RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin最新文献

{"title":"Contrast Media Extravasation in CT and MRI - A Literature Review and Strategies for Therapy.","authors":"Veronika Mandlik,&nbsp;Lukas Prantl,&nbsp;Andreas G Schreyer","doi":"10.1055/a-0628-7095","DOIUrl":"https://doi.org/10.1055/a-0628-7095","url":null,"abstract":"<p><strong>Background: </strong> Contrast extravasation events in daily radiological routine may lead to serious complications, especially during CT examinations. The resulting symptoms may vary from local pain up to skin ulcers, necrosis or even acute compartment syndrome.There are no uniformly accepted radiological guidelines or recommendations regarding detection and treatment of extravasation events and immanent complications in a timely manner.</p><p><strong>Method: </strong> Systematic literature research considering the last 35 years via PubMed using search terms \"contrast medium extravasation/paravasation\".</p><p><strong>Results: </strong> In the literature, there are conservative management approaches of contrast media extravasation without major evidence base, such as unguent dressings, cooling or splinting. This therapy is mostly symptomatic. Additionally, various invasive techniques are described. We discuss these techniques in the context of contemporary literature, such as the hyaluronidase Injection into the site of extravasation, suction/aspiration technique including flushing of the affected tissue areas and the squeezing technique. However, most citations lack scientific evidence: many articles include anecdotal enumerations, case studies or cite publications from the era, when ionic high osmolar contrast media was state-of-the-art. Besides, many authors derive their extravasation management from studies, where agents other than contrast media were investigated.</p><p><strong>Conclusion: </strong> After detailed literature review, we suggest early (plastic) surgical consultation when non-ionic, low-osmolar contrast medium extravasation is about 150 cc or more. In case of extravasation less than 150 cc but in presence of additional symptoms such as impaired perfusion or altered sensibility, the (plastic) surgeon should also be consulted instantly. We do not recommend any invasive first line therapy when contrast media extravasation is less than 150 cc and the patient presents no additional symptoms, besides swelling and local pain. Nevertheless continuous monitoring and accurate conservative management such as active cooling and elevation, splinting of the affected extremity are mandatory as early detection of critical symptoms helps to initiate prompt surgical intervention and avoid sequelae.</p><p><strong>Key points: </strong>  · Morbidity after contrast media extravasation is extremely rare.. · Predicting sequelae after contrast extravasation is difficult at first sight.. · Treatments such as hyaluronidase injection, suction/aspiration, squeeze technique have been described.. · Surgical consultation is recommended for extravasation > 150 cc or when additional symptoms occur..</p><p><strong>Citation format: </strong>· Mandlik V, Prantl L, Schreyer AG. Contrast Media Extravasation in CT and MRI - A Literature Review and Strategies for Therapy. Fortschr Röntgenstr 2019; 191: 25 - 32.</p>","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"25-32"},"PeriodicalIF":1.8,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0628-7095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40441447","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":"Gezielte Magnetresonanztomografie zur exakten Leckage-Detektion beim Chylothorax.","authors":"Christopher Kloth,&nbsp;Gregor Cammerer,&nbsp;Stefan Andreas Schmidt","doi":"10.1055/a-0630-6161","DOIUrl":"https://doi.org/10.1055/a-0630-6161","url":null,"abstract":"Der Chylothorax ist eine Komplikation nach thorakaler Chirurgie, insbesondere nach Lungenteilresektion, Ösophagusresektion und Versorgung angeborener Herzfehler mit einer beschriebenen postoperativen Inzidenz von 1 – 4 % (Maruyama K et al. Int J Surg Case Rep 2017; 41: 247 – 250). Hinsichtlich Alter und Geschlecht gibt es keine Präferenz (Rudrappa M et al. StatPearls Publishing LLC 2017). Gehäuft ist bei dem Krankheitsbild die rechte Thoraxhälfte betroffen, dies aufgrund des eng benachbarten Verlaufs des Ductus thoracicus zur rechten Pleura. Eine Diagnosesicherung ist durch eine diagnostische Pleurapunktion mit charakteristischer milchig-chylöser Ergussflüssigkeit möglich. Die Diagnosefindung ist bildgebend herausfordernd, die Möglichkeiten zur Darstellung und Sicherung auf nicht invasive Weise sind limitiert.","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"62-64"},"PeriodicalIF":1.8,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0630-6161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40440984","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":"Forensic Odontology: Automatic Identification of Persons Comparing Antemortem and Postmortem Panoramic Radiographs Using Computer Vision.","authors":"Andreas Heinrich,&nbsp;Felix Güttler,&nbsp;Sebastian Wendt,&nbsp;Sebastian Schenkl,&nbsp;Michael Hubig,&nbsp;Rebecca Wagner,&nbsp;Gita Mall,&nbsp;Ulf Teichgräber","doi":"10.1055/a-0632-4744","DOIUrl":"https://doi.org/10.1055/a-0632-4744","url":null,"abstract":"<p><strong>Purpose: </strong> In forensic odontology the comparison between antemortem and postmortem panoramic radiographs (PRs) is a reliable method for person identification. The purpose of this study was to improve and automate identification of unknown people by comparison between antemortem and postmortem PR using computer vision.