Poster Discussion Abstracts最新文献

{"title":"187 Effectiveness of library instruction on medical students’ information literacy skills","authors":"H. Wong, Lily Ren","doi":"10.1136/bmjebm-2022-podabstracts.109","DOIUrl":"https://doi.org/10.1136/bmjebm-2022-podabstracts.109","url":null,"abstract":"","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73116834","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":"058 Role of dual antiplatelet therapy in transient ischemic attack","authors":"Julia Lim, I. Goh, Zun Niang Ng, Nicholas Shearer, H. Smith, B. Clissold","doi":"10.1136/bmjno-2021-anzan.58","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.58","url":null,"abstract":"Objectives Short-term dual antiplatelet therapy (DAPT) with clopidogrel and aspirin for secondary prevention in transient ischemic attack (TIA) has been shown to reduce 90-day stroke risk, including for symptomatic high-grade carotid stenosis >50%.1–3 Beyond 30 days, haemorrhagic complications outweighed benefits.3 At our institution, there remains hesitancy of the use of DAPT. We aim to determine prescription rate of DAPT by Emergency Department (ED) versus Stroke Unit (SU) and evaluate 90-day stroke and bleeding risk. Methods Retrospective analysis was performed on all TIA patients admitted to Barwon Health between January 2019 to July 2020. Patients commenced on 21-day DAPT were identified. High-risk TIA was defined as symptomatic carotid stenosis >50%. Bleeding risk was defined as major haemorrhage i.e. symptomatic intracranial haemorrhage or gastrointestinal bleeding. Results 208 TIA patients were identified; 127 patients and 81 patients were admitted to ED and SU respectively. A higher rate of DAPT prescription was seen in the SU at 33.3% (27/81) versus 16.5% (21/127) in ED. 18.5% (5/27) SU patients versus 14.3% (3/21) ED patients were deemed to have had high-risk TIA. No cases of recurrent stroke or major haemorrhage at 90 days were seen in patients receiving DAPT. Conclusion DAPT prescription is lower in ED when compared to SU. At Barwon Health, consultation with the stroke team is encouraged to facilitate high-risk TIA management. A low 90-day stroke and bleeding risk on short term DAPT for TIA was observed in this study. Given our small sample size, this finding may not be generalisable to different settings. References Hackam DG, Spence JD. Antiplatelet therapy in ischemic stroke and transient ischemic attack. Stroke 2019 Mar;50(3):773–778. Wang Y, Wang Y, Zhao X, Liu L, Wang D, Wang C, et al; CHANCE Investigators. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013;369:11–19. Johnston SC, Easton JD, Farrant M, Barsan W, Conwit RA, Elm JJ, et al; Clinical Research Collaboration, Neurological Emergencies Treatment Trials Network, and the POINT Investigators. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N Engl J Med 2018;379:215–225.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75161156","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":"062 Pembrolizumab induced lambert-eaton myasthenic syndrome","authors":"Jasmine Ashhurst, Rami Y. Haddad, R. Zielinski","doi":"10.1136/bmjno-2021-anzan.62","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.62","url":null,"abstract":"Case Report Lambert-Eaton Myasthenic Syndrome (LEMS) is a neuromuscular disorder caused by antibodies directed to the presynaptic voltage-gated calcium channel. It is often paraneoplastic, most commonly associated with Small Cell Lung Cancer (SCLC). This report outlines the case of a patient who developed LEMS secondary to pembrolizumab treatment for metastatic melanoma. An 82 year-old female presented to hospital 1 week after cycle 2 of pembrolizumab treatment for metastatic melanoma. On examination, she was found to have dysphagia, ocular muscle weakness and generalised weakness (most markedly weakness in hip flexors). Her weakness was fatigable and she had a waddling gait. Clinical picture was consistent with a clinical diagnosis of LEMS rather than myositis, which was confirmed by elevated anti-VGCC antibodies and response to Acetylcholinesterase inhibitors. Results Anti-VGCC antibodies elevated at 119pM( Transiently elevated CK, negative myositis autoantibodies, negative anti-MuSK antibodies, negative AChR antibodies. Although repetitive nerve stimulation did not show increment in the right ulnar CMAP after isometric muscle activation, the clinical picture was consistent with LEMS. Marked improvement to treatment with oral prednisone and pyridostigmine. Due to side effects, pyridostigmine was changed to 3,4-Diaminopyridine therapy with excellent response. Steroids were weaned off and the patient is adequately controlled on 3,4-Diaminopyridine. Conclusion Our case report shows that LEMS can arise as a result of an immune-related adverse event (irAE) to pembrolizumab; an Anti-PD-1 Monoclonal Antibody. The immune response persists after cessation of this checkpoint inhibitor medication. It is important to recognise and treat this condition early.