Asthma is a chronic inflammatory airway disease affecting about 300 million people and responsible for 500,000 deaths annually globally. Eosinophilic asthma is one of the most common phenotypes of asthma. It constitutes about 50% to 60% of all cases of asthma, and it is the most common phenotype in children presenting with severe acute asthma. The mechanism of eosinophilic asthma is chronic airway inflammation which leads to airway hyperresponsiveness, and remodeling due to the immunopathological effects of inflammatory cytokines. The duet cytokines interleukin-4 (IL-4) and IL-13 play the most central role in the pathophysiology of eosinophilic asthma. The two sister cytokines are slightly similar with a 25% homology, they share a common signaling IL-4Rα chain, and have identical biological effects. Their principal biological effect is the development of Th2 cells from naïve T helper type 0 (Th0) lymphocytes. Th2 cells produce several cytokines responsible for inducing airway eosinophilic inflammation. They induce the ε isotype switch and the switching of the B cell immunoglobulin (Ig) production from IgM to IgE. Furthermore, they stimulate eosinophil proliferation, and migration to the allergic airways and promote eosinophil survival by suppressing eosinophil apoptosis. Activated eosinophils secrete several cytotoxic cationic proteins which damage the airway epithelium, and amplify the inflammatory cascade and airway remodeling. Most patients with eosinophilic asthma can achieve control on a long-acting β2-agonist, inhaled corticosteroid, and a leukotriene receptor antagonist. However, about 3.6-10% do not achieve asthma control. These patients usually benefit from treatment with a biologic. Dupilumab is the only biologic targeting IL-4 and IL-13 approved for the treatment of moderate-to-severe eosinophilic asthma. Clinical trials have shown that treatment with dupilumab results in good asthma control, and significantly reduces moderate-to-severe exacerbation rates (p < 0.001). Additionally, treatment with dupilumab has been shown to significantly improve lung function (p < 0.001), and health-related quality of life, and allows patients to taper or discontinue corticosteroid treatment.
{"title":"Targeting interleukin-4 and interleukin-13 in the treatment of severe eosinophilic asthma","authors":"S. Nightingale","doi":"10.17352/aprc.000082","DOIUrl":"https://doi.org/10.17352/aprc.000082","url":null,"abstract":"Asthma is a chronic inflammatory airway disease affecting about 300 million people and responsible for 500,000 deaths annually globally. Eosinophilic asthma is one of the most common phenotypes of asthma. It constitutes about 50% to 60% of all cases of asthma, and it is the most common phenotype in children presenting with severe acute asthma. The mechanism of eosinophilic asthma is chronic airway inflammation which leads to airway hyperresponsiveness, and remodeling due to the immunopathological effects of inflammatory cytokines. The duet cytokines interleukin-4 (IL-4) and IL-13 play the most central role in the pathophysiology of eosinophilic asthma. The two sister cytokines are slightly similar with a 25% homology, they share a common signaling IL-4Rα chain, and have identical biological effects. Their principal biological effect is the development of Th2 cells from naïve T helper type 0 (Th0) lymphocytes. Th2 cells produce several cytokines responsible for inducing airway eosinophilic inflammation. They induce the ε isotype switch and the switching of the B cell immunoglobulin (Ig) production from IgM to IgE. Furthermore, they stimulate eosinophil proliferation, and migration to the allergic airways and promote eosinophil survival by suppressing eosinophil apoptosis. Activated eosinophils secrete several cytotoxic cationic proteins which damage the airway epithelium, and amplify the inflammatory cascade and airway remodeling. Most patients with eosinophilic asthma can achieve control on a long-acting β2-agonist, inhaled corticosteroid, and a leukotriene receptor antagonist. However, about 3.6-10% do not achieve asthma control. These patients usually benefit from treatment with a biologic. Dupilumab is the only biologic targeting IL-4 and IL-13 approved for the treatment of moderate-to-severe eosinophilic asthma. Clinical trials have shown that treatment with dupilumab results in good asthma control, and significantly reduces moderate-to-severe exacerbation rates (p < 0.001). Additionally, treatment with dupilumab has been shown to significantly improve lung function (p < 0.001), and health-related quality of life, and allows patients to taper or discontinue corticosteroid treatment.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130556022","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}
Not many doctors are aware of the most important obstacle in pulmonology and respiration care which is determined by the electronic structure of molecular oxygen. In great contrast to a huge majority of chemically stable substances, the O2 molecule possesses two non-paired electrons with parallel spins.
