Pub Date : 2025-05-01DOI: 10.1016/j.ogrm.2025.02.004
Karolina Palinska-Rudzka, Raj Mathur
Pre-implantation genetic testing (PGT) is a specialized technique that combines in vitro fertilization (IVF) technology with genetic testing. This paper provides a comprehensive overview of the different types of PGT, including PGT-A, PGT-M, and PGT-SR, highlighting their roles in reducing miscarriage rates, optimizing embryo selection, and minimizing the transmission of genetic conditions. Additionally, it discusses the technical aspects of embryo biopsy, the challenges associated with mosaicism, and ethical considerations, and patient counselling.
{"title":"Pre-implantation genetic testing: a practical guide","authors":"Karolina Palinska-Rudzka, Raj Mathur","doi":"10.1016/j.ogrm.2025.02.004","DOIUrl":"10.1016/j.ogrm.2025.02.004","url":null,"abstract":"<div><div>Pre-implantation genetic testing (PGT) is a specialized technique that combines in vitro fertilization (IVF) technology with genetic testing. This paper provides a comprehensive overview of the different types of PGT, including PGT-A, PGT-M, and PGT-SR, highlighting their roles in reducing miscarriage rates, optimizing embryo selection, and minimizing the transmission of genetic conditions. Additionally, it discusses the technical aspects of embryo biopsy, the challenges associated with mosaicism, and ethical considerations, and patient counselling.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 5","pages":"Pages 144-146"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912890","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 : 2025-05-01DOI: 10.1016/j.ogrm.2025.02.001
Sheila Radhakrishnan
Sexual health is an important area of public and personal health. It is linked to sexual well-being where respect and positivity in relationships is promoted. A focus on promoting intimacy and pleasure needs to be emphasized in any form of sex education, rather than in only preventing disease and pregnancy. Symptoms in gynaecology clinics are frequently representative of the somatization of unrecognized sexual problems. Studies estimate 40% of gynaecological consultations have a psychosexual component to them, which may be overt or covert. Although a 20 minute consultation is insufficient for dealing with sexual difficulties, useful work can easily be done in this time. Having exposure to psychosexual skills can help gynaecologists uncover the distress, explore feelings generated, use sensitive language to communicate, examine with the patient the area of distress and help them obtain some insight into their difficulty.
{"title":"Psychosexual problems in gynaecological practice","authors":"Sheila Radhakrishnan","doi":"10.1016/j.ogrm.2025.02.001","DOIUrl":"10.1016/j.ogrm.2025.02.001","url":null,"abstract":"<div><div>Sexual health is an important area of public and personal health. It is linked to sexual well-being where respect and positivity in relationships is promoted. A focus on promoting intimacy and pleasure needs to be emphasized in any form of sex education, rather than in only preventing disease and pregnancy. Symptoms in gynaecology clinics are frequently representative of the somatization of unrecognized sexual problems. Studies estimate 40% of gynaecological consultations have a psychosexual component to them, which may be overt or covert. Although a 20 minute consultation is insufficient for dealing with sexual difficulties, useful work can easily be done in this time. Having exposure to psychosexual skills can help gynaecologists uncover the distress, explore feelings generated, use sensitive language to communicate, examine with the patient the area of distress and help them obtain some insight into their difficulty.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 5","pages":"Pages 123-127"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912887","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 : 2025-05-01DOI: 10.1016/j.ogrm.2025.02.002
Kshitij Jamdade, Ketankumar Gajjar
The incidence of ovarian cysts in pregnancy appears to be rising, especially with the increased use of routine antenatal ultrasounds. Most of them are benign and tend to resolve spontaneously. It is rare to diagnose malignant ovarian tumours during pregnancy. Evaluating the adnexa during routine antenatal ultrasound is considered opportunistic screening. Even though several factors can make ultrasound less reliable during pregnancy, it is the preferred initial imaging method. MRI is also a safe option during pregnancy for further evaluation of ovarian lesions. Surgery is recommended for larger, symptomatic cysts or those suspected of malignancy. Laparoscopic management of ovarian cysts is possible between 14 and 16 weeks of gestation but requires advanced laparoscopic skills. Due to the risk of adverse fetal and maternal outcomes associated with surgery during pregnancy, conservative management is preferred when it is deemed safe. Multi-disciplinary team approach is recommended for complicated and malignant adnexal masses.
