Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko最新文献

{"title":"[HARDI-CSD tractography in determining the structure of diencephalic pathways in craniopharyngiomas].","authors":"V V Ivanov, A N Konovalov, N E Zakharova, R M Afandiev, E L Pogosbekyan, I N Pronin, A N Shkarubo, P L Kalinin","doi":"10.17116/neiro20258901130","DOIUrl":"10.17116/neiro20258901130","url":null,"abstract":"<p><p>Craniopharyngioma is a benign tumor in adults and children characterized by local invasion of surrounding brain structures. HARDI-CSD tractography is one of the modern MR methods for comprehensive visualization of functionally significant conduction pathways.</p><p><strong>Objective: </strong>To determine the possibility of visualizing some structures of chiasmatic-sellar region and third ventricle (hypothalamic-pituitary tract (pituitary stalk), optic pathways, fornix, mammillothalamic tract) using HARDI-CSD tractography in patients with suprasellar craniopharyngiomas, especially after failed CT and standard MRI of these structures.</p><p><strong>Material and methods: </strong>A pilot study included 4 patients (2 adults and 2 children) with craniopharyngiomas who underwent surgical treatment at the Burdenko Neurosurgery Center between January and July 2024. Patients underwent MR tractography before and after surgery.</p><p><strong>Results: </strong>HARDI-CSD tractography reconstructed optic tracts in 3 patients before and after surgery. Simultaneous visualization of several structures (pituitary stalk, fornix, optic tracts) was performed before and after surgery in 1 case. These data were useful for planning surgery and evaluating postoperative outcomes. In one patient, imaging of mammillothalamic tract was obtained after resection of large cystic intra-extraventricular craniopharyngioma.</p><p><strong>Conclusion: </strong>HARDI-CSD tractography provides valuable information about basal cerebral pathways (optic pathways, pituitary stalk, fornix, mammillothalamic tract) when planning and evaluating the results of surgical treatment of craniopharyngiomas.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 1","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190666","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":"[Risk factors of unfavorable outcome after decompressive craniectomy in children with severe traumatic brain injury].","authors":"Zh B Semenova, S V Meshcheryakov, E A Rogozhin, V I Lukyanov","doi":"10.17116/neiro20258903142","DOIUrl":"https://doi.org/10.17116/neiro20258903142","url":null,"abstract":"<p><p>Although the first publication devoted to early decompressive craniectomy in children with TBI and refractory intracranial hypertension occurred more than two decades ago, the issue of effectiveness and functional outcomes continues to be discussed. Variability of data and methods for assessing the effectiveness of decompressive craniectomy in children with severe TBI does not allow for convincing recommendations.</p><p><strong>Objective: </strong>To identify the risk factors of unfavorable outcomes after decompressive craniectomy in children with severe TBI.</p><p><strong>Material and methods: </strong>The study included 64 patients with refractory intracranial hypertension over 20 mm Hg. Age, GCS score at admission, GOS grade after 6 months, intracranial pressure and cerebral perfusion pressure before surgery, energy of ICP fluctuations process-E², pupil status and ISS score were analyzed. Treatment outcomes were assessed after 6 months.</p><p><strong>Results: </strong>GOS grade 4-5 was observed in 45.3% of cases, grade 3 - in 31% of cases, grade 1-2 - in 23.4% of cases. Mortality rate was 18.7% (12 patients). There are significant predictors of unfavorable outcome: GCS score, ICP ≥40 mm Hg, wide pupils, impaired photoreaction, type of injury (isolated/combined), midline shift (<i>p</i><0.05).</p><p><strong>Conclusion: </strong>Risk factors of unfavorable outcome after decompressive craniectomy in children include independent factors (severity of primary brain injury) and controllable factors (ICP and its derivatives). ICP ≥40 mm Hg increases the risk of unfavorable outcome after decompressive craniectomy. Decompressive craniectomy is a preventive measure and should be considered as a tool for dislocation syndrome control.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 3","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188170","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":"[The one-line principle in classification of cerebral aneurysm clipping].","authors":"Yu V Pilipenko, Sh Sh Eliava, D N Okishev, An N Konovalov, A S Kheyreddin, M B Kholmatov, F V Grebenev, A A Abramyan","doi":"10.17116/neiro2025890515","DOIUrl":"https://doi.org/10.17116/neiro2025890515","url":null,"abstract":"<p><p>Despite numerous clipping techniques, a standardized classification based on a single unifying principle remains absent.</p><p><strong>Objective: </strong>To develop a classification of clipping methods based on the one-line principle.</p><p><p>Material and Methods. The classification was developed based on studies by Ishikawa T. et al., who introduced the «ideal closure line» for aneurysm clipping. We analyzed 678 cases of reconstructive clipping of cerebral aneurysms performed at the 3rd Neurosurgical Department of the Burdenko Neurosurgical Center between September 1, 2024, and December 29, 2024.