As in adults, functional complaints of the gastrointestinal system in children and adolescents are common and are a cause of great anxiety, morbidity and significant healthcare costs. As far back as the 1960’s, attempts were made to classify functional complaints leading to the first diagnostic criteria for adult irritable bowel syndrome (IBS), the “Manning Criteria”, in 1978. By the late 1980’s and early 1990’s it became clear that there was a need to standardise criteria for the diagnosis, treatment and study of functional gastrointestinal disorders (FGIDs).
{"title":"Private Practice Review: A time bomb of resentment is ticking among doctors who are subjected to government and third-party payers interfering with the doctor-patient relationship","authors":"Lambiotte Mej, Van Rensburg Cj","doi":"10.4314/SAGR.V11I1","DOIUrl":"https://doi.org/10.4314/SAGR.V11I1","url":null,"abstract":"As in adults, functional complaints of the gastrointestinal system in children and adolescents are common and are a cause of great anxiety, morbidity and significant healthcare costs. As far back as the 1960’s, attempts were made to classify functional complaints leading to the first diagnostic criteria for adult irritable bowel syndrome (IBS), the “Manning Criteria”, in 1978. By the late 1980’s and early 1990’s it became clear that there was a need to standardise criteria for the diagnosis, treatment and study of functional gastrointestinal disorders (FGIDs).","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2013-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615136","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}
A. Mahomed, E. Cremona, C. Fourie, Lifa Dhlamini, Michael Klos, Thokozani Ntshalintshali, Sagar Patel, S. Shabangu, M. Shongwe, Sandhia Singh, Natalie Irwin, K. Moeng
Background : Colonoscopy is a valuable tool for diagnosing various colonic pathologies. There is little recent research regarding the use of colonoscopy in South Africa. Objective : To describe the findings of the audit done on the practice of colonoscopy in a specialised gastroenterology unit (GEU) of a tertiary teaching hospital. Design : A retrospective audit of colonoscopies performed between the 01 January 2008 and 31 March 2010 in a single gastroenterology unit at Charlotte Maxeke Johannesburg Academic Hospital(CMJAH) was conducted. Details of colonoscopy records were obtained from an administrative database of patient files. No patient specific inclusion or exclusion criteria were applied. Results : In total 1143 colonoscopies were performed during the study period, and 989 were analysed. The mean age was 63.04 years (10 - 93), 61.58% female, 61.48% were Caucasians and 25.88% were of black ethnicity. The indications for colonoscopies were; screening for colorectal cancer (22.95%), case findings (14.16%) and surveillance (14.96%). Caecal intubation rate (CIR) was 80.08%. Findings included macroscopically normal colons (38.12%), polyps (28.18%) and diverticular disease (23.15%). Of the biopsies obtained during colonoscopy procedures 30.50% were reported as normal colonic mucosa, 10.40% revealed adenocarcinoma and 55.37% were tubular adenomas. Conclusions : The audit identified a number of shortfalls, which include: poor colonoscopy performance quality as reflected by the low CIR, non standardised colonoscopy reporting format resulting in paucity of information on scope reports, under-representation of the black community, to mention a few. It therefore would appear, based on the findings from this study that there is room for improvement in a number of areas in the practice of colonoscopy in this unit. Further studies may be of value to identify reasons behind these shortfalls.