{"title":"Management of ovarian cysts and cancer in pregnancy","authors":"Kshitij Jamdade, Ketankumar Gajjar","doi":"10.1016/j.ogrm.2025.02.002","DOIUrl":"10.1016/j.ogrm.2025.02.002","url":null,"abstract":"<div><div>The incidence of ovarian cysts in pregnancy appears to be rising, especially with the increased use of routine antenatal ultrasounds. Most of them are benign and tend to resolve spontaneously. It is rare to diagnose malignant ovarian tumours during pregnancy. Evaluating the adnexa during routine antenatal ultrasound is considered opportunistic screening. Even though several factors can make ultrasound less reliable during pregnancy, it is the preferred initial imaging method. MRI is also a safe option during pregnancy for further evaluation of ovarian lesions. Surgery is recommended for larger, symptomatic cysts or those suspected of malignancy. Laparoscopic management of ovarian cysts is possible between 14 and 16 weeks of gestation but requires advanced laparoscopic skills. Due to the risk of adverse fetal and maternal outcomes associated with surgery during pregnancy, conservative management is preferred when it is deemed safe. Multi-disciplinary team approach is recommended for complicated and malignant adnexal masses.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 5","pages":"Pages 128-137"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912888","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 : 2025-05-01DOI: 10.1016/j.ogrm.2025.02.003
Rachel Barlow-Evans, Kate Johanna Campbell
Women with complex medical conditions face increased risk during pregnancy or when using certain contraceptive methods. This makes appropriate contraception provision planning essential for their health and well-being. Effective contraception provision will enable these women to plan and space pregnancies or avoid unintended pregnancies and therefore reduce the risk of maternal or fetal complications. Obstetricians and Gynaecologists along with other healthcare providers will frequently encounter these women and may be expected to advise on suitable contraceptive options. In this case-based article, we explore how to assess these patients and provide tailored contraceptive advice by considering medical eligibility, efficacy and acceptability of various contraceptive methods. We hope to emphasize the importance of individualized care, shared decision-making, and maintaining up to date clinical knowledge when providing contraceptive advice.
{"title":"Contraception options for women with medical conditions","authors":"Rachel Barlow-Evans, Kate Johanna Campbell","doi":"10.1016/j.ogrm.2025.02.003","DOIUrl":"10.1016/j.ogrm.2025.02.003","url":null,"abstract":"<div><div>Women with complex medical conditions face increased risk during pregnancy or when using certain contraceptive methods. This makes appropriate contraception provision planning essential for their health and well-being. Effective contraception provision will enable these women to plan and space pregnancies or avoid unintended pregnancies and therefore reduce the risk of maternal or fetal complications. Obstetricians and Gynaecologists along with other healthcare providers will frequently encounter these women and may be expected to advise on suitable contraceptive options. In this case-based article, we explore how to assess these patients and provide tailored contraceptive advice by considering medical eligibility, efficacy and acceptability of various contraceptive methods. We hope to emphasize the importance of individualized care, shared decision-making, and maintaining up to date clinical knowledge when providing contraceptive advice.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 5","pages":"Pages 138-143"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912889","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 : 2025-04-22DOI: 10.1016/j.ogrm.2025.03.001
Alina-Maria Guna, Kimberley Raynsford
Termination of pregnancy, also known as abortion, is a common medical procedure undertaken to end a pregnancy. It is a complex and sensitive topic influenced by medical, ethical, legal, and societal factors. Broadly, termination of pregnancy can be classified into two main methods: medical termination and surgical termination. Each approach has its own indications, contraindications, benefits, and risks. This article provides an exploration of these methods, discussing their pros and cons, and signposts to guidelines and resources. This article was designed to provide a concise read on surgical and medical termination of pregnancy, focusing on the pros and cons of each method, risks and benefits, technique and implications. Further, learning on the subject can be found in the guidelines and resources mentioned at the end of this article, suggested for preparation for MRCOG Part II.
