Pub Date : 2024-08-01Epub Date: 2024-01-24DOI: 10.1055/a-2243-9399
Reiner Hanewinkel, Sabina Ulbricht
E-cigarettes are used in clinical trials to facilitate smoking cessation. Due to the health risks associated with the use of e-cigarettes, the results of clinical trials should be fully reported, including continued exclusive use and dual use of tobacco and e-cigarettes. Nicotine cessation outcomes should be reported as the primary endpoint as well as the analysis of tobacco cessation alone. As there is currently no robust evidence that reducing cigarette consumption provides substantial health benefits, cigarette consumption reduction should not be used as a health outcome in clinical trials. Continued nicotine dependence should be included as an "adverse event" in the reporting of trial results.
{"title":"[Intended and unintended effects of e-cigarettes in clinical studies: a plea for (more) transparency].","authors":"Reiner Hanewinkel, Sabina Ulbricht","doi":"10.1055/a-2243-9399","DOIUrl":"10.1055/a-2243-9399","url":null,"abstract":"<p><p>E-cigarettes are used in clinical trials to facilitate smoking cessation. Due to the health risks associated with the use of e-cigarettes, the results of clinical trials should be fully reported, including continued exclusive use and dual use of tobacco and e-cigarettes. Nicotine cessation outcomes should be reported as the primary endpoint as well as the analysis of tobacco cessation alone. As there is currently no robust evidence that reducing cigarette consumption provides substantial health benefits, cigarette consumption reduction should not be used as a health outcome in clinical trials. Continued nicotine dependence should be included as an \"adverse event\" in the reporting of trial results.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545717","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}
Pub Date : 2024-08-01Epub Date: 2024-02-21DOI: 10.1055/a-2248-9672
Volodymyr Berezutskyi, Maryna Berezutska
Ungewöhnliche klinische Fälle wecken bei praktizierenden Ärzten immer wieder Interesse und ermöglichen es ihnen, ihre Wissensbasis zu erweitern und ihre Fähigkeiten zum klinischen Denken zu verbessern. Der Zweck dieser Studie besteht darin, einen klinischen Fall von Stimmresonanz beim Singen bei einem schwindsüchtigen Teenager aus dem Roman "Der Landarzt" von Honoré de Balzac unter Verwendung induktiver und deduktiver Methoden des klinischen Denkens zu analysieren. Stimmresonanzen beim Singen in Schwindsucht können als pathognomonisches Zeichen für eine kavernöse Tuberkulose gewertet werden, da nur mit dem Bronchus verbundene Hohlräume als Helmholtz-Resonator wirken. Trotz der Einzigartigkeit ist das Gehäuse durchaus realistisch, da es nicht im Widerspruch zu den Gesetzen der Akustik steht. Praktizierende Ärzte verfügen über die Kenntnisse der medizinischen Physik, Morphologie und Physiologie, die zum Verständnis der Pathogenese der klinischen Manifestation einer Lungenhöhle erforderlich sind. Dieser Fall zeigt deutlich die Vor- und Nachteile klinischer Denkmethoden, die in der Praxis eingesetzt werden. Dank der Kombination aus Originalität und Realismus kann der Fall von Stimmresonanz aus Balzacs Roman "Der Landarzt" seinen rechtmäßigen Platz in der persönlichen Sammlung klinischer Fälle eines jeden Lungenarztes einnehmen.