{"title":"A Clinical Audit of Colonoscopy in a Gastroenterology Unit at a Tertiary Teaching Hospital in South Africa","authors":"A. Mahomed, E. Cremona, C. Fourie, Lifa Dhlamini, Michael Klos, Thokozani Ntshalintshali, Sagar Patel, S. Shabangu, M. Shongwe, Sandhia Singh, Natalie Irwin, K. Moeng","doi":"10.4314/SAGR.V10I3","DOIUrl":"https://doi.org/10.4314/SAGR.V10I3","url":null,"abstract":"Background : Colonoscopy is a valuable tool for diagnosing various colonic pathologies. There is little recent research regarding the use of colonoscopy in South Africa.\u0000Objective : To describe the findings of the audit done on the practice of colonoscopy in a specialised gastroenterology unit (GEU) of a tertiary teaching hospital.\u0000Design : A retrospective audit of colonoscopies performed between the 01 January 2008 and 31 March 2010 in a single gastroenterology unit at Charlotte Maxeke Johannesburg Academic Hospital(CMJAH) was conducted. Details of colonoscopy records were obtained from an administrative database of patient files. No patient specific inclusion or exclusion criteria were applied.\u0000Results : In total 1143 colonoscopies were performed during the study period, and 989 were analysed. The mean age was 63.04 years (10 - 93), 61.58% female, 61.48% were Caucasians and 25.88% were of black ethnicity. The indications for colonoscopies were; screening for colorectal cancer (22.95%), case findings (14.16%) and surveillance (14.96%). Caecal intubation rate (CIR) was 80.08%. Findings included macroscopically normal colons (38.12%), polyps (28.18%) and diverticular disease (23.15%). Of the biopsies obtained during colonoscopy procedures 30.50% were reported as normal colonic mucosa, 10.40% revealed adenocarcinoma and 55.37% were tubular adenomas.\u0000Conclusions : The audit identified a number of shortfalls, which include: poor colonoscopy performance quality as reflected by the low CIR, non standardised colonoscopy reporting format resulting in paucity of information on scope reports, under-representation of the black community, to mention a few. It therefore would appear, based on the findings from this study that there is room for improvement in a number of areas in the practice of colonoscopy in this unit. Further studies may be of value to identify reasons behind these shortfalls.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"10 1","pages":"9-15"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70615433","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":"Viral Hepatitis and HIV co-infection","authors":"M. Andersson, C. Rensburg","doi":"10.4314/SAGR.V9I3.69667","DOIUrl":"https://doi.org/10.4314/SAGR.V9I3.69667","url":null,"abstract":"","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"9 1","pages":"16-21"},"PeriodicalIF":0.0,"publicationDate":"2011-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616549","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}
Clostridium difficile, classically causing bloody diarrhoea after long term antibiotic use, and producing pseudo-membrenous colitis on endoscopy used to be a rarity. It has reached epidemic proportions in Europe and North America and has become commonplace in South Africa.
{"title":"Management of Clostridium Difficile : case study and review of the basic tenets : case report","authors":"M. Roberts","doi":"10.4314/SAGR.V9I2.69477","DOIUrl":"https://doi.org/10.4314/SAGR.V9I2.69477","url":null,"abstract":"Clostridium difficile, classically causing bloody diarrhoea after long term antibiotic use, and producing pseudo-membrenous colitis on endoscopy used to be a rarity. It has reached epidemic proportions in Europe and North America and has become commonplace in South Africa.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"9 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616450","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}
A 63 year old male presented with a 4 year history of progressive dysphagia to solids. He had no background medical or surgical history. He did not smoke or consume any alcohol.
一位63岁男性，有4年进行性固体吞咽困难病史。他没有病史或手术史。他不抽烟也不喝酒。
{"title":"Achalasia complicated by squamous cell carcinoma of the oesophagus : case report","authors":"N. Rajabally, M. Locketz, D. Levin, S. Thomson","doi":"10.4314/SAGR.V9I2.69482","DOIUrl":"https://doi.org/10.4314/SAGR.V9I2.69482","url":null,"abstract":"A 63 year old male presented with a 4 year history of progressive dysphagia to solids. He had no background medical or surgical history. He did not smoke or consume any alcohol.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"9 1","pages":"17-19"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616484","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}
We face massive challenges as coding and tariff issues drag on unresolved, private healthcare costs targeted as inappropriately high, the National Health Insurance (NHI) policy still shrouded in darkness and shortages of health workers. This is a time of great uncertainty, an uncertainty brought about by living in a country that finds itself in a persistent transitional state.
