Acta endocrinologica最新文献

{"title":"MINIMALLY INVASIVE PARATHYROIDECTOMY FOR PRIMARY HYPERPARATHYROIDISM.","authors":"M. Urkan, Y. S. Peker, E. Ozturk","doi":"10.4183/AEB.2019.182","DOIUrl":"https://doi.org/10.4183/AEB.2019.182","url":null,"abstract":"Context\u0000Primary hyperparathyroidism (PHPT), characterized by the inappropriate secretion of parathyroid hormone (PTH) with respect to the extracellular calcium concentration. Curative treatment of PHPT is surgery and bilateral neck exploration has been replaced by minimally invasive parathyroidectomy (MIP), with the advanced imaging technologies combined with radio-guided occult lesion localization (ROLL).\u0000\u0000\u0000Objectives\u0000The present study analyzes the MIP data from 45 patients who underwent surgery for parathyroid adenoma and debates if MIP is a feasible technique for the treatment of PHPT.\u0000\u0000\u0000Design\u0000The study presents the MIP excision data of 45 hyperparathyroidism patients with a 58-month follow up period.\u0000\u0000\u0000Results\u0000Forty-five operations were performed for 48 parathyroid adenomas. The mean duration of operation was 22.7 (12-55) minutes. Mean follow-up was 14.2 (6-26) months. All patients had normal postoperative calcium levels and PTH levels were normal in the follow-up period, except for one persistent hyperparathyroidism.\u0000\u0000\u0000Conclusions\u0000ROLL-guided MIP is a feasible technique for parathyroid surgery and reduces surgeon based failure. It also provides the widespread application of parathyroid surgery by decreasing the need for specific experience.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"72 1","pages":"182-186"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74436450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"THE MULTIFARIOUS CUSHING'S - LESSONS FROM A CASE SERIES.","authors":"I. Ilie, V. Ciubotaru, A. Tulin, D. Hortopan, A. Caragheorgheopol, M. Purice, C. Neamtu, V. Elian, A. Banica, L. Oprea, M. Mușat","doi":"10.4183/AEB.2019.261","DOIUrl":"https://doi.org/10.4183/AEB.2019.261","url":null,"abstract":"Endogenous Cushing's syndrome is rare, with an incidence of 0.7-2.4 per a million people a year. Clinical presentation of Cushing syndrome can be pleomorphic, and establishing diagnosis can be difficult. Early recognition and rapid control of hypercortisolaemia are necessary to decrease morbidity and mortality in these patients. We report a series of 6 endogenous Cushing's syndromes of different etiologies (4 Cushing's disease and 2 adrenal Cushing's syndrome) assessed in our endocrine department over a decade (2009-2019). In order to highlight the diversity of clinical forms, diagnostic tools and specific management of this condition we labelled each case suggestively: the typical Cushing's disease, the Pseudo Cushing's, the elusive Cushing's disease, the mild autonomous cortisol hypersecretion, Cushing's syndrome in pregnancy and Cushing's disease with thromboembolism. We discussed their particularities which were revelatory for the diagnosis, such as dermatologic, cardiovascular, musculoskeletal, neuropsychiatric, or reproductive signs, reviewing literature for each manifestation. We also discuss the commonalities and differences in laboratory and imagistic findings. Therapeutic approach can also differ with respect to the particular condition of each patient and the multiple choices of therapy will be reviewed.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"70 1","pages":"261-269"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84130295","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":"OXIDATIVE STRESS IS MARKEDLY REDUCED BY COMBINED VOLUNTARY EXERCISE AND TESTOSTERONE IN THE HEART OF DIABETIC RATS.","authors":"L. Chodari, S. Smailnejad, M. Fallahi, N. Khalaji, V. Ghorbanzadeh","doi":"10.4183/AEB.2019.173","DOIUrl":"https://doi.org/10.4183/AEB.2019.173","url":null,"abstract":"Objective\u0000Cardiovascular disorders in diabetes condition arise from increased oxidative stress. Both regular mild exercise and testosterone influence on body's antioxidant system in diabetes. In this study, we evaluated treatment of testosterone and voluntary exercise, alone or together on oxidative stress in the heart and blood of diabetic rats.\u0000\u0000\u0000Methods\u0000Type 1 diabetes was induced by intraperitoneal injection of 50 mg/kg of streptozotocin in rats. Sixty three rats have been divided into eight groups as follows: Diabetes, diabetes+ testosterone, diabetes+ exercise, diabetes+ testosterone+ exercise, diabetes+ castration, diabetes+ castration+ testosterone, Diabetes+ castration+ exercise, Diabetes+ castration+ exercise+ testosterone. Type 1 diabetes was induced by intraperitoneal injection of 50 mg/kg of streptozotocin in the male Wistar rats and after a week, castration was performed. After 42 days of treatment with testosterone (2 mg/kg/day) or voluntary exercise alone or in combination, SOD, GPX and CAT activities and MDA levels were measured in the blood and heart tissue samples in the groups of study. In the end of study, SOD, GPX and CAT activities and MDA levels were measured in blood and heart tissue samples in the groups of study.