Monaldi Archives for Chest Disease最新文献

{"title":"Gluteal muscle metastases from malignant pleural mesothelioma: a case report.","authors":"Emanuele Stirpe, Floriana Bardaro, Johanna Köhl","doi":"10.4081/monaldi.2024.2629","DOIUrl":"10.4081/monaldi.2024.2629","url":null,"abstract":"<p><p>Malignant pleural mesothelioma (MPM) is a rare malignancy arising from the mesothelial or subthelial layer of the pleura, and it has increased in recent decades, mainly associated with asbestos exposure. Sarcomatoid mesothelioma is the second-most common subtype of MPM. It is usually difficult to differentiate MPM from benign mesothelial pleural proliferations or other cancers. Because of its nonspecific symptoms, MPM is often diagnosed at a late stage with distal metastases. However, it is extremely rare to see a metastatic lesion within subcutaneous tissue and muscles, which is most likely caused by hematogenous spread. We present a case of sarcomatoid mesothelioma with a metastatic lesion of the right gluteal muscles.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899758","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":"Thoracoscopic blood patch instillation for persistent air leak in pneumothorax: a case series and systematic review.","authors":"Yash Kedia, Manu Madan, Rajnish Kaushik, Rohit Kumar, A J Mahendran, Pranav Ish, Neeraj Gupta, Tanmaya Talukdar, Nitesh Gupta","doi":"10.4081/monaldi.2024.2994","DOIUrl":"10.4081/monaldi.2024.2994","url":null,"abstract":"<p><p>Persistent air leaks in patients with pneumothorax can lead to significant morbidity. If a patient with a persistent air leak is medically unfit for thoracic surgery, either medical pleurodesis via chest tube or thoracoscopy is an option. Thoracoscopy offers the advantage of visualizing the site of the air leak and enabling direct instillation of the pleurodesis agent or glue at that location. Autologous blood patch instillation via chest tube has been reported to be a cheap and very effective technique for the management of persistent air leaks. However, thoracoscopic blood patch instillation has not been reported in the literature. We report two cases of secondary spontaneous pneumothorax in which patients had persistent air leaks for more than 7 days and were subjected to thoracoscopy to locate the site of the leak. In the same sitting, 50 mL of autologous blood patch was instilled directly at the leak site. Post-procedure, the air leak subsided in both patients, and the chest tube was removed with complete lung expansion. We also conducted a systematic review of the use of medical thoracoscopic interventions for treating persistent air leaks.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874032","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":"Smoking cessation among tuberculosis patients during the coronavirus disease-2019 pandemic.","authors":"Sandra Eugênia Coutinho, Raimunda Sinthia Lima de Braga, André Külzer Santos, Joanna Scopel Velho, Denise Rossato Silva","doi":"10.4081/monaldi.2024.2970","DOIUrl":"10.4081/monaldi.2024.2970","url":null,"abstract":"<p><p>Smoking has been recognized as a significant risk factor for COVID-19 and mortality. The World Health Organization (WHO) has recommended smoking cessation to reduce the impact of COVID-19. This study aimed to evaluate the smoking cessation rate of patients starting tuberculosis (TB) treatment at 6 months using motivational interviewing based on the WHO \"five steps to quit\" model. In addition, we assessed the knowledge about smoking and the barriers to smoking cessation. We conducted a retrospective cohort study. Outpatients aged >18 years, smokers, and those who are starting TB treatment in two outpatient TB clinics were invited to participate. Patients received information about the importance of smoking cessation, especially in TB patients, and standardized advice based on guidelines. This information was repeated during phone calls during the second and fourth months of treatment. During the study period, 111 patients were included. The primary outcome was the smoking cessation rate at the end of the sixth month of treatment, which was 26.8% (19/71). The barriers to smoking cessation described by the patients were anxiety/depression (47.4%), seeing someone smoking (38.5%), drug use (19.2%), and alcohol abuse (2.6%). The assessment of knowledge about smoking showed that patients had some information gaps. In conclusion, TB smokers who tried to quit smoking during the COVID-19 pandemic faced many challenges. Despite this, we demonstrated a reasonable smoking cessation rate with a nurse-conducted motivational interview.