Systolic time interval (STI) estimation is an established noninvasive method for the quantifiable assessment of left ventricular (LV) performance in well-being and disease states; it stays valuable for clinical application and forms no burden to the subjects. This manuscript reviews the potential clinical applications and prognostic value of STI for the assessment of LV systolic function in cardiovascular disease (CVD). STIs could be obtained by several noninvasive imaging modalities such as transthoracic echocardiography, tissue Doppler imaging M-mode echocardiography, conventional echocardiography, and so on. In view of that, a literature review for studies reporting the clinical applications of STI in assessing LV systolic function among CVD patients was carried out using PubMed search. Accordingly, the current review describes how STI can be measured; reliability of cardiac time interval measurement in patients with CVD and its role in a clinical setting. With the advent of modern techniques, STI could be easily measured in a clinical setting. Likewise, STI parameter, particularly preejection period and LV ejection time ratio (PEP/LVET), has got the highest degree of correlation with LV ejection fraction (LVEF) in assessing LV performance. Furthermore, reproducibility of systolic ejection time (SET) achieved by the TDI M-mode method is outstanding and better when compared with the reproducibility of SET obtained by the conventional pulsed Doppler method. Furthermore, prolonged SET is independently related with enhanced outcomes among heart failure with reduced EF (HFrEF, i.e., EF ≤40%) but not HF with preserved EF (HFpEF, i.e., EF >40%) patients, indicating that stabilizing SET would be helpful in the case of systolic dysfunction. Clinically, tissue Doppler-derived time intervals could be beneficial to analyze abnormal cases in comparison with other invasive and noninvasive methods of ventricular function examination. Furthermore, phonoelectrocardiography-derived STI parameters, particularly electromechanical activation time-to-LVET ratio, may have a significant role in the diagnostic approach of heart failure (HF) in patients with undifferentiated dyspnea. In addition, in HF patients, PEP/LVET of >0.43 helps to detect LVEF <35% by pulsed Doppler echocardiography. Moreover, LVET continues to be an independent predictor of incident HF and provides incremental prognostic value on the future HF risk and death but not myocardial infarction. In conclusion, STI measurement could be useful, particularly in identifying LVEF <35% in the case of refractory HF patients. This could be beneficial in the selection of patients requiring cardiac resynchronization, specifically when accurate LVEF evaluation by echocardiography proves challenging in atrial fibrillation or if the evaluation is done by a trainee echocardiographer. Furthermore, the cardiac time intervals including SET can be acquired irrespective of rhythm. Good image quality is required for the
{"title":"A narrative review of clinical applications of systolic time intervals","authors":"S. Seetharam, M. Shankar, N. Reddy","doi":"10.4103/jpcs.jpcs_63_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_63_21","url":null,"abstract":"Systolic time interval (STI) estimation is an established noninvasive method for the quantifiable assessment of left ventricular (LV) performance in well-being and disease states; it stays valuable for clinical application and forms no burden to the subjects. This manuscript reviews the potential clinical applications and prognostic value of STI for the assessment of LV systolic function in cardiovascular disease (CVD). STIs could be obtained by several noninvasive imaging modalities such as transthoracic echocardiography, tissue Doppler imaging M-mode echocardiography, conventional echocardiography, and so on. In view of that, a literature review for studies reporting the clinical applications of STI in assessing LV systolic function among CVD patients was carried out using PubMed search. Accordingly, the current review describes how STI can be measured; reliability of cardiac time interval measurement in patients with CVD and its role in a clinical setting. With the advent of modern techniques, STI could be easily measured in a clinical setting. Likewise, STI parameter, particularly preejection period and LV ejection time ratio (PEP/LVET), has got the highest degree of correlation with LV ejection fraction (LVEF) in assessing LV performance. Furthermore, reproducibility of systolic ejection time (SET) achieved by the TDI M-mode method is outstanding and better when compared with the reproducibility of SET obtained by the conventional pulsed Doppler method. Furthermore, prolonged SET is independently related with enhanced outcomes among heart failure with reduced EF (HFrEF, i.e., EF ≤40%) but not HF with preserved EF (HFpEF, i.e., EF >40%) patients, indicating that stabilizing SET would be helpful in the case of systolic dysfunction. Clinically, tissue Doppler-derived time intervals could be beneficial to analyze abnormal cases in comparison with other invasive and noninvasive methods of ventricular function examination. Furthermore, phonoelectrocardiography-derived