Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Determination of markers of ethyl alcohol consumption in pregnancy.","authors":"Maroš Boďa, Andrej Chyba, Jozef Záhumenský, Petra Pšenková","doi":"10.48095/cccg2025360","DOIUrl":"https://doi.org/10.48095/cccg2025360","url":null,"abstract":"<p><p>Prenatal alcohol exposure (PAE), with a global prevalence of approximately 10%, is the most common preventable cause of fetal morbidity, with fetal alcohol syndrome representing its most severe manifestation. The current gold standard for diagnosing PAE relies on self-reported questionnaires; however, underreporting remains a significant limitation. Consequently, there is a need for objective diagnostic methods. Among the most promising biomarkers are ethanol metabolites present in the first stool of newborns (meconium). In this preliminary study, we quantified ethyl glucuronide (EtG) and ethyl sulfate (EtS) in meconium samples and compared the results with self-reported PAE data from questionnaires. The study included 51 pregnant women. A meconium sample was collected from each newborn and analyzed using liquid chromatography-mass spectrometry. All participants were asked to complete a questionnaire regarding alcohol consumption during pregnancy. EtG was detected in 41 samples (80.3%) and EtS was present in all 51 samples (100%). Three of the 51 women did not complete the questionnaire. Of the remaining 48, six (11.7%) reported alcohol consumption during pregnancy. The median concentrations of EtG and EtS were 49.6 ng/g and 13.9 ng/g, respectively. Median levels of both biomarkers were higher among women who reported alcohol use compared to those who denied it. Notably, EtG concentrations exceeding 30 ng/g - previously suggested in the literature as a potential cut off for PAE - were found in 82.35% of women who reported no alcohol use. This study confirms that EtG and EtS are reliable markers of ethanol exposure in meconium. However, we were unable to determine definitive cut off values for PAE based on these biomarkers. Elevated EtG levels in women who denied alcohol consumption may be attributable to alternative sources of ethanol exposure or endogenous ethanol production. The possibility of underreporting PAE also cannot be ruled out.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 5","pages":"360-365"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423047","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":"Placental insufficiency and late-onset growth restriction in fetuses appropriate for gestational age.","authors":"Luděk Kostka, Marta Ježová, Zuzana Mikulenková, Anna Jouzová, Lukáš Hruban","doi":"10.48095/cccg2025398","DOIUrl":"https://doi.org/10.48095/cccg2025398","url":null,"abstract":"<p><p>Fetal growth restriction is a condition in which the fetus fails to reach its genetically determined growth potential, most often as a result of impaired placental function. The late-onset form, which develops after 32 weeks of gestation, poses a significant diagnostic challenge due to its subtle clinical and sonographic manifestations. Placental insufficiency is usually associated with pregnancies that meet the established diagnostic criteria for fetal growth restriction. However, there is increasing evidence to suggest that even fetuses with an estimated weight appropriate for gestational age may be affected by a subclinical form of this condition. Typical features of advanced placental dysfunction include abnormal Doppler flow patterns, a slowed fetal growth trajectory, altered levels of maternal serum biomarkers, and specific histopathological findings in the placenta. Despite advances in prenatal diagnostics, there is still no reliable tool capable of identifying pregnancies complicated by placental insufficiency in a timely manner, especially in cases without overt fetal growth deviation. This diagnostic gap limits our ability to identify fetuses at increased risk of adverse perinatal outcomes.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 5","pages":"398-406"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423053","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":"Cost-effectiveness of mental health screening in pregnancy.","authors":"Kristýna Hrdličková, Lucie Nováková, Hana Němcová, Antonín Šebela","doi":"10.48095/cccg202558","DOIUrl":"10.48095/cccg202558","url":null,"abstract":"<p><strong>Objective: </strong>To provide an overview of recent literature on the cost-effectiveness of mental health screening for women during pregnancy.</p><p><strong>Results: </strong>1,988 publications were retrieved from databases, of which four were included in the systematic review. Models of care with screening are cost-effective compared with standard care without screening. Multi-level screening models are more cost-effective than single-level models. Effectiveness is affected by the number of false-positive cases, which decreases in multi-level models.</p><p><strong>Conclusion: </strong>Mental health screening in pregnancy appears to be cost-effective. We recommend its use in comprehensive health care for pregnant women in our country.