Pub Date : 2022-12-31DOI: 10.23937/2572-3286.1510079
Alferes Daniela, de Faria VitÓria Paes, Sousa Clemente, Teles Paulo, Almeida Clara, Ventura Ana
Introduction: The benefits of dialysis in the octogenarian are dubious. This study aimed to investigate whether initiation of chronic hemodialysis (HD) changes the rate and duration of hospitalizations in a Portuguese cohort of octogenarian patients. Material and methods: A single-centre, retrospective, observational study was performed. Patients aged ≥ 80 years who initiated HD in a Portuguese Central Hospital between January 2007 and December 2017 were screened for inclusion. Hospitalizations in the 2-year period before HD initiation were compared to the first 2 years after starting HD. McNemar and Wilcoxon signed rank test were used. Results: A total of 88 patients were included, with a mean age of 84 ± 2.8 years. Nearly all the patients (97.7%) had one or more comorbid conditions. In 60.2% of the patients the functional activity was normal (Karnofsky score ≥ 80). Hemodialysis was initiated in an emergency situation in 58% of the patients and the majority (59.1%) had an arteriovenous fistula as vascular access. In the pre-HD period, most patients (54.5%) had at least one hospitalization (min = 1; max = 4). After HD started, the number of hospitalizations decreased ( p = 0.034) and only 39.8% of the patients required hospital admission (min = 1; max = 3), with shorter average hospital stay ( p = 0.013). Conclusion: The number and length of hospitalizations did not increase with the beginning of HD
{"title":"Hospitalizations in Octogenarian Patients with End-Stage Renal Disease: What Changes after Beginning of Hemodialysis?","authors":"Alferes Daniela, de Faria VitÓria Paes, Sousa Clemente, Teles Paulo, Almeida Clara, Ventura Ana","doi":"10.23937/2572-3286.1510079","DOIUrl":"https://doi.org/10.23937/2572-3286.1510079","url":null,"abstract":"Introduction: The benefits of dialysis in the octogenarian are dubious. This study aimed to investigate whether initiation of chronic hemodialysis (HD) changes the rate and duration of hospitalizations in a Portuguese cohort of octogenarian patients. Material and methods: A single-centre, retrospective, observational study was performed. Patients aged ≥ 80 years who initiated HD in a Portuguese Central Hospital between January 2007 and December 2017 were screened for inclusion. Hospitalizations in the 2-year period before HD initiation were compared to the first 2 years after starting HD. McNemar and Wilcoxon signed rank test were used. Results: A total of 88 patients were included, with a mean age of 84 ± 2.8 years. Nearly all the patients (97.7%) had one or more comorbid conditions. In 60.2% of the patients the functional activity was normal (Karnofsky score ≥ 80). Hemodialysis was initiated in an emergency situation in 58% of the patients and the majority (59.1%) had an arteriovenous fistula as vascular access. In the pre-HD period, most patients (54.5%) had at least one hospitalization (min = 1; max = 4). After HD started, the number of hospitalizations decreased ( p = 0.034) and only 39.8% of the patients required hospital admission (min = 1; max = 3), with shorter average hospital stay ( p = 0.013). Conclusion: The number and length of hospitalizations did not increase with the beginning of HD","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45601262","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: Children with a solitary kidney are at risk of developing hypertension due to decreased nephron number with a consequence of hyperfiltration of the remnant. In patients with high-risk conditions, ambulatory blood pressure monitoring (ABPM), which records blood pressure (BP) for 24 hours, is helpful in detecting hypertension. Objectives: To investigate the prevalence of hypertension in children with solitary kidney using 24-h ABPM and comparing with the office blood pressure (OBP). Methods: Twenty-three patients aged 5-18 years-old were enrolled. Demographic, anthropometric and biochemical data were collected. OBP measurement with sphygmomanometer was recorded at the out-patient clinic, and patients were given a 24-h ABPM automatically records BP every 20 minutes during the day and every 30 minutes at night. Results: Mean age of the subjects was 9.5 ± 3.9 years-old. Eleven patients (47.8%) were diagnosed with hypertension using 24-h ABPM, while only 6 patients (26.1%) were hypertensive using OBP measurement. Among 11 hypertensive patients in the ABPM group, 63.6% are considered to have masked hypertension. Subgroup analysis showed that obese had mean systolic BP load higher than non-obese, 48.1 ± 22.3% and 28.1 ± 17.3% respectively. in children with solitary kidney is seen more often if based on ABPM than on OBP measurement. Using 24-h ABPM in a high-risk group should be implemented in out-patient settings to early detect hypertension.
