Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Endometriosis: «Nivel de conocimiento y expectativas de formación específica entre profesionales especialistas en medicina de familia y comunitaria y matronas en atención primaria en la isla de Gran Canaria»","authors":"V. Sánchez Sánchez ,&nbsp;J.L. Alonso Bilbao ,&nbsp;A. Santana Suárez ,&nbsp;A. de Arriba Fernández ,&nbsp;L. Ocón Padrón ,&nbsp;A.B. Alvarez Medina ,&nbsp;A. Martín Martínez","doi":"10.1016/j.gine.2023.100901","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100901","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the level of knowledge of endometriosis in primary care doctors and midwives and to identify their training needs in this area.</p></div><div><h3>Design</h3><p>Descriptive study conducted in the primary care services of the Health Area of Gran Canaria, through an anonymous online questionnaire.</p></div><div><h3>Results</h3><p>One hundred and nineteen doctors and 37 midwives completed the questionnaire; 54.6% of doctors and 67.6% of midwives considered that their knowledge about endometriosis was poor. Less than 50% of healthcare professionals knew the National System of Health's guidelines for the management of women with endometriosis. Symptoms most frequently associated to endometriosis included: moderate/severe dysmenorrhea, chronic pelvic pain and sterility. Less frequently related ones included: digestive symptoms and catamenial urinary disorders; 80% of doctors suspected endometriosis in &lt;10 women per year; 75% of midwives suspected this condition in &lt;20 women per year; 40% of doctors would prescribe oral contraceptives to patients with dysmenorrhea who were not planning pregnancy; 8% of doctors considered that menstruation-associated pain was common. Medical therapy was the most frequently chosen first-line treatment; 25% of doctors would choose long-term NSAIDs therapy as a first-line treatment; less than 25% of them would refer a patient to the Gynecology service only for suspected endometriosis. Most health professionals expressed their interest in improving their knowledge about endometriosis; 94.6% of midwives considered that they played a strategic role in the identification and management of patients with endometriosis.</p></div><div><h3>Conclusion</h3><p>Delays in the diagnosis of endometriosis are partially due to ignorance of the disease. Primary care professionals constitute the first line of health care. In this context, it is essential to develop specific training strategies, which would be welcome by health professionals.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100901"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823593","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 tasa de cesáreas en el Hospital Universitario Materno-Infantil La Paz de Madrid (2010-2018) a través de la clasificación de Robson","authors":"L. López-Mendizábal ,&nbsp;J.L. Bartha ,&nbsp;A. Ruiz de León ,&nbsp;C. Varea","doi":"10.1016/j.gine.2023.100904","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100904","url":null,"abstract":"<div><h3>Introduction</h3><p>The need to rationalise and optimise the use of caesarean sections is an international public health challenge. To this end, the WHO recommends the use of the Robson classification, which allows comparison of caesarean section rates according to the maternal-fetal profile. The aim of this study is to evaluate the rate of caesarean section in the Hospital Universitario Materno-Infantil La Paz in Madrid between 2010 and 2018 using the Robson classification.</p></div><div><h3>Material and methods</h3><p>The population analysed corresponds to data from the 41,037 deliveries registered in the Obstetrics programme of the Hospital Universitario Materno-Infantil La Paz of Madrid from 2010 to 2018. Using SPSS software, the temporal change in (a) the percentage of deliveries (vaginal and caesarean) with respect to total births, (b) the caesarean rate with respect to vaginal deliveries and (c) the relative contribution to the overall caesarean rate is evaluated.</p></div><div><h3>Results</h3><p>The highest partial contributions to the overall caesarean section rate were made by nulliparous women with induced labour, previous caesarean section, nulliparous women with spontaneous labour and multiple gestations. The group of nulliparous with induced labour was the only one with a significant increase in its contribution to the overall caesarean section rate (30.4% in 2018).</p></div><div><h3>Conclusions</h3><p>The results of this work indicate that the challenge in public health is to further assess the relationship between induction of labour and risk of intrapartum caesarean section, particularly in nulliparous women, the group with the highest and significantly increasing relative caesarean section rate.