World Journal of Cardiovascular Surgery最新文献

{"title":"New Insight in the Assessment of Left Ventricular Function in Paradoxical Low Flow Aortic Stenosis Patients with Normal Left Ventricular Ejection Fraction: A Mini-Review","authors":"S. B. Allah, E. Mangieri, J. Fedacko, P. Lohana, M. Elmahal, Amena Elsaady, Madian Abdelrahman, Jaipaul Singh, M. Khorshid, Ram B. Singh, G. Elkilany","doi":"10.4236/WJCS.2020.1012028","DOIUrl":"https://doi.org/10.4236/WJCS.2020.1012028","url":null,"abstract":"Paradoxical valvular aortic stenosis (VAS) \u0000is a challenging area of clinical cardiology for the practitioners. It involves \u0000a small aortic valve area, low flow rate and mean pressure gradient although \u0000there is normal left ventricular ejection fraction. The aim of this study was \u0000to assess left ventricular (LV) dysfunction in a symptomatic severe aortic \u0000valve stenosis which is of crucial importance in identifying patients at risk \u0000of heart failure, postoperative complications and increased mortality. There \u0000are new insights which are involved in assessment of LV myocardial function \u0000including global longitudinal strain (GLS) by two-dimensional speckle tracking \u0000echocardiography (2D STE), myocardial performance index (MPI) and maximum rate \u0000of LV pressure rise (+dP/dt) during isovolumetric contraction time of the LV. \u0000This information can provide both diagnostic and prognostic information in \u0000addition to standard echocardiographic and clinical parameters. However, a profound \u0000understanding of the complex interaction between loading conditions, chamber \u0000geometry and contractility is necessary for the correct interpretation of \u0000myocardial deformation in order to draw appropriate conclusions in patients \u0000with aortic valve disease. This mini review is related to new and novel \u0000insights into the assessment of left ventricular function (LVF) in paradoxical \u0000low flow aortic stenosis patients with normal left ventricular ejection \u0000fraction (LVEF).","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"31 1","pages":"264-270"},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87119279","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":"Metabolic Acidosis in the Surgical Intensive Care Unit: Risk Factors, Clinical Correlates and Outcome. Findings from a High Dependency Heart and Vascular Surgical Center in Nigeria","authors":"P. Uduagbamen, M. Sanusi, O. Udom, O. Salami, A. Adebajo, O. J. Alao","doi":"10.4236/wjcs.2020.1011025","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1011025","url":null,"abstract":"Background: Metabolic acidosis \u0000(MA) is a common finding on the surgical ward, more so in the intensive care \u0000unit. Diseases affecting the major organ systems of the body and higher grades \u0000of surgery are common risk factors for MA. It is associated with poor treatment \u0000outcome. Aim: To determine the risk \u0000factors and clinical correlates of metabolic acidosis and assess its \u0000relationship with treatment outcome. Methodology: A retrospective \u0000study at the “Tristate Heart and vascular Center” in Ilishan-Remo South west \u0000Nigeria, on patients that had cardiac and vascular surgeries from January 2015 to December 2019. Three hundred and forty two participants took part in the study. \u0000The demographic, clinical and laboratory findings were entered. Statistical \u0000analysis was with Student’s t-test and Chi square. Results: Two hundred and six \u0000males and 136 females were studied. The incidences of metabolic acidosis prior to induction, on \u0000post-operative day one (POD1) and on POD28 were 20.7%, 39.8% and 14.1% respectively. Nine (2.6%) participants died during admission, of \u0000this, 6 (66.7%) had MA at presentation but all (100%) had MA on POD1. \u0000The Risk factors for MA were advanced age, comorbidities, open heart surgery, \u0000elevated systolic blood pressure and low eGFR. Metabolic acidosis was a risk \u0000factor for prolonged hospital stay, perioperative death and declining kidney \u0000function which was commoner among participants with preexisting kidney \u0000dysfunction. Conclusion: The incidence of \u0000metabolic acidosis was 20.7% at induction of anesthesia, rose to 39.8% on POD1 and by POD28, it has significantly reduced to 14.1%. While advancing \u0000age and comorbidities were risk factors for MA, the occurrence of MA increased \u0000the risk of declining kidney function, prolonged hospital stay and death.