Emergency Radiology最新文献

{"title":"Impact of virtual monoenergetic images on the assessability of lower extremity arteries in (Poly-) trauma photon-counting detector CT.","authors":"Daniel Dillinger, Christian Bauer, Hanns L Kaatsch, Achim Neufang, Achim Hagen, Stephan Waldeck, Daniel Overhoff","doi":"10.1007/s10140-026-02502-1","DOIUrl":"10.1007/s10140-026-02502-1","url":null,"abstract":"<p><strong>Background: </strong>Computed tomography (CT) is state of the art imaging modality in patients after severe trauma. A double-bolus contrast media protocol can be used to combine both arterial and parenchymal contrast in one scan. In case of lower extremity trauma, the CT scans can be extended to include the legs in order to rule out vascular pathologies. Virtual monoenergetic (VME) images derived from a Photon-Counting detector CT (PCDCT) proved to be helpful in vascular diagnostics and could therefore also add information in these extended trauma scans. Aim of this study was to determine the VME reconstructions with sufficient vascular contrast (> 200 Hounsfield Units) and to examine, which VME level has best specificity and sensitivity as well as best subjective vascular visibility.</p><p><strong>Methods: </strong>In a retrospective analysis, we identified 34 patients undergoing extended whole-body trauma scans including lower extremities on a PCDCT with pathologies of the lower extremity arteries (extravasation, dissection etc.) and paired them with 34 patients without vascular pathologies. We measured CT values and noise of six vascular segments on energy levels 40 to 190 keV and calculated signal to noise (SNR) and contrast to noise (CNR) ratio. Subjective ratings for vascular visibility were performed on a five point Likert scale and two readers analyzed the images for vascular lesions across four energy levels (40, 70, 90 and 110 keV).</p><p><strong>Results: </strong>CT attenuation was measured above 200 HU below 88 keV in the common femoral artery, below 86 keV in the superficial femoral artery and below 85 keV in the popliteal artery. For the tibial arteries, we found higher CT values above 200 HU at the energy levels below 87 keV. Noise was highest at 40 keV for all energy levels, SNR and CNR for common femoral artery was highest at 40 keV. Sensitivity peaked at 40 keV (78.4%) and showed decreasing values for higher energy levels. Specificity increased with higher keV levels up to 91.7%. 40 keV showed the highest sum of Likert ratings regarding vascular visibility.</p><p><strong>Conclusion: </strong>PCDCT derived VME reconstructions below 86 keV showed sufficient vascular contrast in extended whole-body trauma scans after double-bolus contrast media administration. Smaller vessel depiction can be hampered by increased noise on lower energy levels resulting in decreased image parameters. Lower energy levels have the potential to improve the detection of vascular pathologies, such as bleeding and vascular occlusions.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"981-990"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257936","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":"A rare case of fatal delayed aortic rupture caused by repeated microtrauma from a posterior rib fracture.","authors":"Shintaro Isa, Homare Kaga, Ryohei Kuroda, Atsushi Yamada, Shuuji Namiki, Yoto Oh, Yohsuke Makino, Toshitaka Yoshii, Kana Unuma","doi":"10.1007/s10140-026-02524-9","DOIUrl":"10.1007/s10140-026-02524-9","url":null,"abstract":"<p><p>Sharp bone fragments can cause damage to major blood vessels or internal organs during the subacute or chronic phases, even if such bone fracture itself does not immediately affect hemodynamics or the patient's condition. Herein, we report a fatal case of delayed aortic rupture in which the anatomically significant relationship between a posterior 8th rib fracture and descending aortic injury was initially overlooked. The patient initially appeared hemodynamically stable under conservative management for fall-related injuries; however, he suddenly collapsed on hospitalization day 10 and subsequently died. Autopsy revealed a full-thickness perforation of the descending thoracic aorta due to the sharp edge of the fractured rib. Retrospective review of premortem computed tomography demonstrated that the rib fracture fragment was extremely close to the aortic wall; however, this finding did not receive sufficient clinical attention. Histologically, the aorta exhibited partially organized adventitial injury, providing objective evidence of repeated premortem contact between the rib fragment and the aortic wall. These findings strongly support delayed traumatic aortic rupture secondary to rib fracture, rather than spontaneous vascular disease. Posterior left lower rib fractures can precipitate delayed and fatal aortic injury. Following initial screening for life-threatening conditions, rib fractures are often managed conservatively, with only pain control and respiratory support. However, posterior left lower rib fractures may warrant consideration for surgical intervention, both for emergent and even prophylactic purposes. This case provides unique pathological and clinical insights into a rare but lethal complication of blunt thoracic trauma, expanding current understanding of delayed aortic injury due to posterior rib fractures.