Acute intermittent porphyria (AIP) is an autosomal disorder marked by a deficiency of the enzyme, the hydroxymethylbilane synthase which is part of the heme biosynthesis. It is manifested clinically by multi-system involvement. Our patient does have chronic ischemic heart disease needed surgical revascularization; his sternotomy incision revealed the classical blackish discoloration of the bone marrow, which guided us for his work up and diagnosis.
{"title":"Diagnosis of Porphyria after Sternotomy for Severe Calcific Coronary Artery Disease : A Case Report","authors":"Fuad M. Al-Azzam, S. Altarabsheh, M. Khasawneh","doi":"10.5742/MEIM.2017.92937","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92937","url":null,"abstract":"Acute intermittent porphyria (AIP) is an autosomal disorder marked by a deficiency of the enzyme, the hydroxymethylbilane synthase which is part of the heme biosynthesis. It is manifested clinically by multi-system involvement. Our patient does have chronic ischemic heart disease needed surgical revascularization; his sternotomy incision revealed the classical blackish discoloration of the bone marrow, which guided us for his work up and diagnosis.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"432 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122877800","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}
Background: Role of white coat hypertension (WCH) is unknown in metabolic syndrome. Methods: The study was performed in the Internal Medicine Polyclinic. Results: The study included 1,068 patients (628 females). Prevalence of excess weight increased from the third (28.7%) up to the seventh decades (87.0%), gradually (p<0.05 nearly in all steps), and then decreased in the eighth decade of life (78.5%, p<0.05). The most significant increase was detected during the passage from the third to the fourth decade (28.7% versus 63.6%, p<0.001) parallel to the smoking. Similarly, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired glucose tolerance (IGT), and WCH increased up to the seventh decade of life and decreased afterwards (p<0.05 nearly in all steps). On the other hand, hypertension (HT), type 2 diabetes mellitus (DM), and coronary heart disease (CHD) always increased without any decrease by decades (p<0.05 nearly in all steps) indicating their irreversible properties. Conclusion: Probably metabolic syndrome is an accelerated atherosclerotic process all over the body. It includes some reversible parameters such as smoking, alcohol, sedentary life style, animal-rich diet, overweight, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired fasting glucose, IGT, and WCH for the development of terminal illnesses such as early aging, obesity, DM, HT, peripheric artery disease, chronic obstructive pulmonary disease, cirrhosis, CHD, and stroke. The terminal illnesses are mainly due to the chronic inflammatory process on the arterial endothelial systems due to the much higher blood pressure in them. WCH may be an initial sign of the accelerated atherosclerotic process that can be detected easily.
{"title":"White Coat Hypertension May Be an Initial Sign of an Accelerated Atherosclerotic Process","authors":"M. Helvaci, O. Ayyıldız, Orhan Ekrem Muftuoglu","doi":"10.5742/MEIM.2017.92940","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92940","url":null,"abstract":"Background: Role of white coat hypertension (WCH) is unknown in metabolic syndrome. Methods: The study was performed in the Internal Medicine Polyclinic. Results: The study included 1,068 patients (628 females). Prevalence of excess weight increased from the third (28.7%) up to the seventh decades (87.0%), gradually (p<0.05 nearly in all steps), and then decreased in the eighth decade of life (78.5%, p<0.05). The most significant increase was detected during the passage from the third to the fourth decade (28.7% versus 63.6%, p<0.001) parallel to the smoking. Similarly, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired glucose tolerance (IGT), and WCH increased up to the seventh decade of life and decreased afterwards (p<0.05 nearly in all steps). On the other hand, hypertension (HT), type 2 diabetes mellitus (DM), and coronary heart disease (CHD) always increased without any decrease by decades (p<0.05 nearly in all steps) indicating their irreversible properties. Conclusion: Probably metabolic syndrome is an accelerated atherosclerotic process all over the body. It includes some reversible parameters such as smoking, alcohol, sedentary life style, animal-rich diet, overweight, hypertriglyceridemia, hyperbetalipoproteinemia, dyslipidemia, impaired fasting glucose, IGT, and WCH for the development of terminal illnesses such as early aging, obesity, DM, HT, peripheric artery disease, chronic obstructive pulmonary disease, cirrhosis, CHD, and stroke. The terminal illnesses are mainly due to the chronic inflammatory process on the arterial endothelial systems due to the much higher blood pressure in them. WCH may be an initial sign of the accelerated atherosclerotic process that can be detected easily.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126031055","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}
Background & Objectives: Acute myeloid leukemia (AML) is the most prevalent form of acute leukemias in adults; unfortunately it carries very poor prognosis. Over the past decade marvelous advances were achieved in understanding pathophysiology of AML and this was reflected in management of AML patients. Nevertheless the standard anthracycline based induction regimens remained the cornerstone for treatment of AML; however their effectiveness is limited by their well known cardiotoxicity. To our knowledge this is the first study that investigated anthracycline versus non-anthracycline induction regimens in patients with AML. Methods: 90AML patients were enrolled in the study; they were retrospectively recruited from AML patients who were admitted at South Egypt Cancer Institute (SECI) from 2000-2010. Demographic, clinical, hematologic and data concerning treatment and therapeutic response were collected from hospital records of patients. Results: Analysis of the collected data showed lower median age of the study participants compared to other studies, FAB M2, M3, M4, followed by M1 were the commonest FAB subtypes among the study patients. Survival analysis showed longer overall survival (OS) and progression free survival (PFS) in those treated with anthracycline induction regimens compared with the non-anthracycline treated group. Also, higher incidence of relapse was observed in the non-anthracycline group. Conclusion: Anthracycline based induction regimens are still more effective than non-anthracycline regimens for treatment of AML, however the search for safer drugs than anthracyclines is still mandatory.
