Neurohospitalist最新文献

{"title":"High-Risk Plaque Features in the Non-stenosing Carotid Artery, How Frequently is This Reported? A Retrospective Study.","authors":"Ammar Jumah, Abdalla Jamal Albanna, Abdelrahman Elfaham, Lara Eltous, Sohaib Zoghoul, Daniel Miller","doi":"10.1177/19418744241283858","DOIUrl":"10.1177/19418744241283858","url":null,"abstract":"<p><strong>Background: </strong>High-risk features of non-stenosing (ie, <50%) carotid plaques are emerging as a possible source of embolism in patients with embolic stroke of undetermined source (ESUS). However, in the absence of hemodynamically significant stenosis, neuroradiology reports rarely describe these morphological features. Our aim was to determine how often high-risk features of non-stenosing plaques are included in diagnostic imaging reports.</p><p><strong>Methods: </strong>In this retrospective study, we evaluated computed tomography angiography (CTA) reports associated with the CTA imaging results for a previously published cohort study. Plaque features reporting frequencies were calculated and defined as the number of times specific plaque features were included in the CTA reports (Thickness, ulceration, length, soft component and calcification) divided by the number of occurrences of high-risk plaque features (Thickness >0.3 cm; ulceration; length >1.0 cm), soft component, or calcification identified in the CTA results. We used Fisher exact test to compare the reporting frequencies of the 5 plaque features.</p><p><strong>Results: </strong>We analyzed 152 CTA reports. The frequency of reporting plaque thickness (0/40; 0%), ulceration (3/37; 8.1%), and length (7/29; 24.1%) was significantly lower than the reporting of plaque calcification (122/122; 100%) and presence of soft component (31/34; 72.1%) when these features were present in CTA imaging results (all <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>When carotid plaques are not causing hemodynamically significant stenosis, neuroradiology reports frequency mention plaque density but often exclude other characteristics. Neuroradiologists and neurologists should collaborate to create algorithms, scoring systems and prediction models to accurately determine which plaque features are highly associated with embolism.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"155-158"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Ghost in the Machine: Artificial Intelligence in Neurocardiology Will Advance Stroke Care.","authors":"Harneel Saini, David Z Rose","doi":"10.1177/19418744241288887","DOIUrl":"10.1177/19418744241288887","url":null,"abstract":"<p><p><b>Background:</b> Innovations in artificial intelligence (AI) and machine learning (ML) are poised to transform stroke care, particularly for Neuro-Cardiac Programs (NCP) within both academic and community hospital systems. <b>Purpose:</b> Given AI's success in large-vessel occlusion (LVO) detection and perfusion mapping delivered to our smartphones, the next leap for this \"Ghost in the Machine\" technology seems to be into the world of NCP: AI-enhanced logistics have started to help with cardiac monitoring after cryptogenic, large-artery and small-vessel stroke, looking for atrial fibrillation (AF) with an insertable loop recorder (ILR) and/or external patch. <b>Results:</b> The 'CONNECT' study from UCSD demonstrated that AI can increase protocol efficiency and reduce patient wait-times for ILR; with more AF detected, fewer strokes may result as more patients receive anticoagulation or Left Atrial Appendage Closure (LAAC). <b>Conclusion:</b> Therefore, organically, the next AI and ML-enhanced NCP frontier may involve inter-departmental \"Shared Decision-Making\" (SDM) process with LAAC, and/or Patent Foramen Ovale (PFO), in appropriately selected patients. In this editorial, we explore AI's capability to disrupt current antiquated siloed communication tools, refine and streamline SDM processes and tailor patient-specific treatment plans, nevertheless advocating for intercalation of AI into NCP pathways in a secure, ethically-guided manner.