Acta otorrinolaringologica espanola最新文献

{"title":"Eficacia del neurofeedback como tratamiento para personas con tinnitus subjetivo en la reducción del síntoma y de las consecuencias relacionadas: una revisión sistemática del 2010 al 2020","authors":"Fabiola Varela Barrenechea","doi":"10.1016/j.otorri.2022.06.001","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.06.001","url":null,"abstract":"<div><h3>Background and objective</h3><p><em>Tinnitus</em> is a symptom experienced by millions of people around the world, generating psychological, physical, and social consequences. There are different therapeutic options that seek to reduce the symptom and the related consequences. One of the newest alternatives is training with Neurofeedback, a neuromodulation technique that looks for modify brain activity. The objective of this research was to determine the efficacy of Neurofeedback treatment parameters in reducing the perception of <em>tinnitus</em> and in reducing the behavioral consequences triggered by the symptom, through a systematic review between 2010 and 2020.</p></div><div><h3>Materials and methods</h3><p>The data search was carried out in Spanish and English on PubMed/MedLine, EBSCO Host, Embase, Scopus, CENTRAL, SpringerLink and OpenGrey databases. The systematic review was carried out according to the stages established by PRISMA and five studies were identified to be included in the qualitative analysis.</p></div><div><h3>Results</h3><p>All studies demonstrated that NFB training for <em>tinnitus</em> decreases symptom perception and related consequences. At the neural level, there was an increase in the activity of the alpha wave and a decrease in the activity of delta, gamma, and beta.</p></div><div><h3>Conclusions</h3><p>Neurofeedback has a modulating effect on brain activity patterns. However, although all the studies reported a decrease in the consequences related to the symptom at the behavioral level after treatment, due to the lack of development of this technique for the symptom and the characteristics of the studies reviewed, it cannot be certainty of efficacy on behavioral and neurophysiological consequences.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778560","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":"Thyroglossal duct cyst carcinoma case series—Management strategy and outcomes","authors":"Aleix Rovira ,&nbsp;Aina Brunet ,&nbsp;Jean Pierre Jeannon ,&nbsp;Paul V. Carroll ,&nbsp;Phil Touska ,&nbsp;Fahim Hassan ,&nbsp;Ann Sandison ,&nbsp;Ricard Simo","doi":"10.1016/j.otorri.2022.05.002","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.05.002","url":null,"abstract":"<div><h3>Objective</h3><p>To review the clinical presentation, diagnosis, pathology and management strategies in a modern cohort of patients with thyroglossal duct cyst carcinoma.</p></div><div><h3>Study design</h3><p>Retrospective case series following PROCESS Guidelines.</p></div><div><h3>Setting</h3><p>Comprehensive cancer centre.</p></div><div><h3>Methods</h3><p>Data recorded included: gender, age at diagnosis, clinical presentation, thyroid function, diagnostic investigations, cytological results, final histology, staging and follow up status. The risk of malignancy in cytological analysis was stratified according to the Royal College of Pathologists classification in United Kingdom.</p></div><div><h3>Results</h3><p>Twelve patients were included. The majority of patients (66.7%) presented with an isolated thyroglossal duct cyst. Only 4 patients had preoperative cytological suspicion of carcinoma (sensitivity: 33.3%). At the time of presentation all patients were euthyroid. Following diagnosis of malignancy, a total thyroidectomy was performed in all patients, with the exception of 2, who had a thyroglossal duct cyst carcinoma of less than 10<!--> <!-->mm. Among the 10 patients who underwent total thyroidectomy, 7 (70%) patients had proven carcinoma in the thyroid gland, 3 with deposits of less than 10<!--> <!-->mm. The average size of the thyroid cancer deposits was 7.2<!--> <!-->mm (1–20<!--> <!-->mm). With a mean follow-up of is 44 months (5–120), all patients were alive and free of recurrence at the end of the study period.</p></div><div><h3>Conclusion</h3><p>Thyroglossal duct cyst carcinoma is a rare condition and its management should be discussed in a multidisciplinary meeting. As with differentiated thyroid cancer originating in the thyroid gland, it bears extraordinary survival rates. Accordingly, the management of these cancers has shifted towards a more conservative approach although its peculiarities must be taken into account: ease of extracystic invasion and possible different lymph node invasion.