{"title":"Anthracycline versus Non-Anthracycline Induction Regimens in Patients with De Novo Acute Myeloid Leukemia","authors":"A. Alyamany, N. Abdel-Aziz, Safaa A. A. Khaled","doi":"10.5742/MEIM.2017.92935","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92935","url":null,"abstract":"Background & Objectives: Acute myeloid leukemia (AML) is the most prevalent form of acute leukemias in adults; unfortunately it carries very poor prognosis. Over the past decade marvelous advances were achieved in understanding pathophysiology of AML and this was reflected in management of AML patients. Nevertheless the standard anthracycline based induction regimens remained the cornerstone for treatment of AML; however their effectiveness is limited by their well known cardiotoxicity. To our knowledge this is the first study that investigated anthracycline versus non-anthracycline induction regimens in patients with AML. Methods: 90AML patients were enrolled in the study; they were retrospectively recruited from AML patients who were admitted at South Egypt Cancer Institute (SECI) from 2000-2010. Demographic, clinical, hematologic and data concerning treatment and therapeutic response were collected from hospital records of patients. Results: Analysis of the collected data showed lower median age of the study participants compared to other studies, FAB M2, M3, M4, followed by M1 were the commonest FAB subtypes among the study patients. Survival analysis showed longer overall survival (OS) and progression free survival (PFS) in those treated with anthracycline induction regimens compared with the non-anthracycline treated group. Also, higher incidence of relapse was observed in the non-anthracycline group. Conclusion: Anthracycline based induction regimens are still more effective than non-anthracycline regimens for treatment of AML, however the search for safer drugs than anthracyclines is still mandatory.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"18 3-4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121006266","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}
Deciduosis or ectopic decidua is the presence of a group of decidual cells outside the endometrium. Walker was the first to define the condition in 1887(1). In pregnancy, the occurrence of ectopic deciduas was observed in ovaries, uterus and tubes, while localization in peritoneum was rare(2-6). It is important to differentiate between this benign phenomena and Mesothelioma , malignant carcinoma and metastatic malignant Melanoma(7,8). We are reporting a case of ectopic deciduas in a 27-year -old lady who was asymptomatic during the course of her pregnancy, presented with preterm labour pain, and underwent ceasarean section due to Triplet pregnancy. The lesions were discovered accidentally; they were nodular covering most of the peritoneum and there was omental cake. Biopsies were taken to differentiate it from malignant conditions. Histopathological diagnosis confirmed deciduosis.
