Minerva Urologica E Nefrologica最新文献

{"title":"Lower urinary tract and gastrointestinal dysfunction in sportswomen: systematic review and meta-analysis of observational studies.","authors":"M. Cerruto, M. Balzarro, E. Rubilotta, T. Processali, M. Latini, A. Porcaro, Chiara Scancarello, Simona Cantaluppi, M. C. Di Dedda, A. Antonelli, M. Serati","doi":"10.23736/S0393-2249.19.03582-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03582-3","url":null,"abstract":"INTRODUCTION\u0000The aim of this review was to assess the prevalence of gastrointestinal (GI) and lower urinary tract symptoms (LUTS) in sportswomen having high intensity training and to determine whether the type of sport might also affect LUTS and GI symptoms.\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000A systematic review of the literature was performed by searching PubMed, CINAHL, Cochrane Library and Web of Science up to November 2018. The search strategy included several keywords concerning pelvic floor disorders, urinary dysfunction, bowel dysfunction, sportswomen, and elite sports. Inclusion criteria were studies of women who performed any kind of sport with a prevalence of LUTS and/or bowel symptoms without any restriction for age, sport modality or frequency of training. Outcomes were prevalence of LUTS and GI symptoms and meta- analyses and moderator analyses to identify risk factors for the occurrence of these symptoms in female athletes.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000The search screened 1263 records, 31 of which met the methodological criteria for qualitative analysis and 5 for meta-analysis. Sportswomen during daily activity showed a 3-fold higher risk to develop urinary incontinence (UI) than controls (OR 3.13; CI 95% 2.39-4.00). No differences were found stratifying data for UI types. Cumulative prevalence rates were: 58.7% of all kinds of UI (daily life together with sport time), 32.8% at rest (during daily life out of sport time), 36.3% during sport time; 23% of stress urinary incontinence (SUI) during sport time versus 38.6% at rest; 11% of urge urinary incontinence (UUI) during sport time versus 17.8% at rest; 11.9% of mixed urinary incontinence (MUI) during sport time versus 20.7% at rest. Prevalence rates of GI symptoms before sport time were 57.6%, during sport competition 35.2% and 58.2% after competition.\u0000\u0000\u0000CONCLUSIONS\u0000All the analysed studies showed bias. This meta-analysis indicated that competitive sport activities represent a risk factor for urinary incontinence and gastrointestinal disorders. To prevent urinary leakage athletes should be instructed to strengthen the pelvic floor muscles.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77811387","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":"Development and validation of a simple stone score (SSS) to estimate the probability of residual stones prior to percutaneous nephrolithotomy.","authors":"Ahmed M Harraz, A. El-Nahas, M. Nabeeh, M. Laymon, Khalid Z Sheir, H. El-Kappany, Y. Osman","doi":"10.23736/S0393-2249.20.04055-2","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04055-2","url":null,"abstract":"BACKGROUND\u0000The purpose is to develop and internally validate a simple stone score (SSS) to estimate the probability of clinically significant residual fragments (CSRF) prior to percutaneous nephrolithotomy (PNL).\u0000\u0000\u0000METHODS\u0000The files of 1170 PNL procedures between January and December 2015 were evaluated. CT-derived stone characteristics were examined. Caliceal stone distribution (CSD) was assigned three grades based on the number of calices involved regardless of the renal pelvis (I: no or single calix; II: more than one calix; III: more than 2 calices or complete staghorn stones). CSRF was defined as any residuals >4 mm in postoperative CT. A logistic regression model to predict the CSRF was fitted and coefficients were used to develop the SSS. The SSS was validated by discrimination, calibration, and decision curve analysis (DCA).\u0000\u0000\u0000RESULTS\u0000Patients' data were split into training (936, 80%) and validating (234, 20%) datasets. In the training partition, independent predictors of CSRF were CSD-grade II (OR: 4.2; 95%CI: 2.5-7; p<0.001), grade III (OR: 7.8; 95%CI: 4.2-14.4; p<0.001) and largest stone diameter (LSD) (OR:1.3; 95%CI: 1.1-1.6; p<0.001). Score points 0, 1, 2, and 0, 3, 9 were given to LSD <30, 30- 40, >40 mm, and CSD grades I, II, III, respectively. Discrimination of the SSS was 0.79 and after 10-fold cross-validation and internal validation was 0.86. The calibration plot and DCA highlighted the validity and clinical significance of the SSS.\u0000\u0000\u0000CONCLUSIONS\u0000The novel SSS could be used to describe the risk of CSRF prior to PNL. Further studies are invited for external validation.