Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology最新文献

{"title":"Simplifying the drug provocation test in non-immediate hypersensitivity reactions to amoxicillin in children: The experience of a tertiary care allergy unit.","authors":"Giulia Liccioli,&nbsp;Mattia Giovannini,&nbsp;Jean-Christoph Caubet,&nbsp;Simona Barni,&nbsp;Lucrezia Sarti,&nbsp;Paola Parronchi,&nbsp;Manuela Capone,&nbsp;Leonardo Tomei,&nbsp;Francesca Mori","doi":"10.1111/pai.13809","DOIUrl":"https://doi.org/10.1111/pai.13809","url":null,"abstract":"<p><strong>Background: </strong>Mild non-immediate reactions (NIR) to beta-lactams (βLs) are the most common manifestation of adverse drug reactions in children, and the drug provocation test (DPT) remains the gold standard for diagnosis. However, there are still controversies about the protocol that should be used, especially regarding the administration of doses and the DPT length.</p><p><strong>Objective: </strong>This study aimed to evaluate a pediatric population with a history of mild NIR to amoxicillin (AMX) or to amoxicillin-clavulanic acid (AMX/CL) who underwent a diagnostic workup including a DPT with the culprit drug, to understand if a graded DPT or, instead, a single full dose could be the most appropriate way of administration in clinical practice.</p><p><strong>Methods: </strong>The data of children were retrospectively analyzed for a 5-year period, with demographic and clinical characteristics collected. We reported the allergy workup and the results of the DPT performed with the administration of incremental doses and a prolonged DPT at home for a total of 5 days.</p><p><strong>Results: </strong>Three hundred fifty-four patients were included. Overall, 23/354 (6.5%) DPTs were positive: 11/23 patients showed a reaction after 2-8 h after the last dose on the 1st or 2nd day (1 reacted 30 min after the last dose), 1/23 reacted with urticaria 30 min after the first dose, 11/23 reacted at home on the 5th day of the DPT.</p><p><strong>Conclusion: </strong>This paper indirectly suggests that a single therapeutic dose administered on the 1st day of a DPT could be safe in the diagnostic workup of mild NIR to AMX/CL. Moreover, this could be less time-consuming as patients would spend less time in the hospital, also considering the public health restrictions imposed during the COVID-19 pandemic.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13809"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/02/PAI-33-0.PMC9328376.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396357","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":"Alarmins and innate lymphoid cells 2 activation: A common pathogenetic link connecting respiratory syncytial virus bronchiolitis and later wheezing/asthma?","authors":"Giovanni A Rossi,&nbsp;Stefania Ballarini,&nbsp;Pietro Salvati,&nbsp;Oliviero Sacco,&nbsp;Andrew A Colin","doi":"10.1111/pai.13803","DOIUrl":"https://doi.org/10.1111/pai.13803","url":null,"abstract":"<p><p>Severe respiratory syncytial virus (RSV) infection in infancy is associated with increased risk of recurrent wheezing in childhood. Both acute and long-term alterations in airway functions are thought to be related to inefficient antiviral immune response. The airway epithelium, the first target of RSV, normally acts as an immunological barrier able to elicit an effective immune reaction but may also be programmed to directly promote a Th2 response, independently from Th2 lymphocyte involvement. Recognition of RSV transcripts and viral replication intermediates by bronchial epithelial cells brings about release of TSLP, IL-33, HMGB1, and IL-25, dubbed \"alarmins.\" These epithelial cell-derived proteins are particularly effective in stimulating innate lymphoid cells 2 (ILC2) to release IL-4, IL-5, and IL-13. ILC2, reflect the innate counterparts of Th2 cells and, when activate, are potent promoters of airway inflammation and hyperresponsiveness in RSV bronchiolitis and childhood wheezing/asthma. Long-term epithelial progenitors or persistent epigenetic modifications of the airway epithelium following RSV infection may play a pathogenetic role in the short- and long-term increased susceptibility to obstructive lung diseases in response to RSV in the young. Additionally, ILC2 function may be further regulated by RSV-induced changes in gut microbiota community composition that can be associated with disease severity in infants. A better understanding of the alarmin-ILC interactions in childhood might provide insights into the mechanisms characterizing these immune-mediated diseases and indicate new targets for prevention and therapeutic interventions.