Cureus最新文献

{"title":"Acromion and Clavicle Stress Fractures After Reverse Total Shoulder Arthroplasty Reflect Failure to Address Osteoporosis: A Case Report and Literature Review.","authors":"John T Cronin, Kevin B Curtis, Brett W Richards, Julia N Hibbard, John G Skedros","doi":"10.7759/cureus.79993","DOIUrl":"10.7759/cureus.79993","url":null,"abstract":"<p><p>The exponential increase in the rate of reverse total shoulder arthroplasty (RTSA) has been accompanied by a rise in complication rates of this procedure. Of these, peri-prosthetic stress fractures can be particularly problematic due to their potential to cause significant impairment of shoulder function. Despite the association between these stress fractures and osteopenia/osteoporosis, pre-operative bone density assessment is not standard practice for elective RTSA. We report the case of a 68-year-old female patient who, at eleven weeks after elective RTSA (for rotator cuff-tear arthropathy), experienced a non-traumatic stress (insufficiency) fracture of the acromion process of the ipsilateral scapula. Thirteen weeks later, new-onset pain occurred with minimal shoulder use, and a midshaft clavicle stress fracture was detected. She was then diagnosed and treated for osteoporosis, vitamin D deficiency, and hypothyroidism. An ultrasound-based bone-growth stimulator was used to treat both fractures, but only the acromion fracture healed. The clavicle fracture became a 100% displaced chronic non-union. However, the patient felt that surgical fixation of the clavicle fracture would not provide a significant benefit. At 1.5 years after the RTSA, she was moderately satisfied with her shoulder function and highly satisfied with pain reduction, and no additional surgery was required. This is the first reported case describing a patient with acromion and clavicle stress fractures occurring in association with ipsilateral RTSA. We also review the literature of cases with clavicle stress fractures in association with RTSA and highlight key findings: (i) the prevalence of osteoporosis in the population undergoing shoulder arthroplasty is high and (ii) performing shoulder arthroplasty on patients with poor bone quality presents multiple challenges that are underappreciated. This case underscores the importance of pre-operative bone density/health screening to mitigate stress fracture risk after RTSA.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79993"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11876088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559745","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":"Geriatric Assessment Tools in Head and Neck Radiation Oncology: An Unmet Need.","authors":"Rebecca E McIver, Lily Ottensoser, Bhupesh Parashar","doi":"10.7759/cureus.79979","DOIUrl":"10.7759/cureus.79979","url":null,"abstract":"<p><p>The geriatric population faces unique challenges in cancer treatment due to higher rates of comorbidities, which can complicate the risk-benefit analysis of treatment regimens and overall treatment decisions for both physicians and patients. This is especially true for head and neck cancers (HNC) since these patients experience significant treatment-related morbidity. Currently, there are several geriatric assessment (GA) tools available to predict outcomes in older cancer patients treated with surgery or chemotherapy, but no such tool exists to assess the frailty of geriatric patients undergoing radiation therapy for HNC. In this review, we discuss the available geriatric tools, especially those meant for cancer patients, their limitations in HNC patients, and an additional limitation of predicting radiation (RT) treatment outcomes in this challenging group of patients. We also present preliminary data for a new GA tool for HNC patients that can predict premature termination (PT) of treatment or extended treatment (ET) time.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79979"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545011","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":"Mycoplasma hominis Intracranial Abscess Diagnosed by Characteristic Colonies Obtained Through Extended Culture: Case Report and Literature Review.","authors":"Oki Sato, Keitaro Iwata, Makoto Murase, Eiyu Ebata, Kiyofumi Ohkusu, Masakazu Sasaki, Daisuke Ono","doi":"10.7759/cureus.79981","DOIUrl":"10.7759/cureus.79981","url":null,"abstract":"<p><p><i>Mycoplasma hominis (M. hominis)</i> causes genitourinary infections and pregnancy-related complications. Reports of intracranial abscesses due to <i>M. hominis</i> infection are rare. Here, we report a <i>M. hominis</i> intracranial abscess case following a traffic accident who was admitted to our hospital (day 0). The patient, a man in his 70s, underwent cystourethrography, and a urethral catheter was inserted. On day three, the patient underwent intracerebral hematoma evacuation, and on day seven, intravenous ceftazidime and vancomycin were administered after the patient developed a fever. On day 10, the antibiotics were switched to meropenem and vancomycin due to persistent fever. On day 17, magnetic resonance imaging revealed brain and epidural abscesses, and abscess drainage was performed. Gram staining of the