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85026944","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":"Intravesical ureteral stent position is highly variable over time and with patient position: an analysis of 1'466 radiographic images.","authors":"A. C. Tekin, M. Pratsinis, Valentin Zumstein, S. Güsewell, H. Schmid, D. Abt, P. Betschart","doi":"10.23736/S0393-2249.20.04224-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04224-1","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78209678","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":"Implant of ATOMS® system for the treatment of postoperative male stress urinary incontinence: an Italian multicentric study.","authors":"A. Giammò, E. Ammirati, A. Tullio, G. Morgia, S. Sandri, C. Introini, G. Canepa, L. Timossi, C. Rossi, C. Mozzi, R. Carone","doi":"10.23736/S0393-2249.19.03457-X","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03457-X","url":null,"abstract":"BACKGROUND\u0000The aim of this study is to evaluate efficacy and safety of the ATOMS system for the treatment of postoperative stress urinary incontinence (SUI).\u0000\u0000\u0000METHODS\u0000We included all consevutive male patients referring for postoperative SUI and treated with ATOMS system from June 2013 to July 2017. Patients received anamnesis, 24h pad test, pad count, physical examination, urodynamic evaluation, ICIQ-UI SF questionnaire. We excluded patients with low bladder capacity and compliance, uncontrolled detrusor overactivity.\u0000\u0000\u0000RESULTS\u0000We treated 98 patients with median age of 70.21 ± 10.02 years. The most common cause of SUI was open radical prostatectomy in 79 patients. Ten patients had undergone urethrotomy, 7 bladder neck incision, 14 adjuvant radiotherapy. Thirty-nine patients suffered of mild incontinence (24h pad test <200g), 49 moderate incontinence (200-400g), 10 severe incontinence (≥400g). 31 patients underwent previous incontinence surgery: 29 ProACT, 3 artificial urinary sphincter (in 2 cases both devices), 1 bulking agents and subsequent male sling. Median follow-up was 21.5 months. We had a significant reduction of mean 24h pads test, pad count and ICIQ-UI SF questionnaire (p<0.01). At last follow-up 47.96% of patients were dry and 79.59% reached social continence. A high incontinence grade, adjuvant radiotherapy, previous urethral surgery and incontinence surgery have been associated with lower continence results. We had complications in 33 patients (33.7%). The device was removed in 4 cases due to scrotal port erosion and in one case due to persistent pain.\u0000\u0000\u0000CONCLUSIONS\u0000The ATOMS system seems to be an effective and safe surgical treatment for postoperative male SUI.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"84 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72642657","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":"Role of cultural analysis in patients with indwelling ureteral stent submitted to ureteroscopy for stones.","authors":"Francesca Carobbio,&nbsp;Stefania Zamboni,&nbsp;Luca Cristinelli,&nbsp;Damiano D'''''Aietti,&nbsp;Marco Lattarulo,&nbsp;Julian Daja,&nbsp;Evelyn van Hauwermeiren,&nbsp;Alessandra Moroni,&nbsp;Alessandro Antonelli,&nbsp;Claudio Simeone","doi":"10.23736/S0393-2249.19.03549-5","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03549-5","url":null,"abstract":"<p><strong>Background: </strong>Aim of our study is to analyze the incidence of postoperative infectious complications and to assess its predictors in patients with indwelling ureteral stent treated with ureteroscopy (URS).</p><p><strong>Methods: </strong>We retrospectively evaluated data of patients treated with URS from January 2017 to July 2018 at our center. We included 88 consecutive patients with available stent culture (SC) and urine culture (UC). Cefoxitin 2 g IV was given as prophylaxis in all patients with negative preoperative UC; otherwise, the choice of antibiotic was based on antibiogram. Ureteral stent was removed before URS procedure and analyzed. No postoperative antibiotic was given. Multivariable logistic regression analysis was built to assess preoperative predictors of postoperative infectious complications.</p><p><strong>Results: </strong>Nineteen patients (22%) developed postoperative infectious complications and fever was the most common one. E. faecalis, which is not responsive to common prophylaxis schemes in force in our institution, was the most frequent pathogen isolated. Overall, 26% of patients were found to have a discordance between SC and UC. At multivariable logistic regression analysis preoperative SC positivity (Odds Ratio [OR]: 11.00, 95% Confidence Interval [CI]:1.08-111.41, P=0.04) was the only significant predictor of postoperative infectious complications.