Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0088
J. Roth, S. Constantini
Paediatric brain tumours (PBT) are a unique entity, in children and in the overall general brain tumour population. They are distinct from adult brain tumours for several reasons, including patient-related factors (size, blood volume), location of the tumours, histological and genetic factors, treatment factors, and prognosis. Even technical surgical aspects may differ from those applied in the adult population. This chapter reviews the main aspects of PBT and their treatment in relation to the aforementioned factors. This text has pinpointed the most important topics of PBT but due to the breadth of the subject, this text cannot be a comprehensive account of every aspect of these pathologies or their treatments.
{"title":"Paediatric brain tumours","authors":"J. Roth, S. Constantini","doi":"10.1093/med/9780198746706.003.0088","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0088","url":null,"abstract":"Paediatric brain tumours (PBT) are a unique entity, in children and in the overall general brain tumour population. They are distinct from adult brain tumours for several reasons, including patient-related factors (size, blood volume), location of the tumours, histological and genetic factors, treatment factors, and prognosis. Even technical surgical aspects may differ from those applied in the adult population. This chapter reviews the main aspects of PBT and their treatment in relation to the aforementioned factors. This text has pinpointed the most important topics of PBT but due to the breadth of the subject, this text cannot be a comprehensive account of every aspect of these pathologies or their treatments.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127801053","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0020
G. Gioffre’, I. Timofeev
Skull vault lesions are rare and represent 1–2% of all bone masses. They are commonly an incidental finding or may be discovered during staging work-up for other diseases. Different classification systems can be employed in order to categorize such lesions: primary (benign and malignant) or secondary as well as neoplastic and non-neoplastic (inflammatory and proliferative). For many of these lesions the clinical and radiological features are often non-specific making the diagnosis cumbersome. Rather than being defined clinical entities, they frequently form part of a spectrum of disease where ruling out an unfavourable progression is of paramount importance. Combining a basic knowledge of the epidemiology, clinical presentation, imaging findings, and histopathology is essential to differentiate these pathologies. The aim of this chapter is to define the important features of each lesion, to offer an overview of the investigations and treatment, and to provide guidance for the differential diagnosis based on imaging. Therefore, pathological entities with similar radiological appearances are grouped together.
{"title":"Skull lesions","authors":"G. Gioffre’, I. Timofeev","doi":"10.1093/med/9780198746706.003.0020","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0020","url":null,"abstract":"Skull vault lesions are rare and represent 1–2% of all bone masses. They are commonly an incidental finding or may be discovered during staging work-up for other diseases. Different classification systems can be employed in order to categorize such lesions: primary (benign and malignant) or secondary as well as neoplastic and non-neoplastic (inflammatory and proliferative). For many of these lesions the clinical and radiological features are often non-specific making the diagnosis cumbersome. Rather than being defined clinical entities, they frequently form part of a spectrum of disease where ruling out an unfavourable progression is of paramount importance. Combining a basic knowledge of the epidemiology, clinical presentation, imaging findings, and histopathology is essential to differentiate these pathologies. The aim of this chapter is to define the important features of each lesion, to offer an overview of the investigations and treatment, and to provide guidance for the differential diagnosis based on imaging. Therefore, pathological entities with similar radiological appearances are grouped together.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116961693","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0008
A. Brodbelt, R. Zakaria
The incidence of brain metastases is increasing due to better management of the systemic primary disease, a lack of chemotherapeutic agents that cross the blood–brain barrier, and more sensitive imaging methods. Presenting symptoms include seizures, headache, and neurological deficit caused by the tumour and associated oedema. Steroids and antiepileptic drugs assist in initial symptom control, and allows assessment of the patient’s performance which remains an important determinant of treatment and outcome. Assessment starts with history and examination, contrast-enhanced MRI brain, and whole-body staging. Newer multimodal MRI techniques can help in diagnostic and treatment dilemmas. Definitive treatments include surgery, radiosurgery, whole-brain radiotherapy, and chemotherapy. The optimal combination and timing of these therapies remains controversial, however there are principles of management that can help the physician guide the patient on the best course. A true multidisciplinary approach is required to optimize treatment and care in an efficient and effective manner.
