Postgraduate medicine最新文献

{"title":"The triglyceride-glucose index as an indicator of latent atherogenicity of the plasma lipid profile in healthy men with normolipidaemia.","authors":"Anastasiya M Kaneva, Natalya N Potolitsyna, Evgeny R Bojko","doi":"10.1080/00325481.2024.2426970","DOIUrl":"10.1080/00325481.2024.2426970","url":null,"abstract":"<p><strong>Objectives: </strong>The triglyceride-glucose (TyG) index is a novel diagnostic marker for various metabolic and cardiovascular diseases. However, little is known about the association of the TyG index with plasma atherogenicity, especially with its latent forms. The aim of this study was to assess the potential of the use of the TyG index as a marker of atherogenic risk.</p><p><strong>Methods: </strong>A total of 202 men with normolipidaemia, aged 20-60 years, were enrolled in this study. Fasting biochemical parameters were measured. The TyG index was calculated as ln[triglyceride(mg/dL)×glucose(mg/dL)]/2. The diagnostic ability of the TyG index for detecting atherogenic risk was tested by receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A substantial portion of normolipidaemic men had deviations from the reference values for the indices calculated using apolipoproteins. Unfavorable values for the apolipoprotein (apo) B/apoA-I ratio, low-density lipoprotein cholesterol/apoB (LDL-C/apoB) ratio, and the atherogenic index (ATH index) were observed in 32.7%, 31.7%, and 14.4% of men, respectively. The results of ROC curve analysis showed that the TyG index had good diagnostic ability for identifying unfavorable apolipoprotein indices in normolipidaemic men.</p><p><strong>Conclusions: </strong>Thus, the TyG index can be a valuable additional marker for assessing latent atherogenic risk; it can provide useful information for the diagnosis and treatment of early atherosclerosis.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585114","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":"Pentoxifylline improves anemia through its novel effect on hypoxia-inducible factor-2 alpha in hemodialysis patients: a randomized, double-blind, placebo-controlled clinical trial.","authors":"Hadeer Zakaria, Noha Alaa Hamdy, Nagy Ah Sayed-Ahmed, Ahmed El-Mallah","doi":"10.1080/00325481.2024.2426448","DOIUrl":"https://doi.org/10.1080/00325481.2024.2426448","url":null,"abstract":"<p><strong>Objectives: </strong>This randomized, double-blind, placebo-controlled clinical trial aimed to prospectively examine the effect of pentoxifylline (PTX) on hypoxia-inducible factor-2 alpha (HIF-2α) and its role in controlling anemia in hemodialysis (HD) patients.</p><p><strong>Methods: </strong>Eighty patients on HD were randomized to receive 400 mg of PTX or placebo twice daily for 6 months. The hemoglobin (Hb) and other hematologic parameters, the weekly erythropoiesis-stimulating agents (ESAs), and the ESA resistance index (ERI) were assessed monthly during the study. The HIF-2α, transforming growth factor-β1 (TGF-β1), and high-sensitivity C-reactive protein (hs.CRP) were measured before and after the intervention.</p><p><strong>Results: </strong>In the pentoxifylline group, an appreciable increase in Hb from 9.7 (9.3, 10.3) g/dl to 10.5 (9.3, 11.4) g/dl and hematocrit (Hct) from 31.3 (29.6, 32.4)% to 33.2 (29.4, 35.9)% was observed after one month of PTX administration, and this effect was maintained over the study time (<i>p</i> < 0.001). This was along with a decrease in the ESA doses required from 8000 (8000, 11500) IU/wk to 4000 (2000, 8000) IU/wk (<i>p</i> < 0.001), and an improvement in the ERI from 11.6 (8.07, 16.97) IU/kg/wk/g/dl to 5.79 (2.01, 10.09) IU/kg/wk/g/dl (<i>p</i> < 0.001). Additionally, the HIF-2α increased significantly at the end of the intervention in patients who received PTX from 3245.35 (2886.8, 4691.56) pg/ml to 7208.75 (5382, 9182.7) pg/ml, while TGF-β1 and hs.CRP decreased significantly from 657.78 (539.78, 1146.62) pg/ml and 88.08 (39.93, 100.4) mg/l to 329.94 (228.67, 793.18) pg/ml and 48.65 (34.44, 84.61) mg/l, respectively. The percent changes in HIF-2α, TGF-β1, and hs.CRP levels in the pentoxifylline group were also statistically significant in comparison with the placebo group.</p><p><strong>Conclusions: </strong>PTX could be a promising agent for correcting anemia in HD patients via increasing HIF-2α levels.</p><p><strong>Clinical trial registration: </strong>Clinicaltrials.gov, February 2023, registry number: NCT05708248.