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 1","pages":"58-63"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674672","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":"Comparison of perinatal outcomes using oral misoprostol, vaginal misoprostol, and intracervical dinoprostone for induction of labor.","authors":"Petra Szekeresová, Lukáš Hruban, Anna Jouzová, Petr Janků, Romana Gerychová, Michal Huptych","doi":"10.48095/cccg2025105","DOIUrl":"https://doi.org/10.48095/cccg2025105","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effectiveness and safety of the methods of pharmacological induction of labor. To identify the advantages and disadvantages of oral and vaginal administration of misoprostol and intracervical administration of dinoprostone.</p><p><strong>Materials and methods: </strong>Analysis of a group of women who gave birth at the Faculty Hospital Brno from 1st August 2019 to 31st January 2020, and one of the following labor induction schemes was used: group A: misoprostol 25 µg orally every 2 hours, group B: misoprostol 50 µg vaginally every 6 hours, group C: intracervical dinoprostone 1 mg every 2 hours. Inclusion criteria were: singleton pregnancy, completed 36th gestational week, live fetus, cephalic presentation, and cervix score ≥ 6. Exclusion criteria were uterine scars and fetal growth restriction. Time factors of induction, occurrence of acute hypoxia during labor, mode of delivery, use of tocolysis during labor, necessity of oxytocin infusion, use of epidural analgesia, blood loss, uterine rupture, umbilical artery pH, and Apgar score at the 5th min were evaluated.</p><p><strong>Results: </strong>A total of 378 women were included (133 vs. 145 vs. 100). A statistically significantly higher success rate of vaginal delivery was demonstrated in group A compared to groups B and C (88 vs. 77.9 vs. 76%; P = 0.035). The longest time from the administration of the first dose of the preparation to delivery of the fetus was in group A (medians in minutes 700 vs. 565 vs. 375; P &lt; 0.0001). There was no difference between the groups in the I. and II. labor stage duration. Cesarean delivery rate due to acute hypoxia was the lowest in group A (2.3 vs. 10.3 vs. 9%; P = 0.023). Uterine rupture was not recorded; there were no differences in neonatal outcome parameters.</p><p><strong>Conclusion: </strong>The highest success rate of vaginal delivery was achieved with the use of low-dose oral misoprostol. The disadvantage of this method is a significant increase in the time from the start of induction to the delivery of the fetus. There was no difference in the occurrence of severe perinatal complications between the induction methods.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 2","pages":"105-112"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152371","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":"Educational value of surgical videos on YouTube - quality assessment of and set of standards for hysterectomy using vaginal natural orifice transluminal endoscopic surgery videos.","authors":"Esra Ayanoglu, Arzu Bilge Tekin, Pınar Birol Ilter, Memiş Ali Mutlu, Murat Yassa, Cihan Kaya, Niyazi Tug","doi":"10.48095/cccg2025194","DOIUrl":"https://doi.org/10.48095/cccg2025194","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the reliability and educational value of vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy videos on YouTube and their suitability for training surgeons.</p><p><strong>Materials and methods: </strong>On June 12, 2024, YouTube was searched using the keywords \"vNOTES hysterectomy,\" \"TVNOTES hysterectomy,\" \"transvaginal natural orifice transluminal endoscopic hysterectomy,\" \"vNOTES,\" and \"vaginal notes hysterectomy.\" A total of 73 videos met the inclusion criteria. Viewer engagement metrics, such as time since upload, number of views, likes, dislikes, comments, and video duration were recorded. Ratios such as a view ratio, a like ratio, and Video Power Index (VPI) were calculated. The videos were categorized by the modified Global Quality Scale (GQS) and evaluated based on a scoring system derived from a standardized 10-step vNOTES hysterectomy procedure, with scores ranging from 0 to 15.</p><p><strong>Results: </strong>Out of 73 videos, 40 (53.8%) were categorized as poor quality, 13 (17.8%) as moderate, and 20 (27.4%) as good. No significant differences were found between groups in terms of time since upload, views, dislikes, comments, or a like ratio. However, videos in the good-quality group had a significantly higher number of likes and VPI scores. Critical elements such as patient preparation and positioning, setup of the operation room, circumcision of the cervix, and vault closure were inadequately addressed in lower-quality videos. Videos with a didactic voice had significantly more views, likes, and comments than those with music or no sound. No significant correlations were found between video length and engagement metrics.</p><p><strong>Conclusion: </strong>The majority of vNOTES hysterectomy videos (53.8%) on YouTube lack comprehensive educational content, with only a small fraction deemed appropriate for surgical training. The interest rates of the viewers may not be correlated with the usefulness rates of the videos. Surgeons and organizations should focus on producing high-quality, peer-reviewed instructional videos to improve the educational value of YouTube as a resource.