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"52 1","pages":"226-241"},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85181790","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":"Surgery for Pericardial Syndromes in Adults and Children: Clarification of Questionable Aspects","authors":"A. Elassal, Osman O. Al-Radi, H. Jabbad, Z. Zaher, Mohamed H. Abdelsalam, Ahmed M. Dohain, G. Abdelmohsen, K. Al_ebrahim","doi":"10.4236/wjcs.2020.1011024","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1011024","url":null,"abstract":"Background: The knowledge on \u0000pericardial disease has increased but the European Society of Cardiology in the \u0000last guidelines 2015 stated a section of perspective and unmet needs referring \u0000to the surgical management as one of these needs. Here, we present an institutional \u0000experience to contribute with other studies \u0000in explanation of questionable aspects about their surgical management. Methods: \u0000Among 127 cases (93 adults and 34 children) that were diagnosed as pericardial \u0000syndrome, we retrospectively analyzed 45 cases (40 adults and 5 children) \u0000operated for pericardial syndrome from May 2012 to June 2019. Echocardiogram \u0000was the main preoperative diagnostic tool. Surgical approach was selected \u0000according to each diagnosis. Postoperative clinical assessment, recurrence and \u0000mortality rate were the main determinants of outcome. Results: Regarding pericardial effusions, the mean preoperative medical treatment period was 17.7 ± 21.9 days and pericardial window \u0000through thoracotomy was the common approach (54.5%). In constrictive \u0000pericarditis, infection was the main etiology (40%), mean preoperative medical \u0000treatment period was 16 ± 8.8 days and complete pericardiectomy was the \u0000surgical procedure for most cases. Trans-sternal drainage was the standard \u0000approach for cardiac tamponade. No postoperative same admission recurrences \u0000were reported and 11 (24.4%) mortalities were recorded, 7 (15.5%) cases of them were diagnosed as malignant effusions. Conclusion: Decision making and surgical approach \u0000affect the outcome of surgery for pericardial syndromes. Children are \u0000more responsive to medical treatment than adults are. Primary etiology and \u0000patient’s condition are still the leading determinants of morbidity and \u0000mortality.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84336758","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":"Level of Cardiac Biomarkers in Immediate Post-Operative Period after Off-Pump CABG and Its Comparison with On-Pump CABG: A Prospective Analytical Study","authors":"S. Munshi, A. Halder, Pares Bandyopadhyay","doi":"10.4236/wjcs.2020.1010023","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1010023","url":null,"abstract":"Background: Coronary artery \u0000bypass grafting (CABG) is an important modality of treatment for ischemic heart \u0000disease. Both off-pump and on-pump CABG have direct effect on the level cardiac \u0000biomarkers in the perioperative period. The use of cardiopulmonary bypass (CPB) \u0000and aortic cross-clamping may cause additive myocardial damage leading to \u0000further elevation of blood markers. The present study is aimed at measuring and \u0000comparing the cardiac biomarker levels in immediate post-operative period after \u0000on-pump CABG (ONCAB) and off-pump CABG (OPCAB). Methods: All the patients who \u0000underwent CABG from January 2015 to June 2016 on elective or emergency basis at \u0000Nilratan Sircar Medical College & Hospital have been included in the study. \u0000Total 106 patients were operated for CABG of which 75 patients were operated \u0000for OPCAB and 31 patients were operated for ONCAB. For the comparison of \u0000data the blood markers Troponin-T (Trop-T) and Creatine Kinase-MB (CK-MB) are \u0000measured during anesthesia before surgery, post-operatively \u0000after 1 hour, post-operatively after 4 hours and post-operatively after 20 hours. All recorded data are analyzed using standard statistical methods. Results: We found the markers are elevated immediately \u0000after surgery and gradually come down within 24 hours after surgery in both OPCAB and ONCAB groups. The elevation is more after ONCAB than \u0000OPCAB group in immediate post-operative period but the difference is not \u0000significant after 20 hours of surgery. Conclusion: Elevated levels of \u0000cardiac biomarkers in the immediate post-operative period indicate myocardial \u0000damage during surgery, especially after ONCAB in comparison to OPCAB. This may \u0000attribute to the better hemodynamic stability in the immediate post-operative \u0000period after OPCAB than ONCAB assuming comparable and adequate \u0000revascularization in patients of both groups. The avoidance of CPB and \u0000cross-clamp may explain better myocardial functioning immediately after OPCAB. But after 20 \u0000hours, the level of cardiac markers is comparable in both groups indicating \u0000little difference in post-operative recovery and long-term prognosis.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90754316","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":"Essential Thrombocytosis and Fatal Coronary Graft Occlusion: A Case Report","authors":"J. Blidgen, C. McGaw","doi":"10.4236/wjcs.2020.1010021","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1010021","url":null,"abstract":"Essential thrombocytosis (ET) is a rare myeloproliferative disorder, \u0000which is a major risk factor for thrombosis and bleeding, which complicates \u0000cardiovascular surgery. ET is a risk factor for coronary artery disease that \u0000should be treated. We present a case of a male with ET who underwent coronary \u0000artery bypass grafting (CABG) at the University Hospital of the West Indies, \u0000and died post-surgery. Post mortem revealed early graft thrombosis. We believe \u0000that post-operative aspirin therapy maybe would have prevented this fatal outcome.