Current Problems in Diagnostic Radiology最新文献

{"title":"Beyond milestones and percentiles: Revisiting non-cognitive and non-interpretive skills in radiology","authors":"Emil J. Barkovich MD ,&nbsp;Mary Heekin MD ,&nbsp;Matthew J. Barkovich MD ,&nbsp;John P. Lichtenberger III MD","doi":"10.1067/j.cpradiol.2024.08.004","DOIUrl":"10.1067/j.cpradiol.2024.08.004","url":null,"abstract":"<div><div>While there is no precise formula for a great radiology resident, certain attributes and achievements may herald success during training. We briefly review prior works exploring predictive factors and evaluation metrics of top resident performance, noting that those focusing on non-cognitive attributes are over twenty years old. As radiology practice and education has substantially evolved in the interim, we revisit this topic from a contemporary perspective. Inspired by the literature and our own personal experiences, we suggest that the following non-cognitive traits are invaluable for radiology trainees: communication expertise, workplace adaptability, self-awareness, tech savvy and genuine interest in one's individual work and greater community. These characteristics should be highlighted by applicants, sought by selection committees, cultivated by mentors, evaluated by programs and valued by colleagues.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 167-169"},"PeriodicalIF":1.5,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977526","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":"Imaging enigma in mastitis: A comprehensive study of multifaceted causes, clinical and radiological presentations","authors":"Dr. Veenu Singla MD ,&nbsp;Dr. Dollphy Garg MD, DNB ,&nbsp;Dr. Ashish Dua MD ,&nbsp;Dr. Amanjit Bal MD ,&nbsp;Dr. Tulika Singh MD ,&nbsp;Dr. Nidhi Prabhakar MD ,&nbsp;Dr. Divya Dahiya","doi":"10.1067/j.cpradiol.2024.08.006","DOIUrl":"10.1067/j.cpradiol.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Mastitis is an inflammatory condition of the breast which represents an array of underlying etiologies encompassing both infectious and non-infectious causes. Exacerbating factors include endemic infections, lack of awareness and suboptimal breastfeeding practices. Neglected cases lead to prolonged morbidity, recurrent episodes, and complications such as abscess or sinus formation, resulting in permanent breast disfigurement. Its overlapping clinical presentation with breast cancer necessitates an integrated multidisciplinary approach for diagnosis and treatment.</div></div><div><h3>Objectives</h3><div>The primary aim was to investigate demographic, radiological, and histopathological characteristics of mastitis. Objectives included correlating radiological and histopathological findings, classifying mastitis by etiology, identifying the clinical and imaging patterns across diverse clinical settings to enhance the understanding of mastitis.</div></div><div><h3>Material and method</h3><div>This is a retrospective observational study, analysing the clinical, radiological, and histopathological data from 65 patients with mastitis between February 2023 and February 2024.</div></div><div><h3>Results</h3><div>The study included 65 patients, aged 18 to 65 years, with breast pain as the most prevalent clinical presentation. Cases were classified as infectious (47.6%) and non-infectious (52%). Acute puerperal mastitis (26.15%) and granulomatous mastitis (30%) were the most common subtypes. The commonest mammographic finding was focal asymmetry. On ultrasound, infectious mastitis showed oedema with other inflammatory changes, including diffuse skin thickening and collections; while non-infectious mastitis typically presented as solitary or multiple breast masses (p &lt; 0.001). Surprisingly, idiopathic granulomatous mastitis constituted the largest percentage amongst various histopathological causes of mastitis in our study.</div></div><div><h3>Conclusion</h3><div>An integrated multidisciplinary approach with understanding of the pathogenesis is imperative for prompt diagnosis and optimizing treatment strategies, thereby improving patient outcome. Radiological imaging is critical for diagnosis, evaluating disease extent, conducting guided interventions, and monitoring treatment response.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 214-227"},"PeriodicalIF":1.5,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047683","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":"Optimizing biopsy training experience for trainees and faculty: Utilizing 5S methodology with a focus on safety","authors":"Philipp Kocher MD ,&nbsp;Irina Kalyan RT ,&nbsp;Haydee Ojeda-Fournier MD, FACR, FSBI","doi":"10.1067/j.cpradiol.2024.08.002","DOIUrl":"10.1067/j.cpradiol.2024.08.002","url":null,"abstract":"<div><div>This manuscript explores the application of the 5S methodology in optimizing workplace safety and efficiency within the context of biopsy training equipment. Drawing from a Quality Improvement Report presented at the 2023 RSNA annual meeting, our manuscript focuses on implementing 5S principles with a dedicated emphasis on safety (the 6th S). We demonstrate how the systematic application of 5S principles can revolutionize the functionality of biopsy training equipment, mitigate safety risks, and enhance overall workplace productivity. This manuscript offers valuable insights and practical strategies for improving healthcare training environments, with broader implications for quality improvement initiatives in the healthcare sector.