Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia最新文献

{"title":"External Validation of a Clinical Nomogram for Predicting Intracranial Hematoma Following Head Computed Tomography in Pediatric Traumatic Brain Injury","authors":"Apisorn Jongjit, Thara Tunthanathip","doi":"10.1055/s-0043-1775579","DOIUrl":"https://doi.org/10.1055/s-0043-1775579","url":null,"abstract":"Abstract Introduction Over-investigation of head computed tomography (CT) has been observed in children with TBI. Long-term effects from a head CT brain scan have been addressed and those should be balanced. A nomogram is a simple prediction tool that has been reported for predicting intracranial injuries following a head CT of the brain in TBI children in literature. This study aims to validate the performance of the nomogram using unseen data. Additionally, the secondary objective aims to estimate the net benefit of the nomogram by decision curve analysis (DCA). Methods We conducted a retrospective cohort study with 64 children who suffered from traumatic brain injury (TBI) and underwent a CT of the brain. Nomogram's scores were assigned according to various variables in each patient; therefore sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and F1 score were estimated by the cross-tabulation of the actual results and the predicted results. Additionally, the benefits of a nomogram were compared with “None” and “All” protocols using DCA. Results There were 64 children with TBI who underwent a head CT in the present study. From the cross-tabulation, the nomogram had a sensitivity of 0.60 (95%CI 0.29–0.90), specificity of 0.96 (0.91–1.0), PPV of 0.75 (0.44–1.0), NPV of 0.92 (0.86–0.99), accuracy of 0.90 (0.83–0.97), and an F1 score of 0.66 (0.59–0.73). Also, the area under the curve was 0.78 which was defined as acceptable performance. For the DCA at 0.1 high-risk threshold, the net benefit of the nomogram was 0.75, whereas the “All” protocol had the net benefit of 0.40 which was obviously different. Conclusion A nomogram is a suitable method as an alternative prediction tool in general practice that has advantages over other protocols.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588520","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 a Genetic Relationship between Acute Lymphoblastic Leukemia and Meningioma? A Case Report of the Analyses of Three Genes","authors":"Mehmet Besir Surme, Fatih Demir, Deniz Erol, Metin Kaplan","doi":"10.1055/s-0043-1775554","DOIUrl":"https://doi.org/10.1055/s-0043-1775554","url":null,"abstract":"Abstract Meningiomas are the most common tumors of the central nervous system, and they are generally slow growing and benign. Acute lymphoblastic leukemia (ALL) is a life-threatening ltype of cancer that involves the accumulation of peripheral blood vessels and immature cells in the bone marrow. Genetic mutations play an important role in the etiology of both diseases. Therefore, in the case herein presented, we investigated the meningioma 1 (MN1), nucleophosmin 1 (NPM1), and Wilms tumor 1 (WT1) genes for possible genetic mutations. A 27-year-old female with a chief complaint of headache and history of lllALL presented with a mass in the left frontal lobe. The pathological analysis revealed a fibroblastic meningioma. However, the three genes were found to be normal in the analysis. In light of these findings, we did not encounter any evidence of a genetic relationship between meningioma and ALL in the present study.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588525","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":"Spinopelvic Parameters in the Clinical and Functional Outcomes of Patients Submitted to Lumbar Interbody Fusion Surgery – A Prospective Study","authors":"Renata Marques, Ana Cristina Silva, João Nogueira, Miguel Afonso, Nubélio Duarte","doi":"10.1055/s-0042-1758209","DOIUrl":"https://doi.org/10.1055/s-0042-1758209","url":null,"abstract":"Abstract Objectives The relevance of spinopelvic parameters in the patients' clinical and functional outcomes has been widely studied in long spinal fusion. Yet, the importance of the spinopelvic parameters in short-segment fusion surgeries needs further investigation. We analyzed the spinopelvic parameters and surgical outcomes of patients undergoing short-segment lumbar interbody fusion. Materials and Methods An observational, prospective study was conducted between January and June 2021. We selected 25 patients with lumbar stenosis, with or without concomitant spondylolisthesis, undergoing transforaminal lumbar interbody fusion. Variables related to the patient, diagnosis, and surgery were collected. The clinical and functional outcomes were assessed using the Visual Analogue Scale for low-back and leg pain and the Oswestry Disability Index (ODI). The surgical outcomes and spinopelvic parameters were analyzed pre- and postoperatively. Results There was a significant clinical and functional improvement after surgery (p < 0.001), with a mean ODI decrease of 63.6%. The variables of obesity, concomitant spondylolisthesis, absence of osteotomy, and two-level fusion were all associated with lower levels of improvement after surgery (p < 0.05). Pelvic incidence minus lumbar lordosis (PI-LL) was the only parameter that significantly changed regarding the pre- and postoperative periods (p < 0.05). Before surgery, PI-LL < −10° correlates with less low-back pain after surgery (r = 0.435; p < 0.05). Postoperatively, no correlation was found between surgical outcomes and all the spinopelvic parameters analyzed. Conclusions The clinical and functional outcomes significantly improved with the surgical intervention but did not correlate with the change in spinopelvic parameters. Patients with preoperative PI-LL < −10° seem to benefit the most from surgery, showing greater improvement in back pain.