Clinical Medicine & Research最新文献

{"title":"COVID-19 Chest CT Quantification: Triage and Prognostic Value in Different Ages.","authors":"Alireza Almasi Nokiani,&nbsp;Razieh Shahnazari,&nbsp;Mohammad Amin Abbasi,&nbsp;Farshad Divsalar,&nbsp;Marzieh Bayazidi,&nbsp;Azadeh Sadatnaseri","doi":"10.3121/cmr.2023.1772","DOIUrl":"https://doi.org/10.3121/cmr.2023.1772","url":null,"abstract":"<p><p><b>Objective:</b> We evaluated the triage and prognostic performance of seven proposed computed tomography (CT)-severity score (CTSS) systems in two different age groups.<b>Design:</b> Retrospective study.<b>Setting:</b> COVID-19 pandemic.<b>Participants:</b> Admitted COVID-19, PCR-positive patients were included, excluding patients with heart failure and significant pre-existing pulmonary disease.<b>Methods:</b> Patients were divided into two age groups: ≥65 years and ≤64 years. Clinical data indicating disease severity at presentation and at peak disease severity were recorded. Initial CT images were scored by two radiologists according to seven CTSSs (CTSS1-CTSS7). Receiver operating characteristic (ROC) analysis for the performance of each CTSS in diagnosing severe/critical disease on admission (triage performance) and at peak disease severity (prognostic performance) was done for the whole cohort and each age group separately.<b>Results:</b> Included were 96 patients. Intraclass correlation coefficient (ICC) between the two radiologists scoring the CT scan images were good for all the CTSSs (ICC=0.764-0.837). In the whole cohort, all CTSSs showed an unsatisfactory area under the curve (AUC) in the ROC curve for triage, excluding CTSS2 (AUC=0.700), and all CTSSs showed acceptable AUCs for prognostic usage (0.759-0.781). In the older group (≥65 years; n=55), all CTSSs excluding CTSS6 showed excellent AUCs for triage (0.804-0.830), and CTSS6 was acceptable (AUC=0.796); all CTSSs showed excellent or outstanding AUCs for prognostication (0.859-0.919). In the younger group (≤64 years; n=41), all CTSSs showed unsatisfactory AUCs for triage (AUC=0.487-0.565) and prognostic usage (AUC=0.668-0.694), excluding CTSS6, showing marginally acceptable AUC for prognostic performance (0.700).<b>Conclusion:</b> Those CTSSs requiring more numerous segmentations, namely CTSS2, CTSS7, and CTSS5 showed the best ICCs; therefore, they are the best when comparison between two separate scores is needed. Irrespective of patients' age, CTSSs show minimal value in triage and acceptable prognostic value in COVID-19 patients. CTSS performance is highly variable in different age groups. It is excellent in those aged ≥65 years, but has little if any value in younger patients. Multicenter studies with larger sample size to evaluate results of this study should be conducted.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"14-25"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153680/pdf/0210014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Down-Regulation of the Mineralocorticoid Receptor (MR) and Up-Regulation of Hydroxysteroid 11-Beta Dehydrogenase Type 2 (HSD11B2) Isoenzyme in Critically Ill Patients.","authors":"Alice G Vassiliou,&nbsp;Dimitra A Vassiliadi,&nbsp;Chrysi Keskinidou,&nbsp;Edison Jahaj,&nbsp;Efi Botoula,&nbsp;Stylianos Tsagarakis,&nbsp;Anastasia Kotanidou,&nbsp;Ioanna Dimopoulou","doi":"10.3121/cmr.2023.1743","DOIUrl":"https://doi.org/10.3121/cmr.2023.1743","url":null,"abstract":"<p><p><b>Objective:</b> The mineralocorticoid receptor (MR) has two ligands, aldosterone and cortisol. Hydroxysteroid 11-beta dehydrogenase (HSD11B) isoenzymes regulate which ligand will bind to MR. In this study we aimed to evaluate the expression of the MR and the HSD11B isozymes in peripheral polymorphonuclear cells (PMNs) in critical illness for a 13-day period.<b>Design:</b> Prospective study<b>Setting:</b> One multi-disciplinary intensive care unit (ICU)<b>Participants:</b> Forty-two critically ill patients<b>Methods:</b> Messenger RNA (mRNA) expression of <i>MR, HSD11B1</i>, and <i>HSD11B2</i>, aldosterone levels, and plasma renin activity (PRA) were measured in 42 patients on ICU admission and on days 4, 8, and 13. Twenty-five age and sex-matched healthy subjects were used as controls.<b>Results:</b> Compared to healthy controls, <i>MR</i> expression in critically ill patients was lower during the entire study period. <i>HSD11B1</i> expression was also lower, while <i>HSD11B2</i> expression was higher. In patients, PRA, aldosterone, the aldosterone:renin ratio, and cortisol remained unaltered during the study period.<b>Conclusion:</b> Our results suggest that, in our cohort of critically ill patients, local endogenous cortisol availability is diminished, pointing towards glucocorticoid resistance. Aldosterone probably occupies the MR, raising the possibility that PMNs might be useful to study to gain insights into MR functionality during pathological states.