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778567","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":"Manifestaciones otorrinolaringológicas en la viruela del mono","authors":"Berta Alegre ,&nbsp;Sara Jubés ,&nbsp;Natalia Arango ,&nbsp;Daniela Pastene ,&nbsp;Eduardo Lehrer ,&nbsp;Isabel Vilaseca","doi":"10.1016/j.otorri.2022.10.002","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.10.002","url":null,"abstract":"<div><h3>Background and objective</h3><p>In the current health emergency declared by the World Health Organization (WHO) for monkeypox, few data on the otorhinolaryngological (ENT) manifestations of the disease have been detailed. The purpose of this study is to describe the clinical features of the ENT manifestations in monkeypox.</p></div><div><h3>Material and methods</h3><p>Descriptive analysis of 11 consecutive patients with odynodysphagia or oral cavity lesions referred to the ENT emergency department of a tertiary hospital with epidemiological risk factors suggestive of monkeypox infection. Clinical, diagnostic, and treatment findings are described.</p></div><div><h3>Results</h3><p>90.9% of the patients had previous unsafe sexual contact. The predominant presenting features included fever over 38<!--> <!-->°C with severe odynodysphagia. Physical examination showed ulcers and exudative lesions of variable presentation in the upper respiratory tract. Smear of the lesions confirmed polymerase chain reaction (PCR) positivity for monkeypox in all patients.</p></div><div><h3>Conclusions</h3><p>Monkeypox virus infection can occur in the ENT area with multiple manifestations that require a high degree of epidemiological suspicion and confirmation with PCR to reach a diagnosis of certainty.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778561","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-resolution computerized tomography for ossicular replacement prostheses","authors":"Pongsathorn Sagonrat ,&nbsp;Kan Radeesri ,&nbsp;Sirinan Junthong","doi":"10.1016/j.otorri.2022.07.006","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>To study the accuracy of high-resolution computed tomography (HRCT) for assessing the ossicular structures in cadaveric temporal bone by the distance between temporal bone elements is of great interest.</p></div><div><h3>Objectives</h3><p>To record the distances between the malleal neck and both the stapedial head and footplate by HRCT. Further, after partially opening the temporal bone toward the ossicular structure, to record the actual distances between those structures during surgical dissection.</p></div><div><h3>Material and methods</h3><p>This study compared actual and HRCT measurements of cadaveric temporal bone. We studied, measured, and recorded distances within and between various structural elements. All data are reported as means and were analyzed to prove the accuracy of HRCT to assess ossicular structure from the temporal bone.</p></div><div><h3>Results</h3><p>This study included the temporal bones of 10 male and 10 female cadavers (mean age, 70.4 years). By surgical dissection, the distances between the malleal neck and the stapedial head and footplate were 3.40 and 5.30 mm, respectively (measured from the bone); by HRCT, the corresponding values were 3.35 and 5.29 mm. The intraclass correlation coefficients for assessing ossicular structure in contrast to the actual measurements were 0.901 (malleal neck to stapedial head) and 0.923 (malleal neck to stapedial footplate) (p &lt; 0.05). There were no differences between the actual malleal neck to stapedial head (p = 0.793) or footplate (p = 0.242) measurements.</p></div><div><h3>Conclusion</h3><p>HRCT produced statistically comparable, reliable, and accurate measurements compared with actual measurements in cadaveric temporal bone.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778602","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":"Melanoma maligno metastásico de laringe","authors":"Daniel-Iván Martín-Jiménez,&nbsp;José Palacios-García,&nbsp;Serafín Sánchez-Gómez","doi":"10.1016/j.otorri.2022.04.007","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.04.007","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778569","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":"Evaluación acústica de la voz: la relevancia del ruido de fondo","authors":"María-José Marsano-Cornejo ,&nbsp;Ángel Roco-Videla","doi":"10.1016/j.otorri.2022.09.004","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.09.004","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778570","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":"Unidad de Atención al Paciente Traqueostomizado. Una solución innovadora desde Otorrinolaringología con carácter transversal para el hospital","authors":"Serafín Sánchez-Gómez ,&nbsp;Beatriz Tena-García ,&nbsp;Daniel Iván Martín Jiménez ,&nbsp;Marta Álvarez Cendrero ,&nbsp;Santiago Cuello Entrena ,&nbsp;Nuria López González ,&nbsp;Julissa Vizcarra Melgar ,&nbsp;Elena Molina-Fernández ,&nbsp;Rocío Tabernero Gallego ,&nbsp;Juan Lorente Guerrero ,&nbsp;José María Palacios-García","doi":"10.1016/j.otorri.2022.04.005","DOIUrl":"10.1016/j.otorri.2022.04.005","url":null,"abstract":"<div><h3>Background and objective</h3><p>The care of tracheostomized patients are high risk skills and low incidence. Strategies for improvement of health care in hospital wards and specialties other than otolaryngology based solely on training have not been able to offer an adequate solution. A tracheostomized patient unit is presented directed by the otolaryngology service to attend all tracheostomized hospitalized patients of all specialties.