Pub Date : 2023-11-01DOI: 10.1097/md9.0000000000000301
E. Fysh, Bhaumik V. Mevavala, Charlotte Wigston, Dana Hince, Isuru Sirisinghe, A. Regli, Edward Litton, Brad Wibrow
Pleural effusions are common in intensive care patients. Without strong evidence to guide management, clinicians variably undertake either intervention with drainage procedures, or expectant management, that is, observation, whilst treating the underlying cause. Early drainage may be associated with improved diagnostic accuracy and oxygenation, without increased complications. However, randomized evidence is needed to confirm these observations. In patients diagnosed with a safely drainable pleural effusion while admitted to the intensive care units (ICU) and in whom there is no absolute indication for immediate drainage, intervention with early pleural drainage compared with initial expectant management: improves oxygenation and is safe. To undertake a phase II multicenter randomized controlled trial evaluating the safety and efficacy of early pleural effusion drainage compared with expectant management in the intensive care setting. Population – patients admitted in intensive care units and diagnosed with a safely drainable pleural effusion in whom there is no absolute indication for immediate drainage. Co-primary endpoints – ratio of arterial oxygen partial pressure to fraction of inspired oxygen ratio at 48 hours after randomization and number of Pleural Effusion Related Serious Adverse Events at 90 days. Inclusion criteria – admitted to intensive care, age > 18 years, pleural effusion safely drainable, and no absolute indication for immediate drainage. Exclusion criteria – in the opinion of treating clinician trial not in patient’s best interests, inability to gain consent from patient or responsible decision-maker, and patient requiring extracorporeal membrane oxygenation. Randomization – open-label, 1:1 patient ratio using permuted block randomization. Intervention and comparator – drainage of pleural effusion as opposed to expectant management. Outcomes – physiological data including ratio of arterial oxygen partial pressure to fraction of inspired oxygen and/or ratio of oxygen saturation measured by pulse oximetry to fraction of inspired oxygen ratio will be collected at randomization and 6 hourly until 72 hours or ICU discharge (whichever sooner). Adverse event and clinical data will be recorded daily to ICU discharge, hospital discharge and death up to 90 days after randomization.
{"title":"Efficacy and safety outcomes of drainage of intensive care pleural effusions: Study protocol for the ESODICE randomized controlled trial","authors":"E. Fysh, Bhaumik V. Mevavala, Charlotte Wigston, Dana Hince, Isuru Sirisinghe, A. Regli, Edward Litton, Brad Wibrow","doi":"10.1097/md9.0000000000000301","DOIUrl":"https://doi.org/10.1097/md9.0000000000000301","url":null,"abstract":"Pleural effusions are common in intensive care patients. Without strong evidence to guide management, clinicians variably undertake either intervention with drainage procedures, or expectant management, that is, observation, whilst treating the underlying cause. Early drainage may be associated with improved diagnostic accuracy and oxygenation, without increased complications. However, randomized evidence is needed to confirm these observations. In patients diagnosed with a safely drainable pleural effusion while admitted to the intensive care units (ICU) and in whom there is no absolute indication for immediate drainage, intervention with early pleural drainage compared with initial expectant management: improves oxygenation and is safe. To undertake a phase II multicenter randomized controlled trial evaluating the safety and efficacy of early pleural effusion drainage compared with expectant management in the intensive care setting. Population – patients admitted in intensive care units and diagnosed with a safely drainable pleural effusion in whom there is no absolute indication for immediate drainage. Co-primary endpoints – ratio of arterial oxygen partial pressure to fraction of inspired oxygen ratio at 48 hours after randomization and number of Pleural Effusion Related Serious Adverse Events at 90 days. Inclusion criteria – admitted to intensive care, age > 18 years, pleural effusion safely drainable, and no absolute indication for immediate drainage. Exclusion criteria – in the opinion of treating clinician trial not in patient’s best interests, inability to gain consent from patient or responsible decision-maker, and patient requiring extracorporeal membrane oxygenation. Randomization – open-label, 1:1 patient ratio using permuted block randomization. Intervention and comparator – drainage of pleural effusion as opposed to expectant management. Outcomes – physiological data including ratio of arterial oxygen partial pressure to fraction of inspired oxygen and/or ratio of oxygen saturation measured by pulse oximetry to fraction of inspired oxygen ratio will be collected at randomization and 6 hourly until 72 hours or ICU discharge (whichever sooner). Adverse event and clinical data will be recorded daily to ICU discharge, hospital discharge and death up to 90 days after randomization.","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139298831","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 : 2023-11-01DOI: 10.1097/md9.0000000000000296
Hao-Chuan Wang, Yanan Li, Dao-Jing Li, Hongfang Li