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"6-13"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153682/pdf/0210006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9482327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Complications after Percutaneous Coronary Interventions on Concurrent Metformin Therapy: A Systematic Review with Meta-Analysis.","authors":"Xenofon M Sakellariou, Theofilos M Kolettis, Dimitrios N Nikas","doi":"10.3121/cmr.2022.1759","DOIUrl":"10.3121/cmr.2022.1759","url":null,"abstract":"<p><p><b>Objective:</b> Metformin, commonly prescribed in diabetic patients, can cause lactic acidosis. Although generally rare, this side effect remains a source of concern in procedures requiring contrast media, due to the risk of contrast-induced nephropathy. Temporarily withdrawing metformin during the peri-procedural period is often practiced, but clinical decisions are difficult in emergency situations, such as acute coronary syndromes. In this systematic review with meta-analysis, we aimed to further investigate the safety of percutaneous coronary interventions in patients on concurrent metformin therapy.<b>Design, Setting and Participants:</b> We analyzed studies in patients undergoing (elective or emergency) percutaneous coronary interventions with or without concurrent metformin administration, reporting on the incidence of metformin-associated lactic acidosis and peri-procedural renal function.<b>Methods:</b> PubMed, ClinicalTrials.gov, Cochrane Library, and Scopus were systematically searched without language restrictions throughout August 2022. Randomized clinical trials and observational studies were assessed with the Revised Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa quality scale, respectively. Data synthesis addressed the mean drop in estimated glomerular filtration rate (eGFR) and the incidence of contrast-induced nephropathy, in addition to lactic acidosis.<b>Results:</b> Nine studies were included, totaling 2235 patients (1076 continuing metformin during the peri-procedural period), mostly with eGFR above 30 mL/min/1.73m² No cases of lactic acidosis were reported. The mean post-procedural drop in eGFR was 6.81mL/min/1.73m² (95% confidence interval [CI]: 3.41 to 10.21) in the presence of metformin and 5.34 mL/min/1.73m² (95% CI: 2.98 to 7.70) in its absence. The incidence of contrast-induced nephropathy was not affected by concurrent metformin, as shown by a (between-groups) standardized mean difference of 0.0007 (95% CI: -0.1007 to 0.1022).<b>Conclusion:</b> Concurrent metformin during percutaneous coronary interventions in patients with relatively preserved renal function is safe, without added risk of lactic acidosis or contrast-induced nephropathy. Thus, emergency revascularization in the context of acute coronary syndromes should not be deferred. More data from clinical trials in patients with severe renal disease are needed.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"26-35"},"PeriodicalIF":1.2,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153679/pdf/0210026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Mesenteric Artery Syndrome in an Adolescent Female with Anorexia Nervosa.","authors":"Lauren Bloomberg,&nbsp;Matthew Hoscheit,&nbsp;Steven Hendler,&nbsp;Ayokunle T Abegunde","doi":"10.3121/cmr.2022.1768","DOIUrl":"https://doi.org/10.3121/cmr.2022.1768","url":null,"abstract":"<p><p>Superior mesenteric artery syndrome (SMAS) is a rare condition that develops from compression of the duodenum between the superior mesenteric artery (SMA) and abdominal aorta. SMAS is an atypical complication of restrictive eating disorders. The SMA is supported by adipose tissue to create an aortomesenteric angle that varies from 25-60 degrees. A reduction in adipose tissue causes narrowing of this angle, and SMAS develops when the aortomesenteric angle is narrow enough that it compresses the distal duodenum passing through. Patients present with small bowel obstructive symptoms. We report a severe case of SMAS in an adolescent female with anorexia nervosa who presented with acute and chronic symptoms of bowel obstruction. Awareness of the association between SMAS and restrictive eating disorders can help guide clinical decision-making and prevent delay of diagnosis and serious complications.