Journal of the Egyptian Society of Cardio-Thoracic Surgery最新文献

{"title":"Influence of the caliber in Endoscopic Saphenous Vein Harvesting during Coronary Artery Bypass Grafting","authors":"Ibrahim M. Yassin ,&nbsp;Farouk M. Oueida ,&nbsp;Azza A. Zidan ,&nbsp;Mustafa AlRefaei ,&nbsp;Khaled A. Eskandar","doi":"10.1016/j.jescts.2018.03.002","DOIUrl":"10.1016/j.jescts.2018.03.002","url":null,"abstract":"<div><h3>Background</h3><p>The required high degree of technical expertise is much more with the small caliber saphenous vein (SV) grafts using Endoscopic Saphenous Vein Harvesting (ESVH) during CABG Surgery and the patency may be affected. We thought to compare these small caliber vein grafted patients (GroupI) regarding their operative difficulties and mid-term graft patency with a controlled normal caliber grafted patients (groupII).</p></div><div><h3>Methods</h3><p>Retrospective data collection was from June 2013 to June 2016 in a consecutive order after exclusion of the first 50 patients done in our center. A cutoff point of 3 mm diameter of the SV was identified. GroupI (&lt;3 mm) (34patients) was compared to GroupII (&gt;3 mm) (100patients). ESVH procedure time and SV characteristics were compared between the groups and the incidence of perioperative myocardial infarction as well as the Myocardial Perfusion Imaging (MPI) for the mid-term patency rate. Patients who had been commented as having clinical varicosity and those who refused the (MPI) evaluation during the follow up period were excluded.</p></div><div><h3>Results</h3><p>Significant difference in the number of side branches and repaired small avulsed branches (GroupI vs. GroupII)(11.7 ± 4.8 vs. 9.7 ± 3.4) (P &lt; 0.01) and (5.7 ± 1.7 vs. 1.7 ± 0.9) (p = 0.001) respectively. SV harvested required a longer time (min.) for total preparation (54.5 ± 14.8 vs. 39.9 ± 13.9 min) (p &lt; 0.001) whereas the time required for endoscopy did not differ. The overall incidence of peri-operative myocardial infarction was (2.2%) with no significance between both groups. Normal/Mild ischemia in the territory of the venous graft (s) occurred in (88.2% vs. 91%) after a follow up period of (15.3 ± 7.9 m) that was non significant.</p></div><div><h3>Conclusions</h3><p>ESVH is feasible regardless the SV caliber with good mid-term patency rate in CABG patients. Small caliber SV needs longer time and more experience to be ready for usage but its quality can be better. The possibility of scoring the SV is difficult to be completely achieved except in the Operating Theater.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 110-117"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90137728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early management of deep sternal wound infections using omental flaps","authors":"Ashraf Zahra ,&nbsp;Hosam F. Sayed ,&nbsp;Mohamed Abd El-Hafez Fouly ,&nbsp;Mahmoud Ghalwash","doi":"10.1016/j.jescts.2018.02.001","DOIUrl":"10.1016/j.jescts.2018.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Deep sternal wound infections (DSWI) are a grave complication that occurs in 0.3%–5% of post-sternotomy patients. In the meantime, there is no consensus over the most appropriate surgical management for sternal wound infections, following open heart surgery. In this retrospective study, we aimed to evaluate the early versus late use of omental-flaps for DSWI and mediastinitis.</p></div><div><h3>Methods</h3><p>This retrospective study included patients with DSWI following open cardiac surgeries with variable risk factors, degrees of infection and timing of management. The omental-flap was obtained from the greater omentum and transposed into the pleural cavity through a diaphragmatic incision.</p></div><div><h3>Results</h3><p>Out of the 15 enrolled patients, seven (46.6%) were diabetics and eight (53.3%) had chronic obstructive pulmonary disease. The severe form of mediastinitis occurred with gram-negative infections due to endotoxemia, as well as with resistant infections as methicillin-resistant staph aureus. Eleven patients had a primary omental-flap coverage after debridement (group I), while the other four underwent sternal rewiring, followed by omental-flap coverage (group II). Only three patients (27.2%) in group I died post-operatively, compared to four patients (100%) in group II. Among group I patients, eight had an early omental-flap coverage (IA), while three had a late coverage (IB). Only two patients died after early management, while five out of the seven (71.4%) patients (groups IB and II) died.</p></div><div><h3>Conclusions</h3><p>Early management of mediastinitis through omental-flaps has a better prognosis than rewiring. This should include a high index of clinical suspicion and a close post-operative follow-up of clinical manifestations.