{"title":"Multiple Sclerosis in Pregnancy and its Role in Female Fertility: A Systematic Review.","authors":"Rivia Lamaita, Carolina Melo, Cláudia Laranjeira, Paula Barquero, Joyce Gomes, Agnaldo Silva-Filho","doi":"10.5935/1518-0557.20210022","DOIUrl":"https://doi.org/10.5935/1518-0557.20210022","url":null,"abstract":"Multiple sclerosis (MS) is a neurological disease that typically affects young women of reproductive age. There are still many questions and heterogeneous clinical approaches partly due to the lack of consensus and guidelines. For many years, women with MS have been discouraged from getting pregnant for fears that the disease might negatively affect the fetus or increase their obstetric risk or for claims that the disease might decrease fertility. However, fertility does not seem to be impaired to a larger extent in women with MS. Therefore, all healthcare providers involved in the follow-up of multiple sclerosis patients must be prepared to discuss future fertility, pregnancy, and others matters, in addition to providing them with the best possible counseling. This study presents data based on updated evidence and discusses fertility and pregnancy in patients with MS with respect to the impacts of pregnancy on the risk and prognostic factors tied to MS, and the impact of MS on pregnancy outcomes and fertility treatments administered to females with MS. In conclusion, a clear relationship between infertility and MS has not been established. There seems to exist a link between disease aggressiveness and progression with several processes that might impair fertility. However, MS does not stand as a contraindication to assisted reproductive technology. From the several studies analyzed, it is possible to conclude that pregnancy is possible in women with MS. It is important to discuss and plan the ideal moment to start treatment and managing pregnancy and contraception aiming at better results.","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"493-499"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38970344","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}
Iheanyichukwu Wopara, Emmanuel U Modo, Samuel Kelechi Mobisson, G Adebayo Olusegun, E B Umoren, Blessing O Orji, Philippe E Mounmbegna, Stephanie Okoye Ujunwa
{"title":"Synthetic Food dyes cause testicular damage via up-regulation of pro-inflammatory cytokines and down-regulation of FSH-R and TESK-1 gene expression.","authors":"Iheanyichukwu Wopara, Emmanuel U Modo, Samuel Kelechi Mobisson, G Adebayo Olusegun, E B Umoren, Blessing O Orji, Philippe E Mounmbegna, Stephanie Okoye Ujunwa","doi":"10.5935/1518-0557.20200097","DOIUrl":"https://doi.org/10.5935/1518-0557.20200097","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effects of Tartrazine and Erythrosine (T+E) on the reproductive hormones and expression of some pro-inflammatory cytokines and testicular genes in testis of male Wistar rats.</p><p><strong>Methods: </strong>25 male Wistar rats (150-180g) were divided into 5 groups (n=5). Group 1 received distilled water while groups 2, 3, 4 and 5 were treated with T+E (2.5mg/kg, 5mg/kg, 10mg/kg and 20mg/kg) for the period of 23 days. Toxicity studies of the combined dye were investigated by evaluating serum reproductive hormones [Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Testosterone], gene expression and profiling, and testes histology.</p><p><strong>Results: </strong>male Wistar rats (150-180g) were divided into 5 groups (n=5). Group 1 received distilled water while groups 2, 3, 4 and 5 were treated with T+E (2.5mg/kg, 5mg/kg, 10mg/kg and 20mg/kg) for the period of 23 days. Toxicity studies of the combined dye were investigated by evaluating serum reproductive hormones [Follicle stimulating hormone (FSH), Luteinizing hormone (LH), Testosterone], gene expression and profiling, and testes histology.</p><p><strong>Conclusions: </strong>This present study reveals that the dyes could impair testicular function as evident in the up-regulation of pro-inflammatory cytokines and down-regulation of TESK-1 gene expression and architecture of the testes leading to Orchitis.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"341-348"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25351939","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}
Luis Vargas-Tominaga, Andrea Vargas, Fiorella Alarcón, Andrea Medina, Maritza Gómez, Katherine Bejar