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"46-48"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153676/pdf/0210046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9838389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Case of Translocation T(2;7)(p23;q35) in Recurrent Pregnancy Loss.","authors":"Abdulbaki Yildirim,&nbsp;Duygu Taskin,&nbsp;Rumeysa Atasay,&nbsp;Munis Dundar","doi":"10.3121/cmr.2023.1766","DOIUrl":"https://doi.org/10.3121/cmr.2023.1766","url":null,"abstract":"<p><p>Recurrent pregnancy loss is a phenomenon caused by many etiologies. The majority of these causes are chromosomal anomalies. In this case report, cytogenetic analysis was performed on the family who consulted our department with the complaint of recurrent pregnancy loss. A normal karyotype was found in the female (46, XX); however, t(2;7)(p23;q35) translocation was detected in the male. Reciprocal translocations are a common class of chromosomal abnormalities, and we anticipate this case of translocation will be a new cause for recurrent pregnancy loss. In the analysis, preparations at the level of 500 bands were examined, and at least 20 metaphase areas were evaluated. From the results of cytogenetic and FISH (fluorescence in situ hybridization) analysis, we determined the male had t(2;7)(p23;q35) chromosomal anomaly. The probe binding the patient's 2p23 region signaled at the q-terminal of chromosome 7; however, the other two chromosomes (2 and 7) were normal. There is no report of such a case in the literature for recurrent pregnancy loss complaints. With this case, it will be reported for the first time that an embryo formed with the gametes carrying unbalanced genetic material of an individual with the karyotype 46, XY, t(2;7)(p23;q35) is incompatible with life.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"53-55"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153683/pdf/0210053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9413412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrence of Hyperhidrosis and Hypohidrosis in Ross Syndrome.","authors":"Gracia Hamadeh,&nbsp;Jawad Fares","doi":"10.3121/cmr.2022.1780","DOIUrl":"https://doi.org/10.3121/cmr.2022.1780","url":null,"abstract":"<p><p>Ross Syndrome is a rare disorder characterized by tonic pupils, hyporeflexia, and abnormal segmental sweating. The pathophysiology of the disease remains unclear, with either hypohidrosis or hyperhidrosis reported in individual patients. We present the case of a man, aged 57 years, who presented with hyperhidrosis in his right extremities, anhidrosis in the left extremities, and changes in his pupils. The disease was not associated with markers of autoimmune disease, which supports recent research findings on the role of neurodegeneration. The patient's son was exhibiting similar symptoms, which implicates genetic inheritance in the process. A multidisciplinary approach is crucial for the diagnosis and ultimate management of patients with Ross Syndrome.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"21 1","pages":"49-52"},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153678/pdf/0210049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Integrated Care in Atrial Fibrillation (MICAF): A Systematic Review and Meta-Analysis.","authors":"Adnan Khan,&nbsp;Alberto Cereda,&nbsp;Claudia Walther,&nbsp;Aqsa Aslam","doi":"10.3121/cmr.2022.1702","DOIUrl":"https://doi.org/10.3121/cmr.2022.1702","url":null,"abstract":"<p><p><b>Objective:</b> To assess the effectiveness of multidisciplinary integrated care in the clinical outcomes of atrial fibrillation patients.<b>Methods:</b> Medline, EMBASE, and the CENTRAL trials registry of the Cochrane Collaboration were searched for articles on multidisciplinary integrated care in atrial fibrillation patients. The systematic review and meta-analysis included six and five articles, respectively, that compared the outcomes between the integrated care group and control group.<b>Results:</b> Multidisciplinary integrated care was concomitant with a decrease in all-cause mortality (OR 0.52, 95%CI 0.36-0.74, <i>P</i>=0.0003) and cardiovascular hospitalization (OR 0.66, 95%CI 0.49-0.89, <i>P</i>=0.007). Multidisciplinary integrated care had no significant impact on major adverse cardiovascular event (MACE) (OR 0.76, 95%CI 0.37-1.53, <i>P</i>=0.44), cardiovascular deaths (OR 0.49, 95% CI 0.21-1.17, <i>P</i>=0.11), atrial fibrillation (AF)-related hospitalization (OR 0.76, 95%CI 0.53-1.09, <i>P</i>=0.14), major bleeding (OR 1.02, 95%CI 0.59-1.75, <i>P</i>=0.94), minor bleeding (OR 1.12, 95%CI 0.55-2.26, <i>P</i>=0.76), and cerebrovascular events (OR 0.72, 95%CI 0.45-1.18, <i>P</i>=0.19).<b>Conclusion:</b> In comparison to usual care, a multidisciplinary integrated care approach (i.e., nurse-led care along with usual specialist care) in AF patients is associated with reduced all-cause mortality and cardiovascular hospitalization.