背景:孤立肾患儿由于残肾的高滤过导致肾单位数量减少，有发生高血压的危险。对于高危患者，动态血压监测(ABPM)，记录血压(BP) 24小时，有助于发现高血压。目的:探讨孤立肾儿童高血压的患病率，并与办公室血压(OBP)进行比较。方法:选取23例5 ~ 18岁的患者。收集了人口统计学、人体测量学和生化数据。门诊记录血压计测血压，给予患者24 h ABPM，白天每20分钟自动记录血压，夜间每30分钟自动记录血压。结果:患者平均年龄9.5±3.9岁。24 h ABPM诊断为高血压11例(47.8%)，OBP诊断为高血压6例(26.1%)。ABPM组11例高血压患者中，63.6%被认为有隐匿性高血压。亚组分析显示，肥胖患者的平均收缩压负荷高于非肥胖患者，分别为48.1±22.3%和28.1±17.3%。单纯性肾脏病患儿的ABPM比OBP更常见。高危人群应在门诊实施24小时血压监测，以早期发现高血压。
{"title":"Ambulatory Blood Pressure Monitoring in Children with Solitary Kidney","authors":"Sirisomboonlarp Kanjaporn, Chanakul Ankanee, Deekajorndech Tawatchai","doi":"10.23937/2572-3286.1510071","DOIUrl":"https://doi.org/10.23937/2572-3286.1510071","url":null,"abstract":"Background: Children with a solitary kidney are at risk of developing hypertension due to decreased nephron number with a consequence of hyperfiltration of the remnant. In patients with high-risk conditions, ambulatory blood pressure monitoring (ABPM), which records blood pressure (BP) for 24 hours, is helpful in detecting hypertension. Objectives: To investigate the prevalence of hypertension in children with solitary kidney using 24-h ABPM and comparing with the office blood pressure (OBP). Methods: Twenty-three patients aged 5-18 years-old were enrolled. Demographic, anthropometric and biochemical data were collected. OBP measurement with sphygmomanometer was recorded at the out-patient clinic, and patients were given a 24-h ABPM automatically records BP every 20 minutes during the day and every 30 minutes at night. Results: Mean age of the subjects was 9.5 ± 3.9 years-old. Eleven patients (47.8%) were diagnosed with hypertension using 24-h ABPM, while only 6 patients (26.1%) were hypertensive using OBP measurement. Among 11 hypertensive patients in the ABPM group, 63.6% are considered to have masked hypertension. Subgroup analysis showed that obese had mean systolic BP load higher than non-obese, 48.1 ± 22.3% and 28.1 ± 17.3% respectively. in children with solitary kidney is seen more often if based on ABPM than on OBP measurement. Using 24-h ABPM in a high-risk group should be implemented in out-patient settings to early detect hypertension.","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44292682","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 : 2022-03-17DOI: 10.23937/2572-3286.1510069
Servais Abigail M, Langewisch Eric D, Westphal Scott G, Miles Clifford D
{"title":"Safety and Efficacy of Patiromer in Kidney and Liver Transplant Recipients","authors":"Servais Abigail M, Langewisch Eric D, Westphal Scott G, Miles Clifford D","doi":"10.23937/2572-3286.1510069","DOIUrl":"https://doi.org/10.23937/2572-3286.1510069","url":null,"abstract":"","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43507459","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 : 2022-01-01DOI: 10.23937/2572-3286.1510075
Khemiri Souhir, Masmoudi Sonda, Mezghanni Sonda, Kridis Wala Ben, H. Adnène, K. Afef
Purpose: Urinary tract infection (UTI) is one of the most common infections in patients with cancer. It may occur at different phases of the disease and results from the interaction of several factors. The objective of our study was to determinate the particularities of these infection in this special population. Patients and Methods: Retrospective study including all patients followed for solid tumor in the medical oncology who had developed at least one episode of UTI documented between 2017 and 2019. Results: Forty-six patients were collected: 24 women and 22 men. The median age was 57 years. A history of diabetes and urolithiasis were found in 23.9% and 19.6% of cases respectively. The site of the primary tumor waspelvic in 30 cases (65.3%), including 17 bladder tumors, and extra-pelvic in the other cases. Ten patients (21.7%) had recurrent episodes of UI during their follow-up, including 8 cases of bladder tumors. Urinary catheters was used in ten cases. All the patients had received at least one line of chemotherapy. The majority of UTIs (82.6%) occurred during cycles of chemotherapy, 26% of which were associated with febrile neutropenia. The most common bacteria was Escherichia coli (58.6%) which was resistant to cefotaxime and ciprofloxacin in 25% and 39.3% of cases respectively. Seven patients (15%) presented polymicrobial UTIs. The urine contained at least one multi-resistant germs in 26.1% of cases more frequently in pelvic tumors then extra-pelvic tumors (36.2% versus 6.2%; p = 0.035), in the presence of urinary catheter (70% versus 13.9% in the absence of catheter; p = 0.001) and during chemotherapy (35.7% versus 6.2% apart from chemotherapy; p = 0.02), the UTI was complicated of bacteremia in 6 cases (13%), four of which were undergoing chemotherapy and three were associated with febrile neutropenia, resulting in one case in septic shock and death. Conclusion: It seems necessary, following this study, to implement recommendations for treatment and prevention of UTIs in solid tumors. They must be particularly adapted to the level of risk incurred by the different risk factors.