{"title":"Glass half full : private practice report","authors":"S. Grobler","doi":"10.4314/SAGR.V9I2.69527","DOIUrl":"https://doi.org/10.4314/SAGR.V9I2.69527","url":null,"abstract":"We face massive challenges as coding and tariff issues drag on unresolved, private healthcare costs targeted as inappropriately high, the National Health Insurance (NHI) policy still shrouded in darkness and shortages of health workers. This is a time of great uncertainty, an uncertainty brought about by living in a country that finds itself in a persistent transitional state.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"58 1","pages":"21-23"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616497","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}
A 28 year old female presented to a regional hospital in early February 2011 with severe gallstone pancreatitis. She required admission to the Intensive Care Unit where she was mechanically ventilated for 11 days, as a result of Acute Respiratory Distress Syndrome. She was 7 weeks pregnant at the time.
{"title":"Endosonar pseudocyst drainage without fluoroscopy during pregnancy : an optimal indication for a technique : case report","authors":"D. Levin, S. Burmeister, S. Thomson, J. Brink","doi":"10.4314/SAGR.V9I2.69480","DOIUrl":"https://doi.org/10.4314/SAGR.V9I2.69480","url":null,"abstract":"A 28 year old female presented to a regional hospital in early February 2011 with severe gallstone pancreatitis. She required admission to the Intensive Care Unit where she was mechanically ventilated for 11 days, as a result of Acute Respiratory Distress Syndrome. She was 7 weeks pregnant at the time.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"9 1","pages":"14-15"},"PeriodicalIF":0.0,"publicationDate":"2011-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616600","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: The operating room is a high-risk setting for occupational sharps injuries and bloodborne pathogen exposure. In Africa, where prevalence of bloodborne pathogens is often high and resources are often low, the risks are especially high for surgeons. This study systematically documents risk factors among South African surgeons regarding bloodborne pathogen transmission during surgery. Methods: A retrospective survey was conducted among surgeons attending the ASSA biennial meeting. The survey results reflect patterns of risk and availability and use of safety practices, garments and devices. Results: Of 96 surgeons participating in the survey, 70% reported at least one percutaneous injury during the previous year, with the average rate of percutaneous injury 2.75 per year. Suture needles were the most common source of injury (84%). More than half reported being splashed by blood or body fluids, with an annual average of 3.5, most often to the eyes. Sixty-nine percent reported complete HBV vaccination, and HIV Post-Exposure Prophylaxis (PEP) was readily available. Eyes were not sufficiently protected. Slightly more than half reported using hands-free passing, and more than one-third reported using blunt suture needles. Comparing surgeons who used a combination of hands-free passing and blunt sutures and those who did not revealed markedly different rates of injury. Conclusions: Risks of blood exposure among South African surgeons are high. Wider adoption of safe techniques, devices and personal protective equipment could reduce the risks. Recommendations for injury prevention and safe practice that can protect the health and lives of the surgical team are offered.