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 127-131"},"PeriodicalIF":1.5,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984179","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":"A Virtual Multi-institution Pediatric Radiology Peer Teaching Conference Improves Knowledge of Educators","authors":"Eric L. Tung ,&nbsp;Randheer Shailam ,&nbsp;Matthew G. Tung ,&nbsp;Katherine Barton","doi":"10.1067/j.cpradiol.2024.07.017","DOIUrl":"10.1067/j.cpradiol.2024.07.017","url":null,"abstract":"<div><h3>Rationale and Objectives</h3><div>Medical education led by peers and near-peers has been shown to benefit both teachers and learners and can be successfully incorporated into radiology education. The authors created a virtual, multi-institution pediatric radiology conference employing peer and near-peer teaching with the goals of improving radiology knowledge and enhancing the educational experience of radiology trainees.</div></div><div><h3>Materials and Methods</h3><div>Two radiology residency programs implemented a common pediatric radiology curriculum and joint quarterly virtual peer teaching conference. Conferences featured short teaching sessions led by six to ten radiology trainees and were facilitated by attending pediatric radiologists. Knowledge assessments (KA) consisting of multiple-choice questions inspired by conference learning objectives were sent to peer educators before the conference (pre-conference), directly after the conference (immediate post-conference), and three months after the conference (delayed post-conference). Surveys were distributed to peer educators immediately after conferences to assess conference reception and solicit feedback. Quantitative data was analyzed using ANOVA, Kruskal-Wallis test, and post-hoc Tukey HSD test.</div></div><div><h3>Results</h3><div>Four conferences featured 33 peer educators consisting primarily of first-year (60.6 %), second-year (18.2 %), and third-year (15.2 %) radiology residents. Compared to pre-conference scores, immediate post-conference scores were significantly increased (HSD 13, p = 0.02) and delayed post-conference scores were increased without statistical significance (HSD 5.8, p = 0.29). Almost all survey respondents perceived the conferences as helpful, well-organized, and effective in teaching pediatric radiology. A majority of participants expressed interest in participating in future peer teaching radiology conferences.</div></div><div><h3>Conclusion</h3><div>A virtual pediatric radiology peer and near-peer teaching conference held between two radiology residencies improved short-term radiology knowledge of educators and was highly received.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 3","pages":"Pages 377-381"},"PeriodicalIF":1.5,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141891287","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":"Industry relationships with interventional radiologists: Who are the high payment physicians?","authors":"Chris Lee ,&nbsp;Mihir Khunte B.S. ,&nbsp;Kyle Tegtmeyer MD ,&nbsp;Dheeman Futela MD ,&nbsp;Suryansh Bajaj MBBS ,&nbsp;Seyedmehdi Payabvash MD ,&nbsp;Dheeraj Gandhi MD, FACR ,&nbsp;Ajay Malhotra MD, MMM, FACR","doi":"10.1067/j.cpradiol.2024.07.020","DOIUrl":"10.1067/j.cpradiol.2024.07.020","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify characteristics of interventional radiologists receiving more than $100,000 in general industry payments over a 5-year period (2017-2021).</div></div><div><h3>Methods</h3><div>The Open Payments database was queried to identify interventional radiologists who received more than $100,000 in consulting fees, speaker fees, education, and/or gifts over a 5-year period from 2017 to 2021. The national provider identifier registry, Scopus, and a web-based search were used to identify physician characteristics, such as demographics, research profile, leadership positions, and social media presence.</div></div><div><h3>Results</h3><div>From 2017-2021, 125 interventional radiologists received cumulative payments greater than $100,000 in consulting fees, speaker fees, education, and gifts. For this subset of physicians, the median (IQR) cumulative payment value was $214,380 ($141,812 - $383,740), and the total payment value was $40 million. While the highest-paid subset of physicians represented only 3 % (125/4272) of all US interventional radiologists paid by industry, the total payment value represented 66 % ($40,039,610.08/$60,859,025) of the total payment value among all interventional radiologists. 47 % (59/125) had faculty appointments and 30 % (37/125) had hospital leadership positions. 22 % (27/125) were clinical practice guideline authors, while 18 % (23/125) served on journal editorial boards and 12 % (15/125) had positions in specialty association leadership. Castle Connolly recognized 26 % (32/125) as top doctors. Among the 96 % (120/125) with published research in the past 5 years, the median (IQR) H-index was 17 (7-31). 