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78438685","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":"056 Outcome of endovascular thrombectomy for ultra-long aeromedical transfers: The experience of one ‘hub’ and eleven ‘spoke’ sites covering more than 1.8 million km2","authors":"Seppy Pakrah, Karen E. Huang, Haylee Berrill, M. Tan, P. Bailey, A. Sabet, L. Devilliers, Hal Rice, D. Shah","doi":"10.1136/bmjno-2021-anzan.56","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.56","url":null,"abstract":"Background Local endovascular services for acute stroke in rural and remote regions remain a significant challenge despite higher rates of stroke in these regions. Objectives We present time metrics, logistics, safety and outcome data on stroke patients with large vessel occlusion (LVO) that were aero-medically transferred from rural and remote ‘spoke’ sites to the Gold Coast University Hospital (GCUH) ‘hub’ for endovascular thrombectomy (EVT). Methods This is a retrospective observational study utilizing prospectively collected stroke database from December 2018 to March 2020. Aeromedical transfers from ten rural and remote Queensland sites and one Northern New South Wales site were included, covering more than 1.8 million km² catchment area. Results Over the period of 16 months, 20 out of 26 transferred patients underwent EVT. Mean distance was 1350 km, median time of ictus to recanalization was 928 minutes and TICI 2b-3 was achieved in 90% of the patients. One out of 20 patients (5%) had symptomatic intracranial hemorrhage (sICH), and 9 out of 20 (45%) achieved functional independence (mRS 0-2) at 90 days; similar to the recent pivotal trials. Conclusions Our 12-center network experience confirms real world reproducibility of trial results, including ultra-long transfers, and supports such transfers at other centers worldwide.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79395608","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":"072 Impact of telehealth on multiple sclerosis (MS) outpatient clinics during the COVID-19 pandemic","authors":"V. Li, A. Nguyen, I. Roos, K. Buzzard, C. Dwyer, M. Marriott, M. Monif, C. Malpas, Stefanie Roberts, Lisa Taylor, Elizabeth Carle, Nicola Taylor, Kelsey Tunnell, T. Kilpatrick, T. Kalincik","doi":"10.1136/bmjno-2021-anzan.72","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.72","url":null,"abstract":"Objectives Characterise telehealth use in MS clinics during the COVID–19 pandemic. Assess patient and clinician attitudes towards telehealth. Compare telehealth–based and physical EDSS obtained during period of telehealth implementation. Methods Clinic records from Mar-Dec 2020 were reviewed. Patients and clinicians completed questionnaires about experiences using Telehealth. The iMed database was searched for EDSS recorded via face-to-face and telehealth appointments during and compared to face-to-face EDSS preceding and following the study period. T-test and Chi-square test were used for between-group comparisons. Results 2023 appointments (27% face-to-face, 35% video, 37% telephone) were conducted. New referrals were predominantly face-to-face (66%). 89% of patients were satisfied with telehealth. 58% felt they were as good as face-to-face visits, whilst only 11% of clinicians agreed. Many patients favoured a hybrid model. Safety during the COVID-19 pandemic was important to both groups. EDSS increase from the preceding visit was recorded in a significantly higher proportion of face-to-face than telehealth appointments (p=0.027), with the increase driven by patients with baseline EDSS≤4.0. Amongst patients with EDSS increases, similar numbers of suspected relapses were seen via both modalities. Absolute increase in EDSS was also significantly greater amongst patients seen face-to-face (p Conclusion Patient satisfaction with telehealth was high, whilst clinicians preferred face-to-face consultations. EDSS increase was more frequently recorded via face-to-face than telehealth appointments, which may underestimate lower EDSS. Future clinics could combine both modalities.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84870697","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":"103 An undifferentiated autoimmune neuroinflammatory illness associated with low CSF hypocretin & central hypothalamic dysregulation","authors":"Hoang-Mai Dinh, Nicholas E Gazy, L. Gardner, S. Tisch, A. Carr","doi":"10.1136/bmjno-2021-anzan.103","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.103","url":null,"abstract":"Introduction This case report explores a possible undifferentiated autoimmune neuroinflammatory illness presenting with recurrent fevers, abdominal pain, hypersomnolence and sleep attacks with low cerebrospinal fluid (CSF) hypocretin, and a partial response to anakinra, a human interleukin 1 receptor antagonist. Case Presentation A 19 year old female presented with 5 years of abdominal pain and fatigue with no clear aetiology identified following extensive investigation. She subsequently was found to have recurrent fevers to 38°C, an intermittent fine, macular