N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Although the development of upper abdominal metastases in relapsed ovarian cancer has been considered as a sign of biological aggressive disease once the surgical techniques improved these extended resections have been successfully implemented in the armamentarium of cytoreductive surgery. Case: a 54 year old patient diagnosed with an isolated metastasis at the level of upper abdomen invading the pancreatic head, the portal vein and the common hepatic artery was submitted to surgery. Venous reconstruction was performed by using a Goretex patch while arterial reconstruction was performed by using a saphenous graft which was placed between the celiac trunk and the proper hepatic artery. Conclusion: extended local visceral and vascular resections might be needed in order to achieve complete cytoreduction for relapsed ovarian cancer.
{"title":"Total gastrectomy en bloc with total pancreatoduodenectomy, splenectomy, portal vein and celiac axis resection for isolated recurrence from epithelial ovarian cancer – A case report","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.16","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.16","url":null,"abstract":"Although the development of upper abdominal metastases in relapsed ovarian cancer has been considered as a sign of biological aggressive disease once the surgical techniques improved these extended resections have been successfully implemented in the armamentarium of cytoreductive surgery. Case: a 54 year old patient diagnosed with an isolated metastasis at the level of upper abdomen invading the pancreatic head, the portal vein and the common hepatic artery was submitted to surgery. Venous reconstruction was performed by using a Goretex patch while arterial reconstruction was performed by using a saphenous graft which was placed between the celiac trunk and the proper hepatic artery. Conclusion: extended local visceral and vascular resections might be needed in order to achieve complete cytoreduction for relapsed ovarian cancer.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78198202","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}
R. Ursu, Radu Alexandru Truica, Alexandra Cojocaru, Diana Prepelita, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu
According to the World Health Organization, as of 2021, breast cancer is the most common malignancy in women worldwide, accounting for up to 12% of all new cancer cases diagnosed each year. Moreover, breast cancer is the second leading cause of cancer-related death in women. In Romania, over 7.000 new breast cancer cases are diagnosed every year, with 80% of them being diagnosed in an advanced stage where treatment does not lead to curing the disease but only to prolonging life. The genetic factors identified to be involved in breast cancer risk comprise numerous biomarkers including the highly penetrant breast cancer susceptibility genes (BRCA1, BRCA2, PTEN, TP53, CDH1 and STK11), a number of genes with more moderate penetrance (CHEK2, BRIP1, ATM, PALB2) and low penetrance alleles. Prediction models suggest that, for now, there is a low probability to discover new high-penetrance genes.
{"title":"Genetic factors involved in breast cancer","authors":"R. Ursu, Radu Alexandru Truica, Alexandra Cojocaru, Diana Prepelita, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu","doi":"10.37897/rmj.2022.s3.2","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.2","url":null,"abstract":"According to the World Health Organization, as of 2021, breast cancer is the most common malignancy in women worldwide, accounting for up to 12% of all new cancer cases diagnosed each year. Moreover, breast cancer is the second leading cause of cancer-related death in women. In Romania, over 7.000 new breast cancer cases are diagnosed every year, with 80% of them being diagnosed in an advanced stage where treatment does not lead to curing the disease but only to prolonging life. The genetic factors identified to be involved in breast cancer risk comprise numerous biomarkers including the highly penetrant breast cancer susceptibility genes (BRCA1, BRCA2, PTEN, TP53, CDH1 and STK11), a number of genes with more moderate penetrance (CHEK2, BRIP1, ATM, PALB2) and low penetrance alleles. Prediction models suggest that, for now, there is a low probability to discover new high-penetrance genes.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77420393","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}
L. Pop, Madalina Piron, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Rare conditions are always challenging due to the difficulty of diagnosis and the fact that there are no guidelines or protocol. As ovarian vein thrombosis (OVT) has an incidence 60 times lower than deep venous thrombosis (DVT), openmindedness and thinking outside the box is necessary. This short article, looks into the pathophysiology of postpartum ovarian vein thrombosis (PVOT), diagnosis, complications and management.
{"title":"Update on ovarian vein thrombosis","authors":"L. Pop, Madalina Piron, V. Rădoi, R. Ursu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.10","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.10","url":null,"abstract":"Rare conditions are always challenging due to the difficulty of diagnosis and the fact that there are no guidelines or protocol. As ovarian vein thrombosis (OVT) has an incidence 60 times lower than deep venous thrombosis (DVT), openmindedness and thinking outside the box is necessary. This short article, looks into the pathophysiology of postpartum ovarian vein thrombosis (PVOT), diagnosis, complications and management.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74545030","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Background/Aim: Since March 2020 when the number of COVID-19 positive patients reported a fulminant increase in Romania, reorganisation of the medical services took place in order to provide the possibility of treating increasing number of cases with this pathology and to diminish as much as possible the number of COVID-19 related deaths. The aim of the current paper is to analyse the outcomes of 273 patients with gynaecological cancers who could not be treated in the service were they were initially addressed. Material and Method: a total number of 343 patients with gynecologic oncology disorders were addressed to “Dr. Ion Cantacuzino” hospital in Bucharest Romania and could not be treated in this unit due to the fact that it became an auxiliary service for obstetrical COVID positive patients. Results: complete follow up was possible in 273 cases 87 patients were redistributed to other services of gynecologic oncology and received their surgical treatment as planned, 141 patients received their surgical treatment in other clinics after a mean delay of six months while 45 cases were further submitted to oncological treatment, four of them being dead at the end of the study. Conclusions: modification of hospital structure and diminishing the oncological patients’ access to oncologic surgery during COVID pandemic significantly impacted on gynecologic cancer care.
