Hematology, transfusion and cell therapy最新文献

{"title":"When innovation meets patient blood management - a new way to see bleeding.","authors":"Guilherme Rabello, Rosangela Monteiro, Bianca Meneghini, Fabio Biscegli Jatene","doi":"10.1016/j.htct.2024.07.002","DOIUrl":"https://doi.org/10.1016/j.htct.2024.07.002","url":null,"abstract":"<p><p>The first step in innovation is to identify a problem of real relevance and systematically address it to deliver a sophisticated and viable solution. Disruptive innovation is a process where technology, products, or services are transformed or replaced by a better innovative solution. This superiority must be perceived by users as being more accessible, simple, or convenient. Patient Blood Management (PBM) suggests the notion of the timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis and minimize blood loss thus improving patient outcomes, that is, they are aimed at changing patient care, assisting healthcare professionals in disease treatment and cure as well as risk reduction. Thus, innovation in PBM is a new frontier to be pursued. The management of patient's blood and preparation for surgical procedures is an enormous challenge that helps minimize anemia and control blood loss during hospitalization, ensuring they are discharged in adequate clinical conditions. Until 2016, there was no standard definition or classification for the severity of intraoperative bleeding or hemostasis. The development of a PBM program when combined to the development of a bleeding scale such as the validated Intraoperative Bleeding (VIBe) Scale, represents a new solution that balances perioperative blood loss and more importantly, enables a critical cultural change which can be useful to help surgeons communicate anticipated hemostatic needs throughout a case and therefore enhance efficiency leading to better outcomes.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142304649","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":"Optimizing O red blood cell concentrate usage in the emergency department in the era of patient blood management.","authors":"Louisiane Courcelles, Marie Pouplard, Orla Braun, Corentin Streel, Véronique Deneys","doi":"10.1016/j.htct.2024.05.008","DOIUrl":"https://doi.org/10.1016/j.htct.2024.05.008","url":null,"abstract":"<p><strong>Background: </strong>Emergency transfusion may require the availability of O-negative red blood cell concentrates without pre-transfusion testing. At the Cliniques Universitaires Saint-Luc, the emergency department was used to having access to two decentralized O-negative red blood cell concentrates. This study aims to analyze the consumption of O-negative red blood cell concentrates in emergency situations both before and after the implementation of a novel strategy aiming at optimizing stocks. This strategy provides a combined allocation of one unit of O-positive red blood cell concentrate and one unit of O-negative red blood cell concentrate decentralized in the emergency department and reserve the transfusion of the negative unit only to under 45-year-old women and under 20-year-old men.</p><p><strong>Materials and methods: </strong>A retrospective study was conducted of the transfusion and medical records of all patients who received immediate transfusions in the emergency department without pre-transfusion testing between 2008 and 2022.</p><p><strong>Results: </strong>A total of 193 patients received O red blood cell concentrates without pre-transfusion testing in emergency situations between 2008 and 2022. During the first 24 h of hospitalization, 354 O-negative units were transfused. Mean ratios of number of O-negative bags between 2008 and 2020 was 1.98 unit/patient. After implementation of the new strategy, the ratio in 2021 was 1.46 unit/patient and drastically decreased in 2022 to 0.79 unit/patient.</p><p><strong>Conclusion: </strong>In situations of emergency, allocating O-negative units only for women younger than 45 years and men younger than 20 years could have saved 85% of O-negative red blood cell concentrates transfused (303/354) yet balancing the immunological risk. Limiting the number of delocalized units of O-negative red blood cell concentrates in the emergency department seems to lower O-negative consumption. With this strategy, the units spared could have been transfused to patients with greater needs (e.g., sickle cell patients or chronically transfused patients).</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057661","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":"Comparison of plasma cell bone marrow counts by different methods in patients diagnosed with plasma cell disorders.","authors":"Claudia Monteiro, Paulo Campregher, Denise Pasqualin, Nydia Bacal, Liliana Suganuma, Elvira Velloso","doi":"10.1016/j.htct.2024.06.002","DOIUrl":"https://doi.org/10.1016/j.htct.2024.06.002","url":null,"abstract":"<p><strong>Introduction: </strong>Plasma cell quantification in bone marrow is important for diagnosis, prognosis, and treatment of plasma cell diseases. It can be performed by several methods such as aspiration, imprint and flow cytometry, and biopsy.</p><p><strong>Objectives: </strong>To compare plasma cell counts at diagnosis of plasma cell diseases using different methods.