Neurocirugia (English Edition)最新文献

{"title":"Image Control After Aneurysm Clipping: Is 3D Computed Tomogram Angiography Enough?","authors":"Sebastián Menéndez-Girón, Antonio González-Crespo, Alberto Blanco Ibáñez de Opacua, Roser García-Armengol, Carlos J Dominguez, Ana Rodríguez-Hernández","doi":"10.1016/j.neucie.2025.500677","DOIUrl":"https://doi.org/10.1016/j.neucie.2025.500677","url":null,"abstract":"<p><strong>Background: </strong>Cerebral digital subtraction angiography (DSA) remains the gold standard for the control of aneurysmal remnants after surgical clipping. Despite being associated with minimal risks, it is an invasive procedure far from being iatrogenia free. Furthermore, it has limited availability which may prolong patient's postoperative stay. On the other hand, the image quality of computed tomography angiography (CTA) has improved significantly over the past decades providing a valuable alternative to DSA. The objective of this study was to compare the capacity of CTA and DSA to detect clinically significant aneurysmal remnants.</p><p><strong>Methods: </strong>From a prospective series of surgically treated aneurysms, those with postoperative CTA and DSA were retrospectively included in the study. A three-dimensional reconstruction of the CTA was performed using the Brainlab Elements software and the results were compared with those of the DSA. In addition, variables that could affect the three-dimensional reconstruction were collected, such as the number of clips per aneurysm and previous clipping or embolization. In case of an aneurysm remnant, its size was also recorded.</p><p><strong>Results: </strong>Between January 2020 and January 2022, a total of 42 patients in whom 52 aneurysms were clipped (8 of them ruptured) were included. CTA presented a sensitivity of 50% and a specificity of 97% in the detection of aneurysmal remnants. The cases in which CTA did not detect the aneurysmal remnant were previously embolized aneurysms or complex aneurysms that required neck reconstruction with 3 or more clips. None of the remnants undetected by CTA were significant enough to warrant retreatment of the aneurysm.</p><p><strong>Conclusions: </strong>Excluding complex aneurysms (previously embolized or requiring surgical reconstruction with 3 or more clips), three-dimensional reconstructions of CTA images showed excellent results in detecting clinically significant postoperative aneurysm remnants and may obviate the need for a the more invasive and less available DSA.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500677"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082609","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 monopolar electrocautery use in vagus nerve stimulator revision surgery a risk to avoid or a safe surgical option?","authors":"Cezmi Çağrı Türk, Umut Ogün Mutlucan, Orhan Günay, Fatma Genç, Meltem Korucuk, Gültekin Kutluk","doi":"10.1016/j.neucie.2025.500674","DOIUrl":"https://doi.org/10.1016/j.neucie.2025.500674","url":null,"abstract":"<p><strong>Background: </strong>The use of monopolar electrocautery in vagal nerve stimulator (VNS) revision surgeries has been debated due to concerns about device interference. Thus, herein, we aimed to evaluate the safety and efficacy of monopolar electrocautery during VNS generator replacement surgeries, particularly its impact on seizure control and battery performance.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on 30 patients who underwent VNS generator revision at a tertiary care center. Patients were divided into two groups: those in whom monopolar electrocautery was used (n = 18) and those in whom it was not used (n= = 12). Pre- and postoperative data were collected, including seizure frequency, VNS settings, and operative time. The McHugh Outcome Classification was used to assess seizure control.</p><p><strong>Results: </strong>The surgeries were significantly shorter in the electrocautery group than in the nonelectrocautery group (20.06± ± 2.29 vs. 51.83± ± 12.76 min, p < 0.001). Furthermore, there was no significant difference in seizure control between the two groups (p> > 0.05). In two patients, a decline in seizure control classification was noted. However, this did not reach statistical significance. No lead damage or major complications developed in either group.</p><p><strong>Conclusion: </strong>Monopolar electrocautery significantly reduces the operative time during VNS generator revisions without compromising seizure control or increasing the risk of complications. Thus, monopolar electrocautery can be safely used in VNS revision surgeries, potentially streamlining the procedure and improving patient outcomes. However, further studies with larger populations are needed to confirm these findings.