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868696","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":"Prevalence of extrapulmonary tuberculosis among people living with HIV/AIDS in Southeast Asia: a systematic review and meta-analysis.","authors":"Amit Harshana, Mohit Goyal, Augustine Chako, Raman Mahajan","doi":"10.4081/monaldi.2024.2899","DOIUrl":"10.4081/monaldi.2024.2899","url":null,"abstract":"<p><p>The dual burden of HIV and tuberculosis (TB) impacts people living with HIV (PLHIV) coinfected with TB. Although some primary studies have been reported on the burden of extrapulmonary TB (EPTB) among PLHIV in Southeast Asia (SEA), there is no systematic review or meta-analysis that attempts to summarize the available literature. Therefore, this review aims to summarize the prevalence of EPTB/HIV co-infection in SEA using meta-analysis based on a systematic review of published articles and gray literature. A comprehensive 3-stage methodology was adopted to conduct a thorough literature search, encompassing both published and gray literature. Data sources such as MEDLINE and Web of Science were searched for articles reporting data from SEA between 2010 and 2022. Findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and were sourced using a predefined search strategy from different databases. The Joanna Briggs Institute prevalence studies checklist was employed for critical appraisal. The meta-analysis of proportions was carried out using the \"metaprop\" function in R software (version 4.3.1) to generate pooled estimates. Effects were summarized using random-effects models, and sources of heterogeneity were explored through I2, utilizing subgroup and sensitivity analyses. Publication bias was assessed using funnel plots and pertinent statistical tests, including Egger's regression analysis. A total of 474 studies were initially identified in our search. After the removal of duplicates and a meticulous screening process of titles and abstracts, along with the application of exclusion criteria, 22 studies comprising 34,740 PLHIV were included in the final meta-analysis. The summary effect, or pooled proportion estimate, of EPTB among PLHIV was found to be 18% [95% confidence interval (CI): 15-22; heterogeneity: τ2=0.0056; degrees of freedom=21, p<0.001; I2=99%]. Our study showed that there was a diverse range of prevalence of EPTB among PLHIV in the SEA region, which ranged from 5% (95% CI: 4.0-7.0) in South Korea to 48% (95% CI: 41.0-55.0) in Thailand. Our systematic review and meta-analysis indicate a notably higher prevalence of EPTB among PLHIV. Early diagnosis of EPTB is crucial to mitigating associated morbidity and mortality. Therefore, a thorough medical history and comprehensive physical examination are imperative in assessing PLHIV, aiming to promptly identify and rule out EPTB. After a diligent evaluation, appropriate diagnostic measures and tailored management strategies should be promptly instituted.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762531","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":"Clinical characteristics, imaging, and lung function among patients with persistent dyspnea of COVID-19: a retrospective observational cohort study.","authors":"Ravi Manglani, Moshe Fenster, Theresa Henson, Ananth Jain, Neil Schluger","doi":"10.4081/monaldi.2024.2733","DOIUrl":"10.4081/monaldi.2024.2733","url":null,"abstract":"<p><p>The available medical literature on lung function and corresponding clinical characteristics among symptomatic survivors of COVID-19 (long COVID) is sparse. Primary physicians referred patients who manifested persistent dyspnea months after their index case of infection to a designated clinic. Patients underwent symptom-driven, quality-of-life, physical, and focused respiratory [pulmonary function tests and computed tomography (CT) of the chest] evaluations and were followed over time. In this paper, we present our findings. Patients with abnormal CT imaging were more likely to be of advanced age and to have been hospitalized during their COVID-19 infection. Forced exhaled volume in the first second, forced vital capacity (FVC), total lung capacity, and diffusion capacity of carbon monoxide measurements were found to be significantly lower in patients with abnormal CT imaging. Multivariate regression of clinical characteristics uncovered a significant association between FVC, body mass index, history of hospitalization, and diabetes mellitus. In conclusion, longer-term studies will help further our understanding of the risk factors, disease course, and prognosis of long COVID patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873647","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":"Prognostic value of the oxygenation index measured during mechanical ventilation and weaning. A retrospective cohort study.","authors":"Esra Eriş, Ayshan Mammadova, Ayşe Taşçı Kara, Aydın Atasoy, Zeynep Sena Solmaz, Gül Gürsel","doi":"10.4081/monaldi.2024.2840","DOIUrl":"10.4081/monaldi.2024.2840","url":null,"abstract":"<p><p>This study aimed to investigate the predictive value of the ratio of oxygen saturation (ROX) index calculated during mechanical ventilation (MV) and the weaning period in evaluating readiness to wean and the success of the spontaneous breathing trial (SBT), extubation, and mortality. We also compared the results of the ROX index calculated with partial arterial oxygen pressure (PaO2), arterial oxygen saturation (SaO2%), and probe oxygen saturation (SpO2%). In this retrospective cohort study, the ROX index was calculated by SpO2%, PaO2, and SaO2% separately using the ROX index formula (PaO2 or SaO2 or SpO2 /FiO2)/respiratory rate. ROX was calculated during the first 3 days of MV treatment and the weaning period daily (SBT). Positive end-expiratory pressure and peak inspiratory pressure values were also recorded during these measurements. These ROX values were used to analyze whether they predict weaning readiness, SBT, extubation failure (EF), and mortality. The study included 107 mechanically ventilated patients. Weaning could be tried in 64 (60%) of the 107 patients; 44 (69%) of the 64 patients succeeded, and extubation was performed. 