{"title":"Abortion methods: the pros and cons of medical and surgical termination of pregnancy","authors":"Alina-Maria Guna, Kimberley Raynsford","doi":"10.1016/j.ogrm.2025.03.001","DOIUrl":"10.1016/j.ogrm.2025.03.001","url":null,"abstract":"<div><div>Termination of pregnancy, also known as abortion, is a common medical procedure undertaken to end a pregnancy. It is a complex and sensitive topic influenced by medical, ethical, legal, and societal factors. Broadly, termination of pregnancy can be classified into two main methods: medical termination and surgical termination. Each approach has its own indications, contraindications, benefits, and risks. This article provides an exploration of these methods, discussing their pros and cons, and signposts to guidelines and resources. This article was designed to provide a concise read on surgical and medical termination of pregnancy, focusing on the pros and cons of each method, risks and benefits, technique and implications. Further, learning on the subject can be found in the guidelines and resources mentioned at the end of this article, suggested for preparation for MRCOG Part II.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 6","pages":"Pages 149-153"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139225","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 : 2025-04-07DOI: 10.1016/j.ogrm.2025.03.002
Elizabeth Swift, Nawal Nasir, Kathryn Parry
The increasing incidence of perinatal mental health conditions presents a substantial financial challenge to the NHS and significantly affects mothers, birthing individuals, and unborn children if untreated. The literature emphasises that many postnatal psychiatric conditions in women begin during the antenatal period. This article delves into case studies to illustrate some common presentations in perinatal mental health, particularly focusing on antenatal and postnatal management. It underscores the critical role of an individualised birth care plan in enhancing patient outcomes. Through these cases we demonstrate that timely intervention during pregnancy could potentially mitigate the severe postpartum consequences associated with maternal mental health conditions.
{"title":"An individualised approach to the management of pre-existing mental health conditions in pregnancy and puerperium","authors":"Elizabeth Swift, Nawal Nasir, Kathryn Parry","doi":"10.1016/j.ogrm.2025.03.002","DOIUrl":"10.1016/j.ogrm.2025.03.002","url":null,"abstract":"<div><div>The increasing incidence of perinatal mental health conditions presents a substantial financial challenge to the NHS and significantly affects mothers, birthing individuals, and unborn children if untreated. The literature emphasises that many postnatal psychiatric conditions in women begin during the antenatal period. This article delves into case studies to illustrate some common presentations in perinatal mental health, particularly focusing on antenatal and postnatal management. It underscores the critical role of an individualised birth care plan in enhancing patient outcomes. Through these cases we demonstrate that timely intervention during pregnancy could potentially mitigate the severe postpartum consequences associated with maternal mental health conditions.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 6","pages":"Pages 154-160"},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139226","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 : 2025-04-01DOI: 10.1016/j.ogrm.2025.01.003
Bernadette Jenner, William Jenner, Rahul Chattopadhyay, Catriona J Bhagra
The 2024 MBRRACE-UK report showed a rise in overall maternal mortality, with deaths from cardiac disease remaining the main indirect cause, barring deaths from COVID-19. Advancing maternal age and a rise in cardiovascular co-morbidities, along with improvements in congenital heart disease management and assisted reproductive technology have all contributed to an increasingly complex maternity population with higher pregnancy risks. Despite improvements in obstetric and cardiac care, health inequalities for women with multiple comorbidities, socio-economic deprivation and those from Black and Asian ethnic groups persist, with these groups being more likely to have poor cardiovascular and pregnancy outcomes. In this review we consider the importance of pre-conception counselling for women with known heart disease, review the physiological changes of pregnancy and explore maternal risk, from a cardiovascular perspective. Importantly, management of women with moderate to severe heart disease during pregnancy should be delivered by the pregnancy heart team, as coined by the European Society of Cardiology in its 2018 guidelines. Individualized care empowers trust and shared decision making, and early access to multidisciplinary care is vital in optimizing maternal and fetal outcomes.
