Clinical obstetrics, gynecology and reproductive medicine最新文献

{"title":"Effect of “Time To Surgery” On The Endometrial Cancer Prognosis","authors":"E. Celik, H. Yumru Celiksoy, H. Sozen, H. Goksever Celik, S. Onder, M. Y. Salihoglu, S. Topuz","doi":"10.21613/gorm.2021.1202","DOIUrl":"https://doi.org/10.21613/gorm.2021.1202","url":null,"abstract":"OBJECTIVE: Endometrial cancer is the most common gynecological cancer in developed countries. Our study aims to determine the effect of the time between diagnosis and surgery of endometrial cancer on the prognosis of the disease.\u0000STUDY DESIGN: Patients who were diagnosed with epithelial type endometrial cancer and did not receive preoperative chemotherapy, radiotherapy, or hormonal therapy were included in the study.\u0000RESULTS: Two hundred eighty-five patients were included in the study. We divided the patients into two groups regarding before and after 8 weeks from diagnosis to surgery. Clinical characteristics of the patients were comparable between the groups, except for comorbid conditions and body mass index. Using cox-regression analysis, time to operation did not have a significant effect on both recurrence and cancer-associated death risk. The log-rank test analysis also showed that there was no significant difference in progression-free survival and disease-specific survival between the patients. There was no significant difference between the groups in terms of progression-free survival and disease-specific survival for cases with endometrioid type grade 1-2 tumors. There was also no significant difference between the groups regarding progression-free survival and disease-specific survival in the patients with tumors of endometrioid type grade 3 and non-endometrioid histology.\u0000CONCLUSION: Time delay between diagnosis to surgery of the patients with endometrial cancer has no prognostic importance for recurrence and survival outcomes.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86030554","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 Predictive Value of the Pentraxin 3 Concentration in Cumulus Cell Culture Media for the Embryo Implantation","authors":"T. Irez, Y. Sahin, E. Malik, O. Guralp","doi":"10.21613/gorm.2021.1188","DOIUrl":"https://doi.org/10.21613/gorm.2021.1188","url":null,"abstract":"OBJECTIVE: Many studies on the interrelation of cumulus cells and oocytes, and research on cumulus protein factors continue. This study aims to investigate the relationship of Pentraxin 3 level with embryo implantation in the cumulus culture fluid. \u0000STUDY DESIGN: A total of 31 women with idiopathic infertility who underwent intracytoplasmic sperm injection treatment were prospectively evaluated. Cell suspensions containing 5 million/mL cumulus cells were obtained post-hyase and incubated for 24 hours in a culture medium. A possible association between the culture media Pentraxin 3 concentrations and embryo implantation was analyzed.\u0000RESULTS: The cumulus cell culture media Pentraxin 3 concentrations were significantly higher in the pregnant group compared to the non-pregnant group (98.9 ng/mL vs 53.2 ng/mL, respectively, p=0.005). There was a significant positive correlation between the culture media Pentraxin 3 concentrations and embryo implantation (r=0.500, p=0.005). The culture media Pentraxin 3 concentration was a significant predictor for successful embryo implantation (AUC=0.845, p=0.006). A cut-off value of 64.25 ng/mL had an 86% sensitivity and 80% specificity to predict embryo implantation. There was no pregnancy under the cut-off value of 60 ng/mL, whereby seven women had good quality grade 1 oocytes according to the traditional morphological criteria. \u0000CONCLUSION: The cumulus cell culture medium Pentraxin 3 concentration was predictive for successful embryo implantation. Low Pentraxin 3 levels (<60 ng/mL were associated with failure of conception.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81606491","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":"Ocular Surface Disease Severity in Polycystic Ovary Syndrome: is This Really Significant in Daily Life?","authors":"Demet Yabanoğlu, F. Gode","doi":"10.21613/gorm.2021.1173","DOIUrl":"https://doi.org/10.21613/gorm.2021.1173","url":null,"abstract":"OBJECTIVE: The purpose of this study was to ascertain the extent to which the ocular surface of women with polycystic ovary syndrome is impacted.\u0000STUDY DESIGN: Included in this case-control study were 23 eyes of 23 patients (Group I) with polycystic ovary syndrome and 10 eyes of 10 healthy subjects (Group II). Polycystic ovary syndrome was diagnosed when two of the following conditions were met: oligo- or anovulation, clinical and/or biochemical signs of hyperandrogenism, and ultrasonographic documentation of polycystic ovaries. Ocular surface disease grading was performed using the Ocular Surface Disease Index questionnaire, slit lamp examination, meibomian gland secretion scoring, tear film breakup time, staining scores of ocular surfaces, the Schirmer's test, and tear osmolarity assessment.