International Tinnitus Journal最新文献

{"title":"Amplifiers in Tinnitus Patients.","authors":"Henk M Koning,&nbsp;Bas C Ter Meulen","doi":"10.5935/0946-5448.20210013","DOIUrl":"https://doi.org/10.5935/0946-5448.20210013","url":null,"abstract":"<p><strong>Introduction: </strong>High tinnitus loudness can be provoked by peripheral disorders of the somatosensory and/or auditory system.</p><p><strong>Objectives: </strong>The object of our study was to compare high tinnitus loudness patients with low tinnitus loudness patients and to find specific factors associated with high tinnitus loudness.</p><p><strong>Design: </strong>A retrospective cohort analysis of 234 patients with tinnitus as main complaint who visited our clinic in a four-year period.</p><p><strong>Methods: </strong>Data obtained from the subjects were age, sex, the loudness of tinnitus estimated by the VAS, and the outcomes of the audiogram and the cervical spine radiograph.</p><p><strong>Results: </strong>High tinnitus loudness was associated with a higher prevalence of females, more dizziness, less self-perceived hearing loss, more cervical disc degeneration at C3 to C6, and a larger anterior spur of cervical vertebrae C3 to C6. Females had a lower prevalence of tinnitus but a higher chance on high tinnitus loudness. Gender, the size of the largest anterior spur from C3 to C6, and the ratio of hearing loss at 8 kHz and hearing loss at 2 kHz are involved in the amplification of tinnitus loudness.</p><p><strong>Conclusions: </strong>High tinnitus loudness can be provoked by peripheral disorders of the somatosensory and/or auditory system. A steep audiometric edge between hearing at 2 kHz and hearing at 8 kHz and/or cervical spine pathology with sympathetic nervous system irritation can amplify tinnitus loudness causing high tinnitus loudness.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"25 1","pages":"66-70"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39327297","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":"Somatosensory Pulsatile Tinnitus Syndrome (SSPT) Revisited.","authors":"Robert Aaron Levine","doi":"10.5935/0946-5448.2021009","DOIUrl":"https://doi.org/10.5935/0946-5448.2021009","url":null,"abstract":"<p><strong>Introduction: </strong>Our initial study reported consecutive patients with constant cardiac synchronous subjective tinnitus (pulsatile tinnitus without an identifiable acoustic source (P)) all of whom could suppress their pulsations with head and neck intense muscle contractions (\"somatic testing\" (ST)). The term somatosensory pulsatile tinnitus syndrome (SSPT) was coined to refer to this type of P. With now more than a decade of clinical experience with P, herein are reported (a) other ways P can present, beside SSPT, (b) how P is related to the somatosensory system and recumbency, and (c) what treatments have been effective.</p><p><strong>Methods: </strong>Retrospective case series of 58 adults with P encountered in an outpatient clinic or through telemedicine.</p><p><strong>Results: </strong>P could be constant or intermittent, with or without non-pulsatile tinnitus (nP). 90% of cases could suppress their pulsations with ST; 9% could not. In 7 of 11 cases that had no P at time of testing, ST elicited P. The most common type of P was SSPT (constant pulsatile tinnitus suppressible by ST) (60%). Treatment of head and neck muscle dysfunction (muscle dry needling and Botulinum toxin injection) has abolished P; auricular electrical stimulation was effective in 2 cases.</p><p><strong>Conclusion: </strong>Suppression of pulsations by ST, eliciting P by ST, and abolishment of P by head and neck muscle treatments all support a major role of the craniocervical somatosensory system in the etiology of most, if not all, cases of P. Three mechanisms are proposed: (A) somatosensory afferents causing dysfunction of the CNS mechanisms that normally suppress self-generated cardiac and vascular sounds, (B) cardiac synchronous disinhibition of the auditory CNS by somatosensory afferents and (C) some combination of A and B.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"25 1","pages":"39-45"},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39327293","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":"Cervical Nerve Projections to the Auditory Pathway in Tinnitus.","authors":"Henk M Koning","doi":"10.5935/0946-5448.20200011","DOIUrl":"https://doi.org/10.5935/0946-5448.20200011","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical spinal nerves project to the auditory system and take part in the pathology of tinnitus.</p><p><strong>Objectives: </strong>The intention of our research was to estimate the outcome of treatment of C6 and C7 to lessen tinnitus intensity and to find criteria for a long-term success.</p><p><strong>Design: </strong>Subjects were 78 tinnitus patients who were treated with infiltration of the sixth and seventh cervical nerve. Clinical data form these patients were reviewed retrospectively. An independent perceiver evaluated the long-term effect of the therapy by telephone interview.