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500674"},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082612","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":"Influence of the magnitude and orientation of forces on the odontoid fracture: a Finite Element model analyses.","authors":"P Gonzalez-Vargas, J Caramés, A Riveiro, J Thenier-Villa, C Conde, J Pou","doi":"10.1016/j.neucie.2025.500675","DOIUrl":"https://doi.org/10.1016/j.neucie.2025.500675","url":null,"abstract":"<p><strong>Background: </strong>Fractures of the odontoid, prevalent among the elderly but affecting diverse demographics, pose significant risks ranging from mild discomfort to severe disability or fatality. These fractures, often stemming from trauma, are particularly frequent in the cervical spine. While commonly attributed to high-impact events like traffic accidents in adults, even low-energy incidents such as falls can precipitate these fractures in the elderly. Previous studies have explored loading conditions and treatment effects; however, a comprehensive investigation into the influence of the magnitude and direction of the force involved in the trauma, and the influence of the sex and age of the patient remains scarce so we want to delve deeper into this topic.</p><p><strong>Methods: </strong>This study uses a finite element (FE) model to analyze the response of 3D models of the second cervical vertebra (extracted from computed tomography images) exposed to different loads of magnitude and force. 52 patients were analyzed in this study. The patients were divided into 4 groups: male <70, female <70, male >70, female >70) under different force conditions. Von Mises stress values were obtained when loads of 200N and 1500N were applied to the anterior surface of the odontoid with different angles of incidence in the sagittal and axial plane.</p><p><strong>Results: </strong>Odontoid fractures in subjects over 70 years of age are more frequent in female, the maximum stresses produced in the odontoid are 181 MPa and are considerably higher compared to male, which is 131 MPa. In young subjects (<70 years), the differences between sex are less marked, 113 MPa for female and 114 MPa for male.</p><p><strong>Conclusions: </strong>Load direction is one of the main factors affecting odontoid fracture, especially in subjects >70 years of age; by understanding this, the mechanisms that cause different types of fractures can be understood and better strategies can be proposed to apply different treatment approaches to them, both from a medical and surgical point of view.</p>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":" ","pages":"500675"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082611","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":"Diagnostic considerations of tumors of the sellar region according to their geometry and vector growth","authors":"Marlon Manuel Ortiz Machín,&nbsp;Omar López Arbolay,&nbsp;Carlos Roberto Vargas Gálvez","doi":"10.1016/j.neucie.2024.12.003","DOIUrl":"10.1016/j.neucie.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Sellar and parasellar tumors are frequent lesions in neurosurgical practice, highlighting pituitary adenomas, craniopharyngiomas, and sellar tubercle meningiomas. The clinical manifestations are similar, however; There are imaging aspects that differentiate them.</div></div><div><h3>Objective</h3><div>Show imaging aspects of tumors in the sellar and parasellar region that guide their histopathological diagnosis.</div></div><div><h3>Method</h3><div>A descriptive, longitudinal and prospective study was carried out that included 200 patients from the Hermanos Ameijeiras Hospital, of which 120 had a histopathological diagnosis of pituitary adenoma, 50 of craniopharyngioma and 30 of sellar tubercle meningioma. The variations in the displacement of the point of the anterior communicating arterial complex and in the premammillary angle were analyzed by means of a cerebral nuclear magnetic resonance study. For data analysis, absolute and relative frequencies were used as summary measures.</div></div><div><h3>Results</h3><div>A cephalic displacement of the anterior communicating arterial complex was evident in the craniopharyngiomas, of 10–11.9 mm (84.0 %); in pituitary macroadenomas, 12−14 mm (78.3%); and in sellar tubercle meningioma, ≥14 (86.6 %) mm. When evaluating the premammillary angle, pituitary adenomas were identified between 85º and 95º (73.3 %); in craniopharyngiomas, &lt;85º (90.0 %); and in meningiomas of the sellar tubercle, between 85 and 95º (86.6 %).</div></div><div><h3>Conclusions</h3><div>The present study allows us to identify imaging characteristics in sellar and parasellar tumors that guide with high certainty the histopathological diagnosis and thus establish a more effective treatment.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 179-184"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822769","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":"Olfactory neuroblastoma: literature review and presentation of two clinical cases with different tumour infiltrations and different approaches","authors":"Carlos Andres Ferreira ,&nbsp;Carlos Eduardo Quevedo ,&nbsp;Gina Vanessa Vilardy ,&nbsp;Mario Andres Arias","doi":"10.1016/j.neucie.2024.12.001","DOIUrl":"10.1016/j.neucie.2024.12.001","url":null,"abstract":"<div><div>The olfactory neuroblastoma is a rare malignant neoplasm derived from the olfactory neuroepithelium. It can metastasize to cervical lymph node chains and distant organs through hematogenous or lymphatic routes. Two clinical cases are presented: the first, a 56-year-old man with no pathological history, exhibited symptoms evolving over 2 months, characterized by persistent rhinorrhea with frequent epistaxis, ipsilateral proptosis, left hemicranial pain, anosmia, and dysgeusia. Radiological images showed involvement of paranasal sinuses, left orbital cavity, and intracranial region. The second case involved a 46-year-old male with progressive symptoms over more than 1 year, including nasal obstruction, rhinorrhea, self-limited epistaxis, anosmia, weight loss in the last 3 months, and subjective decrease in visual acuity. A protruding mass in the left nasal fossa was observed without intracranial involvement. Both cases were pathologically and immunohistochemically consistent with olfactory neuroblastoma, Hyams grade 2.