International Medical Case Reports Journal最新文献

{"title":"Challenges in Diagnosis and Management of Acute Limb Ischemia 30 Days Postpartum in Lithotomy Position: A Case Report from Somalia Leading to Bilateral Lower Limb Amputation.","authors":"Ubah Mumin Ali Osman, Halwo Bashir Adan, Hanan Hassan Hirei, Yahye Sheikh Abdulle Hassan","doi":"10.2147/IMCRJ.S478373","DOIUrl":"10.2147/IMCRJ.S478373","url":null,"abstract":"<p><p>Acute limb ischemia in postpartum women is a rare and severe vascular emergency that can lead to significant complications if not promptly diagnosed and managed. A 31-year-old woman, 30 days postpartum following uncomplicated vaginal delivery in the lithotomy position, presented with bilateral lower limb paralysis and paresthesia There was no history of trauma, falls, or use of assistive instruments during delivery. The patient weighed 65 kg and was 162 cm tall, while the infant had a birth weight of 2.8 kg. Initial suspicion of a neurological condition was later ruled out through imaging, including thoracolumbar MRI and CT angiography, which revealed bilateral arterial occlusions. Despite timely thromboembolectomy, the patient underwent bilateral below-knee amputation due to progressive ischemia. This case highlights the diagnostic challenges of acute limb ischemia in postpartum patients, stressing the crucial role of early imaging and prompt multidisciplinary intervention in preventing severe outcomes. Increased clinical vigilance and timely investigations are vital for improving prognosis and reducing the risk of limb loss.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"845-850"},"PeriodicalIF":0.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626302","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":"Surviving Unrepaired Tetralogy of Fallot to 43 Years in a Low-Resource Setting: The Oldest Reported Case from Somalia.","authors":"Abdirahman A Warfaa, Abdirahman Ibrahim Said, Mohamoud Abdulahi, Mohamed Said Hassan","doi":"10.2147/IMCRJ.S529873","DOIUrl":"10.2147/IMCRJ.S529873","url":null,"abstract":"<p><strong>Introduction: </strong>Tetralogy of Fallot (ToF) is a congenital heart defect characterized by a combination of four anomalies: right ventricular hypertrophy, ventricular septal defect (VSD), right ventricular outflow tract (RVOT) obstruction, and an overriding aorta. While surgical interventions have significantly improved the prognosis of ToF, cases of undiagnosed or untreated ToF in adulthood remain, particularly in low-resource settings. This report highlights the case of an adult patient with uncorrected ToF, underscoring the challenges individuals face in such environments.</p><p><strong>Case report: </strong>A 43-year-old male from Somalia presented with recurrent syncope, exertional dyspnea, and a history of congenital heart disease diagnosed in childhood. Due to financial constraints and limited healthcare access, he was unable to undergo surgery. On clinical examination, the patient exhibited cyanosis, grade 3 clubbing, and a pansystolic murmur. Investigations showed secondary polycythemia, right ventricular hypertrophy on ECG, and a large VSD with an overriding aorta. Echocardiography confirmed these findings, revealing the anatomical abnormalities typical of ToF.</p><p><strong>Discussion: </strong>Untreated ToF often leads to significant morbidity, including worsening cyanosis, syncope, and heart failure. In this case, delayed surgical intervention and lack of resources contributed to the progression of symptoms. The patient's case emphasizes the importance of early diagnosis and surgical repair, particularly in resource-limited settings where access to advanced care is limited.</p><p><strong>Conclusion: </strong>This case highlights the critical need for early intervention and improved healthcare access for individuals with congenital heart defects in low-income settings. Timely diagnosis, surgical repair, and ongoing care can substantially improve outcomes for patients with ToF.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"827-835"},"PeriodicalIF":0.7,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600362","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":"Infection Leading to Breast Abscess Formation in Pregnancy: A Case Report.","authors":"Jiangting Yu, Jiaying Chen, Tianjian Huang, Xidong Gu","doi":"10.2147/IMCRJ.S512859","DOIUrl":"10.2147/IMCRJ.S512859","url":null,"abstract":"<p><strong>Introduction: </strong>Breast abscess, the most severe complication of mastitis, occurs when an infection spreads through the nipple into the breast tissue, contaminating the milk ducts and forming a purulent cavity. Nonetheless, this condition is less common in pregnant women. <i>Staphylococcus aureus</i> is the predominant causative agent in lactating women; however, <i>Prevotella bivia</i>-associated breast abscesses during pregnancy remain clinically rare, with limited documented cases.