Laboratory medicine最新文献

{"title":"Impact of SARS-CoV-2 vaccination on CD4+ and CD8+ T lymphocyte profiles in an HIV-positive and HIV-negative female cohort.","authors":"Olive Khaliq, Niren Maharaj, Mikyle David, Ahmad Jassen, Nomakhuwa Tabane, Jagidesa Moodley","doi":"10.1093/labmed/lmag014","DOIUrl":"10.1093/labmed/lmag014","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic led to rapid global vaccine deployment, especially among high-risk groups, such as individuals living with HIV. Data are limited, however, on the immunologic effects of SARS-CoV-2 vaccination-specifically, on CD4+ and CD8+ T lymphocyte levels-in HIV-positive women in South Africa, a population with high HIV prevalence.</p><p><strong>Methods: </strong>This prospective cross-sectional study included 40 women (aged 14-42 years) admitted to a South African tertiary-care hospital, stratified by HIV and SARS-CoV-2 vaccination status. Flow cytometry (BD Multitest [BD Biosciences]) was used to determine absolute CD4+ and CD8+ T-cell counts. Data were analyzed with GraphPad Prism, version 8, software (GraphPad Software). The Mann-Whitney U test was used for comparisons between 2 independent groups. For comparisons across more than 2 groups, either a 1-way analysis of variance or the Kruskal-Wallis test was applied, with statistically significant results followed by the Dunn multiple comparisons test. Spearman correlation was used to assess relationships between variables. In all cases, statistical significance was defined as P < .05.</p><p><strong>Results: </strong>Of the 40 participants, 27 (68%) were HIV positive and 20 (50%) were vaccinated. CD4+ T-cell counts were statistically significantly higher in HIV-negative women than in HIV-positive women (P = .01), while CD8+ levels did not differ significantly (P = .41). Vaccination status had no statistically significant impact on CD4+ or CD8+ counts. The CD4/CD8 ratio was statistically significantly higher in HIV-positive women (P = .01), especially among the unvaccinated subgroup (P = .002).</p><p><strong>Conclusions: </strong>SARS-CoV-2 vaccination did not substantially alter CD4+ or CD8+ T lymphocyte levels, regardless of HIV status.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719166","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":"Evaluating the diagnostic efficacy of a 4-marker serum panel for hepatitis B virus-related hepatocellular carcinoma.","authors":"Qiang Fang, Yali Zhu, Ying Liang, Huiming Li, Shaoying Yan","doi":"10.1093/labmed/lmaf093","DOIUrl":"10.1093/labmed/lmaf093","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to investigate the diagnostic efficacy of protein induced by vitamin K absence or antagonist II combined with ɑ-fetoprotein, aspartate aminotransferase/alanine aminotransferase ratio, and γ-glutamyltransferase and to provide a more reliable combined detection scheme for the clinical diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>The research used a retrospective case-control framework encompassing 300 participants who were allocated to 1 of 4 groups. Clinical data and serum biomarker levels were collected. A multivariable logistic regression model was developed to integrate these markers into a quantitative risk score. The diagnostic performance of all models was evaluated using receiver operating characteristic curve analysis, with areas under the curve (AUCs) compared using the DeLong test. Optimal diagnostic thresholds were determined based on prespecified high-sensitivity targets to align with clinical screening and surveillance goals.</p><p><strong>Results: </strong>For broad screening (HBV-related HCC vs control), the combined model achieved a superior AUC of 0.906; at 90% sensitivity, its specificity was 70.7%. For high-risk surveillance (HBV-related HCC vs benign liver disease), the model achieved an AUC of 0.837; at 80% sensitivity, its specificity was 74.6%, representing a clinically optimal balance.</p><p><strong>Discussion: </strong>The multimarker combined detection strategy substantially improves diagnostic efficacy for HBV-related HCC compared with single-marker approaches.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147617197","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":"A liquid chromatography-tandem mass spectrometry method for therapeutic drug monitoring of treosulfan.","authors":"Jeayeon Ryu, Sollip Kim, Sang-Hee Lee, Sung Han Kang, Woochang Lee, Sail Chun, Ho Joon Im","doi":"10.1093/labmed/lmag017","DOIUrl":"10.1093/labmed/lmag017","url":null,"abstract":"<p><strong>Introduction: </strong>Treosulfan is an alkylating agent administered before hematopoietic stem cell transplantation. Because pharmacokinetic parameters exhibit interindividual variability, therapeutic drug monitoring may be necessary. In this study, a liquid chromatography-tandem mass spectrometry method for monitoring treosulfan was developed and validated.</p><p><strong>Methods: </strong>Treosulfan was separated from 25 µL plasma after protein precipitation with acetonitrile. Treosulfan-D4 was used as the internal standard. Separation was performed using an ACQUITY UPLC Ι-Class PLUS System (Waters Corporation) coupled with a Xevo TQ-XS Mass Spectrometer (Waters Corporation). Limit of quantification, selectivity, linearity, imprecision, carryover, matrix effect, and stability were validated according to Clinical and Laboratory Standards Institute guidelines.