{"title":"Rare Example of abnormal vocal resonance: a case from Balzac's novel.","authors":"Volodymyr Berezutskyi, Maryna Berezutska","doi":"10.1055/a-2248-9672","DOIUrl":"10.1055/a-2248-9672","url":null,"abstract":"<p><p>Ungewöhnliche klinische Fälle wecken bei praktizierenden Ärzten immer wieder Interesse und ermöglichen es ihnen, ihre Wissensbasis zu erweitern und ihre Fähigkeiten zum klinischen Denken zu verbessern. Der Zweck dieser Studie besteht darin, einen klinischen Fall von Stimmresonanz beim Singen bei einem schwindsüchtigen Teenager aus dem Roman \"Der Landarzt\" von Honoré de Balzac unter Verwendung induktiver und deduktiver Methoden des klinischen Denkens zu analysieren. Stimmresonanzen beim Singen in Schwindsucht können als pathognomonisches Zeichen für eine kavernöse Tuberkulose gewertet werden, da nur mit dem Bronchus verbundene Hohlräume als Helmholtz-Resonator wirken. Trotz der Einzigartigkeit ist das Gehäuse durchaus realistisch, da es nicht im Widerspruch zu den Gesetzen der Akustik steht. Praktizierende Ärzte verfügen über die Kenntnisse der medizinischen Physik, Morphologie und Physiologie, die zum Verständnis der Pathogenese der klinischen Manifestation einer Lungenhöhle erforderlich sind. Dieser Fall zeigt deutlich die Vor- und Nachteile klinischer Denkmethoden, die in der Praxis eingesetzt werden. Dank der Kombination aus Originalität und Realismus kann der Fall von Stimmresonanz aus Balzacs Roman \"Der Landarzt\" seinen rechtmäßigen Platz in der persönlichen Sammlung klinischer Fälle eines jeden Lungenarztes einnehmen.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139932490","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}
Pub Date : 2024-08-01Epub Date: 2024-06-12DOI: 10.1055/a-2341-6337
Norbert Suttorp
{"title":"1 Million beatmete Patienten in Deutschland: Eine komplette Übersicht über die Jahre 2019–2022.","authors":"Norbert Suttorp","doi":"10.1055/a-2341-6337","DOIUrl":"10.1055/a-2341-6337","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311492","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}
Pub Date : 2024-08-01Epub Date: 2024-08-22DOI: 10.1055/a-2395-6368
E Büscher, W Windisch, J Kappes, D Skowasch, M Kreuter, J Wälscher
{"title":"Erratum: YoungDGP-Pilotprojekt Pneumo Speed Dating – Innovatives Fortbildungsformat mit Zukunftspotenzial.","authors":"E Büscher, W Windisch, J Kappes, D Skowasch, M Kreuter, J Wälscher","doi":"10.1055/a-2395-6368","DOIUrl":"https://doi.org/10.1055/a-2395-6368","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142036717","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}
Pub Date : 2024-08-01Epub Date: 2024-01-24DOI: 10.1055/a-2238-1840
Christian Schulz, Martin Proescholdt, Nils Ole Schmidt, Felix Steger, Daniel Heudobler
Cerebral metastases in patients with metastatic lung cancer are found in more than 30% of patients at baseline and manifest themselves in two out of three patients during disease evolution. For a long time, the cerebral manifestation of the disease was classified as prognostically unfavorable and hence such patients were regularly excluded from therapy studies. In the context of targeted molecular therapy strategies and established immuno-oncological systemic therapies, the blood-brain barrier no longer represents an insurmountable barrier. However, the treatment of brain metastases requires decision making in a multidisciplinary team within dedicated lung cancer and/or oncology centers. The differentiated treatment decision is based on the number, size and location of the brain metastases, neurology and general condition, comorbidities, potential life expectancy and the patient's wishes, but also tumor biology including molecular targets, extra-cranial tumor burden and availability of a CNS-effective therapy. Systemic therapies as well as neurosurgical and radiotherapeutic concepts are now often combined for optimized and prognosis-improving therapeutic strategies.
