Sleep & breathing = Schlaf & Atmung最新文献

{"title":"Community awareness of obstructive sleep apnea (OSA): Saudi Arabia.","authors":"Kareemah Salem Alshurtan, Sarrah Yousef Aldhaifi, Siwar Awad Alamrani","doi":"10.1007/s11325-025-03436-7","DOIUrl":"10.1007/s11325-025-03436-7","url":null,"abstract":"<p><strong>Purpose: </strong>OSA is a potentially serious medical condition associated with metabolic and cardiovascular hazards. The Saudi population remains inadequately informed, despite its increasing prevalence. The purpose of this study is to evaluate Saudi Arabian public awareness about OSA.</p><p><strong>Methods: </strong>992 people from all around Saudi Arabia participated in a descriptive cross-sectional study using a validated online questionnaire. Descriptive statistics were used to assess the demographic, health, and OSA knowledge data, and Pearson's Chi-Square test was used to look for correlations with the demographic characteristics.</p><p><strong>Results: </strong>The survey indicated that just 39% of participants were aware of OSA. Age, geographic location, healthcare profession, and familial medical history shown significant correlations with awareness (p < 0.05). The signs, ramifications, and therapies of OSA were inadequately comprehended.</p><p><strong>Conclusion: </strong>The research indicated that 39% of Saudi Arabians lacked enough knowledge of OSA. Targeted programs that focus on symptoms, dangers, and treatments are critical for improving early diagnosis and results. These efforts should focus specifically on marginalized populations and non-healthcare sectors.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 5","pages":"271"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144824836","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":"Are sleep disturbances modifiable risk factors for mild cognitive impairment and dementia? A systematic review of large studies.","authors":"Giusy Bergamo, Claudio Liguori","doi":"10.1007/s11325-025-03421-0","DOIUrl":"10.1007/s11325-025-03421-0","url":null,"abstract":"<p><p>Studies have shown a connection between sleep disorders, mild cognitive impairment and dementia. In this context, the present systematic review aimed to determine in large studies whether sleep disturbances are modifiable risk factors for cognitive decline. Following the application of inclusion and exclusion criteria, this systematic review selected 15 studies, with large cohort of subjects included (more than 1000 participants), who were longitudinally observed. Studies predominantly used questionnaires and interviews to collect subjective data on sleep. Eleven studies were based on subjective measurements, one was based on the International Classification of Diseases - 9th Edition diagnosis codes, and three based on objective actigraphic measurements. No study used polysomnographic assessments for the evaluation of sleep disorders.The results of this systematic review showed that extreme sleep durations (either too short or too long), daytime sleepiness, circadian sleep-wake cycle disruption, and variation in sleep patterns are factors associated with an increased risk of developing cognitive decline and dementia. Actigraphy, as an objective instrument for monitoring the sleep-wake rhythm, provided further insights into the association between sleep problems and longitudinal cognitive decline. These findings emphasize the strong connection between sleep disturbances, circadian rhythm, and the risk of developing dementia and Alzheimer's disease (AD). Sleep disorders may serve as an early indicator for cognitive decline, also considering that they may represent a modifiable risk factor for dementia. Therefore, recognition and treatment of sleep problems should be included in the prevention strategies against cognitive decline, opening up new opportunities for the prevention and treatment of cognitive impairment and AD.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"269"},"PeriodicalIF":2.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805587","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":"Shanghan Lun and Gam Saan songs for older Chinese Americans with insomnia.","authors":"Benjamin K P Woo","doi":"10.1007/s11325-025-03440-x","DOIUrl":"10.1007/s11325-025-03440-x","url":null,"abstract":"","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"270"},"PeriodicalIF":2.0,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805588","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":"Osa in women: When does cpap increase blood pressure?","authors":"Grace Oscullo, Amina Bekki, Thais Beaperthuy, Jose Daniel Gómez-Olivas, Marina Anglés, Sergio Mompeán, Rosalía Martínez, Silvia Ponce, Martino F Pengo, Miguel Angel Martinez-Garcia","doi":"10.1007/s11325-025-03434-9","DOIUrl":"10.1007/s11325-025-03434-9","url":null,"abstract":"<p><strong>Background: </strong>There has been only one randomised clinical trial (RCT) on the effect of CPAP on women at three months. It showed that, overall, this treatment had no effect on blood pressure levels, even though some of the women presented increased blood pressure while under CPAP. Identifying this group of women could therefore be of clinical interest.