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"89-90"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559459/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of Dual Antiplatelet Therapy After High-Risk Transient Ischemic Attack at a University Hospital.","authors":"Morin Beyeler, Philipp Bücke, Pasquale Castigliego, Joel Baumann, Victor Ziegler, Babak B Navi, Simon Jung, Marcel Arnold, Ava L Liberman","doi":"10.1177/19418744241289625","DOIUrl":"10.1177/19418744241289625","url":null,"abstract":"<p><p>Multiple randomized controlled trials have demonstrated that dual antiplatelet therapy (DAPT) significantly reduces the risk of subsequent stroke as compared to aspirin monotherapy after high-risk transient ischemic attack (TIA) or minor ischemic stroke. We sought to evaluate the uptake of DAPT after high-risk TIA at a single center. We conducted a retrospective cohort study of consecutive TIA patients admitted via the Emergency Department (ED) of Bern University Hospital (1/1/2018-12/31/2019). We use descriptive statistics to detail cohort characteristics and compared patients treated with DAPT to those not treated. Statistical significance was set at α = 0.05 and all tests of comparison were two-sided. A total of 383 TIA patients were seen during the study period, 247 were eligible for DAPT. Among those eligible for DAPT, mean age was 72 years and 51% were female. A total of 49 (19.8%) eligible TIA patients were treated with DAPT; use of DAPT significantly increased from 2018 to 2019. Patients admitted to the stroke unit or intensive care unit (n = 33) had a significantly higher proportion of DAPT treatment as compared to those admitted to the general neurology ward or discharged to home from the ED. DAPT use was also significantly higher in patients with large artery atherosclerotic disease (n = 23) as compared to other etiological subtypes and significantly higher among patients who arrived to the ED within 24 h of symptom onset (n = 178). In conclusion, we found that only 2 out of every 10 high-risk TIA patients received DAPT in the years following its introduction in the clinical practice. Our results suggest that strategies to improve the uptake of new, evidence-based secondary stroke prevention treatment after high-risk TIA are needed.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"159-162"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Hepatic Porphyria Presenting as Guillain-Barré Syndrome: Importance of Early Recognition and Screening.","authors":"Kumar Porakapalli Yuvasai, Sanveer Singh, Pratiksha Jayant Pai, Sathvik Reddy Erla, Ashok Kumar Pannu","doi":"10.1177/19418744251331651","DOIUrl":"10.1177/19418744251331651","url":null,"abstract":"<p><p>Acute hepatic porphyria (HP) often presents with recurrent neurovisceral symptoms in young adults, mimicking more common neurological conditions such as Guillain-Barré Syndrome (GBS) and posing significant diagnostic challenges. We report a case of a 25-year-old male who presented with progressive weakness of all 4 limbs over 4 days, culminating in respiratory paralysis requiring mechanical ventilation. Neurological examination revealed acute flaccid paralysis with areflexia, and nerve conduction studies showed acute motor axonal neuropathy, initially supporting a diagnosis of GBS. However, the patient's young post-pubertal age, onset in the upper limb with proximal weakness, pure motor axonal neuropathy, and presence of hyponatremia due to the syndrome of inappropriate antidiuresis raised suspicion of acute HP. Screening with qualitative urine porphobilinogen testing, followed by quantitative confirmation, diagnosed acute HP. The patient was treated with intravenous dextrose in the absence of hemin, resulting in gradual clinical improvement. This case underscores the importance of distinguishing acute HP from GBS and the need for early recognition and screening to initiate life-saving therapy.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251331651"},"PeriodicalIF":0.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 22-Year-Old Man With Headache, Facial Numbness, Diplopia and Left Leg Numbness.","authors":"Daniel Gabay Moreira, Paul E Sanmartin","doi":"10.1177/19418744241276711","DOIUrl":"10.1177/19418744241276711","url":null,"abstract":"<p><p>We present a 22-year-old male with a subacute course of chin numbness, ophthalmoplegia, headache and left leg numbness in the setting of fever, chills and night sweats. Initial imaging investigations revealed cauda equina enhancement plus an infiltrative process at the basis of the skull associated with extensive bone marrow infiltration and lymphadenopathy elsewhere. We discuss the localization, differential diagnosis, and appropriate investigations for this unique clinical scenario. Important laboratory findings and treatment considerations are reviewed for this unusual final diagnosis.