{"title":"[Brain metastases].","authors":"Christian Schulz, Martin Proescholdt, Nils Ole Schmidt, Felix Steger, Daniel Heudobler","doi":"10.1055/a-2238-1840","DOIUrl":"10.1055/a-2238-1840","url":null,"abstract":"<p><p>Cerebral metastases in patients with metastatic lung cancer are found in more than 30% of patients at baseline and manifest themselves in two out of three patients during disease evolution. For a long time, the cerebral manifestation of the disease was classified as prognostically unfavorable and hence such patients were regularly excluded from therapy studies. In the context of targeted molecular therapy strategies and established immuno-oncological systemic therapies, the blood-brain barrier no longer represents an insurmountable barrier. However, the treatment of brain metastases requires decision making in a multidisciplinary team within dedicated lung cancer and/or oncology centers. The differentiated treatment decision is based on the number, size and location of the brain metastases, neurology and general condition, comorbidities, potential life expectancy and the patient's wishes, but also tumor biology including molecular targets, extra-cranial tumor burden and availability of a CNS-effective therapy. Systemic therapies as well as neurosurgical and radiotherapeutic concepts are now often combined for optimized and prognosis-improving therapeutic strategies.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545675","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}
Arno Mohr, Stefanie Zahn, Florian Geismann, Stefan Blaas, Michael Pfeifer, Maximilian Malfertheiner, Bernd Salzberger, Frank Hanses, Stilla Bauernfeind, Myriam Koch, Florian Hitzenbichler
Introduction: Face masks increase airway resistance, data on the actual extent of this effect are scarce. The aim of this study was to assess the effect of different mask types on clinical parameters during moderate exercise in healthy non-smokers, active smokers and patients with interstitial lung disease (ILD) without the need of oxygen therapy.
Methods: In a prospective observational pilot study participants performed a six-minute walk test without mask, with a surgical mask, a well-fitted FFP2 mask and with a valved FFP3 mask. Respiratory rate, blood pressure, heart rate, blood gas analysis parameters, dyspnoea and six-minute walk distance were measured. Data were analysed in an ANOVA model.
Results: 21 healthy participants, 17 active smokers without known pulmonary disease and 15 patients with interstitial lung disease were included. Participants with ILD had a significant lower walking distance, a higher respiratory rate and a lower pO2 when using FFP2 masks, but not with valved FFP3 masks or surgical masks compared to not wearing a mask.
Conclusion: For patients with ILD without the need of oxygen therapy wearing an FFP2 mask had a negative impact on pO2, respiratory rate and walking distance in the six-minute walk test. This effect was not seen with valved FFP3 masks or surgical masks.
{"title":"Negative impact of face masks in patients with interstitial lung disease: A prospective study.","authors":"Arno Mohr, Stefanie Zahn, Florian Geismann, Stefan Blaas, Michael Pfeifer, Maximilian Malfertheiner, Bernd Salzberger, Frank Hanses, Stilla Bauernfeind, Myriam Koch, Florian Hitzenbichler","doi":"10.1055/a-2361-4723","DOIUrl":"https://doi.org/10.1055/a-2361-4723","url":null,"abstract":"<p><strong>Introduction: </strong>Face masks increase airway resistance, data on the actual extent of this effect are scarce. The aim of this study was to assess the effect of different mask types on clinical parameters during moderate exercise in healthy non-smokers, active smokers and patients with interstitial lung disease (ILD) without the need of oxygen therapy.</p><p><strong>Methods: </strong>In a prospective observational pilot study participants performed a six-minute walk test without mask, with a surgical mask, a well-fitted FFP2 mask and with a valved FFP3 mask. Respiratory rate, blood pressure, heart rate, blood gas analysis parameters, dyspnoea and six-minute walk distance were measured. Data were analysed in an ANOVA model.</p><p><strong>Results: </strong>21 healthy participants, 17 active smokers without known pulmonary disease and 15 patients with interstitial lung disease were included. Participants with ILD had a significant lower walking distance, a higher respiratory rate and a lower pO<sub>2</sub> when using FFP2 masks, but not with valved FFP3 masks or surgical masks compared to not wearing a mask.</p><p><strong>Conclusion: </strong>For patients with ILD without the need of oxygen therapy wearing an FFP2 mask had a negative impact on pO<sub>2</sub>, respiratory rate and walking distance in the six-minute walk test. This effect was not seen with valved FFP3 masks or surgical masks.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856283","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}
Ulrich Koehler, Mikail Aykut Degerli, Olaf Hildebrandt, Wulf Hildebrandt, Heike Korbmacher-Steiner, Peter von Wichert, Thomas Podszus
The original Valsalva manoeuvre (VM) was described in detail by the Italian anatomist, physician and surgeon Antonio Maria Valsalva (1666-1723). The VM consists of a voluntary forced expiratory effort against a closed upper airway. It was used tradionally in otolaryngology for testing the openess of the eustachian tubes and expelling pus/fluid from the middle to the external ear. VM is associated with increased intrathoracic and -abdominal pressure and leads to hemodynamic changes. The use of VM for cardiovascular purposes was first described by Eduard Friedrich Weber, a German physiologist. The Müller manoeuvre (MM) represents the opposite of the VM by forced inspiration against a closed upper airway. Negative intrathoracic and abdominal pressure (ITP) with direct effects on cardiac function and hemodynamics can be generated by the MM. MM has also been used to simulate the hemodynamic effects of negative ITP in obstructive sleep apnea patients. The Müller manoeuvre was first described by the German anatomist and physician Johannes Müller (1801-1858).
