Journal of medical cases最新文献

{"title":"Intraoperative Neuromuscular Monitoring: Electromyography Monitor Versus Peripheral Nerve Stimulator. Does the Face Lie?","authors":"Edison E Villalobos, Stephania Paredes Padilla, Sorin J Brull, Joseph D Tobias","doi":"10.14740/jmc5267","DOIUrl":"10.14740/jmc5267","url":null,"abstract":"<p><p>During intraoperative anesthetic care, the administration of neuromuscular blocking agents (NMBAs) may be required to facilitate endotracheal intubation or provide ongoing skeletal muscle relaxation during surgical procedures. Assessments of the train-of-four (TOF) responses may be used to judge the adequacy of block and the need for redosing of NMBAs. The TOF evaluation can be performed qualitatively, by manual palpation or visual evaluation of the twitch response, or quantitatively, by using devices that measure the amplitude of the twitches. As an operator-dependent technique, qualitative techniques are prone to error, particularly in pediatric patients, and are not sensitive enough to detect a clinically significant TOF fade, which may increase the risk of postoperative residual neuromuscular block. We present a pediatric case of intraoperative neuromuscular monitoring that demonstrates discrepancies between an electromyography (EMG)-based quantitative monitor and qualitative TOF assessments using a peripheral nerve stimulator. The different sensitivities between respiratory and peripheral muscles to NMBAs, as well as the difference between qualitative and quantitative TOF monitoring are discussed.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"163-169"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446747","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":"Spontaneous Onset of Postoperative Chilaiditi Syndrome: A Case Report and Its Potential Other Association?","authors":"Ridwan Hashi, Khaled Elmagraby, Hannah Faherty, Daniel Huntley, Mohamed H Ahmed","doi":"10.14740/jmc5249","DOIUrl":"10.14740/jmc5249","url":null,"abstract":"<p><p>Chilaiditi syndrome is characterized by the interposition of the colon between the liver and diaphragm, leading to various abdominal symptoms. Current literature explores the suspected etiology of this condition including diaphragmatic conditions such as phrenic injury or deficient peritoneal attachments that lead to laxity of suspensory ligaments or enlarged subdiaphragmatic space; however, there is considerable ambiguity in the contributing factors to the development of Chilaiditi syndrome due to its rarity. Furthermore, an association between Chilaiditi syndrome and psychiatric conditions has been found in the literature but the evidence base is limited due to paucity of cases. We present a case involving an 85-year-old female patient who was initially admitted with hip pain, later found to have a neck of femur fracture, and underwent hemiarthroplasty. The patient's past medical history was significant for depression, generalized anxiety disorder, pulmonary embolism, osteopenia, osteoarthritis, and a previous stroke. Postoperatively, the patient exhibited abdominal distention and absent bowel movements. A chest X-ray showed gas-filled loops in both hemidiaphragms, and computed tomography (CT) imaging identified the anterior interposition of bowel segments into the liver. The patient had been prescribed pregabalin as part of the treatment for her psychiatric conditions. Although no link has been established between the development of Chilaiditi syndrome and the use of pregabalin in current literature, it is worth noting that pregabalin's side effect profile includes gastrointestinal symptoms such as abdominal distention and constipation, similar to those seen in Chilaiditi syndrome. Further research is needed to assess the potential association between pregabalin and Chilaiditi syndrome. As well as considering pregabalin's possible contribution to the development of Chilaiditi syndrome, it is worth considering psychological conditions as a risk factor for development of Chilaiditi syndrome, independent of medications. There is an established link which already exists, but the reasons as to why this exists are yet to be cemented. Similarly, few cases of Chilaiditi syndrome developing in the perioperative setting have been reported, so this case is valuable in considering the role of anesthetics and postoperative analgesia in the development of this syndrome.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"153-156"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446759","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":"Successful Conservative Management of Complicated <i>Brucella</i> Endocarditis.","authors":"Mashael M Alhajri","doi":"10.14740/jmc5283","DOIUrl":"10.14740/jmc5283","url":null,"abstract":"<p><p><i>Brucella</i> endocarditis (BE) is a rare but life-threatening complication of brucellosis and remains the principal cause of disease-related mortality. Prosthetic-valve involvement is exceptionally uncommon and is usually managed with combined medical and surgical therapy because of the high risk of abscess formation and embolic complications. We report a 51-year-old man with a bioprosthetic aortic valve who presented with recurrent fever, weight loss, and acute