Journal of the College of Physicians and Surgeons--Pakistan : JCPSP最新文献

{"title":"A Case of HER2-Negative Male Breast Cancer with Skin Ulceration: Challenges in Therapeutic Decision-Making for the Luminal B Subtype.","authors":"Tao Wu, Fuxing Zhao, Zhen Liu","doi":"10.29271/jcpsp.2026.10.1373","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1373","url":null,"abstract":"<p><p></p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1373-1374"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140142","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":"Symptoms, Triggers, and Prodromes of Hereditary Angioedema in the Pakistani Population.","authors":"Muhammad Hussain, Muhammad Omair Riaz, Mustajab Alam, Hamid Nawaz Tipu, Muhammad Aftab Hassan","doi":"10.29271/jcpsp.2026.10.1359","DOIUrl":"10.29271/jcpsp.2026.10.1359","url":null,"abstract":"<p><p>This cross-sectional observational study was conducted at the Department of Immunology, Armed Forces Institute of Pathology/ CMH / NUMS, Rawalpindi, Pakistan, from September 2021 to December 2024. It aimed to identify the frequency of common presentations, triggers, and prodromes of hereditary angioedema (HAE) in the Pakistani population. Fifty HAE cases were screened using a specially designed questionnaire. The most common symptom was abdominal pain (92%), followed by swelling of hands and feet (66%), eyelids (60%), lips (58%), face (56%), laryngeal oedema (56%), and genital swelling (28%). Common triggers included food (42%), stress (42%), infection/fever (34%), trauma/surgery (22%), and fatigue (20%). The most frequent prodrome was discomfort at the site of swelling  (64%), followed by tingling (36%), nausea (22%), asthenia (16%), fatigue (16%), and rash (4%). HAE is underdiagnosed in Pakistan due to limited awareness and diagnostic facilities. Recognising its clinical features is essential for early diagnosis, management, and improved outcomes. Key Words: Clinical features, C1 esterase, C4 levels, Hereditary angioedema, Prodromes, Triggers.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1359-1361"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139915","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":"Malaria-Dengue Co-Infection among Febrile Inpatients in Peshawar: Prevalence, Species Distribution, and Risk Factors.","authors":"Mehwash Iftikhar, Sheraz Jamal Khan, Imran Khan","doi":"10.29271/jcpsp.2026.10.1266","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1266","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and species distribution of malaria among febrile inpatients, document the co-infection burden, assess severe malaria by World Health Organisation (WHO) criteria, and identify risk factors for malaria positivity.</p><p><strong>Study design: </strong>An analytical cross-sectional study. Place and Duration of the Study: Department of Internal Medicine, Hayatabad Medical Complex and Khyber Girls Medical College, Peshawar, Pakistan, from January 2024 to December 2025.</p><p><strong>Methodology: </strong>Febrile patients were screened using blood smear microscopy and rapid diagnostic testing (RDT). Severe malaria was defined according to WHO criteria. Co-infection was confirmed by dengue non-structural protein 1 (NS1) antigen and immunoglobulin M (IgM) serology, chikungunya IgM serology, and blood culture for Salmonella Typhi. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using binary logistic regression (SPSS version 26.0).</p><p><strong>Results: </strong>Of 5,022 febrile patients screened, 81 (1.61%) were malaria-positive. Plasmodium (P.) vivax accounted for 58 (71.60%), P. falciparum for 19 (23.46%), and mixed P. vivax /P. falciparum infection for 4 (4.94%). Nine (11.1%) met WHO severe malaria criteria, mostly severe anaemia (5/9). Concurrent confirmed infection was present in 35 (43.2%): dengue in 18 (22.2%), chikungunya in 8 (9.9%), typhoid fever in 7 (8.6%), and other pathogens in 2 (2.5%). Male gender (OR 1.78, 95% CI 1.13-2.81; p = 0.014) and monsoon season (OR 2.02, 95% CI 1.24-3.31; p = 0.005) were significant risk factors.</p><p><strong>Conclusion: </strong>P. vivax was the dominant species. Concurrent confirmed infection was present in more than two in every five malaria- positive inpatients, with dengue infection present in nearly one in four. Mixed Plasmodium infection was uncommon but was still observed. Routine parallel screening is warranted in febrile patients in the studied geographical area.</p><p><strong>Key words: </strong>Malaria, Dengue, Co-infection, Plasmodium vivax, Plasmodium falciparum, Febrile illness, Risk factors, Species distribution.