Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Parir después de los 50 años. Estudio piloto observacional","authors":"M.J. Cuerva ,&nbsp;B. Sanchez-Rico ,&nbsp;M.A. Leal ,&nbsp;L. de Castro ,&nbsp;M. de la Calle ,&nbsp;J.L. Bartha","doi":"10.1016/j.gine.2023.100925","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100925","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess whether there is a higher rate of adverse obstetric outcomes, postpartum urinary incontinence, and sexual problems among women who give birth over 50.</p></div><div><h3>Material and methods</h3><p>A single-center ambispective observational study. Rate of cesarean birth, gestational diabetes, preeclampsia, intrauterine growth restriction (IUGR), prematurity, urinary incontinence (Incontinence Questionnaire Short Form [ICIQ-SF]), and sexual dysfunction (Female Sexual Function Index [FSFI-6]) were recorded.</p></div><div><h3>Results</h3><p>Twenty-five (0.06%) of 38,510 births occurred in women over 50 during the study period. There were 16 (64%) cesarean births. Seven (28%) women had gestational diabetes. Preeclampsia was diagnosed in 3 (12%) women. There were 5 (20%) cases of IUGR. There were 5 (20%) preterm births. The differences in the rate of cesarean birth, gestational diabetes, and IUGR between the study group and the total population were statistically significant. The results of the ICIQ-SF and FSFI-6 questionnaires were obtained from 17 women. Some degree of urinary incontinence was found in 7 (41.1%) and sexual dysfunction in 9 (52.9%) women.</p></div><div><h3>Conclusions</h3><p>Pregnancies in women over 50 may be associated with a higher rate of gestational diabetes, IUGR, and preeclampsia. There is a high prevalence of urinary incontinence and sexual problems among these women.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100925"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471477","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":"Evaluation of the incorporation of an IOTA-ADNEX model in the discrimination of adnexal masses in our third-level hospital centre, taking into account the menopausal status of patients. Five years of experience","authors":"N. Elsner Hernández ,&nbsp;J.F. De Luis Escudero ,&nbsp;L.I. Pérez Méndez ,&nbsp;D.R. Báez Quintana ,&nbsp;E. Bruno Santana ,&nbsp;J.A. Pérez Álvarez ,&nbsp;N.R. Sierra Medina ,&nbsp;C. Chulilla Pérez ,&nbsp;A. Quesada López-Fe","doi":"10.1016/j.gine.2023.100910","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100910","url":null,"abstract":"<div><h3>Objective</h3><p>The objectives were to estimate the performance of the IOTA-ADNEX model test after its incorporation into the ultrasound tests of our third-grade hospital gynecology service, as well as to assess whether its capacity of accuracy is modified when taking into account the patient's menopausal status.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted to clinically evaluate the diagnostic performance of the IOTA-ADNEX model test, which was performed between January 2016 and December 2021. The study included 573 women with an adnexal injury who underwent surgical excision within 180 days after ultrasound diagnosis and histological confirmation (gold standard). After the ultrasound exam, the injuries were classified using the ADNEX model. The study estimated the area under the receiver-operating-characteristics curve (AUC) of the ADNEX model for classifying between benign and malignant adnexal masses and compared the performance by menopausal state. Sensitivity and specificity were determined for different cut-off points.</p></div><div><h3>Results</h3><p>Out of the 573 women, 183 (31.9%) had a malignant tumor. The AUC of the ADNEX model for differentiating between benign and malignant adnexal masses at the time of ultrasound examination was 0.92 and the best malignancy threshold, detected by Youden index, was 22.5%. At this cut-off, the sensitivity of the ADNEX model was 91.8% and the specificity was 76.4%. However, it varies according to menopausal status: in the group of pre-menopausal patient, sensitivity was 86.1% (95% CI, 85.4%–86.8%) and specificity was 81.3% (95% CI, 85.4%–86.8%). In the postmenopausal group, sensitivity was 96.1% (95% CI, 95.6%–96.7%) and specificity was 68.5% (95% CI, 68.1%–68.8%).</p></div><div><h3>Conclusions</h3><p>The IOTA-ADNEX model is a reliable diagnostic tool to discard ovarian cancer. However, the accuracy of the test, at the same cut-off point, varies according to the menopausal state of the patient so it may be important to take it into account when taking decisions in clinical practice.