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"167-171"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Systemic Lupus Erythematosus Presenting as Isolated Mononeuropathy Multiplex.","authors":"Mia Andreoli, Cecilia N Hollenhorst, Tulsi Malavia, Jasmine L May, Shubadra Priyadarshini, Arjun Seth, Karan Dixit","doi":"10.1177/19418744241285551","DOIUrl":"10.1177/19418744241285551","url":null,"abstract":"<p><p>Mononeuropathy multiplex is a pattern of progressive sensory and motor deficits in the distribution of two or more peripheral nerves. The differential for mononeuropathy multiplex includes vasculitis, autoimmune disorders, infectious diseases, sarcoidosis, amyloidosis, cryoglobulinemia, and paraneoplastic disease. We present a case of a 42-year-old woman with hypothyroidism who presented with 1 week of ascending numbness and weakness, persistent fevers, and 3 months of constant burning pain in both feet. Her neurologic exam was notable for asymmetric weakness, loss of sensation, and diminished reflexes of her lower extremities. Other than mild fever and tachycardia, there were no systemic exam findings. Her laboratory workup was significant for elevated inflammatory markers, positive ANA, anti-ribonucleoprotein, smooth muscle antibody, and lupus anticoagulant, high anti-dsDNA titers, and low complement levels. An MRI of her lumbar spine was negative for lumbosacral nerve root pathology. Cerebrospinal fluid studies demonstrated normal cell counts, glucose, and protein and no evidence of infection. An electromyography (EMG) and nerve conduction studies (NCS) demonstrated asymmetric involvement of multiple individual peripheral nerves. Given the patient's symptoms, asymmetric exam findings, laboratory results, and EMG/NCS findings, she was diagnosed with mononeuropathy multiplex secondary to systemic lupus erythematosus (SLE) and started on steroid and immunosuppressant therapy with symptomatic improvement. Overall, this case illustrates the unique presentation of mononeuropathy multiplex as the initial manifestation of SLE. The identification of this specific type of neuropathy may play a crucial role in the prompt diagnosis of SLE and timely initiation of treatment, preventing further complications of the disease.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"176-181"},"PeriodicalIF":0.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Radiological Mimic of Intracranial Hemorrhage -Interpeduncular Lipoma.","authors":"Somarajan Anandan, Sajeesh Rajendran","doi":"10.1177/19418744251325672","DOIUrl":"10.1177/19418744251325672","url":null,"abstract":"<p><p>Intracranial lipomas are rare congenital malformations which are neither hamartomas nor true neoplasms. Rarely lipomas show blooming on susceptibilty weighted images and this can be confused with subacute blood especially if the patient present with headache and MRI brain is the only available image. Do fat saturated images or CT scan if T1 weighted MRI brain shows hyperintensity along with blooming on susceptibilty weighted images.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251325672"},"PeriodicalIF":0.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Predictors of Stroke Mimics in Code Stroke Patients Evaluated via Telemedicine and Treated With Thrombolytic Therapy.","authors":"Andrea Loggini, Amber Schwertman, Jessie Henson, Julie Wesler, Jonatan Hornik, Karam Dallow, Alejandro Hornik","doi":"10.1177/19418744251324675","DOIUrl":"10.1177/19418744251324675","url":null,"abstract":"<p><strong>Background: </strong>Intravenous thrombolysis is an established treatment to improve functional outcomes in acute ischemic stroke. However, various acute central nervous system dysfunctions can mimic stroke, where thrombolytic therapy may provide no benefit and carries potential risks. The ability to accurately distinguish stroke mimics vs stroke by telemedicine evaluation is uncertain. This study aims to identify clinical predictors of stroke mimics in patients evaluated via telemedicine for suspected ischemic stroke and treated with thrombolytics.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of patients treated with thrombolytics for suspected acute ischemic stroke via telemedicine at Southern Illinois Healthcare between 2017 and 2024. Data on demographics, past medical history, clinical presentation, National Institutes of Health Stroke Scale (NIHSS), stroke metrics, and laboratory values were collected. Final diagnoses were categorized as cerebrovascular disease (CD), including acute ischemic stroke and transient ischemic attack, and stroke mimic (SM). Outcomes included hospital length of stay (LOS) and discharge disposition.</p><p><strong>Results: </strong>Of 171 patients treated with thrombolytics via telemedicine, 128 (75%) were diagnosed with CD, and 43 (25%) were SM, with toxic-metabolic encephalopathy being the most common mimic (40%, n = 17). Adjusted forward logistic regression showed age (OR: 0.957, 95% CI: 0.931-0.984, <i>P</i> = .002) and NIHSS (OR: 1.098, 95% CI: 1.032-1.168, <i>P</i> = .003) remained independently associated with SM. The predictive TeleStroke Mimic was score performed with c-statistic of 0.61. SM had shorter median LOS (3 [2-3] vs 3 [2-6], <i>P</i> < .01) and higher rate of discharge home (86% vs 55%, <i>P</i> < .01).