2024年MBRRACE-UK报告显示，总体孕产妇死亡率上升，除COVID-19死亡外，心脏病死亡仍然是主要的间接原因。产妇年龄的增加和心血管合并症的增加，以及先天性心脏病管理和辅助生殖技术的改善，都导致产妇人口日益复杂，怀孕风险更高。尽管产科和心脏护理有所改善，但患有多种合并症、社会经济贫困的妇女以及黑人和亚洲族裔群体的妇女的健康不平等现象仍然存在，这些群体更有可能出现不良的心血管和妊娠结局。在这篇综述中，我们考虑了孕前咨询对已知心脏病妇女的重要性，回顾了怀孕的生理变化，并从心血管角度探讨了产妇的风险。重要的是，正如欧洲心脏病学会（European Society of Cardiology）在其2018年指南中提出的那样，怀孕期间患有中度至重度心脏病的女性的管理应由妊娠心脏团队提供。个性化护理增强了信任和共同决策，尽早获得多学科护理对于优化孕产妇和胎儿结局至关重要。
{"title":"Maternal cardiac disease in pregnancy","authors":"Bernadette Jenner, William Jenner, Rahul Chattopadhyay, Catriona J Bhagra","doi":"10.1016/j.ogrm.2025.01.003","DOIUrl":"10.1016/j.ogrm.2025.01.003","url":null,"abstract":"<div><div>The 2024 MBRRACE-UK report showed a rise in overall maternal mortality, with deaths from cardiac disease remaining the main indirect cause, barring deaths from COVID-19. Advancing maternal age and a rise in cardiovascular co-morbidities, along with improvements in congenital heart disease management and assisted reproductive technology have all contributed to an increasingly complex maternity population with higher pregnancy risks. Despite improvements in obstetric and cardiac care, health inequalities for women with multiple comorbidities, socio-economic deprivation and those from Black and Asian ethnic groups persist, with these groups being more likely to have poor cardiovascular and pregnancy outcomes. In this review we consider the importance of pre-conception counselling for women with known heart disease, review the physiological changes of pregnancy and explore maternal risk, from a cardiovascular perspective. Importantly, management of women with moderate to severe heart disease during pregnancy should be delivered by the pregnancy heart team, as coined by the European Society of Cardiology in its 2018 guidelines. Individualized care empowers trust and shared decision making, and early access to multidisciplinary care is vital in optimizing maternal and fetal outcomes.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 101-110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791457","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 : 2025-04-01DOI: 10.1016/j.ogrm.2025.01.001
Natalia Price, Paul Moran
Stress urinary incontinence (SUI) is a prevalent condition, affecting a significant proportion of women, with 13.6% requiring surgical intervention during their lifetime. Surgical treatments primarily aim to provide suburethral support or enhance urethral closure mechanisms. Traditionally, colposuspensions and autologous rectus fascial slings have been considered effective first-line surgical options for managing SUI. These procedures have shown reliable outcomes in terms of symptom relief and long-term efficacy. The use of midurethral tapes, once the most popular treatment option in the UK, is currently suspended due to the concerns about the risk of chronic pelvic pain and vaginal mesh exposure. It remains an option for women with deemed ‘exceptional circumstances’ and may be cautiously reintroduced into practice with certain prerequisites. The mesh ‘pause’ has driven a much-improved process of patient counselling, expectation setting, utilizsation of the ‘MDT’, enhanced surgical standards and data collection. It has led to a reassessment of surgical approaches. The current trend is for many women to request intra-urethral bulking (Bladder neck injection) as a first line procedure to treat primary SUI. There is a renewed focus on established methods like colposuspension, open or laparoscopic, and modified autologous fascial ‘sling on a string’. These procedures avoid mesh related risks but are associated with different risks such as new onset vaginal prolapse and post-operative voiding difficulty, respectively.