19 (43%) of 44 patients had EF. ROX values calculated with PaO2 during MV and SBT predicted readiness to wean, EF, and mortality better than ROX values calculated with SaO2 and SpO2. ROX values calculated with PaO2 during the third day of MV had the highest sensitivity and specificity for EF (sensitivity: 81%, specificity: 70% for the ROX<11 value). The results of this study suggest that the calculation of the ROX index, not only with SpO2% but also with arterial blood gas PaO2 and SaO2% values, may be helpful in predicting the weaning readiness evaluation, SBT, and extubation success and mortality. Further studies with more patients are necessary to verify and standardize these results.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762532","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":"Study of risk factors and clinical management of patients with clinical non-response due to low plasma levels of anti-tubercular drugs.","authors":"Rupak Singla, Amitesh Gupta, Vikas Kumar, Chandrasekaran Padmapriyadarsini, Devika Tayal, Shweta Anand, Abhishek Faye, Ak Hemanth Kumar, Madhumita Paul Choudhary","doi":"10.4081/monaldi.2024.3036","DOIUrl":"10.4081/monaldi.2024.3036","url":null,"abstract":"<p><p>This study was carried out to assess the role of therapeutic drug monitoring of crucial first-line anti-tubercular drugs [rifampicin (R) and isoniazid (H)] among 75 non-responding proven drug-sensitive tuberculosis (TB) patients on treatment followed by intervention in field conditions. The intervention was done in the form of either an increase in the dosage of R and H in patients with minimally low drug levels or a modification of the regimen in a certain group of patients with significantly low drug levels by augmenting it with three or four second-line drugs in addition to standard first-line drugs. This study also aimed to determine the relationship between the measured plasma concentration of anti-tubercular drugs and various demographic, microbiological, radiological, and malabsorption factors, and the presence of comorbidities affecting them. The study also focused on the clinical impact of the intervention for low plasma levels of anti-tubercular drugs on TB treatment outcomes. In our study, overall, 85.5% of patients had low levels of any drug. In 85.3% of patients, R levels were low, and in 39.1%, H levels were low. On univariate analysis, low body mass index (BMI), hypoalbuminemia, bilateral disease on chest X-rays, and the presence of cavities were found to be significantly associated with low drug levels, while none of the factors were independently significantly associated. Low BMI, pulmonary TB, and disseminated TB, far-advanced disease, and bilateral disease on chest X-ray, presence of cavities, and only low R levels were associated with unfavorable outcomes, with none of the factors found to be significant on multivariate analysis. In our study, it was seen that the treatment outcome was favorable in 59.6% of patients in whom this intervention was done by augmenting the treatment regimen with three/four second-line drugs along with increasing the dose of R and H. To conclude, various factors may be associated with low plasma levels of anti-tubercular drugs. If such patients show clinical non-response after ≥6 months of treatment and have significantly low drug levels, with an absence of drug resistance, their treatment regimen may need augmentation with three/four second-line drugs along with an increase in the dose of R and H, which may lead to a favorable outcome.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762534","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 noninvasive modalities in long-term pediatric ventilation: a scoping review.","authors":"Martino Pavone, Giovanni Misseri, Mariachiara Ippolito, Cesare Gregoretti, Renato Cutrera","doi":"10.4081/monaldi.2024.2841","DOIUrl":"10.4081/monaldi.2024.2841","url":null,"abstract":"<p><p>Long-term noninvasive ventilation modalities for the pediatric population have undergone a continuous evolution. Hybrid noninvasive ventilation modalities have been recently introduced in clinical practice. Combining the advantages of conventional ventilation, hybrid modes use algorithms that automatically adjust the ventilator's settings to achieve a predefined ventilation target. Most of the recommendations on the use and settings of hybrid noninvasive ventilation modalities in children are derived from adult experience. Therefore, there is a lack of evidence on its implementation in pediatric chronic respiratory diseases. This scoping review aims to map the existing information regarding the use of hybrid ventilation modalities in the pediatric population and identify knowledge or research gaps. We performed a literature search using MEDLINE and PubMed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. We