neurological deficits following previously treated, culture-confirmed brucellosis related to consumption of unpasteurized goat milk. Diagnostic evaluation revealed an embolic ischemic stroke, prosthetic-valve vegetation complicated by a paravalvular aortic-root abscess, rising <i>Brucella melitensis</i> serological titers despite negative blood cultures, and concomitant brucellar spondylitis. A diagnosis of prosthetic-valve BE with systemic dissemination was established. Although urgent surgical intervention was recommended, the patient declined surgery and was treated conservatively with prolonged combination antimicrobial therapy. The outcome was favorable, with complete clinical recovery, significant neurological improvement, normalization of inflammatory markers, and complete echocardiographic resolution of vegetation and abscess while preserving ventricular function. This case supports the potential role of individualized conservative management in selected patients with complicated BE.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"176-182"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446758","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":"Perioperative Care of a Four-Year-Old Child With Teebi Hypertelorism Syndrome: A Rare Craniofacial Disorder.","authors":"Eslam Abdelhady, Joseph D Tobias","doi":"10.14740/jmc5268","DOIUrl":"10.14740/jmc5268","url":null,"abstract":"<p><p>Teebi hypertelorism syndrome (THS) is a rare, autosomal dominant craniofacial malformation disorder, characterized by orbital hypertelorism and characteristic craniofacial features, including a prominent forehead, wide arched eyebrows, short broad nasal root and tip, a thin upper lip, and a small chin. In addition to the characteristic phenotypic traits, systemic malformations may involve the limbs, central nervous system, urogenital tract, uterus, umbilicus (omphalocele), or cardiac system. Most cases can now be attributed to pathogenic variants in the <i>SPECC1L</i> gene on chromosome 22q11.23, leading to what is known as SPECC1L-related hypertelorism syndrome, which is associated with disruption of a cytoskeletal cross-linking protein. This protein is crucial for normal craniofacial morphogenesis during neural crest cell migration and midline facial formation. To date, there are no previous reports of anesthetic care in a patient with THS. We present a 4-year-old child with THS who presented for anesthetic care during thoracic laminectomy and excision of an intradural mass. We explore the history and clinical presentation of the disorder, outline end-organ involvement, and discuss perioperative concerns.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"141-145"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446656","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":"Extranodal Marginal Zone B-cell Lymphoma Presenting as a Painless Buccal Mass in the Masticator Space.","authors":"Li Lin, Jiun-Sheng Lin","doi":"10.14740/jmc5203","DOIUrl":"10.14740/jmc5203","url":null,"abstract":"<p><p>Extranodal marginal zone B-cell lymphoma (EMZL, mucosa-associated lymphoid tissue type) is an indolent non-Hodgkin lymphoma that only rarely arises in deep facial spaces. Primary masticator-space involvement is particularly uncommon and can mimic benign buccal soft-tissue lesions. We report a 67-year-old woman with a 4-year history of a painless, slowly enlarging left cheek mass. Examination showed a soft, mobile 3-cm buccal swelling with normal overlying skin and no intraoral lesion. Contrast-enhanced computed tomography demonstrated an infiltrative soft-tissue mass measuring 3.1 × 1.5 × 3.5 cm, centered in the left masticator space, with effacement of fat planes between the masseter, pterygoid, and temporalis muscles. Intraoral incisional biopsy revealed a dense infiltrate of small-to-medium CD20-positive, Bcl-2-positive B cells, with a CD5, CD10, CD23, Bcl-6-negative immunophenotype and follicular colonization on CD21 staining, consistent with EMZL. A multidisciplinary tumor board recommended involved-site radiotherapy to the masticator space combined with rituximab-based immunotherapy. This case represents a rare example of primary EMZL arising in the masticator space, which highlights the need to include lymphoma in the differential diagnosis of persistent head and neck masses, to obtain tissue diagnosis for infiltrative head and neck lesions and to coordinate organ-preserving treatment through multidisciplinary care.