</p><p><strong>Conclusions: </strong>In our population, younger age and higher NIHSS were associated with higher odds of SM diagnosis in patients treated with telemedicine-administered thrombolytics. These variables are insufficient to reliably identify a subgroup of patients evaluated via telemedicine for whom thrombolytics could be withheld. The poor performance of Telestroke Mimic score highlights the need for improved predictive tools. Until larger studies are conducted, telemedicine-administered thrombolytics should adhere to current in-person guidelines.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251324675"},"PeriodicalIF":0.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-Onset Multiple Acyl-CoA Dehydrogenase Deficiency Presenting as Hyperammonemia and Encephalopathy: Case Series.","authors":"Cristina Viguera Altolaguirre, Andrew B Stergachis, David A Sweetser, Nina B Gold","doi":"10.1177/19418744251324959","DOIUrl":"10.1177/19418744251324959","url":null,"abstract":"<p><p><b>Background:</b> Multiple acyl-CoA dehydrogenase deficiency (MADD) is an inherited metabolic disorder (IMD) that affects the electron transfer chain and fatty acid oxidation. The late-onset form of MADD has a heterogenous clinical presentation that typically results in episodic lethargy, hypoglycemia, acidosis, and rhabdomyolysis during metabolic decompensations. <b>Purpose:</b> In this case report series we describe three cases of late-onset MADD presenting with hyperammonemia and encephalopathy, a less frequent but severe complication. <b>Methods:</b> the medical records of three patients with MADD and hyperammonemia were retrospectively analyzed for details surrounding their presentation and workup. <b>Results:</b> One patient had hyperammonemia to 445 μmol/L, obtundation, and seizures, requiring venovenous hemodialysis. Two patients had abnormal brain imaging findings. Two of the cases were initially diagnosed as hepatic encephalopathy, but treatment for this did not reverse the hyperammonemia. Workup for IMDs revealed biochemical profiles consistent with MADD, with non-diagnostic genetic testing. MADD-directed therapy led to a reversal of hyperammonemia and return to neurologic baseline of all patients. <b>Conclusion:</b> This series highlights hyperammonemia as a presentation of late-onset MADD, a potentially lethal but treatable disorder.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251324959"},"PeriodicalIF":0.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Skilled Nursing Facility Length of Stay and Discharge After Aneurysmal Subarachnoid Hemorrhage.","authors":"Carl M Porto, Dylan N Wolman, Joshua R Feler, Carlin C Chuck, Gnaneswari Karayi, Radmehr Torabi, Krisztina Moldovan, Karen L Furie, Ali Mahta","doi":"10.1177/19418744251323639","DOIUrl":"10.1177/19418744251323639","url":null,"abstract":"<p><strong>Background and purpose: </strong>Aneurysmal subarachnoid hemorrhage (aSAH) carries high morbidity and mortality with survivors often requiring extended care at skilled nursing facilities (SNF). Predictors of SNF discharge to home (SNFdcH) remain unclear.</p><p><strong>Methods: </strong>Retrospective review of a single-center prospectively maintained aSAH database from June 2016-March 2024 was conducted. Patients discharged to SNF were grouped by subsequent discharge to home. Predictors of discharge to home and facility length of stay (LOS) were determined using t-tests, Fisher analyses, and cumulative link modeling.</p><p><strong>Results: </strong>Of 450 aSAH patients, 61 (13.5%) were discharged to SNFs. 49 (80.3%) returned home, with 61% achieving mRS <3 at discharge. Discharged patients were younger (mean 63.3 ± 11.5 vs 70.2 ± 9.3 years, <i>P</i> = .040) with lower median modified Fisher scores (3 [IQR 3-4] vs 4 [4-4], <i>P</i> = .046). Tracheostomy (OR = .14, 95% CI [.02, .75], <i>P</i> = .023) and gastrostomy tube (PEG) placement (OR = .13, 95% CI: .03-.51, <i>P</i> = .003) decreased the odds of SNFdcH. Discharged patients had shorter hospital LOS (26 ± 10 vs 39 ± 15 days, <i>P</i> < .001) and lower median modified Rankin scores (mRS) at hospital discharge (4 [4-5] vs 5 [4-5], <i>P</i> = .028) and at 90 days post-discharge (4 [3-5] vs 6 [5-6], <i>P</i> = .001). Multivariable regression identified age, PEG, and hospital LOS as predictors of SNFdcH. Tracheostomy and PEG predicted SNF LOS.</p><p><strong>Conclusions: </strong>Most aSAH patients discharged from SNFs returned home, with 61% achieving mRS <3. Patients not discharged were medically complex with neurological deficits. These findings may guide care discussions and highlight the role of SNFs in bridging hospitalization and independence.</p>","PeriodicalId":46355,"journal":{"name":"Neurohospitalist","volume":" ","pages":"19418744251323639"},"PeriodicalIF":0.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}