</p><p><strong>Results: </strong>Reconstructive clipping methods for cerebral aneurysms, based on the one-line principle, were categorized into eight types. Clipping along a one line without segmenting the aneurysm neck, including simple single clipping, simple reinforced clipping, and clipping with tunneling of the efferent artery, was performed in the majority of cases (58.5%). Linear fragmented clipping of individual aneurysm neck segments, including tandem, counter, and cross techniques, tunneling of the parent artery, perpendicular clipping, and combined clipping, was performed in 39.8% of cases. Discrete fragmented clipping with multiple lines of aneurysm neck clamping was used in only 1.8% of cases.</p><p><strong>Conclusion: </strong>We developed a novel classification of aneurysm clipping based on the one-line principle. This classification primarily serves scientific purposes, facilitating the evaluation of clinical and angiographic outcomes of various clipping methods across different topographic and morphological variants of cerebral aneurysms.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 5","pages":"5-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303717","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":"[Combined extravasal compression of the right subclavian artery caused by stellate ganglion schwannoma and additional rudimentary cervical rib. Clinical case and literature review].","authors":"D Yu Usachev, V A Lukshin, A A Shulgina, E V Vinogradov, A S Nazarova, G A Denisova, A D Akhmedov","doi":"10.17116/neiro20258902172","DOIUrl":"10.17116/neiro20258902172","url":null,"abstract":"<p><p>Unlike widespread and well-studied atherosclerosis of supra-aortic arteries, non-atherosclerotic vascular diseases are less common. Of these, one of the most unusual is extravasal compression by additional structures between scalene muscles. Close topographic and anatomical connections of scalene muscles, vertebral and subclavian arteries, brachial plexus and stellate ganglion can lead to complex syndrome including impaired blood supply to the arm, brachial plexus compression and vertebrobasilar circulatory disorders. The main treatment method for supraclavicular compression syndromes is surgery. However, differential diagnosis, indications for surgical treatment and optimal technique are still discussable due to small incidence of disease. The key factor in determining treatment strategy is the cause of compression (congenital or acquired scalene muscle hypertrophy, age-related ptosis of the shoulder girdle; neck injuries; cervical spine degeneration). One of the rarest causes of compression is rudimentary additional cervical rib («cervical rib syndrome») and vessels. Combination of these factors is a casuistic etiology. The authors present a 25-year-old patient with stellate ganglion schwannoma whose mass effect caused dislocation and compression of subclavian artery by rudimentary additional cervical rib and scalene muscle. Surgical treatment including resection of tumor, release of the artery and scalenotomy restored arterial patency and eliminated clinical symptoms.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"72-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781252","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":"[Combined treatment of high-risk cerebral arteriovenous malformations according to Spetzler-Martin classification].","authors":"I V Senko, K Yu Orlov, S D Zalogin, M S Staroverov, P D Matveev, I V Grigoriev","doi":"10.17116/neiro202589021104","DOIUrl":"10.17116/neiro202589021104","url":null,"abstract":"<p><strong>Background: </strong>High-risk cerebral AVMs (Spetzler-Martin grade IV-V) are characterized by higher cumulative risk of hemorrhage during life, as well as higher mortality and disability rates in case of rupture compared to low-risk AVMs. Nevertheless, there are currently no clear indications for surgical intervention for high-risk AVMs, and most patients with this disease are followed-up. However, available data on less favorable course of high-risk AVMs requires active surgical tactics to reduce long-term disability and mortality.</p><p><p>Currently, the following strategies are preferable for high-risk AVMs: combination of preoperative embolization with microsurgical resection and combination of partial endovascular embolization with subsequent radiosurgery.</p><p><strong>Objective: </strong>To analyze the most common treatment combinations for high-risk AVMs regarding resection quality, functional outcomes and complications.</p><p><strong>Material and methods: </strong>The study was carried out in accordance with international recommendations for systematic reviews and meta-analyses (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Searching was conducted in the Pubmed/Medline and eLibrary databases using the keywords «High grade», «Arteriovenous Malformations», «Management», «IV-V» and «AVM» for English-language search engines, \"high-grade arteriovenous malformations.\" for Russian-language systems. Available full-text English- and Russian-language articles were selected between 1981 and 2024.</p><p><strong>Results: </strong>Among 371 articles, 6 studies met the inclusion criteria. There were 478 patients who underwent two most common strategies for combined treatment of high-risk AVMs.