rash and sudden sleeping at inappropriate times. Her brain MRI was normal and (CSF) showed normal protein and no white cells, but a low hypocretin level ( Management and Outcome For a presumptive diagnosis of an undifferentiated autoinflammatory disorder, she was received prednisolone 10 mg daily for 4 weeks with no benefit. She then initiated anakinra, which improved in rash and sleep attacks. Despite initially controlling her recurrent fevers for a period of four weeks, this symptom ultimately recurred, with ongoing abdominal pain. Discussion Low levels of hypocretin in the CSF has been associated with narcolepsy type 1 and has thought to been associated with an undefined autoimmune mechanism. It is hypothesised that her hypothalamic orexin has been altered due to these inflammatory changes leading to body temperature dysregulation and sleep disorder. Interestingly the hypersomnolence appear to have improved with anakinra, a therapy not typically used in narcolepsy.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"45 17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78502585","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":"104 Overlapping autoimmunity: a case of concomitant aquaporin-4 and myelin oligodendrocyte glycoprotein (MOG) antibody positivity in neuromyelitis optica spectrum disorder","authors":"M. Wronski, Justine Wang","doi":"10.1136/bmjno-2021-anzan.104","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.104","url":null,"abstract":"Objectives To describe a rare case of double antibody positive Neuromyelitis Optica Spectrum Disorder (NMOSD) with both Aquaporin-4 and MOG antibodies, occurring following a Pertussis infection in a patient with a history of auto-immunity. Methods Retrospective review of clinical records. Results A 41-year-old Chinese woman with a history of Systemic Lupus Erythematosus presented with a sub-acute onset of progressive gait ataxia and urinary retention occurring seven days after a confirmed Bordetella pertussis infection. Magnetic resonance imaging revealed extensive subcortical and thalamic T2/FLAIR hyperintensities with subtle enhancement, and a longitudinally extensive non-enhancing spinal cord lesion (T1-T7), without optic nerve involvement. Cerebrospinal fluid protein was raised (0.55 g/L) with 7 mononuclear cells and matched oligoclonal bands. Viral PCRs were negative including JC virus and Pertussis. Established live cell-based immunoassays revealed positivity for both Aquaporin-4 antibodies (in CSF and serum) and MOG antibodies in high titres. Our patient meets the 2015 Consensus Diagnostic Criteria for NMOSD.1 Treatment with high dose corticosteroids and rituximab lead to clinical and radiological improvement, but she had a clinical relapse 10 months later with new LETM (T3-T7), necessitating increased immunosuppression with more rigorous rituximab dosing of 1000mg every 6 months. Conclusions Double positivity for both Aquaporin-4 and MOG antibodies in NMOSD is rare. We describe a case of double-positive NMOSD occurring following an infective illness. This case demonstrates that NMOSD may occasionally masquerade as post-infectious Acute Disseminated Encephalomyelitis and highlights the importance of checking antibodies in these patients, given the treatment strategies and risk of relapse differs considerably.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72804325","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":"054 An adult case of acute cerebellitis as a manifestation of Mycoplasma Pneumoniae infection","authors":"A. Ji, Michael Roizman, Andrew Swayne","doi":"10.1136/bmjno-2021-anzan.54","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.54","url":null,"abstract":"Introduction Acute cerebellitis is exceptionally rare in adults often preceded by systemic viral or bacterial infections. We present a case of acute cerebellitis following otherwise asymptomatic Mycoplasma Pneumoniae infection. Case Descriptions A 40-year-old man presented with a three-day history of acute onset of dizziness, vomiting and headache which was initially diagnosed and managed as vestibular neuritis. He was discharged and four days later represented with slurred speech and difficulty walking. On examination, he was alert, had an ataxic gait, dysarthria and bilateral hypermetric saccades. CSF studies showed an elevated leukocyte count of 152X106/L with 100% mononuclear cells and a mildly elevated protein level of 0.7g/L with normal glucose. Other CSF analysis including a multiplex PCR panel for a variety of viral, bacterial and fungal pathogens, cytology, flow cytometry, antineuronal and encephalitis antibody tests were negative. MRI showed features consistent with acute cerebellitis including subtle diffuse cerebellar hyperintense signal on T2 and FLAIR sequences. Serological testing showed the presence of Mycoplasma Pneumoniae IgM and IgG. A diagnosis of acute cerebellitis was made, and the patient received supportive care and made a complete neurological recovery after 10 days. A repeat MRI one month later showed imaging resolution and he remained asymptomatic at clinic follow-up. Conclusion This case describes an adult with cerebellitis most likely secondary to Mycoplasma Pneumoniae infection with other causes excluded on extensive investigation. Although rare, acute cerebellitis should be considered as a part of the differential diagnosis of acute vertigo particularly in the presence of cerebellar signs.