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86475686","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":"Atrial Septal Defect Closure by Anterior Mini Thoracotomy with Total Peripheral Cannulation: A Step towards Establishing Mini Invasive Cardiac Surgery in a Developing Nation","authors":"P. Khakural, R. Baral, A. Bhattarai, B. Koirala","doi":"10.4236/wjcs.2020.1010022","DOIUrl":"https://doi.org/10.4236/wjcs.2020.1010022","url":null,"abstract":"Background: Atrial Septal Defect \u0000(ASD) closure is a common cardiac surgical procedure performed worldwide. Due \u0000to favourable clinical outcome, minimal invasive approach is becoming popular. \u0000Hence this study was conducted to compare the outcome of two surgical \u0000approaches, median sternotomy and mini thoracotomy with total peripheral \u0000cannulation, in a developing country Nepal. Methods: A prospective study \u0000of 62 ASD patients, randomized to undergo surgical closure either via right \u0000anterior mini thoracotomy or median sternotomy was conducted and followed up \u0000over three years. The clinical outcome parameters like intensive care unit \u0000stay, hospital stay, post-operative duration of ventilation, cardiopulmonary \u0000bypass time, aortic cross clamp time, mediastinal drainage, size of scar and \u0000complication were compared between two groups. Results: Cardiopulmonary \u0000bypass time and aortic cross clamp time were significantly longer in right \u0000anterior mini thoracotomy group as compared to median sternotomy group (43.97 min ± 12.70 min vs 34.42 min ± 10.42 min and 25.13 min ± 7.82 min vs 19.48 min ± 6.93 min respectively, p-value 0.05). There was no significant difference in duration of surgery (2.75 hrs ± 0.43 hrs vs 2.56 hrs ± 0.41 hrs, p-value = 0.09), post-operative ventilation (2.90 hrs ± 1.22 hrs and 2.88 hrs ± 1.07 hrs, p-value = 0.96) between two groups. Post-operative mediastinal drainage was \u0000significantly less in right anterior mini thoracotomy group (214.52 ml ± 91.79 ml vs 284.03 ml ± 158.91 ml, p-value = 0.04). There was no significant difference in ICU stay and hospital stay. Conclusion: Atrial septal defect can be safely closed by right anterior \u0000mini thoracotomy with a small, cosmetically acceptable submammary scar with \u0000less pain and bleeding.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87843930","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":"Follow Up of Hypertensive Patients at Regional Hospital of Bafoussam, West Cameroon: Biochemical Profiles in Naive and Hypotensive Drug Treated Patients","authors":"V. Nzesseu, C. Kouam, J. Tamokou, J. Kuiaté","doi":"10.4236/WJCS.2020.109020","DOIUrl":"https://doi.org/10.4236/WJCS.2020.109020","url":null,"abstract":"Objective: The aim of this work was to study the effects of antihypertensive therapies on \u0000certain metabolic parameters in hypertensive patients. Methods: A \u0000cross-sectional and analytical study conducted within the Bafoussam Re-gional \u0000Hospital on 343 patients including 99 normotensives and 244 hyperten-sives \u0000distributed in 71 patients naive to treatment and 173 patients under treatment \u0000(84 under monotherapy, 67 under bitherapy and 21 under trithera-py). The \u0000antihypertensive medications were recorded from the medical records. A \u0000questionnaire survey was administered to study participants and potential risk \u0000factors for hypertension sought. Blood and urine samples were collected for \u0000lipid, renal and hepatic disorder analysis. Two blood pressure measure-ments enabled \u0000us to diagnose hypertensive patients. Measurements of bio-chemical parameters \u0000such as total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, \u0000creatinine, glucose, aspartate aminotransferase (ASAT), alanine \u0000aminotransferase (ALT), potassium, chloride and calcium were done in serum by \u0000methods resulting from commercial kits. Results: Cal-cium Channel Blockers were \u0000significantly associated with increases in blood potassium (odd-ratios (OR) = \u00008.63, p = 0.036) and sodium (OR = 0.20, p = 0.037). Angiotensin-converting \u0000enzyme/Angiotensin II receptor blockers were significantly associated with an \u0000increase in plasma activity of ASAT (OR = 0.12, p = 0.03) whereas Diuretics \u0000were significantly associated with an increase in ALAT plasma activity (OR = 0.003, \u0000p = 0.012). Dual therapies were associ-ated with highest frequencies of \u0000hypercreatininemia (41.8%) and hyperglyce-mia (44.8%) whereas \u0000hypocholesterolemia HDL (38.1%) was most observed in hypertensive patients on \u0000triple therapy. The different therapies resulted in very low frequencies of \u0000abnormal liver profiles (in general almost all below 10%). Tritherapy had the \u0000most beneficial effects on the different profiles, with no cases of \u0000hyperkalemia, glycosuria, hypochloremia, hematuria, hyponatremia, total hypercholesterolemia, \u0000ALAT and ASAT hyperactivity. Conclusion: Triple therapy should be recommended \u0000as it has the most beneficial effects on met-abolic parameters in the study population.