{"title":"Urinary Tract Infections in Patients with Solid Tumors: Retrospective Study","authors":"Khemiri Souhir, Masmoudi Sonda, Mezghanni Sonda, Kridis Wala Ben, H. Adnène, K. Afef","doi":"10.23937/2572-3286.1510075","DOIUrl":"https://doi.org/10.23937/2572-3286.1510075","url":null,"abstract":"Purpose: Urinary tract infection (UTI) is one of the most common infections in patients with cancer. It may occur at different phases of the disease and results from the interaction of several factors. The objective of our study was to determinate the particularities of these infection in this special population. Patients and Methods: Retrospective study including all patients followed for solid tumor in the medical oncology who had developed at least one episode of UTI documented between 2017 and 2019. Results: Forty-six patients were collected: 24 women and 22 men. The median age was 57 years. A history of diabetes and urolithiasis were found in 23.9% and 19.6% of cases respectively. The site of the primary tumor waspelvic in 30 cases (65.3%), including 17 bladder tumors, and extra-pelvic in the other cases. Ten patients (21.7%) had recurrent episodes of UI during their follow-up, including 8 cases of bladder tumors. Urinary catheters was used in ten cases. All the patients had received at least one line of chemotherapy. The majority of UTIs (82.6%) occurred during cycles of chemotherapy, 26% of which were associated with febrile neutropenia. The most common bacteria was Escherichia coli (58.6%) which was resistant to cefotaxime and ciprofloxacin in 25% and 39.3% of cases respectively. Seven patients (15%) presented polymicrobial UTIs. The urine contained at least one multi-resistant germs in 26.1% of cases more frequently in pelvic tumors then extra-pelvic tumors (36.2% versus 6.2%; p = 0.035), in the presence of urinary catheter (70% versus 13.9% in the absence of catheter; p = 0.001) and during chemotherapy (35.7% versus 6.2% apart from chemotherapy; p = 0.02), the UTI was complicated of bacteremia in 6 cases (13%), four of which were undergoing chemotherapy and three were associated with febrile neutropenia, resulting in one case in septic shock and death. Conclusion: It seems necessary, following this study, to implement recommendations for treatment and prevention of UTIs in solid tumors. They must be particularly adapted to the level of risk incurred by the different risk factors.","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68754487","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 : 2022-01-01DOI: 10.23937/2572-3286.1510076
Cassandro Raiani Feu, Gonçalves Mirela Dias, Filetti Filipe Martinuzo
Renal failure is a chronic disease of complex treatment and has a great impact on people’s quality of life. Pregnancy in women on renal replacement therapy is considered high risk, requiring specific care to promote adequate treatment and improvement in maternal and fetal outcomes. This study consists in evidencing the effects of the increase of hemodialysis sessions on the health of pregnant women with Chronic Renal Insufficiency. The profile is based on women between 18 and 44 years of childbearing age. To this end, it seeks to identify the profile of women who become pregnant on dialysis treatment and outcomes. This is an integrative review, with selection of articles from the Virtual Health Library and the PUBMED from the last five years on the subject. The results show that increasing from four to six weekly hemodialysis sessions was related to decreased maternal-fetal mortality risks, and increasing gestational length from 31 to 34 weeks reduced rates of preterm births. The studies reviewed provide evidence of the benefit of increased hemodialysis sessions in dialysis pregnant women, reducing complications and improving the quality of life of the pregnant woman and the child.