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100904"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823595","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":"Evaluación del impacto, los patrones de tratamiento y las percepciones de pacientes y clínicos de los síntomas vasomotores moderado-graves asociados a la menopausia en España","authors":"A. Cano ,&nbsp;E. González Antona Sánchez ,&nbsp;M. Scott ,&nbsp;A. Ortiz Núñez","doi":"10.1016/j.gine.2023.100882","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100882","url":null,"abstract":"<div><h3>Introduction</h3><p>Menopause generates different symptoms, among which vasomotor symptoms are especially prevalent and bothersome. The aim of this work was to determine their impact and the treatment patterns and perceptions in Spain by analyzing the opinions of physicians and patients with moderate-to-severe vasomotor symptoms (MS-VMS).</p></div><div><h3>Methods</h3><p>Descriptive cross-sectional study of the Spanish subpopulation from the Adelphi-VMS™ Disease-Specific Program. Primary Care and Gynecology and Obstetrics physicians selected the patients. These patients were invited to complete a survey and the MENQOL and WPAI:SHP questionnaires. Data are presented as percentage or mean<!--> <!-->±<!--> <!-->standard deviation.</p></div><div><h3>Results</h3><p>Overall 32 Primary Care and Gynecology and Obstetrics physicians participated in the study, enrolling 241 women, of whom 143 experienced MS-VMS. Despite the reported impact on global work (24.84%<!--> <!-->±<!--> <!-->17.49 presentism) and quality of life (3.37<!--> <!-->±<!--> <!-->1.52 MENQOL score), only 53.85% of women with MS-VMS were treated. Menopausal hormone treatment was the most prescribed (77.92%), followed by serotonin reuptake inhibitors (32.47%). Fifty-nine percent of clinicians were very or completely satisfied with hormone treatment, whereas only 19% had this level of satisfaction with selective serotonin reuptake inhibitors. Less than 38% of patients and physicians were satisfied with the control of VMS.</p></div><div><h3>Conclusions</h3><p>Menopause-associated MS-VMS have an important impact on quality of life. Increased awareness about their management and better therapeutic options would significantly contribute to improving women's health and well-being during their climacteric period.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100882"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823643","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":"Association of free testosterone, glucose level and obesity among women with polycystic ovary syndrome in Soran city, Kurdistan-Iraq","authors":"P.J. Jalil ,&nbsp;B.H. Shnawa ,&nbsp;M.H. Ahmed","doi":"10.1016/j.gine.2023.100903","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100903","url":null,"abstract":"<div><h3>Background</h3><p>Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting approximately 5–10% of women of reproductive age and it is also a major cause of anovulatory infertility. PCOS is associated with obesity and conditions like hirsutism, acne, diabetes, and irregular periods.</p></div><div><h3>Aim</h3><p>The present study aimed to evaluate the serum-free testosterone (FT) levels of women afflicted with hirsutism, one of the main physical manifestations of PCOS versus healthy women and determine whether their serum testosterone levels correlate with polycystic ovaries, glucose levels, menstrual abnormalities, and obesity.</p></div><div><h3>Methods</h3><p>This study assessed 180 women; this included 140 females who suffered from excessive and unwanted hair growth on the chin and 40 healthy women as a control group. Free testosterone levels and fasting blood glucose levels were taken. Prior to the study, ultrasonographic (US) tests were performed for all patients to diagnose polycystic ovaries.</p></div><div><h3>Results</h3><p>Patients with hirsutism exhibited a significant elevation in free testosterone (FT) compared to the control group. Approximately half of these women were confirmed to have a polycystic ovary, and 42.8% of them were overweight and obese. Additionally, women between 18 and 20 years old (G1) present with the highest level of FT.</p></div><div><h3>Conclusion</h3><p>Serum FT levels were significantly increased in hirsute women, and this positively correlated with BMI and glucose levels in women with PCOS. Glucose levels may serve as a potentially effective biomarker in evaluating the severity of hirsutism in women suspected of having PCOS.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100903"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823645","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":"A multi-centre, open-label, prospective, observational study to assess the safety of a nifedipine oral solution in the treatment of preterm labor","authors":"C. Murillo ,&nbsp;F. Migliorelli ,&nbsp;C. Nieto ,&nbsp;H. Martínez ,&nbsp;C. Rueda ,&nbsp;R. Bermejo ,&nbsp;A. Corrales ,&nbsp;M. Palacio","doi":"10.1016/j.gine.2023.100883","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100883","url":null,"abstract":"<div><h3>Objective</h3><p>To analyze the safety profile of a nifedipine oral solution in the treatment of preterm labor (PTL).</p></div><div><h3>Methods</h3><p>A multi-center, open-label, prospective, single-arm, observational study was conducted in 500 women with PTL to whom a nifedipine oral solution was prescribed according to its Summary of Product Characteristics. Safety profile and tolerability of oral administration of nifedipine solution during routine clinical practice was assessed as the primary objective of the study and treatment efficacy as secondary objective.