</p><p><strong>Results: </strong>In a cohort of tinnitus patients, 18% had less tinnitus after treatment of C6 and C7. The majority of the patients announced a moderate easing of their tinnitus. At 2,5 months, half of the patients with a positive response still had benefit. The combination of hearing loss at 8 kHz and the highness of the intervertebral disc at C4-C5 forecasted a beneficial result of therapy of C6 and C7 with a longer period of relief.</p><p><strong>Conclusions: </strong>Treating afferent cervical nerves can lessen tinnitus. Therapy of C6 and C7 caused less tinnitus for 18% of the tinnitus patients. Especially patients with no hearing loss at 8 kHz and no disc degeneration at C4-C5 forecasted a beneficial result of therapy of C6 and C7 on tinnitus with a longer period of relief.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"70-74"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781434","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":"Comparison of the Effect of Dexmedetomidine and Remifentanil on Controlled Hypotension During Rhinoplasty: A Clinical Trial Study.","authors":"Farzad Zamani,&nbsp;Narges Naseri,&nbsp;Farzaneh Farmani,&nbsp;Alireza Kamali","doi":"10.5935/0946-5448.20200013","DOIUrl":"https://doi.org/10.5935/0946-5448.20200013","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most important problems during cosmetic nose surgery is excessive bleeding. Controlled hypotension is an appropriate technique for reducing intraoperative bleeding as well as satisfactory and non-bloody surgical field. Different drugs, such as dexmedetomidine and remifentanil, are used to control hypotension. The aim of this study was to compare the effect of dexmedetomidine and remifentanil on the creation of control hypotension during rhinoplasty.</p><p><strong>Material and method: </strong>This study is a randomized, double-blind clinical trial which was performed on 60 patients randomly divided into two groups D (Dexmedetomidine) and R (Remifentanil). In group D (0.5 mg / kg / h) Dexmedetomidine infusion and in group R (50-100 μg / kg / h) Remifentanil infusion. The study groups were compared in terms of hemodynamics and intraoperative bleeding. The data obtained from completed questionnaires were analyzed using SPSS software, T-test and ANOVA statistical tests and were presented in tables and statistical charts.</p><p><strong>Results: </strong>The results of this study showed that the mean MAP (Mean Arterial Pressure) was significantly lower in remifentanil group patients than in dexmedetomidine group, while the intraoperative bradycardia rate was different at various time.</p><p><strong>Conclusion: </strong>During rhinoplasty surgery, both dexmedetomidine and remifentanil were effective in controlling hypotension and reducing intraoperative bleeding, but the effect of remifentanil was more pronounced than dexmedetomidine.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781432","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":"Insomnia in Tinnitus Patients: A Prospective Study Finding a Significant Relationship.","authors":"Gregory M Asnis,&nbsp;Henderson Ma,&nbsp;Sylvester C,&nbsp;Thomas M,&nbsp;Kiran M,&nbsp;Richard De La G","doi":"10.5935/0946-5448.20200010","DOIUrl":"https://doi.org/10.5935/0946-5448.20200010","url":null,"abstract":"<p><p>Tinnitus is a highly prevalent medical disorder occurring in 10-30% of the general population. This disorder often becomes chronic and severe effecting quality of life contributing to significant psychiatric consequences; one that we have written about recently is comorbid insomnia. The latter can predispose effected persons to depressive episodes and a worsening of their total functioning. We have reported in the past that comorbid insomnia occurs in 10-80% of tinnitus patients with most reports finding over a 40% frequency. Unfortunately, these prior studies tended to evaluate only insomnia as a symptom and not as a diagnosis; therefore its seriousness and implications could not be assessed. Furthermore, most studies utilized only open-ended questionnaires with many being sent via the mail. Our study evaluated 72 tinnitus patients who were prospectively evaluated over the telephone for a tinnitus treatment study program at our center focusing on possible co-morbid insomnia symptoms as well as whether the insomnia satisfied a diagnosis with its accompanying dysfunctional state. The interview included questions regard a full range of questions assessing sleep onset, sleep continuity, early morning awakening, sleep duration as well as daytime consequences necessary for a diagnosis of insomnia. We found that not only were insomnia symptoms highly prevalent, but 60% of the tinnitus sample met strict diagnostic criteria (DSM-IV-TR) of insomnia secondary to a general medical condition, i.e., tinnitus. Alarmingly, only 4 % were being treated for their insomnia. In addition, our data suggests that tinnitus patients with co-morbid insomnia have a more severe form of tinnitus and thus, may need further care and treatment.