</p><p><strong>Methods: </strong>An observational study was carried out of laboratory results of adult patients with plasma cell diseases, who underwent aspiration, imprint cytology, flow cytometry (CD38, C138) and biopsy in a single institution between January 2015 and May 2021. The intraclass correlation coefficient was used to assess agreement between different methods with results stratified into three groups: <10%; 10-59% and ≥60% of infiltration.</p><p><strong>Results: </strong>Sixty-seven cases were studied: 59.7% were men with a median age of 70 (range: 32-85) years. The diagnoses were multiple myeloma in 61%, gammopathy of undetermined significance in 25.4%, smoldering myeloma in 6% and other plasma cell dyscrasias in 7.6%. Less than 10% infiltration was found in 32 (47.7%), 35 (52.2%), 44 (65.7%) and 25 (37.3%) of patients, respectively by aspiration, imprint cytology, flow cytometry and biopsy. Infiltration ≥60% was detected in 7 (10.4%), 4 (6.0%), 2 (3.0%) and 21 (31.3%) cases, respectively. There was disagreement between the results in 37 (55.2%) of patients. Of these, 28 had greater infiltration in biopsies. The concordance (Kappa index) of biopsy with aspiration, imprint and flow cytometry was 0.501, 0.408 and 0.17; of aspiration with imprint and flow cytometry, it was 0.738 and 0.541 and between imprint and flow cytometry, it was 0.573%.</p><p><strong>Conclusions: </strong>Only aspiration and imprint cytology results agreed. Biopsy showed greater infiltrations than the other methods, but aspiration, and imprint and flow cytometry provided additional data in the diagnosis and thus should also be performed.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570807","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 hepcidin-25/erythroferrone ratio as a potential biomarker for iron utility and erythropoiesis responsiveness to erythropoiesis-stimulating therapy in comparison to immature erythrocyte/reticulocyte parameters in hemodialysis patients.","authors":"Salwa Bakr, Karem Mohamed Salem, Ahmed Mohammed Rashed, Mohamed E A Tantawy, Asmaa Younis Elsary, Hanan Abdelmoneam Shamardl, Eman Mahmoud Ezzat","doi":"10.1016/j.htct.2024.04.125","DOIUrl":"https://doi.org/10.1016/j.htct.2024.04.125","url":null,"abstract":"<p><strong>Background: </strong>Anemia-associated chronic kidney disease increases in more advanced stages with a subsequent acceleration in renal impairment progressing to end-stage renal disease. Although hepcidin and erythroferrone have been described as novel biomarkers of iron metabolism, there is still an area of ambiguity regarding iron utility in anemia-associated end-stage renal disease.</p><p><strong>Objectives: </strong>This study aims to determine the correlations between erythropoietin, erythroferrone, and hepcidin-25 in hemodialysis, and to evaluate the clinical utility of the hepcidin-25/erythroferrone ratio as a biomarker of erythropoiesis-stimulating agent effectiveness compared to reticulocyte maturation parameters.</p><p><strong>Methods: </strong>Serum erythropoietin, erythroferrone, and hepcidin-25 levels in 35 dialysis-dependent patients on a maintenance dose of a short-acting erythropoiesis-stimulating agent were consequently assessed on Days 0, 5, and 7. The erythropoiesis activity was monitored by measuring the increment in reticulocyte maturation parameters.</p><p><strong>Results: </strong>Though the effectiveness of erythropoiesis in these patients was not associated with the hepcidin-25/erythroferrone ratio, it was lower among those with effective erythropoiesis than those with ineffective erythropoiesis. The effective group showed a statistically significant increase in reticulocyte maturation parameters compared to the ineffective group.</p><p><strong>Conclusions: </strong>The findings show the pathogenesis of iron homeostasis in hemodialysis, the validity of hepcidin-25/erythroferrone ratio as a biomarker of erythropoiesis-stimulating agent effectiveness, and the advantageous monitoring of reticulocyte maturation measures to improve management of anemia-associated chronic kidney disease.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047700","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 bacteremia following allogeneic hematopoietic stem cell transplantation without antibiotic prophylaxis: epidemiology and antimicrobial resistance.","authors":"Nour Ben Abdeljelil, Rihab Ouerghi, Insaf Ben Yaiche, Amine Ben Moussa, Yosra Chebbi, Tarek Ben Othman","doi":"10.1016/j.htct.2024.05.009","DOIUrl":"https://doi.org/10.1016/j.htct.2024.05.009","url":null,"abstract":"<p><strong>Objective: </strong>Bacteremia is a serious complication in patients undergoing allogeneic hematopoietic stem cell transplantation. The aim of this study was to determine the frequency, epidemiological profile, and risk factors of bacteremia early after allogeneic hematopoietic stem cell transplantation.</p><p><strong>Methods: </strong>An observational descriptive retrospective study was conducted in patients who received transplants between January 2016 and December 2021. Early bacteremia was defined as blood stream infection occurring between Day 0 and Day 100 after transplantation.