Pub Date : 2022-11-01DOI: 10.4103/cmrp.cmrp_105_21
Ala Ram, P. Saini, A. Garg, S. Singh, K. Kumar, S. Maheshwari
Central nervous system (CNS) toxoplasmosis is one of the leading causes of secondary CNS infection and seizures in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients along with cryptococcosis and tuberculosis. Encephalitis can be a primary presentation in undiagnosed HIV patients. We are reporting a rare case of HIV/AIDS that presented to us with encephalitis and was later diagnosed as toxoplasma encephalitis. A 32-year-old male truck driver presented with altered behaviour for about 1 month and vomiting for 4 days. On clinical examination, papilloedema was present. Further investigations revealed serologically proven HIV with CD4 T lymphocyte count of 56 cells/microL. Brain imaging showed multiple ring-enhancing lesions in the bilateral cerebral hemispheres and right cerebellar hemisphere. Serum toxoplasma antibodies were found to be positive and a diagnosis of CNS toxoplasmosis encephalitis was made. Treatment with trimethoprim–sulphamethoxazole and highly active antiretroviral therapy was initiated following which there was a significant improvement in the patient's clinical condition. The patient is on regular follow-up now.
{"title":"Toxoplasma encephalitis – A presenting feature of HIV disease","authors":"Ala Ram, P. Saini, A. Garg, S. Singh, K. Kumar, S. Maheshwari","doi":"10.4103/cmrp.cmrp_105_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_105_21","url":null,"abstract":"Central nervous system (CNS) toxoplasmosis is one of the leading causes of secondary CNS infection and seizures in human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) patients along with cryptococcosis and tuberculosis. Encephalitis can be a primary presentation in undiagnosed HIV patients. We are reporting a rare case of HIV/AIDS that presented to us with encephalitis and was later diagnosed as toxoplasma encephalitis. A 32-year-old male truck driver presented with altered behaviour for about 1 month and vomiting for 4 days. On clinical examination, papilloedema was present. Further investigations revealed serologically proven HIV with CD4 T lymphocyte count of 56 cells/microL. Brain imaging showed multiple ring-enhancing lesions in the bilateral cerebral hemispheres and right cerebellar hemisphere. Serum toxoplasma antibodies were found to be positive and a diagnosis of CNS toxoplasmosis encephalitis was made. Treatment with trimethoprim–sulphamethoxazole and highly active antiretroviral therapy was initiated following which there was a significant improvement in the patient's clinical condition. The patient is on regular follow-up now.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82702013","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":"Three delays for maternal near miss in India","authors":"P. Roy, D. Sahu, B. Behera","doi":"10.4103/cmrp.cmrp_81_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_81_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81824192","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":"Analysing suicide in India","authors":"H. Gupta","doi":"10.4103/cmrp.cmrp_62_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_62_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91332536","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}
Hepatocellular carcinoma (HCC) is the eighth-most frequent cause of cancer mortality in India. The staging system most often used for treatment decisions in India is the Barcelona clinic liver cancer (BCLC) system. However, this staging system is often criticised for several reasons, such as heterogeneity of patient prognosis in each BCLC stage, limited guidance on expanding the role of liver transplantation (LT), no recommendation on combination therapies, no guidance on downstaging and limited treatment options for late presenters (stages C or D). Hence, we propose a simplified five-step algorithm for making treatment decisions for HCC patients in India. This algorithm incorporates evidence-based treatment allocations based on the step-by-step assessment of major prognostic and treatment-related parameters. The five steps of the algorithm are – Step 1: assessment of performance status, Step 2: assessment of extrahepatic spread and macrovascular invasion, Step 3: assessment for living donor LT, Step 4: assessment for the eligibility of liver resection and Step 5: assessment for appropriate locoregional therapy. Each of these steps does not require any separate investigations, and the initial workup for the diagnosis of HCC (dynamic computed tomography/magnetic resonance imaging and routine laboratory tests) would suffice in this five-step algorithm. We hope that this algorithm will not only simplify the management approach to HCC patients in India, but also it will bring uniformity in the treatment protocol for HCC in India.