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1266-1271"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139583","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":"Baseline Brain Abscess Volume as a Predictor of Repeat Surgery: A Prospective Cohort Study.","authors":"Musawer Khan, Muhammad Naveed Khan, Waseem Sajjad, Bahrul Amin Khan, Muhammad Kamil Khan, Syed Nasir Shah","doi":"10.29271/jcpsp.2026.10.1277","DOIUrl":"10.29271/jcpsp.2026.10.1277","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether baseline brain abscess volume predicts the need for repeat surgical intervention within 90 days after the index procedure.</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: Department of Neurosurgery, Medical Teaching Institution/Mardan Medical Complex, Mardan, Pakistan, from January 2024 to September 2025.</p><p><strong>Methodology: </strong>Consecutive patients with a brain abscess confirmed by contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) who underwent surgical intervention and completed at least 90 days of follow-up were included. Patients with epidural or subdural empyema, fungal or tuberculous abscesses, and those managed non-surgically were excluded. Baseline abscess volume was estimated using the ellipsoid (ABC/2) method on contrast-enhanced imaging. The primary outcome was repeat surgical intervention within 90 days of the index surgery. Baseline abscess volume was compared between the groups, and logistic regression and receiver operating characteristic (ROC) analyses were performed.</p><p><strong>Results: </strong>Fifty-three patients (mean age 28.9 ± 17.9 years; 64.2% male) were included. Fourteen patients (26.4%) required repeat surgical intervention within 90 days. Baseline abscess volume was significantly higher in patients requiring re-intervention compared with those who did not (28.55 ± 7.03 cm3 versus 21.18 ± 8.06 cm3, p = 0.004). In univariable logistic regression, the odds ratio (OR) for baseline volume was 1.128 per cm3; the 95% confidence interval (CI) was 1.032-1.234 (p = 0.008). ROC analysis demonstrated acceptable discrimination, with an area under the curve (AUC) of 0.752.</p><p><strong>Conclusion: </strong>Larger baseline brain abscess volume was associated with an increased likelihood of repeat surgical intervention within 90 days. Baseline abscess volume may serve as a useful adjunct for early risk stratification; however, larger multicentre studies are required for validation.</p><p><strong>Key words: </strong>Brain abscess, Abscess volume, Neurosurgery, Repeat surgery, Prognosis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1277-1281"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140114","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":"Mortality Predictive Accuracy of JAAM-DIC Score in Patients with Sepsis-Induced Coagulopathy.","authors":"Muhammad Hannan, Ghulam Abbas Khan, Muhammad Haseeb Lodhi, Javeria Ehtisham, Qurat Ul Ain Azam, Zurmeen Lodhi","doi":"10.29271/jcpsp.2026.10.1272","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1272","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy of the Japanese Association for Acute Medicine disseminated intravascular coagulation (JAAM-DIC) score in predicting 28-day mortality in patients admitted to the intensive care unit (ICU) with sepsis-induced coagulopathy.</p><p><strong>Study design: </strong>An analytical study. Place and Duration of the Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from September 2025 to February 2026.</p><p><strong>Methodology: </strong>Patients aged between 18 and 65 years were enrolled, with sepsis confirmed by either a blood culture-confirmed bacterial infection or a qSOFA score of ≥2. The JAAM-DIC score was calculated within 6 hours of ICU admission, based on SIRS criteria, platelet count, prothrombin time (PT), international normalised ratio (INR), and fibrinogen degradation products. Patients were followed up for 28 days. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were determined using the reference standard of actual mortality.</p><p><strong>Results: </strong>The mean age of the 150 patients was 51.9 ± 8.7 years. Males constituted 60% (n = 90) and females 40% (n = 60). Seventy- two patients (48.0%) had a JAAM-DIC score ≥4. The 28-day mortality rate was 43.3% (65 deaths). The JAAM-DIC score had a sensitivity of 81.5% and a specificity of 77.6%; PPV was 73.6%, and NPV was 84.6%, with an overall diagnostic accuracy of 79.3%.</p><p><strong>Conclusion: </strong>The JAAM-DIC score proved to be a feasible tool for identifying high-risk septic patients with DIC at ICU admission.</p><p><strong>Key words: </strong>Disseminated intravascular coagulation, Intensive care unit, JAAM-DIC score, Mortality, Sepsis, Sepsis-induced coagulopathy.