{"title":"Diffuse Peritoneal Deciduosis in Pregnancy : A Case Report","authors":"Nansi Al Fayez, B. Khreisat","doi":"10.5742/MEIM.2017.92936","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92936","url":null,"abstract":"Deciduosis or ectopic decidua is the presence of a group of decidual cells outside the endometrium. Walker was the first to define the condition in 1887(1). In pregnancy, the occurrence of ectopic deciduas was observed in ovaries, uterus and tubes, while localization in peritoneum was rare(2-6). It is important to differentiate between this benign phenomena and Mesothelioma , malignant carcinoma and metastatic malignant Melanoma(7,8). We are reporting a case of ectopic deciduas in a 27-year -old lady who was asymptomatic during the course of her pregnancy, presented with preterm labour pain, and underwent ceasarean section due to Triplet pregnancy. The lesions were discovered accidentally; they were nodular covering most of the peritoneum and there was omental cake. Biopsies were taken to differentiate it from malignant conditions. Histopathological diagnosis confirmed deciduosis.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117146151","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}
Background: Heterotopic pregnancy is a condition in which pregnancy occurs synchronously intrauterine and extrauterine. The estimated incidence following spontaneous conception is below 1/30,000. On the other hand, the incidence in artificial reproductive techniques has been reported to be as high as 1/100. Case: This case report is of a 20 year old woman, nulliparous, who presented to the emergency department with acute abdominal pain post ovulation induction with human menopausal gonadotrophins and intrauterine insemination. Examination revealed acute surgical abdomen. Ultra-sonographic examination showed viable triplet intrauterine gestation of 10 weeks and presence of right complex adnexal mass. Laparotomy was done and the patient was found to have right tubal ectopic pregnancy that was managed by salpingostomy. Post operative period was uneventful and patient was discharged with viable three embryos and she was followed as an outpatient in a high risk pregnancy clinic. Comment: Though the incidence of heterotopic pregnancy is low following spontaneous pregnancy but a high index of suspicion must be considered in any patient with intrauterine pregnancy who presented with abdominal pain and adnexal mass and particularly if conception occurs after artificial reproductive techniques. This approach would avoid maternal morbidity and mortality.
{"title":"Quadruplet Heterotopic Pregnancy : A Case Report","authors":"Rema Khlaif Omosh, I. Fayez, Nancy Dari Alfayez","doi":"10.5742/MEIM.2017.92938","DOIUrl":"https://doi.org/10.5742/MEIM.2017.92938","url":null,"abstract":"Background: Heterotopic pregnancy is a condition in which pregnancy occurs synchronously intrauterine and extrauterine. The estimated incidence following spontaneous conception is below 1/30,000. On the other hand, the incidence in artificial reproductive techniques has been reported to be as high as 1/100. Case: This case report is of a 20 year old woman, nulliparous, who presented to the emergency department with acute abdominal pain post ovulation induction with human menopausal gonadotrophins and intrauterine insemination. Examination revealed acute surgical abdomen. Ultra-sonographic examination showed viable triplet intrauterine gestation of 10 weeks and presence of right complex adnexal mass. Laparotomy was done and the patient was found to have right tubal ectopic pregnancy that was managed by salpingostomy. Post operative period was uneventful and patient was discharged with viable three embryos and she was followed as an outpatient in a high risk pregnancy clinic. Comment: Though the incidence of heterotopic pregnancy is low following spontaneous pregnancy but a high index of suspicion must be considered in any patient with intrauterine pregnancy who presented with abdominal pain and adnexal mass and particularly if conception occurs after artificial reproductive techniques. This approach would avoid maternal morbidity and mortality.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"641 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116086801","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":"Obesity Management in Primary Health Care","authors":"A. Abyad","doi":"10.5742/MEIM.2016.9290","DOIUrl":"https://doi.org/10.5742/MEIM.2016.9290","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129571540","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}
Results: The study included 411 patients (199 females). As one of the significant endpoints of SCDs, patients with chronic obstructive pulmonary disease (COPD) and without were collected into two groups. There were 60 patients (14.5%) with COPD. Mean age (33.0 versus 29.5 years, P=0.005) and male ratio (80.0% versus 46.7%, P<0.001) were higher in the COPD group. Smoking (36.6% versus 9.9%, P<0.001) and alcohol (3.3% versus 0.8%, P<0.05) were also higher among the COPD cases. Transfused red blood cell units in their lives (69.1 versus 32.9, P=0.001), priapism (10.0% versus 1.9%, P<0.001), leg ulcers (26.6% versus 11.6%, P<0.001), digital clubbing (25.0% versus 7.1%, P<0.001), coronary heart disease (26.6% versus 13.1%, P<0.01), chronic renal disease (16.6% versus 7.1%, P<0.01), and stroke (20.0% versus 7.9%, P<0.001) were all higher among the COPD cases, too. Interestingly, against the higher rates of the above problems in the COPD group, incidence of ACS was even lower among them, nonsignificantly (1.6% versus 3.9%, P>0.05).