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585001","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 masters athlete and use of antihypertensive medications.","authors":"Audrey H Wu, Riley Patzsch, Andrew Cornett","doi":"10.1080/00325481.2024.2426449","DOIUrl":"https://doi.org/10.1080/00325481.2024.2426449","url":null,"abstract":"<p><p>Hypertension is the most common cardiovascular condition in recreational athletes, especially older (masters) athletes. The interacting effects of hypertension, cardiac adaptation to endurance training, and antihypertensive medications on exercise performance are complex and of relevance to athletes, trainers, and health care providers. Cardiac adaptations occur in response to aging and endurance training, and findings may overlap with pathologic cardiac remodeling. This review summarizes the influence of antihypertensive medications on exercise performance, which can include both hemodynamic and metabolic effects, and includes practical considerations in choice of antihypertensive agent for the masters endurance athlete. Whereas the overriding priority for choice of antihypertensive is control of hypertension and improving clinical outcomes, other considerations regarding effects on exercise performance may also influence the choice of agent.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585005","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":"Evaluating cardiac electrophysiological markers for predicting arrhythmic risk in hypothyroid patients.","authors":"Sibel Tunç Karaman, Abdullah Ozan Polat, Okcan Basat","doi":"10.1080/00325481.2024.2419358","DOIUrl":"10.1080/00325481.2024.2419358","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the impact of hypothyroidism and levothyroxine (LT4) treatment on arrhythmic risk by concurrently analyzing multiple electrocardiogram (ECG) parameters such as the Index of Cardio-Electrophysiological Balance (iCEB), frontal QRS-T angle, Tpeak-Tend (Tp-e) interval/QT interval ratio, and QT dispersion (QTd).</p><p><strong>Methods: </strong>This cross-sectional study included 132 adult patients with primary hypothyroidism who had been receiving LT4 treatment, and 132 demographically matched healthy controls. The hypothyroid group was also stratified by thyroid-stimulating hormone (TSH) levels (subclinical <4.5 and overt ≥ 4.5). Participants underwent a series of thyroid function and ECG measurements.</p><p><strong>Results: </strong>The hypothyroid and healthy control groups were matched for age and gender (<i>p</i> = 0.080; <i>p</i> = 0.176). Participants with hypothyroidism had higher Tp-e/QT ratios, iCEB, median frontal QRS-T angle, and corrected QT dispersion (cQTd) than healthy controls (<i>p</i> = 0.004; <i>p</i> = 0.025; <i>p</i> = 0.004; <i>p</i> = 0.004, respectively). In the overt group, the Tp-e/QT ratio, iCEB, and median frontal QRS-T angles were all higher (<i>p</i> = 0.012, <i>p</i> = 0.037, and <i>p</i> = 0.016, respectively). Logistic regression analysis indicated that a higher iCEB score (β = 0.60, <i>p</i> = 0.003) was significant for the detection of arrhythmia risk. ROC analysis showed that iCEB had the highest sensitivity (0.80), moderate specificity (0.60), and AUC 0.70.</p><p><strong>Conclusion: </strong>Patients with hypothyroidism have a higher risk of arrhythmia. To assess this risk, it is important to analyze the Tp-e interval, iCEB, frontal QRS-T angle, and QTd. Differentiating between patients with subclinical and overt hypothyroidism can help minimize the risk of arrhythmia. iCEB is the most effective method for identifying arrhythmic risk. Using all these parameters can improve the accuracy of arrhythmic risk detection in patients with hypothyroidism.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484619","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":"SGLT2 inhibitors across the spectrum of chronic kidney disease: a narrative review.","authors":"Lance Sloan","doi":"10.1080/00325481.2024.2418795","DOIUrl":"10.1080/00325481.2024.2418795","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a growing public health concern, affecting at least 1 in 7 adults in the United States, and accounting for a large proportion of healthcare spending. The risk of mortality rises steeply with declining kidney function, mostly due to cardiovascular-related deaths. Since CKD is asymptomatic in the early stages, diagnosis is sometimes delayed. However, early diagnosis is important for timely initiation of interventions to reduce disease progression, and to avoid the need for hospitalizations, dialysis, or kidney transplantation. This review focuses on the impact of sodium glucose transporter 2 inhibitors (SGLT2i) on CKD based on mechanistic and clinical trial evidence. These agents affect the kidneys through changes in sodium transport and metabolic factors that interfere with the primary pathological mechanisms shared by most kidney diseases. Following clinical trials of SGLT2i in patients with type 2 diabetes which demonstrated reductions in the risk of major adverse CV events, death, and hospitalizations for heart failure (HHF), and in patients with heart failure (HF) with and without diabetes which showed reductions in death and HHF, recent trials in patients with CKD have provided overwhelming support for the use of SGLT2i as foundational therapy across a broad spectrum of patients with CKD, regardless of diabetes status, primary kidney disease (except polycystic kidney disease), or kidney function. While clinical trials in CKD generally recruit patients with a high risk of events, patients at lower risk could also benefit from SGLT2i in terms of reduction of CKD progression, HF, and death, as well as other beneficial effects including reductions in blood sugar, body weight, and blood pressure.