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13803"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40398761","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":"T-cell-mediated hypersensitivity to lumacaftor and ivacaftor in cystic fibrosis.","authors":"Aida Semic-Jusufagic, Monday O Ogese, Christopher Edwards, Mark Wilkinson, Claire Nissenbaum, Tim Lee, Munir Pirmohamed, Dean J Naisbitt","doi":"10.1111/pai.13815","DOIUrl":"10.1111/pai.13815","url":null,"abstract":"","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13815"},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396361","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":"Epigenetic/genetic variations in CG-rich elements of immune-related genes contribute to food allergy development during childhood.","authors":"Maria Kostara,&nbsp;Vasiliki Chondrou,&nbsp;Vassilis Fotopoulos,&nbsp;Argyro Sgourou,&nbsp;Sophia Tsabouri","doi":"10.1111/pai.13812","DOIUrl":"https://doi.org/10.1111/pai.13812","url":null,"abstract":"<p><strong>Background: </strong>Genetic areas of FOXP3 TSDR, human leukocyte antigen-G (HLA-G) upstream of CpG island 96, CpG41 and CpG73 islands of the HLA-DRB1 and HLA-DQB1 genes respectively, previously documented to display immune-modulatory properties, were subjected to epigenetic/genetic analysis to assess their influence in IgE-mediated food allergy (FA) development in children.</p><p><strong>Methods: </strong>Sixty-four orally challenged and IgE-tested food allergic subjects together with 44 controls were recruited. Targeted pyrosequencing analysis to detect DNA methylation status and genetic variations was utilized and experimental results obtained were analyzed by a statistical software platform and correlated to clinical data. Also, transcription factor (TF) binding sites in study areas were unmasked by the JASPAR prediction database.</p><p><strong>Results: </strong>Parents' smoking was significantly correlated with aberrant methylation patterns, regardless of food allergic or control status. HLA-G promoter region showed a trend for hypomethylation in food allergic subjects, with one of the CG sites displaying significantly decreased methylation values. Rs1233333, residing within the HLA-G promoter region preserved a protective role toward DNA methylation. Variable methylation patterns were recorded for CpG41 of the HLA-DRB1 gene and hypermethylation of the region was significantly correlated with the presence of single nucleotide polymorphisms (SNPs). TFs' recognition sites, located in studied genetic areas and exerting pivotal regulatory biological roles, are potentially affected by divergent DNA methylation status.</p><p><strong>Conclusions: </strong>We propose that HLA-G expression is triggered by food-derived allergens, providing a Treg^{FoxP3-/HLA-G+} subpopulation generation to promote direct immune tolerance. Furthermore, clear evidence is provided for the underlying co-operation of genetic polymorphisms with epigenetic events, mainly at the CpG41 island of the HLA-DRB1 gene, which needs an extended investigation and elucidation.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13812"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40398764","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":"Can the response to a single dose of beclomethasone dipropionate predict the outcome of long-term treatment in childhood exercise-induced bronchoconstriction?","authors":"Vera S Hengeveld,&nbsp;Natasja Lammers,&nbsp;Mattienne R van der Kamp,&nbsp;Job van der Palen,&nbsp;Bernard J Thio","doi":"10.1111/pai.13808","DOIUrl":"https://doi.org/10.1111/pai.13808","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced bronchoconstriction (EIB) is a frequent and highly specific symptom of childhood asthma. Inhaled corticosteroids (ICS) are the mainstay of controller therapy for EIB and asthma; however, a proportion of asthmatic children and adolescents is less responsive to ICS. We hypothesized that a single dose response to ICS could function as a predictor for individual long-term efficacy of ICS.</p><p><strong>Objective: </strong>To assess the predictive value of the bronchoprotective effect of a single-dose beclomethasone dipropionate (BDP) against EIB for the bronchoprotective effect of 4 weeks of treatment, using an exercise challenge test (ECT).</p><p><strong>Methods: </strong>Thirty-two steroid-naïve children and adolescents aged 6 to 18 years with EIB were included in this prospective cohort study. They performed an ECT at baseline, after a single-dose BDP (200µg) and after 4 weeks of BDP treatment (100 µg twice daily) to assess EIB severity.</p><p><strong>Results: </strong>The response to a single-dose BDP on exercise-induced fall in FEV1 showed a significant correlation with the response on exercise-induced fall in FEV1 after 4 weeks of BDP treatment (r = .38, p = .004). A reduction in post-exercise fall in FEV1 of more than 8% after a single-dose BDP could predict BDP efficacy against EIB after 4 weeks of treatment with a positive predictive value of 100% (CI: 86.1-100%) and a negative predictive value of 29.4% (CI: 11.7%-53.7%).</p><p><strong>Conclusion: </strong>We found that the individual response to a single-dose BDP against EIB has a predictive value for the efficacy of long-term treatment with BDP. This could support clinicians in providing personalized management of EIB in childhood asthma.