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 194-198"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822770","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":"Mortality risk factors for adult trauma patients treated with halo brace for cervical spine fracture","authors":"Kim Hoang ,&nbsp;Jeffrey Santos ,&nbsp;Areg Grigorian ,&nbsp;Lourdes Swentek ,&nbsp;Hansen Bow ,&nbsp;Jeffry Nahmias","doi":"10.1016/j.neucie.2024.09.003","DOIUrl":"10.1016/j.neucie.2024.09.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Halo braces treat upper cervical spine fractures and serve as the most rigid form of external immobilization. Recently, halo braces have lost favor due to known complications and advances in surgical stabilization. This study aims to determine the contemporary incidence for use of halo braces and identify risk factors associated with mortality in trauma patients undergoing halo brace for cervical spine fractures.</div></div><div><h3>Materials and methods</h3><div>The 2017–2019 Trauma Quality Improvement Program Database was queried for patients ≥18 years-old with a cervical spine fracture undergoing halo brace. Patients sustaining penetrating trauma and severe torso injuries (abbreviated injury scale &gt;3 for the abdomen or thorax) were excluded. Bivariate and multivariable logistic regression analyses were performed.</div></div><div><h3>Results</h3><div>From 144,434 patients with a cervical spine fracture, 272 (0.2%) underwent halo brace and 14 (5%) of these died. Those who died were older (73.5 vs. 53 years-old, p = 0.011) and had higher rates of hypertension (78.6% vs 33.1%, p &lt; 0.001) and chronic kidney disease (14.3% vs. 1.2%, p &lt; 0.001). Glasgow Coma Scale ≤8 (46.2% vs. 8.2%, p &lt; 0.001) and cervical spinal cord injury (71.4% vs. 21.3%, p &lt; 0.001) were more common in patients who died. In addition, those who died more often sustained respiratory complications (7.1% vs. 0.4%, p = 0.004) and sepsis (7.1% vs. 0.4%, p = 0.004). On multivariable logistic regression analysis, only Glasgow Coma Scale ≤8 (OR 19.77, 3.04–128.45, p = 0.002) was associated with increased mortality.</div></div><div><h3>Conclusions</h3><div>Only 5% of cervical spine fracture patients undergoing halo brace died. Respiratory complications and sepsis were more common in those who died. On multivariable analysis only Glasgow Coma Scale ≤8 remained an independent associated risk factor for mortality.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 145-150"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367752","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":"Moyamoya disease and moyamoya syndrome: A case series from multicentre private hospitals in Indonesia","authors":"Rusli Muljadi ,&nbsp;Koesbandono ,&nbsp;Teodorus Alfons Pratama ,&nbsp;Gilbert Sterling Octavius","doi":"10.1016/j.neucie.2024.11.008","DOIUrl":"10.1016/j.neucie.2024.11.008","url":null,"abstract":"<div><h3>Background</h3><div>Moyamoya disease (MMD) and moyamoya syndrome (MMS) are considered rare in Indonesia, without any proper epidemiological data backing this claim. Hence, this case series aims to assess all MMD and MMS cases from the perspective of a multicentre private hospital in Indonesia.</div></div><div><h3>Methods</h3><div>This is a descriptive analysis using data from the picture archiving and communication system (PACS) from January 2019 to December 2023. The inclusion criteria included all patients who fulfilled the radiological criteria for MMD and/or MMS, while patients who only underwent brain non-contrast computed tomography (CT) scans were excluded.</div></div><div><h3>Results</h3><div>There are 58,905 unique MRI scans from 2019 to 2023. The cohort comprises 8 females and 2 males, with a median age of 37 (7–65) years old. Three cases are probable MMD. with six MMD cases and one MMS case. Therefore, the prevalence rate for the four years is approximately 11.9 cases per 100,000 scans. Out of the confirmed Moya-Moya cases, the majority (4/7) are ischemic subtypes, followed by epileptic (electroencephalography shows slowing brain waves) and TIA in one case each. The most common presenting symptom is weakness in the extremity (N = 7), followed by headache (N = 5). Four patients underwent operative procedures, with three of them being superior temporal artery to middle cerebral artery (STA-MCA) bypass procedures and one of them being encephalo-duro-myo-arterio-pericraniosynangiosis (EDMAPS).