</p></div><div><h3>Results</h3><p>No severe adverse events were reported among these women, including severe hypotension. Eight patients (2.3%) reported adverse reactions of moderate intensity, and in 0.9% of the patients (3 cases), these adverse reactions caused the discontinuation of the treatment.</p></div><div><h3>Conclusions</h3><p>The results of this study show that nifedipine oral solution exhibits an excellent safety profile used as a tocolytic treatment in women with PTL.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100883"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823609","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":"Fezolinetant: un nuevo tratamiento en estudio para la menopausia","authors":"P. Luque González ,&nbsp;J.C. Mora Palma","doi":"10.1016/j.gine.2023.100888","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100888","url":null,"abstract":"<div><p>Menopause is the physiological cessation of menstruation that can occur in women between 42 and 58 years of age with diverse symptoms. The most common clinic is vasomotor, which can greatly affect the quality of life of women. Traditionally, hormone replacement therapy has been used and is considered the most effective treatment. However, there are contraindications for which the use of non-hormonal therapy should be considered. Nowadays, these options are suboptimal in terms of effectiveness and tolerance, which is why research is being carried out on new treatments such as fezolinetant, a neurokinin 3 receptor antagonist.</p><p>To elucidate these investigations a bibliographic search has been carried out in the main databases. Although its safety and long-term effects remain to be established, fezolinetant looks promising in patients for whom hormonal therapy cannot be used. It decreases statistically significant the moderate or severe vasomotor symptoms from the first day of treatment when compared with placebo and with other non-hormonal treatments with a good tolerance profile and few side effects. However, this drug is still in phase III trials, so it needs to continue with its study.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100888"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823596","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":"Metroplastia cervical histeroscópica en útero septo completo, septo cervical y tabique vaginal. Análisis de resultados clínicos y reproductivos en serie de casos de 2011 a 2021","authors":"I. Hinojal Toscano,&nbsp;M.A. Sánchez Oliver","doi":"10.1016/j.gine.2023.100884","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100884","url":null,"abstract":"<div><h3>Background</h3><p>The septum uterus with cervical septum and vaginal septum is a rare entity only described in classifications that include complex Müllerian malformations such as the VCUAM (2005), ESHRE/ESGE (2013) and ASRM (2021) classifications. The objective of our work is to describe the results of hysteroscopic cervical metroplasty according to the Vercellini technique in our patients.</p></div><div><h3>Material and method</h3><p>This is a retrospective observational cohort study with a duration of 10<!--> <!-->years. Only patients with a diagnosis of a complete septum uterus, cervical septum, and vaginal septum with indication of cervical metroplasty according to the Vercellini technique between 2011 and 2021 were included.</p></div><div><h3>Results</h3><p>The results of five patients with indication of the technique were analyzed. Analyzing our result, we highlight a live newborn at term after performing the technique, which was followed up in the prematurity clinic without cervical modifications because of the resection of the cervical septum.</p></div><div><h3>Conclusion</h3><p>There is very little evidence available regarding the treatment of the uterus complete septum with cervical septum and vaginal septum due to its low prevalence and the heterogeneity of the diagnosis. Analyzing the results obtained, we consider the Vercellini intervention to be effective in removing the septum, which does not seem to be associated with major or minor complications. Based on the existing evidence, it could be useful to improve the reproductive prognosis of patients with this type of malformation; individualizing the need for a second hysteroscopic touch-up.