\u0000RESULTS: The study observed no significant difference in age (p=0.896). Group I was found to have a significantly higher median luteinizing hormone level (p=0.027). The Ocular Surface Disease Index scores in group I were significantly higher than those in group II (p=0.031). The prevalence of anterior blepharitis was significantly greater in group I (p=0.05). Tear film breakup time was higher in group I than in group II (p=0.026). The ocular surface disease severity was found to be significantly higher in group I (p=0.03). In group I, Ocular Surface Disease Index scores were significantly positively correlated with free testosterone, while tear osmolarity was significantly positively correlated with estradiol levels but significantly negatively correlated with dehydroepiandrosterone sulfate levels (p<0.05).\u0000CONCLUSIONS: Daily activities appear to be slightly impaired in patients with polycystic ovary syndrome due to ocular surface problems. However, environmental factors (humidity, temperature, etc.) contribute to the aggravation of ocular symptoms. Patients with polycystic ovary syndrome may be referred to an ophthalmologist to preserve ocular surface health.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87905953","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":"Mature Cystic Teratoma of the Ovary; Clinicopathological Evaluation of 143 Cases in our Series, 5 Years Experience","authors":"Betul Ogut, F. Kazancı, D. Yapar, Ö. Erdem, M. Onan","doi":"10.21613/gorm.2021.1189","DOIUrl":"https://doi.org/10.21613/gorm.2021.1189","url":null,"abstract":"OBJECTIVE: Mature cystic teratoma, also known as a dermoid cyst, is the most common germ cell tumor of the ovary. In this retrospective study, it is aimed to evaluate clinicopathological findings of the patients who were operated on due to the preliminary diagnosis of dermoid cyst. \u0000STUDY DESIGN: Between May 2013 and May 2018, the findings of a total of 143 patients who were operated on with a preliminary diagnosis of dermoid cyst in our institution were analyzed retrospectively. In addition to demographic characteristics such as age, parity number and tumor size, lateralization, preoperative tumor markers, surgical procedure, presence of other pathological findings, and the rate of malignant transformation were analyzed. \u0000RESULTS: The median age of patients was 35.4 years and the ratio of nulliparous, primiparous, and multiparous patients was 46.9%, 25.2%, and 28%, respectively. The median tumor diameter was 6.7 cm, 50.3% of which were right-sided, 46.9% were left-sided and the remaining 2.8% were bilateral. Intraoperative torsion was found in 15 (10.5%) cases. The treatment consisted of 60.1% cystectomy by laparoscopy, 3.5% unilateral salpingo-oophorectomy by laparoscopy, 9.8% unilateral salpingo-oophorectomy by laparotomy, while the rate of 16.1% cases underwent hysterectomy with bilateral salpingo-oophorectomy by laparotomy, 10.5% of the cases, cysts were excised during cesarean section. As the final pathology report revealed, of 143 patients, immature teratoma was observed in five cases (3.5%), in one of them (0.7%) mixed germ cell tumor and in three of them (2.1%) borderline mucinous cancer, squamous cell carcinoma, and carcinoid tumor on mature cystic teratoma base were observed.\u0000CONCLUSION: Torsion is the most common complication with mature cystic teratoma. The size of the tumor is an important prognostic factor in terms of the malignant transformation of teratoma. Fertility sparing surgery with a minimally invasive surgical approach is available for fertility patients diagnosed with Mature cystic teratoma.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89586911","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":"Placental Maspin Gene Expression Pattern May Be Used to Distinguish Between Preeclampsia and Intrauterine Growth Restriction","authors":"G. Onalan, Y. Terzi, Y. Tohma, E. Yurtçu, E. Kuşçu, F. Sahin, H. Zeyneloglu","doi":"10.21613/gorm.2019.969","DOIUrl":"https://doi.org/10.21613/gorm.2019.969","url":null,"abstract":"Objective: Maspin is one of the members of serin protease inhibitor superfamily, and acts as a tumor suppressor protein. Here we report maspin expression in placental tissues of preeclampsia or intrauterine growth retardation pregnancies.Study Design: Maspin expression level was analyzed by semi-quantitative RT-PCR method. For this purpose, placental tissue samples were obtained from pregnancies 13 with intrauterine growth retardation, and 6 with preeclampsia, and also 12 tissues from women without preeclampsia or intrauterine growth retardation history were included as controls. Results: Maspin expression was found to be 11-fold higher in placentas from preeclampsia patients than placentas from intrauterine growth retardation patients (p=0.036). However, there was no difference between preeclampsia and control groups (p=0.76), and intrauterine growth retardation and control groups (p=0.849).Conclusion: As far as we know this is the first study reporting expression level of maspin in placental tissues of pregnancies with intrauterine growth retardation. These findings support that molecular pathology between preeclampsia and IUGR might be different at the molecular level and maspin levels in the placenta may be used to differentiate preeclampsia from IUGR.