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13808"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396356","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":"Lymphomatoid granulomatosis in a patient with DOCK8 deficiency.","authors":"Eduardo Liquidano-Perez,&nbsp;Adriana Del Carmen Alva-Chaire,&nbsp;Marco Antonio Yamazaki-Nakashimada,&nbsp;Ángela Andrea Pesantez Abril,&nbsp;Sara Alejandra Solorzano Morales,&nbsp;Alfonso G Ramírez Ristori,&nbsp;Tania Barragán Arévalo,&nbsp;María Edith Gonzalez-Serrano,&nbsp;Selma C Scheffler-Mendoza,&nbsp;Rodolfo Rodríguez-Jurado","doi":"10.1111/pai.13804","DOIUrl":"https://doi.org/10.1111/pai.13804","url":null,"abstract":"(support) and writing— revision and editing (support). Sara Alejandra Solorzano Morales involved in data curation (same); monitoring (same); and writing— revision and editing (same). Alfonso G. Ramírez Ristori and Tania Barragán Arévalo involved in data curation (same); original writing— draft (support); and writing— revision and editing (support). María Edith Gonzalez-Serrano and Rodolfo Rodríguez- Jurado involved in conceptualiza-tion (lead); supervision (lead); and writing— revision and editing (same). Selma C. Scheffler- Mendoza involved in data curation (same); monitoring (same); and writing— revision and editing (same).","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13804"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40396362","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":"Hypoallergenicity assessment of an extensively hydrolyzed whey-protein formula in cow's milk allergic infants.","authors":"Lamia Dahdah,&nbsp;Mieke Roelofs,&nbsp;Karen Knipping,&nbsp;Esther de Vries,&nbsp;Anneke Rijnierse,&nbsp;Johan Garssen,&nbsp;Paul L P Brand,&nbsp;Alessandro Fiocchi","doi":"10.1111/pai.13814","DOIUrl":"https://doi.org/10.1111/pai.13814","url":null,"abstract":"<p><strong>Background: </strong>Extensively hydrolyzed formulas are recommended for the dietary management of infants with cow's milk allergy (CMA).</p><p><strong>Objectives: </strong>Hypoallergenicity, growth, and gastrointestinal (GI) tolerability of a new extensively hydrolyzed whey-protein formula (eHWF) in CMA children were assessed.</p><p><strong>Methods: </strong>In this prospective, randomized, international, multi-center study (Trial NL3889), 34 children with confirmed CMA (74% IgE-mediated) underwent a double-blind, placebo-controlled food challenge (DBPCFC) with an eHWF developed with non-porcine enzymes, supplemented with prebiotic short-chain galacto- and long-chain fructo-oligosaccharides (0.8 g/L, ratio 9:1), arachidonic acid (0.35/100 g), and docosahexaenoic acid (0.35/100 g). If tolerant to the eHWF, children participated in a 7-day open food challenge with this eHWF. Anthropometrics and GI tolerability were assessed in an optional 16-weeks follow-up.</p><p><strong>Results: </strong>Of the 34 children who started the DBPCFC with the eHWF, 25 subjects (19 boys, mean age: 61 weeks, 18 with IgE-mediated CMA) completed the DBPCFC and 7-day open challenge without major protocol deviations and tested negative at both challenges. One child experienced a late moderate eczematous allergic reaction in the optional follow-up period, indicating the need for close monitoring of subjects starting new formula. Weight and length gain followed the World Health Organization growth curves. Changes in frequency and consistency of stools upon test formula intake were transient.</p><p><strong>Conclusions: </strong>The newly developed eHWF is a suitable option in CMA treatment as all subjects tolerated the product. This result is in line with the international criteria for hypoallergenicity (American Academy of Pediatrics) that state that more than 90% of CMA children must tolerate the formula. Use of the formula is also associated with normal growth curves and GI tolerability.</p><p><strong>Trial registration: </strong>Trial NL3889, https://www.trialregister.nl/trial/3889.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13814"},"PeriodicalIF":4.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/01/PAI-33-0.PMC9542408.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40398759","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":"Lower caprylate and acetate levels in the breast milk is associated with atopic dermatitis in infancy.","authors":"Li-Chieh Wang,&nbsp;Yen-Ming Huang,&nbsp;Chieh Lu,&nbsp;Bor-Luen Chiang,&nbsp;Ying-Rou Shen,&nbsp;Hsun-Yi Huang,&nbsp;Chien-Chang Lee,&nbsp;Nan-Wei Su,&nbsp;Bi-Fong Lin","doi":"10.1111/pai.13744","DOIUrl":"https://doi.org/10.1111/pai.13744","url":null,"abstract":"<p><strong>Background: </strong>Atopic dermatitis (AD) occurs in exclusively breastfed infants. As fatty acids have some immunomodulatory effect, we aimed to investigate the influence of fatty acid compositions in breast milk (BM) on the development of AD in exclusively breastfed infants.