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"79 1","pages":"167-185"},"PeriodicalIF":0.0,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88167124","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":"Outcomes of Extracorporeal Membrane Oxygenation in Blood Culture Positive Septic Patients","authors":"C. Blazoski, Qiong Yang, H. Hirose","doi":"10.4236/wjcs.2020.108019","DOIUrl":"https://doi.org/10.4236/wjcs.2020.108019","url":null,"abstract":"INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is commonly used for \u0000refractory cardiac or respiratory failure. There are reported cases of \u0000successful use of ECMO in patients with septic shock; however, there is a lack \u0000of evidence to prove its overall efficacy. Thus, we conducted this study to \u0000analyze the relationship between sepsis and ECMO in our own patients. METHODS: 305 patients who were placed on ECMO between 2010 and 2020 were identified \u0000within an IRB-approved database. Their clinical outcomes were analyzed with a specific focus on patients who were \u0000septic before or during ECMO, defined as a positive blood culture. Group S was \u0000composed of patients with a positive blood culture before or during ECMO, while \u0000Group N was composed of all patients without a positive blood culture before or \u0000during ECMO. The primary outcome compared between groups was ECMO survival rate. RESULTS: Among the \u0000305 patients on ECMO, 58 (19%) were in Group S and 247 (81%) were in Group N. \u0000ECMO survival rates were 45% in Group S and 62% in Group N (p = 0.017). CONCLUSION: Of our 305 patients, patients who were septic upon \u0000ECMO placement or those who \u0000developed sepsis during ECMO had worse ECMO survival rates than non-septic \u0000patients. Ultimately, patients who are septic or have a high probability of \u0000becoming septic may not be indicated for ECMO placement, and cautious \u0000administration of ECMO to these patients may be necessary.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"243 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91422088","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":"Atrioventricular Septal Defect with Intact Interatrial Septum. Case Report","authors":"P. S. Ba, Yacouba Tamboura, M. Diop, Papa Amath Diagne, N. F. Sow, P. A. Dieng, A. G. Ciss","doi":"10.4236/wjcs.2020.108017","DOIUrl":"https://doi.org/10.4236/wjcs.2020.108017","url":null,"abstract":"In atrioventricular septal defect (AVSD), anatomical \u0000lesions usually are an ostium primum atrio-septal defect; a common \u0000atrioventricular valve, an inlet ventricular septal defect (VSD). It is most \u0000often associated with major chromosomal abnormalities. It is the most common \u0000congenital disease in Down syndrome. Our case was an infant with a Down \u0000syndrome who was admitted for a dyspnea (stage 3 in New York Heart Association classification) \u0000and tachycardia. The diagnosis was made by a transthoracic echocardiography. It \u0000showed a rare variety of atrioventricular septal defect without an atrial \u0000septal defect. The child was treated successfully with one patch technic and no \u0000recurrence was noted.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"86 1","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2020-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83218907","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":"Palliative Senning Procedure: Management of dTGA with VSD and PVOD in an Adolescent","authors":"A. Satsangi, Biswajit Singh","doi":"10.4236/wjcs.2020.108018","DOIUrl":"https://doi.org/10.4236/wjcs.2020.108018","url":null,"abstract":"Patients with D-TGA with atrial level mixing of \u0000systemic and pulmonary blood, the morphological left ventricle supports the low \u0000pressure pulmonary circulation and regresses in mass and volume as time passes. \u0000The LV once regressed is unable to support the high pressure systemic \u0000circulation after ASO. These patients are candidates for early ASO, preferably \u0000within 3 weeks of life. As age progresses, the scope of these surgical \u0000procedures skews and an atrial switch remains the only option to improve \u0000quality of life. In Atrial switch, the pulmonary and systemic circulation is returned \u0000into an “in series” circulation and cyanosis is obliterated.","PeriodicalId":23646,"journal":{"name":"World Journal of Cardiovascular Surgery","volume":"32 1","pages":"150-157"},"PeriodicalIF":0.0,"publicationDate":"2020-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77656787","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}