Lymphoblastic lymphoma is a rare form of highly aggressive non-Hodgkin lymphoma. The most common clinical manifestations are superficial lymphadenopathy and mediastinal mass. In a few cases, invasion of the central nervous system is the first manifestation. It is also difficult to diagnose patients using the central nervous system as the first manifestation. Here, we report the case of a 26-year-old man with central nervous system disease as the primary manifestation; we used cerebrospinal fluid cytology (CSF-C) for early diagnosis and shared the importance of CSF-C for early diagnosis of T-cell lymphoblastic lymphoma. The patient was admitted to the hospital because of “right eyelid closure weakness with headache for 1 month and exacerbation with sluggish response for 1 week.” Physical examination revealed a bilateral Kernig sign (+) and Lasgue sign (+). The Mini-Mental State Examination and Montreal Cognitive Assessment scores were 20 (out of 30). When there was no abnormality in the imaging examination, the patient was misdiagnosed with meningoencephalitis and received anti-inflammatory treatment because the initial symptom was a clinical manifestation of the central nervous system, and the imaging and blood tests showed no definite abnormality. Cerebrospinal fluid has been studied and second-generation sequencing detection, such as after CSF-C tip to abnormal lymphocytes, to open the breakthrough of the diagnosis of lymphoma. In the cases with central nervous system injury as the first manifestation, CSF-C was combined with immunohistochemistry and cerebrospinal fluid flow cytometry to provide a clear and effective method and evidence for the early diagnosis of T-cell lymphoblastic lymphoma.
{"title":"Cerebrospinal fluid cytology-assisted diagnosis of T-lymphoblastic lymphoma: A case report","authors":"Hao-Chuan Wang, Yanan Li, Dao-Jing Li, Hongfang Li","doi":"10.1097/md9.0000000000000296","DOIUrl":"https://doi.org/10.1097/md9.0000000000000296","url":null,"abstract":"Lymphoblastic lymphoma is a rare form of highly aggressive non-Hodgkin lymphoma. The most common clinical manifestations are superficial lymphadenopathy and mediastinal mass. In a few cases, invasion of the central nervous system is the first manifestation. It is also difficult to diagnose patients using the central nervous system as the first manifestation. Here, we report the case of a 26-year-old man with central nervous system disease as the primary manifestation; we used cerebrospinal fluid cytology (CSF-C) for early diagnosis and shared the importance of CSF-C for early diagnosis of T-cell lymphoblastic lymphoma. The patient was admitted to the hospital because of “right eyelid closure weakness with headache for 1 month and exacerbation with sluggish response for 1 week.” Physical examination revealed a bilateral Kernig sign (+) and Lasgue sign (+). The Mini-Mental State Examination and Montreal Cognitive Assessment scores were 20 (out of 30). When there was no abnormality in the imaging examination, the patient was misdiagnosed with meningoencephalitis and received anti-inflammatory treatment because the initial symptom was a clinical manifestation of the central nervous system, and the imaging and blood tests showed no definite abnormality. Cerebrospinal fluid has been studied and second-generation sequencing detection, such as after CSF-C tip to abnormal lymphocytes, to open the breakthrough of the diagnosis of lymphoma. In the cases with central nervous system injury as the first manifestation, CSF-C was combined with immunohistochemistry and cerebrospinal fluid flow cytometry to provide a clear and effective method and evidence for the early diagnosis of T-cell lymphoblastic lymphoma.","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139302680","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}
Drug-induced agranulocytosis (DIAG) is a fatal idiosyncratic reaction characterized by a peripheral neutrophil count <0.5 × 109/L. Almost all classes of medications have been implicated with DIAG. However, agranulocytosis induced by antihypertensive drugs is rare worldwide. To the best of our knowledge, this is the first case of nifedipine-associated agranulocytosis with a positive rechallenge. An 82-year-old man was admitted to our hospital due to uncontrolled fasting blood sugar. He had a history of hypertension and underwent treatment with nifedipine 6 years prior to admission. Blood tests showed white blood cell count of 2.30 × 109/L with a neutrophil count of 0.49 × 109/L. Other malignancies that contributed to agranulocytosis were excluded, and the patient was diagnosed with DIAG. At first, gliclazide, rather than nifedipine, was considered as the culprit for DIAG and it was discontinued. Neutrophil count improved upon hematopoietic growth factors and traditional Chinese medicine. During the follow-up, the neutrophil count decreased again, and nifedipine was thought to be the offending agent for agranulocytosis. The neutrophil count increased to 0.91 × 109/L 2 months after nifedipine discontinuation. However, the patient was re-exposed to nifedipine and the neutrophil count decreased to 0.70 × 109/L. Nifedipine-induced agranulocytosis is a rare but serious adverse drug reaction. For any patients with clinical suspicion or diagnosis of DIAG, a full drug history should be chronologically and completely taken in order to identify the suspected agents. Sometimes diagnosis of DIAG is challenging since some patients may be entirely asymptomatic. Management of DIAG starts with immediate discontinuation of the implicated drug. Empirical broad-spectrum antibiotics and hematopoietic growth factors may improve patient outcomes and reduce recovery time.