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484621","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":"Exploring the potential of artificial intelligence models for triage in the emergency department.","authors":"Fatma Tortum, Kamber Kasali","doi":"10.1080/00325481.2024.2418806","DOIUrl":"https://doi.org/10.1080/00325481.2024.2418806","url":null,"abstract":"<p><strong>Objective: </strong>To perform a comparative analysis of the three-level triage protocol conducted by triage nurses and emergency medicine doctors with the use of ChatGPT, Gemini, and Pi, which are recognized artificial intelligence (AI) models widely used in the daily life.</p><p><strong>Materials and methods: </strong>The study was prospectively conducted with patients presenting to the emergency department of a tertiary care hospital from 1 April 2024, to 7 April 2024. Among the patients who presented to the emergency department over this period, data pertaining to their primary complaints, arterial blood pressure values, heart rates, peripheral oxygen saturation values measured by pulse oximetry, body temperature values, age, and gender characteristics were analyzed. The triage categories determined by triage nurses, the abovementioned AI chatbots, and emergency medicine doctors were compared.</p><p><strong>Results: </strong>The study included 500 patients, of whom 23.8% were categorized identically by all triage evaluators. Compared to the triage conducted by emergency medicine doctors, triage nurses overtriaged 6.4% of the patients and undertriaged 3.1% of the yellow-coded patients and 3.4% of the red-coded patients. Of the AI chatbots, ChatGPT exhibited the closest triage approximation to that of emergency medicine doctors; however, its undertriage rates were 26.5% for yellow-coded patients and 42.6% for red-coded patients.</p><p><strong>Conclusion: </strong>The undertriage rates observed in AI models were considerably high. Hence, it does not yet seem appropriate to solely rely on the specified AI models for triage purposes in the emergency department.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484620","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":"Unmasking bocavirus: is it a co-infectious agent or an actual respiratory pathogen?","authors":"Damla Hanalioglu, Selin Cetin, Meltem Cetin, Bedia Dinc, Leman Akcan Yildiz, Mustafa Oguz Kaynak, Funda Kurt, Halise Akca, Saliha Senel, Can Demir Karacan","doi":"10.1080/00325481.2024.2412972","DOIUrl":"10.1080/00325481.2024.2412972","url":null,"abstract":"<p><strong>Objectives: </strong>Although human bocavirus (HBoV) is primarily linked to respiratory tract infections, its exact role as a respiratory pathogen remains unclear. This study aims to investigate HBoV detection rates, as well as clinical, laboratory, microbiological, and radiological characteristics, length of stay in the emergency department (ED), rate of hospitalization, and severity of illness in cases where HBoV is detected in respiratory secretions.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of all consecutive patients under 18 years who visited a large-volume tertiary pediatric ED from January to December 2023 and tested positive for HBoV in their respiratory viral panel (RVP).</p><p><strong>Results: </strong>Among the 14,315 patients who underwent RVP testing during the study period, 591 (4%) tested positive for HBoV. After excluding those with incomplete data, 528 patients (57% male) were included in the analyses. The median age was 2.8 [1.2-4.9] years. The most common symptoms were cough (67%), fever (58%), runny nose/nasal congestion/sore throat (34%), and respiratory distress (24%). Thirty percent of the patients had a history of antibiotic use before admission. Thirteen percent of the patients had at least one chronic illness. Co-infection with HBoV occurred in 37% of the patients, with respiratory syncytial virus (RSV) being the most frequently co-detected virus (45%). Lymphopenia was documented in 12% of patients, and 36% had elevated C-reactive protein levels (median 21 [12-38] g/dl). Abnormal chest X-rays were noted in 85% of patients. The management approach included outpatient care for more than half of the patients (69%). Clinical severity was classified as high in 11% of patients (<i>n</i> = 60), necessitating ICU admission.</p><p><strong>Conclusion: </strong>Although typically mild, HBoV infections can escalate to severe respiratory illnesses, requiring respiratory support and intensive care.