</p><p><strong>Conclusions: </strong>About one to five patients treated with URS developed an infectious complication and E. faecalis and E. coli were the most frequent pathogen isolated. A positive SC is the only independent risk factor for postoperative infection: consequently, an early SC analysis could allow a prompt antibiotic therapy in all patients with positive SC even if mildly symptomatic.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"755-762"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37453915","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":"The surgical learning curve for salvage robot-assisted radical prostatectomy: a prospective single-surgeon study.","authors":"X. Bonet, M. Moschovas, F. Onol, K. Bhat, T. Rogers, G. Ogaya‐Pinies, B. Rocco, M. Sighinolfi, T. Woodlief, F. Vigués, V. Patel","doi":"10.23736/S0393-2249.20.04077-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04077-1","url":null,"abstract":"BACKGROUND\u0000To report the overall results and the learning curve (LC) in salvage robot-assisted radical prostatectomy (sRARP) patients, in terms of morbidity, oncological and functional outcomes in a single surgeon tertiary-referral center.\u0000\u0000\u0000METHODS\u0000One hundred and twenty patients underwent sRARP by a single surgeon (V.P.) from 2008 to 2018. To assess the trends in the learning experience they were sub-divided in 4 groups of 30 consecutive patients based on date of surgery. The Kaplan- Meier method and regression models were used to identify survival estimations and predictors of potency, continence and biochemical failure (BCF) at 12 months.\u0000\u0000\u0000RESULTS\u0000As the learning experience for sRALP increased operative time (OT) was significantly shorter (from 139,5 to 121 min) and the amount of nerve-sparing (NS) undertaken increased (from 46 to 80%). While complications rate remained stable, estimated blood loss (EBL) and radiographic anastomotic leaks (RAL) decreased through the groups (from 124 to 69 ml and 40% to 16,7%, respectively). BCF and continence rates at 12 months after sRARP were similar among groups (23-36% and 36,7-50%, respectively) and chance of potency rates tended to increase (from 3,3% to 16-23%) but was not statistically significant. In a multivariate analysis, predictors for BCF were PSM and GS 8-10. Non-radiation primary treatment was the unique predictor of continence at 12 months after sRARP.\u0000\u0000\u0000CONCLUSIONS\u0000Our data may suggest a decreasing trend in terms of OT and EBL through the sRARP learning curve. While morbidity remained stable through the time, radiographic anastomotic leaks trended towards a decline. A higher degree of NS was observed through the groups and there was a slight correlation trend between surgical expertise and potency recovery. PSM and GS 8-10 were predictors of BCF and non-radiation primary treatment predicted a better continence after sRARP.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81945921","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":"Performance of prostate multiparametric MRI for prediction of prostate cancer extra-prostatic extension according to NCCN risk categories: implication for surgical planning.","authors":"Ugo G Falagario,&nbsp;Ivan Jambor,&nbsp;Parita Ratnani,&nbsp;Alberto Martini,&nbsp;Patrick-Julien Treacy,&nbsp;Ethan Wajswol,&nbsp;Anna Lantz,&nbsp;George Papastefanou,&nbsp;Rachel Weil,&nbsp;Deron Phillip,&nbsp;Sara Lewis,&nbsp;Kenneth Haines,&nbsp;Luigi Cormio,&nbsp;Giuseppe Carrieri,&nbsp;Natasha Kyprianou,&nbsp;Peter Wiklund,&nbsp;Ashutosh K Tewari","doi":"10.23736/S0393-2249.20.03688-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03688-7","url":null,"abstract":"<p><strong>Background: </strong>Prediction of extra-prostatic extension (EPE) in men undergoing radical prostatectomy (RP) is of utmost importance. Great variability in the performance of multiparametric magnetic resonance imaging (mpMRI) has been reported for prediction of EPE. The present study aimed to determine the diagnostic performance of mpMRI for predicting EPE in different National Comprehensive Cancer Network (NCCN) risk categories.</p><p><strong>Methods: </strong>Overall 664 patients who underwent radical prostatectomy with a staging mpMRI were enrolled in this single-center, retrospective study. Patients with mpMRI report non-compliant with PI-RADSv2.0, were excluded. Patients were stratified according to NCCN criteria: very low/low (VLR-LR) to High Risk (HR) in order to assess final pathology EPE rates (focal and established). Sensitivity, specificity, positive and negative predictive values of staging mpMRI were computed in each group. Univariable and multivariable analysis were used to evaluate predictors of positive surgical margins.