</p></div><div><h3>Material and methods</h3><p>Background: Third level public hospital with 876 hospitalization beds and 30 ICU beds for 481,296 inhabitants. <em>Unit model</em>: Transversal unit for the hospital providing attention to all tracheostomized patients, adults, and children, of all specialties, with dedication of 50% of a ENT nurse of hospitalization that moves to the hospitalization bed of the specialty of each patient and 50% of another office ENT nurse for ambulatory patients care, with the consultancy of an ENT specialist and coordinated by the ENT supervisor.</p></div><div><h3>Results</h3><p>572 patients between 2016 and 2021, 80% men, aged 63<!--> <!-->±<!--> <!-->14 years, were attended in the unit. 14.7<!--> <!-->±<!--> <!-->2 tracheostomized patients daily and 96<!--> <!-->±<!--> <!-->4 complication annual consultations were attended, rising up to 19 tracheostomized patients daily by 2020 and 141<!--> <!-->±<!--> <!-->8.4 consultations by complications in 2020 and 2021, during the COVID-19 pandemic. The mean stay of the non-ENT specialties was reduced in 13 days, increasing the satisfaction of the ENT and non-ENT professionals and the satisfaction of the users.</p></div><div><h3>Conclusions</h3><p>A Tracheostomized Patient Care Unit proactively directed from the Otorhinolaryngology Service to transversally care for all tracheostomized patients improves the quality of health care by reducing stay, complications, and emergencies. Improves the satisfaction of non-otolaryngological professionals by reducing the anxiety of facing care of patients who lack knowledge and experience and that of ENT specialists and nurses by reducing unplanned extemporaneous demands for care. Improves user satisfaction by perceiving adequate continuity of care. The Otorhinolaryngology Services provide their experience in the management of laryngectomized and tracheostomized patients and in teamwork with other specialists and professionals without the need to create new structures outside otorhinolaryngology.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47721781","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":"Value of simple otoscopy in diagnosing otitis media with effusion in children","authors":"Cátia Azevedo ,&nbsp;João Firmino Machado ,&nbsp;António Fontes Lima ,&nbsp;Fernando Milhazes Mar ,&nbsp;Sérgio Vilarinho ,&nbsp;Luís Dias","doi":"10.1016/j.otorri.2022.07.002","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.07.002","url":null,"abstract":"<div><h3>Aims</h3><p><span>To explore the value of otoscopy<span> in diagnosing OME when performed by otorhinolaryngology, pediatrics, and </span></span>primary care physicians; to evaluate the interobserver and intraobserver agreement of interpretation of otoscopy images.</p></div><div><h3>Material and methods</h3><p>A cross-sectional study using an anonymous mailed survey was used. We presented pre-recorded otoscopy images of pediatric patients to otorhinolaryngology, pediatrics, and primary care physicians (ten volunteer specialists and residents from each medical specialty). All participants had to answer “yes” or “no” if they considered that the image corresponded or not to an OME case, respectively. We considered that the images were positive for OME whenever the respective tympanogram was type B.</p></div><div><h3>Results</h3><p>Thirty-one otoscopy images and 1860 responses provided by sixty physicians were analyzed. The accuracy of otoscopy in diagnosing OME was highest in the Otolaryngologists group (mean 74.8%), with the worst rate observed in the primary care residents group (mean 51.3%). Overall sensitivity, specificity, and positive predictive value of otoscopy for diagnosing OME were significantly higher when performed by otorhinolaryngologists (75.8%, 72.8%, 66.8%, respectively). Fleiss' kappa showed that interobserver agreement was globally weak within each group of specialties, with overall better interobserver agreement observed among otorhinolaryngologists (κ = 0.30; 95% CI 0.27–0.32).</p></div><div><h3>Conclusion</h3><p>According to our data, simple otoscopy as a single diagnostic method in pediatric OME is insufficient, even for otorhinolaryngologists. Current recommendations must be followed to improve diagnostic accuracy.