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"170-175"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446712","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":"High-Risk Chronic Lymphocytic Leukemia in a Young Adult Treated With Reduced-Dosage, Fixed-Duration Ibrutinib and Venetoclax.","authors":"Caryn Louise D Gutierrez, Anne Kristine H Quero-Taggaoa, Timothy Carl F Uy, Januario Antonio D Veloso","doi":"10.14740/jmc5237","DOIUrl":"10.14740/jmc5237","url":null,"abstract":"<p><p>Chronic lymphocytic leukemia (CLL) is a disease primarily of the elderly; however, in rare cases, it can occur among adolescents and young adults (AYAs). While evidence-based guidelines are established, the guidelines include elderly with very limited data among young adults. CLL in AYA is deemed as high-risk disease. They experience longer survival than their older age counterparts, but this longevity increases their susceptibility to secondary cancers, CLL-related complications, and treatment-related adverse events. Thus, effective treatment requires a careful balance of efficacy and safety. A 32-year-old female presented with multiple neck masses, night sweats, weight loss, and easy fatigability. Workup revealed bicytopenia (anemia and thrombocytopenia). A cervical lymph node biopsy was compatible with small lymphocytic lymphoma (SLL); however, bone marrow aspiration with biopsy was done and signed out as CLL. Due to overlapping immuno-morphologic features, and her age, B-cell acute lymphoblastic leukemia cannot be entirely ruled out. Further testing with flow cytometry for basic leukemia panel and histopathology with immunohistochemistry favored a diagnosis of CLL. She was started on a reduced-dosage, fixed-duration ibrutinib and venetoclax. Since treatment initiation, patient had significant symptom improvement and no longer require blood transfusion. The report emphasized the need for individualized therapy to enhance outcomes and quality of life in young CLL patients. It discussed a rare case of a young adult with CLL, highlighting its diagnostic challenges, treatment, and outcomes. A fixed-duration, lower-dose regimen of ibrutinib and venetoclax appears to be a promising, safe, and effective treatment for CLL in young adults.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"146-152"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446684","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":"Ruptured Uterine Leiomyosarcoma With Heterologous Components Including Osteosarcoma and Chondrosarcoma.","authors":"Takuma Hayashi, Yasuaki Amano, Ikuo Konishi","doi":"10.14740/jmc5266","DOIUrl":"10.14740/jmc5266","url":null,"abstract":"<p><p>Tumor rupture is a rare complication of uterine leiomyosarcoma. We report a case of ruptured uterine leiomyosarcoma diagnosed after the onset of abdominal pain following endoscopic examination of the lower gastrointestinal tract. The patient was a 56-year-old woman who was diagnosed with anemia at 48 years of age when she was first referred to our medical team. Contrast-enhanced magnetic resonance imaging (MRI) revealed a 48 × 50 mm mass in the anterior wall of the uterine body, which was diagnosed as a uterine fibroid. After 8 years of regular follow-up once or twice a year, the patient developed abdominal pain after undergoing lower gastrointestinal endoscopy, which was prompted by a positive fecal occult blood test result. Contrast-enhanced computed tomography (CT) showed that the uterine mass had enlarged to 90 × 69 mm. T2-weighted contrast-enhanced MRI demonstrated moderate signal intensity and restricted diffusion, whereas contrast-enhanced T1-weighted MRI revealed high signal intensity, suggestive of hemorrhage. The outlines of the tumor and uterus were interrupted cephalad to the lesion, raising the suspicion of rupture of a malignant uterine mesenchymal tumor. Therefore, total hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed. Intraoperatively, tumor rupture and adhesion of the ruptured tissue to the ileum were observed, necessitating partial ileectomy. Pathological examination of the resected specimen revealed irregularly proliferating spindle cells with marked nuclear atypia, 12 mitotic figures per 10 high-power fields, coagulative necrosis, and multinucleated giant cell infiltration. Another notable finding was the presence of ectopic osteosarcoma and chondrosarcoma.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 4","pages":"157-162"},"PeriodicalIF":0.5,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12978401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446778","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":"Nonsurgical Management of Cardiac Papillary Fibroelastoma on the Aortic Valve.","authors":"Yonis Hakim, Yousef Raslan Hakim, William Barker, Tariq Ahmad","doi":"10.14740/jmc5247","DOIUrl":"10.14740/jmc5247","url":null,"abstract":"<p><p>Papillary fibroelastomas are benign cardiac tumors that constitute the second most common cardiac tumors. Controversy exists in the management of papillary fibroelastoma. When to surgically manage the patient or use pharmaceutical therapy is not clear. There are studies that indicate that nonsurgical management might be associated with higher mortality and morbidity rates and more adverse events. There has not been a reported case of papillary fibroelastoma managed successfully with only anticoagulation. Clearer guidelines are needed for the management of papillary fibroelastoma, especially in cases where a patient is a poor surgical candidate or declines surgical intervention. In this case, a patient has been managed nonsurgically for 4 years and 7 months up to date. The patient is a 57-year-old female who presented to the emergency department with myocardial infarction symptoms. The myocardial infarction was thought to be secondary to an embolic event after a patent foramen ovale was identified on transthoracic echocardiogram or sequelae from arrhythmia. Cardionet ruled out arrhythmia, and patent foramen ovale