</p><p><strong>Results: </strong>The mass-to-charge transitions were treosulfan 296.2 > 87.1 and treosulfan-D4 300.2 > 91.1. The total run time was 4 minutes. The limit of quantification of treosulfan was 3.13 µg/mL. The calibration curve was linear in the 3.13 to 100-µg/mL range. The method was adequately selective and without carryover or matrix effect. Treosulfan was stable in plasma for 2 hours at room temperature and for up to 3 days and 1 week when stored at 10 °C and ‒20 °C, respectively.</p><p><strong>Discussion: </strong>Our liquid chromatography-tandem mass spectrometry method for measuring treosulfan met Clinical and Laboratory Standards Institute validation requirements and exhibited robust performance, suggesting its utility for therapeutic drug monitoring in clinics treating patients with treosulfan.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793455","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":"Systematic investigation of population-wide elevation in serum uric acid among military conscripts: development of a traceable laboratory quality control framework.","authors":"Xianmin Lv, Yulian Li, Luwei Yan, Honglei Yu","doi":"10.1093/labmed/lmag021","DOIUrl":"10.1093/labmed/lmag021","url":null,"abstract":"<p><strong>Introduction: </strong>A collective elevation in serum uric acid levels was detected among 98 military conscripts during routine physical examinations. This study aimed to determine the underlying causes and establish a traceable laboratory quality control framework for abnormal biochemical results.</p><p><strong>Methods: </strong>A systematic investigation encompassing analytical performance, preanalytical variables, and possible exogenous interferences was conducted. Population characteristics, including dietary habits and physical activity, were examined and experimentally validated. Ten participants were retested after controlling high-purine intake and exercise intensity.</p><p><strong>Results: </strong>No deviations were identified in analytical systems or preanalytical procedures. No interference from exogenous substances was observed. Controlled validation experiments demonstrated that consumption of chicken liver and high-intensity exercise increased serum uric acid levels by 21.22% and 20.85%, respectively (P < .001). After intervention, serum uric acid levels decreased by 32.40% on average, with levels in 70% of participants returning to the reference range.</p><p><strong>Discussion: </strong>The generalized serum uric acid elevation in conscripts was primarily attributed to combined effects of a high-purine diet and strenuous exercise. Establishing a traceable, standardized quality management model enables laboratories to accurately identify, verify, and resolve abnormal test results, enhancing analytical reliability and clinical data integrity.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793528","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 silent threat: a true Bombay phenotype with unexpected tolerance to group O-positive incidental transfusion.","authors":"Revathy R Menon, Monali Lokhande, Swati Kulkarni, Satya Prakash, Debasish Mishra, Ansuman Sahu, Somnath Mukherjee","doi":"10.1093/labmed/lmag030","DOIUrl":"10.1093/labmed/lmag030","url":null,"abstract":"<p><strong>Introduction: </strong>Bombay (Oh) blood group individuals are typically transfused with Bombay group red blood cells because transfusion with other blood groups can lead to life-threatening hemolysis. The mutations in the FUT1 gene prevent the expression of the H antigen on red blood cells.</p><p><strong>Methods: </strong>A 35-year-old man presented with severe anemia (hemoglobin, 4.8 g/dL) and was transfused with 3 units of O RhD-positive packed red blood cells at an outside hospital without adverse reaction. One month later, his blood group at our center was revealed as O RhD positive with panagglutination in reverse grouping. Anti-H lectin was negative, and crossmatch with O RhD-positive units showed strong incompatibility, indicating Bombay phenotype.</p><p><strong>Results: </strong>Molecular testing revealed FUT1 c.725T>G homozygosity and FUT2 deletion. Concurrent evaluation revealed plasma cell leukemia with extensive bone marrow infiltration, which may explain the transient immunosuppression and no hemolysis. Bombay-compatible units were procured through the Rare Donor Registry and transfused safely, allowing initiation of chemotherapy.</p><p><strong>Discussion: </strong>This case highlights that the absence of a transfusion reaction cannot exclude a true Bombay phenotype, underscoring the importance of molecular confirmation. It also emphasizes the timely coordination with donors and rare donor registries, ensuring the availability of compatible blood for patients with rare blood types.