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"194-203"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643779","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":"Hysterosalpingographic evaluation following management of ectopic pregnancy.","authors":"Adel Aly Elboghdady, Mohamed Ibrahim Mohamed, Mohammed Farouk Abd El Azeem Farahat, Mohamed Ali Mohamed Mohamed, Emad Mohamed Atalla, Ahmed Abd Elkader Eltabakh, Abdall Khalel Ahmad, Yasser Momamed Said Diab, Gehad Fawzy Ali Ali Khalil, Mai Mohammed Metwally, Alshaimaa Rabie El Makawy, Adel Mohamed Ghit, Ibrahim Mohamed Ibrahim Mohamed Abo Eldahab, Fadila Mamdouh Elsayed","doi":"10.48095/cccg2025222","DOIUrl":"https://doi.org/10.48095/cccg2025222","url":null,"abstract":"<p><strong>Objective: </strong>It is to assess the ipsilateral and contralateral tubal patency by hysterosalpingography following salpingostomy and methotrexate therapy for tubal pregnancy.</p><p><strong>Patients and methods: </strong>The study was conducted between September 2021 and October 2023. It was conducted in the radiodiagnosis and obstetrics and gynecology departments of the Al-Hussin and Al-Azher university hospitals. Patients who had undergone salpingostomy or received methotrexate treatment were included in this research. Three months after being discharged, the individuals who were seeking for fertility were assessed again for Fallopian tube patency using hysterosalpingographs. Two groups of women participated in the study: group I (N = 50) received methotrexate treatment, while group II (N = 50) had undergone salpingostomy management.</p><p><strong>Results: </strong>The two groups (medical and surgery) did not vary statistically significantly in preserving tubal patency. Following methotrexate therapy, the ipsilateral tubal patency was 72%, and following surgical management, it was 74%. Furthermore, following methotrexate therapy, contralateral tubal patency was 92%, and 90% following salpingostomy.</p><p><strong>Conclusion: </strong>The results point to comparable success rates with salpingostomy and methotrexate in preserving fallopian tube patency.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"90 3","pages":"222-225"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643782","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":"Interlabial masses in newborn girls.","authors":"Marta Nováčková, Nikoleta Chubanovová, Roman Chmel","doi":"10.48095/cccg2024411","DOIUrl":"https://doi.org/10.48095/cccg2024411","url":null,"abstract":"<p><p>: An interlabial mass in newborn girls is diagnosed usually after birth or during the first days or weeks of life. According to various studies, its prevalence ranges between 1 : 500 and 1 : 7,000 newborn girls. A mass in the vaginal introitus or between the labia majora can cause a diagnostic dilemma and may be suspected even of ambiguous genitalia. Interlabial masses of different etiologies present clinically similar, and therefore, can be misdiagnosed. The most common causes of an interlabial mass in a newborn are hymenal and paraurethral cysts, both of which present as thin-walled spherical formations filled with golden fluid. When diagnosing a cystic interlabial tumor, it is necessary to particularly exclude a non-perforated hymen with hydrocolpos and prolapse of an ectopic ureterocele. In the differential diagnosis, prolapse of the urethra, rhabdomyosarcoma of the vagina or cervix, urethral or vaginal polyps, and extremely rare conditions such as genital prolapse or duplicate rectum cannot be omitted. A newborn girl with an interlabial formation should be examined by a pediatrician, gynecologist, surgeon, or urologist depending on the nature of the clinical findings. Once the etiology of an interlabial mass is identified, expectant management or surgery should be chosen. Early surgical treatment of hydrocolpos and prolapse of a ureterocele can prevent lower urinary tract obstruction and life-threatening renal damage.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 5","pages":"411-416"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629881","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":"Advantages of next-generation sequencing (NGS) in the molecular classifi cation of endometrial carcinomas - our experience with 270 cases.","authors":"Květoslava Michalová, Jiří Presl, Andrea Straková-Peteříková, Ondrej Ondič, Tomáš Vaneček, Nikola Hejhalová, Petr Holub, Petr Slavík, Adam Hluchý, Polina Gettse, Ondřej Daum, Marián Švajdler, Michal Michal","doi":"10.48095/cccg2024349","DOIUrl":"https://doi.org/10.48095/cccg2024349","url":null,"abstract":"<p><strong>Objective: </strong>Molecular classification of endometrial carcinomas (EC) divides these neoplasms into four distinct subgroups defined by a molecular background. Given its proven clinical significance, genetic examination is becoming an integral component of the diagnostic procedure. Recommended diagnostic algorithms comprise molecular genetic testing of the POLE gene, whereas the remaining parameters are examined solely by immunohistochemistry. The aim of this study is to share our experiences with the molecular classification of EC, which has been conducted using immunohistochemistry and next-generation sequencing (NGS) at our department.