背景/目的:自2020年3月罗马尼亚报告的COVID-19阳性患者数量急剧增加以来，对医疗服务进行了重组，以便有可能治疗越来越多的这种病理病例，并尽可能减少与COVID-19相关的死亡人数。当前论文的目的是分析273名妇科癌症患者的结果，这些患者最初无法在服务中得到治疗。材料和方法:共有343例妇科肿瘤疾病患者被送到罗马尼亚布加勒斯特的“Dr. Ion Cantacuzino”医院，由于该医院成为产科COVID阳性患者的辅助服务而无法在该单位治疗。结果:273例患者获得完整随访，87例患者被重新分配到妇科肿瘤其他部门并按计划接受手术治疗，141例患者在平均延迟6个月后在其他诊所接受手术治疗，45例患者继续接受肿瘤治疗，其中4例患者在研究结束时死亡。结论:新型冠状病毒大流行期间医院结构的改变和肿瘤患者手术机会的减少对妇科肿瘤护理有显著影响。
{"title":"The Destiny of a Gynecology Clinic from Bucharest and its’ patients during COVID-19 Pandemic – A sad Romanian story","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s3.13","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.13","url":null,"abstract":"Background/Aim: Since March 2020 when the number of COVID-19 positive patients reported a fulminant increase in Romania, reorganisation of the medical services took place in order to provide the possibility of treating increasing number of cases with this pathology and to diminish as much as possible the number of COVID-19 related deaths. The aim of the current paper is to analyse the outcomes of 273 patients with gynaecological cancers who could not be treated in the service were they were initially addressed. Material and Method: a total number of 343 patients with gynecologic oncology disorders were addressed to “Dr. Ion Cantacuzino” hospital in Bucharest Romania and could not be treated in this unit due to the fact that it became an auxiliary service for obstetrical COVID positive patients. Results: complete follow up was possible in 273 cases 87 patients were redistributed to other services of gynecologic oncology and received their surgical treatment as planned, 141 patients received their surgical treatment in other clinics after a mean delay of six months while 45 cases were further submitted to oncological treatment, four of them being dead at the end of the study. Conclusions: modification of hospital structure and diminishing the oncological patients’ access to oncologic surgery during COVID pandemic significantly impacted on gynecologic cancer care.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77311170","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Ovarian cancer represents one of the most aggressive malignancies which is characterized by a high capacity of spread via multiple pathways such as lymphatic, peritoneal and hematogenous route, the most commonly encountered sites for metastatic lesions being represented by lung, liver, peritoneum and lymph nodes. In extremely rare cases breast metastases with ovarian origin have been reported. In such cases different therapeutic strategies have been proposed; however the overall prognosis remains extremely poor, the presence of metastatic lesions at this level being usually the sign of disseminated disease.
{"title":"Breast metastases from ovarian cancer","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.3","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.3","url":null,"abstract":"Ovarian cancer represents one of the most aggressive malignancies which is characterized by a high capacity of spread via multiple pathways such as lymphatic, peritoneal and hematogenous route, the most commonly encountered sites for metastatic lesions being represented by lung, liver, peritoneum and lymph nodes. In extremely rare cases breast metastases with ovarian origin have been reported. In such cases different therapeutic strategies have been proposed; however the overall prognosis remains extremely poor, the presence of metastatic lesions at this level being usually the sign of disseminated disease.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84215284","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}
B. Danciu, L. Pop, Madalina Piron, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Hysterectomy remains the most common gynecological procedure for both benign and malignant causes. Throughout the years, various surgical methods have been studied with the purpose of avoiding immediate and late complications. Laparoscopic surgeries have gained momentum in all surgical specialties, and gynecology is no exception.