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73135782","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":"095 ‘No End in Sight’, Management dilemma of refractory MOG antibody positive optic neuritis","authors":"Samuel Kwok, James JH Hughes, Dark LD Lisa","doi":"10.1136/bmjno-2021-anzan.95","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.95","url":null,"abstract":"Background The patient is a 38-year-old lady who presented with impaired visual acuity in her right eye which was accompanied with pain on extra-ocular movements. Her symptoms initially resolved with high dose steroid therapy. This is on a background of eosinophilic asthma which is refractory to maximal inhaler therapy and IL-5 monoclonal antibody therapy. Methods/Results The patient had unremarkable blood results and inflammatory makers and a normal CSF study. She was subsequently found to be myelin oligodendrocyte glycoprotein (MOG) antibody positive but negative for (Aquaporin -4) AQP-4 antibodies. Radiological findings on MRI of the brain and spine was suggestive of multiple sclerosis (MS). Whilst receiving intravenous immunoglobulin (IVIG) as a bridging therapy to Multiple Sclerosis (MS) modifying therapy, the patient developed severe adverse reaction to IVIG with desquamation of her hands and legs. Furthermore, she did not achieve satisfactory disease control with Ocrelizumab. Has cushingoid features secondary to long term high dose steroid therapy. Conclusions To highlight the challenges and difficulty in managing a patient with refractory MOG antibody optic neuritis and its impact on the quality of life of the patient. To demonstrate the gap in available clinical evidence in the management of recurrent MOG antibody positive optic neuritis. To initiate an open discussion regarding the treatment of these challenging group of patients References Chen JJ, Tobin WO, Majed M, Jitprapaikulsan J, Fryer JP, Leavitt JA, Flanagan EP, McKeon A, Pittock SJ. Prevalence of myelin oligodendrocyte glycoprotein and aquaporin-4-IgG in patients in the optic neuritis treatment trial. JAMA ophthalmology 2018;136(4):419–422. Chen JJ, Flanagan EP, Bhatti MT, Jitprapaikulsan J, Dubey D, Lopez Chiriboga ASS, Fryer JP, Weinshenker BG, McKeon A, Tillema J-M, Lennon VA, Lucchinetti CF, Kunchok A. Steroid-sparing maintenance immunotherapy for MOG-IgG associated disorder. Neurology 2020;95(2):e111–e120.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"123 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80187990","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":"048 The indications and utility of electroencephalogram, an audit of hospital practices","authors":"Nicholas F Halliwell, Lucy Q. Zhang, Stephan Golja, Ellie Skacel, Renee Pope, Callan A Coventry, Chinthuran Thilagarajan, Georgie CJ Dixson, Anna Schutz","doi":"10.1136/bmjno-2021-anzan.48","DOIUrl":"https://doi.org/10.1136/bmjno-2021-anzan.48","url":null,"abstract":"Objectives The MBS taskforce recommends discouraging use of electroencephalogram (EEG) investigations for low yield indications without neurological specialty input. This study aimed to examine the indications and utility of electroencephalogram within a hospital setting. Methods A retrospective audit was undertaken over a 3 month period across two hospitals of adult inpatient EEGs ordered by services other than neurology. Results Data was collected on 236 EEG encounters. 11% of EEGs performed had a definitive diagnosis of seizures on discharge, of these EEGs the report documented; a normal EEG in 7%, epileptiform activity in 19%, and non-specific slowing in 74%. 17% of Adult EEGs were performed for low yield indications. None of these EEGs resulted in change of management nor a diagnosis of seizures. An additional 14% were performed as part of a ‘falls work up,’ none of the EEGs for this indication resulted in a diagnosis of seizure on the discharge summary. Conclusion This audit supports previous findings that EEGs have a low sensitivity and can not be exclusively used to attain a diagnosis. Low yield indications were common within this audit and the EEG was not clinically significant in this group. EEG should not be used to rule out seizures when the clinical suspicion for seizures is near zero and this audit identified an additional low yield category within the hospital setting as part of a ‘falls work up.’ This study supports the conservative use of EEG in line with the MBS funding taskforce protocol.","PeriodicalId":20317,"journal":{"name":"Poster Discussion Abstracts","volume":"447 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77022516","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}