</p><p><strong>Methods: </strong>This study includes all cases of EC diagnosed at Šikl's Department of Pathology and Biopticka Laboratory Ltd. from 2020 to the present. All ECs were prospectively examined by immunohistochemistry (MMR, p53), fol lowed by NGS examination using a customized Gyncore panel (including genes POLE, POLD1, MSH2, MSH6, MLH1, PMS2, TP53, PTEN, ARID1A, PIK3CA, PIK3R1, CTNNB1, KRAS, NRAS, BRCA1, BRCA2, BCOR, ERBB2), based on which the ECs were classified into four molecularly distinct groups [POLE mutated EC (type 1), hypermutated (MMR deficient, type 2), EC with no specific molecular profile (type 3), and TP53 mutated (\"copy number high\", type 4)].</p><p><strong>Results: </strong>The cohort comprised a total of 270 molecularly classified ECs. Eighteen cases (6.6%) were classified as POLE mutated EC, 85 cases (31.5%) as hypermutated EC (MMR deficient), 137 cases (50.7%) as EC of no specific molecular profile, and 30 cases (11.1%) as TP53 mutated EC. Twelve cases (4.4%) were classified as \"multiple classifier\" endometrial carcinoma. ECs of no specific molecular profile showed multiple genetic alterations, with the most common mutations being PTEN (44% within the group of NSMP), fol lowed by PIK3CA (30%), ARID1A (21%), and KRAS (9%).</p><p><strong>Conclusion: </strong>In comparison with recommended diagnostic algorithms, NGS provides a more reliable classification of EC into particular molecular subgroups. Furthermore, NGS reveals the complex molecular genetic background in individual ECs, which is especially significant within ECs with no specific molecular profile. These data can serve as a springboard for the research of therapeutic programs committed to targeted therapy in this type of tumor.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 5","pages":"349-359"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629869","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":"Birth plan - legal and medical aspects.","authors":"Andrea Erdősová, Petra Gašparová, Zuzana Ballová, Erik Dosedla","doi":"10.48095/cccg202461","DOIUrl":"10.48095/cccg202461","url":null,"abstract":"<p><p>A birth plan is a document that defines mother's preferences and expectations regarding childbirth and early puerperium. The purpose of the birth plan is to establish communication about mother's birth wishes and to properly convey them to the health care providers. With increasing computerization of society, birth plan is currently the subject of heated debate. In this article, we present historical view of the birth plan, as well as current legislation regarding the birth plan, as we do not consider legal awareness of obstetricians to be sufficient at the moment. The purpose of this article is to appeal to the professional public so they have up-to-date information about the birth plan, especially in discussions with patients, but also during forensic procedures. The preservation of excellent perinatological results under our circumstances is only possible by providing professional, empathetic and very intimate health care in hospital institutions.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 1","pages":"61-65"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991405","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":"New staging of endometrial carcinoma - FIGO 2023.","authors":"Martin Hruda, Borek Sehnal, Michael J. Halaška, Jana Drozenová, Helena Robová, Tomáš Pichlík, Lukáš Rob","doi":"10.48095/cccg2024120","DOIUrl":"10.48095/cccg2024120","url":null,"abstract":"<p><strong>Aim: </strong>To review the changes in the new version of the FIGO 2023 staging system for endometrial cancer.</p><p><strong>Methods and results: </strong>The new FIGO 2023 endometrial cancer staging system provides key updates for the diagnosis and treatment of endometrial cancer. An important step in diagnosis is molecular classification, which allows more accurate risk stratification for recurrence and the identification of targeted therapies. The new staging system, based on the recommendations of the international societies ESGO, ESTRO and ESP, incorporates not only the description of the pathological and anatomical extent of the disease, but also the histopathological characteristics of the tumour, including the histological type and the presence of lymphovascular space invasion. In addition, the staging system uses molecular testing to classify endometrial cancers into four prognostic groups: POLEmut, MMRd, NSMP and p53abn. Each group has its own specific characteristics and prognosis. The most significant changes have occurred in stages I and II, in which the sub-staging better reflects the biological behaviour of the tumour. This update increases the accuracy of prognosis and improves individualized treatment options for patients with endometrial cancer.</p><p><strong>Conclusion: </strong>The updated FIGO staging of endometrial cancer for 2023 incorporates different histologic types, tumour features, and molecular classifications to better reflect the current improved understanding of the complex nature of several endometrial cancer types and their underlying bio logic behaviour. The aim of the new endometrial cancer staging system is to better define stages with similar prognosis, allowing for more precise indication of individualised adjuvant radiation or systemic treatment, including the use of immunotherapy.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 2","pages":"120-127"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862496","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}