{"title":"Increased Hemodialysis Sessions during Pregnancy Improve Fetal Development and Reduce Mortality: Literature Review","authors":"Cassandro Raiani Feu, Gonçalves Mirela Dias, Filetti Filipe Martinuzo","doi":"10.23937/2572-3286.1510076","DOIUrl":"https://doi.org/10.23937/2572-3286.1510076","url":null,"abstract":"Renal failure is a chronic disease of complex treatment and has a great impact on people’s quality of life. Pregnancy in women on renal replacement therapy is considered high risk, requiring specific care to promote adequate treatment and improvement in maternal and fetal outcomes. This study consists in evidencing the effects of the increase of hemodialysis sessions on the health of pregnant women with Chronic Renal Insufficiency. The profile is based on women between 18 and 44 years of childbearing age. To this end, it seeks to identify the profile of women who become pregnant on dialysis treatment and outcomes. This is an integrative review, with selection of articles from the Virtual Health Library and the PUBMED from the last five years on the subject. The results show that increasing from four to six weekly hemodialysis sessions was related to decreased maternal-fetal mortality risks, and increasing gestational length from 31 to 34 weeks reduced rates of preterm births. The studies reviewed provide evidence of the benefit of increased hemodialysis sessions in dialysis pregnant women, reducing complications and improving the quality of life of the pregnant woman and the child.","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68754504","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 : 2022-01-01DOI: 10.23937/2572-3286.1510073
Axenciuc Rostislav, Sai Igor, Bondarenko Anatoliy, Kopcha Vasyl, Metersky Kateryna
The study aim was to study the histological picture of damaged kidneys in patients who died from COVID-19, as well as to attempt to find the objective causes of renal pathology at COVID-19. Kidney damage in this disease is still considered mainly secondary and associated with multiple organ failure, hypoxia, ischemia, disseminated intravascular coagulation (DIC) at severe and extremely severe disease. At the same time, it was found that the initial clinical and laboratory signs of renal pathology (in the form of an increase in the level of creatinine and urea in the blood, the presence of proteinuria, cylindruria in the form of granular cylinders, and then oliguria) coincide with time (by 5-7 -10-12 days of the disease) and are in a parallel progress with lung damage or coronavirus “pneumonia”, which, both pathogenetically and clinically, is initially interstitial, and then alveolar hemorrhagic pulmonary edema (as in influenza lung disease). A characteristic feature of this “pneumonia” (pulmonary edema) and kidney damage is their “deferred” and gradual, rather slow, but steady development. Based on the study of macro- and microscopic preparations of damaged kidneys, the conclusion is that with COVID-19 this lesion with an outcome of acute total nephronecrosis of a direct combined viral-drug cytotoxic the epithelium, manifests itself total nephronecrosis, and clinically, as a form of acute renal failure, usually with a lethal outcome.