{"title":"A proposed five-step simplified algorithm for the management of hepatocellular carcinoma in India","authors":"A. Arora, A. Singal, Praveen Sharma, Ashish Kumar","doi":"10.4103/cmrp.cmrp_69_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_69_22","url":null,"abstract":"Hepatocellular carcinoma (HCC) is the eighth-most frequent cause of cancer mortality in India. The staging system most often used for treatment decisions in India is the Barcelona clinic liver cancer (BCLC) system. However, this staging system is often criticised for several reasons, such as heterogeneity of patient prognosis in each BCLC stage, limited guidance on expanding the role of liver transplantation (LT), no recommendation on combination therapies, no guidance on downstaging and limited treatment options for late presenters (stages C or D). Hence, we propose a simplified five-step algorithm for making treatment decisions for HCC patients in India. This algorithm incorporates evidence-based treatment allocations based on the step-by-step assessment of major prognostic and treatment-related parameters. The five steps of the algorithm are – Step 1: assessment of performance status, Step 2: assessment of extrahepatic spread and macrovascular invasion, Step 3: assessment for living donor LT, Step 4: assessment for the eligibility of liver resection and Step 5: assessment for appropriate locoregional therapy. Each of these steps does not require any separate investigations, and the initial workup for the diagnosis of HCC (dynamic computed tomography/magnetic resonance imaging and routine laboratory tests) would suffice in this five-step algorithm. We hope that this algorithm will not only simplify the management approach to HCC patients in India, but also it will bring uniformity in the treatment protocol for HCC in India.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79179738","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: Preeclampsia (PE) is a disorder of pregnancy with a worldwide prevalence of about 5-8% and 4.6% in India. It is the second leading cause of direct maternal and foetal adverse outcomes, resulting in about 50,000-60,000 deaths annually worldwide. Cortisol is a stress hormone, that suppresses the immune system and inhibits the production of pro-inflammatory substances to reduce inflammation. During pregnancy cortisol levels raise to three-fold of nonpregnant level by the third trimester, it is due to changes in HPA axis regulation, raised oestrogen levels and raised maternal CRH levels through placental secretion. Aims: The objective of this study is to evaluate the cortisol (CORT)-to-highly sensitive C-reactive protein (HS-CRP) ratio and glucocorticoid receptor resistance (GCR) in early pregnancy to understand the pathophysiology of pre-eclampsia (PE) and to test whether these parameters have a role in the prediction of PE. CO + RT: HS-CRP ratio evaluates the interrelationship between the hypothalamic–pituitary–adrenal axis (HPA-axis) and the inflammatory response system. It is a new concept and an integrated approach to understand the pathophysiology of PE. Materials and Methods: In this prospective case–control study, we recruited 250 healthy pregnant women at 11–14 weeks of pregnancy and followed them. Those who developed PE after the 20th week according to the American College of Obstetricians and Gynecologists guidelines were considered study participants and the remaining served as controls. CORT was estimated through the ELISA method and HS-CRP was measured by autoanalyser through the turbidimetric method. The CORT-to-HS-CRP ratio was calculated manually. GCR was measured indirectly through leucocytes subsets, neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-monocyte ratio (NMR); individual leucocytes were obtained from complete blood counts. Data were analysed using the SPSS version 20, Pearson's correlation test was used to correlate the results and receiver operator characteristic (ROC) was used to test the predictive capacity of parameters. Results: Low CORT: HS-CRP was associated with PE, having a significance of P < 0.00, but it did not show any specificity and sensitivity under ROC. NLR and NMR were elevated in cases who developed PE, especially NMR with P < 0.008. NMR showed good specificity and sensitivity under ROC with the area under curve 0.74, cutoff value is 23. Conclusion: Low CORT: HS-CRP ratio has an association with PE, the uncontrolled inflammation during early pregnancy in pregnant women who were destined to develop PE. This is due to low-CORT secretion due to dysregulation of the HPA-axis. GCR also has an association with PE, but it was not fully clarified. HS-CRP and NMR can be used to screen in early pregnancy for the prediction of PE.
