Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"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":"2023-11-30","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}

{"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":"2023-11-09","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":"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":"2023-10-29","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":"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":"2023-10-10","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":"Correlation between the ultrasound and laparoscopic findings in deep endometriosis staging: A narrative review","authors":"P. Rábade ,&nbsp;J. Vara ,&nbsp;J.L. Alcázar","doi":"10.1016/j.gine.2023.100885","DOIUrl":"https://doi.org/10.1016/j.gine.2023.100885","url":null,"abstract":"<div><p>Many women across the world suffer from endometriosis. This disease should be staged by laparoscopy in order to know the extent of disease. Ultrasound may be a reliable diagnostic tool that could complement laparoscopy for endometriosis staging. The aim of this study is to perform a narrative review of the current status of studies comparing ultrasound findings and laparoscopic staging according to American Society Reproductive Medicine (ASRM) and ENZIAN classifications. A search in PubMed and Web of Science databases from 2004 to 2022 was performed using the following terms “endometriosis”, “ultrasound”, “laparoscopy”, “ENZIAN” and “ASRM”. We focused on the accuracy of sonography using laparoscopy as gold standard. Seven studies were ultimately included. We observed that ultrasound is accurate and correlates well with advanced stages in the case of ASRM classification, and correlates well with ENZIAN classification. However, some limitations came up. There is little scientific information out there regarding this specific topic. Some of the studies have a retrospective design and one of them has a small sample size. In addition to this, even if ultrasound could have a relevant role in staging deep endometriosis, this method is highly dependent on the operator's experience. We conclude that diagnostic performance of transvaginal ultrasound (TVS) for evaluating the extent of disease in women with pelvic endometriosis is high. However, evidence is still limited and further studies are needed.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"50 4","pages":"Article 100885"},"PeriodicalIF":0.1,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49863281","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":"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}