{"title":"Pathomorphology of Kidney Damage in Covid-19: Possible Etiological Factors","authors":"Axenciuc Rostislav, Sai Igor, Bondarenko Anatoliy, Kopcha Vasyl, Metersky Kateryna","doi":"10.23937/2572-3286.1510073","DOIUrl":"https://doi.org/10.23937/2572-3286.1510073","url":null,"abstract":"The study aim was to study the histological picture of damaged kidneys in patients who died from COVID-19, as well as to attempt to find the objective causes of renal pathology at COVID-19. Kidney damage in this disease is still considered mainly secondary and associated with multiple organ failure, hypoxia, ischemia, disseminated intravascular coagulation (DIC) at severe and extremely severe disease. At the same time, it was found that the initial clinical and laboratory signs of renal pathology (in the form of an increase in the level of creatinine and urea in the blood, the presence of proteinuria, cylindruria in the form of granular cylinders, and then oliguria) coincide with time (by 5-7 -10-12 days of the disease) and are in a parallel progress with lung damage or coronavirus “pneumonia”, which, both pathogenetically and clinically, is initially interstitial, and then alveolar hemorrhagic pulmonary edema (as in influenza lung disease). A characteristic feature of this “pneumonia” (pulmonary edema) and kidney damage is their “deferred” and gradual, rather slow, but steady development. Based on the study of macro- and microscopic preparations of damaged kidneys, the conclusion is that with COVID-19 this lesion with an outcome of acute total nephronecrosis of a direct combined viral-drug cytotoxic the epithelium, manifests itself total nephronecrosis, and clinically, as a form of acute renal failure, usually with a lethal outcome.","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68754301","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 : 2022-01-01DOI: 10.23937/2572-3286.1510074
Omer Haider, Alhomrany Abdulmalik
Aim: This study aimed to determine the frequency of renal involvement following snake envenomation and the risk factors that contribute to the development of such complications. Methods: This retrospective study was carried out at Asir Central Hospital, a tertiary and referral hospital located in the southern part of Saudi Arabia. Results: Overall, 134 cases of snakebite were identified during the 5-year period of 2015–2019. These included 100 male and 34 female patients, with a mean age of 30 ± 19 y. Hematuria and mild proteinuria were observed in 19.7% and 39.4% cases, respectively. Acute kidney injury (AKI) occurred in 17 cases (12.7%) and supportive renal replacement therapy was required in 4 cases. The cause of renal failure was based mainly on clinical ground with 6 cases due to pre-renal (volume loss due to bleeding) and 10 due to tubulo-interstitial lesions; one case presented with heavy proteinuria and hematuria, and glomerulonephritis was suspected. Full recovery occurred in 15 cases (88.2%), while a partial recovery with permanent damage was observed in 2 cases (11.8%) after follow-up for 24 months. Older age, duration of symptoms before treatment initiated (for instance, late presentation to the hospital), and abnormal coagulation in the form of disseminated intravascular coagulation (DIC) carry higher risk factors for the development of acute kidney injures (AKI ). Conclusions: In this study, AKI occurred in 12.7% victims of snakebite. Hemodialysis and supportive treatment appear to be the mainstay of the therapy in cases complicated with renal failure.
{"title":"Renal Involvement following Snake Bite Envenomation","authors":"Omer Haider, Alhomrany Abdulmalik","doi":"10.23937/2572-3286.1510074","DOIUrl":"https://doi.org/10.23937/2572-3286.1510074","url":null,"abstract":"Aim: This study aimed to determine the frequency of renal involvement following snake envenomation and the risk factors that contribute to the development of such complications. Methods: This retrospective study was carried out at Asir Central Hospital, a tertiary and referral hospital located in the southern part of Saudi Arabia. Results: Overall, 134 cases of snakebite were identified during the 5-year period of 2015–2019. These included 100 male and 34 female patients, with a mean age of 30 ± 19 y. Hematuria and mild proteinuria were observed in 19.7% and 39.4% cases, respectively. Acute kidney injury (AKI) occurred in 17 cases (12.7%) and supportive renal replacement therapy was required in 4 cases. The cause of renal failure was based mainly on clinical ground with 6 cases due to pre-renal (volume loss due to bleeding) and 10 due to tubulo-interstitial lesions; one case presented with heavy proteinuria and hematuria, and glomerulonephritis was suspected. Full recovery occurred in 15 cases (88.2%), while a partial recovery with permanent damage was observed in 2 cases (11.8%) after follow-up for 24 months. Older age, duration of symptoms before treatment initiated (for instance, late presentation to the hospital), and abnormal coagulation in the form of disseminated intravascular coagulation (DIC) carry higher risk factors for the development of acute kidney injures (AKI ). Conclusions: In this study, AKI occurred in 12.7% victims of snakebite. Hemodialysis and supportive treatment appear to be the mainstay of the therapy in cases complicated with renal failure.","PeriodicalId":73669,"journal":{"name":"Journal of clinical nephrology and renal care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68754439","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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