Coline Hehn , Amine Ounajim , Guy Fagherazzi , Antonia Gasch-Illescas , Guillaume Montagu , Catherine Rumeau-Pichon , Jean-Arnaud Elissalde , Ben Braithwaite , Hervé Servy , Charles Thivolet , Jean-François Thébaut , Nicolas Naïditch
{"title":"Development and validation of a Type 1 and Type 2 diabetes-specific patient-reported experience measure e-questionnaire: Diabetes reported experience measures (DREMS)","authors":"Coline Hehn , Amine Ounajim , Guy Fagherazzi , Antonia Gasch-Illescas , Guillaume Montagu , Catherine Rumeau-Pichon , Jean-Arnaud Elissalde , Ben Braithwaite , Hervé Servy , Charles Thivolet , Jean-François Thébaut , Nicolas Naïditch","doi":"10.1016/j.deman.2023.100189","DOIUrl":"10.1016/j.deman.2023.100189","url":null,"abstract":"<div><h3>Introduction</h3><p>Successful diabetes management is associated with an effective partnership between People with Diabetes (PwD) and healthcare professionals. Though possible to measure using Patient-Reported Experience Measures (PREMs), none are specific to Type 1 or Type 2 Diabetes (T1D/T2D) and validated in French. Thus, we developed and validated the DREMS (Diabetes Reported Experience MeasureS) e-questionnaire.</p></div><div><h3>Methodology</h3><p>DREMS is comprised of 18 items evaluating 5 different factors. Validation for use by PwT1D and PwT2D (recruited online) was performed using: Exploratory Factor Analysis (EFA); Confirmatory Factor Analysis (CFA) and Cronbach's Alpha. Test-retest reliability was evaluated through Intraclass Correlation Coefficients (ICC) in a subsample.</p></div><div><h3>Results</h3><p>DREMS was tested by 2,513 respondents, including 942 PwT1D and 1,571 PwT2D. For both groups, EFA results indicated 18 items loaded substantially onto 5 clear factors. CFA showed all coefficients were significant in their respective factors. Goodness-of-fit, assessed using the Comparative Fit Index was >0.90 and by the RMSEA was <0.080. Cronbach's α for the entire DREMS e-questionnaire was ≥0.90. ICC was 0.87 for PwT1D (<em>n</em> = 136) and 0.74 for PwT2D (<em>n</em> = 169).</p></div><div><h3>Innovation</h3><p>DREMS is the first validated French-language diabetes-specific PREM for both PwT1D and PwT2D and can be useful to evaluate and improve health care management and patient health.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100189"},"PeriodicalIF":0.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970623000689/pdfft?md5=71075b5848061526d26e74a4653ae1e9&pid=1-s2.0-S2666970623000689-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764517","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":"Real-life underuse of SGLT2 inhibitors for patients with type 2 diabetes at high cardiorenal risk","authors":"André J. Scheen","doi":"10.1016/j.deman.2023.100184","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100184","url":null,"abstract":"<div><p>Atherosclerotic cardiovascular disease (ASCVD), heart failure (HF) and chronic kidney disease (CKD) are major complications of type 2 diabetes (T2DM). The objectives of preventing these complications are not fully reached in clinical practice. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) have proven their efficacy in reducing major cardiovascular events, diminishing hospitalization for HF and limiting the progression of CKD to end-stage kidney disease in placebo-controlled randomised trials in high-risk patients with T2DM. These evidence-based benefits were confirmed in real-life cohort studies worldwide compared with other glucose-lowering agents. However, real-world data showed that only a minority of eligible patients with T2DM received an SGLT2i, yet encouraging increase was observed in recent years. Surprisingly, in several studies less patients with comorbidities (especially CKD) were treated with SGLT2is compared with T2DM patients without these complications. Bridging the gap between evidence-based cardiorenal protection with SGLT2is and their underuse in daily clinical practice in patients with T2DM at high risk is crucial from a public health viewpoint. Multifaceted and coordinated interventions involving all actors should be implemented to incite the adoption of SGLT2is as part of routine cardiovascular and renal care among patients with T2DM at high risk for these comorbidities.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100184"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67739979","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":"Diabetes-induced cellular changes in the inner ear","authors":"Ahmed Gedawy , Hani Al-Salami , Crispin R. Dass","doi":"10.1016/j.deman.2023.100183","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100183","url":null,"abstract":"<div><h3>Aims</h3><p>literature outlining the impact of diabetes on the inner ear environment and the exact etiology of diabetes-induced hearing malfunctioning is scarce.