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1255-1263"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600214","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":"Imaging of anorectal and perineal emergencies - a multimodality review.","authors":"Parv Mehta, Sriram Jaganathan, Sree Harsha Tirumani, Arpit Nagar, Devendra Kumar, Vijayanadh Ojili","doi":"10.1007/s10140-026-02509-8","DOIUrl":"10.1007/s10140-026-02509-8","url":null,"abstract":"<p><p>Acute anorectal and perineal emergencies encompass a wide spectrum of infectious, inflammatory, traumatic, iatrogenic, and neoplastic conditions that often present with nonspecific symptoms but may rapidly progress to significant morbidity if unrecognized. Imaging plays a central role in diagnosis, assessment of disease extent, detection of complications, and treatment planning because clinical examination frequently underestimates involvement of the complex anorectal and perineal spaces. Computed tomography (CT) is the primary imaging modality in the emergency setting owing to its rapid acquisition and ability to detect abscesses, perforation, hemorrhage, extraluminal gas, and deep pelvic extension, whereas magnetic resonance imaging (MRI) provides superior soft-tissue characterization for evaluation of fistulas, sphincteric involvement, and complex inflammatory disease. This review provides an overview of the pertinent anorectal and perineal anatomy, imaging evaluation strategies, and characteristic multimodality imaging features of common anorectal and perineal emergencies. Particular emphasis is placed on key imaging findings, including rim-enhancing abscesses and fistulous tracts, soft-tissue gas with fascial extension in necrotizing infections, bowel wall thickening and perirectal inflammatory changes in proctocolitis, and the presence of extraluminal air or fluid collections associated with rectal perforation and retained foreign bodies. The review also highlights the value of a compartment-based approach in accurately delineating disease extent and guiding clinical management.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1143-1158"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316267","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":"Subarachnoid contrast staining not attributable to endovascular therapy.","authors":"Saumya Gurbani, Joshua Volin, Taylor Smith, Aline Camargo, Jaydevsinh Dolia, Ranliang Hu, Dan Cohen-Addad","doi":"10.1007/s10140-026-02543-6","DOIUrl":"10.1007/s10140-026-02543-6","url":null,"abstract":"<p><p>Contrast staining within the brain refers to the leakage of iodinated contrast material through a disrupted blood-brain barrier, often in the setting of ischemia and endovascular intervention, which can mimic hemorrhage. While commonly seen within the parenchyma, it can be seen in the subarachnoid space especially after endovascular intervention. In the absence of endovascular intervention, subarachnoid hyperdensities on CT are typically presumed to be hemorrhage. However, in rare causes of trauma and stroke, subarachnoid contrast staining can be seen even in the absence of intervention. In this pictorial review, we present cases of patients with subarachnoid hyperdensities on CT which were subsequently confirmed to represent subarachnoid contrast staining. Awareness of this rare phenomenon is important for radiologists, particularly in the emergency setting, as it can have important clinical management and follow-up implications.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1249-1254"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929325","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":"Hantavirus infection in emergency radiology: Imaging manifestations, pathophysiology, and infection control considerations.","authors":"Platon Braun, Jonathan Lee, Eric D Cyphers, Ali Gholamrezanezhad","doi":"10.1007/s10140-026-02499-7","DOIUrl":"10.1007/s10140-026-02499-7","url":null,"abstract":"<p><p>In April 2026, several cases of severe respiratory illnesses were reported aboard the cruise ship MV Hondius during its voyage from Argentina. Subsequent laboratory testing identified Andes virus (ANDV), a hantavirus subtype, with rare but documented human-to-human transmission. Although hantavirus infections are uncommon, both hantavirus pulmonary syndrome (HPS) and hemorrhagic fever with renal syndrome (HFRS) are associated with substantial morbidity and mortality. Their rapid progression and potential need for intensive respiratory support continue to pose important challenges for emergency departments, intensive care units, and radiology services. Because pulmonary imaging findings often evolve quickly, radiologists play a critical role in early recognition and triage. This review provides an overview of the pathophysiology, imaging manifestations, and operational considerations relevant to hantavirus infection in emergency radiology practice.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1135-1141"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293771","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 computed tomography may miss main pancreatic duct injury in distal pancreatic trauma: a prospective surgically verified diagnostic accuracy study.","authors":"Phan Minh Tri, Nguyen The Hung, Do Huu Liet, Nguyen Tri Dung, Vo Minh Dat, Pham Le An","doi":"10.1007/s10140-026-02504-z","DOIUrl":"10.1007/s10140-026-02504-z","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the diagnostic performance of computed tomography (CT) for predicting main pancreatic duct injury in surgically explored patients with distal pancreatic trauma.