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 141-145"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.02.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86066847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Shone complex: A case report and literature review","authors":"Jaffar S. Shehatha ,&nbsp;Abdulsalam Yaseen Taha ,&nbsp;Aram J. Mirza","doi":"10.1016/j.jescts.2018.03.007","DOIUrl":"10.1016/j.jescts.2018.03.007","url":null,"abstract":"<div><p>Shone complex is a very rare congenital heart disease made of coarctation of aorta, parachute mitral valve, supravalvular mitral ring and subaortic stenosis. Since its first description by Shone et al., in 1963, literature comes from isolated case reports mainly in children. Herein, a 33-year old lady with Shone complex is presented. She had had repair of coarctation of aorta at the age of 5 and mitral valve replacement, resection of subaortic membrane and left venricular myectomy at the age of 33. Surgery of Shone complex is expected to yield good outcome if undertaken before the onset of pulmonary hypertension.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 133-135"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91394395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the role of bedside ultrasonography in the detection of traumatic occult pneumothorax","authors":"Heba Ezzat ,&nbsp;Mohamed Elkahwagy ,&nbsp;Mohamed Eltomey ,&nbsp;Mohab Sabry","doi":"10.1016/j.jescts.2018.04.004","DOIUrl":"10.1016/j.jescts.2018.04.004","url":null,"abstract":"<div><h3>Background</h3><p>Primary management of pneumothorax is usually as simple as it can be done by junior physician. But diagnosis of pneumothorax is sometimes as difficult as it can be missed by senior physician and lead to serious complications that may endanger the patient's life.</p></div><div><h3>Methods</h3><p>This study was conducted on 80 polytraumatized adult patients, within the same day of trauma. They presented to the Emergency Department, Tanta University, Egypt with chest trauma in the period between October 2016 to the end of January 2018. All patients were subjected to chest X-ray either erect position when possible or supine position revealing no pneumothorax. Subsequently, all of those patients underwent thoracic ultrasonography prior to whole body CT scanning performed within 2 h of admission.</p></div><div><h3>Results</h3><p>Ultrasonography detected pneumothorax in 56 out of 62 patients having occult pneumothorax with sensitivity up to 90.32% and positive predictive value of 96.55%. On the other hand, ultrasonography succeeded in exclusion of occult pneumothorax in 16 out of 18 patients that were free of occult pneumothorax in their CT with specificity reaching 88.89% and negative predictive value of 72.73%, the overall accuracy was calculated to be 90%.</p></div><div><h3>Conclusions</h3><p>Bedside thoracic ultrasonography is a simple, rapid and reliable tool with high sensitivity, specificity and accuracy that can be depend on for diagnosis of occult pneumothorax in chest trauma patients.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 146-150"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75565677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term results of mitral valve repair of posterior or bileaflet prolapse with two different concepts","authors":"Ibrahim M. Yassin ,&nbsp;Farouk M. Oueida ,&nbsp;Mustafa Al Refaei ,&nbsp;Khalid A. Eskander","doi":"10.1016/j.jescts.2018.03.001","DOIUrl":"10.1016/j.jescts.2018.03.001","url":null,"abstract":"<div><h3>Background</h3><p>To evaluate the long term results of two simple techniques for correction of posterior or bileaflet prolapse with no incidence of postoperative systolic anterior motion of the anterior mitral leaflet (SAM).</p></div><div><h3>Methods</h3><p>From June 2010 to June 2016, 64 patients underwent mitral valve repair. Edge to edge,(35 patients)(group A) Vs. (‘U’) technique, (29 patients) (group U). A mean follow-up of 58 ± 13 months in (group A) and 42 ± 16 months in (group U).</p></div><div><h3>Results</h3><p>There were no early or late deaths. Both surgical techniques showed excellent immediate postoperative results regarding reduction of the mitral regurgitation grade-accepted mean pressure gradients (MPG) through the mitral valve (2.3 ± 0.6). Left ventricular function was maintained, and tricuspid regurgitation grade was reduced overall. During the follow-up period, Significant increase in the MPG was observed in (group A) with no significant change in the degree of mitral regurge. The majority of them with significant increase are due to the rheumatic pathology(9/12). They became symptomatic and came out of the study after a follow up period of 41 ± 13 months and their valves were replaced while those with non rheumatic pathology remained of reasonable gradient. Redo mitral valve replacement was done in only one patient in (group U) due to early endocarditis.