</p><p><strong>Materials and methods: </strong> The study includes 43 467 PRs from 24 545 patients (46 % females/54 % males). All PRs were filtered and evaluated with Matlab R2014b including the toolboxes image processing and computer vision system. The matching process used the SURF feature to find the corresponding points between two PRs (unknown person and database entry) out of the whole database.</p><p><strong>Results: </strong> From 40 randomly selected persons, 34 persons (85 %) could be reliably identified by corresponding PR matching points between an already existing scan in the database and the most recent PR. The systematic matching yielded a maximum of 259 points for a successful identification between two different PRs of the same person and a maximum of 12 corresponding matching points for other non-identical persons in the database. Hence 12 matching points are the threshold for reliable assignment.</p><p><strong>Conclusion: </strong> Operating with an automatic PR system and computer vision could be a successful and reliable tool for identification purposes. The applied method distinguishes itself by virtue of its fast and reliable identification of persons by PR. This Identification method is suitable even if dental characteristics were removed or added in the past. The system seems to be robust for large amounts of data.</p><p><strong>Key points: </strong>  · Computer vision allows an automated antemortem and postmortem comparison of panoramic radiographs (PRs) for person identification.. · The present method is able to find identical matching partners among huge datasets (big data) in a short computing time.. · The identification method is suitable even if dental characteristics were removed or added..</p><p><strong>Citation format: </strong>· Heinrich A, Güttler F, Wendt S et al. Forensic Odontology: Automatic Identification of Persons Comparing Antemortem and Postmortem Panoramic Radiographs Using Computer Vision. Fortschr Röntgenstr 2018; 190: 1152 - 1158.</p>","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"1152-1158"},"PeriodicalIF":1.8,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0632-4744","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40441333","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 Efficacy, Embolism Rate and Safety of Thrombectomy with Stent Retrievers in an Anterior Circulation Stroke Model.","authors":"Naomi Larsen,&nbsp;Katharina Oberbeck,&nbsp;Rodrigo Lima de Miranda,&nbsp;Jens Trentmann,&nbsp;Jawid Madjidyar,&nbsp;Eckhard Quandt,&nbsp;Olav Jansen","doi":"10.1055/a-0631-4118","DOIUrl":"https://doi.org/10.1055/a-0631-4118","url":null,"abstract":"<p><strong>Purpose: </strong> Various stent retrievers differing in stent design and mechanical properties are currently available for the treatment of ischemic stroke. We conducted this in vitro study to compare the efficacy, embolism rate, and safety of commercially available stent retrievers and prototypes.</p><p><strong>Materials and methods: </strong> Whole blood thrombi were produced in a Chandler loop. The thrombi were inserted into the curved M1 segment of a silicone model of the anterior cerebral circulation. Thrombectomy maneuvers were performed with six commercially available stent retrievers and 2 prototypes with different strut thickness. Wall-stent apposition, first pass recanalization rate, retraction force, and embolism rate were compared.</p><p><strong>Results: </strong> Devices with complete wall-stent apposition had the highest first pass recanalization rate and lowest embolism rate, but showed the highest retraction force. The prototype with thinner struts had a comparable recanalization and embolism rate, while a lower retraction force had to be applied compared to the prototype with thicker struts.</p><p><strong>Conclusion: </strong> Complete wall-stent apposition facilitates a higher recanalization rate and lower embolism rate but also correlates to a higher necessary retraction force and thus possibly higher risk of endothelium damage. Stent modifications leading to a reduced retraction force do not compromise efficacy and embolism rate.</p><p><strong>Key points: </strong>  · Complete wall-stent apposition facilitates an effective thrombectomy. · Complete wall-stent apposition leads to higher retraction force and possibly greater endothelium damage. · Modifications of strut thickness do not compromise recanalization and embolism rate. · Thinner struts correlate with a lower retraction force.