</p><p><strong>Objective: </strong>To identify the risk factors for an increase (of at least 2 mmHg of BP) by analysing the CPAP arm of this RCT in those patients with inadequate and good adherence to CPAP.</p><p><strong>Methods: </strong>151 women from the CPAP arm of the RCT were included. They all followed a complete sleep protocol that included CPAP pressure titration and office BP measures at baseline and one and three months after beginning CPAP treatment.</p><p><strong>Results: </strong>After exclusion, 137 women began the study. 69.3% showed good adherence to CPAP at 3 months and 77 patients (56.2%) increased their BP. In the overall group of women (independently of their adherence to CPAP), age, the presence of depression, baseline AHI and baseline SBP were associated with an increased BP (at least 2 mmHg) at 1 and 3 months. However, the BP increase was observed during the first month and tended to stabilize towards the third month.</p><p><strong>Conclusion: </strong>Greater age, the presence of depression and higher baseline AHI and SBP were independently associated with a clinical significant increase in BP after CPAP, regardless of their adherence. These changes in BP appeared mainly during the first month of treatment.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"268"},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144802420","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":"Belun Sleep Platform versus in-lab polysomnography for obstructive sleep apnea diagnosis.","authors":"Vipada Tirachaimongkol, Wish Banhiran, Wattanachai Chotinaiwattarakul, Sarin Rungmanee, Chawanon Pimolsri, Jindapa Srikajon, Navarat Kasemsuk","doi":"10.1007/s11325-025-03433-w","DOIUrl":"10.1007/s11325-025-03433-w","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to compare the Belun Sleep Platform (BSP), an artificial intelligence-driven home sleep testing device, with polysomnography (PSG) for diagnosing obstructive sleep apnea. The BSP analyzes oxygen saturation, heart rate, and accelerometry patterns.</p><p><strong>Methods: </strong>Participants scheduled for PSG and with no significant cardiovascular or neuromuscular comorbidities were recruited. They underwent simultaneous in-laboratory, full-night PSG with the BSP. We assessed diagnostic properties, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.</p><p><strong>Results: </strong>A total of 40 participants (54.3% male) with a mean age of 49.9 years were enrolled. For an apnea-hypopnea index (AHI) cutoff of ≥ 15 events/h, BSP showed an accuracy of 68.5%, sensitivity of 35.2%, and specificity of 100% under American Academy of Sleep Medicine criteria 1 A and 1B. For AHI thresholds of ≥ 5 and ≥ 30 events/h, sensitivity was 82.1% and 33.3%, respectively, while specificity was 14.2% and 100%, respectively. BSP-AHI correlated moderately with PSG-AHI (intraclass correlation coefficient [ICC] = 0.737). BSP's oxygen desaturation index (ODI) showed a strong correlation with PSG-ODI (ICC = 0.882). Moderate correlations were observed between BSP and PSG for non-rapid eye movement sleep duration (ICC = 0.736), rapid eye movement sleep duration (ICC = 0.664), total sleep time (ICC = 0.617), and sleep efficiency (ICC = 0.719).</p><p><strong>Conclusions: </strong>The BSP's high specificity but low sensitivity suggests it serves better as a confirmatory tool rather than a primary screening method. Its moderate concordance with PSG underscores its potential in settings where PSG is unavailable. However, further investigation is needed to refine its clinical applications.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"266"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796619","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":"Role of arousal in diagnosing sleep apnea in atrial fibrillation patients.","authors":"Susana Sousa, Carlos Teixeira, Dina Grencho, Sara Dias, Marta Drummond, António Bugalho","doi":"10.1007/s11325-025-03435-8","DOIUrl":"10.1007/s11325-025-03435-8","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea syndrome (OSAS) is highly prevalent in patients with atrial fibrillation (AF) and may influence rhythm control outcomes. Accurate diagnosis is essential but depends on the criteria used to define respiratory events. This study aimed to evaluate how the inclusion of EEG arousals in hypopnea scoring affects the diagnosis and severity classification of OSAS in patients with AF.</p><p><strong>Patients and methods: </strong>We conducted a prospective analysis of 88 consecutive patients with AF (paroxysmal or persistent) referred for sleep evaluation with ambulatory type II polysomnography (PSG). Hypopneas were scored according to two criteria: [1] ≥ 3% oxygen desaturation, and [2] ≥ 3% desaturation or EEG-defined arousal. Apnea-hypopnea index (AHI) and OSAS severity were compared across both definitions.