</p><p><strong>Methods: </strong>We enrolled two- to four-month-old exclusively breastfed infants. The objective SCORing Atopic Dermatitis (objSCORAD) was evaluated. The lipid layer of BM was analyzed by gas chromatography for fatty acid levels. Medical charts were reviewed.</p><p><strong>Results: </strong>Forty-seven AD infants and 47 healthy controls were enrolled. The objSCORAD was 20.5 ± 1.7 (shown as mean ± SEM) in the AD group. The age, sex, parental atopy history, and nutrient intake of mothers were not significantly different between two groups. The palmitate and monounsaturated fatty acid (MUFA) levels in BM positively correlated with objSCORAD, while caprylate, acetate, and short-chain fatty acid (SCFA) levels negatively correlated with objSCORAD (p = .031, .019, .039, .013, .022, respectively). However, the butyrate levels in BM were not significantly different. The caprylate and acetate levels in BM were significantly associated with the presence of infantile AD (p = .021 and .015, respectively) after adjusting for age, sex, parental allergy history, MUFA, palmitate, and SCFA levels in BM. ObjSCORAD in infancy was significantly associated with persistent AD (p = .026) after adjusting for age, sex, parental atopy history, caprylate, palmitate, MUFA, acetate, and SCFA levels in BM.</p><p><strong>Conclusion: </strong>Caprylate and acetate levels in BM for exclusively breastfed infants were negatively associated with objSCORAD. Lower caprylate and acetate in BM might be the risk factors for infantile AD, while butyrate in BM was not associated with infantile AD.</p>","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13744"},"PeriodicalIF":4.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39656713","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":"Does SMS text messaging promote the early introduction of food allergens? A randomized controlled trial.","authors":"Merryn J Netting,&nbsp;Michael S Gold,&nbsp;Patrick Quinn,&nbsp;Sacha Palmer,&nbsp;Maria Makrides,&nbsp;Tim J Green","doi":"10.1111/pai.13720","DOIUrl":"https://doi.org/10.1111/pai.13720","url":null,"abstract":"To the Editor, Infant feeding guidelines now promote early and regular inclusion of common food allergens in infant diets to prevent food allergy; however, tools to translate these guidelines into practice have not been evaluated.1– 3 We conducted a randomized controlled trial (RCT) to test whether regular SMS messaging to caregivers with information on allergen introduction improved rates of allergen exposure at one year. We found that nearly all children were exposed to allergens by one year, regardless of SMS messaging, suggesting Australian caregivers were already aware of the importance of early allergen introduction. Some parents were concerned about early adverse reactions to food, highlighting the need for timely advice to prevent unnecessary dietary restrictions.","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13720"},"PeriodicalIF":4.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39745055","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":"Editorial comments on: \"Consumption of differently processed milk products and the risk of asthma in children\".","authors":"Jon Genuneit,&nbsp;Philippe Eigenmann","doi":"10.1111/pai.13730","DOIUrl":"https://doi.org/10.1111/pai.13730","url":null,"abstract":"It is well known that patients may differently react to certain foods according to the degree of heating. In addition to this clinical observation, a large set of laboratory studies have confirmed that cooking reduces the allergenicity while largely keeping the immunogenicity of the food. This observation has a clinical significance as a large number of patients with egg allergy can consume most processed foods containing eggs as they are at least partially or fully cooked. Similarly, milk products are also often processed by cooking, and hence, the proteins are partially denaturized. Strategies using cooked foods in order to induce a favorable immunomodulation without marked allergic reaction have been largely used for oral immunotherapy to foods. With regard to immunotherapy for milk allergy, a French group has recently published a series with 64 children in this journal.1 They could show successful oral desensitization to milk in over 40% of these children, a percentage that was even higher in other studies. Immunotherapy with mixed egg has also been reported by the same group with an even higher rate of success.2 The effect of food allergy prevention through the diet has recently been revised by an EAACI committee, which extensively reviewed the most recent data.3,4 Remarkably, the most efficient preventive measures identified were","PeriodicalId":520742,"journal":{"name":"Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology","volume":" ","pages":"e13730"},"PeriodicalIF":4.4,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39960163","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}