{"title":"Role of the gut microbiota in health and disease : review","authors":"E. Phillips, S. Pillay, P. Goldberg, J. Jagger","doi":"10.4314/SAGR.V9I3.69662","DOIUrl":"https://doi.org/10.4314/SAGR.V9I3.69662","url":null,"abstract":"Background: The operating room is a high-risk setting for occupational sharps injuries and bloodborne pathogen exposure. In Africa, where prevalence of bloodborne pathogens is often high and resources are often low, the risks are especially high for surgeons. This study systematically documents risk factors among South African surgeons regarding bloodborne pathogen transmission during surgery. Methods: A retrospective survey was conducted among surgeons attending the ASSA biennial meeting. The survey results reflect patterns of risk and availability and use of safety practices, garments and devices. Results: Of 96 surgeons participating in the survey, 70% reported at least one percutaneous injury during the previous year, with the average rate of percutaneous injury 2.75 per year. Suture needles were the most common source of injury (84%). More than half reported being splashed by blood or body fluids, with an annual average of 3.5, most often to the eyes. Sixty-nine percent reported complete HBV vaccination, and HIV Post-Exposure Prophylaxis (PEP) was readily available. Eyes were not sufficiently protected. Slightly more than half reported using hands-free passing, and more than one-third reported using blunt suture needles. Comparing surgeons who used a combination of hands-free passing and blunt sutures and those who did not revealed markedly different rates of injury. Conclusions: Risks of blood exposure among South African surgeons are high. Wider adoption of safe techniques, devices and personal protective equipment could reduce the risks. Recommendations for injury prevention and safe practice that can protect the health and lives of the surgical team are offered.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"9 1","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616533","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. Indiveri, R. Berman, M. Bhagowat, K. Govender, W. Meier, A. Payne, P. Poncana, C. Pryce, S. Seetahal, M. Selela, A. Mahomed
Background: Traditionally, inflammatory bowel disease has been a disease entity associated with European ancestry. Despite claims of rarity, numerous studies have emerged which indicate that the prevalence of IBD has increased in various ethnic groups worldwide. We illustrate that IBD is indeed a multi-ethnic disease and the clinical characteristics of IBD in our setting are presented in this study. Methods: A retrospective cross-sectional descriptive study of the medical records of IBD patients presenting to the Department of Gastroenterology, area 554 of the Charlotte Makexe Johannesburg Academic Hospital was undertaken. One hundred twenty-six patients with IBD referred to this tertiary gastrointestinal centre from 2005 through 2010, were assessed. Demographic and historical characteristics, clinical features as well as drug and surgical interventions were assessed according to a predetermined patient data collection form. Results: Analyses demonstrated that 63.5% of the sample had UC, 34.1% had CD and 2.4% were diagnosed as having IC, with a female to male ratio of 1.4: 1. There were comparable numbers of White, Indian and Black patients with UC but very few Black patients contributed to the CD burden. Moreover, CD was established as a more severe disease entity as manifest by a higher proportion of extra-intestinal manifestations, in addition to higher complication and surgery rates in this group. Conclusion: Our findings show that although Caucasians still represent the greater fraction of IBD cases, the numbers of Black South Africans affected by this disease have grown. Moreover, in contrast to earlier studies, we found that disease in Black patients is milder compared to White and Indian counterparts. We have been able to illustrate that IBD is in fact a multi-racial disease entity as shown to affect various ethnic groups.
{"title":"A clinical audit of inflammatory bowel disease in a South African tertiary institution : review","authors":"L. Indiveri, R. Berman, M. Bhagowat, K. Govender, W. Meier, A. Payne, P. Poncana, C. Pryce, S. Seetahal, M. Selela, A. Mahomed","doi":"10.4314/SAGR.V8I3.63098","DOIUrl":"https://doi.org/10.4314/SAGR.V8I3.63098","url":null,"abstract":"Background: Traditionally, inflammatory bowel disease has been a disease entity associated with European ancestry. Despite claims of rarity, numerous studies have emerged which indicate that the prevalence of IBD has increased in various ethnic groups worldwide. We illustrate that IBD is indeed a multi-ethnic disease and the clinical characteristics of IBD in our setting are presented in this study. Methods: A retrospective cross-sectional descriptive study