{"title":"Evaluation of maternal cortisol-to-highly sensitive C-reactive protein ratio and glucocorticoid receptor resistance at 11–14 weeks of pregnancy to predict pre-eclampsia","authors":"K. Jhansi, J. Harsoda","doi":"10.4103/cmrp.cmrp_46_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_46_22","url":null,"abstract":"Background: Preeclampsia (PE) is a disorder of pregnancy with a worldwide prevalence of about 5-8% and 4.6% in India. It is the second leading cause of direct maternal and foetal adverse outcomes, resulting in about 50,000-60,000 deaths annually worldwide. Cortisol is a stress hormone, that suppresses the immune system and inhibits the production of pro-inflammatory substances to reduce inflammation. During pregnancy cortisol levels raise to three-fold of nonpregnant level by the third trimester, it is due to changes in HPA axis regulation, raised oestrogen levels and raised maternal CRH levels through placental secretion. Aims: The objective of this study is to evaluate the cortisol (CORT)-to-highly sensitive C-reactive protein (HS-CRP) ratio and glucocorticoid receptor resistance (GCR) in early pregnancy to understand the pathophysiology of pre-eclampsia (PE) and to test whether these parameters have a role in the prediction of PE. CO + RT: HS-CRP ratio evaluates the interrelationship between the hypothalamic–pituitary–adrenal axis (HPA-axis) and the inflammatory response system. It is a new concept and an integrated approach to understand the pathophysiology of PE. Materials and Methods: In this prospective case–control study, we recruited 250 healthy pregnant women at 11–14 weeks of pregnancy and followed them. Those who developed PE after the 20th week according to the American College of Obstetricians and Gynecologists guidelines were considered study participants and the remaining served as controls. CORT was estimated through the ELISA method and HS-CRP was measured by autoanalyser through the turbidimetric method. The CORT-to-HS-CRP ratio was calculated manually. GCR was measured indirectly through leucocytes subsets, neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-monocyte ratio (NMR); individual leucocytes were obtained from complete blood counts. Data were analysed using the SPSS version 20, Pearson's correlation test was used to correlate the results and receiver operator characteristic (ROC) was used to test the predictive capacity of parameters. Results: Low CORT: HS-CRP was associated with PE, having a significance of P < 0.00, but it did not show any specificity and sensitivity under ROC. NLR and NMR were elevated in cases who developed PE, especially NMR with P < 0.008. NMR showed good specificity and sensitivity under ROC with the area under curve 0.74, cutoff value is 23. Conclusion: Low CORT: HS-CRP ratio has an association with PE, the uncontrolled inflammation during early pregnancy in pregnant women who were destined to develop PE. This is due to low-CORT secretion due to dysregulation of the HPA-axis. GCR also has an association with PE, but it was not fully clarified. HS-CRP and NMR can be used to screen in early pregnancy for the prediction of PE.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80309444","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 : 2022-09-01DOI: 10.4103/cmrp.cmrp_123_21
Abdul Rauf, S. Thekkudan, N. Mampilly, A. Vijayan
Systemic lupus erythematosus (SLE) is a multisystemic and chronic autoimmune disease with varying clinical manifestations. The role of various infectious agents in triggering the disease onset in genetically predisposed patients has been implicated in the pathogenesis of SLE. The severe acute respiratory syndrome coronavirus 2 has been reported to trigger various autoimmune diseases including SLE in few adults. Herein, we report the case of a previously well 12-year-old girl who presented with warm antibody Coombs-positive autoimmune haemolytic anaemia, 3 weeks after testing positive for COVID-19. COVID IgG antibody test was positive. During the hospital stay, she developed multisystem involvement in the form of neurological manifestations and arthritis. She was managed with steroids, intravenous (IV) immunoglobulins and supportive measures. Her anti-nuclear antibody and anti-dsDNA antibodies were positive and complement levels were low, confirming a diagnosis of SLE. Her clinical condition improved rapidly and remained neurologically normal, and serial haemoglobin showed an improving trend. IV steroids were changed to oral form, and hydroxychloroquine was also added. She remained well on 3-week follow-up.
{"title":"Childhood-onset systemic lupus erythematosus, probably triggered by severe acute respiratory syndrome coronavirus 2 infection, presenting with autoimmune haemolytic anaemia","authors":"Abdul Rauf, S. Thekkudan, N. Mampilly, A. Vijayan","doi":"10.4103/cmrp.cmrp_123_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_123_21","url":null,"abstract":"Systemic lupus erythematosus (SLE) is a multisystemic and chronic autoimmune disease with varying clinical manifestations. The role of various infectious agents in triggering the disease onset in genetically predisposed patients has been implicated in the pathogenesis of SLE. The severe acute respiratory syndrome coronavirus 2 has been reported to trigger various autoimmune diseases including SLE in few adults. Herein, we report the case of a previously well 12-year-old girl who presented with warm antibody Coombs-positive autoimmune haemolytic anaemia, 3 weeks after testing positive for COVID-19. COVID IgG antibody test was positive. During the hospital stay, she developed multisystem involvement in the form of neurological manifestations and arthritis. She was managed with steroids, intravenous (IV) immunoglobulins and supportive measures. Her anti-nuclear antibody and anti-dsDNA antibodies were positive and complement levels were low, confirming a diagnosis of SLE. Her clinical condition improved rapidly and remained neurologically normal, and serial haemoglobin showed an improving trend. IV steroids were changed to oral form, and hydroxychloroquine was also added. She remained well on 3-week follow-up.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91202698","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}
Neurofibroma is a benign peripheral nerve sheath tumour usually present on superficial tissues of the head and trunk. Retroperitoneal location is extremely rare for neurofibroma and comprises only 1% of all retroperitoneal tumours. It can be solitary or associated with the genetic disorder, von Recklinghausen's disease or neurofibromatosis type-1. Magnetic resonance imaging (MRI) is the gold standard modality for imaging retroperitoneal tumours because it provides a better definition and specificity in the evaluation of the location, extension, and composition of the lesion. Here, we report the case of a 30-year-old man affected by retroperitoneal solitary neurofibroma of the psoas muscle, but not associated with von Recklinghausen's disease. MRI showed a well-defined lobulated retroperitoneal lesion noted within the right psoas muscle. Complete surgical excision of the tumour was performed, and the diagnosis of neurofibroma was made through histological and immunohistochemical examination.