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"65-69"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781433","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":"Studying the relationship between the Lund Mackay score and response to medical treatment in patients with chronic sinusitis.","authors":"Ali Dashti Khavidaki Gholam,&nbsp;Reza Gharibi","doi":"10.5935/0946-5448.20200019","DOIUrl":"https://doi.org/10.5935/0946-5448.20200019","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most common reasons for patients to visit a doctor is Sinusitis. Treatment of this disease involves a wide range of topical and systemic drugs, if it left untreated, surgery and sinus drainage will be the only choice. Due to symptoms and problems caused by chronic sinusitis and its treatment, as well as the need for an appropriate solution to reduce this, the present study was conducted to investigate the relationship between The Lund Mackay score and response to medical treatment in patients with chronic sinusitis.</p><p><strong>Materials and methods: </strong>The present study was performed cross-sectionally on 150 patients referred to Khatamul- Anbia Hospital in Zahedan for whom the diagnosis of chronic sinusitis was confirmed and met the study criteria. Demographic data and clinical signs of patients were recorded and for based on CT scan, The Lund Mackay score was evaluated. Patients were treated for 4 to 6 weeks and finally re-evaluated for symptoms and response to treatment. Data were analyzed using SPSS software version 24, McNemar test, Mann-Whitney and other necessary tests for descriptive statistics. A significance level of 0.05 was considered.</p><p><strong>Results: </strong>3.55% of patients were male (83 patients) and 7.44% were female (67 patients). The mean score of the Lund Mackay in the present study was 92.11 with a standard deviation of 2.3. Symptoms of olfactory dysfunction, sinus pain, nasal obstruction and nasal discharge showed significant improvement after treatment (p <05.0). Based on the results obtained at the end of the study, the presence of nasal polyps (p = 001.0) and nasal obstruction (p = 003.0), after the end of the treatment period, showed a significant relationship with the response to treatment.</p><p><strong>Conclusion: </strong>In general, this study suggested that the mean score of The Lund Mackay had a significant positive relationship with the severity of patients' clinical symptoms and the severity of sinusitis. Therefore, it can be considered as a suitable criterion in diagnostic and therapeutic evaluations of patients.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781438","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":"Post Market Clinical Follow up Results of the Steady State Coherent Bio-modulator Patch for tinnitus.","authors":"Peter Åhnblad","doi":"10.5935/0946-5448.20200021","DOIUrl":"https://doi.org/10.5935/0946-5448.20200021","url":null,"abstract":"<p><strong>Objectives: </strong>To follow up with a survey for the safety and performance of the coherent biomodulator patch as a device for tinnitus when in clinical use.</p><p><strong>Materials and methods: </strong>A survey with 20 questions was emailed to device users a few weeks after fulfilled treatment. Collected data from 927 responders from February 2017 to July 2020 was exported and analyzed. The treatment time was 3 weeks, and the patches were changed daily and placed behind one year. The analysis was performed in order to investigate the possibility of subgroups and if the effect of one or more treatments are different, and is the relief dependent on how long the users have had troublesome tinnitus, the age of the user, and the severity of the tinnitus.</p><p><strong>Results: </strong>Most users were 45 years and older with a gender ratio of 1.65 men vs women. In general, the users reported highly bothersome tinnitus with 82% answering frequently to a lot before treatment. This follow up survey showed that 33% experienced any kind of improvement. The majority of those that reported improvement came from the subgroup of 4-10 years suffered from tinnitus. A very low frequency of side-effects was reported with no new risks or unexpected issues.</p><p><strong>Conclusion: </strong>When considering the intended purpose of the steady state coherent biomodulator and the provided information in this survey, the device remains suitable for the intended tinnitus users.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38794999","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":"Is There Any Effect of Subjective Tinnitus on Vestibular Evoked Myogenic Potentials.","authors":"Gokhan Toptas,&nbsp;Kemal Keseroğlu,&nbsp;Bülent Öcal,&nbsp;Cem Saka,&nbsp;Serap Er,&nbsp;Mehmet Hakan Korkmaz","doi":"10.5935/0946-5448.20200012","DOIUrl":"https://doi.org/10.5935/0946-5448.20200012","url":null,"abstract":"<p><p>Idiopathic subjective tinnitus has a complex pathophysiology in which not only cochlear and central classical auditory pathways but also nonclassical auditory pathways of different parts of the brain are involved. Vestibuloocular and vestibulocollic pathways are the central projections of utricle and saccule used in the vestibular evoked myogenic potential (VEMP) test. Aim of this study was to investigate the effects of idiopathic subjective tinnitus on vestibuloocular and vestibulocollic pathways via VEMP. We prospectively analyzed 30 unilateral idiopathic subjective tinnitus patient's cervical, ocular VEMP tests, tinnitus handicap index scores, symptom duration and compared with contralateral ear and 35 healthy volunteers. The latencies and amplitudes