</div></div><div><h3>Conclusion</h3><div>The paucity of confirmed cases either points towards the low prevalence of MMD and MMS in Indonesia or the underdiagnosis of these cases.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 151-160"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693819","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":"Cord compression due to atypical T-cell lymphoma from paraspinal soft tissue: Report of a case","authors":"Alejandro Augusto Ortega Rodriguez,&nbsp;Santiago Nicolás Valbuena Dussan,&nbsp;José Luís Caro Cardera,&nbsp;Jordi de Manuel-Rimbau Muñoz","doi":"10.1016/j.neucie.2024.11.004","DOIUrl":"10.1016/j.neucie.2024.11.004","url":null,"abstract":"<div><div>During lymphoma’s natural history of disease, 5–10% of cases may develop Central Nervous affectation. We present the case of a 57-years-old man with less than 24 h of onset symptoms of paraparesis, lower limb hypoesthesia and sphincter dysfunction who was operated due to dorsal tumor with epidural component which caused severe cord compression. Pathological analysis concluded atypical T-cell lymphoblastic lymphoma, a rare subtype of lymphoma which accounts 1%−2% of all Non-Hodgkin Lymphomas. Our case was particularly aggressive and atypical due to its origin in paraspinal soft tissue. Despite specific treatment, the patient presented an early epidural relapse, frequent in this lymphoma subtype.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 199-203"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669967","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":"Trigeminal neuralgia secondary to minor size lesion, anatomical considerations and pathophysiology","authors":"Adrián Fernández García,&nbsp;Carlos Alberto Rodríguez Arias,&nbsp;Estefanía Utiel Monsálvez,&nbsp;Herbert Daniel Jiménez Zapata","doi":"10.1016/j.neucie.2024.11.010","DOIUrl":"10.1016/j.neucie.2024.11.010","url":null,"abstract":"<div><div>Trigeminal neuralgia is a well-characterized disorder of high prevalence among the current population. It may be caused, among many other causes, by a tumor which contacts with the trigeminal nerve, often of large volume. We present the case of a middle-aged woman without any remarkable medical background who suffered a trigeminal neuralgia caused by a subcentimeter tumor which appeared to be a meningioma. Some small tumors like this one may be symptomatic whereas larger ones will not. We discuss the pathogenesis and characterization of the trigeminal neuralgia in such cases proposing some mechanisms that could be involved in the development of a secondary neuralgia.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 204-207"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693826","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":"Utility of very high-pressure valves in persistent symptomatic shunt overdrainage","authors":"Iván Federico Narváez Moscoso,&nbsp;Bienvenido Ros López,&nbsp;Sara Iglesias Moroño,&nbsp;Julia Casado Ruiz,&nbsp;Raquel Simón Wolter,&nbsp;Miguel Ángel Arráez Sánchez","doi":"10.1016/j.neucie.2024.11.011","DOIUrl":"10.1016/j.neucie.2024.11.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Shunt overdrainage is one of the long-term complications associated with ventriculoperitoneal shunts. Treatment of refractory cases may require further upgrading of both the valve opening pressure and antisiphon device. The aim of this paper is to describe the results of this combination in a selected group of patients.</div></div><div><h3>Methods</h3><div>Retrospective cohort study that included 18 pediatric patients between 2003–2022. Previous shunts were exchanged for the combination of a SOPHYSA Polaris® SPVA-300 valve and upgraded fixed or adjustable antigravitatory devices. The following variables were collected: etiology of the hydrocephalus, age at first shunt and type of valve, number of shunt revisions, other surgical procedures, age at inclusion, clinical and radiological outcomes, and follow-up time. A descriptive analysis was done with means, medians and ranges for quantitative variables; percentages and frequencies for the analysis of qualitative data.</div></div><div><h3>Results</h3><div>The median age at first shunt was two months (0–67). The mean number of shunt revisions before inclusion was three. Shunt removal was attempted in seven patients without success; temporary success was observed in two patients who underwent ETV. Two patients had previous cranial expansions. The mean age at inclusion was 9.1 years (2.7–15.2). After the shunt system was exchanged and upgraded, clinical improvement was observed in 94.4% (17/18) of patients, and radiological improvement was observed in 83.3% (15/18) of patients. The median follow-up was 21 months.</div></div><div><h3>Conclusions</h3><div>Before considering more invasive therapeutic measures, shunt system optimization by the combination of very high-pressure valves and upgraded in-line antisiphon devices is a valid and safe strategy for refractory symptomatic shunt overdrainage.</div></div>","PeriodicalId":74273,"journal":{"name":"Neurocirugia (English Edition)","volume":"36 3","pages":"Pages 161-168"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693827","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}