of the medical records of IBD patients presenting to the Department of Gastroenterology, area 554 of the Charlotte Makexe Johannesburg Academic Hospital was undertaken. One hundred twenty-six patients with IBD referred to this tertiary gastrointestinal centre from 2005 through 2010, were assessed. Demographic and historical characteristics, clinical features as well as drug and surgical interventions were assessed according to a predetermined patient data collection form. Results: Analyses demonstrated that 63.5% of the sample had UC, 34.1% had CD and 2.4% were diagnosed as having IC, with a female to male ratio of 1.4: 1. There were comparable numbers of White, Indian and Black patients with UC but very few Black patients contributed to the CD burden. Moreover, CD was established as a more severe disease entity as manifest by a higher proportion of extra-intestinal manifestations, in addition to higher complication and surgery rates in this group. Conclusion: Our findings show that although Caucasians still represent the greater fraction of IBD cases, the numbers of Black South Africans affected by this disease have grown. Moreover, in contrast to earlier studies, we found that disease in Black patients is milder compared to White and Indian counterparts. We have been able to illustrate that IBD is in fact a multi-racial disease entity as shown to affect various ethnic groups.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"40 1","pages":"6-18"},"PeriodicalIF":0.0,"publicationDate":"2011-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616436","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}
C. Babb, Desmond J Schnugh, M. Louw, J. Goedhals, P. Willem
Gastrointestinal Stromal Tumour (GIST) is a rare disease but the most common mesenchymal neoplasm of the gastrointestinal tract. It has an incidence of 14.5-15 per million people. GIST tumor cells originate from the precursors of interstitial cells of Cajal (ICC), and are Kit/CD117 and CD34 positive. The key prognostic factors indicative of GIST metastasis, disease advancement and recurrence are the tumour size and the mitotic index. The anatomical site may also be informative for risk stratification. Despite existing differences in GIST clinicopathology, 75-80% of these tumors have an oncogenic mutation in the KIT (v-kit Hardy-Zuckerman feline sarcoma viral oncogene homolog) or PDGFRa (platelet-derived growth factor receptor, alpha polypeptide) genes. These gain of function mutations have been linked to GIST pathogenesis. Indeed both genes, which map to chromosome 4q12, belong to the type III tyrosine kinase family and encode highly homologous transmembrane glycoproteins. Neurofibromatosis 1 (NF1) patients have an increased risk of developing GISTs, although they will rarely have any KIT or PDGFRa mutations. The treatment of GIST patients has drastically changed since the introduction of tyrosine kinase inhibitors (TKI), such as Imatinib mesylate, which targets KIT and PDGFRa.
{"title":"Getting the gist: what is the importance of molecular genetics in gastro-intestinal stromal tumours (GIST).","authors":"C. Babb, Desmond J Schnugh, M. Louw, J. Goedhals, P. Willem","doi":"10.4314/SAGR.V8I3.63097","DOIUrl":"https://doi.org/10.4314/SAGR.V8I3.63097","url":null,"abstract":"Gastrointestinal Stromal Tumour (GIST) is a rare disease but the most common mesenchymal neoplasm of the gastrointestinal tract. It has an incidence of 14.5-15 per million people. GIST tumor cells originate from the precursors of interstitial cells of Cajal (ICC), and are Kit/CD117 and CD34 positive. The key prognostic factors indicative of GIST metastasis, disease advancement and recurrence are the tumour size and the mitotic index. The anatomical site may also be informative for risk stratification. Despite existing differences in GIST clinicopathology, 75-80% of these tumors have an oncogenic mutation in the KIT (v-kit Hardy-Zuckerman feline sarcoma viral oncogene homolog) or PDGFRa (platelet-derived growth factor receptor, alpha polypeptide) genes. These gain of function mutations have been linked to GIST pathogenesis. Indeed both genes, which map to chromosome 4q12, belong to the type III tyrosine kinase family and encode highly homologous transmembrane glycoproteins. Neurofibromatosis 1 (NF1) patients have an increased risk of developing GISTs, although they will rarely have any KIT or PDGFRa mutations. The treatment of GIST patients has drastically changed since the introduction of tyrosine kinase inhibitors (TKI), such as Imatinib mesylate, which targets KIT and PDGFRa.","PeriodicalId":39144,"journal":{"name":"South African Gastroenterology Review","volume":"8 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2011-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70616370","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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