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89087543","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":"Fetal Thymus Size in Pregnant Women with COVID-19 Infection","authors":"Sule Goncu Ayhan, D. Oluklu, Selcan Sınacı, A. Atalay, S. Erol, Eda Ozden Tokalioglu, Muradiye Yıldırım, O. Moraloğlu Tekin, D. Şahın","doi":"10.21613/gorm.2021.1222","DOIUrl":"https://doi.org/10.21613/gorm.2021.1222","url":null,"abstract":"OBJECTIVE: To determine the effect of SARS-CoV-2 infection on fetal thymus size by ultrasound.\u0000STUDY DESIGN: In this prospective study sonographic fetal thymus size was measured in pregnant women attending our hospital with confirmed SARS-CoV-2 infection by RT-PCR test and age-matched control group. The anteroposterior thymic and the intrathoracic mediastinal diameter was determined in the three-vessel view and their quotient, the thymic-thoracic ratio, was calculated. Results were compared between these two groups.\u0000RESULTS: Thirty-six SARS-CoV-2-infected and 47 control group pregnant women were included in this study. Two groups were similar in terms of demographic features and no difference was found for fetal thymus size.\u0000CONCLUSION: COVID-19 seems to have no adverse effect on fetal thymus size in mild and moderate patients during the acute phase of the infection.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90458668","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":"Early Serum Heme Oxygenase-1, Soluble Vascular Endothelial Growth Factor Receptor-1, and B-Cell Lymphoma/Leukemia-2 Levels and Unfavorable Obstetric Outcomes","authors":"H. Sutcu, G. Varol, C. Inan, I. Uzun, N. Sayin","doi":"10.21613/GORM.2021.1177","DOIUrl":"https://doi.org/10.21613/GORM.2021.1177","url":null,"abstract":"OBJECTIVE: To examine early pregnancy levels of serum heme oxygenase-1, soluble vascular endothelial growth factor receptor-1, B-cell lymphoma/leukemia-2 in relation to unfavorable pregnancy outcomes, including preeclampsia, fetal growth restriction, spontaneous preterm birth, gestational diabetes mellitus and fetal macrosomia.\u0000STUDY DESIGN: A total of randomly selected 140 pregnancies were included in this prospective study. Peripheral blood samples were obtained between 110/7 and 136/7 gestational weeks. All pregnancies were followed up until the outcomes were obtained and classified as preeclampsia, fetal growth restriction, spontaneous preterm birth, gestational diabetes mellitus, fetal macrosomia, and uncomplicated ones. \u0000RESULTS: Significantly high levels of early serum heme oxygenase-1 were found in the cases who subsequently developed preeclampsia, spontaneous preterm birth, and fetal macrosomia (p<0.05), in concordance with high soluble vascular endothelial growth factor receptor-1 levels of the preeclampsia group, however, B-cell lymphoma/leukemia-2 s were similar in all groups. As soluble vascular endothelial growth factor receptor-1 predicted preeclampsia at a value of 11.905 ng/mL, the cutoff values for the heme oxygenase-1 to predict preeclampsia, spontaneous preterm birth, and fetal macrosomia were 0.372 ng/mL, 0.354 ng/mL and 0.494 ng/ml, respectively. \u0000CONCLUSION: Elevated first trimester heme oxygenase-1 levels are remarkable in the pregnancies associated with preeclampsia, spontaneous preterm birth, and fetal macrosomia in comparison with uncomplicated ones.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"23 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2021-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77344728","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":"Access to Essential Contraception, Family Planning, and Safe Motherhood Services During COVID-19 Pandemic: Single Secondary Level Care Hospital Experience","authors":"J. Biswas, S. D. Poddar, Ganesh Saravagi, A. Nilakantan","doi":"10.21613/GORM.2021.1184","DOIUrl":"https://doi.org/10.21613/GORM.2021.1184","url":null,"abstract":"OBJECTIVE: During the COVID-19 pandemic, more precisely as a result of restrictions on movement and continuing altered perception of essential health care services, women’s health is disproportionately affected due to reduced access to services as per reports and statements made by different global and national level Government and non-government agencies. We aimed to evaluate the health care impacts related to contraception, family planning, and safe motherhood in an Indian Armed Forces secondary level care hospital during the COVID-19 pandemic. \u0000STUDY DESIGN: Immediate health care effect on women’s sexual and reproductive life during pandemic months (April to August of the year 2020) is analyzed through a retrospective observational cohort study in a single Indian Armed Forces secondary level care hospital experience. \u0000RESULTS: It has shown more late reported unintended pregnancies requiring surgical intervention, more late-registered antenatal cases and consequently delayed essential evaluations, increased trend in high-risk cases requiring in-patient care (IPD), and reduced access to contraception and family planning services in comparison to those in the previous two years. \u0000CONCLUSION: Considering these negative impacts noted in this observation, with the help of policymakers, government, and other non-government agencies, all services should be made available to women including un-interrupted out-patient (OPD) and IPD services in all hospitals, along with continued basic infection prevention and control precautions (IPC) to both clientele and health care workers (HCW). Telemedicine can also play a supplementary role in various aspects of women’s health to avoid upcoming population explosion and for better maternal-child health care.