</p><p><strong>Case presentation: </strong>A 26-year-old Chinese woman with G1P0 singleton at 33 weeks of pregnancy presented with right breast pain and lumps without obvious triggers, accompanied by enlarged right axillary lymph nodes and a large amount of pus with a peculiar odor in the right breast. After breast ultrasonography, cytological puncture smear, pus culture, and metagenomic next-generation sequencing, the patient was confirmed to have gestational mastitis with <i>P. bivia</i> infection. Given that the patient had a high-risk pregnancy, the use of antibiotics sensitive to <i>Prevotella</i>, such as metronidazole, might affect the intrauterine fetus, and infection with this bacterium could increase the risk of placental abruption and intrauterine fetal distress. Based on the obstetrician's and pediatrician's recommendations, the patient opted for a cesarean section at 37 weeks to facilitate the delivery of a healthy neonate weighing 3110 g (Apgar scores of 10 at 1 min and 5 min) in the left anterior sacral position and was advised to opt for lactation-suppressing medication and postpartum antibiotics.</p><p><strong>Conclusion: </strong>This case highlights the importance of close monitoring of pus characteristics (eg, color, odor, and volume) in pregnancy-associated breast abscesses to expedite the diagnosis of infectious mastitis and pathogen identification. Treatment with small incision drainage and targeted antibiotics during pregnancy significantly improved the outcomes. Postpartum breast milk return and combined antibiotic therapy further contributed to the resolution of inflammation.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"791-809"},"PeriodicalIF":0.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600361","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":"Pomeroy Sterilization in a Teen with Recurrent Pregnancy and Multiple Cesarean Deliveries: A Case Report.","authors":"Windi Nurdiawan, Aisyah Shofiatun Nisa, Hadi Susiarno, Dini Hidayat, Dini Pusianawati, Zulvayanti, Ayu Angelina Ronosulistyo, Putri Nadhira Adinda Adriansyah","doi":"10.2147/IMCRJ.S527311","DOIUrl":"10.2147/IMCRJ.S527311","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent teenage pregnancy refers to an adolescent experiencing more than one pregnancy before reaching full adulthood. Pomeroy sterilization in teenagers with a history of two cesarean sections presents a complex issue requiring careful consideration of medical, ethical, and social factors. This case highlights the appropriate management of adolescents in such situations.</p><p><strong>Case illustration: </strong>An 18-year-old woman, G3P2A0, at full-term pregnancy, presented for elective cesarean section. The patient had no complaints and exhibited no signs of labor at the time of admission. Laboratory findings revealed anemia, with a hemoglobin level of 7.2 g/dL. She received two units of packed red cell (PRC) transfusions preoperatively. A cesarean section was performed, delivering a healthy baby boy weighing 2720 grams and measuring 47 cm. After a thorough discussion and informed consent regarding contraceptive options, the patient and her husband opted for Pomeroy sterilization, as they felt their family was complete.</p><p><strong>Conclusion: </strong>Managing teenage pregnancy requires a holistic and cautious approach, especially in cases involving previous cesarean sections. Comprehensive care, including monitoring for complications such as anemia and fetal growth restriction, is essential for ensuring maternal and neonatal health. Furthermore, informed decision-making regarding contraception is vital to prevent recurrent pregnancies and support the psychosocial well-being of adolescent mothers. This approach helps achieve better outcomes for both mother and child.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"817-826"},"PeriodicalIF":0.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591224","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":"Retrograde Surgical Placement of a Thoracic Epidural Catheter in a Patient Undergoing Combined Thoracic and Spinal Surgery.","authors":"Vanessa B Davis, Mark Li, Flora Mian Li, Ryu Komatsu, Jiang Wu","doi":"10.2147/IMCRJ.S532166","DOIUrl":"10.2147/IMCRJ.S532166","url":null,"abstract":"<p><p>Epidural anesthetic techniques for postoperative analgesia are rarely considered in spinal surgery, and high thoracic epidural analgesia (TEA) is considered medically risky. We present a successful case of surgical retrograde placement of a thoracic (T6-T7) epidural catheter under direct surgical visualization via T2 laminectomy in a patient who underwent combined thoracotomy and spinal surgery. TEA was confirmed by epidurogram, provided adequate postoperative pain relief, and the patient was discharged home three days post-surgery.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"785-790"},"PeriodicalIF":0.