</p></div><div><h3>Conclusions</h3><p>Despite the rationale is completely different in both techniques (double orifice, double leaflet(A) versus Uni-leaflet, Uni-orifice(U)), the long-term results are comparable in both. The U technique is mostly better in rheumatic patients but need more follow up on larger scales of this patient group.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 118-126"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77684653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary clamping versus shunting during off pump CABG, early experience and outcome","authors":"Mahmoud Khairy","doi":"10.1016/j.jescts.2018.03.005","DOIUrl":"10.1016/j.jescts.2018.03.005","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was the evaluation of safety and outcome of temporal clamping of coronary artery in comparison to intraluminal coronary shunting, during distal anastomosis in off-pump coronary artery bypass grafting (CABG).</p></div><div><h3>Methods</h3><p>To evaluate the early outcome of coronary clamping, we randomly compared the results of 25 patients submitted to coronary clamping using microvascular clamps during off-pump CABG (group A), with the results of another 25 patients had traditional intraluminal coronary shunting during same procedure (group B). All patients proved to have coronary artery disease with no difference between the groups in preoperative clinical variables.</p></div><div><h3>Results</h3><p>Clamp group (A) had significant shorter operative time than shunt group (B); it was 224.2 ± 44.1 min in group (A) versus 250.4 ± 33.7 in group (B).</p><p>Our new coronary clamp was applied in (93%) of target vessels but coronary shunt was implanted in (96%) of target vessels during distal coronary anastomosis.</p><p>Clamp group (A) had low number of patients who required inotropic support (adrenaline &gt; 0.15 μg/kg/min) &gt; 24 Hours during perioperative period. The study showed two cases of mortality in both groups.</p><p>At 6 months follow up; no difference between both groups was found, but late postoperative ejection fraction in group (A) was better, when compared to group (B).</p></div><div><h3>Conclusions</h3><p>Temporal coronary clamping technique may be used as an applicable option to create a bloodless field during off-pump CABG surgery. It seems to be faster and cheaper than intraluminal shunting. Also, it has the same complications, mortality and ICU stay.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 95-99"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79543739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Femoral artery versus right axillary artery cannulation in various cardiac procedures, a single center experience: The quest for the holy grail","authors":"Ahmed El Kerdany,&nbsp;Mohammed Abd Al Jawad","doi":"10.1016/j.jescts.2018.03.006","DOIUrl":"10.1016/j.jescts.2018.03.006","url":null,"abstract":"<div><h3>Background</h3><p>There are many arterial cannulation sites to establish cardiopulmonary bypass (CPB). Each site has its advantages and disadvantages. Organ malperfusion especially the cerebral malperfusion during CPB is the most critical outcome in comparing different arterial sites. We aimed to evaluate safety and efficacy of axillary and femoral arterial cannulation in various situations.</p></div><div><h3>Methods</h3><p>This retrospective observational study, included 75 patients underwent redo valve surgery or denovo thoracic aorta surgery. Patients were reviewed in terms of organ malperfusion namely brain and kidney; and cannulation site related complications. Patients were divided into two groups Femoral group (n = 46) and Axillary group (n = 29).</p></div><div><h3>Results</h3><p>The mortality in the femoral group was 4.35%, while the axillary group showed a 3.45% mortality; without statistically significant difference. The axillary group had a significantly lower total hospital stay (p value 0.002), and highly significant lower ventilation hours (p value &lt; 0.001). Other post-operative complications were lower in the axillary groups, without reaching statistical significance.</p></div><div><h3>Conclusions</h3><p>Both axillary and femoral artery cannulation provide a safe quick route for establishing CBP support in critical conditions before opening the chest. The axillary route is more technically demanding while the femoral route is handier in such cases. Individual arterial cannulation strategy should be done for each patient with a backup plan.