{"title":"Nifedipine-induced agranulocytosis: A rare case report and literature review","authors":"Cuicui Lu, Jichao Wu, Yanbin Wei, Yahui Zhang, Xusheng Zhang, Qian Wang","doi":"10.1097/md9.0000000000000295","DOIUrl":"https://doi.org/10.1097/md9.0000000000000295","url":null,"abstract":"Drug-induced agranulocytosis (DIAG) is a fatal idiosyncratic reaction characterized by a peripheral neutrophil count <0.5 × 109/L. Almost all classes of medications have been implicated with DIAG. However, agranulocytosis induced by antihypertensive drugs is rare worldwide. To the best of our knowledge, this is the first case of nifedipine-associated agranulocytosis with a positive rechallenge. An 82-year-old man was admitted to our hospital due to uncontrolled fasting blood sugar. He had a history of hypertension and underwent treatment with nifedipine 6 years prior to admission. Blood tests showed white blood cell count of 2.30 × 109/L with a neutrophil count of 0.49 × 109/L. Other malignancies that contributed to agranulocytosis were excluded, and the patient was diagnosed with DIAG. At first, gliclazide, rather than nifedipine, was considered as the culprit for DIAG and it was discontinued. Neutrophil count improved upon hematopoietic growth factors and traditional Chinese medicine. During the follow-up, the neutrophil count decreased again, and nifedipine was thought to be the offending agent for agranulocytosis. The neutrophil count increased to 0.91 × 109/L 2 months after nifedipine discontinuation. However, the patient was re-exposed to nifedipine and the neutrophil count decreased to 0.70 × 109/L. Nifedipine-induced agranulocytosis is a rare but serious adverse drug reaction. For any patients with clinical suspicion or diagnosis of DIAG, a full drug history should be chronologically and completely taken in order to identify the suspected agents. Sometimes diagnosis of DIAG is challenging since some patients may be entirely asymptomatic. Management of DIAG starts with immediate discontinuation of the implicated drug. Empirical broad-spectrum antibiotics and hematopoietic growth factors may improve patient outcomes and reduce recovery time.","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139301051","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}
This case study presents an elderly patient with an acute ischemic stroke due to occlusion of the left internal carotid artery (ICA) and the left cerebral middle artery (MCA). The study aimed to evaluate the feasibility and effectiveness of a transbrachial approach for mechanical thrombectomy (MT) in patients with tandem occlusions. The patient presented with stroke symptoms, including severe aphasia, right-sided facial palsy, left gaze deviation and right-sided weakness. The patient had a history of uncontrolled hypertension. Diagnostic tests, including computed tomography and angiography, confirmed the presence of occlusions in both the left ICA and the left MCA. The patient received MT bridging intravenous thrombolysis. When bilateral iliac arteries were found to be occluded, a puncture via the transbrachial approach was attempted. Angiography suggested an acute occlusion of both the left ICA and the left MCA. The C1 segment was inflated with a pre-dilated balloon and the thrombus in the M1 segment was removed successfully. Successful reperfusion was achieved, and the patient had a good outcome at discharge. No access-site complications were encountered. Transbrachial approach for MT, especially in those with tandem occlusions, is feasible and could provide an alternative to the transfemoral approach. This approach may be beneficial for patients with occlusions in multiple sites or with iliac artery occlusions. Further research is needed to evaluate the long-term effectiveness of this approach.