</p><p><strong>Citation format: </strong>· Larsen N, Oberbeck K, Lima de Miranda R et al. Comparison of Efficacy, Embolism Rate and Safety of Thrombectomy with Stent Retrievers in an Anterior Circulation Stroke Model. Fortschr Röntgenstr 2018; 190: 1053 - 1058.</p>","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"1053-1058"},"PeriodicalIF":1.8,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0631-4118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40532239","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":"Subependymomas - Characteristics of a \"Leave me Alone\" Lesion.","authors":"Sara Kammerer,&nbsp;Monika Mueller-Eschner,&nbsp;Arne Lauer,&nbsp;Anna-Luisa Luger,&nbsp;Johanna Quick-Weller,&nbsp;Kea Franz,&nbsp;Patrick Harter,&nbsp;Joachim Berkefeld,&nbsp;Marlies Wagner","doi":"10.1055/a-0576-1028","DOIUrl":"https://doi.org/10.1055/a-0576-1028","url":null,"abstract":"<p><strong>Purpose: </strong>Intracranial subependymomas are rare, mostly asymptomatic tumours, which are often found incidentally and therefore did not receive much attention in previous literature. By being classified as benign grade I in the WHO classification of tumours of the central nervous system, they are given a special status compared to the other ependymal tumours. Tumor recurrences are a rarity, spinal \"drop metastases\" do not occur. While etiological, pathological and therapeutic characteristics have been subject of several publications over the last few decades and have meanwhile been well studied, the imaging characteristics are much less well received.</p><p><strong>Material and method: </strong>Retrospective analysis of our relatively large group of 33 patients with subependymoma, including 4 patients with a mixture of subependymomas with ependymal cell fractions in terms of imaging and clinical aspects and with reference to a current literature review.</p><p><strong>Results: </strong>Subependymomas have typical image morphologic characteristics that differentiate them from tumors of other entities, however, the rare subgroup of histopathological mixtures of subependymomas with ependymal cell fractions has no distinctly different imaging properties.</p><p><strong>Conclusions: </strong>Knowing the imaging characteristics of subpendymoma and their differential diagnoses is of particular importance in order to be able to decide between the necessity of follow-up controls, an early invasive diagnosis or, depending on the entity, tumor resection.</p><p><strong>Key points: </strong>· Subependymomas have typical imaging characteristics that are clearly distinguishable from other entities.. · Increased incidence in middle/ older aged men, most frequent localization: 4th ventricle.. · Symptomatic subependymomas, often located in lateral ventricles, are usually characterized by hydrocephalus.. · Radiological identification of mixed subependymoma with ependymal cell fractions is not possible.. · Image based differentiation from other entities is important for the procedure..</p><p><strong>Citation format: </strong>· Kammerer S, Mueller-Eschner M, Lauer A et al. Subependymomas - Characteristics of a \"Leave me Alone\" Lesion. Fortschr Röntgenstr 2018; 190: 955 - 966.</p>","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"955-966"},"PeriodicalIF":1.8,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0576-1028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40441446","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":"Response.","authors":"Dirk Schnapauff","doi":"10.1055/a-0633-6346","DOIUrl":"https://doi.org/10.1055/a-0633-6346","url":null,"abstract":"","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"644"},"PeriodicalIF":1.8,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0633-6346","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40530222","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":"Re: Analysis of Presurgical Uterine Artery Embolization (PUAE) for Very Large Uterus Myomatosus; Patient's Desire to Preserve the Uterus; Case Series and Literature Review.","authors":"Funlayo Odejinmi,&nbsp;Rebecca Mallick,&nbsp;Sharahzed Abdelmoumene","doi":"10.1055/a-0622-8306","DOIUrl":"https://doi.org/10.1055/a-0622-8306","url":null,"abstract":"Dear Sir or Madam, We commend Schnapauff et al. on the publication of this interesting literature review and case series of women who have undergone presurgical uterine artery embolization (PUAE), with the aim of uterine and fertility preservation [1]. However, we feel that this should be against the backdrop of laparoscopic myomectomy as the gold standard for those requiring surgery for fibroids. Although the authors cite the objectives of uterine sparing and improved fertility, they present a case series with a hysterectomy rate of 5 % despite “hybrid treatment”, which is well above the rates reported for laparoscopic myomectomy in modern literature even with “giant fibroids” over 9 cm [2]. Moreover, even though they report a decreased incidence of blood loss and