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100910"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49851022","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":"Secuencia anemia-policitemia en la gestación monocorial. Manejo prenatal y resultados perinatales","authors":"M.J. Cabrero Gañán,&nbsp;M. Turiel Miranda,&nbsp;I. Duyos Mateo,&nbsp;B. Herrero Ruiz,&nbsp;J.L. Bartha Rasero,&nbsp;E. Antolín Alvarado","doi":"10.1016/j.gine.2023.100913","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100913","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this paper is to describe and analyze the perinatal outcomes of a series of TAPS cases followed and treated in a Fetal Medicine referral center, in terms of the type of TAPS and the prenatal behavior applied.</p></div><div><h3>Methods</h3><p>Descriptive and inferential statistical analysis with IBM SPSS Statistics software.</p></div><div><h3>Results</h3><p>Thirteen cases of TAPS were diagnosed in a total of 510 monocorial gestations. Most of the spontaneous TAPS were diagnosed at early stages (5 cases), whereas, in post-laser TAPS, 3/6 cases were diagnosed at advanced stages.</p><p>Four fetuses (4/26; 15.4%) presented alterations in neurosonography, 3 (3/14; 21.4%) in spontaneous TAPS and one (1/12, 8.3%) in post-laser TAPS <em>(P</em>=0.308).</p><p>Myocardial hypertrophy was detected in 7 fetuses, 5 (71.4%) of which corresponded to advanced stage TAPS. Four were spontaneous TAPS (4/14; 28.6%) and 3 were post-laser TAPS (3/12; 25%) <em>(P</em>=0.797).</p><p>Eight cases (8/13; 62.5%) required some fetal therapy procedure.</p><p>There were 3 antepartum fetal deaths and one couple decided to legally terminate the pregnancy (19.23%). All 5 losses were stage IV <em>(P</em>=0.008).</p><p>Overall survival was 80.8% (21/26 live newborns). There were no significant differences according to the type of TAPS <em>(P=</em> 0.159) and the prenatal behavior adopted <em>(P=</em>0.746).</p></div><div><h3>Conclusions</h3><p>Spontaneous TAPS is therefore a clinical entity with an impact on perinatal outcomes similar to post-laser. It seems that expectant management and laser achieve higher gestational age at birth.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100913"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49851025","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":"Histerectomía laparoscópica en patología benigna en un hospital universitario terciario. Análisis y evolución de un periodo de 8 años","authors":"J. Álvarez-Sala Torreano,&nbsp;J.Á. López López,&nbsp;I. Lete Lasa","doi":"10.1016/j.gine.2023.100914","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100914","url":null,"abstract":"<div><h3>Objective</h3><p>To reflect from the analysis of the data of the number of laparoscopic hysterectomies that each member of a gynaecology service of a tertiary hospital can perform on the convenience of limiting this procedure to a limited number of professionals.</p></div><div><h3>Material and methods</h3><p>Retrospective, descriptive study on hysterectomies performed for any indication in our hospital in the period between May 1, 2014 and April 30, 2022.</p></div><div><h3>Results</h3><p>In this period, we have performed 1548 hysterectomies of which 760 were performed laparoscopically and of these, 289 were indicated for benign pathology. Considering the total number of professionals that make up the pool of surgeons who perform surgery for benign pathology, the average number of laparoscopic hysterectomies per surgeon per year would be 1.4 cases.</p></div><div><h3>Conclusions</h3><p>To ensure adequate quality of surgery, the number of professionals performing laparoscopic hysterectomies in a tertiary hospital should be limited.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100914"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91729554","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":"Cáncer de mama metaplásico: a propósito de un caso","authors":"N. Camejo ,&nbsp;F. Nantes ,&nbsp;C. Castillo ,&nbsp;D. Centurion ,&nbsp;G. Krygier","doi":"10.1016/j.gine.2023.100926","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100926","url":null,"abstract":"<div><h3>Introduction</h3><p>Metaplastic breast carcinoma (MBC) is a rare and aggressive type of breast cancer that is often diagnosed in advanced stages, with large tumors and a high histological grade. In this study, we present a case of MBC, and conduct a review and discussion of the related literature.</p></div><div><h3>Main symptoms or clinical findings</h3><p>A 35-year-old patient with no relevant personal or family history presents with a progressively growing 2 cm breast mass, which, over time, develops into nipple retraction and breast pain. A breast ultrasound reveals a suspicious-looking polilobulated solid mass. In summary: a BI-RADS 5 mass in the left breast.</p></div><div><h3>Main diagnoses, therapeutic interventions, and outcomes</h3><p>A core biopsy is performed, and the pathology report reveals an infiltrating ductal carcinoma, metaplastic variety, triple-negative with PDL1 expression &gt; 1%. A modified radical mastectomy is performed. During follow-up, pulmonary metastasis is diagnosed, and the patient receives first and second-line systemic treatment.