</p><p><strong>Conclusion: </strong>At present, there is no consensus on the advantage of certain combined method. There are data on less favorable course of high-grade AVMs and unsatisfactory outcomes after monomodal treatment. Thus, combined methods may be valuable for such AVMs.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"104-112"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781258","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":"[Surgical treatment of intracerebral metastases of Ewing sarcoma in children. Case report and review].","authors":"A V Sanakoeva, A E Samarin, E I Konopleva, A V Tarakanova, I V Sidorov, A E Druy, A I Karachunsky","doi":"10.17116/neiro20258902192","DOIUrl":"10.17116/neiro20258902192","url":null,"abstract":"<p><strong>Background: </strong>Metastatic brain lesions following Ewing sarcoma of bones and soft tissues in children are extremely rare and have unfavorable prognosis. There are few publications devoted to this issue. Survival rates after craniotomy are extremely low.</p><p><p>The authors describe a patient with metastatic form of Ewing sarcoma and two intracerebral (supra- and infratentorial) metastases. Total resection with subsequent radio- and chemotherapy were followed by stable remission for 23 months.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 2","pages":"92-96"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781226","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":"[Complexity index of endovascular treatment of unruptured cerebral aneurysms].","authors":"F V Grebenev, S B Yakovlev, Sh Sh Eliava, G V Danilov, I O Kurzakova, S R Arustamyan, E V Vinogradov, Yu V Koledova, S F Saidov","doi":"10.17116/neiro20258904139","DOIUrl":"https://doi.org/10.17116/neiro20258904139","url":null,"abstract":"<p><strong>Introduction: </strong>The concept of «complex» aneurysm is now widely used in the planning of neurosurgical interventions. It is obvious that the definition and objectification of this concept should be separate for microsurgical and endovascular treatment.</p><p><strong>Objective: </strong>Is to objectify the «complex aneurysm» concept with regard to endovascular treatment.</p><p><strong>Material and methods: </strong>A total of 739 patients, who underwent endovascular treatment of the unruptured aneurysm in the NMRC of Neurosurgery named after Academician N. N Burdenko in the period from 01.01.2018 to 01.02.2022, were analyzed. We evaluated 8 anatomical and morphological characteristics (AMCs) of the aneurysm and presence of 2 pathologies of brachiocephalic arteries (BCAs). Statistical analysis of the treatment results, determination of the statistical significance of differences in complications incidence depending on the presence of studied AMCs of the aneurysm and BCAs pathology were performed. On the basis of this analysis, an index of the complexity of endovascular treatment of unruptured aneurysms (ICAe) was created and the significance of differences in the incidence of complications according to the value of ICAe was evaluated. Web application for ICAe calculation - www.isae.rf - was created.</p><p><strong>Results: </strong>The proportion of patients with pronounced neurological deficit on the day of discharge amounted to 0.8%, the incidence of death - 0.1% (1 patient). New neurological deficit after the surgery occurred in 4.6% of cases, moderate and severe complications - in 3.2% of cases. Non-radical aneurysm exclusion after 12 months was observed in 22.1% of cases.</p><p><p>At ICAe=0, the incidence of complications was lower in the general group by 0.9 - 10.9%. The ICAe value of 1 score was intermediate (part of complications occurred more often, part less). The incidence of adverse outcomes and complications was increased by 1.8-18.5% for ICAe=2, by 0.8-27.9% for ICAe=3 and by 6.5-28.7% for ICAe=4-5.</p><p><strong>Conclusion: </strong>The created ICAe allows to objectively distinguish a group of aneurysms complex for endovascular treatment, stratify aneurysm complexity and incidence of adverse outcomes and complications.</p><p><p>Aneurysms with ICAe³2 can be classified as «complex» for endovascular treatment.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"39-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971809","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":"[Functional results after surgical treatment of long-lasting epidural compression of the neural structures in patients with spinal tumors].","authors":"O A Smekalenkov, V S Murakhovsky, N S Zaborovsky, S V Masevnin, D A Ptashnikov","doi":"10.17116/neiro20258904169","DOIUrl":"https://doi.org/10.17116/neiro20258904169","url":null,"abstract":"<p><p>Surgical treatment of cancer patients with severe neurological symptoms is a complex multidisciplinary problem that often does not lead to a positive disease's outcome. It is also not always possible to perform operative treatment in a short time frame after paraparesis debut.</p><p><strong>Objective: </strong>To evaluate the impact of the timeframe from the onset of neurological disorders to surgical decompression in patients with plegia, caused by the neural structures compression by the spinal tumor, on the disease's outcome.