</p></div><div><h3>Methods</h3><p>The Scopus, Pubmed and google scholar databases were used to source relevant epidemiological, clinical, biomedical, histopathological, otolaryngological and pharmacological articles published between 1960 and 2020 using keywords ‘diabetes, hearing loss, inner ear, cellular, cochlea, microangiopathy, neuropathy’. AG and CD preidentified and reviewed selected articles to structure and construct the manuscripts based on relevant inclusion criteria of epidemiological, animal histopathological as well as human temporal bone findings in diabetes setting.</p></div><div><h3>Results</h3><p>several histopathological findings in different animal models of diabetes have highlighted the existence of various abnormalities in their ears, compared with healthy control animals. The prevalence of such associations on the other hand has recently been observed in numerous epidemiological studies across various populations. A plethora of events associated with diabetes and dysglycaemia are linked to biochemical alterations, impaired physiological homeostasis, perturbed blood rheological characteristics and architectural disturbances in the vestibulocochlear system. While various hypotheses have been put forward to explain such associations, microvascular impairment of the inner ear vasculature as well as neuropathic involvement constitute two major ones to date.</p></div><div><h3>Conclusions</h3><p>this review highlights associations between diabetes as a serious endocrinological manifestation and hearing impairment (an overlooked sequalae of diabetes), discusses fundamental etiologies (microangiopathy and neuropathy) of hearing dysfunction in patients with diabetes and sheds light on the otological and audiological impacts of diabetes on the inner ear environment.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100183"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67739977","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":"Diabetic retinopathy prevalence in Mexico: Results from a primary public health access initiative for screening in patients with type 2 diabetes","authors":"Ruben Silva-Tinoco , Dolores Cabrera-Gerardo , Lilia Castillo-Martínez , Teresa Cuatecontzi-Xochitiotzi","doi":"10.1016/j.deman.2023.100182","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100182","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate diabetic retinopathy (DR) prevalence in primary care scenarios in Mexico.</p></div><div><h3>Materials and methods</h3><p>We evaluated adult patients with type 2 diabetes with conventional care in primary care units. A mydriatic fundus examination was performed by an ophthalmologist with retinal photographs.</p></div><div><h3>Results</h3><p>Implementing a strategy for screening diabetic retinopathy in primary care settings in patients with type 2 diabetes in Mexico reported a prevalence of 33.6 %, comprising non-sight-threatening retinopathy at 24.2 %, and sight-threatening retinopathy at 9.4 %. The number needed to screen to detect DR obtained in the screened population was 3.</p></div><div><h3>Conclusions</h3><p>Our study reveals the need for DR screening strategies for its timely detection in primary care scenarios.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"13 ","pages":"Article 100182"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67739611","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}
Rajat Das Gupta , Rohan Jay Kothadia , Ateeb Ahmad Parray
{"title":"Association between abdominal obesity and diabetes in India: Findings from a nationally representative study","authors":"Rajat Das Gupta , Rohan Jay Kothadia , Ateeb Ahmad Parray","doi":"10.1016/j.deman.2023.100155","DOIUrl":"10.1016/j.deman.2023.100155","url":null,"abstract":"<div><h3>Background</h3><p>Both abdominal obesity and diabetes are two major public health problems in India. This study aimed to find out the association between abdominal obesity and diabetes in Indian adult population using nationally representative National Family Health Survey 2019–21 data.</p></div><div><h3>Methods</h3><p>Diabetes was defined as having a raised blood glucose level or seeking treatment for diabetes. Abdominal obesity was defined as a waist-hip ratio of >0.90 for males and >0.85 for females. After adjusting for covariates (including body mass index), multivariable logistic regression was carried out to identify the association between abdominal obesity and diabetes.</p></div><div><h3>Findings</h3><p>In total, 687,607 samples were included. The prevalence of diabetes was 8.65% and 7.39% among male and female participants, respectively. The prevalence of abdominal obesity was 51.77% and 57.91% among male and female, respectively. In both gender, abdominal obesity was associated with diabetes. Among the male and female, the odds of having diabetes 27% (AOR:1.27; 95% CI: 1.13–1.42) and 5% (AOR: 1.05; 95% CI: 1.00–1.11) higher among those who had abdominal obesity than those who did not have abdominal obesity. A significant interaction was observed between abdominal obesity and high body mass index (overweight and obesity) regarding the odds of diabetes.</p></div><div><h3>Conclusion</h3><p>Abdominal obesity was significantly associated with diabetes in Indian population. The high burden of abdominal obesity should be addressed to prevent diabetes.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100155"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42142226","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}