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638453","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":"Nasal Cerebrospinal Leaks in the Milieu of COVID-19 Pandemic","authors":"Oleg I. Sharipov, Nadeghda A. Chenikova, Ashraf Abdali, Vishal Chavda, Elizaveta B. Shelesko, Maksim A. Kutin, Olga N. Ershova, Pavel L. Kalinin, Bipin Chaurasia","doi":"10.1055/s-0043-1774742","DOIUrl":"https://doi.org/10.1055/s-0043-1774742","url":null,"abstract":"Abstract Background The unintentional ingestion of oropharyngeal or gastric contents into the respiratory tract is known as aspiration. Rhinorrhea can cause aspiration pneumonia (cerebrospinal fluid leakage). Objective There are only a few reports in the literature about pneumonia as a complication of rhinorrhea. There are no reports on how to handle such cases if they present to the clinic at the peak of COVID-19 disease and distinguish between these two conditions. Methods We reviewed the literature and retrospectively analyzed the clinical information and treatment protocols used to treat the two clinical cases. Results By screening the COVID-19 PCR and antibodies more than twice, surgery was postponed for 10–14 days in both cases to rule out COVID-19-induced pneumonia. Chest CT scans still revealed ground glass opacities. In both cases, the skull base defect was repaired. In both cases, radiological signs of rhinorrhea-induced pneumonia had completely resolved at the 24- and 30-day follow-ups. Conclusion CSF aspiration causes radiological changes in the lungs in rhinnorhea. This is a short-term local decrease in lung tissue airness (partial filling of alveoli with fluids), which is visible radiographically (ground-glass opacities). To rule out COVID-19 infection, surgery should be postponed for 10–14 days, and PCR and antibodies (IgG,IgM) should be performed at least twice. If the COVID-19 screening test is negative, repair surgery can be scheduled.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588528","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":"Aneurysmal Subarachnoid Hemorrhage: Is the Time Until Intervention Related to Minor Disabilities in 6 Months?","authors":"Yuri Tebelskis, Nícollas Nunes Rabelo, Leonardo Zumerkorn Pipek, João Paulo Mota Telles, Guilherme Bitencourt Barbosa, Natalia Camargo Barbat, Antônio Carlos Samaia da Silva Coelho, Marcia Harumy Yoshikawa, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo","doi":"10.1055/s-0043-1775557","DOIUrl":"https://doi.org/10.1055/s-0043-1775557","url":null,"abstract":"Abstract Background Aneurysmal subarachnoid hemorrhages (aSAHs) account for 5% of all strokes, an appalling number when it comes to the second most common cause of death worldwide. The basis of the treatment is clinical support and either endovascular or surgical intervention. The purpose of the present study is to analyze if the time from the onset of the thunderclap headache until treatment intervention is related to the degree of disability after 6 months. Methods In the present prospective observational study, data were collected from all patients (n = 223) admitted to the hospital with a diagnosis of aSAH. Patients whose data were missing or who missed the follow-up after 6 months were excluded. Then, the number of days from the thunderclap headache until the surgical intervention (Delta T) was obtained. The degree of disability was evaluated using standardized scales, Rankin Scale (RS) and Glasgow Outcome Scale (GOS), at the time of discharge as well as 6 months later. Then, the RS and GOS were correlated with Delta T. Results An average of 6.8 days was found from the onset of symptoms to the intervention, the average age was 54 years old, 73% were women and 55% were smokers. The mean Glasgow Coma Scale on admission was 13. The mean score on the Hunt and Hess scale was 2.1. From the radiological point of view, the mean size of the aneurysm was 6 mm, and the modified Fisher Scale was 3.1. Of the total number of patients at the end of the study (n = 78), 50 underwent microsurgical treatment (63%). Rankin scale at discharge was 1.9 and GOS was 4.5, with no statistically significant change at 6 months. Analyzing the data distribution using linear regression, no statistically significant correlation was found between the time until treatment and disability using RS and GOS (p &gt; 0.05). The same results were found even analyzing age subgroups (≤ 45 years old, 45 to 55 years old, 55 to 70 years old, and &gt; 70 years old with a p-value &gt; 0.05). Conclusions The present study suggests that there is no linear correlation between Delta T and disability at 6 months for the population studied. However, more studies are needed to assess whether these findings may be present in other populations, especially with a shorter time from symptoms to intervention, since the greatest risk of rebleeding occurs in the first 3 days after the event.