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12233021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583893","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 Presentation of Isolated Persistent Left Superior Vena Cava with Absent Right Superior Vena Cava Manifesting as Heart Failure: A Case Report.","authors":"Said Abdirahman Ahmed, Osman Farah Dahir, Ahmed Elmi Abdi, Ahmed Shafie Adan, Ishak Ahmed Abdi, Mohamud Mire Waberi, Mohamed Abdullahi Mohamud, Abdullahi Mohamed Hassan Fujeyra, Abdijalil Abdullahi Ali, Mohammed A M Ahmed, Bakar Ali Adan Ali, Mohamed Sheikh Hassan, Feyza Aksu, Mahad Sadik Mukhtar, Ismail Gedi Ibrahim, Mohamed Omar Hassan","doi":"10.2147/IMCRJ.S525707","DOIUrl":"10.2147/IMCRJ.S525707","url":null,"abstract":"<p><strong>Background: </strong>Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is a rare congenital venous anomaly, typically asymptomatic and discovered incidentally. In rare cases, it may contribute to hemodynamic disturbances and arrhythmias, potentially leading to heart failure, especially when associated with other cardiac anomalies or conduction abnormalities.</p><p><strong>Case presentation: </strong>We report the case of a 45-year-old male who presented with progressive symptoms of heart failure, including dyspnea, fatigue, and reduced exercise tolerance. Initial workup revealed an unexplained dilated coronary sinus and reduced left ventricular function with dilated heart chambers. Further imaging with contrast-enhanced echocardiography and CT angiography confirmed the presence of a PLSVC draining into the coronary sinus with absence of right superior vena cava. No other congenital heart defects were identified like coronary sinus atrial septal defect (ASD). The delayed diagnosis of PLSVC likely contributed to chronic atrial stretch, arrhythmia development- atrial fibrillation in this case, and eventual heart failure symptoms.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering vascular anomalies like PLSVC in the differential diagnosis of unexplained heart failure or dilated coronary sinus. Early detection through appropriate imaging can guide management and potentially prevent progression of symptoms.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"811-816"},"PeriodicalIF":0.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583807","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":"Valsalva Retinopathy in Pregnancy: A Case Report and Review of the Literature.","authors":"Brenda Zhou, Faiza Sarwar, Noy Ashkenazy","doi":"10.2147/IMCRJ.S524362","DOIUrl":"10.2147/IMCRJ.S524362","url":null,"abstract":"<p><p>The current case report and literature review evaluate the management and optimal mode of delivery for Valsalva retinopathy in pregnancy. A 30-year-old primigravid female was discussed presenting with Valsalva retinopathy in the left eye at 35 weeks of gestation after dry heaving with a visual acuity of 20/200. Four weeks after cesarean-section, she had worse central vision and improving residual hemorrhage. A literature review of 25 Valsalva retinopathy cases showed all patients treated with laser posterior hyaloidotomy or pars plana vitrectomy achieved complete resolution (median of 1.5 weeks, p = 0.08), compared to 67% of untreated eyes (median of 5 months, p = 0.08). Average final visual acuity was 20/30 for the treated and untreated cohorts. Intervention may result in faster recovery time but with similar final visual acuity. Four (15%) cases of Valsalva retinopathy were incited by vaginal delivery. However, neither vaginal delivery nor cesarean section resulted in recurrence/worsening of premacular hemorrhage. These findings may help guide treatment of challenging Valsalva retinopathy cases in pregnancy.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"777-784"},"PeriodicalIF":0.7,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575462","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 Battle: Multidisciplinary Care for a Child with Rhino-Orbital Cerebral Mucormycosis in Somali Region of Ethiopia.","authors":"Abdirashid Abdirahman Hussein, Mahamed Mahamoud Mahamed, Habtamu Dildil, Ismail Abdulahi, Abdulaziz Ibrahim Osmael, Sebsbie Admas, Mohamoud Hashi Abdi, Abdirahman Omer Ali","doi":"10.2147/IMCRJ.S524811","DOIUrl":"10.2147/IMCRJ.S524811","url":null,"abstract":"<p><strong>Background: </strong>Rhino-orbital-cerebral mucormycosis (ROCM) is a rare, aggressive fungal infection with high mortality, primarily affecting immunocompromised individuals, especially those with uncontrolled diabetes mellitus, though it can occur in immunocompetent hosts. Cerebral involvement carries a near 100% fatality rate if untreated, and overall mortality remains high (>30%) even with therapy. We present a pediatric ROCM case from the resource-limited Somali region of Ethiopia.