closure workup revealed a 0.3-cm mobile papillary fibroelastoma. Surgical management was not pursued due to surgical risks and the patient's preference, and the patient was prescribed long-term apixaban. The patient was followed for 4 years and 7 months and experienced an episode of vaginal bleeding during this time. This case shows an example of when nonsurgical management can be pursued as the patient declined surgical intervention after benefits and risks were discussed. Also, this case shows the importance of considering the patient's bleeding risk, such as this patient's history of hematuria due to acute cystitis, miscarriages, and heparin-induced gingival hematoma while hospitalized, prior to initiating anticoagulation. Bleeding risk can be assessed using the HAS-BLED risk score or equivalent.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 2","pages":"70-74"},"PeriodicalIF":0.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109492","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":"Giant Left Atrial Pleomorphic Sarcoma With Echocardiographic Characteristics Mimicking a Myxoma.","authors":"Madeline Castella-Chin, Kayla Canteras, Christopher Cullom","doi":"10.14740/jmc5212","DOIUrl":"10.14740/jmc5212","url":null,"abstract":"<p><p>Primary cardiac tumors are rare. Cardiac tumors of substantial size may present in the perioperative setting urgently, bypassing conventional imaging, thus relying on echocardiography for characterization and operative guidance. We report a unique case of a 66-year-old female with a large left atrium mass, who presented with worsening dyspnea and fatigue, with biopsy suggesting a primary cardiac sarcoma. This case is unique, as approximately 70% of left atrial masses reported in the literature are cardiac myxomas, whereas the most common site in which cardiac sarcomas develop is the right atrium. In this particular case, the location of the left-sided sarcoma resulted in mitral valve and left ventricular outflow obstruction, as well as severe pulmonary hypertension, leading to complicated anesthetic induction during surgery. This rare case of a primary cardiac tumor highlights the sequelae of obstructive atrial masses, which potentially resulted in cardiovascular collapse with induction of anesthesia. It is especially unique for pathologic findings suggesting a cardiac sarcoma. This case provides an opportunity to discuss diagnostic challenges for patients with complex pathophysiology and contributes to the limited collection of literature on cardiac sarcomas located in the left atrium.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 2","pages":"41-47"},"PeriodicalIF":0.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109479","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":"Novel Utilization of Circulating Tumor DNA in Primary Dedifferentiated Seminal Vesicle Adenocarcinoma: A Case Report of Molecular Clearance Following Multimodal Therapy.","authors":"Kamil Malshy, Brendan J Guercio, Laena Hines, Sarah K Findeis, Philip A Sutera, Shawn W Thomas, Jean V Joseph","doi":"10.14740/jmc5238","DOIUrl":"10.14740/jmc5238","url":null,"abstract":"<p><p>Primary seminal vesicle adenocarcinoma (PSVA) is an exceptionally rare malignancy, with fewer than 100 cases reported worldwide and poses significant diagnostic and surveillance challenges due to its deep pelvic location, nonspecific clinical manifestations, frequent coexistence with other genitourinary malignancies, and lack of validated serum tumor markers. A 77-year-old male with long-standing lower urinary tract symptoms and mildly elevated prostate-specific antigen was found to have a large (7.4 cm) predominantly cystic pelvic mass replacing the left seminal vesicle on magnetic resonance imaging. Histologic evaluation revealed synchronous high-grade prostate adenocarcinoma and a distinct dedifferentiated carcinoma not arising from prostatic tissue. Comprehensive immunohistochemical analysis supported a diagnosis of PSVA. The patient underwent robotic-assisted radical prostatectomy with <i>en bloc</i> excision of the seminal vesicle mass, rectal repair, and ureteral reimplantation. Postoperatively, prostate-specific antigen remained undetectable; however, tumor-informed circulating tumor DNA (ctDNA) testing detected molecular residual disease. Following completion of radiotherapy, ctDNA became undetectable, and the patient has remained disease-free at nearly 1 year of follow-up. This case highlights the importance of comprehensive imaging, detailed immunohistochemical profiling, and aggressive multimodal management in PSVA, and represents the first documented report of molecular clearance using ctDNA after treatment for this rare malignancy. While causal inference cannot be established from a single case, this report suggests that ctDNA may serve as a promising adjunctive tool for postoperative surveillance in rare urologic cancers lacking reliable serum biomarkers.</p>","PeriodicalId":101328,"journal":{"name":"Journal of medical cases","volume":"17 2","pages":"62-69"},"PeriodicalIF":0.9,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12861512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146109527","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}