Roshan Kumar Mahat , Suchismita Panda , Vedika Rathore
{"title":"The correct formula for computing the triglyceride-glucose index","authors":"Roshan Kumar Mahat , Suchismita Panda , Vedika Rathore","doi":"10.1016/j.deman.2023.100156","DOIUrl":"10.1016/j.deman.2023.100156","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44167844","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 role of Imeglimin in glycemic control, beta cell function and safety outcomes in patients with type 2 diabetes mellitus: A comprehensive meta-analysis","authors":"Palaniappan Vinayagam , Vengojayparassad Senathipathi , Vishnu Shivam , Nandhini Velraju","doi":"10.1016/j.deman.2023.100164","DOIUrl":"10.1016/j.deman.2023.100164","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this meta-analysis is to evaluate the role of Imeglimin in glycemic control (HbA1c & FPG), Homeostatic Model Assessment of β-cell function, pro-insulin to c-peptide ratio and its safety outcomes in patients with type 2 diabetes mellitus.</p></div><div><h3>Methods</h3><p>A thorough literature search was performed on PubMed Central, PubMed, Cochrane, Wiley online library databases and efficacy outcomes such as changes in HbA1c, FPG, pro-insulin to c-peptide ratio and HOMA- β were summarized as standardized mean difference and safety outcomes were summarized as odds ratio. (PROSPERO registration no. CRD42023422787).</p></div><div><h3>Results</h3><p>Seven randomized controlled trials conducted on 1,454 patients with type 2 diabetes mellitus were included. Overall the random effects model meta-analysis of standardized mean difference demonstrated that Imeglimin was significantly associated with HbA1c reduction of -0.85% (95% CI -1.08 to -0.62, p<0.00001) with heterogeneity (i<sup>2</sup> = 70%, <em>p</em> = 0.002), fasting plasma glucose (FPG) reduction of -0.64 mmol/L (95% CI -0.81 to -0.47, <em>p</em><0.00001) with non-significant low heterogeneity (i<sup>2</sup> = 35%, <em>p</em> = 0.16) and significantly improved HOMA-β function by 0.46 (95% CI 0.25 to 0.67, <em>p</em><0.0001) compared to control groups with non-significant heterogeneity (i<sup>2</sup> = 4%, <em>p</em> = 0.31). Further, the overall analysis of gastrointestinal (GI) adverse events demonstrated that Imeglimin was significantly associated with GI events (OR, 1.83; 95% CI, 1.19 to 2.82; <em>p</em> = 0.006) with no heterogeneity (i<sup>2</sup> = 0%, <em>p</em> = 0.80).</p></div><div><h3>Conclusion</h3><p>Our results demonstrated that Imeglimin is significantly associated with the glycemic control (reduction of HbA1c by -0.85% & FPG by -0.64 mmol/L), improved beta cell function (HOMA-β by 0.46) and associated with GI adverse events by 1.83 fold increased odds as compared to controls.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100164"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46112298","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":"Evaluation of retinal structure and function in prediabetes","authors":"Angelica Echiverri, Wendy W. Harrison","doi":"10.1016/j.deman.2023.100154","DOIUrl":"10.1016/j.deman.2023.100154","url":null,"abstract":"<div><h3>Purpose</h3><p>Alterations in retinal structure and function have been well documented in type 2 diabetes (T2DM). However, few studies have evaluated the eye in prediabetes (preDM), a precursor to T2DM. It is unknown which retinal deficits, if any, occur before T2DM diagnosis. This study evaluates retinal structure via optical coherence tomography (OCT) and retinal function via multifocal electroretinogram (mfERG) N1 and P1 in those with PreDM. The goal is to evaluate associations between structure and function across glucose dysfunction.</p></div><div><h3>Methods</h3><p>85 subjects (aged 28–69yrs) were tested with VERIS mfERG and Heidelberg Spectralis OCT. Demographic and health information was collected. Subjects were grouped by HbA1c: 33 controls (HbA1c <5.7%), 31 with preDM (HbA1c 5.7–6.4%), and 21 with T2DM (HbA1c >6.4% at the time of testing or diagnosed by physician) and mild or no retinopathy. mfERG N1 and P1 latency and amplitude were measured for the right eye in the foveal hexagon (central 2.4°). Average macular thickness was also measured over the central 3.3°. Groups were compared with ANOVA and corrected t-tests. Models of these associations with diabetes diagnosis (in groups above) were created with backward multivariate regression.