</p><p><strong>Results: </strong>Participants had a mean age of 63 ± 9.7 years, were predominantly male (68%), and had a mean BMI of 30 ± 4.8 kg/m². OSAS was diagnosed in 100% of patients. Using the desaturation-only criterion, OSAS severity was classified as mild in 24.7%, moderate in 31.8%, and severe in 43.5% of patients. In contrast, scoring hypopneas based on desaturation or arousal led to reclassification: 5.7% mild, 17.0% moderate, and 77.3% severe. Thirty-one patients classified as severe OSAS were missed using desaturation-only scoring. The number of hypopneas detected was significantly higher when arousals were included (200.0 ± 105.6 vs. 81.9 ± 48.9; p < 0.001), with a moderate positive correlation between the two methods (r = 0.436).</p><p><strong>Conclusion: </strong>The use of arousal-inclusive criteria significantly increases OSAS detection and alters severity classification in patients with AF. Relying solely on oxygen desaturation may lead to underdiagnosis and misclassification, particularly in non-desaturating patients. Incorporating EEG arousals into hypopnea scoring provides a more accurate assessment of disease burden and may support more effective, individualized treatment strategies.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"267"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796633","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":"Determinants of patient satisfaction in continuous positive airway pressure therapy for obstructive sleep apnea: A multivariate analysis of knowledge, technical, and psychosocial factors.","authors":"Marcel Braun, Sarah Dietz-Terjung, Torsten Eggert, Christoph Schoebel","doi":"10.1007/s11325-025-03438-5","DOIUrl":"10.1007/s11325-025-03438-5","url":null,"abstract":"<p><strong>Background: </strong>Positive airway pressure (PAP) therapy is the primary treatment for obstructive sleep apnea (OSA), but long-term adherence remains challenging. This study aimed to identify key predictors of patient satisfaction with PAP therapy by examining the interrelationships between disease knowledge, care provision, health beliefs, and patient-reported experiences.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a tertiary sleep center in Germany. Adult patients with confirmed OSA diagnosis and experience with PAP therapy completed a comprehensive questionnaire assessing four domains: health attitudes and self-management, OSA care provision perceptions, OSA disease knowledge, and treatment experience. Multiple regression analysis was performed to identify predictors of treatment satisfaction.</p><p><strong>Results: </strong>Among 148 participants (72.8% male, mean age 57.9 ± 11.8 years), 58.8% were active PAP users. High levels of family support (> 90%) and disease knowledge were reported, with 94.4% acknowledging the importance of regular treatment. Treatment experience emerged as the primary predictor of satisfaction in domain-level analysis. The final regression model identified four significant predictors explaining 75.9% of variance in satisfaction: treatment effectiveness (β = 0.304, p <. 001), routine integration (β = 0.286, p =. 001), nocturnal awakening (β = 0.273, p <. 001), and mask removal (β = 0.198, p =. 007). Patient satisfaction negatively correlated with alternative treatment usage (τ=-0.274, p <. 001) and positively with disease duration (τ = 0.187, p =. 008).</p><p><strong>Conclusion: </strong>PAP therapy satisfaction is predominantly influenced by treatment-specific factors rather than general health attitudes or care provision perceptions. Understanding these predictors may help clinicians identify patients at risk for low satisfaction and target interventions accordingly.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"265"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796620","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":"Factors affecting compliance in CPAP device usage for obstructive sleep apnea: a mixed-methods study integrating quantitative and qualitative findings.","authors":"Serhat Firat, Mehmet Nurullah Kurutkan","doi":"10.1007/s11325-025-03424-x","DOIUrl":"10.1007/s11325-025-03424-x","url":null,"abstract":"<p><strong>Background: </strong>This study aims to identify novel factors influencing adherence to Continuous Positive Airway Pressure (CPAP) devices, the primary treatment for obstructive sleep apnea (OSA), and to compile the most comprehensive list of variables in the literature.</p><p><strong>Methods: </strong>A mixed-methods approach was adopted, analyzing patient records from a sleep center between 2018 and July 1, 2023. Quantitative data were obtained from surveys administered to 449 patients, while qualitative data were collected through in-depth interviews with 30 patients and document reviews of 449 records. Analyses were conducted using FACTORY Analysis, SmartPLS, IBM SPSS, and MAXQDA software.</p><p><strong>Results: </strong>The combined analysis of quantitative and qualitative findings identified previously unreported variables affecting CPAP adherence. A comprehensive list of influencing factors was developed, spanning device/accessory-related, psychosocial, environmental, individual, regional, and political domains. Eight novel variables were uncovered, including barriers such as fear of lightning/thunder, fear of earthquakes, relocation, religious practices, air pollution, and long hair, as well as facilitators like the use of automatic devices and rural residency. These findings indicate that existing theories and models are insufficient to fully explain CPAP adherence, highlighting the complexity of the process.