</p><p><strong>Results: </strong>Forty episodes of early bacteremia occurred in 36/245 transplanted patients. Fifteen episodes (37.5%) were due to gram-positive bacteria and 25 (62.5%) to gram-negative bacteria. The most frequent species isolated were coagulase negative staphylococci (CoNS) in gram-positive bacteremia (n = 8/15), and Klebsiella species (8/25) and Pseudomonas species (8/25) in gram-negative bacteremia. Twenty-nine episodes of bacteremia (72.5%) occurred during the first 30 days after transplantation with a median time of nine days (range: 0-90 days). Coagulase negative staphylococci were methicillin-resistant in 75% of cases, the only Staphylococcus aureus isolated was methicillin-resistant. All gram-positive bacilli were penicillin-resistant. Gram-negative bacilli were multidrug resistant in 61.5% of cases. In multivariate analysis, bone marrow as source of graft (p-value = 0.02) and cytomegalovirus reactivation (p-value = 0.02) were significantly associated with an increased risk of bacteremia. Mortality attributable to bacteremia was 2.8%. The one-year overall survival was not significantly different between those with and without bacteremia.</p><p><strong>Conclusions: </strong>Bacteremia was more frequent within the first 30 days after transplantation indicating the crucial role of neutropenia. An increase in multidrug resistant gram-negative bacteremia was noted.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335169","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":"Overcoming challenges to reduce time to antibiotic therapy in febrile neutropenic children: insights from a Mexican center.","authors":"Julia Esther Colunga-Pedraza, Ingrid Gabriela Lopez-Reyna, Denisse Natalie Vaquera-Aparicio, Samantha Paulina Peña-Lozano, Jafet Arrieta, Lucía Elizabeth Hernández-Torres, Perla Rocío Colunga-Pedraza, Mónica Regalado, Yajaira Valentine Jiménez-Antolinez, Fernando García-Rodríguez, Oscar González-Llano","doi":"10.1016/j.htct.2024.04.123","DOIUrl":"https://doi.org/10.1016/j.htct.2024.04.123","url":null,"abstract":"<p><strong>Background: </strong>Providing quality supportive therapy for children with cancer is essential to reduce the high mortality rates in low- and middle-income countries. Febrile neutropenia is the most common life-threatening complication of cancer in children. The objective of this study was to evaluate the long-term effectiveness of the 'Golden Hour' intervention in reducing the time to administer antibiotics and its impact on clinical outcomes in a Mexican hospital.</p><p><strong>Methods: </strong>A comparative study of children with febrile neutropenia who attended the emergency department at the Hospital Universitario \"Dr. José Eleuterio González\" was performed between January 2017 and December 2022. In May 2019, this center joined the collaborative 'Mexico in Alliance with St. Jude' project. An adapted improvement program was developed based on the implementation of an algorithm comprising institutional guidance, supplies kit, standardization of sample processing, training of healthcare providers, and patient education. The time to antibiotic administration was compared with clinical outcomes between the historical control and post-intervention groups.</p><p><strong>Results: </strong>A total of 291 patients were included, 122 in the pre-intervention period and 169 in the intervention period. Only 5.7 % of the pre-intervention group received the first dose of antibiotics within 60 min of presenting to the emergency department compared to 84.6 % in the intervention group (p-value <0.000). The median times to antibiotic administration in the pre-intervention and post-intervention periods were 269.4 and 50.54 min, respectively (p-value <0.000). Clinical deterioration and admission to the pediatric intensive care unit decreased significantly from 6.6 % to 2.3 % (p-value = 0.03).</p><p><strong>Conclusions: </strong>Sustainability of the quality improvement project 'Golden Hour' in low- to mid-income countries demonstrated high effectiveness in reducing time to antibiotic administration among children with febrile neutropenia and improved clinical outcomes over three years of implementation.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116466","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":"Hemolytic disease of the fetus and newborn-a perspective of immunohematology.","authors":"Mirelen Moura de Oliveira Rodrigues, Denise Mattos, Silvana Almeida, Marilu Fiegenbaum","doi":"10.1016/j.htct.2024.04.122","DOIUrl":"https://doi.org/10.1016/j.htct.2024.04.122","url":null,"abstract":"<p><strong>Background: </strong>Hemolytic disease of the fetus and newborn is a public health problem caused by maternal-fetal incompatibility; no prophylaxis is available for most alloantibodies that induce this disease. This study reviews the literature regarding which antibodies are the most common in maternal plasma and which were involved in hemolytic disease of the fetus and newborn.</p><p><strong>Method: </strong>Seventy-five studies were included in this review using a systematic search. Two independent authors identified studies of interest from the PubMed and SciELO databases.