null,"abstract":"Objective: Providing a risk-assessment framework that guides Phoniatric clinical services delivery and also identify patients for whom these services should be prioritized during pandemics. Design: Cross-sectional study. Settings: A questionnaire-based survey was designed and directed to the phoniatricians based on their professional experience, work environment, and institutional resources. It was distributed online through various Phoniatric societies during the first wave of the COVID-19 pandemic. The questionnaire included grading of Phoniatric clinical services, methods of service delivery, triaging of patients/complaints according to morbidity, and demographic characteristics. Main outcome measures: Recognition of the high acuity Phoniatric clinical services that should be delivered during pandemics as well as triaging the patient/complaint according to morbidity. Results: The majority of Phoniatric clinical services are considered low acuity services except for the voice and swallowing disorders diagnostics. High acuity services include newborn hearing screening and rehabilitative services of swallowing disorders. Conclusion: Most phoniatric services can be safely postponed during pandemics except for voice and swallowing disorders diagnostics and treatments. Consideration of tele-practice during pandemics. © 2021, Egyptian Society of Ear Nose Throat and Allied Sciences. All rights reserved.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"368 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82736080","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":"Vineland Adaptive Behavior Scales to Identify Neurodevelopmental Outcomes in Children with Congenital Hypothyroidism","authors":"H. Nazif, H. Kamal, Dina M. Khaled, Samer Elkhayat, A. Ramzy","doi":"10.21608/ejentas.2021.66743.1327","DOIUrl":"https://doi.org/10.21608/ejentas.2021.66743.1327","url":null,"abstract":"Background: Congenital hypothyroidism (CH) is the most common preventable causes of mental retardation in children. Screening and early treatment an important prognostic factors for normal neurodevelopment in children with CH. The Vineland Adaptive Behavior Scales Second Edition (VABS-II) is a parent report measure of adaptive functioning that could be used as a developmental screening tool in patients with CH. We have investigated the performance of VABS-II as a screening tool to identify developmental delay in children with CH. VABS-II questionnaires testing communication, daily living skills, social skills, motor skills and behaviour domains were completed by parents of 50 children with CH initially at time of diagnosis and follow up after six month with age distribution 3rd day of life 12 months (CH, n = 35) and 1324 months (CH, n = 15). Both had positive results of screening program and positive values for thyroid function tests. Objective: The aim of this study to assess and follow up neurodevelopmental abilities in children with congenital hypothyroidism using Vineland Adaptive Behavior Scales-Second Edition (Vineland-II). Patients and Methods: We conducted a prospective study at Benha Children Hospital, Egypt. The study participants were 50 infants with CH and their mothers (patients group), and 50 age matched volunteers of healthy infants (control group). Data were collected to determine socioeconomic state, clinical picture at presentation, personal, family, obstetric history and assessment of neurodevelopment by using Vineland-II scale. Results: About 64% of cases were permanent CH and about 14% of cases were transient CH. There was significant positive correlation between compliance score and the parameters of the physical and neurological development. Conclusion: Our study adds further evidence to normalize TSH as soon as possible to avoid long-term neurodevelopmental outcomes.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87424006","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":"Assessment of Sensitivity and Specificity of Nasopharyngeal and Throat Swabs in Detection of COVID-19 Infection Among Admitted Patients: A Scientific Perspective","authors":"A. Elmalky, A. Ahmed, H. Albalawi, Abdulmajeed Al Husain, A. Alshammari, Khalid Alqarni, Marwa Albalawi","doi":"10.21608/ejentas.2021.50673.1285","DOIUrl":"https://doi.org/10.21608/ejentas.2021.50673.1285","url":null,"abstract":"Background: Early and accurate detection of respiratory viruses (RV) is important for patient management. We have previously shown that self-collected nasal swabs (NS) are feasible and as sensitive as clinician-collected nasal washes for detection of RV, but the additive benefit of self-collected throat swabs is unknown. Objectives: To test the rise in auto sufficient nasal yields to the throat swabs in patients with upper respiratory (URTI) symptoms for PCR identification of RV. Study Design: Patients with URTI symptoms self-collected paired polyurethane foam NS and nylon flocked throat swabs and completed a symptom survey. Swabs were tested for 12 RV by real-time reverse transcription (RT)-PCR. Descriptive, McNemar's, and Wilcoxon signed rank statistical tests were used. Results: The sample was made up of 115 paired swab nasals and throat, with at least 1 specimen being positive for RV (71/115 (62 percent), including 51 positive for both specimens, 17 positive for NS only and 3 favorable for RV only with throat swab. NS was 96 percent sensitive (95 percent CI: 88-99) compared with 76 per cent in throat swabs, p<0.001 (95 percent CI: 65-85). The median PCR period threshold (Ct) of 51 concordant samples was lower in NS (25.1) than in swabs of the throat (32.0). Conclusion: Self-collection of NS was significantly more sensitive than self-collection of throat swabs for detection of RV by RT-PCR. The addition of throat sampling does not appear to increase the diagnostic load in the self-testing setting. © 2018, EBX. All rights reserved.","PeriodicalId":37983,"journal":{"name":"Egyptian Journal of Ear, Nose, Throat and Allied Sciences","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91244343","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}