abscess specimen showed numerous polymorphonuclear leukocytes, but no visible microorganisms. On day 19, two days after inoculating the culture, tiny pinpoint colonies were observed on the blood agar. Sequencing of the 16S rRNA gene from these colonies revealed the presence of <i>M. hominis</i>. On day 27, the treatment was changed to levofloxacin and clindamycin for treatment of the intracranial abscesses caused by <i>M. hominis</i>. Antibiotic therapy was continued for an additional 52 days until the abscesses disappeared. No recurrences were observed. When bacteria are suspected to be the cause of an intracranial abscess with a risk of <i>M. hominis</i> infection, and Gram staining does not show any microorganisms, considering <i>M. hominis</i> as one of the causative pathogens, conducting extended culture is important.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79981"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545020","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":"Mycoplasma pneumoniae-Induced Erythema Multiforme in an 11-Year-Old Boy: Diagnostic and Therapeutic Challenges.","authors":"Hamdah T Kalantar, Suneel Pooboni","doi":"10.7759/cureus.79944","DOIUrl":"10.7759/cureus.79944","url":null,"abstract":"<p><p><i>Mycoplasma pneumoniae</i> is a causative agent of respiratory tract infections that can also trigger immune-mediated complications such as erythema multiforme (EM), presenting with characteristic target-like skin lesions. Recognizing <i>M. pneumoniae</i> as a potential cause of EM is crucial for accurate diagnosis and timely intervention. We present the case of an 11-year-old boy hospitalized with <i>M. pneumoniae</i> infection followed by severe EM. Initially presenting with high fever, oral ulcers, and a characteristic rash on his extremities, he was misdiagnosed with pharyngotonsillitis and herpetic gingivostomatitis. His symptoms persisted despite treatment until a positive polymerase chain reaction (PCR) confirmed an <i>M. pneumoniae</i> infection. By day 6, the rash had evolved into target lesions, leading to a revised diagnosis of EM. The patient was treated with IV azithromycin, corticosteroids, and IV immunoglobulin (IVIg), which resulted in significant clinical improvement. Recognizing <i>M. pneumoniae</i> as a potential cause of EM is essential for accurate and prompt diagnosis. Timely identification and a multidisciplinary treatment approach, including appropriate antimicrobial therapy and supportive care, can significantly enhance patient outcomes.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79944"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545025","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":"Myocarditis: Diagnostic Modalities and Treatment Options.","authors":"Dihan Thilakaratne, Roshan Bista, Mark Zenker, Rohan Kaza, Sasan Raissi, Timir Paul","doi":"10.7759/cureus.79949","DOIUrl":"10.7759/cureus.79949","url":null,"abstract":"<p><p>Myocarditis is an underdiagnosed condition that affects people of all ages. It can be asymptomatic or present with a variety of symptoms. The etiology of myocarditis is broad and can be infectious, autoimmune, or toxin-induced. The diagnosis of myocarditis can be challenging at times due to varied clinical features that sometimes overlap with other cardiac conditions. It is essential to have a high index of suspicion and use appropriate diagnostic methods for timely detection. In this review, we discuss establishing the diagnosis of acute myocarditis with initial workup to gold standard noninvasive cardiac magnetic resonance imaging methods and the use of invasive techniques such as endomyocardial biopsy. Furthermore, we discuss the treatment options, including novel approaches based on the severity of the symptoms and the specific etiologies of myocarditis.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79949"},"PeriodicalIF":1.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545039","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":"Mortality 30, 60, and 90 Days After Discharge Is Greater in Patients Who Experienced Postoperative Respiratory Depression and Pulmonary Complication.","authors":"Robert B Raffa, Joseph V Pergolizzi, George C Dungan, Thomas L Miller","doi":"10.7759/cureus.79913","DOIUrl":"10.7759/cureus.79913","url":null,"abstract":"<p><p>Upon the induction of general anesthesia, a predictable sequence of physiological changes occurs within the respiratory and neuromuscular systems. The sequelae of these changes include an assortment of postoperative pulmonary complications (PPCs), including postoperative respiratory depression (PORD), that are observed during the immediate postoperative period and in the post-anesthesia care unit (PACU). These adverse events are anticipated, because several of the drugs that are used during surgery (e.g., opioids, which are traditionally used to manage pain during and after surgery), albeit therapeutically beneficial, have these adverse effects as part of their pharmacology. Nevertheless, the effects are traditionally considered transitory. However, several studies provide evidence suggesting that PPC-related morbidity and mortality extend 30, 60, and even 90 days after discharge from the hospital. These studies are summarized and assessed in this narrative review. Although exact estimates vary depending on the definitions used, the type of surgery, patient population, and risk factors (such as age), it is clear that PORD and other PPCs can be severe postoperative complications with significant associated mortality risks that extend weeks to months after discharge from the hospital.