{"title":"Cumulative live birth rates of patients in the Peruvian Andes according to the POSEIDON criteria: a single-center retrospective analysis.","authors":"Luis Vargas-Tominaga, Andrea Vargas, Fiorella Alarcón, Andrea Medina, Maritza Gómez, Katherine Bejar","doi":"10.5935/1518-0557.20200107","DOIUrl":"https://doi.org/10.5935/1518-0557.20200107","url":null,"abstract":"<p><strong>Objective: </strong>To identify low prognosis in-vitro fertilization (IVF) patients treated at Centro de Fertilidad y Ginecología del Sur (CFGS) based on the POSEIDON criteria.</p><p><strong>Methods: </strong>This retrospective study included 412 IVF patients and assessed them based on the POSEIDON criteria to describe the cumulative live birth rates seen in each group.</p><p><strong>Results: </strong>13.1% of patients met the POSEIDON criteria, and the proportion of cases in POSEIDON groups 1, 2, 3 and 4 were 20.4%, 31.5%, 14.8%, and 33.3%, respectively. The cumulative live birth rate for the individuals meeting the POSEIDON criteria was 25.9%, while for patients in POSEIDON groups 1, 2, 3, and 4 the rates were 45.5%, 29.4%, 25.0%, and 11%, respectively. The differences were not statistically significant due to the small number of cases.</p><p><strong>Conclusions: </strong>Patients belonging to the four POSEIDON groups were described at CFGS. Age and number of retrieved mature oocytes were determining parameters in the prognosis of pregnancy in IVF/ICSI patients.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"412-416"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495037","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":"Fertility awareness, attitudes towards parenting, and knowledge about Assisted Reproductive Technology among university students in Argentina.","authors":"Ludmila Jurkowski, Rocio Manubens, Julieta Olivera Ryberg, Mariela Rossi","doi":"10.5935/1518-0557.20210019","DOIUrl":"https://doi.org/10.5935/1518-0557.20210019","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to assess the fertility awareness, attitudes towards parenting, and knowledge about Assisted Reproductive Technology of Argentinian university students.</p><p><strong>Methods: </strong>This naturalistic, cross-sectional and quantitative study included the translation into Spanish of the Swedish Fertility Awareness Questionnaire; adjustments were also made to fit the questionnaire to local cultural norm. Through a snowball design using social media, university students were contacted in June 2019 and asked to complete an anonymous online self-report survey.</p><p><strong>Results: </strong>A total of 680 students (83.2% females and 16.4% males) aged 24.7 years on average (SD=5.6) answered the questionnaire. Approximately 70% believed they had high levels of knowledge about human reproduction; nevertheless, 46% thought that women could get pregnant in any stage of the cycle; 36.2% believed that fertility in women decreased between the ages of 45 and 50, 33.2% between the ages of 40 and 45, and 25.9% between the ages of 35 and 40 years. Half of the studied population thought that the chances of getting pregnant during the ovulation period ranged between 80-100%. In regard to age-related fertility decline in men, 57% believed that it simply did not happen. As to their desire to become parents, 58.3% stated that they planned to have children, and 50% said it was very important. The risk factors tied to infertility listed by the students were as follows: drug use (79.2%); aging (78.2%); smoking (69.2%); alcohol (66.5%); and sexually transmitted infections (43%).</p><p><strong>Conclusions: </strong>Argentinian university students wrongly see themselves as knowledgeable about fertility. Interventions are required to improve awareness over fertility among university students in Argentina.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"453-458"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38970343","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}
B Ogunlade, S A Adelakun, V O Ukwenya, T T Elemoso
{"title":"Potentiating response of D- Ribose-L-Cysteine on Sodium arsenate- induced hormonal imbalance, spermatogenesis impairments and histomorphometric alterations in adult male Wistar rat.","authors":"B Ogunlade, S A Adelakun, V O Ukwenya, T T Elemoso","doi":"10.5935/1518-0557.20200109","DOIUrl":"https://doi.org/10.5935/1518-0557.20200109","url":null,"abstract":"<p><strong>Objective: </strong>Reproductive toxicity is an important health challenge, mostly associated with exposure to several environmental toxicants. Arsenic is a ubiquitous toxic compound naturally present in the environment. This study was carried out to evaluate the dietary supplements of D-Ribose-L-Cysteine against sodium arsenate-induced testicular toxicity in adult male Wistar rats.</p><p><strong>Methods: </strong>A total of 32 male rats (150-250g) were randomly divided into four (4) groups (n=8). Group A received normal saline as placebo; Group B received 8mg/kg BW of Sodium arsenate only; Group C received 8mg/kg BW of Sodium arsenate and 10 mg/kg BW of D-Ribose- L-cysteine; Group D received 8mg/kg BW of Sodium arsenate and 30 mg/kg BW of D-Ribose- L-cysteine. All administration was done via oral gavage for 28 days, thereafter the animals were sedated with pentobarbital sodium (intraperitoneally); we obtained testes and blood serum for analysis.