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588522","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":"Ten Steps for NPH Management: Advancements in Diagnosis and Treatment of Adult Hydrocephalus","authors":"Alex Roman, Prince Takkar, Tanmoy Maiti","doi":"10.1055/s-0043-1774741","DOIUrl":"https://doi.org/10.1055/s-0043-1774741","url":null,"abstract":"Abstract Objectives The authors of the present study intend to describe a straightforward protocol for normal pressure hydrocephalus diagnosis and management, with the employment of a multidisciplinary team approach effort. Methods Using a strict methodological approach for initial diagnosis, taking into consideration occupational therapy and physical therapy assessment, the authors have set out to elaborate a simple protocol for suspicion and, once diagnosed, treatment of normal pressure hydrocephalus. We have used the MoCA (Montreal Cognitive Assessment) and walking assessment that included speed, independence, and distance (SID), 10 m walk test, TUG (timed up and go) evaluation, 6-minute Walk Test, MiniBESTest, as the main factors for pre and post lumbar drainage assessment, after which, the alternatives were deliberated and followed, or not, by ventriculoperitoneal shunt insertion. Results The authors have described a protocol, consisting of ten easy steps, which involves a multidisciplinary team, including occupational therapy and physical therapy professionals, as well as neurologists and neurosurgeons for improved and objective assessment prior to insertion of lumbar drain and, thereafter, detecting the population at most benefit for ventriculoperitoneal shunt insertion. We have described the Ten Step Approach for Normal Pressure Hydrocephalus management, including from initial clinical presentation and imaging, to pre and post lumbar drainage, for lastly deciding upon necessity for ventriculoperitoneal shunt insertion. Conclusions A straightforward protocol for normal pressure hydrocephalus seems not only feasible, but simple to implement in most neurosurgical departments, with good accuracy of prediction of lumbar drainage assessment to shunting outcomes.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588529","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 Outcome of Microvascular Decompression for Hemifacial Spasm: Symptom Control and Quality of Life","authors":"Thayanna Bentes Lemanski Lopes Rodrigues, Lucas Crociati Meguins, Antonio Ronaldo Spotti, Carlos Eduardo Dall Aglio Rocha, Waldir Antônio Tognola, Dionei Freitas de Morais","doi":"10.1055/s-0043-1774785","DOIUrl":"https://doi.org/10.1055/s-0043-1774785","url":null,"abstract":"Abstract Introduction Hemifacial spasm (HFS) is characterized by a segmental myoclonus of the face muscles innervated by the ipsilateral facial nerve. The accepted pathophysiology of HFS suggests that it is a disease process of the nerve root entry zone associated with any neuro-vascular conflict. Aim Review the surgical results and outcome regarding spasm control, post-operative quality of life and morbidity of microvascular decompression (MVD) for HFS from a Brazilian neurosurgical team. Method An observational investigation was conducted with data collection from patients with hemifacial spasm treated with MVD from January 2000 to December 2015 in two different centers in the West of São Paulo State, Brazil. Results A total of 152 patients underwent MVD for the treatment of HFS, ninety-eight (64.5%) female. Eighty-seven (57.2%) patients presented right-side spasms. The most common offending vessel was the posterior inferior cerebellar artery (PICA) with 78 (51.3%) patients. According to clinical presentation, an amount of 144 (94.7%) patients presented total control of symptoms after 36 months of follow-up. Regarding quality of life, a total of 125 (82.2%) patients referred normal quality of life after MVD for HFS and 121 (96.8%) from then were able to return to work or previous occupation. Permanent facial paresis / palsy was observed in 6 (3.6%) patients. There was no surgical mortality. Conclusion MVD for the treatment of HFS is a safe and efficacious surgical procedure to control spasm. Neurosurgeons experience, adequate patient selection and good anatomical knowledge are fundamental to success of the treatment.