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79913"},"PeriodicalIF":1.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545016","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 Coexisting Presentation of Autosomal Dominant Polycystic Kidney Disease With Rapid Deterioration of Renal Function and Neurofibromatosis Type 1.","authors":"Haruna Noishiki, Hiroko Yamauchi, Kazumi Komaki, Tetsuro Kusaba, Keiichi Tamagaki","doi":"10.7759/cureus.79931","DOIUrl":"10.7759/cureus.79931","url":null,"abstract":"<p><p>Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary kidney disorders, characterized by progressive cyst development. Neurofibromatosis type 1 (NF1) is another autosomal dominant disorder, characterized by café-au-lait spots, neurofibromas, and multisystem involvement. We report the case of an 18-year-old male with ADPKD and NF1, referred due to progressively worsening renal dysfunction. His initial estimated glomerular filtration rate (eGFR) was 71.9 mL/min/1.73m², with MRI showing bilateral cystic renal enlargement (total kidney volume: 758 mL). One year later, his eGFR declined to 56.7 mL/min/1.73m², and kidney volume increased by 10.4% over one year. Tolvaptan was initiated, and he remains under follow-up. Mutations in the PKD1/PKD2, which are responsible for ADPKD, affect intracellular signaling, including the mammalian target of the rapamycin (mTOR) pathway, leading to cyst formation and progression, while NF1 mutations overactivate the Ras proteins. His disease progression was more severe than that of his father with ADPKD alone, suggesting NF1 may have accelerated cyst enlargement. The co-occurrence of ADPKD and NF1 is extremely rare, with only a few cases reported in the past.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79931"},"PeriodicalIF":1.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574823","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":"Utility of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (FDG-PET/CT) Imaging for Evaluating Treatment Efficacy in Mycobacterium avium Complex Pulmonary Disease.","authors":"Takahiro Takazono, Naoki Hosogaya, Reiko Ideguchi, Masataka Yoshida, Kazuaki Takeda, Shotaro Ide, Naoki Iwanaga, Ryo Toya, Takashi Kudo, Koichi Izumikawa, Katsunori Yanagihara, Hiroshi Mukae","doi":"10.7759/cureus.79891","DOIUrl":"10.7759/cureus.79891","url":null,"abstract":"<p><p>Introduction <i>Mycobacterium avium</i> complex pulmonary disease (MAC-PD) necessitates prolonged treatment. However, determining the appropriate time to conclude treatment is challenging because of the lack of indices for evaluating disease activity. Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) can be used to visualize inflammatory sites and is hypothesized to indicate treatment efficacy in inflammatory diseases. Therefore, we conducted this single-arm, open-label, interventional study to investigate the utility of FDG-PET/CT imaging as an indicator of treatment efficacy by analyzing the correlation between pre- and post-treatment FDG-PET/CT imaging and treatment efficacy in MAC-PD. Methods FDG-PET/CT scans were performed before and 52 weeks after the initiation of MAC-PD treatment to assess the utility of FDG-PET/CT as an indicator of treatment efficacy. The primary endpoint was the association between treatment efficacy/culture-negative conversion and the standardized uptake value (SUV) max, SUV peak, target/background ratio (TBR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG). Results Ten patients were enrolled after obtaining informed consent, and comparative evaluation after one year of treatment was feasible in nine patients. Based on predefined comprehensive clinical endpoints (symptoms, imaging, and inflammatory findings), five cases were deemed effective, and four cases were deemed ineffective. The effective cases exhibited a significantly lower SUV peak and TBR in the pre- and post-treatment ratios than the ineffective cases. However, no statistically significant associations were observed between these indices and culture-negative conversions. Conclusion These findings suggest that the pre- and post-treatment ratios of SUV peak and TBR may be valuable for evaluating disease activity in patients with MAC-PD.