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 89-94"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79292642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous uniportal VATS right upper lobectomy with NUSS procedure for pectus excavatum repair; first reported uniportal combined lobectomy and Nuss operation","authors":"H. Elkhayat, Emad Zarief, M. Sallam, E. Mohamed, Ahmed Elminshawy","doi":"10.1016/J.JESCTS.2018.04.002","DOIUrl":"https://doi.org/10.1016/J.JESCTS.2018.04.002","url":null,"abstract":"","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83678363","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":"Tracheostomy for weaning prolonged mechanical ventilation in adult post cardiac surgical patients","authors":"Aly Makram Habib ,&nbsp;Makhlouf Belghith","doi":"10.1016/j.jescts.2018.03.004","DOIUrl":"10.1016/j.jescts.2018.03.004","url":null,"abstract":"<div><h3>Background</h3><p>This is a retrospective observational study to show the role of tracheostomy in liberation of mechanical ventilation in adult post cardiac surgery.</p></div><div><h3>Methods</h3><p>Between January 2009 and December 2013, all post cardiac surgical patients who were ventilated for ≥7 days were allocated into: group (T) who had tracheostomy or group (PI) who did not have tracheostomy. Both groups were compared for ventilator free days at 30 (VFD-30) and 60 days (VFD-60) post Cardiac Surgical Intensive Care Unit (CSICU) admission, Length of Stay (LOS), and mortality.</p></div><div><h3>Results</h3><p>VFD-30 and VFD-60 were statistically significant higher in (PI) group compared to (T) group (7.5 ± 9.2 vs.0.9 ± 3.3, P = 0.000) and (22.3 ± 23.8 vs. 6.7 ± 13.3, P = 0.007) respectively. Comparing VFD at 30 and 60 days post tracheostomy (VFD-30T and VFD-60T) in (T) group to VFD at 30 and 60 days after admission in (PI) group, no difference was found (6.9 ± 8.9 vs. 7.5 ± 9.2, P = 0.8) and (29 ± 22.6 vs. 22.3 ± 23.8, P = 0.5) respectively. CSICU LOS was statistically significant higher in the (T) group compared to the (PI) group (71.6 ± 61.2 vs. 30.3 ± 35.6, P = 0.04). The hospital LOS and CSICU mortality, were not different between the 2 groups.</p></div><div><h3>Conclusions</h3><p>Tracheostomy for post cardiac surgery patients with prolonged mechanical ventilation did not improve VFD or CSICU LOS in our institute.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 2","pages":"Pages 100-109"},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2018.03.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81628235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long term management of thoracic trauma in a high frequency trauma center; what have we learned?","authors":"Mohamed Abdel Bary ,&nbsp;Detlev Branscheid ,&nbsp;Fritz Mertzlufft ,&nbsp;Morris Beshay","doi":"10.1016/j.jescts.2017.12.004","DOIUrl":"10.1016/j.jescts.2017.12.004","url":null,"abstract":"<div><h3>Background</h3><p>One of the most frequently seen lethal causalities is the thoracic trauma (TT). We aim to distinguish risk factors affecting the outcome of TT to find the best way for its management.</p></div><div><h3>Methods</h3><p>Over a 12-year data were collected and retrospectively analyzed patients with TT. Two patients' groups were involved: Group I: patients managed between January 2003–December 2008. Group II: patients managed between January 2009–December 2014. Risk factors were analyzed.</p></div><div><h3>Results</h3><p>A total number of 630 thoracic trauma cases were admitted. Group I included 285 patients (197 males, their mean age 46 years). 345 patients were managed in Group II (251 males, their mean age 49 years). Higher thoracic trauma score (TTS), and higher abbreviated injury score (AIS thoracic) were associated with overall higher morbidity and mortality (p = .017). 94 (15%) of patients who had severe lung contusions showed a higher morbidity and mortality (p &lt; .001). 23 (8%) patients had emergency thoracotomy in group I versus 14 (4%) patients in group II (p = .041). Overall mortality was 12.5% with higher incidence in group I (p = .024). Overall morbidity was 52% (n = 331) with a higher incidence in group I (p = .039). More young patients (&lt;50 years) were frequently injured but showed fewer mortality rates (p = .014).</p></div><div><h3>Conclusions</h3><p>Optimal management is achievable in specialized centers under the supervision of an experienced thoracic surgeon. Early mobilization and repeated bronchoscopic examination resulted in a good outcome in most of the patients. Severe pulmonic injuries marked TTS and AIS thoracic scores, and also the age were independent prognostic factors for the outcome.</p></div>","PeriodicalId":100843,"journal":{"name":"Journal of the Egyptian Society of Cardio-Thoracic Surgery","volume":"26 1","pages":"Pages 73-81"},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.jescts.2017.12.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75894772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}