STI parameters, particularly electromechanical activation time-to-LVET ratio, may have a significant role in the diagnostic approach of heart failure (HF) in patients with undifferentiated dyspnea. In addition, in HF patients, PEP/LVET of >0.43 helps to detect LVEF <35% by pulsed Doppler echocardiography. Moreover, LVET continues to be an independent predictor of incident HF and provides incremental prognostic value on the future HF risk and death but not myocardial infarction. In conclusion, STI measurement could be useful, particularly in identifying LVEF <35% in the case of refractory HF patients. This could be beneficial in the selection of patients requiring cardiac resynchronization, specifically when accurate LVEF evaluation by echocardiography proves challenging in atrial fibrillation or if the evaluation is done by a trainee echocardiographer. Furthermore, the cardiac time intervals including SET can be acquired irrespective of rhythm. Good image quality is required for the ","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"1 - 8"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44465807","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":"Finish: Give yourself the gift of done","authors":"L. Giray","doi":"10.4103/jpcs.jpcs_33_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_33_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815530","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}
Anamika Giri, S. Acharya, Sandeep Kamat, Gajendra Agrawal
{"title":"Crochetage sign – A signature electrocardiographic sign of atria septal defect","authors":"Anamika Giri, S. Acharya, Sandeep Kamat, Gajendra Agrawal","doi":"10.4103/jpcs.jpcs_32_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_32_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"3 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815464","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}
K. Subramaniam, Dhruva Sharma, Vishal Vinayak Bhende, V. Kudumula, Shrinath Reddy
Anomalous left coronary artery from the right pulmonary artery (RPA) is a rare congenital coronary anomaly and is one of the surgically treatable causes of ventricular dysfunction in infants. The left coronary artery when it arises from the RPA or near its base tends to follow the intramural course. Careful echocardiographic evaluation of the course of the coronary artery is necessary under sedation to avoid missing this anomaly. Unroofing of this coronary artery and closing of the pulmonary artery origin are recommended for treatment. We report a case where the intramural course was retrocommissural and unroofing would have resulted in aortic incompetence. We describe how a 90° rotation is possible by augmenting the coronary button with an anterior pericardial hood. The reconstruction of the RPA should be done with adequate mobilization and redundancy to prevent compression and bowstringing of the reimplanted coronary artery.
{"title":"Anomalous left coronary artery from the right pulmonary artery with an intramural course","authors":"K. Subramaniam, Dhruva Sharma, Vishal Vinayak Bhende, V. Kudumula, Shrinath Reddy","doi":"10.4103/jpcs.jpcs_12_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_12_22","url":null,"abstract":"Anomalous left coronary artery from the right pulmonary artery (RPA) is a rare congenital coronary anomaly and is one of the surgically treatable causes of ventricular dysfunction in infants. The left coronary artery when it arises from the RPA or near its base tends to follow the intramural course. Careful echocardiographic evaluation of the course of the coronary artery is necessary under sedation to avoid missing this anomaly. Unroofing of this coronary artery and closing of the pulmonary artery origin are recommended for treatment. We report a case where the intramural course was retrocommissural and unroofing would have resulted in aortic incompetence. We describe how a 90° rotation is possible by augmenting the coronary button with an anterior pericardial hood. The reconstruction of the RPA should be done with adequate mobilization and redundancy to prevent compression and bowstringing of the reimplanted coronary artery.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"59 - 61"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44900391","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}
Sandeep Kamat, V. Sagar, C. Akhil, S. Acharya, S. Shukla, Sunil Kumar
Escherichia coli, a Gram-negative facultative anaerobe, is the common causative organism leading to urinary tract infection. However, the involvement of endocardium by E. coli has been reported to be very rare in spite of the septicemia caused by this organism. However, the mortality rate due to infective endocarditis caused by E. coli was reported to be higher than due to other organisms like HACEK group of organisms. Conventional risk factors leading to infective endocarditis include cirrhosis of the liver, prosthetic heart valves, and other sources of infection like urosepsis. Here, we report the case of a 60-year-old diabetic male who presented with obstructive uropathy-induced urinary tract infection leading to infective endocarditis.