</p><p><strong>Conclusion: </strong>This study highlights the complexity of CPAP adherence and calls for new theoretical models. It highlights the importance of geographical, cultural, and religious influences, advocating for further research to address these gaps and improve patient adherence strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"264"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796621","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":"Association between skin temperature variability and sleep apnea severity: findings from a pilot study.","authors":"Gary Garcia Molina, Trevor Winger, Megha Rajam Rao, Leah McGhee, Nikhil Makaram, Pavlo Chernega, Yehor Shcherbakov, Vidhya Chellamuthu, Erwin Veneros, Rajasi Mills, Daniela Grimaldi, Kathryn J Reid, Phyllis C Zee","doi":"10.1007/s11325-025-03437-6","DOIUrl":"10.1007/s11325-025-03437-6","url":null,"abstract":"<p><strong>Purpose: </strong>Obstructive sleep apnea (OSA) may disrupt autonomic and vascular control, affecting skin temperature variability (STV). We aimed to assess whether STV (measured at distal and proximal sites) is associated with OSA severity (apnea-hypopnea index [AHI] and percent of sleep time with oxygen saturation below 90% [T90]) and if STV can aid in non-invasive OSA risk screening.</p><p><strong>Methods: </strong>Eighteen participants underwent two nights of polysomnography with simultaneous distal and proximal skin temperature recording using iButtons. STV was calculated by standard deviation, median absolute deviation, and Poincaré plot analyses for sleep onset-to-offset, non-rapid eye movement (NREM), rapid eye movement (REM), and wake intervals. Linear mixed-effect models assessed relationships between STV and AHI/T90. Mediation analysis evaluated the role of body mass index (BMI), and receiving-operator-characteristic-curve (ROC)-based analysis assessed the screening potential of STV for moderate-to-severe OSA. All p-values were adjusted by the Benjamini-Hochberg False Discovery Rate (FDR).</p><p><strong>Results: </strong>AHI showed a strong, negative association with distal STV during NREM sleep, especially median absolute deviation (fixed effect coefficient = - 8.16, FDR-adjusted p < 0.001). T90 was similarly associated (- 1.90, FDR-adjusted p < 0.01). No significant relationships were found during REM or wake. BMI did not mediate these associations. ROC analysis revealed high discriminative ability for moderate-to-severe OSA (AUC: 0.93-0.97).</p><p><strong>Conclusion: </strong>Reduced distal STV during NREM sleep independently signals OSA severity and may serve as a promising, non-invasive biomarker for screening OSA risk.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"263"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791817","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":"Factors influencing the effect of melatonin on sleep quality in children with autism spectrum disorder: a systematic review and meta-analysis.","authors":"Hao Yang, Feng Lu, Xiaoyan Zhao","doi":"10.1007/s11325-025-03432-x","DOIUrl":"10.1007/s11325-025-03432-x","url":null,"abstract":"<p><p>Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction and communication. The prevalence of ASD has risen globally. Sleep disturbances exacerbates the core symptoms of children with ASD, and numerous studies demonstrated that melatonin is efficacious in treating autism-related insomnia in children. This study intended to comprehensively analyze the therapeutic effects of melatonin on sleep disturbances in children with autism, focusing on effect sizes across different treatment parameters, including medication dosage, type, treatment course, and the age of the children. Additionally, the analysis examines the effects of melatonin on various sleep indicators. Through systematic review and meta-analyses, data from existing studies were collected and categorizing them based on medication parameters and the age of the participants. The influence of melatonin on multiple sleep indicators was evaluated, revealing that melatonin significantly improves sleep quality and total sleep time in children with autism. The Hedges' g values for these two indicators were 0.75 and 0.58, with both P-values less than 0.05. The overall effect of melatonin displayed a parabolic relationship with dosage, achieving its optimal effectiveness at approximately 5.7 mg. Subject age also influenced the therapeutic effect with optimal results observed in children aged 10 years and older, where the Hedges' g effect size reached 0.09. Melatonin shows substantial effectiveness in improving the sleep in children with ASD, with minimal and mild adverse reactions. These findings support the development of individualized treatment approaches for melatonin administration in this population.</p>","PeriodicalId":520777,"journal":{"name":"Sleep & breathing = Schlaf & Atmung","volume":"29 4","pages":"262"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791818","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}