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76043477","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":"Neonatal Bacterial Meningitis: Single Reference Center Experience and Review of Current Literature: A Retrospective Cohort Study","authors":"Alper Aykanat, H. Çelik, G. Hazırolan, Ş. Yiğit, M. Yurdakok","doi":"10.21613/GORM.2021.1142","DOIUrl":"https://doi.org/10.21613/GORM.2021.1142","url":null,"abstract":"OBJECTIVE: Despite improvements in neonatal care, neonatal bacterial meningitis is still an emerging problem worldwide with high rates of mortality. The present study evaluates data on suspected- and culture-proven neonatal bacterial meningitis in the light of a single tertiary reference center experience in Turkey in comparison with the globe. \u0000STUDY DESIGN: In this retrospective cohort study newborns admitted to Hacettepe University Ihsan Dogramaci Children’s Hospital Neonatal Intensive Care Unit during a 5-year-period between April 2014-May 2019 and who underwent atraumatic lumbar puncture were included. \u0000RESULTS: Two hundred sixty-four patients fulfilled the inclusion criteria. Most common symptoms in all patients raised suspicion in favor of NBM and resulted in lumbar puncture were fever (34.5%, n=91), respiratory distress (31.1%, n=82), lethargy (31.1%, n=82), and apnea (26.1%, n=69). The incidence of culture-proven NBM among suspected patients was 5.7% (n=15/264); while the incidence is 3.1 per 1000 (15/4574) at all Neonatal Intensive Care Unit admissions. Respiratory distress (60.0%, n=9/15) and apnea (40.0%, n=6/15) were the most common symptoms in patients with NBM; which may be due to the predominance of premature newborns in the NBM group. The most common microorganisms in CSF cultures were coagulase-negative Staphylococci with Methicillin-resistant Staphylococcus epidermidis being most common among all. \u0000CONCLUSIONS: The present study underlines high rates of culture-proven neonatal bacterial meningitis among suspected newborns despite improvements in modern health care, which raises attention to careful evaluation of these patients and early administration of properly-selected antibiotics. Our incidence rates are in keeping with studies from the developed world.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"51 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86629716","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 Effect of Maternal Body Mass Index on In Vitro Fertilization-Intracytoplasmic Sperm Injection Treatment: A Prospective Comparative Study","authors":"Z. Inal, H. Inal","doi":"10.21203/RS.3.RS-298772/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-298772/V1","url":null,"abstract":"\u0000 Purpose: To evaluate whether or not maternal body mass index (BMI) has an effect on pregnancy rates following in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment.Methods: A total of 869 patients who had undergone IVF-ICSI treatment between 2012 and 2017 were included in this study. The participants were stratified according to maternal BMI as Group 1 (BMI<25 kg/m2; n=394), Group 2 (25 kg/m225 kg/m2; n=172). Basal parameters and IVF-ICSI outcomes were compared between the groups.Results: While there were no differences between the groups in terms of age, smoking status, etiology of infertility, thyroid-stimulating hormone, prolactin levels, antral follicle count, and stimulation protocol (p>0.05), there was significant statistical difference (p<0.05) in terms of BMI, duration of infertility, baseline follicle-stimulating hormone, luteinizing hormone, estradiol (E2), duration of stimulation, total gonadotropin dose required, peak E2 levels, progesterone levels, endometrial thickness on hCG administration, and cycle cancellation rate. In addition, the numbers of MII and 2PN oocytes retrieved and the rates of clinical pregnancy, live births, and miscarriages were also different between the groups (p<0.05).Conclusion: Our data suggest that there is an inverse impact of increased BMI on laboratory and reproductive outcome parameters of IVF-ICSI treatment. Taking cost-effectiveness into consideration, weight loss should be suggested before ovulation is induced.","PeriodicalId":87233,"journal":{"name":"Clinical obstetrics, gynecology and reproductive medicine","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89023168","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}