</p><p><strong>Case presentation: </strong>A 12-year-old female with type 1 diabetes mellitus presented with a 10-day history rapidly progressing from headache and fever to right-sided periorbital swelling, proptosis, vision loss, and a necrotic eschar. She had uncontrolled hyperglycemia and diabetic ketoacidosis (DKA) upon arrival. Imaging via CT and MRI revealed findings highly suggestive of ROCM, demonstrating right orbital involvement, cavernous sinus thrombosis, and further intracranial extension including cerebral abscesses/cerebritis and meningeal enhancement. Microbiological confirmation was unavailable due to resource limitations. Treatment included intravenous liposomal amphotericin B (requiring dose adjustment for transient nephrotoxicity), extensive endoscopic nasal debridement, right eye exenteration, and intensive glycemic control.</p><p><strong>Discussion and conclusion: </strong>This case highlights the diagnostic and management challenges of ROCM in resource-limited settings. Despite the high mortality associated with ROCM, particularly in children, the patient improved significantly and was discharged in good health, albeit with persistent visual impairment. Successful management involved prompt recognition, aggressive multimodal therapy (medical and surgical), and close multidisciplinary collaboration (Pediatrics, Ophthalmology, ENT). This outcome demonstrates the feasibility of successful treatment even in resource-constrained environments and underscores the critical importance of managing underlying conditions like diabetes to prevent opportunistic infections.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"769-776"},"PeriodicalIF":0.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527847","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":"Treatment and Survival Outcomes in Rhino-Orbital Mucormycosis with and without Orbital Exenteration: A Retrospective Case Series and Literature Review.","authors":"Shadi Boqaaiya, Yuval Cohen, Karine Beiruti Wiegler, Otzem Chassid","doi":"10.2147/IMCRJ.S530233","DOIUrl":"10.2147/IMCRJ.S530233","url":null,"abstract":"<p><p>Rhino-orbital mucormycosis (ROM) is a life-threatening, fungal infection, primarily affecting immunocompromised patients. The role of orbital exenteration in treatment remains debated, especially regarding its impact on survival outcomes. This case series presents two patients from our Ophthalmology department and compares them with eight cases from the literature, focusing on treatment outcomes and survival rates. We specifically explore the impact of orbital exenteration and other management strategies. The analysis reveals that survival outcomes are closely linked to the timely initiation of antifungal therapy, the patient's underlying conditions, and the extent of orbital involvement at the time of diagnosis. Our findings, in line with the literature, show that early-stage ROM can be treated successfully with less invasive methods, while advanced cases may require orbital exenteration. The need for exenteration should be evaluated on a case-by-case basis, with early detection and appropriate antifungal treatment being critical factors for survival. This study highlights the importance of early diagnosis and individualized treatment plans, emphasizing that while orbital exenteration may improve survival in severe cases, less invasive interventions should be considered for less advanced ROM. Further research and standardized guidelines are needed to refine treatment strategies.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"747-762"},"PeriodicalIF":0.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527850","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":"Full-Thickness Macular Hole Formation After Intravitreal Faricimab Injection for Polypoidal Choroidal Vasculopathy.","authors":"Fahsiri Tavonvunchai, Karntida Chanwimol","doi":"10.2147/IMCRJ.S527975","DOIUrl":"10.2147/IMCRJ.S527975","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of an Asian man with idiopathic polypoidal choroidal vasculopathy (PCV) who developed a full-thickness macular hole (FTMH) following treatment with intravitreal faricimab, which resolved after vitreoretinal surgery.</p><p><strong>Patients and methods: </strong>A 63-year-old man with idiopathic PCV was treated with intravitreal faricimab. Although pigment epithelial detachment (PED) decreased, he developed cystoid macular edema with vitreomacular traction (VMT), which progressed to a FTMH.</p><p><strong>Results: </strong>Pars plana vitrectomy and internal limiting membrane peeling successfully treated the FTMH. One year after the procedure, the macular hole remains closed, and the PCV was inactive.</p><p><strong>Conclusion: </strong>Various mechanisms may have contributed to the exacerbation of the preexisting VMT and PED, which finally resulted in the development of a FTMH. Careful attention should be paid to changes in the vitreomacular interface and posterior vitreous detachment before performing intravitreal anti-vascular endothelial growth factor treatment. Nevertheless, FTMHs can be successfully treated with prompt vitreoretinal surgery.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"18 ","pages":"741-746"},"PeriodicalIF":0.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527848","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}