</p></div><div><h3>Conclusions</h3><p>Given the aggressive nature of this type of tumor and the limited treatment options available, participation in clinical trials may be considered to improve outcomes in these patients. A multidisciplinary approach, and review in a tumor committee are essential to guide therapeutic decisions and provide the best possible care for these patients.</p><p>.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100926"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138550066","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":"Actualización del abordaje de la endometriosis","authors":"F. Carmona ,&nbsp;I. Lete ,&nbsp;C. Ros","doi":"10.1016/j.gine.2023.100924","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100924","url":null,"abstract":"<div><p>The growing commitment to gynecological health has highlighted the need to update the approach to endometriosis. Therefore, a comprehensive review of the scientific literature has been carried out to gather the latest relevant advances in its healthcare. In this regard, a gynecology congress was held on September 30 and October 1, bringing together various experts to review clinical, pharmacological, and cutting-edge aspects.</p><p>The review emphasizes the direct, indirect, and soft markers that determine the presence of endometriosis during examination, as well as the appropriate guidelines for diagnosis through imaging tests. Furthermore, it discusses the importance of conducting a complete and detailed diagnosis in patients exhibiting symptoms of the disease.</p><p>Additionally, it highlights advancements in the treatment of this condition, with a particular emphasis on the benefits of N-acetyl cysteine. Finally, it explores the role of surgery, emphasizing its advantages but pointing out that endometriosis should not always be associated with surgery since it can entail numerous complications.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100924"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92136184","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":"Atypical umbilical endometriosis: Microscopic and immunohistochemical characterization","authors":"M.P. Marín Sánchez ,&nbsp;I. Ñiguez Sevilla ,&nbsp;S. Cánovas Sanchis","doi":"10.1016/j.gine.2023.100927","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100927","url":null,"abstract":"<div><h3>Introduction</h3><p>Atypical endometriosis is considered a precursor lesion to cancer associated with endometriosis. Two types of atypical endometriosis have been proposed: an architectural type with a higher risk of malignancy and a cytological type with a lower potential for malignancy.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>A 37-year-old Caucasian woman presented with umbilical bleeding coinciding with menstruation. On physical examination, two small, bluish lesions were observed in the umbilical scar.</p></div><div><h3>Primary diagnosis</h3><p>This clinical case is of interest because it describes a lesion of atypical architectural endometriosis located in the navel.</p></div><div><h3>Therapeutic interventions and results</h3><p>The microscopic and immunohistochemical characteristics of the lesion were examined. The presence of nuclear stratification, hyperchromatism, and pleomorphism were observed as microscopic qualities. In terms of the immunohistochemical panel, the degree of cell proliferation was analyzed using Ki 67, BAF250a was used as the surrogate marker of ARID 1A, inflammation was assessed through COX, and estrogen and progesterone receptors were examined. The results showed increased cellular activity, the presence of inflammation, and no mutation of the ARID1a gene, with moderate cell proliferation.</p></div><div><h3>Conclusion</h3><p>Umbilical endometriosis is rare, and while malignancy is infrequent, it is possible. For this reason, a complete anatomopathological study including an immunohistochemical panel should be performed to diagnose atypical endometriosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100927"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471479","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":"Filtro de vena cava inferior ante diagnóstico de trombosis venosa profunda en gestante en trabajo de parto. A propósito de un caso clínico","authors":"M. del Mar Rubio Arroyo ,&nbsp;M. Crespo Criado ,&nbsp;J.A. Del Pozo Jiménez","doi":"10.1016/j.gine.2023.100909","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100909","url":null,"abstract":"<div><h3>Introduction</h3><p>Pregnancy represents a procoagulant state that increases women's risk of thrombotic phenomena. As in the non-pregnant population, we must diagnose and treat these events as early as possible to avoid the migration of the thrombus to other locations. Anticoagulation is the first-line therapeutic measure. However, certain situations of increased bleeding such as labor may be a contraindication to initiate such anticoagulation. The following article develops a clinical case in which the deep vein thrombosis diagnosis occurred at the onset of labor.