最初的瓦尔萨尔瓦动作(VM)由意大利解剖学家、内科医生和外科医生安东尼奥-玛丽亚-瓦尔萨尔瓦(Antonio Maria Valsalva,1666-1723 年)详细描述。VM 包括在上气道关闭的情况下自主用力呼气。传统上,它被用于耳鼻喉科测试咽鼓管是否通畅,以及将脓液/液体从中耳排出到外耳。VM 与胸腔内和腹腔压力增加有关,并导致血液动力学变化。德国生理学家爱德华-弗里德里希-韦伯(Eduard Friedrich Weber)首次将 VM 用于心血管目的。Müller manoeuvre(MM)与 VM 相反,是在关闭上气道的情况下强制吸气。缪勒动作可产生胸腹负压(ITP),直接影响心脏功能和血液动力学。MM还可用于模拟阻塞性睡眠呼吸暂停患者负ITP对血液动力学的影响。德国解剖学家和医生约翰内斯-缪勒(Johannes Müller,1801-1858 年)首次描述了缪勒动作。
{"title":"[Valsalva and Müller maneuvers: who is who and what is what?]","authors":"Ulrich Koehler, Mikail Aykut Degerli, Olaf Hildebrandt, Wulf Hildebrandt, Heike Korbmacher-Steiner, Peter von Wichert, Thomas Podszus","doi":"10.1055/a-2349-1034","DOIUrl":"https://doi.org/10.1055/a-2349-1034","url":null,"abstract":"<p><p>The original Valsalva manoeuvre (VM) was described in detail by the Italian anatomist, physician and surgeon Antonio Maria Valsalva (1666-1723). The VM consists of a voluntary forced expiratory effort against a closed upper airway. It was used tradionally in otolaryngology for testing the openess of the eustachian tubes and expelling pus/fluid from the middle to the external ear. VM is associated with increased intrathoracic and -abdominal pressure and leads to hemodynamic changes. The use of VM for cardiovascular purposes was first described by Eduard Friedrich Weber, a German physiologist. The Müller manoeuvre (MM) represents the opposite of the VM by forced inspiration against a closed upper airway. Negative intrathoracic and abdominal pressure (ITP) with direct effects on cardiac function and hemodynamics can be generated by the MM. MM has also been used to simulate the hemodynamic effects of negative ITP in obstructive sleep apnea patients. The Müller manoeuvre was first described by the German anatomist and physician Johannes Müller (1801-1858).</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601352","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}
Frank Kanniess, Kerstin Defosse, Marek Lommatzsch, Thomas Schultz, Hartmut Timmermann, Olaf Schmidt, Stefan Heindl, Hans Jörg Baumann, Roland Buhl, Christian Taube, Fabian Höing, Stephanie Korn
Background: The Asthma Impairment and Risk Questionnaire (AIRQ), a 10-item, equally weighted, yes/no tool assessing symptom impairment and risk of exacerbations in patients with asthma aged ≥12 years, was developed and validated in a US patient population to evaluate varying levels of asthma control. This study aimed to validate the German language version of the AIRQ in patients aged ≥12 years with different levels of asthma control.