{"title":"Escherichia coli urosepsis leading to native valve endocarditis","authors":"Sandeep Kamat, V. Sagar, C. Akhil, S. Acharya, S. Shukla, Sunil Kumar","doi":"10.4103/jpcs.jpcs_7_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_7_22","url":null,"abstract":"Escherichia coli, a Gram-negative facultative anaerobe, is the common causative organism leading to urinary tract infection. However, the involvement of endocardium by E. coli has been reported to be very rare in spite of the septicemia caused by this organism. However, the mortality rate due to infective endocarditis caused by E. coli was reported to be higher than due to other organisms like HACEK group of organisms. Conventional risk factors leading to infective endocarditis include cirrhosis of the liver, prosthetic heart valves, and other sources of infection like urosepsis. Here, we report the case of a 60-year-old diabetic male who presented with obstructive uropathy-induced urinary tract infection leading to infective endocarditis.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"42 - 44"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42460870","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}
J. Thomas, Simon Philipose, Aswathy K. Vijayan, Y. Mohammed, M. Padmanabhan, Antony George, J. Wilson, G. George, J. Abraham, G. Sunil, Bhaskar Ranganathan, J. Periappuram
Objective: The aim of this study is to investigate the postoperative outcomes in post COVID versus non-COVID patients undergone cardiac surgery. Materials and Methods: A retrospective cohort study to analyze the impact of COVID-19 in patients undergoing elective or emergency cardiac surgeries. A total of 512 patients were included in the study over a period of 6 months. The study consists of 35 post-COVID patients and 477 non-COVID patients. All data were collected from previous medical records and hospital database. The clinical outcomes and mortality of post-COVID patients were compared with a cohort of non-COVID patients. The endpoints were compared using t-test or Chi-squared test. Results: Among the post-COVID patients, 54.3% (19) of the post-COVID patients were under COVID category A followed by category B 28.6% (10) and category C 17.1% (6). About 50% of post-COVID patients had complications, especially pneumonia and myocardial infarction following COVID-19. Around 43% of patients showed fibrotic changes in computed tomography (CT) Thorax at the time of admission for surgery. 63% showed CT score in between 1 and 5. The mean COVID antibody titer was 158 U/ml. Majority of the surgeries were coronary artery bypass graft and significant difference was observed in the requirement of intra-aortic balloon pump in post-COVID patients (P < 0.0001). No postoperative mortality reported in post-COVID patients. The postoperative outcomes and survival rates were almost similar in both groups. Conclusion: In our study, the post-COVID patients were recover in a similar way as non-COVID patients after cardiac surgery.
{"title":"Postoperative outcomes of cardio-thoracic surgery in post-COVID versus non-COVID patients - Single-center experience","authors":"J. Thomas, Simon Philipose, Aswathy K. Vijayan, Y. Mohammed, M. Padmanabhan, Antony George, J. Wilson, G. George, J. Abraham, G. Sunil, Bhaskar Ranganathan, J. Periappuram","doi":"10.4103/jpcs.jpcs_66_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_66_21","url":null,"abstract":"Objective: The aim of this study is to investigate the postoperative outcomes in post COVID versus non-COVID patients undergone cardiac surgery. Materials and Methods: A retrospective cohort study to analyze the impact of COVID-19 in patients undergoing elective or emergency cardiac surgeries. A total of 512 patients were included in the study over a period of 6 months. The study consists of 35 post-COVID patients and 477 non-COVID patients. All data were collected from previous medical records and hospital database. The clinical outcomes and mortality of post-COVID patients were compared with a cohort of non-COVID patients. The endpoints were compared using t-test or Chi-squared test. Results: Among the post-COVID patients, 54.3% (19) of the post-COVID patients were under COVID category A followed by category B 28.6% (10) and category C 17.1% (6). About 50% of post-COVID patients had complications, especially pneumonia and myocardial infarction following COVID-19. Around 43% of patients showed fibrotic changes in computed tomography (CT) Thorax at the time of admission for surgery. 63% showed CT score in between 1 and 5. The mean COVID antibody titer was 158 U/ml. Majority of the surgeries were coronary artery bypass graft and significant difference was observed in the requirement of intra-aortic balloon pump in post-COVID patients (P < 0.0001). No postoperative mortality reported in post-COVID patients. The postoperative outcomes and survival rates were almost similar in both groups. Conclusion: In our study, the post-COVID patients were recover in a similar way as non-COVID patients after cardiac surgery.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"22 - 29"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48066686","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}
Vinoda Sharma, Brig K. Arora, L. Gupta, Amitabh Poonia, Sukriti Raina, U. Yadav, Ruchi Sharma, S. Dwivedi
Introduction: Prosthetic valve thrombosis (PVT) is a serious complication seen with mechanical prosthetic cardiac valves and is associated with high mortality. Emergency surgery (thrombectomy or valve replacement) had been the traditional treatment, but now with intravenous thrombolytic therapy as an alternative to emergency surgery in patients with PVT has shown excellent success rate and acceptable risk. This study is aimed to determine efficacy and safety of use of thrombolytic agents (tPA or STK) in patients with PVT. Materials and Methods: This was a retrospective, single-center study of patients with PVT admitted between 2004 and 2020 at a tertiary care center in North India. The diagnosis of PVT was based on a history of prosthetic heart valve replacement, clinical presentation, and by diagnostic methods. All patients received either tenecteplase or streptokinase given as a bolus dose of 2.5 lac units over ½ h, followed by 1 lac units/h for 24–48 h depending on clinical response and complication, whereas tenecteplase (1 mg/kg of body weight) was given as bolus. Results: Of 72 patients, 45 patients received t-PA as a thrombolytic drug. Complete success was obtained in 39 patients (86.66%), whereas partial success in 3 (17.77%) and failure in 3 (6.66%). Among the patients who received streptokinase (n = 27), complete success was found in 23 patients (85.19%), whereas partial success was seen in 3 (11.11%) and failure was seen in 1 patient (3.7%). Conclusion: Thrombolysis is a reasonable option in patients with PVT. Our study has reiterated that major factors for PVT are warfarin poor compliance and subtherapeutic international normalized ratio. Postclosure clinical follow-up along with patient education should be followed in patients with mechanical prosthetic valve.