</p><p><strong>Main results: </strong>Forty-four case reports were identified, of which 11 babies evolved to death. From 17 prevalence studies, the alloimmunization rate was 0.17 % with 161 babies receiving intrauterine transfusions and 23 receiving transfusions after birth. From 28 studies with alloimmunized pregnant women (7616 women), 455 babies received intrauterine transfusions and 21 received transfusions after birth.</p><p><strong>Conclusion: </strong>Rh, Kell, and MNS were the commonest blood systems involved. The geographical distribution of studies shows that as these figures vary between continents, more studies should be performed in different countries. Investing in early diagnosis is important to manage the risks and complications of hemolytic disease of the fetus and newborn.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142147188","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":"Refractory immune thrombocytopenia responding to combination therapy of eltrombopag and low-dose rituximab: a case series.","authors":"Tan-Huy Chu, Thien-Ngon Huynh, Quoc-Vu Trinh-Le, Chi-Dung Phu","doi":"10.1016/j.htct.2024.03.011","DOIUrl":"https://doi.org/10.1016/j.htct.2024.03.011","url":null,"abstract":"","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094238","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 modulations in platelets stored in SSP+, PAS-G and Tyrode's buffer: a comparative analysis.","authors":"Magdaline Christina Rajanand, Anusha Berikai Ananthakrishna, Vani Rajashekaraiah","doi":"10.1016/j.htct.2024.04.121","DOIUrl":"https://doi.org/10.1016/j.htct.2024.04.121","url":null,"abstract":"<p><strong>Background: </strong>Platelet additive solutions (PASs) improve the efficacy of stored platelets. Oxidative stress causes storage lesions and platelet functions deteriorate. Studies assessing the influence of oxidative stress on platelets stored in PASs are limited. This study compares variations in platelets in different storage solutions (SSP+, PAS-G and Tyrode's buffer).</p><p><strong>Methods: </strong>Platelets isolated from the blood of Wistar rats were resuspended in SSP+, PAS-G and Tyrode's buffer and stored for seven days at 22 °C. The markers of platelet metabolism, function, oxidative stress, antioxidant status and viability were analyzed on Days 1, 3, 5 and 7 of storage.</p><p><strong>Main results: </strong>SSP+ is associated with platelet function, viability and antioxidant defenses (SOD, CAT and GSH); it decreased primary lipid peroxidation products and maintained the susceptible protein groups in reduced state. Platelet function, antioxidant defenses such as SOD and GSH improved, and lipids and thiols were protected from oxidation in PAS-G. SOD and GSH increased, and lipids and thiols were preserved in Tyrode's buffer.</p><p><strong>Conclusion: </strong>SSP+ and PAS-G are more effective in maintaining platelet efficacy till Day 7 compared to Tyrode's buffer. Thus, PAS-G and SSP+ are better than Tyrode's buffer in terms of platelet responses to oxidative stress during storage. This is the first comparative account on the influence of PASs (SSP+, PAS-G and Tyrode's buffer) on platelets in altering oxidative stress. It provides a comprehensive view of the differential responses of platelets in PASs.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047701","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":"Ponatinib in the treatment of patients with chronic myeloid leukemia and increased cardiovascular risk: A review of management strategies.","authors":"Tomasz Sacha, Katarzyna Krawczyk","doi":"10.1016/j.htct.2024.04.124","DOIUrl":"https://doi.org/10.1016/j.htct.2024.04.124","url":null,"abstract":"<p><p>The introduction of tyrosine kinase inhibitors has revolutionized the treatment of chronic myeloid leukemia vastly improving the prognosis and clinical outcome of most patients. It was estimated that approximately 40-50 % of patients treated with imatinib will require treatment with a second-generation or third-generation tyrosine kinase inhibitor to achieve an optimal response. The treatment duration, increased patient survival, and aging of the population receiving tyrosine kinase inhibitors raise concerns as to long-term toxicities, such as an elevated cardiovascular risk and a higher rate of comorbidities. Ponatinib is a highly potent third-generation tyrosine kinase inhibitor that was shown to be effective in patients with a wide range of ABL mutations, including T315I. The use of ponatinib is associated with significant vascular toxicity, including peripheral arterial occlusive disease, ischemic heart disease, cerebrovascular accidents, and venous thromboembolism. This review discusses the vascular toxicity of ponatinib and presents a comprehensive panel of tests for the evaluation of patients requiring ponatinib therapy. Moreover, the management of patients with cardiovascular risk factors who receive ponatinib is discussed. Finally, the strategy for establishing the optimal dose of ponatinib in patients with chronic myeloid leukemia is described.</p>","PeriodicalId":94026,"journal":{"name":"Hematology, transfusion and cell therapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515299","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}