{"title":"Complications of laparoscopic assisted hysterectomy","authors":"B. Danciu, L. Pop, Madalina Piron, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s4.5","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.5","url":null,"abstract":"Hysterectomy remains the most common gynecological procedure for both benign and malignant causes. Throughout the years, various surgical methods have been studied with the purpose of avoiding immediate and late complications. Laparoscopic surgeries have gained momentum in all surgical specialties, and gynecology is no exception.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1154 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83928102","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Pelvic exenteration has been proposed in order to treat locally advanced or relapsed pelvic malignancies with different origins such as digestive, urological or gynecological cancers. However it seems that cases diagnosed with relapsed uterine malignancies are rarely candidates for extended pelvic resections, most cases presenting disseminated lesions at the time of relapse. The aim of the current paper is to report a case series of five patients diagnosed with pelvic recurrences after surgically treated uterine cancer who were submitted to extended pelvic resections with curative intent between August and December 2021. The histopathological studies demonstrated the presence of negative resection margins in two cases. The postoperative outcome was favorable in three cases, one case necessitated prolonged intensive care stay while the last one necessitated reoperation due to the presence of a pelvic abscess. However all patients were discharged within the first three weeks postoperatively. In conclusion, pelvic exenteration can be successfully performed in selected cases diagnosed with pelvic recurrences after surgically treated uterine cancer.
{"title":"Total pelvic exenteration for recurrent uterine malignancies – a case series","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.17","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.17","url":null,"abstract":"Pelvic exenteration has been proposed in order to treat locally advanced or relapsed pelvic malignancies with different origins such as digestive, urological or gynecological cancers. However it seems that cases diagnosed with relapsed uterine malignancies are rarely candidates for extended pelvic resections, most cases presenting disseminated lesions at the time of relapse. The aim of the current paper is to report a case series of five patients diagnosed with pelvic recurrences after surgically treated uterine cancer who were submitted to extended pelvic resections with curative intent between August and December 2021. The histopathological studies demonstrated the presence of negative resection margins in two cases. The postoperative outcome was favorable in three cases, one case necessitated prolonged intensive care stay while the last one necessitated reoperation due to the presence of a pelvic abscess. However all patients were discharged within the first three weeks postoperatively. In conclusion, pelvic exenteration can be successfully performed in selected cases diagnosed with pelvic recurrences after surgically treated uterine cancer.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80621955","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}
Madalina Piron, L. Pop, V. Rădoi, R. Ursu, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Cervical cancer is the 4 the most common cancer in women’s across the world, with a 10 year survival rate of more than 60%. An important proportion of these women are at a reproductive age. Therefore depending of the stage at the time of diagnosis, different approaches have been used in order to preserve fertility function. Two methods have been tried, knife biopsy with or without laparoscopic lymphadenectomy and trachelectomy for IA1, respectively IA2-IB1. Described by Dargent in 1994, has changed approach in cervical cancer for young women that have not completed their families. The rational behind this technique is to remove the cervix and surround parametrium, followed uniting the vagina to the isthmus, anastomosis which is reinforced by a stich.
{"title":"Early cervical cancer treatment and pregnancy","authors":"Madalina Piron, L. Pop, V. Rădoi, R. Ursu, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.14","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.14","url":null,"abstract":"Cervical cancer is the 4 the most common cancer in women’s across the world, with a 10 year survival rate of more than 60%. An important proportion of these women are at a reproductive age. Therefore depending of the stage at the time of diagnosis, different approaches have been used in order to preserve fertility function. Two methods have been tried, knife biopsy with or without laparoscopic lymphadenectomy and trachelectomy for IA1, respectively IA2-IB1. Described by Dargent in 1994, has changed approach in cervical cancer for young women that have not completed their families. The rational behind this technique is to remove the cervix and surround parametrium, followed uniting the vagina to the isthmus, anastomosis which is reinforced by a stich.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80463209","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Uterine metastases from extragenital cancers in the absence of associated ovarian metastases represents a very scarce event, isolated cases being reported so far. The aim of the current paper is to discuss about this issue and to present the most relevant cases presented so far from the point of view of positive and differential diagnostic and of the most appropriate therapeutic strategy. Meanwhile attention on the impact on the overall survival was focused.
{"title":"Uterine metastases from breast cancer – literature review","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.19","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.19","url":null,"abstract":"Uterine metastases from extragenital cancers in the absence of associated ovarian metastases represents a very scarce event, isolated cases being reported so far. The aim of the current paper is to discuss about this issue and to present the most relevant cases presented so far from the point of view of positive and differential diagnostic and of the most appropriate therapeutic strategy. Meanwhile attention on the impact on the overall survival was focused.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90552539","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}
Madalina Piron, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Gynecological surgery, especially oncological surgery, is a daily challenge with an impressive development over time. The anatomy of the pelvis and its study have led to the development of new surgical techniques with the discovery of spaces and structures that bring considerable benefits to the postoperative result, both oncological and hemodynamic or functional. Radical nerve-sparing hysterectomy is a topical issue that significantly improves patients' quality of life.
{"title":"The Yabuki space: landmark in pelvic anatomy and surgery","authors":"Madalina Piron, L. Pop, V. Rădoi, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s3.12","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.12","url":null,"abstract":"Gynecological surgery, especially oncological surgery, is a daily challenge with an impressive development over time. The anatomy of the pelvis and its study have led to the development of new surgical techniques with the discovery of spaces and structures that bring considerable benefits to the postoperative result, both oncological and hemodynamic or functional. Radical nerve-sparing hysterectomy is a topical issue that significantly improves patients' quality of life.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86061622","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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