{"title":"The spin of dioxygen as the main factor in pulmonology and respiratory care","authors":"Minaev Boris","doi":"10.17352/aprc.000081","DOIUrl":"https://doi.org/10.17352/aprc.000081","url":null,"abstract":"Not many doctors are aware of the most important obstacle in pulmonology and respiration care which is determined by the electronic structure of molecular oxygen. In great contrast to a huge majority of chemically stable substances, the O2 molecule possesses two non-paired electrons with parallel spins.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126023841","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}
Kucukardali Yasar, Gunturk Arzu, Ozturk Mehmet Akif, Acikel Şenay, Ceylan Hatice Zeynep, F. Pınar, S. Banu
Mediastinal lymphadenopathy is rare in Coronavirus Disease-2019 (COVID-19) patients with mild clinical course. The frequency of lymphadenopathy increases in COVID-19 patients who develop Acute Respiratory Distress Syndrome (ARDS). In a 38-year-old male patient, mediastinal lymphadenopathy and asymptomatic pulmonary embolism were detected during the third week of COVID-19 infection at home. Sarcoidosis was diagnosed with a finding of non-caseating granulomas. Even if it is asymptomatic, pulmonary embolism should be considered, especially in COVID-19 patients with high C - Reactive Protein (CRP) and D-dimer levels. If mediastinal lymphadenopathy is detected in mild COVID-19 cases, systemic diseases should be investigated. In severe COVID-19 cases, if lymphadenopathy continues despite a COVID-19 recovery, further investigation is required.
{"title":"Is there a relationship between COVID-19 and sarcoidosis? A case report","authors":"Kucukardali Yasar, Gunturk Arzu, Ozturk Mehmet Akif, Acikel Şenay, Ceylan Hatice Zeynep, F. Pınar, S. Banu","doi":"10.17352/aprc.000080","DOIUrl":"https://doi.org/10.17352/aprc.000080","url":null,"abstract":"Mediastinal lymphadenopathy is rare in Coronavirus Disease-2019 (COVID-19) patients with mild clinical course. The frequency of lymphadenopathy increases in COVID-19 patients who develop Acute Respiratory Distress Syndrome (ARDS). In a 38-year-old male patient, mediastinal lymphadenopathy and asymptomatic pulmonary embolism were detected during the third week of COVID-19 infection at home. Sarcoidosis was diagnosed with a finding of non-caseating granulomas. Even if it is asymptomatic, pulmonary embolism should be considered, especially in COVID-19 patients with high C - Reactive Protein (CRP) and D-dimer levels. If mediastinal lymphadenopathy is detected in mild COVID-19 cases, systemic diseases should be investigated. In severe COVID-19 cases, if lymphadenopathy continues despite a COVID-19 recovery, further investigation is required.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"8 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131840404","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}
Nearly all very preterm infants will require some form of respiratory support in the neonatal unit. It is standard practice to humidify the inspired gases. It appears logical to bring this practice of humidification forward to the time immediately after birth. There is an evidence base for early provision of heated humidified gases in the delivery room, but because several forms of respiratory support may be needed (eg binasal prong CPAP and use of a T-piece resuscitator) this may be difficult to achieve. We describe a setup using a radiant warmer and humidification circuits to make this possible.
{"title":"Achieving humidification of inspired gases in the delivery room for very preterm infants: Rationale and set up","authors":"Meyer Michael P, Barrett Jonathan","doi":"10.17352/aprc.000078","DOIUrl":"https://doi.org/10.17352/aprc.000078","url":null,"abstract":"Nearly all very preterm infants will require some form of respiratory support in the neonatal unit. It is standard practice to humidify the inspired gases. It appears logical to bring this practice of humidification forward to the time immediately after birth. There is an evidence base for early provision of heated humidified gases in the delivery room, but because several forms of respiratory support may be needed (eg binasal prong CPAP and use of a T-piece resuscitator) this may be difficult to achieve. We describe a setup using a radiant warmer and humidification circuits to make this possible.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132689428","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}
Buvat Jean Sébastien, Faivre Laurent, Romet Pierre, Vitu Ludovic, Badie Julio, Berdaguer Ferrari Fernando Daniel, Malfroy Sylvain
Background: During the COVID health crisis, intensive care units were quickly overwhelmed and had to call for help. The only solution was to call for this help among nurses, nursing auxiliaries, and physicians that were normally not working in the ICU units (consultations, operating room, medical units). These people needed mechanical ventilation courses before beginning their job in the ICU unit. Simulation appeared to be the best solution because of its safety and educational effectiveness. Approach: We developed an artificial lung during the 36 hours innovation marathon Crunch Maker Camp 2021. It included three main settings which were lung compliance, airways resistances, and diaphragmatic inspiratory trigger. These parameters seemed to be essential for us in order to simulate the mechanical ventilation characteristics of a COVID lung. The simulator was entirely made of physical components. Evaluation: The team composed of engineers and intensive care medical instructors developed the first proof of concept of the artificial lung. The different controllable modules were able to adjust compliance, and resistance on the respirator, and an inspiratory trigger was efficient. They reflected correctly a normal or a COVID lung, simulating a patient on a ventilator. The simulator was presented to the jury and after deliberation, the teams’ work was rewarded with the first innovation prize. Reflection: We designed a controlled simulation for COVID respiratory issues; the artificial lung was rewarded during this innovation marathon Crunch Maker Camp 2021. This allowed us to improve the simulator and we plan to start using this tool during training sessions soon. We will then measure Pedagogic impact, focusing on long-term memorization.