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"219-230"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799227/pdf/0200219.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Mesenteric Ischemia in COVID-19 While Receiving Prophylactic Enoxaparin.","authors":"Nandhini Bindukumari Sureshkumar,&nbsp;Sreerag Alumparambil Surendran","doi":"10.3121/cmr.2022.1751","DOIUrl":"https://doi.org/10.3121/cmr.2022.1751","url":null,"abstract":"<p><p>COVID-19 infection is known to cause thromboembolic complications. This is why patients hospitalized with COVID-19 are put on prophylactic anticoagulation. We present the case of a Caucasian woman, aged 71 years, with risk factors of class 1 obesity, hyperlipidemia, and hypertension, initially admitted for COVID-19 pneumonia, and later developed acute mesenteric ischemia followed by pulmonary embolism. These incidents occurred while the patient was receiving high-dose prophylactic enoxaparin (40 mg twice daily). COVID-19 associated acute mesenteric ischemia is a complication with high mortality. Therefore, high suspicion, early recognition, and surgical management is necessary. Apart from that, this case emphasizes the question of whether there is a need for proactively administering therapeutic anticoagulation for high thrombotic risk COVID-19 patients to prevent deadly complications.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"236-240"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799224/pdf/0200236.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of Toxic Stress and Adverse Childhood Experiences among Dutch Pediatric Health Care Providers: A National Survey.","authors":"Lisette K M Walbeehm-Hol,&nbsp;Jamiu O Busari","doi":"10.3121/cmr.2022.1748","DOIUrl":"https://doi.org/10.3121/cmr.2022.1748","url":null,"abstract":"<p><p><b>Introduction:</b> Early recognition of adverse childhood experiences (ACEs) and adequate interventions are required to prevent negative effects on the child's mental and physical health later in life caused by toxic stress. This study aimed to assess how familiar the concepts of ACEs and toxic stress are among Dutch pediatric health care providers (PHCPs) and whether screening for ACEs is standard practice in the Netherlands.<b>Methods:</b> From October 2018 until March 2019, a nation-wide questionnaire survey was held.<b>Results:</b> Of 548 participating PHCPs, 29% were familiar with toxic stress, 67% were familiar with ACEs, and 63% knew of the relationship between multiple ACEs and somatic diseases. Routine inquiries about ACEs were done always by 17% of the participants and sometimes by 65%. The ACEs which PHCPs asked about the most included divorce (n=288; 76.8%), bullying (n=265; 70.7%), physical domestic violence (n=184; 49.1%), parental psychiatric diseases (n=205; 54.7%) and sexual abuse (n=164; 43.7%). The ACEs asked about the least included deportation of a family member (n=22; 5.9%), gender discrimination (n=9; 2.4%) and racism (n=17; 4.5%).<b>Conclusion:</b> Even in 2019, there is limited awareness among Dutch PHCPs of ACEs and toxic stress. While most acknowledged to be aware of the role that toxic stress plays in the physical and mental health consequences of ACEs later in life, only 17% of the respondents performed standard ACE screening. Our findings underscore the need for standard ACE screening guidelines to support early recognition and adequate treatment of children suffering with toxic stress.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"211-218"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799223/pdf/0200211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Cases of Atypical Breast Metastasis from Lung Adenocarcinoma.","authors":"Roshini Ramwani, Jessica Wernberg","doi":"10.3121/cmr.2022.1735","DOIUrl":"10.3121/cmr.2022.1735","url":null,"abstract":"<p><p>Metastatic disease to the breast is rare. Melanoma and lymphoma are the most common primary tumors metastasizing to the breast, and breast metastasis from a primary lung neoplasm is uncommon. It can be difficult to distinguish metastatic disease from primary breast cancer clinically. Immunohistochemistry, combined with further diagnostic imaging, play important roles in identifying the primary origin of the malignancy. An accurate diagnosis is imperative for therapeutic planning, and further workup should be considered for unusual cytological patterns. In this report, three cases of pulmonary metastasis to the breast with atypical clinical presentations are presented and discussed.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"20 4","pages":"231-235"},"PeriodicalIF":1.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799225/pdf/0200231.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9236320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}