\u0000\u0000\u0000Results\u0000SOD, GPX and CAT activities significantly (p<0.05) increased in groups that treated either testosterone or exercise and MDA level significantly (p<0.01) decreased in the blood and heart tissue of diabetic and castrated diabetic rats. Simultaneously, treatment with testosterone and exercise had a synergistic effect on antioxidant enzymes level in diabetic and diabetic castrated rats. In the castrated animals with diabetes, SOD, GPX and CAT activities significantly decreased (p<0.05) and MDA levels significantly increased (p<0.05) in blood and heart tissue.\u0000\u0000\u0000Conclusion\u0000Voluntary exercise and testosterone alone or together heightened body's antioxidant system and were able to reduce the MDA levels in blood and heart of diabetic and castrated diabetic rats.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"15 2 1","pages":"173-181"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77715902","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":"18F-FDG PET/CT IN DIFFERENTIATED THYROID CARCINOMA.","authors":"M. Larg, E. Bărbuș, K. Gabora, C. Peștean, M. Cheptea, D. Piciu","doi":"10.4183/AEB.2019.203","DOIUrl":"https://doi.org/10.4183/AEB.2019.203","url":null,"abstract":"Aim\u0000Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) become an important tool in oncology by combining the metabolic information from 18F-FDG PET with the morphological information of CT. The main objective of this study was to assess the diagnostic value of PET/CT in patients with differentiated thyroid carcinoma (DTC).\u0000\u0000\u0000Material and Methods\u0000We analyzed 173 PET/CT scans of patients with DTC presenting elevated thyroglobulin (Tg) levels, negative Tg-antibodies levels, negative Iodine-131 whole-body scanning (I-131 WBS) and without any signs of clinical or other imaging technique for tumor recurrence/metastases.\u0000\u0000\u0000Results\u0000PET/CT scans were positive in 38% of cases (65/173). The sensitivity, specificity, positive predictive values and the accuracy of PET/CT imaging were 88.09%, 98.6%, 93.1% respectively 96.53%. After the PET/CT scan 29 patients underwent surgery, 24 of them continued radio-iodine therapy, 5 patients initiated tyrosine kinase inhibitors treatment and external radiotherapy.\u0000\u0000\u0000Conclusion\u000018F-FDG PET/CT is a valuable imaging technique which has the capability of identifying those cases of thyroid recurrence/metastases with elevated Tg levels and negative I-131 WBS. The treatment strategy was changed in 89.2% cases of positive PET/CT scans which shows us that 18F-FDG PET/CT imaging should be integrated into the follow-up programs for DTC patients.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"5 4 1","pages":"203-208"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90249198","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":"OSTEOPOROSIS AND FRACTURE RISK IN PATIENTS WITH TYPE 2 DIABETES MELLITUS.","authors":"C. Poiană, C. Capatina","doi":"10.4183/AEB.2019.231","DOIUrl":"https://doi.org/10.4183/AEB.2019.231","url":null,"abstract":"Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fragility fractures compared to the general population. The pathogenesis of the elevated fracture risk is multifactorial and still largely elusive. In contrast to primary osteoporosis, in T2DM the bone mineral density (BMD) is increased compared to controls, suggesting that specific alterations in bone quality occur in diabetic patients. Even more, the specific increase in BMD observed in these patients impairs at least in part both the classical diagnosis of osteoporosis by dual-energy X-ray absorptiometry (DXA) and the current fracture risk estimation by FRAX (fracture risk assessment tool). Trabecular bone score (TBS) and TBS-adjusted FRAX could improve fracture risk estimation in patients with T2DM but improved tools are needed in the future as well as specific risk stratification criteria. Decreases in the fracture risk of patients with T2DM can be obtained by optimal diabetes control and standard treatment of osteoporosis (most drugs appear to have similar efficacy in patients with T2DM and primary osteoporosis).","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"16 1","pages":"231-236"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87936311","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":"PERCEIVED STRESS AND GASTROINTESTINAL HABITS IN COLLEGE STUDENTS.","authors":"I. Balmuș, M. Robea, A. Ciobica, D. Timofte","doi":"10.4183/AEB.2019.274","DOIUrl":"https://doi.org/10.4183/AEB.2019.274","url":null,"abstract":"Context\u0000Many negative effects of stress regarding cognitive performances and gastrointestinal habits were previously reported in both animal models and human participants.\u0000\u0000\u0000Objective\u0000We aimed to compare perceived stress levels with declared gastrointestinal habits changes in a small cohort of college students during academic acquisition and evaluation periods.