</p><p><strong>Results: </strong>Pathological evaluation demonstrated established and focal EPE in 60 (9%) and 106 (16%) patients, respectively, while mpMRI suspicion for EPE was present in 180 (27%) patients. Age, preoperative PSA, PSA density, number of positive cores, NCCN groups, prostate volume, mpMRI suspicion for EPE, PIRADSv2.0 and lesion size differed significantly between the patients with any EPE and without EPE (all P≤0.05). The sensitivity of mpMRI in detecting any EPE varied from 12% (95% CI: 0.6-53%) in VLR-LR to 83% (66-93%) in HR while the corresponding values for the specificity were 92% (85-96%) and 63% (45-78%), respectively. Patients with false-negative mpMRI EPE prediction were more likely to have positive surgical margins in univariable (OR: 2.14; CI: 1.18, 3.87) as well as multivariable analysis adjusting for NCCN risk categories (OR: 1.97; CI: 1.08, 3.60).</p><p><strong>Conclusions: </strong>The performance of mpMRI for prediction of EPE varies greatly between different NCCN risk categories with a low positive predicting value in patients at low to favorable intermediate risk and a low negative predictive value in patients at Unfavorable intermediate to high risk PCa. Given that mpMRI EPE misdiagnosis could have a negative impact on oncological and functional outcomes, NCCN risk categories should be considered when interpreting mpMRI findings in PCa patients.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"746-754"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37746108","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":"Robotic repair of iatrogenic ureteral stricture after pelvic surgery: a changing treatment paradigm.","authors":"S. Sforza, R. Tellini, A. Grosso, F. di Maida, A. Mari, A. Cocci, G. Cito, M. Carini, A. Minervini, L. Masieri","doi":"10.23736/S0393-2249.20.04138-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04138-7","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"492 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82123333","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":"The role of metabolic syndrome in high grade prostate cancer: development of a clinical nomogram.","authors":"Cosimo De Nunzio,&nbsp;Giorgia Tema,&nbsp;Riccardo Lombardo,&nbsp;Antonio Cicione,&nbsp;Paolo Dell'''''Oglio,&nbsp;Andrea Tubaro","doi":"10.23736/S0393-2249.20.03797-2","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03797-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study is to develop a clinical nomogram including metabolic syndrome status for the prediction of high-grade prostate cancer (HG PCa).</p><p><strong>Methods: </strong>A series of men at increased risk of PCa undergoing prostate biopsies were enrolled in a single center. Demographic and clinical characteristics of the patients were recorded. Metabolic syndrome was defined according to the adult treatment panel III. A nomogram was generated based on the logistic regression model and used to predict high grade prostate cancer defined as grade group ≥3 (ISUP 2014). ROC curves, calibration plots and decision curve analysis were used to evaluate the performance of the nomogram.</p><p><strong>Results: </strong>Overall, 738 patients were enrolled. Greater than or equal to 294/738 (40%) of the patients presented PCa and of those patients, 84/294 (39%) presented high grade disease (Grade Group ≥3). On multivariate analysis, DRE (OR: 3.24, 95% CI: 1.80-5.84), PSA (OR: 1.10, 95% CI: 1.05-1.16), PV (OR: 0.98, 95% CI: 0.97-0.99) and MetS (OR: 2.02, 95% CI: 1.13-3.59) were predictors of HG PCa. The nomogram based on the model presented good discrimination (AUC: 0.76), good calibration (Hosmer-Lemeshow Test, P>0.05) and a net benefit in the range of probabilities between 10% and 70%.</p><p><strong>Conclusions: </strong>Metabolic syndrome is highly prevalent in patients at risk of prostate cancer and is particularly associated with high-grade prostate cancer. Our nomogram offers the possibility to include metabolic status in the assessment of patients at risk of prostate cancer to identify men who may have a high-grade form of the disease. External validation is warranted before its clinical implementation.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"729-736"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38233473","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":"Is androgen deprivation therapy protective against SARS-CoV-2 infection and related complications in prostate cancer patients?","authors":"Alberto Dalla Volta,&nbsp;Francesca Valcamonico,&nbsp;Stefania Zamboni,&nbsp;Vittorio D Ferrari,&nbsp;Salvatore Grisanti,&nbsp;Claudio Simeone,&nbsp;Alfredo Berruti","doi":"10.23736/S0393-2249.20.04021-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04021-7","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"778-779"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38458195","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}