</p><p><strong>Material and methods: </strong>An observation of 34 patients who underwent surgery for epidural tumor compression of the spinal neural structures from 2005 to 2021 was presented. Functional deficit was evaluated by the Karnofsky, ASIA AIS scales. All patients had paraplegia and sensitivity impairment (ASIA AIS A, B) before the operation. Primary sources were the mammary gland (7.7%), prostate (15%), kidney (27%), multiple myeloma (3.8%), lungs, liver and plasmocytoma (by 7.7% each), stomach, colon and chondrosarcoma (3.8%), other tumors (15.8%).</p><p><strong>Results: </strong>Surgical treatment demonstrates a satisfactory result in the form of partial or complete restoration of the neurological deficit in a quarter of cases (23.5%) with no significant impact on life expectancy. Each day of persistent compression of the neural structures reduces the probability of neurological deficit regression by 4%.</p><p><strong>Conclusion: </strong>Performance of surgery in patients with severe neurological disorders 27 days or more after the debut has an extremely low probability of restoring the ability to move independently. Diagnostic awareness in the detection of spinal tumors and timely surgical treatment of patients with the threat of developing epidural compression of the neural structures allow to reduce the risk of disability and improve the quality of life of patients.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 4","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971924","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":"[External validation of the ETVSS scale for predicting the outcomes after third ventriculostomy in children less than one year of age with obstructive hydrocephalus].","authors":"V E Danilin, G V Letyagin, A A Pashkov, S A Kim, A V Shcherbakov, A A Sysoeva","doi":"10.17116/neiro20258905145","DOIUrl":"https://doi.org/10.17116/neiro20258905145","url":null,"abstract":"<p><strong>Background. s: </strong>Uccessful endoscopic third ventriculostomy (ETV) depends on patient characteristics, including age, etiology of hydrocephalus and previous shunting. Kulkarni et al. [1] developed the Endoscopic Third Ventriculostomy Success Score (ETVSS) to predict the success of ETV using these factors. We analyzed own experience of ETV in children under one year of age and validity of the ETVSS scale.</p><p><strong>Objective: </strong>To assess prognostic significance of the ETVSS scale in children under one year of age after ETV.</p><p><strong>Material and methods: </strong>There were 1105 surgeries in children with hydrocephalus between 2012 and 2021 including 273 ETV procedures. Primary ETV was performed in 129 patients (47.3% of all procedures), they met the inclusion criteria. ETVSS score was calculated retrospectively for each patient and compared with actual success of ETV. ROC analysis was used to determine the quality of the validated version of the ETVSS scale.</p><p><strong>Results: </strong>The study included 129 primary ETVs in children under one year of age. Success rate was 52.7% (<i>n</i>=68), the minimum follow-up - 6 months. When analyzing the results, we found mild prognostic underestimation in short-term and long-term outcomes of ETV according to the ETVSS scale. ROC analysis revealed AUC 0.67 that corresponds to satisfactory level of this classification. Sensitivity was 66%, specificity - 63%.</p><p><strong>Conclusion: </strong>ETVSS scale demonstrated good ability to predict success according to actual success rate of ETV in neonates and infants. This tool may be useful in decision-making for endoscopic surgery. The ETVSS scale should be used by neurosurgeons to assess possible outcomes after ETV in infants.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 5","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303601","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":"[Surgical treatment of glial tumors of the frontal lobe. Current state of the problem. Part I: motor functional system].","authors":"A E Bykanov, T S Bezbabicheva, D I Pitskhelauri","doi":"10.17116/neiro202589051115","DOIUrl":"https://doi.org/10.17116/neiro202589051115","url":null,"abstract":"<p><p>In everyday clinical practice, neurosurgeons usually deal with glial tumors localized precisely in the frontal lobe. There is a widespread opinion that almost any neurosurgeon can resect glioma of the frontal lobe regardless of experience and microsurgical skills. However, working at the federal center, we observe how employees often have to operate on patients with frontal lobe gliomas after previous surgery in other hospitals. Therefore, treatment of these patients seems to be quite difficult problem of neurosurgery for glial tumors, and incidence of postoperative complications is still high. We analyzed literature data on anatomical and functional aspects of surgery for frontal lobe gliomas and practical nuances of their surgical treatment. Motor functional system of the frontal lobe is represented by several cortical zones united into a complexly organized network of functional connections through associative fibers. Theor lesion can lead to postoperative motor deficit.</p>","PeriodicalId":24032,"journal":{"name":"Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko","volume":"89 5","pages":"115-121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303708","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}