</p><p><strong>Methods: </strong>We conducted a prospective single-center diagnostic accuracy study from August 2024 to March 2026. Consecutive patients with distal pancreatic trauma underwent contrast-enhanced abdominal CT before surgery. On CT, main pancreatic duct injury was defined by either a deep pancreatic parenchymal laceration involving at least 50% of pancreatic thickness or complete pancreatic transection. CT findings were compared with intraoperative assessment as the reference standard.</p><p><strong>Results: </strong>Forty-two patients were included; 39 (92.9%) had intraoperatively confirmed main pancreatic duct injury. CT correctly classified 37 patients (36 true positives and 1 true negative), with 3 false-negative and 2 false-positive results. Sensitivity, positive predictive value, specificity, negative predictive value, and overall accuracy were 92.3% (95% CI: 79.1-98.4%), 94.7% (95% CI: 82.3-99.4%), 33.3% (95% CI: 0.8-90.6%), 25.0% (95% CI: 0.6-80.6%), and 88.1% (95% CI: 73.6-96.5%), respectively. All false-negative results occurred after early CT, performed 3-7 h after trauma. No clear pancreatic laceration was seen on the initial scan, but the injuries became more apparent on repeat CT.</p><p><strong>Conclusion: </strong>In surgically explored patients with distal pancreatic trauma, CT criteria based on a deep parenchymal laceration involving at least 50% of gland thickness or complete transection showed high sensitivity for predicting main pancreatic duct injury. However, specificity and negative predictive value were imprecise because very few duct-intact patients underwent surgical verification. All diagnostic estimates should therefore be interpreted in the context of selection and partial verification bias. Early CT can miss duct injury, and repeat CT should be considered when clinical suspicion remains high.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"999-1006"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270783","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":"CT oral contrast and contemporary imaging pathways for suspected oesophageal perforation in the emergency department: a retrospective observational study.","authors":"Samyak Shah, Adil Zia, Bruno Di Muzio","doi":"10.1007/s10140-026-02532-9","DOIUrl":"10.1007/s10140-026-02532-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate contemporary computed tomography (CT) imaging pathways for Emergency Department (ED) patients with suspected oesophageal perforation or leak, with a particular focus on oral contrast utilisation, radiologic findings and downstream investigations following the index CT examination.</p><p><strong>Methods: </strong>We performed a single-centre retrospective observational study of all adult ED patients who underwent CT imaging including the chest for suspected oesophageal perforation or leak between January 2015 and March 2026. Patients were identified through radiology database search. Demographics, clinical indications, oral contrast use, radiologic findings and investigations performed within five days of the index CT were recorded.</p><p><strong>Results: </strong>A total of 107 patients were included, with six (5.6%) confirmed oesophageal perforations. Oral contrast was administered in 62 (57.9%) CT examinations. Overall, 45 patients (42.1%) underwent downstream investigations, with similar rates regardless of oral contrast administration (43.5% vs. 40.0%). However, repeat CT was less frequent following oral contrast-enhanced CT (3.2% vs. 17.8%). Among patients with confirmed perforation, direct signs including oesophageal wall defect and extraluminal contrast leak were common (66.7% each), whilst indirect signs were also frequent present, including pneumomediastinum and pleural effusion (83.3% each). Pneumomediastinum was also frequently observed in patients without perforation.</p><p><strong>Conclusion: </strong>Rates of downstream investigation were similar regardless of oral contrast administration, however, repeat CT was less frequently performed following oral contrast-enhanced examinations. These findings suggest that oral contrast may influence subsequent imaging pathways. Prospective studies are warranted to determine whether selective oral contrast administration can improve diagnostic confidence while reducing unnecessary CT examinations.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1047-1056"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757642","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":"Hepatic abscess on CT: pearls, pitfalls and diagnostic challenges.","authors":"Zahra F Rahmatullah, Hajra Arshad, Linda C Chu, Satomi Kawamoto, Elliot K Fishman","doi":"10.1007/s10140-026-02516-9","DOIUrl":"10.1007/s10140-026-02516-9","url":null,"abstract":"<p><p>Hepatic abscess (HA) poses a diagnostic challenge worldwide, with up to around 80% of cases initially missed in emergency settings. This can be attributed to their clinical and imaging appearance varying considerably depending on the underlying pathogen and abscess type. Computed tomography (CT) remains the primary imaging modality for evaluation, and this pictorial essay highlights the characteristic imaging features of the subtypes of HA which include pyogenic, amebic, fungal, and hydatid infections. Key imaging findings discussed include the cluster sign and double target sign in pyogenic abscesses, the solitary right subcapsular morphology of amebic abscesses, the disseminated microabscess pattern of fungal infections in immunocompromised hosts, and the daughter cysts with peripheral calcifications characteristic of hydatid disease. Furthermore, HA has neoplastic mimickers which can demonstrate similar imaging characteristics. The diagnosis is further complicated as patients with known malignancies or surgical intervention are prone to developing HA. This pictorial review highlights the key imaging features that enable radiologists to recognize HA on CT in emergency settings and differentiate it from its most clinically significant mimics.