included 13 studies (10 studies on average volume-assured pressure-support ventilation, 2 studies on intelligent volume-assured pressure-support ventilation, and 1 study on adaptive servoventilation). The use of new noninvasive ventilation modes in the pediatric population has been applied for the treatment of neuromuscular and hypoventilation syndromes as an alternative therapeutic option in the case of the failure of conventional noninvasive ventilation. Their widespread use has been hampered by the limited evidence available. Longitudinal studies on a larger number of patients are needed to confirm their effectiveness and evaluate their long-term clinical and functional outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762530","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":"Severe heart failure and intracardiac thrombosis: going beyond the appearance for diagnosis and treatments.","authors":"Andrea Segreti, Sara Mastroberardino, Lorenzo Frau, Alessandro Appetecchia, Luca D'Antonio, Danilo Ricciardi, Gian Paolo Ussia, Francesco Grigioni","doi":"10.4081/monaldi.2024.2882","DOIUrl":"10.4081/monaldi.2024.2882","url":null,"abstract":"<p><p>We describe the case of a 45-year-old female affected by asthma and nasal polyposis who presented to the emergency department because of worsening dyspnea and paresthesia of the left lower limb. Comprehensive instrumental examinations revealed the presence of severe left ventricle dysfunction, intracardiac thrombus, deep vein thrombosis, pulmonary embolism, lung infiltrates, polyserositis, and neurological involvement. Finally, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome, a rare vasculitis of small-medium blood vessels with several organ involvements. Treatment with anticoagulants, corticosteroids, and cyclophosphamide led to a significant clinical improvement. However, a subcutaneous cardiac defibrillator was implanted because of the persistence of severe left ventricular dysfunction and the high cardiovascular risk phenotype. Indeed, several cardiac manifestations may occur in EGPA, particularly in patients with anti-neutrophil cytoplasmic antibody-negative disease. Therefore, clinicians should have high clinical suspicion because cardiac involvement in EGPA results in a poor prognosis if not diagnosed and adequately treated.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856673","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":"Relationship of fractional exhaled nitric oxide with blood eosinophilia in characterizing type-2 airway inflammation in treatment-naïve patients with chronic obstructive pulmonary disease.","authors":"Riksoam Chatterjee, Mansi Gupta, Zia Hashim, Ajmal Khan, Alok Nath, Vikas Aggarwal","doi":"10.4081/monaldi.2025.3315","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3315","url":null,"abstract":"<p><p>Fractional exhaled nitric oxide (FeNO), a sensitive and reproducible, non-invasive biomarker for type-2 (T2) inflammation in asthma, remains underutilized in chronic obstructive pulmonary disease (COPD). We investigated the potential role of FeNO and its relationship with blood eosinophilia in characterizing T2 airway inflammation in COPD. A single-center prospective observational study was conducted in 75 treatment-naïve adult patients with stable COPD and 75 age-sex-matched controls. The Global Initiative for Chronic Obstructive Lung Disease criteria were used for the diagnosis of COPD. FeNO levels were compared with clinico-radiological features, pulmonary functions, and other markers of T2 inflammation in COPD. Participants in the COPD subgroup had a median age of 62 (55.0, 69.0) years with a male predominance (77.3%). The median FeNO value was 27.0 ppb (19.0, 39.0) in COPD and 14.0 ppb (10.0, 20.0) in controls (p<0.001). FeNO values were categorized as low (≤25 ppb), intermediate (25-50 ppb), and high (≥50 ppb), with 57.3% of COPD patients having intermediate to high FeNO. In contrast, 46.7% of these patients had an absolute eosinophil count (AEC) ≥300/mm³. Higher values of FeNO in COPD were associated with the history of atopy (p<0.001), a positive bronchodilator reversibility on spirometry (p<0.05), and high-resolution computed tomography findings such as emphysema, bronchial wall thickening, bronchiectasis/bronchiolectasis, and mosaic attenuation (p<0.05). In addition, FeNO levels showed a strong positive linear correlation with serum immunoglobulin E (IgE) levels (r²=0.66, p<0.001) and AEC (r²=0.56, p<0.001). FeNO's best diagnostic cut-off level to detect T2 inflammation was 31 ppb (sensitivity: 65.9%, specificity: 86.5%; area under the receiver operating characteristic curve: 0.79). FeNO measurement, besides blood eosinophilia, is an effective, direct, airway-specific, non-invasive tool for detecting T2 airway inflammation in stable patients with COPD. Atopy (IgE sensitization) is a crucial factor in explaining higher FeNO values in COPD patients. FeNO correlates well with blood eosinophilia in COPD patients with an eosinophilic phenotype as a surrogate biomarker with good sensitivity and specificity.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692384","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}