{"title":"Design a simulating lung in 36h or less","authors":"Buvat Jean Sébastien, Faivre Laurent, Romet Pierre, Vitu Ludovic, Badie Julio, Berdaguer Ferrari Fernando Daniel, Malfroy Sylvain","doi":"10.17352/aprc.000077","DOIUrl":"https://doi.org/10.17352/aprc.000077","url":null,"abstract":"Background: During the COVID health crisis, intensive care units were quickly overwhelmed and had to call for help. The only solution was to call for this help among nurses, nursing auxiliaries, and physicians that were normally not working in the ICU units (consultations, operating room, medical units). These people needed mechanical ventilation courses before beginning their job in the ICU unit. Simulation appeared to be the best solution because of its safety and educational effectiveness. Approach: We developed an artificial lung during the 36 hours innovation marathon Crunch Maker Camp 2021. It included three main settings which were lung compliance, airways resistances, and diaphragmatic inspiratory trigger. These parameters seemed to be essential for us in order to simulate the mechanical ventilation characteristics of a COVID lung. The simulator was entirely made of physical components. Evaluation: The team composed of engineers and intensive care medical instructors developed the first proof of concept of the artificial lung. The different controllable modules were able to adjust compliance, and resistance on the respirator, and an inspiratory trigger was efficient. They reflected correctly a normal or a COVID lung, simulating a patient on a ventilator. The simulator was presented to the jury and after deliberation, the teams’ work was rewarded with the first innovation prize. Reflection: We designed a controlled simulation for COVID respiratory issues; the artificial lung was rewarded during this innovation marathon Crunch Maker Camp 2021. This allowed us to improve the simulator and we plan to start using this tool during training sessions soon. We will then measure Pedagogic impact, focusing on long-term memorization.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128706754","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}
According to the International Union of Pure and Applied Chemistry (IUPAC) Smart Polymers (SP) or stimulus-responsive polymers are “polymers that respond or that is designed to respond to a stimulus like pH, light, heat, etc. change, and provides a predetermined action”.
{"title":"Smart polymers: Challenges and future","authors":"A. Hernandez-Martinez","doi":"10.17352/aprc.000076","DOIUrl":"https://doi.org/10.17352/aprc.000076","url":null,"abstract":"According to the International Union of Pure and Applied Chemistry (IUPAC) Smart Polymers (SP) or stimulus-responsive polymers are “polymers that respond or that is designed to respond to a stimulus like pH, light, heat, etc. change, and provides a predetermined action”.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116901739","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}
Introduction: In Spain, few data have been reported on mortality and survival in rheumatoid arthritis with diffuse interstitial lung disease. Objectives: To estimate mortality and survival for patients with symptomatic diffuse interstitial lung disease and rheumatoid arthritis and to analyze the effect of clinical factors. Methods: We performed an observational study between 2007 and 2018 at the Interdisciplinary Rheumatology and Pulmonology Clinic, from a tertiary Hospital. Patients with rheumatoid arthritis and symptomatic of diffuse interstitial lung disease confirmed by high-resolution computed tomography were included. Causes of death and clinical factors were reported. Results: We identified 90 patients with rheumatoid arthritis and symptomatic interstitial lung disease. Twenty-six patients died and diffuse interstitial lung disease was the most frequent cause (50%). The overall mortality rate was 19.7 per 1000 patient-years (95% CI: 13.4 - 29). The multivariate model revealed the predictors of mortality to be a long time between diagnosis of rheumatoid arthritis and lung involvement (HR = 1.17; p = 0.003) and low forced vital capacity (HR = 0.02; p = 0.018). The probability of survival was 50% at 10.2 years from diagnosis of interstitial lung disease. Comparison of survival did not reveal significant differences by type of radiologic pattern (p = 0.823). Conclusions: The fact that almost one-third of patients died and that survival is 50% at 10 years highlights the important role of diffuse interstitial lung disease in rheumatoid arthritis. The radiologic pattern does not seem to be as important for survival as forced vital capacity at diagnosis and the time between diagnosis of rheumatoid arthritis and lung involvement. Key points 1. DILD is associated with shorter survival in patients with RA. 2. The radiologic pattern does not seem to influence the survival in patients with RA and DILD. 3. The FVC at diagnosis is an important factor that influences the prognosis of patients with RA and DILD.