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100884"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823601","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":"Decúbito prono en el tercer trimestre del embarazo durante la era COVID-19: un abordaje transdisciplinar","authors":"A. Fajardo-Campoverdi ,&nbsp;A. Rodríguez ,&nbsp;C. Chica-Meza","doi":"10.1016/j.gine.2023.100906","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100906","url":null,"abstract":"<div><p>There is very limited evidence regarding the use of prone position as part of the treatment of severe acute respiratory distress syndrome in pregnant patients. Currently, recommendations for invasive ventilatory management in this population are very scarce and are based on the extrapolation of conclusions obtained in studies of non-pregnant patients. The available literature asserts that the anatomy and physiology of the pregnant woman undergoes complex adaptive changes that must be considered during invasive ventilatory support and prone position. With prone ventilation, the benefits obtained for the couple far outweigh the eventual risks. Adequate programming of the mechanical ventilator correlates with a clear and simple concept: individualization of support. In any case, the decision on the timing of termination of pregnancy should be based on adequate multidisciplinary clinical judgment and should be supported by strict monitoring of the product.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100906"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823600","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":"Importancia del papel de Haemophilus no ducreyi en el tracto genital femenino y su relación con la clínica","authors":"M. Neukirch ,&nbsp;M. Ruiz del Pino ,&nbsp;J.M. Navarro-Marí ,&nbsp;J. Gutiérrez-Fernández ,&nbsp;A. Rosales-Castillo","doi":"10.1016/j.gine.2023.100892","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100892","url":null,"abstract":"<div><h3>Background</h3><p>The isolation of new pathogens in clinical samples from the genital tract of subjects with suspected infection, such as <em>Haemophilus</em> no <em>ducreyi</em> (HND) species, is becoming more frequent. The objective of this work is to analyze the pathogenic role and the clinical importance of the isolation of these species in female genital tract.</p></div><div><h3>Patients and methods</h3><p>We carried out an observational, descriptive, and retrospective study from a Hospital in Granada (Spain). HND isolates in female genital samples between 2016 and 2019 from specialized care were studied. Clinical, epidemiological, and microbiological variables of clinical episodes of adult women and girls were analyzed.</p></div><div><h3>Results</h3><p>Forty-five (25 women and 20 girls) isolates of HND were found, corresponding to 1%; the most frequent specie was <em>Haemophilus influenzae</em> (64.4%). In women, leukorrhea and abdominal pain was frequent and in 72% there was a polymicrobial isolate. In girls, it was frequently in isolation, with the presence of vulvovaginal erythema, pathological discharge, and local itching. We highlight the high rate of resistance of <em>Haemophilus parainfluenzae</em> to azithromycin (72.7%) and cotrimoxazole (18.2%) in adult women, in contrast to resistance to azithromycin in girls (25%).</p></div><div><h3>Conclusions</h3><p><em>H. influenzae</em> and <em>H. parainfluenzae</em> should be considered as a possible etiological agent in cases of vaginitis and cervicitis in adult women, as well as in suspected pelvic inflammatory disease. In girls, <em>H.</em> <em>influenzae</em> represents one of the microbiological agents within the etiologies of vulvovaginal infections. We highlight the rate of resistance to azithromycin in <em>H.</em> <em>parainfluenzae</em> and to cotrimoxazole in both species.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100892"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823644","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":"Linfoma difuso de células B grandes primario de cérvix. A propósito de un caso","authors":"B. Pando Ruiz ,&nbsp;I. Gonzalo García ,&nbsp;L.M. Fernández Abad","doi":"10.1016/j.gine.2023.100886","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100886","url":null,"abstract":"<div><h3>Introduction</h3><p>Primary involvement of the female genital tract by non-Hodgkin lymphoma is very rare, so there is no consensus on treatment, and for this reason we present this clinical case and the treatment performed, as well as the prognosis of our patient.</p></div><div><h3>Clinical findings</h3><p>The patient presented is a 72-year-old woman who consulted for vaginal bleeding.</p></div><div><h3>Diagnosis</h3><p>Primary extranodal non-Hodgkin lymphoma of the cervix with immunophenotype<!--> <!-->B of high cytological grade and high proliferative index was diagnosed.</p></div><div><h3>Therapeutic interventions and results</h3><p>The treatment of choice was chemotherapy only. This patient has presented a disease-free survival of 5<!--> <!-->years. It is currently being monitored by carrying out annual analytical controls.</p></div><div><h3>Conclusion</h3><p>The symptoms of this type of tumor are highly non-specific, as well as cytology is frequently negative, which is why it is necessary to resort to biopsy. Immunohistochemistry is essential for both diagnosis and prognosis. There are multiple imaging techniques used for both extension study and follow-up, highlighting the role of FDG-PET.</p><p>It currently seems that the most recommendable treatment is the R-CHOP chemotherapy regimen followed by radiotherapy.</p><p>The prognosis is generally good, with up to 80% survival at 5<!--> <!-->years.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100886"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49823594","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}