blood transfusions, they do not present a series that is truly uterine sparing and have not reported on the fertility outcomes of these patients. In our series of laparoscopic myomectomies [2] in patients with fibroids greater than 9 cm, though there was a significantly greater operating time as well as blood loss, there were no increased rates of blood transfusion, not dissimilar to the values in this study. However, the duration of hospital stay following laparoscopic myomectomy was 1.64 days, compared to 8 – 10 days in the patients presented in this study. The authors present a series of cases of PUAE, but have not stratified for the type of myomectomy carried out and did not compare with other women who have had myomectomy without embolization or those who have had embolization without myomectomy in their institution, which would have allowed us to draw even more useful conclusions. We agree with the authors that PUAE is a tool in the armamentarium for the management of uterine fibroids and that women who need to have interventions for their fibroids should go through multidisciplinary team review to ensure that they have the right procedure tailored to their needs, with laparoscopic myomectomy being the gold standard. Where such expertise does not exist or there is a perceived increased risk, embolization prior to surgery may be offered. Women must also be informed that pregnancy after embolization in itself is not without complications [4], and that fertility outcome after “hybrid interventions” remains unknown. In the 21st century we should be able to provide evidence-based information to our patients. The previously conducted REST trial comparing uterine artery embolization with surgery found similar satisfaction in both groups, but did not address fertility [3]. As PUAE is feasible, it is time for a multicenter randomized controlled trial comparing women who have undergone PUAE with those who have undergone surgery alone stratifying for age and assessing the long-term fertility outcomes.","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"643"},"PeriodicalIF":1.8,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/a-0622-8306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40532216","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":"Radiologie in Europa.","authors":"","doi":"10.1055/s-0043-122367","DOIUrl":"https://doi.org/10.1055/s-0043-122367","url":null,"abstract":"","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"1183-1184"},"PeriodicalIF":1.8,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0043-122367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40354680","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":"Unzulässige Beteiligung von Radiologen an Kontrastmittelunternehmen und deren Rechtsfolgen – Ein unhanseatischer Fall.","authors":"","doi":"10.1055/s-0043-122359","DOIUrl":"https://doi.org/10.1055/s-0043-122359","url":null,"abstract":"Der Bundesgerichtshof (BGH) hat mit einem Beschluss vom 25.07.2017 (Az. 5 StR 46/17) die Entscheidung des Landgerichtes Hamburg vom 18.08.2016 in einem aufsehenerregenden Strafverfahren bestätigt, das die Radiologen in Deutschland über mehrere Jahre beschäftigte. Gegenstand des Verfahrens waren nicht die im Jahr 2016 neu eingeführten Straftatbestände der Bestechlichkeit und Bestechung im Gesundheitswesen nach § 299a StGB. Vielmehr betrafen die Rechtsfragen des Verfahrens die Straftatbestände des Betruges und der Untreue nach den §§ 263, 266 StGB. Der rechtliche Kern der Straftaten betraf die Frage nach der Zulässigkeit der Beteiligung eines Radiologen an einem Unternehmen von Leistungserbringern nach § 128 Abs. 2 S. 3 und Abs. 6 Sozialgesetzbuch Fünftes Buch (SGB V), welches den Einkauf von Kontrastmitteln zum Gegenstand hatte.","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"1185-1188"},"PeriodicalIF":1.8,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0043-122359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40354681","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":"Radiologiekongress Nord 2018.","authors":"","doi":"10.1055/s-0043-122368","DOIUrl":"https://doi.org/10.1055/s-0043-122368","url":null,"abstract":"Am 16. und 17. Februar 2018 findet die gemeinsame Jahrestagung der Norddeutschen Röntgengesellschaft und der Röntgengesellschaft von Niedersachsen, Bremen und Sachsen-Anhalt im Radisson Blu Hotel Dammtor in Hamburg statt. Das Programm besticht durch seine Vielfältigkeit in den Themen und den Formaten. So können sich Ärzte und MTRA auf zahlreiche Workshop-Angebote freuen und auch für den radiologischen Nachwuchs wird es ein spezielles Programm geben. Im Folgenden finden Sie die Schwerpunkt-Themen sowie eine Auswahl der Highlights.","PeriodicalId":520772,"journal":{"name":"RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin","volume":" ","pages":"1182"},"PeriodicalIF":1.8,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0043-122368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40354679","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}