</p><p><strong>Results: </strong>The results showed abnormal testicular morphology with degeneration and decrease in spermatogonia, vacuolation and empty lumen, intense necrosis, spermatogenesis disruption (decrease sperm count, motility, viability) and degraded germinal epithelium of the seminiferous tubules, reduction in the hormone profile (FSH, LH, and TT) and oxidative stress parameters (CAT, GSH, and SOD) with a corresponding increase in MDA level in the arsenic-only treated rats (group B) compared to their control counterparts (group A), but it was ameliorated after DRLC administration, both in low and high doses, respectively.</p><p><strong>Conclusions: </strong>D-Ribose-L-Cysteine attenuated distorted testicular morphology, altered semen characteristics, hormone profile, and oxidative stress markers by preventing the deleterious toxicity of sodium arsenate.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"358-367"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39077757","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":"Live birth outcomes from IVF treatments in younger patients with low AMH.","authors":"Maho Miyagi, Keiko Mekaru, Rie Nakamura, Sugiko Oishi, Kozue Akamine, Chiaki Heshiki, Yoichi Aoki","doi":"10.5935/1518-0557.20210006","DOIUrl":"https://doi.org/10.5935/1518-0557.20210006","url":null,"abstract":"<p><strong>Objective: </strong>Anti-Müllerian hormone (AMH) is used to predict in vitro fertilization outcomes. However, predicting live birth is difficult in younger patients with low AMH. Thus, this study aimed to determine the live birth rates from younger patients with low anti-Müllerian hormone levels.</p><p><strong>Methods: </strong>A total of 296 infertile patients with AMH measured (younger group, aged 25-38 years; older group, aged 39-42 years) were included in this study. In vitro fertilization outcomes between patients with AMH levels of <1.0ng/mL and ≥1.0ng/mL were compared.</p><p><strong>Results: </strong>Younger patients with AMH levels <1.0ng/mL (younger low AMH group) exhibited lower number of oocytes retrieved than patients with AMH levels ≥1.0ng/mL (younger normal AMH group). However, there were no significant differences in cumulative pregnancy or cumulative live birth rates between groups. Older patients with AMH levels ≥1.0ng/mL (older normal AMH group) had significantly better outcomes as per mean number of oocytes, cumulative pregnancy rate, and cumulative live birth rate than older patients with AMH levels <1.0ng/mL (older low AMH group). In the younger low AMH group, the frequency of oocyte retrieval was significantly higher in patients who achieved live birth. In addition, the blastocyst transfer rate was significantly higher in individuals with live births versus subjects with non-live births.</p><p><strong>Conclusions: </strong>AMH is a predictor of live birth among older, but not younger, women. Our report suggests that younger women may become pregnant even with low AMH levels when they obtain blastocysts from frequent oocyte retrievals.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"417-421"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39077759","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":"Off-gassing plasticware to decrease the toxicity effect in embryo culture.","authors":"Jhon Troya Santos, Lisa Soobrian, Sonya Kashyap","doi":"10.5935/1518-0557.20210005","DOIUrl":"https://doi.org/10.5935/1518-0557.20210005","url":null,"abstract":"Objective\u0000To determine if reproductive toxicity might be reduced by off-gassing plasticware before use in in vitro fertilization culture.\u0000\u0000\u0000Methods\u0000Petri dishes were grouped according to the off-gassing days before use for testing as follow: 0 day (Group A); 3 days (Group B); 7 days (Group C). Two bioassays were run: Human survival sperm assay (HSSA) at 24 hours for all groups and mouse embryo assay (MEA) to evaluate the effect of the off-gassing procedure. Sperm motility and sperm motility index values were examined and blastocyst formation was calculated on Days 4 and 5.\u0000\u0000\u0000Results\u0000HSSA revealed decreased sperm motility in Group A (84%) compared to Groups B (94%) and C (93%) (p<0.5). MEA showed no statistical difference in blastocyst formation for the off-gassing groups (79.6%, 84.4%, 80%, Group A, B, and C, respectively; p>0.5). Hatching blastocyst formation on Day 5 was decreased in the nonoff- gassing group (49% vs. 56.7%, p>0.5).\u0000\u0000\u0000Conclusions\u0000Off-gassing for at least 72 hours decreases the toxicity of plasticware before use in in vitro fertilization cultures for HSSA. Further investigation needs to be done in order to standardize the bioassays used to evaluate this procedure.","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"428-433"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204142","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}
Arivaldo José Conceição Meireles, João Paolo Bilibio, Pânila Longhi Lorenzzoni, Emily De Conto, Fábio Costa do Nascimento, João Sabino da Cunha-Filho