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1272-1276"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139716","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":"Identification and Clinical Significance of Differentially Expressed Genes in the Tumour Microenvironment of Clear Cell Renal Cell Carcinoma.","authors":"Ruipeng Yang, Yanyan Guo","doi":"10.29271/jcpsp.2026.10.1287","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1287","url":null,"abstract":"<p><strong>Objective: </strong>To perform a bioinformatics analysis of differentially expressed genes (DEGs) in clear cell renal cell carcinoma (ccRCC), evaluate their clinical significance, and identify potential therapeutic targets for ccRCC.</p><p><strong>Study design: </strong>An analytical study. Place and Duration of the Study: Department of Clinical Medicine, Inner Mongolia Medical University, Hohhot, China, from February 2024 to March 2026.</p><p><strong>Methodology: </strong>RNA-sequencing data from 601 patients with ccRCC in the Cancer Genome Atlas (TCGA) were analysed using R. Immune and stromal scores were estimated using ESTIMATE, and immune-cell fractions were calculated using CIBERSORT. Associations with survival and clinicopathological features were assessed. Overlapping DEGs from ImmuneScore and StromalScore groups underwent Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) enrichment analyses. A protein-protein interaction (PPI) network and univariate Cox regression were used to identify prognostic genes. Core genes were identified by intersecting PPI hub nodes with significant Cox predictors, followed by immune-infiltration analysis.</p><p><strong>Results: </strong>The immune score showed significant relationships with both overall survival and clinicopathological characteristics in ccRCC (p <0.05). Differential expression screening retained 375 shared DEGs. Functional enrichment identified 114 significant GO terms and 28 significant KEGG pathways (p <0.05). Plasminogen (PLG) emerged as the core candidate associated with survival and clinicopathological stage (p <0.05). CIBERSORT analysis further demonstrated significant differences in resting dendritic cells, resting mast cells, plasma cells, M0 macrophages, and activated memory CD4⁺ T cells between the high- and low-PLG-expression groups (p <0.05).</p><p><strong>Conclusion: </strong>Bioinformatics analysis identified PLG as a core gene associated with ccRCC prognosis and immune-cell infiltration, thereby providing a basis for subsequent mechanistic investigation and external validation.</p><p><strong>Key words: </strong>Clear cell renal cell carcinoma, Tumour microenvironment, Plasminogen, The Cancer Genome Atlas, ESTIMATE, CIBERSORT.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1287-1298"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139615","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":"Harnessing Artificial Intelligence to Restore Standards in Medical and Dental Education in Pakistan.","authors":"Orooj Bashir, Syeda Kashaf Abbas, Javed Ashraf","doi":"10.29271/jcpsp.2026.10.1350","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1350","url":null,"abstract":"<p><p>Pakistan's medical and dental education has experienced declining standards, inconsistent regulation, and periodic loss of degree recognition. This viewpoint proposes a structured role for artificial intelligence (AI) to analyse past failures and to guide prospective reforms. As medical education globally adapts to information overload and AI‑assisted clinical reasoning, curricula must balance knowledge management, communication, and empathy. Natural language processing (NLP) can mine inspection reports and policy documents to detect regulatory weaknesses, while machine learning (ML) can identify predictors of institutional under‑performance. Retrospective AI can uncover patterns of governance breakdown, admissions irregularities, and curriculum gaps. Prospectively, predictive modelling, adaptive learning platforms, and AI‑driven accreditation dashboards can enable real‑time monitoring and decision support. Generative AI, virtual reality (VR), and augmented reality (AR) can expand faculty development and clinical simulation opportunities. Embedding AI into accreditation and institutional practice can align Pakistan with World Federation for Medical Education (WFME) standards, strengthen accountability, and rebuild global credibility. Adoption of AI is essential for restoring public trust and ensuring the competitiveness of Pakistan's healthcare workforce. Key Words: Artificial intelligence, Medical education, Dental education, Accreditation, Pakistan, WFME, Data governance, Faculty development, Digital divide.