{"title":"Solitary neurofibroma of the psoas muscle: An unusual location","authors":"C. Chaturvedi, H. Chaturvedi","doi":"10.4103/cmrp.cmrp_32_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_32_22","url":null,"abstract":"Neurofibroma is a benign peripheral nerve sheath tumour usually present on superficial tissues of the head and trunk. Retroperitoneal location is extremely rare for neurofibroma and comprises only 1% of all retroperitoneal tumours. It can be solitary or associated with the genetic disorder, von Recklinghausen's disease or neurofibromatosis type-1. Magnetic resonance imaging (MRI) is the gold standard modality for imaging retroperitoneal tumours because it provides a better definition and specificity in the evaluation of the location, extension, and composition of the lesion. Here, we report the case of a 30-year-old man affected by retroperitoneal solitary neurofibroma of the psoas muscle, but not associated with von Recklinghausen's disease. MRI showed a well-defined lobulated retroperitoneal lesion noted within the right psoas muscle. Complete surgical excision of the tumour was performed, and the diagnosis of neurofibroma was made through histological and immunohistochemical examination.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85073196","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}
S. Bhargava, A. Manocha, M. Kankra, P. Singla, Anisha K. Sharma, Rashmirasi Datta
Hypertension remains one of the most significant causes of mortality, affecting more than 1 billion people worldwide. It is a significant public health concern and a major risk factor for renal disease, heart failure, stroke, coronary artery disease and peripheral vascular disease. In more than 90% of hypertensive patients, the cause of blood pressure elevation is unknown. Therefore, early diagnosis and timely interventions are crucial to prevent complications. Over the last four decades, various blood biomarkers have been identified, which can help in understanding the cause of the underlying processes involved in the onset, development and progression of hypertension (HT). It is our attempt, in this review, to suggest a more robust use of circulating biomarkers that may prove to be beneficial in better elucidating the pathophysiology, development, progression and therapeutic efficacy in the management of HT.
{"title":"The laboratory and hypertension - Novel approach for diagnosis and management","authors":"S. Bhargava, A. Manocha, M. Kankra, P. Singla, Anisha K. Sharma, Rashmirasi Datta","doi":"10.4103/cmrp.cmrp_65_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_65_22","url":null,"abstract":"Hypertension remains one of the most significant causes of mortality, affecting more than 1 billion people worldwide. It is a significant public health concern and a major risk factor for renal disease, heart failure, stroke, coronary artery disease and peripheral vascular disease. In more than 90% of hypertensive patients, the cause of blood pressure elevation is unknown. Therefore, early diagnosis and timely interventions are crucial to prevent complications. Over the last four decades, various blood biomarkers have been identified, which can help in understanding the cause of the underlying processes involved in the onset, development and progression of hypertension (HT). It is our attempt, in this review, to suggest a more robust use of circulating biomarkers that may prove to be beneficial in better elucidating the pathophysiology, development, progression and therapeutic efficacy in the management of HT.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82960349","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":"Granulomatosis with polyangiitis presenting with strawberry gingivitis","authors":"A. Kakar, S. Kakar, S. Tripathi:","doi":"10.4103/cmrp.cmrp_95_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_95_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78382071","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":"Busting the myth: Has there been desensitising corporatisation of the Indian private health-care sector?","authors":"Ashish Kakar, S. Kakar, S. Tripathi:","doi":"10.4103/cmrp.cmrp_93_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_93_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76336621","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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