38 % (48/125) had a presence on Twitter with a median (IQR) Kardashian index of 2.03 (0.48-6.16).</div></div><div><h3>Conclusion</h3><div>A small subset of interventional radiologists receive large payments from drug and medical device companies. These physicians are leaders in their field with influence in hospitals, research, associations, and social media. Further work is needed to understand how the concentration of these payments affects decisions in clinical practice and policy.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 206-209"},"PeriodicalIF":1.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851084","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":"Treatment response assessment of acute pyelonephritis: A multi-reader DWI-based MRI approach","authors":"Martina Morgillo ,&nbsp;Carlotta Bernabei ,&nbsp;Marco Bianchi ,&nbsp;Valeria Vezzani ,&nbsp;Domenico Mastrodicasa ,&nbsp;Francesco Lorenzo Serafini ,&nbsp;Giulio Cocco ,&nbsp;Antonio Corvino ,&nbsp;Barbara Seccia ,&nbsp;Lorenzo Di Liberato ,&nbsp;Massimo Caulo ,&nbsp;Andrea Delli Pizzi","doi":"10.1067/j.cpradiol.2024.07.019","DOIUrl":"10.1067/j.cpradiol.2024.07.019","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the diagnostic accuracy of a structured reporting score (SRS) in treatment response assessment for acute pyelonephritis (APN) using a diffusion-weighted imaging (DWI) -based MRI approach. Additionally, we explored the influence of reader experience on the interpretation of SRS and DWI, including lesion conspicuity and measurements of Apparent Diffusion Coefficient (ADC) maps.</div></div><div><h3>Methods</h3><div>Follow-up DWI-based MRIs of 36 patients treated for APN between September 2021 and June 2023 were retrospectively reviewed by three readers. Follow-up blood inflammatory markers were used as reference standard. Treatment response was assessed using a structured reporting score (SRS). Each reader assigned a score from 1 to 3 to the \"conspicuity\" of the residual disease on DWI. Quantitative ADC measurements were compared with the Mann-Whitney U test. Descriptive statistics and Intraclass Correlation Coefficient (ICC) were calculated.</div></div><div><h3>Results</h3><div>The diagnostic accuracy of SRS was 80.6 %, 76.9 %, and 72.2 % for the Reader 1, 2, and 3 respectively. ICC decreased from 0.82 (Reader 1 and 2), to 0.68 when considering all readers. The average conspicuity varied between 2.3 and 2.7. ADC values were significantly higher in complete responders for Reader 1 and 2 (153.5-154.5 vs 107.7-116.2, p &lt; 0.001). The ICC was good (0.89) for Reader 1 and 2 and moderate (0.60) when considering all readers.</div></div><div><h3>Conclusions</h3><div>Treatment response of pyelonephritis can be accurately assessed by a DWI-based MRI, potentially avoiding unnecessary contrast agent administration and radiation exposure. SRS and DWI analysis showed a good inter-observer agreement but a certain learning curve may be necessary for less expert readers.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 197-205"},"PeriodicalIF":1.5,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851286","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":"Expenditure mapping of pediatric imaging costs using a resource utilization band analysis of claims data","authors":"Danika Baskar MD ,&nbsp;Jamie A. Jarmul MD, PhD ,&nbsp;Lane F. Donnelly MD","doi":"10.1067/j.cpradiol.2024.07.018","DOIUrl":"10.1067/j.cpradiol.2024.07.018","url":null,"abstract":"<div><h3>Objective</h3><div>To segregate imaging expenditures from claims data by resource utilization bands (RUBs) and underlying conditions to create an “expenditure map” of pediatric imaging costs.</div></div><div><h3>Methods</h3><div>A Claims data for children enrolled in a commercial value-based plan were categorized by RUB 0 non-user, 1 healthy user, 2 low morbidity, 3 moderate morbidity, 4 high morbidity, &amp; 5 very high morbidity. The per member per year (PMPY) expense, total imaging spend, and imaging modality with the highest spend were assessed for each RUB. Diagnosis categories associated with high imaging costs were also evaluated.</div></div><div><h3>Results</h3><div>There were 40,022 pediatric plan members. 14% had imaging-related claims accounting for approximately $2.8 million in expenditures. Member distribution and mean PMPY expenditure RUB was respectively: RUB 0 (3,037, $0), RUB 1 (6,604, $7), RUB 2 – 13,698, $27), RUB 3 – 13,341, $87), RUB 4 (2,810, $268), RUB 5 (532, $841). RUB 3 had the largest total imaging costs at $1,159,523. The imaging modality with the greatest mean PMPY expense varied by RUB with radiography highest in lower RUBs and MRI highest in higher RUBs. The top 3 diagnoses associated with the highest total imaging costs were developmental disorders ($443,980), asthma ($388,797), and congenital heart disease ($294,977) and greatest mean PMPY imaging expenditures malignancy/leukemia ($3,100), transplant ($2,639), and tracheostomy ($1,661).</div></div><div><h3>Discussion</h3><div>Expense mapping using claims data allows for a better understanding of the distribution of imaging costs across a covered pediatric population. This tool may assist organizations in planning effective cost-reduction initiatives and learning how imaging utilization varies by patient complexity in their system.