\u0000\u0000\u0000Design\u0000College students were recruited and divided into two groups: the control group evaluated during the acquisition period of the academic year and the stressed group evaluated during the examination period.\u0000\u0000\u0000Subject and Methods\u0000The students' psychological and gastrointestinal status was evaluated using a common stress questionnaire and a gastrointestinal habits survey.\u0000\u0000\u0000Results\u0000Our results showed increased perceived stress in college students during stressful conditions, as compared to lesser demanding periods. Similarly, more than 40%of the participants declared that gastrointestinal habits changes occurred during stressful periods. We observed significant correlations between the perceived stress levels and gastrointestinal habits changes.\u0000\u0000\u0000Conclusion\u0000This small-sized survey study showed that the occurrence of the stressful event in young adults recorded higher perceived stress scores and frequent functional gastrointestinal symptoms, as compared to the lower stressful periods. Also, we showed that functional gastrointestinal symptoms are rather common and could be regarded as a negative response to stress.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"1 1","pages":"274-275"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72905690","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":"GALLIC ACID IMPROVES OXIDATIVE STRESS AND INFLAMMATION THROUGH REGULATING MICRORNAS EXPRESSIONS IN THE BLOOD OF DIABETIC RATS.","authors":"F. R. A. Akbari, Mohammad Badavi, Mahin Dianat, S. Mard, Akram Ahangarpour","doi":"10.4183/AEB.2019.187","DOIUrl":"https://doi.org/10.4183/AEB.2019.187","url":null,"abstract":"Context\u0000Endothelial dysfunction and diabetic cardiomyopathy are critical complications of diabetes. Gallic acid (GA) plays a significant role in cardiovascular disorders resulted from diabetes. In addition, increased plasma miR-24, miR-126 associated with endothelial dysfunction.\u0000\u0000\u0000Aim\u0000The current study was designed to assess the effects of GA on plasma miR-24, miR-126 levels in the diabetic rats.\u0000\u0000\u0000Animals and Methods\u0000Adult male Sprague-Dawley rats were divided into three groups (n=8): control (C), diabetic (D) and diabetic group treated with GA (D+G, 25 mg/kg, by gavage) for eight weeks. The blood glucose level, body weight, lipid profile, blood pressure, plasma miR-24 and miR-126 levels, antioxidant and inflammatory biomarkers were measured.\u0000\u0000\u0000Results\u0000The plasma levels of miR-24, miR-126, body weight, high-density lipoprotein cholesterol (HDL-c), total anti-oxidant capacity (TAC) and the systolic blood pressure significantly reduced and blood glucose, total cholesterol (TC), triglycerides (TG), very low-density lipoprotein cholesterol (VLDL-c), malondialdehyde (MDA), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and low-density lipoprotein cholesterol (LDL-c) significantly elevated among the diabetic rats compared with the control group. However, GA restored body weight, blood pressure, TC, TG, VLDL-c, TNF-α, miR-126, blood glucose, HDL-c, MDA, TAC, miR-24 and IL-6 among the GA treated rats compared with the diabetic group.\u0000\u0000\u0000Conclusion\u0000GA improves inflammation, oxidative stress and hypotension result from diabetes. These protective effects are probably mediated via increasing plasma miR-24 and miR-126 levels.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"15 1","pages":"187-194"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79242769","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":"HIGH-SENSITIVITY C-REACTIVE PROTEIN, POSSIBLE BIOMARKER FOR DEPRESSION IN ELDERLY POPULATION.","authors":"T. Purnichi, V. Matei, R. Grigoraş, C. Banu, M. Pîrlog","doi":"10.4183/AEB.2019.215","DOIUrl":"https://doi.org/10.4183/AEB.2019.215","url":null,"abstract":"Context\u0000The immune system has an important role in the etiology of depression, through the pro-inflammatory cytokines and acute phase protein mechanisms. In elderly people, frequent association between depression and medical conditions leads to a difficult psychiatric diagnosis, becoming necessary to determine a specific biological marker for this category of population. C-Reactive Protein (CRP) did not prove to have a high level of validity, but higher levels of high-sensitivity C-Reactive Protein (hs-CRP) were found to be associated both with cardiovascular disease and depressive disorder, through a bidirectional relationship.\u0000\u0000\u0000Objectives\u0000To investigate the possible association between a major depressive episode and levels of inflammatory markers among a population of elderly.\u0000\u0000\u0000Subjects and methods\u0000A prospective study on a sample of 82 individuals aged over 65 years, who presented for laboratory evaluations in an outpatient setting. They were recorded socio-demographic and clinical data; depression and anxiety were assessed using the Hospital Anxiety and Depression Scale. Blood samples were collected and analyzed according to the protocol of the study.