{"title":"The efficacy and safety of thrombolytic agents for patients with prosthetic valve thrombosis","authors":"Vinoda Sharma, Brig K. Arora, L. Gupta, Amitabh Poonia, Sukriti Raina, U. Yadav, Ruchi Sharma, S. Dwivedi","doi":"10.4103/jpcs.jpcs_54_21","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_54_21","url":null,"abstract":"Introduction: Prosthetic valve thrombosis (PVT) is a serious complication seen with mechanical prosthetic cardiac valves and is associated with high mortality. Emergency surgery (thrombectomy or valve replacement) had been the traditional treatment, but now with intravenous thrombolytic therapy as an alternative to emergency surgery in patients with PVT has shown excellent success rate and acceptable risk. This study is aimed to determine efficacy and safety of use of thrombolytic agents (tPA or STK) in patients with PVT. Materials and Methods: This was a retrospective, single-center study of patients with PVT admitted between 2004 and 2020 at a tertiary care center in North India. The diagnosis of PVT was based on a history of prosthetic heart valve replacement, clinical presentation, and by diagnostic methods. All patients received either tenecteplase or streptokinase given as a bolus dose of 2.5 lac units over ½ h, followed by 1 lac units/h for 24–48 h depending on clinical response and complication, whereas tenecteplase (1 mg/kg of body weight) was given as bolus. Results: Of 72 patients, 45 patients received t-PA as a thrombolytic drug. Complete success was obtained in 39 patients (86.66%), whereas partial success in 3 (17.77%) and failure in 3 (6.66%). Among the patients who received streptokinase (n = 27), complete success was found in 23 patients (85.19%), whereas partial success was seen in 3 (11.11%) and failure was seen in 1 patient (3.7%). Conclusion: Thrombolysis is a reasonable option in patients with PVT. Our study has reiterated that major factors for PVT are warfarin poor compliance and subtherapeutic international normalized ratio. Postclosure clinical follow-up along with patient education should be followed in patients with mechanical prosthetic valve.","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"8 1","pages":"30 - 34"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44291174","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}
Sujit Kshirsagar, S. Naik, Neharica Seth, Pradnya Bhambire
{"title":"Anesthesia management of radiofrequency ablation in a pediatric patient of ebstein anomaly with wolff–Parkinson–White syndrome","authors":"Sujit Kshirsagar, S. Naik, Neharica Seth, Pradnya Bhambire","doi":"10.4103/jpcs.jpcs_25_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_25_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"35 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815276","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}
ChandraPrakash Thakur, Satyajit Singh, S. Naik, Muneshwar Kumar
{"title":"Hyperkalemia-induced brugada phenocopy: A rare electrocardiogram manifestation","authors":"ChandraPrakash Thakur, Satyajit Singh, S. Naik, Muneshwar Kumar","doi":"10.4103/jpcs.jpcs_16_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_16_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814775","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":"Evaluation of systolic time intervals in patients of ischemic heart disease with clinical heart failure","authors":"S. Seetharam, M. Vinutha Shankar, N. Reddy","doi":"10.4103/jpcs.jpcs_17_22","DOIUrl":"https://doi.org/10.4103/jpcs.jpcs_17_22","url":null,"abstract":"","PeriodicalId":17503,"journal":{"name":"Journal of the Practice of Cardiovascular Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815075","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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