of P1 and N1 waves were recorded and pathologic wave criteria was calculated according to healthy volunteer's data. In cervical VEMP there were significant longer latencies of P1 and N1 waves with respect to contralateral ear and control group. In ocular VEMP test, N1 and P1 latencies and amplitudes were not significantly different. The percentages of pathologic wave of the tinnitus side were not significantly higher in both cervical VEMP and ocular VEMP tests with respect to contralateral side. Tinnitus handicap index scores and symptom duration had no relationship with latency and amplitude of VEMP tests. Although cervical VEMP P1 and N1 latencies were significantly longer, subjective tinnitus did not result in pathological alterations in the VEMP test. Presence of subjective tinnitus is not an influencing factor in the VEMP interpretation.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38860929","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":"Evaluation of Auditory Brainstem Response (ABR) in Vitamin B12 Deficiency.","authors":"İdris Turan,&nbsp;Selim Ünsal,&nbsp;Hanifi Kurtaran","doi":"10.5935/0946-5448.20200015","DOIUrl":"https://doi.org/10.5935/0946-5448.20200015","url":null,"abstract":"<p><strong>Purpose: </strong>Changes in the central nervous system are observed due to vitamin B12 deficiency. The purpose of this study is to assess the effects of vitamin B12 deficiency on the central auditory tracks utilizing ABR.</p><p><strong>Material and method: </strong>30 individuals (16 females, 14 males) with vitamin B12 deficiency and 30 individuals (17 females, 13 males) without any hearing problem and B12 deficiency have participated in the study. The ages of the individuals with vitamin B12 deficiency varied between 18 and 39, with a mean of 28±5.6, The ages of the individuals with normal hearing in the control group were between 18 and 42, with a mean of 30±6.2. The I, III and V. wave latencies and I-III, I-V and III-V inter-wave latencies and amplitudes of the participants with vitamin B12 deficiency and with normal hearing were evaluated using click stimulus.</p><p><strong>Results: </strong>No statistically significant change was observed between the group with vitamin B12 deficiency and the normal group in the I, III and V. wave latencies and the I-III, I-V and III-V inter-latency values and amplitudes.</p><p><strong>Conclusion: </strong>Although vitamin B12 deficiency effects the central nervous system, normal latencies and amplitudes were obtained in the ABR test. It was especially observed that the brainstem region, where the I, III ve V. Waves originate, is not effected by vitamin B12 deficiency.</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"74-78"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781435","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":"Evaluation of the Effect of Frequency-Shifting Technique Used in Hearing Aids for Speech Discrimination.","authors":"Gökhan Palabıyık,&nbsp;Selim Ünsal,&nbsp;Mehmet Gündüz","doi":"10.5935/0946-5448.20200016","DOIUrl":"https://doi.org/10.5935/0946-5448.20200016","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effect of frequency-shifting techniques recently used in hearing aids for speech discrimination scores and hearing thresholds.</p><p><strong>Methods: </strong>Thirty individuals (16 men and 14 women) with sensorineural hearing loss who used normal fitting monaural hearing aids and frequency-shifting feature for at least 2 months and whose 4000-8000 Hz hearing threshold was over 70 dB participated. The average age was 69.73 ± 10 (range: 65-80 years). We detected the types and degree of each participant's hearing loss. Measurements with and without hearing aids were made in a free field. For speech discrimination scores, 6 listings consisting of 25 monosyllables have been used. It has been avoided to learn words thanks to presentation of words in different listings to subjects.</p><p><strong>Results: </strong>Pure-tone averages of the participants were measured using a supra-aural headphone, normal fitting hearing aid, and frequency-shifting feature. The results were 55.93 ± 6.89, 40.47 ± 5.48, and 36.73 ± 5.72 dB, respectively (p˂0.05). Speech discrimination scores for hearing aids worn on the right ear were measured as 67.73 ± 12.42%, 77.33 ± 10.33%, and 82.13 ± 10.46% with supra-aural headphones, normal fitting hearing aids, and frequency-shifting feature, respectively. Scores for hearing aids worn on the left ear were 68 ± 7.56%, 76.80 ± 6.96%, and 82.13 ± 6.67% with supra-aural headphone, normal fitting hearing aid, and frequency-shifting feature, respectively (p˂0.05).</p><p><strong>Conclusion: </strong>Elderly individuals using hearing aids had low speech discrimination scores. The frequency-shifting feature recently used in hearing aids significantly increased the scores, making a significant contribution to the solution of speech reception and communication problems in cases of high-frequency hearing loss caused by presbyacusis in elderly individuals..</p>","PeriodicalId":39842,"journal":{"name":"International Tinnitus Journal","volume":"24 2","pages":"86-91"},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38781437","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}