\u0000\u0000\u0000Results\u0000Anxiety, identified in 57 persons, was not statistically significant correlated with the levels of inflammatory markers. For depressive disorder (37 subjects), both CRP and hs-CRP were significantly higher, with an almost medium effect size.\u0000\u0000\u0000Conclusions\u0000The high levels of CRP and hs-CRP are associated with the presence of depression in elderly patients, but not with the anxiety. Further and complex studies need to validate these findings on this group of age.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"1 1","pages":"215-220"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82323507","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":"A 40-YEAR FOLLOW-UP OF A PATIENT WITH MULTIPLE PARAGANGLIOMAS AND A SDHD MUTATION.","authors":"A. Elenkova, R. Robeva, A. Gimenez-Roqueplo, S. Zacharieva","doi":"10.4183/AEB.2019.254","DOIUrl":"https://doi.org/10.4183/AEB.2019.254","url":null,"abstract":"Context\u0000Germline mutations in Succinate Dehydrogenase Complex Subunit D gene (SDHD) predispose to predominantly benign head and neck and/or thoracic-abdominal pelvic paragangliomas (PGLs).\u0000\u0000\u0000Objective\u0000We present the case of a patient carrying a germline SDHD mutation responsible for multiple PGLs, who was followed for 40 years. He was initially diagnosed with a left cervical PGL at the age of 23 years, treated by surgery. Then, he recurred and developed a multifocal disease. The second-line therapeutic option was a three-dimensional conformal radiotherapy performed in 2008. In 2013 the patient had clinical, hormonal, PET- and SPECT-CT data revealing a disease progression. The treatment with the long-acting somatostatin analogue Octreotide Lar was carried out till the patient's death caused by pulmonary embolism in December 2014.\u0000\u0000\u0000Results\u0000Complex treatment led to a long clinical and biochemical remission and control of tumor growth.\u0000\u0000\u0000Conclusions\u0000Despite their usually benign behavior, multicentric SDHD-related PGLs can require a multimodal approach involving surgery, radiotherapy and medical treatment for providing a long-term control of the disease and maintaining a good quality of life.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"23 1","pages":"254-260"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89462789","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":"RELIABILITY OF THE CORTICOTROPIN RELEASING HORMONE STIMULATION TEST FOR DIFFERENTIATING BETWEEN ACTH DEPENDENT AND INDEPENDENT CUSHING SYNDROME.","authors":"O. Polat Korkmaz, B. Karayel, M. Korkmaz, O. Haliloglu, S. Şahin, E. Durcan, M. M. Oren, P. Kadıoğlu","doi":"10.4183/AEB.2019.195","DOIUrl":"https://doi.org/10.4183/AEB.2019.195","url":null,"abstract":"Context\u0000It is a challenge to determine the origin of Cushing syndrome (CS), especially in patients with low-normal adrenocorticotropic hormone (ACTH) concentrations.\u0000\u0000\u0000Objective\u0000To evaluate the reliability of the corticotropin-releasing hormone (CRH) stimulation test in patients with CS whose origin of disease was not clearly identified using ACTH values, the high-dose dexamethasone suppression test (HDDST), and imaging in a single tertiary referral center.\u0000\u0000\u0000Design and Methods\u0000Twenty-one patients with CS who were admitted to the endocrinology-metabolism clinic between 2004 and 2016 whose ACTH concentrations were 5-20 pg/mL and needed CRH stimulation test were retrospectively assessed.\u0000\u0000\u0000Results\u0000Nine out of 21 patients were diagnosed as having Cushing's disease (CD) and 12/21 had adrenal CS. The CRH stimulation test had a sensitivity and specificity of 100% and 8%, and positive and negative predictive values of 100% and 45% according to the current diagnostic criteria, respectively. An increase in ACTH ≥115% at 15 minutes and cortisol ≥86% at 60 minutes after CRH were associated with the highest likelihood ratio. The sensitivity and specificity of ACTH was 67% and 83% (AUC=0.75±0.12, 95% CI: [0.5-0.9]; p=0.03), and for cortisol it was 75% and 78% (AUC=0.71±0.15, 95% CI: [0.5-0.9]; p=0.03). Cortisol suppression of more than 64% from basal level in the HDDST suggested CD with the highest likelihood ratio. When these cut-off values were used together, both tests were negative in the patients with CD.\u0000\u0000\u0000Conclusion\u0000The CRH stimulation test has low specificity to localize CS in patients with ACTH concentrations of 5-20 pg/mL according to the current diagnostic criteria. Different diagnostic criteria may be used in the CRH stimulation test and also in the HDDST in this group of patients.","PeriodicalId":6910,"journal":{"name":"Acta endocrinologica","volume":"4 1","pages":"195-202"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83269581","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}