{"title":"Intracranial metastases","authors":"A. Brodbelt, R. Zakaria","doi":"10.1093/med/9780198746706.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0008","url":null,"abstract":"The incidence of brain metastases is increasing due to better management of the systemic primary disease, a lack of chemotherapeutic agents that cross the blood–brain barrier, and more sensitive imaging methods. Presenting symptoms include seizures, headache, and neurological deficit caused by the tumour and associated oedema. Steroids and antiepileptic drugs assist in initial symptom control, and allows assessment of the patient’s performance which remains an important determinant of treatment and outcome. Assessment starts with history and examination, contrast-enhanced MRI brain, and whole-body staging. Newer multimodal MRI techniques can help in diagnostic and treatment dilemmas. Definitive treatments include surgery, radiosurgery, whole-brain radiotherapy, and chemotherapy. The optimal combination and timing of these therapies remains controversial, however there are principles of management that can help the physician guide the patient on the best course. A true multidisciplinary approach is required to optimize treatment and care in an efficient and effective manner.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114785351","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0029
C. Chandler
Ependymomas which include both subependymoma and myxopapillary ependymoma variants are slow growing tumours of glial origin, believed to arise from radial glial stem cells within the ependymal surface within the central nervous system and spinal cord. Consequently, they are most commonly found in association with a ventricular surface, primarily within the fourth ventricle. Most of these tumours occur in children, representing approximately 10% of all paediatric central nervous system tumours, following astrocytomas and primitive neuroectodermal tumours in frequency, and there does not appear to be a gender bias. The majority of paediatric ependymomas are intracranial and about half occur in children less than 5 years old.
{"title":"Ependymoma","authors":"C. Chandler","doi":"10.1093/med/9780198746706.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0029","url":null,"abstract":"Ependymomas which include both subependymoma and myxopapillary ependymoma variants are slow growing tumours of glial origin, believed to arise from radial glial stem cells within the ependymal surface within the central nervous system and spinal cord. Consequently, they are most commonly found in association with a ventricular surface, primarily within the fourth ventricle. Most of these tumours occur in children, representing approximately 10% of all paediatric central nervous system tumours, following astrocytomas and primitive neuroectodermal tumours in frequency, and there does not appear to be a gender bias. The majority of paediatric ependymomas are intracranial and about half occur in children less than 5 years old.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124807770","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0089
M. Bailey, C. Parks, C. Malucci
Paediatric hydrocephalus is the commonest disorder to be managed by paediatric neurosurgeons. Rather than representing a single disease process, hydrocephalus can result from a variety of different pathological processes or insults that culminate in an imbalance of cerebrospinal fluid (CSF) production and absorption. If left untreated, the majority of cases are fatal, but with appropriate surgical management most patients survive, with some leading normal lives into adulthood. The mainstay of treatment is with CSF shunts, but with technological improvements in imaging and surgical techniques an increasing number are being successfully treated with neuroendoscopic procedures. The disorder can be complex to manage, with many patients requiring multiple surgical procedures and lifelong follow-up. This chapter gives an overview of paediatric hydrocephalus, its causes and classification, management with shunts and endoscopy, description of surgical techniques, and the outcomes of surgical care.
{"title":"Paediatric hydrocephalus","authors":"M. Bailey, C. Parks, C. Malucci","doi":"10.1093/med/9780198746706.003.0089","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0089","url":null,"abstract":"Paediatric hydrocephalus is the commonest disorder to be managed by paediatric neurosurgeons. Rather than representing a single disease process, hydrocephalus can result from a variety of different pathological processes or insults that culminate in an imbalance of cerebrospinal fluid (CSF) production and absorption. If left untreated, the majority of cases are fatal, but with appropriate surgical management most patients survive, with some leading normal lives into adulthood. The mainstay of treatment is with CSF shunts, but with technological improvements in imaging and surgical techniques an increasing number are being successfully treated with neuroendoscopic procedures. The disorder can be complex to manage, with many patients requiring multiple surgical procedures and lifelong follow-up. This chapter gives an overview of paediatric hydrocephalus, its causes and classification, management with shunts and endoscopy, description of surgical techniques, and the outcomes of surgical care.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"232 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122195028","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0072
G. Bourke, M. Syed
Peripheral nerve entrapment is common. Patients present with tingling and pain in the distribution of the affected nerve. This will progress to altered sensation and weakness with prolonged and/or increasing pressure. The most common nerve entrapment syndromes are carpal tunnel affecting the median nerve at the wrist and cubital tunnel affecting the ulnar nerve at the elbow. They affect the working population, so time-efficient diagnosis and robust effective treatment strategies are important to minimize the financial implications to industry. Aetiology, diagnosis, and management strategies for carpal tunnel, cubital tunnel, and meralgia paraesthetica are discussed in this chapter along with a brief overview of other entrapment syndromes. Current controversies between open and endoscopic carpal tunnel release are also reviewed.