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778568","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":"Impact of adenotonsillectomy in pediatric respiratory function","authors":"Francisco Alves de Sousa ,&nbsp;Sara Raquel Azevedo ,&nbsp;Ana Nóbrega Pinto,&nbsp;Miguel Bebiano Coutinho,&nbsp;Luís Meireles,&nbsp;Cecília Almeida e Sousa","doi":"10.1016/j.otorri.2022.09.001","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Adenotonsillar hypertrophy<span> (ATH) is an important health condition that leads to upper airway obstruction and constitutes the main cause of </span></span>obstructive sleep disordered breathing<span> (OSDB) in children. The aim of this study was to analyze the effect of surgical intervention on spirometrical parameters of children with ATH/OSDB and upper airway recurrent infections (URTIs).</span></p></div><div><h3>Material and methods</h3><p>The study covered children treated surgically in a Pediatric Ambulatory Unit in a tertiary hospital. Spirometric tests were performed before and three months after surgery and results were compared.</p></div><div><h3>Results</h3><p><span>A total of 78 children were enrolled with a mean age of 6.95 ± 2,81 years. There was a significant improvement in forced vital capacity<span> (FVC), forced expiratory volume<span><span><span> in the first second (FEV1), peak expiratory flow (PEF) and </span>forced expiratory flow rate at 25% (F25) values after surgery in children suffering from OSDB (FVC pre: 1.52 ± 0.47 L vs FVC post: 1.85 ± 0.63 L, p &lt; 0.001; FEV1 pre: 1.24 ± 0.38 L vs FEV1 post: 1.39 ± 0.40 L, p = 0.014; PEF pre: 2.04 ± 0.85 L/s vs PEF post: 2.33 ± 0.76 L/s, p = 0.014; F25 pre: 1.77 ± 0.77 L/s vs F25 post: 2.02 ± 0.73 L/s, p = 0.030). On a </span>multivariate analysis<span><span> model, preoperative tonsil size and performing </span>tonsillectomy<span> were the most significant determinants of improvement in spirometric values (p &lt; 0.05). Children with isolated adenoid hypertrophy without tonsillar obstruction and those with URTIs alone did not show relevant differences in spirometric values after surgery (p &gt; 0.05). No significant differences were found concerning pre-operative and post-operative forced expiratory flow rate at 75% (F75) and forced expiratory flow between 25 and 75% of the pulmonary volume (FEF</span></span></span></span></span>_25–75%) in any group (p &gt; 0.05).</p></div><div><h3>Conclusions</h3><p>Surgery seems effective in ameliorating spirometry<span> values in patients with OSDB and ATH, namely FVC, FEV1, PEF and F25. Spirometry may give a clue on the importance of adequate surgical resolution of pediatric lymphoid hypertrophy obstruction. No significant differences exist on spirometric parameters of children with isolated adenoid hypertrophy and URTIs without ATH. Further studies are needed in order to evaluate the potential benefit of spirometry utilization in the daily clinical setting.</span></p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778572","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":"Resultados de la radioterapia en los carcinomas de orofaringe","authors":"Xavier León ,&nbsp;Núria Farré ,&nbsp;Laura Montezuma ,&nbsp;Anna Holgado ,&nbsp;Rosselin Vásquez ,&nbsp;Eduard Neumann ,&nbsp;Miquel Quer","doi":"10.1016/j.otorri.2022.04.002","DOIUrl":"https://doi.org/10.1016/j.otorri.2022.04.002","url":null,"abstract":"<div><h3>Objective</h3><p>To present the results of radiotherapy treatment in patients with oropharyngeal carcinomas.</p></div><div><h3>Material and methods</h3><p>Retrospective study of a cohort of 359 patients treated with radiotherapy, including chemo- and bio-radiotherapy, during the period 2000-2019. Information on human papillomavirus (HPV) status was available for 202 patients, of whom 26.2% were HPV-positive.</p></div><div><h3>Results</h3><p>Five-year local recurrence-free survival was 73.5% (95% CI: 68.8-78.2%). The variables that were related to local disease control in a multivariate study were the local tumor extension category and the HPV status. Five-year local recurrence-free survival for patients with cT1 tumors was 90.0%, for cT2 88.0%, for cT3 70.6%, and for cT4 42.3%. Five-year local recurrence-free survival for HPV-negative tumors was 67.2% and for HPV-positive tumors 93.3%. Five-year specific-disease survival was 64.4% (95% CI: 59.1-69.7%). Variables that were related to specific survival in a multivariate study were the patient's general condition, local and regional extent of the tumor, and HPV status.</p></div><div><h3>Conclusions</h3><p>Five-year local recurrence-free survival of patients with oropharyngeal carcinomas treated with radiotherapy was 73.5%. Variables that were related to local control were local tumor extension and HPV status.</p></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49778556","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}