</p></div><div><h3>Results</h3><p>The T2DM group was exceptionally well-controlled with an HbA1c of 7.0% ± 0.68 but also had elevated systolic blood pressure compared to other groups (<em>P</em><0.01). The age of the control group was younger (<em>P</em><0.01), so other testing was age controlled. There was a borderline but statistically significant difference in P1 between the control group and both the preDM and T2DM groups after Bonferroni corrections (<em>P</em><0.03). There was also a difference in N1 latency between the control and other groups (<em>P</em><0.001). A multivariate model demonstrated a significant relationship between T2DM/PreDM diagnosis and delayed N1 latency, reduced foveal thickness, and age.</p></div><div><h3>Conclusions</h3><p>Structure and function together can provide an associative model of preDM or T2DM changes for patients. Based on this multivariate model, N1 is strongly associated with preDM and T2DM. N1 findings and decreasing foveal thickness are additive and can together inform ocular health related to preDM. Future longitudinal studies are needed to understand changes in function and structure in preDM and T2DM.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100154"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43263690","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}
Howard H. Moffet , Elbert S. Huang , Jennifer Y. Liu , Melissa M. Parker , Kasia J. Lipska , Neda Laiteerapong , Richard W. Grant , Alexandra K. Lee , Andrew J. Karter
{"title":"Severe hypoglycemia and falls in older adults with diabetes: The Diabetes & Aging Study","authors":"Howard H. Moffet , Elbert S. Huang , Jennifer Y. Liu , Melissa M. Parker , Kasia J. Lipska , Neda Laiteerapong , Richard W. Grant , Alexandra K. Lee , Andrew J. Karter","doi":"10.1016/j.deman.2023.100162","DOIUrl":"10.1016/j.deman.2023.100162","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate rates of severe hypoglycemia and falls among older adults with diabetes and evaluate their association.</p></div><div><h3>Research Design and Methods</h3><p>Survey in an age-stratified, random sample adults with diabetes age 65–100 years; respondents were asked about severe hypoglycemia (requiring assistance) and falls in the past 12 months. Prevalence ratios (adjusted for age, sex, race/ethnicity) estimated the increased risk of falls associated with severe hypoglycemia.</p></div><div><h3>Results</h3><p>Among 2,158 survey respondents, 79 (3.7%) reported severe hypoglycemia, of whom 68 (86.1%) had no ED visit or hospitalization for hypoglycemia. Falls were reported by 847 (39.2%), of whom 745 (88.0%) had no fall documented in outpatient or inpatient records. Severe hypoglycemia was associated with a 70% greater prevalence of falls (adjusted prevalence ratio = 1.7 (95% CI, 1.3–2.2)).</p></div><div><h3>Conclusion</h3><p>While clinical documentation of events likely reflects severity or care-seeking behavior, severe hypoglycemia and falls are common, under-reported life-threatening events.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648644","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 telomere attrition on diabetes mellitus and its complications","authors":"Venkata Chaithanya , Janardanan Kumar , Kakithakara Vajravelu Leela , Ria Murugesan , Matcha Angelin , Abhishek Satheesan","doi":"10.1016/j.deman.2023.100174","DOIUrl":"10.1016/j.deman.2023.100174","url":null,"abstract":"<div><p>Diabetes mellitus is a chronic metabolic condition marked by persistent hyperglycemia. It is a major issue of public health with wide-ranging effects. Telomeres are protective caps at chromosome ends, essential for preserving genomic stability and cellular integrity. Research highlights the complex link between diabetes and telomere biology and the potential interactions between the two. This review aims to present a summary of the relationship between diabetes and telomeres, highlighting significant discoveries and probable underlying mechanisms. Telomere shortening in those with diabetes and those at risk of getting the condition provides evidence that telomere dysfunction is linked to diabetes. It is said that telomere attrition, which is influenced by elements such as oxidative stress, inflammation, insulin resistance, and hyperglycemia, plays a major role in the pathophysiology of diabetes. Diabetes Mellitus's hallmark symptoms are chronic inflammation and oxidative stress, accelerating telomere shortening <em>via</em> pro-inflammatory cytokines production and reactive oxygen species, respectively. Telomere dysfunction is enhanced further by the long-term effects of insulin resistance and hyperglycemia. The onset of diabetic comorbidities such as cardiovascular disease, nephropathy, retinopathy, and neuropathy has also been linked to telomere shortening. Understanding how telomeres contribute to these issues may offer new therapeutic ideas. Diabetes and its consequences may be treated with telomere-targeted medicines, such as telomerase activators, telomerase gene therapy, and treatments that target telomere-associated proteins. However, more investigation is required to assess these strategies' security, effectiveness, and long-term impacts.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43578196","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}