{"title":"Entrapment syndromes","authors":"G. Bourke, M. Syed","doi":"10.1093/med/9780198746706.003.0072","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0072","url":null,"abstract":"Peripheral nerve entrapment is common. Patients present with tingling and pain in the distribution of the affected nerve. This will progress to altered sensation and weakness with prolonged and/or increasing pressure. The most common nerve entrapment syndromes are carpal tunnel affecting the median nerve at the wrist and cubital tunnel affecting the ulnar nerve at the elbow. They affect the working population, so time-efficient diagnosis and robust effective treatment strategies are important to minimize the financial implications to industry. Aetiology, diagnosis, and management strategies for carpal tunnel, cubital tunnel, and meralgia paraesthetica are discussed in this chapter along with a brief overview of other entrapment syndromes. Current controversies between open and endoscopic carpal tunnel release are also reviewed.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131710124","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0058
Sadaquate Khan, K. Tsang, Lamia Nayeb
The spinal column in addition to its mechanical and structural role in bipedal primates also plays an important role in three physiological processes: motor control, sensory perception, and autonomic function. This chapter aims to describe the role of the spinal cord in these physiological processes and the patterns of deficit that result from injuries to the spinal cord. The initial section will cover spinal tract anatomy of transmission of pain, proprioception, motor function, and coordination. This will be followed by a description of autonomic control of bladder, bowel, sexual function, and blood pressure. The final segment will describe the patterns of neurological deficit resulting from spinal cord injury.
{"title":"Spinal physiology","authors":"Sadaquate Khan, K. Tsang, Lamia Nayeb","doi":"10.1093/med/9780198746706.003.0058","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0058","url":null,"abstract":"The spinal column in addition to its mechanical and structural role in bipedal primates also plays an important role in three physiological processes: motor control, sensory perception, and autonomic function. This chapter aims to describe the role of the spinal cord in these physiological processes and the patterns of deficit that result from injuries to the spinal cord. The initial section will cover spinal tract anatomy of transmission of pain, proprioception, motor function, and coordination. This will be followed by a description of autonomic control of bladder, bowel, sexual function, and blood pressure. The final segment will describe the patterns of neurological deficit resulting from spinal cord injury.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115089184","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0026
R. Fahlbusch, V. Gerganov, H. Metwali
Both craniopharyngiomas and Rathke’s cysts are rare pituitary lesions of dysembryogenic origin. Their radiological differentiation may be sometimes difficult due to their occasionally similar imaging characteristics. The surgical management of these lesions, especially of craniopharyngiomas, may be very challenging. Gross total removal of a craniopharyngioma is associated with longer recurrence-free survival but could be associated with higher rate of surgery-related morbidities and pituitary insufficiency. Craniopharyngiomas are considered in the majority of cases to be a ‘chronic disease’. A principle difference in the operative management of these two lesions is that in craniopharyngiomas, resection of their thicker capsule is mandatory in order to achieve complete removal, whereas it is nearly impossible and not recommended to attempt such cyst wall removal in Rathke’s cysts. Emptying of the cyst content is usually sufficient to provide cure in the majority of these patients. Recurrences in Rathke’s cyst are only rarely observed in contrast to craniopharyngiomas.