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019659","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":"Whole genome sequencing reveals diagnosis in a 12-month-old child with elevated creatinine kinase, pseudohypertriglyceridemia, and a complex phenotype.","authors":"Jude Abadie, Maria Flores","doi":"10.1093/labmed/lmag010","DOIUrl":"10.1093/labmed/lmag010","url":null,"abstract":"<p><strong>Introduction: </strong>Contiguous gene deletion syndromes (CGDSs) can be inherited or the result of microdeletions (eg, resulting from crossing-over errors) in gene-rich chromosome regions. Molecular mechanisms leading to chromosome loss in hotspot areas, such as errors in chromosome crossing-over events, can explain phenotypic presentations in CGDSs. Accurate interpretation of laboratory results in the context of clinical presentation can guide genetic testing that supports a timely diagnosis so that quicker interventions can improve clinical outcomes. Treatment of genetic disorders not only requires timely and accurate treatment, however, but also necessitates management and education of family members who care for the patient. Xp21.3-p21.2 deletion syndrome is a CGDS that has been documented in more than 100 male patients; it presents with primary adrenal insufficiency in the neonatal period.</p><p><strong>Methods: </strong>Here, we report the largest Xp21.3-p21.2 CGDS series to date.</p><p><strong>Results and discussion: </strong>Initial presentation was incorrectly diagnosed as adrenal insufficiency only, despite excessively elevated creatinine kinase and triglycerides, which could have expedited the correct diagnosis of Xp21.3p21.1 CGDS by guiding whole genome or targeted sequencing.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 3","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147663504","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":"Elevated blood lead in pregnancy: evidence supporting enhanced surveillance.","authors":"Ashley R Weaver, Halimat Olaniyan, Rejwi A Dahal","doi":"10.1093/labmed/lmag004","DOIUrl":"https://doi.org/10.1093/labmed/lmag004","url":null,"abstract":"<p><strong>Introduction: </strong>Prenatal lead exposure increases the risk of pregnancy complications and results in fetal neurodevelopmental damage. Despite well-documented risks, most clinicians predominantly rely on risk-based screening rather than on blood lead testing. The study aimed to measure whole blood lead levels (BLLs) in pregnant women from parts of Indiana and explore associations with maternal age, residential zip code, and median household income.</p><p><strong>Methods: </strong>Remnant whole blood samples submitted for hemoglobin electrophoresis were diluted 250-fold with aqueous diluent, and lead was measured by inductively coupled plasma tandem mass spectrometry. A BLL of 1 μg/dL or greater was classified as elevated in this study, although thresholds set for public health screening are higher.</p><p><strong>Results: </strong>Among 548 samples analyzed, 37 (6.8%) had a BLL of 1 µg/dL or higher, 2 samples were between 3.5 and 4.9 µg/dL, and 4 samples were 5 µg/dL or higher. We found no association between median household income based on zip code and elevated BLL. Participants were also grouped by age (analysis of variance P < .05), with Tukey honestly significant difference indicating higher mean BLL in participants 40 years of age or older.</p><p><strong>Discussion: </strong>Nearly 7% of the sampled pregnant population had elevated BLLs, which highlights continued need for surveillance of lead exposure in this vulnerable population.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501291","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":"Reporting the CENP-F-like (AC-14) antinuclear antibody pattern in the internet age: a case report.","authors":"Sally Maramotti, Alessia Cocconcelli, Lucia Dardani, Lucia Belloni, Stefania Croci, Ilaria Giovanelli, Veronica Galli, Alessandro Zerbini","doi":"10.1093/labmed/lmaf092","DOIUrl":"10.1093/labmed/lmaf092","url":null,"abstract":"<p><strong>Introduction: </strong>Laboratory immunologists occasionally encounter rare immunofluorescence patterns, such as the centromere protein F (CENP-F)-like pattern, classified as AC-14 by the International Consensus on ANA Patterns (ICAP). The clinical and biological significance of anti-CENP-F antibodies remains unclear, but their presence appears to be related to events involving increased or abnormal cell proliferation, including malignancies.</p><p><strong>Methods: </strong>This case report describes the diagnostic journey of a patient who presented with clinical manifestations of chronic spontaneous urticaria (CSU), the laboratory report for which indicated the presence of a CENP-F-like (AC-14) antinuclear antibody (ANA) pattern during routine testing for the cause of her symptoms. Concerned by the result, the patient independently searched for information online and discovered a potential association between anti-CENP-F autoantibodies and cancer. This search led to considerable anxiety and prompted her to pursue further medical evaluations to rule out malignancy. The resulting diagnostic pathway involved consultations across several medical disciplines.</p><p><strong>Results: </strong>This case highlights the complexity of interpreting uncommon ANA patterns and underscores the critical role of the laboratory in such contexts. In particular, it emphasizes that (1) ANA testing should be requested only in well-defined clinical contexts; (2) the CENP-F-like ANA pattern is not diagnostic of malignancy in low-risk patients.