{"title":"Acute Chest Syndrome Does Not Have a Chronic Inflammatory Background in Sickle Cell Diseases","authors":"M. Helvaci, H. Sahan, N. Atçı","doi":"10.5742/MEIM.2016.92862","DOIUrl":"https://doi.org/10.5742/MEIM.2016.92862","url":null,"abstract":"Results: The study included 411 patients (199 females). As one of the significant endpoints of SCDs, patients with chronic obstructive pulmonary disease (COPD) and without were collected into two groups. There were 60 patients (14.5%) with COPD. Mean age (33.0 versus 29.5 years, P=0.005) and male ratio (80.0% versus 46.7%, P<0.001) were higher in the COPD group. Smoking (36.6% versus 9.9%, P<0.001) and alcohol (3.3% versus 0.8%, P<0.05) were also higher among the COPD cases. Transfused red blood cell units in their lives (69.1 versus 32.9, P=0.001), priapism (10.0% versus 1.9%, P<0.001), leg ulcers (26.6% versus 11.6%, P<0.001), digital clubbing (25.0% versus 7.1%, P<0.001), coronary heart disease (26.6% versus 13.1%, P<0.01), chronic renal disease (16.6% versus 7.1%, P<0.01), and stroke (20.0% versus 7.9%, P<0.001) were all higher among the COPD cases, too. Interestingly, against the higher rates of the above problems in the COPD group, incidence of ACS was even lower among them, nonsignificantly (1.6% versus 3.9%, P>0.05).","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"61 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132531263","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":"Splenomegaly in Patients with Sideropenic Anemias : Clinical and Hematologic Significance","authors":"Safaa A. A. Khaled, G. Seifeldein","doi":"10.5742/MEIM.2016.92863","DOIUrl":"https://doi.org/10.5742/MEIM.2016.92863","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124700860","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":"Effectiveness of an interventional program for the management of hypertension through strengthening of the health care delivery system : a pilot study","authors":"W. Qidwai, K. Kazmi, K. Nanji, Sana Anees","doi":"10.5742/MEIM.2016.92861","DOIUrl":"https://doi.org/10.5742/MEIM.2016.92861","url":null,"abstract":"","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"83 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123120610","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}
Methylcobalamin (MeCbl), the activated form of vitamin B12, has been used to manage some nutritional diseases and other diseases in the clinic, including Alzheimer’s disease and rheumatoid arthritis. As an adjuvant, it effects neuronal protection by fostering regeneration of injured nerves and alienating glutamate-induced neurotoxicity. Recently several studies revealed that MeCbl may have conceivable analgesic effects in experimental and clinical studies. It can reduce, pain behaviors in diabetic neuropathy, low back pain and neuralgia. MeCbl ameliorate nerve conduction, stimulated the regeneration of injured nerves, and inhibited ectopic spontaneous discharges of injured primary sensory neurons. Low back pain is an everyday problem worldwide. It can lead to a great financial burden to society due to absenteeism or having work limitations. Back pain is one of the most common symptoms for seeing primary care physicians and one of the top 5 causes of surgery. Recent studies have shown a correlation between vitamin B12 injection and a decrease in Low back pain. This review aims to synopsize the analgesic effect and mechanisms of MeCbl at the present with particular stress on chronic low back pain. Intramuscular vitamin B12 injections appear to be of benefit in the reduction of chronic low back pain and also improve associated disability. However, further research is necessary to study the possible long term adverse reactions of these intramuscular injections.
{"title":"Update on the Use of Vitamin B12 in Management of Pain","authors":"A. Abyad","doi":"10.5742/MEIM.2016.92864","DOIUrl":"https://doi.org/10.5742/MEIM.2016.92864","url":null,"abstract":"Methylcobalamin (MeCbl), the activated form of vitamin B12, has been used to manage some nutritional diseases and other diseases in the clinic, including Alzheimer’s disease and rheumatoid arthritis. As an adjuvant, it effects neuronal protection by fostering regeneration of injured nerves and alienating glutamate-induced neurotoxicity. Recently several studies revealed that MeCbl may have conceivable analgesic effects in experimental and clinical studies. It can reduce, pain behaviors in diabetic neuropathy, low back pain and neuralgia. MeCbl ameliorate nerve conduction, stimulated the regeneration of injured nerves, and inhibited ectopic spontaneous discharges of injured primary sensory neurons. Low back pain is an everyday problem worldwide. It can lead to a great financial burden to society due to absenteeism or having work limitations. Back pain is one of the most common symptoms for seeing primary care physicians and one of the top 5 causes of surgery. Recent studies have shown a correlation between vitamin B12 injection and a decrease in Low back pain. This review aims to synopsize the analgesic effect and mechanisms of MeCbl at the present with particular stress on chronic low back pain. Intramuscular vitamin B12 injections appear to be of benefit in the reduction of chronic low back pain and also improve associated disability. However, further research is necessary to study the possible long term adverse reactions of these intramuscular injections.","PeriodicalId":243742,"journal":{"name":"Middle East Journal of Internal Medicine","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126257523","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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