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1209-1217"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148445069","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":"From order to image: reducing CT order to exam start time through targeted quality improvement in the ED.","authors":"Obert Xu, Morgan Black, Bryanna De Lima, Keith Cross, Louis Riccelli, Sheven Thorson, Melinda Hartenstein, Steven McGaughey, John Organick-Lee, Skyler Kieran, Beech Burns","doi":"10.1007/s10140-026-02528-5","DOIUrl":"10.1007/s10140-026-02528-5","url":null,"abstract":"<p><strong>Purpose: </strong>Our Emergency Department (ED), like many others in the US, experiences chronic congestion, slow flow, and long wait times - all of which have notably worsened in recent years. For many of our patients, computed tomography (CT) turnaround time is a key determinant of ED flow, yet strategies to reduce preacquisition delays remain under-described. Our objective was to reduce CT order-to-exam start time by 25% through iterative quality improvement (QI) workflow interventions.</p><p><strong>Methods: </strong>This single-center QI study was conducted in the adult ED of a metropolitan academic hospital from January 2024 through March 2026 using the Plan-Do-Study-Act (PDSA) framework. A one-year baseline preceded four PDSA cycles targeting different aspects of the process. The primary outcome was median CT order-to-exam start time.</p><p><strong>Results: </strong>This study included 30,865 patients. Median CT order-to-exam start time decreased from 59 to 46 min, a 22% reduction (p < 0.001). ED arrival-to-disposition order time decreased from 335 to 315 min (p < 0.001). Median daily CT volume increased from 43 to 46 exams (p < 0.001), with no significant change in new hemodialysis diagnoses (0.0% vs. 0.1%, p = 0.30) or post-CT acute kidney injury (3.0% vs. 2.8%, p = 0.42).</p><p><strong>Conclusion: </strong>Four sequential, low-cost workflow interventions addressing pre-imaging laboratory practices and real-time CT readiness signaling significantly reduced CT order-to-exam start time in an academic ED. Meaningful improvements were achieved by redesigning preacquisition workflows and creating visible escalation structures. These practical strategies may help other institutions shorten the time to imaging and support timely disposition.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1017-1028"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683780","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":"Imaging suspected posterior circulation stroke in the emergency department: a practical modality-based review.","authors":"Allison Peng, Mahsa Mayeli, Julian Sison, Charles Wira, Dhasakumar Navaratnam, Jason Johnson, Long H Tu","doi":"10.1007/s10140-026-02518-7","DOIUrl":"10.1007/s10140-026-02518-7","url":null,"abstract":"<p><p>Posterior circulation stroke (PCS) accounts for 20-25% of ischemic strokes and is disproportionately missed at first presentation. This review summarizes brain parenchymal and neurovascular imaging modalities for the evaluation of suspected PCS in the emergency department (ED). We conducted a structured narrative review of established and emerging modalities, describing each modality's technical principles, clinical roles, performance estimates, evidence base, limitations, and real-world application. Searches emphasized ED populations and posterior fossa infarction; society guidelines and meta-analyses were prioritized. Non-contrast CT is insensitive for acute PCS (reported 16-44%) but remains essential for excluding hemorrhage. CT angiography is roughly 80% sensitive for vertebrobasilar occlusion in selected cohorts and ~ 44% sensitive for PCS overall. CT perfusion adds incremental sensitivity (around 70-75%). MRI with diffusion-weighted imaging is ~ 80% sensitive in pooled estimates; high-resolution DWI may approach 90-95% in single-center series. Emerging modalities - dual-energy CT (41-88% sensitive), portable low-field MRI (estimated 69% sensitive), and accelerated or abbreviated MRI (likely 80-95% sensitive) - are at varying stages of adoption. Performance metrics of emerging modalities derive from small, single-center cohorts with probable spectrum bias. Evaluation of the brain parenchyma and vasculature represent distinct clinical questions, for which dedicated imaging may be required. Accurate diagnosis of PCS requires careful selection and, often, a combination of imaging modalities tailored to the clinical question and local resources.</p>","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1177-1192"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520200","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}