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402516","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":"Is it time to finally retire the pantoprazole \"drip\"?","authors":"Ravnit Singh, Nicaulis Gonzalez Lebron, Eduardo A Aviles, Jonathan B Ramharack","doi":"10.1080/00325481.2024.2413356","DOIUrl":"10.1080/00325481.2024.2413356","url":null,"abstract":"","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373952","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":"Juvenile idiopathic arthritis management: insights into the utilization of intra-articular corticosteroid injections.","authors":"Çisem Yıldız, Batuhan Küçükali, Merve Kutlar, Nuran Belder, Nihal Karaçayır, Pelin Esmeray Şenol, Emine Nur Sunar Yayla, Deniz Gezgin Yildirim, Sevcan A Bakkaloğlu","doi":"10.1080/00325481.2024.2412969","DOIUrl":"10.1080/00325481.2024.2412969","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is a common chronic rheumatic disease in children, requiring careful management to reduce both short- and long-term morbidity. In this study, our objective was to assess the clinical features of patients diagnosed with JIA who received intra-articular corticosteroid injections (IACI).</p><p><strong>Methods: </strong>In this retrospective study, we evaluated the clinical and laboratory characteristics of 225 JIA patients monitored from January 2012 to October 2023 at a tertiary care center. We focused on patients who underwent intra-articular corticosteroid injections (IACI) as part of their treatment. Triamcinolone hexacetonide (TH) was used due to its demonstrated safety and efficacy.</p><p><strong>Results: </strong>Our analysis revealed that IACI, particularly utilizing TH, was a widely employed and effective adjunct therapy, contributing to rapid symptom relief and local disease control. Patients receiving IACI exhibited earlier symptom onset, younger age at diagnosis, longer follow-up durations, and higher cumulative treatment burden (<i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.01, <i>p</i> < 0.001 respectively). Despite inconclusive acute-phase reactants, a higher frequency of ANA positivity and elevated initial lymphocyte counts were associated with increased IACI use (<i>p</i> < 0.001, <i>p</i> < 0.001 respectively). Importantly, on a joint basis, a high percentage of arthritis remission following IACI underscores its efficacy and favorable safety profile.</p><p><strong>Conclusions: </strong>Notably, the high percentage of arthritis remission achieved with intra-articular corticosteroid injections (IACI) on a joint-specific basis highlights its efficacy and favorable safety profile. A lymphocyte count exceeding 5000/mm³ at the time of diagnosis may serve as an early indicator for considering intra-articular steroid administration. These findings emphasize the need for nuanced and individualized treatment strategies in JIA management to optimize outcomes for affected children.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376466","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":"Giant cell arteritis (GCA) as a risk factor for seizures: a cohort study.","authors":"Paula David, Esther Houri Levi, Ariel Feifel, Yonatan Shneor Patt, Abdulla Watad, Omer Gendelman, Arnon D Cohen, Howard Amital, Avishai M Tsur","doi":"10.1080/00325481.2024.2413355","DOIUrl":"10.1080/00325481.2024.2413355","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to assess the risk of seizures in Giant Cell Arteritis (GCA) patients in a large cohort of Israeli subjects, in comparison to matched controls.</p><p><strong>Methods: </strong>Patients diagnosed with GCA between 2002 and 2017 were included. Controls were matched based on sex, age, socioeconomic status, country of birth, diabetes mellitus, and hypertension in a 4:1 ratio. Patients with seizure records prior to the study period were excluded. Hazard ratios for seizures was obtained by cox regression models.</p><p><strong>Results: </strong>The study cohort was composed by 8,103 GCA patients and 32,412 matched controls. The GCA group included 5,535 women (68%), 2,644 patients born in Israel (33%), and 2,888 patients with low socioeconomic status (36%). The median age of this group was 71. During the followed cumulative person-years of 54,641 and 222,537 in the GCA and control group, respectively, 15.92 cases per 10,000 person-years was found in the GCA group, compared to 9.62 per 10,000 person-years in the controls. GCA was associated with seizures in the unadjusted (HR = 1.66, 95% CI [1.29 to 2.13]) and adjusted (HR = 1.67, 95% CI [1.3 to 2.14]) models. GCA was also associated with seizures after controlling for strokes (HR = 1.55, 95% CI [1.16 to 2.07]).</p><p><strong>Conclusion: </strong>According to this study, individuals with GCA are at a higher risk of developing seizures when compared to the general population. This increased risk is independent of their predisposition for stroke. One proposed mechanism is that the GCA pro-inflammatory state may decrease the neuronal threshold for depolarization.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376454","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}