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 2","pages":"Pages 210-213"},"PeriodicalIF":1.5,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763454","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":"High-density pulmonary lesions: Review in chest imaging","authors":"Catalina Jaramillo M.D,&nbsp;Emma Ferguson M.D,&nbsp;Erika Odisio M.D,&nbsp;Daniel Ocazionez M.D","doi":"10.1067/j.cpradiol.2024.07.004","DOIUrl":"10.1067/j.cpradiol.2024.07.004","url":null,"abstract":"<div><p><span>High-density pulmonary lesions<span> are frequently seen in chest imaging, and it is important to identify their different causes. Radiologists must be able to distinguish between common and rare conditions in order to provide the best diagnosis and treatment. This article provides an overview of the various causes and imaging features of high-density lesions in the lungs. The lesions are classified into various categories, such as </span></span>pulmonary nodules<span>, inflammatory conditions, deposition diseases, contrast-related lesions, and thoracic devices. A clear understanding of these categories can help radiologists accurately diagnose and manage high-density pulmonary lesions encountered in practice.</span></p></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"53 6","pages":"Pages 745-752"},"PeriodicalIF":1.5,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636228","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":"A model for teaching radiology to clinical specialty trainees: A pilot study in pediatric neuroradiology and neonatology","authors":"Elizabeth K. Sewell ,&nbsp;Sarah S. Milla ,&nbsp;Monideep Dutt ,&nbsp;Erica Riedesel ,&nbsp;Nadja Kadom","doi":"10.1067/j.cpradiol.2024.07.016","DOIUrl":"10.1067/j.cpradiol.2024.07.016","url":null,"abstract":"<div><p>This article describes the development and assessment of a neuroimaging curriculum for neonatology fellows. The curriculum is focused on topics that are relevant to the practice of neonatology and employs contemporary teaching methods, such as flipped classroom, learner engagement, and spaced repetition. Since its implementation 2018 the curriculum has been appreciated by our trainees and demonstrated improvements in trainee knowledge.</p></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"53 6","pages":"Pages 679-684"},"PeriodicalIF":1.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701555","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":"MR Evaluation of Placenta Accreta Spectrum: Concordance Rates and Effect of Structured Reporting on Patient Outcomes","authors":"Robert M. Weinstein BE ,&nbsp;Theresa Boyer MS, MSPH ,&nbsp;Abigail Coco BA ,&nbsp;Arthur Vaught MD ,&nbsp;Torre Halscott MD, MS ,&nbsp;Katarzyna Macura MD, PhD ,&nbsp;Erin Gomez MD","doi":"10.1067/j.cpradiol.2024.07.002","DOIUrl":"10.1067/j.cpradiol.2024.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>To examine the concordance rate of MRI findings with intraoperative and pathologic findings in patients with Placenta Accreta Spectrum (PAS), as well as the use of structured reporting, and their relationship to clinical outcomes.</p></div><div><h3>Methods</h3><p>An IRB approved retrospective chart review was performed for patients with a history of cesarean delivery, a diagnosis of PAS on post-operative pathology report, and a placental MRI prior to delivery between 2008-2022. Concordance rates were calculated between final MRI, ultrasound, operative, and pathologic diagnoses, as well as impact on clinical outcomes. Quantitative variables were analyzed using a t-test. Categorical variables were analyzed using chi-squared and Fischer's exact tests.</p></div><div><h3>Results</h3><p>A total of 59 patients met initial inclusion criteria. Of these 59 patients, 8 (13.6%) were interpreted using structured reporting. Discordance between preoperative imaging, operative findings and final pathology diagnoses were associated with increased blood loss, blood transfusion, ICU admission, and postpartum length of stay. Structured reporting was found to significantly reduce the amount of diagnostic discordance (p=.017) and was associated with decreased ICU admissions when utilized (p=.045).</p></div><div><h3>Conclusions</h3><p>Use of structured reporting in the interpretation of placental MRI may decrease the amount of discordance between imaging and intraoperative or pathologic diagnoses, which in our study is associated with improved patient outcomes including decreased blood loss and amount of blood transfused. Radiologists must be cognizant of key imaging features of PAS on MRI, as interpretation provides an opportunity to positively impact the quality and safety of patient care.</p></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"53 6","pages":"Pages 700-708"},"PeriodicalIF":1.5,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0363018824001117/pdfft?md5=f968752783f1a9d58488b7e39e5bcdc7&pid=1-s2.0-S0363018824001117-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617847","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}