Methods: A cross-sectional, observational, multi-centre study comprising a single visit was conducted in multiple specialised asthma centres and general practices in Germany. A total of 300 patients completed the following measures: 1) Patient Sociodemographic and Clinical Questionnaire, 2) AIRQ, 3) Asthma Control Test (ACT), and 4) Asthma Control Questionnaire (ACQ-6). Logistic regression analyses were conducted to assess the AIRQ score cut points with the greatest predictive validity in discriminating between different control levels relative to a standard of ACT plus prior-year exacerbations or ACQ-6 plus prior-year exacerbations.
Results: The German version of the AIRQ demonstrated a robust capability to correctly identify well-controlled versus not well- or very poorly controlled (AUC values of 0.90 or higher) and well- or not well-controlled versus very poorly controlled asthma (AUC values of 0.89 or higher).
Conclusions: The German version of the AIRQ is a suitable tool to identify adults with varying levels of asthma control, which in turn can help to accurately identify patients with uncontrolled asthma in clinical practice.
{"title":"Validation of the German version of the Asthma Impairment and Risk Questionnaire (AIRQ).","authors":"Frank Kanniess, Kerstin Defosse, Marek Lommatzsch, Thomas Schultz, Hartmut Timmermann, Olaf Schmidt, Stefan Heindl, Hans Jörg Baumann, Roland Buhl, Christian Taube, Fabian Höing, Stephanie Korn","doi":"10.1055/a-2346-9840","DOIUrl":"https://doi.org/10.1055/a-2346-9840","url":null,"abstract":"<p><strong>Background: </strong>The Asthma Impairment and Risk Questionnaire (AIRQ), a 10-item, equally weighted, yes/no tool assessing symptom impairment and risk of exacerbations in patients with asthma aged ≥12 years, was developed and validated in a US patient population to evaluate varying levels of asthma control. This study aimed to validate the German language version of the AIRQ in patients aged ≥12 years with different levels of asthma control.</p><p><strong>Methods: </strong>A cross-sectional, observational, multi-centre study comprising a single visit was conducted in multiple specialised asthma centres and general practices in Germany. A total of 300 patients completed the following measures: 1) Patient Sociodemographic and Clinical Questionnaire, 2) AIRQ, 3) Asthma Control Test (ACT), and 4) Asthma Control Questionnaire (ACQ-6). Logistic regression analyses were conducted to assess the AIRQ score cut points with the greatest predictive validity in discriminating between different control levels relative to a standard of ACT plus prior-year exacerbations or ACQ-6 plus prior-year exacerbations.</p><p><strong>Results: </strong>The German version of the AIRQ demonstrated a robust capability to correctly identify well-controlled versus not well- or very poorly controlled (AUC values of 0.90 or higher) and well- or not well-controlled versus very poorly controlled asthma (AUC values of 0.89 or higher).</p><p><strong>Conclusions: </strong>The German version of the AIRQ is a suitable tool to identify adults with varying levels of asthma control, which in turn can help to accurately identify patients with uncontrolled asthma in clinical practice.</p>","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591144","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}
Pub Date : 2024-07-01Epub Date: 2024-04-26DOI: 10.1055/a-2298-8015
Stefan Andreas, Daniel Tzu-Hsuan Chen, Jonathan Grigg, Filippos T Filippidis
{"title":"[European Respiratory Society statement on novel nicotine and tobacco products, their role in tobacco control and \"harm reduction\"].","authors":"Stefan Andreas, Daniel Tzu-Hsuan Chen, Jonathan Grigg, Filippos T Filippidis","doi":"10.1055/a-2298-8015","DOIUrl":"10.1055/a-2298-8015","url":null,"abstract":"","PeriodicalId":20197,"journal":{"name":"Pneumologie","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867674","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}