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1350-1352"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139564","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":"Bleomycin-Lipiodol Emulsion Plus Polyvinyl Alcohol Particles for the Treatment of Hepatic Focal Nodular Hyperplasia.","authors":"Yan Wang, Weihao Zhang, Yongfei Guo, Zhigang Tian, Mao Yang, Tongguo Si","doi":"10.29271/jcpsp.2026.10.1356","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1356","url":null,"abstract":"<p><p>The purpose of this study was to evaluate the feasibility, effectiveness, and safety of a bleomycin-lipiodol emulsion combined with polyvinyl alcohol (PVA) particles for the treatment of hepatic focal nodular hyperplasia (FNH) by transarterial embolisation (TAE). From September 2020 to February 2022, six patients with hepatic FNH treated with TAE were retrospectively analysed, including 4 males and 2 females (20-55 years of age), with a median maximum tumour diameter of 6.1 cm. The technical success rate was 100%. The volume of all lesions decreased significantly during the 1-6-month follow-up period. According to the mRECIST 1.1 criteria, five cases achieved complete response and one case achieved partial response. None of the patients underwent additional treatment such as surgery during the follow-up period. TAE demonstrated both safety and effectiveness in the treatment of hepatic FNH and may serve as a viable alternative to surgery. Key Words: Focal nodular hyperplasia, Transarterial embolisation, Bleomycin, Liver.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1356-1358"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140139","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":"Beyond Early Detection: Integrating Rehabilitation into Dementia Management in Pakistan.","authors":"Farooq Azam Rathore","doi":"10.29271/jcpsp.2026.10.1375","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1375","url":null,"abstract":"<p><p></p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1375-1376"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140094","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":"Clinical Value of Neuropsychiatric Scales in the Preliminary Identification of Frontotemporal Dementia from Alzheimer's Disease.","authors":"Lingfeng Zhang, Pengxing Lin, Yipan Zhang, Zhijian Lin","doi":"10.29271/jcpsp.2026.10.1344","DOIUrl":"https://doi.org/10.29271/jcpsp.2026.10.1344","url":null,"abstract":"<p><strong>Objective: </strong>To provide a reference for the clinical differentiation of behavioural variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) by analysing differences in scores across various neuropsychiatric scales and their relationships with activities of daily living and caregiver burden.</p><p><strong>Study design: </strong>A cross-sectional study. Place and Duration of the Study: Department of Neurology, the Affiliated Hospital of Putian University, Putian, China, from January 2024 to March 2025.</p><p><strong>Methodology: </strong>Data from the Mild Behavioural Impairment Checklist (MBI-C), Neuropsychiatric Inventory (NPI), Frontal Behavioural Inventory (FBI), Activities of Daily Living (ADL) scale, and Zarit Caregiver Burden Interview (ZBI) were collected from patients with bvFTD and AD. t-test or chi-square test was used to analyse differences in the scores between the two groups. Pearson's correlation analysis was conducted to examine the relationship between ADL and ZBI scores and MBI-C, NPI, and FBI scores. ROC curve analysis was used to evaluate the sensitivity and specificity of the MBI-C, NPI, and FBI scales. The AUC values were calculated and compared.</p><p><strong>Results: </strong>The bvFTD group exhibited significantly higher MBI-C, NPI, and FBI scores than the AD group (p <0.05). Emotional problems, lack of motivation, disinhibition, speech disorders, impaired judgment, lack of self-awareness, inattention, stubbornness, and incontinence were all more pronounced in the bvFTD group. ADL and ZBI scores were positively correlated with MBI-C, NPI, and FBI scores in both groups. The FBI scale had an AUC value of 0.85, with sensitivity and specificity of 81.82% and 74.71%, respectively, when the score exceeded 20.5.</p><p><strong>Conclusion: </strong>The MBI-C, NPI, and FBI scales can quickly and effectively distinguish bvFTD from AD, with the FBI scale having the highest diagnostic value. Neuropsychiatric disturbances in patients with bvFTD and AD reduce their daily living abilities and increase their caregiver burden.</p><p><strong>Key words: </strong>Behavioural variant frontotemporal dementia, Alzheimer's disease, Mild behavioural impairment checklist, Neuropsychiatric inventory, Frontal behavioural inventory.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"36 10","pages":"1344-1349"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140104","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}