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79891"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545118","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":"Comparative Analysis of Psychosocial Outcomes and Quality of Life Among Nulligravida, Primigravida, and Multigravida Women Diagnosed With Polycystic Ovary Syndrome (PCOS).","authors":"Fatima Rehman, Muhammad Muslim Khan, Ashraf Lnu, Naila Lnu, Rumman Lnu, Shah Zeb","doi":"10.7759/cureus.79895","DOIUrl":"10.7759/cureus.79895","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Background Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder that significantly impacts women's physical and mental health. While its metabolic and reproductive effects are well-documented, its psychosocial impact-particularly across different reproductive stages-remains underexplored. Gravidity may influence psychological outcomes, with nulligravida women facing fertility-related distress, primigravida women experiencing pregnancy-related anxiety, and multigravida women dealing with cumulative stress and worsening PCOS symptoms. This study aims to compare anxiety, depression, stress, and quality of life (QoL) among these groups to inform targeted, stage-specific interventions that improve psychosocial well-being in women with PCOS. Objective This study aims to compare psychosocial well-being across nulligravida, primigravida, and multigravida women with PCOS. The findings will inform the development of targeted interventions that address the specific psychosocial needs of each reproductive group. Methods This cross-sectional study, conducted from July 2023 to December 2024 at Mardan Medical Complex, involved women aged 18-45 diagnosed with PCOS based on established clinical guidelines. Participants were systematically sampled and categorized by pregnancy history into nulligravida, primigravida, and multigravida groups. Validated instruments were used to assess depression, anxiety, stress, and quality of life. The data were analyzed using Kruskal-Wallis one-way ANOVA and other relevant statistical methods to compare outcomes across the groups. Results In this study of 510 women with PCOS, significant differences were observed across the three gravidity groups. Multigravida women had the highest mean age (32.57±4.76 years) and the highest prevalence of a family history of PCOS (40; 57.14%). Primigravida women exhibited the highest BMI (31.21±3.82) and reported the most favorable quality of life, with 56 (20.51%) rating it as Good. However, this group also had the highest levels of severe anxiety, with 211 (77.29%) reporting it. Severe depression was most prevalent among nulligravida women, with 119 (71.26%) experiencing it, while multigravida women reported the poorest quality of life, with 45 (64.29%) rating it as Poor and 28 (40%) as Very Poor. Multigravida women also had the highest stress levels, with 71 (71.43%) patients reporting high stress, and experienced the most severe PCOS symptoms, including hirsutism in 25 (35.71%) patients and acne in 37 (52.85%) patients. In comparison, severe hirsutism was observed in 49 (29.34%) of nulligravida women and 46 (16.85%) of primigravida women, while severe acne was present in 61 (36.53%) of nulligravida women and 139 (50.92%) of primigravida women. Conclusion These findings highlight the vital importance of personalized, stage-specific care in the effective management of PCOS, ensuring that interventions are responsive to the distinct needs and psychosocial challenges encountere","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79895"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545008","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":"Applications of Artificial Intelligence in Medical Education: A Systematic Review.","authors":"Eric Hallquist, Ishank Gupta, Michael Montalbano, Marios Loukas","doi":"10.7759/cureus.79878","DOIUrl":"10.7759/cureus.79878","url":null,"abstract":"<p><p>Artificial intelligence (AI) models, like Chat Generative Pre-Trained Transformer (OpenAI, San Francisco, CA), have recently gained significant popularity due to their ability to make autonomous decisions and engage in complex interactions. To fully harness the potential of these learning machines, users must understand their strengths and limitations. As AI tools become increasingly prevalent in our daily lives, it is essential to explore how this technology has been used so far in healthcare and medical education, as well as the areas of medicine where it can be applied. This paper systematically reviews the published literature on the PubMed database from its inception up to June 6, 2024, focusing on studies that used AI at some level in medical education, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Several papers identified where AI was used to generate medical exam questions, produce clinical scripts for diseases, improve the diagnostic and clinical skills of students and clinicians, serve as a learning aid, and automate analysis tasks such as screening residency applications. AI shows promise at various levels and in different areas of medical education, and our paper highlights some of these areas. This review also emphasizes the importance of educators and students understanding AI's principles, capabilities, and limitations before integration. In conclusion, AI has potential in medical education, but more research needs to be done to fully explore additional areas of applications, address the current gaps in knowledge, and its future potential in training healthcare professionals.</p>","PeriodicalId":93960,"journal":{"name":"Cureus","volume":"17 3","pages":"e79878"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11872247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545001","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}