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>Increase in diameter of the left lower limb, with redness of the same and increase in local temperature. The patient described pain at the level of this limb for 15 days. He had no dyspnea and oxygen saturation was 100%.</p></div><div><h3>Main diagnoses</h3><p>Deep vein thrombosis, labor.</p></div><div><h3>Therapeutic interventions</h3><p>The contraindication of anticoagulation and the need for immediate treatment raised the inferior vena cava filter as the most reasonable option.</p></div><div><h3>Results</h3><p>After the placement of the filter, the delivery proceeded without incident. The plunger did not migrate and the filter was removed 29 days after delivery without complications.</p></div><div><h3>Conclusion</h3><p>Despite our limited clinical experience in the management of these cases, we can affirm that the inferior vena cava filter represents a reasonable and safe option in cases of thrombosis of the lower limbs in women in labor.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100909"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49851023","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":"Actualización del tratamiento de fisioterapia en el abordaje de la endometriosis. Una revisión sistemática","authors":"A. Cabanas-Barja,&nbsp;A. Alonso-Calvete,&nbsp;I. Da Cuña-Carrera","doi":"10.1016/j.gine.2023.100929","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100929","url":null,"abstract":"<div><p>Endometriosis is a chronic, inflammatory gynecological pathology characterized by the presence of endometrial tissue outside the uterus. Clinical manifestations include chronic pelvic pain, fatigue, dysmenorrhea, dyspareunia, infertility, dysuria and dyschezia. Physical therapy can be part of the symptomatic treatment of endometriosis; therefore, this review aims to analyze the scientific literature to evaluate the effect of physical therapy in endometriosis. A bibliographic search was carried out during the first two weeks of December 2022 in the databases PubMed, Medline, Scopus, Web of Science, PEDro, CINAHL and ENFISPO. The descriptors “Endometriosis” “Physical Therapy Modalities”, “Physiotherapy”, “Physiotherapist”, “Physical therapy” and “Physical rehabilitation” were used. Results were limited to randomized clinical studies published in English or Spanish. A total of 943 results were obtained, of which 6 were selected after applying the eligibility criteria. The selected studies develop different physiotherapy interventions with techniques such as electrotherapy with TENS and high intensity pulsed laser, progressive muscle relaxation training, aerobic training, manual therapy, and therapeutic exercise through yoga. Physiotherapy appears to provide benefits in terms of reducing pelvic pain and improving quality of life in women with endometriosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100929"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839837","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":"Análisis de la inmunidad de las mujeres infectadas por el virus del papiloma humano y su relación con la lesión intraepitelial cervical","authors":"J. Cantero Piñeiro,&nbsp;E. Ruipérez Pacheco,&nbsp;P. Coronado Martín,&nbsp;S. Sánchez Ramón,&nbsp;L. Fernández Paredes","doi":"10.1016/j.gine.2023.100928","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100928","url":null,"abstract":"<div><h3>Introduction</h3><p>The main objective is to study the NK markers present in circulating blood in patients with high grade intraepithelial cervical lesions compared with women without lesions or low grade lesions. The secondary objectives of the study are to understand the relationship between the NK memory like cells and the infection with HPV, as well as the persistence of the infection.</p></div><div><h3>Methods and materials</h3><p>It is an observational prospective study that studies women from 2019 for 2<!--> <!-->years seen in ginecology rooms in Hospital Clínico San Carlos. The group of patients studied are: women with infection by HPV and high grade lesions, women with infection by HPV but no lesion or low grade lesion and women without lesion or infection.</p></div><div><h3>Results</h3><p>We have recruited 115 patients. We have found more memory like NK cells in patients infected by HPV. And when we analyze the non-smoking patients, the expression of NKp30 is lower in patients infected without lesion.</p></div><div><h3>Conclusions</h3><p>The results show that there could be less capacity to generate an adaptative function by NK in smoking patients than in non-smoking. A better knowledge of the NK cells biology and its role in the infection by HPV could allow us to manipulate with a therapeutic and prognostic end.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 1","pages":"Article 100928"},"PeriodicalIF":0.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138471478","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}