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588521","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":"Correspondence to “Intracranial Pressure Monitoring and Unfavorable Outcomes”","authors":"Salomon Soriano Ordinola Rojas, Rogério Ribeiro da Silveira, Juliana Caldas, Carla Bittencourt Rynkowski, Antônio Eiras Falcão","doi":"10.1055/s-0042-1748847","DOIUrl":"https://doi.org/10.1055/s-0042-1748847","url":null,"abstract":"We would like to express our surprise after reading the reply to Dr. Chiara Robba's Intracranial pressure monitoring and unfavorable outcomes correspondence, written by Brazilian physicians Welling et al., in which the possibilities and tools available for intracranial pressure monitoring in both national and international scenarios are described, stating that “intracranial pressure monitoring is not included in the management strategy for neurocritical patients”, using BEST TRIP[1] as such reference. Our astonishment lies in the fact that we, authors of this letter, use intracranial pressure (ICP) monitoring as a daily practice in our neurocritical care unit. As representatives of The Neurocritical Care Committee of the Brazilian Association of Intensive Care Medicine (AMIB, in the Portuguese acronym), we recommend monitoring intracranial pressure in neurocritical patients, since monitoring-guided treatment of intracranial hypertension is associated with a potential improvement in treatment outcomes.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588523","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":"Pituitary Hormonal Disturbances in Aneurysmal Subarachnoid Hemorrhage","authors":"J. C. Moura, H. Azevedo, M. Valença, C. Vidal, Samuel Miranda de Moura, Mateus de Sousa Rodrigues","doi":"10.1055/s-0043-1769782","DOIUrl":"https://doi.org/10.1055/s-0043-1769782","url":null,"abstract":"Abstract Objective  The objective of the present study was to assess the hormonal alterations that occurred in patients with subarachnoid hemorrhage. Methods  This is a case series with 21 patients diagnosed with subarachnoid hemorrhage of aneurysmal etiology up to 30 days after the ictus. The following hormonal measurements were performed in these patients: cortisol, GH, testosterone, prolactin, estradiol, FSH, LH, FSH, T3, T4 and free T4. The hormonal results of the cases were compared with the results of twelve volunteers from the control group and correlated with findings in brain tomography, cerebral angiography, Hunt-Hess scale, and vasospasm. Results  The main altered hormones were cortisol (52.6%), GH (42.9%) and TSH (28.6%). There was a trend towards more severe cases in the following groups of patients: Hunt-Hess scale > 2, Fisher scale > 1, aneurysmal topography in the anterior communicating artery and those who had vasospasm. Conclusion  The present study observed the tendency of pituitary hormonal changes in patients with subarachnoid hemorrhage of aneurysmal etiology, corroborating the need for dosage of hormones from the hypothalamic-pituitary axis in the management of these cases.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"13 1","pages":"e105 - e113"},"PeriodicalIF":0.1,"publicationDate":"2022-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85192688","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":"Traumatic Atlanto-occipital Dislocation in Children Followed by Hydrocephalus – A Case Report and Literature Review","authors":"C. Formentin, Lucas de Souza Rodrigues dos Santos, F. Maeda, H. Tedeschi, E. Ghizoni, A. Joaquim","doi":"10.1055/s-0042-1744430","DOIUrl":"https://doi.org/10.1055/s-0042-1744430","url":null,"abstract":"Traumatic atlanto-occipital dislocation (TAOD) are uncommon injuries associated with high immediate mortality rate and occurs more than twice in children than adults, due to biomechanical properties and immaturity of children's cervical spine. We report a pediatric patient with TAOD, who underwent occipitocervical stabilization and also developed a late hydrocephalus requiring a shunt procedure. A six-year-old boy was admitted to the emergency department after a car accident with refractory cervical pain. A cervical computed tomography (CT) scan showed an anterior C1–C2 level hematoma, and a dynamic CT scan demonstrated an increasing basion-dens interval on extension. Cervical magnetic resonance imaging (MRI) showed discontinuity of the tectorial membrane and diffused hyperintense signal on the left alar ligament. These findings were attributed to TAOD, and an occipitocervical fusion was performed. The pain and neurological status improved after surgery, but after 3 months he returned with persistent vomiting, headache, and a CT scan showing hydrocephalus. Then, a ventriculoperitoneal shunt was performed, improving the symptoms. One year after the injury, the patient remained asymptomatic, and a later radiography demonstrated satisfactory bone fusion. In conclusion, the decision-making process regarding treatment should consider several clinical and radiographic findings. Occipitocervical fusion is the treatment of choice, while hydrocephalus is not an unusual complication in children.","PeriodicalId":42205,"journal":{"name":"Brazilian Neurosurgery-Arquivos Brasileiros de Neurocirurgia","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80587961","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}