{"title":"Mortality and survival of patients with rheumatoid arthritis and symptomatic diffuse interstitial lung disease","authors":"Bonilla-Hernán M Gema, Gómez-Carrera Luis, Fernández-Velilla Peña María, P.-R. Chamaida, Aguado Pilar, Á. Rodolfo, Balsa Alejandro","doi":"10.17352/aprc.000075","DOIUrl":"https://doi.org/10.17352/aprc.000075","url":null,"abstract":"Introduction: In Spain, few data have been reported on mortality and survival in rheumatoid arthritis with diffuse interstitial lung disease. Objectives: To estimate mortality and survival for patients with symptomatic diffuse interstitial lung disease and rheumatoid arthritis and to analyze the effect of clinical factors. Methods: We performed an observational study between 2007 and 2018 at the Interdisciplinary Rheumatology and Pulmonology Clinic, from a tertiary Hospital. Patients with rheumatoid arthritis and symptomatic of diffuse interstitial lung disease confirmed by high-resolution computed tomography were included. Causes of death and clinical factors were reported. Results: We identified 90 patients with rheumatoid arthritis and symptomatic interstitial lung disease. Twenty-six patients died and diffuse interstitial lung disease was the most frequent cause (50%). The overall mortality rate was 19.7 per 1000 patient-years (95% CI: 13.4 - 29). The multivariate model revealed the predictors of mortality to be a long time between diagnosis of rheumatoid arthritis and lung involvement (HR = 1.17; p = 0.003) and low forced vital capacity (HR = 0.02; p = 0.018). The probability of survival was 50% at 10.2 years from diagnosis of interstitial lung disease. Comparison of survival did not reveal significant differences by type of radiologic pattern (p = 0.823). Conclusions: The fact that almost one-third of patients died and that survival is 50% at 10 years highlights the important role of diffuse interstitial lung disease in rheumatoid arthritis. The radiologic pattern does not seem to be as important for survival as forced vital capacity at diagnosis and the time between diagnosis of rheumatoid arthritis and lung involvement. Key points 1. DILD is associated with shorter survival in patients with RA. 2. The radiologic pattern does not seem to influence the survival in patients with RA and DILD. 3. The FVC at diagnosis is an important factor that influences the prognosis of patients with RA and DILD.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128453813","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}
Novis Ilse M, L. Edward, Novis Hailey S, Sorour Karim, Sorour Khaled A
Nasogastric tubes are used for a multitude of purposes, however, due to their firm composition, they often injure the nasal passages when being placed. While a small amount of bleeding from the nasal mucosa is traditionally acceptable, that small amount of bleeding from the nose can potentially form thrombi that could compromise the airway in patients with impaired sensorium and swallowing.
{"title":"A new method of placing nasogastric tubes in patients at high risk of epistaxis","authors":"Novis Ilse M, L. Edward, Novis Hailey S, Sorour Karim, Sorour Khaled A","doi":"10.17352/aprc.000074","DOIUrl":"https://doi.org/10.17352/aprc.000074","url":null,"abstract":"Nasogastric tubes are used for a multitude of purposes, however, due to their firm composition, they often injure the nasal passages when being placed. While a small amount of bleeding from the nasal mucosa is traditionally acceptable, that small amount of bleeding from the nose can potentially form thrombi that could compromise the airway in patients with impaired sensorium and swallowing.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128507750","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 myth of septic complications of acute pneumonia","authors":"K. Igor","doi":"10.17352/aprc.000073","DOIUrl":"https://doi.org/10.17352/aprc.000073","url":null,"abstract":"","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122665964","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}
K. Arjun, Layek Avishek, Gupta Rahul Kumar, B. Manju, Akhlesh Akhlesh
Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation in the lungs. COPD frequently coexist with Heart Failure (HF) but most patients go undiagnosed because of similarity of symptoms. Data on prevalence of COPD in HF are discrepant and scarce.
{"title":"Aspergilloma in post COVID-19 patient","authors":"K. Arjun, Layek Avishek, Gupta Rahul Kumar, B. Manju, Akhlesh Akhlesh","doi":"10.17352/aprc.000070","DOIUrl":"https://doi.org/10.17352/aprc.000070","url":null,"abstract":"Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation in the lungs. COPD frequently coexist with Heart Failure (HF) but most patients go undiagnosed because of similarity of symptoms. Data on prevalence of COPD in HF are discrepant and scarce.","PeriodicalId":167215,"journal":{"name":"Archives of Pulmonology and Respiratory Care","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127217479","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}
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