{"title":"Association of FSHR, LH, LHR, BMP15, GDF9, AMH, and AMHR polymorphisms with poor ovarian response in patients undergoing in vitro fertilization.","authors":"Arivaldo José Conceição Meireles, João Paolo Bilibio, Pânila Longhi Lorenzzoni, Emily De Conto, Fábio Costa do Nascimento, João Sabino da Cunha-Filho","doi":"10.5935/1518-0557.20210004","DOIUrl":"https://doi.org/10.5935/1518-0557.20210004","url":null,"abstract":"<p><strong>Objective: </strong>This paper aimed to assess the correlation between LH, LHR, GDF9, FSHR, AMH, AMHR2, and BMP15 polymorphisms, which are related to follicular development, and decreased ovarian response in women undergoing controlled ovarian hyperstimulation (COH) for IVF.</p><p><strong>Methods: </strong>This age-matched case-control study included three or four controls per woman undergoing COH. Controls were women with normal ovarian response (NOR) and cases were women with poor ovarian response (POR) in oocyte retrieval (three or fewer oocytes). DNA was extracted from peripheral blood and potential associations with gene polymorphisms related to follicular development (LH, LHR, GDF9, FSHR, AMH, AMHR2, and BMP15) were analyzed.</p><p><strong>Results: </strong>Sixty-six patients were included, 52 in the NOR and 14 in the POR group. Two GDF9 polymorphisms were associated with follicular response after COH, one associated with POR - the presence of a mutant polymorphism in heterozygosis and homozygosis of the GDF9 398-39 (C to G) [23% NOR versus 68% POR (OR 4.01, CI 1.52-10.6, p=0.005)] - and another associated with protective response - the presence of normal homozygosis of GDF9 (C447T) [19.2% NOR versus 50% POR (OR 0.34, IC 0.14-0.84, p=0.019)]. No additional associations were found between the other analyzed polymorphisms and POR.</p><p><strong>Conclusions: </strong>This study found that GDF9 appears to play an important role in follicular development, whereas polymorphisms in its DNA chain may negatively affect ovarian reserve, such as 398-39 (C to G), or positively, as seen in C447T.</p>","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"439-446"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25495035","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":"REDLARA - Latin American Network of Assisted Reproduction.","authors":"Ricardo Marques de Azambuja","doi":"10.5935/1518-0557.20210041","DOIUrl":"https://doi.org/10.5935/1518-0557.20210041","url":null,"abstract":"","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"328"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/85/jbra-25-03-0328.PMC8312285.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204553","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}
Felipe A Morales Martínez, Martha Merino Ruiz, Eddy E Angulo Velarde, Otto H Valdés Martínez, Sara P Peña Lizola, Luis H Sordia Hernández
{"title":"An acute oral administration of Sildenafil in asthenozoospermic patients improves sperm motility after density gradient centrifugation.","authors":"Felipe A Morales Martínez, Martha Merino Ruiz, Eddy E Angulo Velarde, Otto H Valdés Martínez, Sara P Peña Lizola, Luis H Sordia Hernández","doi":"10.5935/1518-0557.20200076","DOIUrl":"https://doi.org/10.5935/1518-0557.20200076","url":null,"abstract":"Objective: Investigate the possible effect of an acute sildenafil dose in asthenozoospermic patients. Methods: We ran this experimental, descriptive, prospective and non-blinded study in 32 patients diagnosed with asthenozoospermia according to the WHO criteria, after two consecutive semen analyses (samples 1 and 2), and we asked them to provide a new semen sample two weeks after the initial exams (sample 3). One hour prior to the semen collection, we gave the patients 100mg oral sildenafil. Samples 2 and 3 were allowed to liquefy and density gradients centrifugation was performed. We assessed sperm motility by Computer-assisted sperm analysis (CASA). Results: There were no significant differences between the samples obtained before (sample2) or after sildenafil administration (sample3). However, a single oral 100 mg sildenafil dose in asthenozoospermic patients increase the percentage of motile sperm recovered after density gradient centrifugation. Conclusions: An acute administration of sildenafil enhances sperm recovery after density gradient centrifugation in asthenozoospermic patients, and it may produce more available mobile sperm to perform intra uterine insemination or to improve the chances of success in this procedure. This approach may be used as an alternative strategy in assisted reproductive programs. Sildenafil was well tolerated and no patient was withdrawn from the study due to adverse events attributed to sildenafil.","PeriodicalId":520656,"journal":{"name":"JBRA assisted reproduction","volume":" ","pages":"390-393"},"PeriodicalIF":1.5,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25405247","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}