{"title":"Craniopharyngioma and Rathke’s cleft cysts","authors":"R. Fahlbusch, V. Gerganov, H. Metwali","doi":"10.1093/med/9780198746706.003.0026","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0026","url":null,"abstract":"Both craniopharyngiomas and Rathke’s cysts are rare pituitary lesions of dysembryogenic origin. Their radiological differentiation may be sometimes difficult due to their occasionally similar imaging characteristics. The surgical management of these lesions, especially of craniopharyngiomas, may be very challenging. Gross total removal of a craniopharyngioma is associated with longer recurrence-free survival but could be associated with higher rate of surgery-related morbidities and pituitary insufficiency. Craniopharyngiomas are considered in the majority of cases to be a ‘chronic disease’. A principle difference in the operative management of these two lesions is that in craniopharyngiomas, resection of their thicker capsule is mandatory in order to achieve complete removal, whereas it is nearly impossible and not recommended to attempt such cyst wall removal in Rathke’s cysts. Emptying of the cyst content is usually sufficient to provide cure in the majority of these patients. Recurrences in Rathke’s cyst are only rarely observed in contrast to craniopharyngiomas.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"1806 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132969063","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0013
S. Hervey-Jumper, M. Berger
Surgical resection plays a central role in the management of intrinsic brain tumours, and there is a growing body of evidence concerning the value of extent of resection to improve patient outcome and quality of life. Maximal resection can be difficult to achieve due to tumour proximity to eloquent structures and uncertainty as to tumour margins. Direct stimulation mapping, functional neuronavigation, intraoperative MRI, and fluorescence-guided surgery are all useful tools to improve the extent of tumour resection while minimizing morbidity. Current evidence suggests that a more extensive surgical resection is associated with longer survival and improved quality of life for patients with either low- or high-grade gliomas. This chapter emphasizes the evidence supporting the role of surgery for intrinsic brain tumours, their surgical neuroanatomy, and techniques to maximize the extent of resection while minimizing morbidity.
{"title":"Surgical techniques in the management of intrinsic tumours","authors":"S. Hervey-Jumper, M. Berger","doi":"10.1093/med/9780198746706.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0013","url":null,"abstract":"Surgical resection plays a central role in the management of intrinsic brain tumours, and there is a growing body of evidence concerning the value of extent of resection to improve patient outcome and quality of life. Maximal resection can be difficult to achieve due to tumour proximity to eloquent structures and uncertainty as to tumour margins. Direct stimulation mapping, functional neuronavigation, intraoperative MRI, and fluorescence-guided surgery are all useful tools to improve the extent of tumour resection while minimizing morbidity. Current evidence suggests that a more extensive surgical resection is associated with longer survival and improved quality of life for patients with either low- or high-grade gliomas. This chapter emphasizes the evidence supporting the role of surgery for intrinsic brain tumours, their surgical neuroanatomy, and techniques to maximize the extent of resection while minimizing morbidity.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131263076","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}
Pub Date : 2019-09-01DOI: 10.1093/med/9780198746706.003.0047
F. Cagnazzo, G. Lanzino, N. Kassell
Intracranial aneurysms (IAs) are pathological dilatations of the arterial wall. With widespread utilization of non-invasive imaging, unruptured IAs are diagnosed with increased frequency. Approximately 80–90% are saccular or berry aneurysms. Their pathophysiology is still controversial, but most likely multifactorial and related to interaction between modifiable (smoking and hypertension) and unmodifiable (haemodynamic, genetics, and wall biology) factors. A small group of IAs presents a different aetiology and pathophysiology (traumatic, dissecting, blister, fusiform, and mycotic aneurysms). Although there is no controversy about the indication for treatment of ruptured IAs, management of unruptured IAs is very controversial. While the vast majority of small IAs will remain quiescent for life, a very small number will go on to rupture. Size, location, shape, and other risk factors for aneurysm rupture, must be taken into account when deciding between invasive or conservative management.
{"title":"The pathophysiology of aneurysms","authors":"F. Cagnazzo, G. Lanzino, N. Kassell","doi":"10.1093/med/9780198746706.003.0047","DOIUrl":"https://doi.org/10.1093/med/9780198746706.003.0047","url":null,"abstract":"Intracranial aneurysms (IAs) are pathological dilatations of the arterial wall. With widespread utilization of non-invasive imaging, unruptured IAs are diagnosed with increased frequency. Approximately 80–90% are saccular or berry aneurysms. Their pathophysiology is still controversial, but most likely multifactorial and related to interaction between modifiable (smoking and hypertension) and unmodifiable (haemodynamic, genetics, and wall biology) factors. A small group of IAs presents a different aetiology and pathophysiology (traumatic, dissecting, blister, fusiform, and mycotic aneurysms). Although there is no controversy about the indication for treatment of ruptured IAs, management of unruptured IAs is very controversial. While the vast majority of small IAs will remain quiescent for life, a very small number will go on to rupture. Size, location, shape, and other risk factors for aneurysm rupture, must be taken into account when deciding between invasive or conservative management.","PeriodicalId":115670,"journal":{"name":"Oxford Textbook of Neurological Surgery","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134280405","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}
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