</p><p><strong>Discussion: </strong>Laboratories can play a crucial role in supporting clinicians, providing confirmation of laboratory results, even in the absence of commercial tests for determining the antigenic specificity. We believe that this case exemplifies the importance of correct and careful laboratory reporting, especially in an era where patients frequently engage in self-diagnosis. It also underlines the value of multidisciplinary collaboration in the management of unexpected laboratory results.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146145364","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":"Approach to hyponatremia: the value of fractional excretion of uric acid and phosphate.","authors":"Beatriz Izquierdo Alarcón, Carlos Castillo Pérez, Purificación Jurado Parras, Raquel Ramos Corral, María Cruz Cardenas Fernandez","doi":"10.1093/labmed/lmag009","DOIUrl":"10.1093/labmed/lmag009","url":null,"abstract":"<p><strong>Introduction: </strong>Differentiating syndrome of inappropriate antidiuretic hormone secretion (SIADH) from cerebral salt-wasting syndrome (CSWS) is a major challenge because of the identical clinical parameters that characterize their etiologies.</p><p><strong>Methods: </strong>A 68-year-old woman presented to the emergency department with fever, chills, and headache. The patient had a history of multiple myeloma in active follow-up, with no recent chemotherapy treatment. During her hospital stay, the patient developed hypoosmolar hyponatremia.</p><p><strong>Results: </strong>Initially, a diagnosis of CWS was made, but the torpid evolution of natremia led to reconsideration of the diagnosis. The use of fractional excretion of uric acid and phosphorus by the clinical laboratory established a definitive diagnosis, and clinical improvement was seen with appropriate therapeutic measures.</p><p><strong>Discussion: </strong>This case report highlights the central role of the laboratory in the study of hyponatremia. The joint evaluation of biomarkers such as uric acid, fractional excretion of uric acid, phosphorus, and fractional excretion of phosphate allows for a more accurate differential diagnosis between SIADH and CSWS, overcoming the limitations of the volume approach and thus minimizing the risks associated with invasive or inconclusive therapeutic tests and delays in the implementation of therapeutic measures.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147523479","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":"Discussion of the practice of centralized multicenter integration of independent medical laboratory test item classification.","authors":"Yuan Mao, Chuanlai Shen, Zhiqiang Li, Juan Gao, Zheng Yuan, Mingliang Zhang, Yuzuo Wang, Jianfei Sun","doi":"10.1093/labmed/lmaf056","DOIUrl":"10.1093/labmed/lmaf056","url":null,"abstract":"<p><strong>Introduction: </strong>Against the backdrop of China's diagnosis-related groups/disease intervention packet payment reforms, which mandate cost-effective laboratory management, this study explored a subspecialty-based, multicenter integration model for nonurgent testing projects in independent clinical laboratories. The mounting pressure on health care expenditure control necessitates innovative approaches to enhance laboratory efficiency and reduce costs without compromising quality.</p><p><strong>Methods: </strong>This research evaluated the impact of integrating testing programs across 4 independent medical laboratories located in cities S, N, H, and L. The integration was conducted on specialized platforms, including flow cytometry, immunoassays, mass spectrometry, and polymer-ase chain reaction. Nonemergent tests with a report turnaround time exceeding 1 day were centralized through cold-chain logistics for intercity sample transfer. Rigorous data collection and analysis methods were employed to compare the efficiency, cost, and quality of preintegration and postintegration performance.</p><p><strong>Results: </strong>The integration substantially improved testing efficiency (12.11%-71.34%) and reduced costs by 3.70% to 6.25%. Quality metrics demonstrated notable enhancements, with turnaround delay rates decreasing by 0.06% to 0.98% and refund rates decreasing by 0.0% to 0.01%. These improvements were primarily driven by using regional laboratory expertise and implementing artificial intelligence-driven automation technologies for analytical processes.</p><p><strong>Discussion: </strong>The findings of this study clearly demonstrate that multicenter integration is an effective strategy for optimizing resource allocation and achieving scalable and cost-effective laboratory operations. This subspecialty-based integration approach provides a viable and scalable solution for laboratories in various regions worldwide, enabling them to strike a balance among testing efficiency, quality, and cost-effectiveness. It not only addresses the urgent challenges posed by health care payment reforms but also offers actionable recommendations for the optimization of laboratory layouts in low- and middle-income countries.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":"57 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505749","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}