{"title":"Modern approaches to surgical treatment for female stress urinary incontinence","authors":"Natalia Price, Paul Moran","doi":"10.1016/j.ogrm.2025.01.001","DOIUrl":"10.1016/j.ogrm.2025.01.001","url":null,"abstract":"<div><div>Stress urinary incontinence (SUI) is a prevalent condition, affecting a significant proportion of women, with 13.6% requiring surgical intervention during their lifetime. Surgical treatments primarily aim to provide suburethral support or enhance urethral closure mechanisms. Traditionally, colposuspensions and autologous rectus fascial slings have been considered effective first-line surgical options for managing SUI. These procedures have shown reliable outcomes in terms of symptom relief and long-term efficacy. The use of midurethral tapes, once the most popular treatment option in the UK, is currently suspended due to the concerns about the risk of chronic pelvic pain and vaginal mesh exposure. It remains an option for women with deemed ‘exceptional circumstances’ and may be cautiously reintroduced into practice with certain prerequisites. The mesh ‘pause’ has driven a much-improved process of patient counselling, expectation setting, utilizsation of the ‘MDT’, enhanced surgical standards and data collection. It has led to a reassessment of surgical approaches. The current trend is for many women to request intra-urethral bulking (Bladder neck injection) as a first line procedure to treat primary SUI. There is a renewed focus on established methods like colposuspension, open or laparoscopic, and modified autologous fascial ‘sling on a string’. These procedures avoid mesh related risks but are associated with different risks such as new onset vaginal prolapse and post-operative voiding difficulty, respectively.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 89-97"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143792036","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 : 2025-04-01DOI: 10.1016/j.ogrm.2025.01.004
Marika Ai Victoria Reinius, Arjun David Napier Kingdon
Women with gynaecological malignancies often suffer significant physical and psychological symptom burden throughout the course of their disease. Despite advances in treatment, up to 25% of women diagnosed with a gynaecological cancers will die from recurrent disease. A palliative approach – delivered by the Gynaecology team, supported by a Specialist Palliative Care team as needed – can be offered alongside curative or life prolonging treatment as well as at end of life. This article reviews the management of common physical symptoms and complications experienced by patients with advanced gynaecological malignancies, including pain, nausea and vomiting, malignant bowel obstruction, constipation, malignant ascites, fistulating and fungating disease, anaemia and bleeding, and ureteric obstruction.
{"title":"Principles of palliative care for advanced gynaecological cancers","authors":"Marika Ai Victoria Reinius, Arjun David Napier Kingdon","doi":"10.1016/j.ogrm.2025.01.004","DOIUrl":"10.1016/j.ogrm.2025.01.004","url":null,"abstract":"<div><div>Women with gynaecological malignancies often suffer significant physical and psychological symptom burden throughout the course of their disease. Despite advances in treatment, up to 25% of women diagnosed with a gynaecological cancers will die from recurrent disease. A palliative approach – delivered by the Gynaecology team, supported by a Specialist Palliative Care team as needed – can be offered alongside curative or life prolonging treatment as well as at end of life. This article reviews the management of common physical symptoms and complications experienced by patients with advanced gynaecological malignancies, including pain, nausea and vomiting, malignant bowel obstruction, constipation, malignant ascites, fistulating and fungating disease, anaemia and bleeding, and ureteric obstruction.</div></div>","PeriodicalId":53410,"journal":{"name":"Obstetrics, Gynaecology and Reproductive Medicine","volume":"35 4","pages":"Pages 111-118"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791456","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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