{"title":"Successful recanalization of an acute occlusion of the left internal carotid artery and the left cerebral middle artery via the transbrachial approach: A case report","authors":"Chao Xu, Tianyu Jin, Qinpu Wang, Danyu Chen, Jiangxian Ying, Peng Wang","doi":"10.1097/md9.0000000000000289","DOIUrl":"https://doi.org/10.1097/md9.0000000000000289","url":null,"abstract":"\u0000 \u0000 This case study presents an elderly patient with an acute ischemic stroke due to occlusion of the left internal carotid artery (ICA) and the left cerebral middle artery (MCA). The study aimed to evaluate the feasibility and effectiveness of a transbrachial approach for mechanical thrombectomy (MT) in patients with tandem occlusions.\u0000 \u0000 \u0000 \u0000 The patient presented with stroke symptoms, including severe aphasia, right-sided facial palsy, left gaze deviation and right-sided weakness. The patient had a history of uncontrolled hypertension.\u0000 \u0000 \u0000 \u0000 Diagnostic tests, including computed tomography and angiography, confirmed the presence of occlusions in both the left ICA and the left MCA.\u0000 \u0000 \u0000 \u0000 The patient received MT bridging intravenous thrombolysis. When bilateral iliac arteries were found to be occluded, a puncture via the transbrachial approach was attempted. Angiography suggested an acute occlusion of both the left ICA and the left MCA. The C1 segment was inflated with a pre-dilated balloon and the thrombus in the M1 segment was removed successfully.\u0000 \u0000 \u0000 \u0000 Successful reperfusion was achieved, and the patient had a good outcome at discharge. No access-site complications were encountered.\u0000 \u0000 \u0000 \u0000 Transbrachial approach for MT, especially in those with tandem occlusions, is feasible and could provide an alternative to the transfemoral approach. This approach may be beneficial for patients with occlusions in multiple sites or with iliac artery occlusions. Further research is needed to evaluate the long-term effectiveness of this approach.\u0000","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132336863","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 : 2023-06-01DOI: 10.1097/md9.0000000000000282
Shoko Hirano, D. Shimizu, S. Seri, Gen Suzuki, H. Yamazaki, Kei Yamada
{"title":"Radiation myositis and myonecrosis of the chest wall after stereotactic body radiation therapy for non-small cell lung cancer: A case report","authors":"Shoko Hirano, D. Shimizu, S. Seri, Gen Suzuki, H. Yamazaki, Kei Yamada","doi":"10.1097/md9.0000000000000282","DOIUrl":"https://doi.org/10.1097/md9.0000000000000282","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123959983","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 : 2023-06-01DOI: 10.1097/md9.0000000000000283
Hideki Taniguchi, T. Kawamitsu, Motoharu Suzuki, Nobue Abe, H. Hino, Y. Matsushita, Kenrei Shi, Y. Otsubo, Takeshi Matsubara, Takahiro Koyama, H. Iwamoto, Kazuhiro Miyaji
{"title":"Tolerability and efficacy of a semi-elemental formula to enterally fed patients in long-term care facilities","authors":"Hideki Taniguchi, T. Kawamitsu, Motoharu Suzuki, Nobue Abe, H. Hino, Y. Matsushita, Kenrei Shi, Y. Otsubo, Takeshi Matsubara, Takahiro Koyama, H. Iwamoto, Kazuhiro Miyaji","doi":"10.1097/md9.0000000000000283","DOIUrl":"https://doi.org/10.1097/md9.0000000000000283","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124254656","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":"Syringomyelia with Charcot arthropathy: A case report","authors":"Tianxiang Yang, Dede Cao, Bowen Zhang, Jinning Zhang, Qiang Wang, Gaopeng Guo, Desheng Chen","doi":"10.1097/md9.0000000000000277","DOIUrl":"https://doi.org/10.1097/md9.0000000000000277","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115430636","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 : 2023-05-01DOI: 10.1097/md9.0000000000000281
Wid Kattan, Rahaf Albarraq
{"title":"Case report of tokophobia","authors":"Wid Kattan, Rahaf Albarraq","doi":"10.1097/md9.0000000000000281","DOIUrl":"https://doi.org/10.1097/md9.0000000000000281","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129270023","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 : 2023-05-01DOI: 10.1097/md9.0000000000000278
Koichi Kitamura, Koichi Hayashi, K. Iwanami, T. Kamesaki, Toshihiko Suzuki
{"title":"Direct antiglobulin test-negative autoimmune hemolytic anemia associated with erythropoiesis stimulating agent resistance in a CKD patient with IgG4-related disease: A case report","authors":"Koichi Kitamura, Koichi Hayashi, K. Iwanami, T. Kamesaki, Toshihiko Suzuki","doi":"10.1097/md9.0000000000000278","DOIUrl":"https://doi.org/10.1097/md9.0000000000000278","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133150459","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 : 2023-05-01DOI: 10.1097/md9.0000000000000280
Manuelito L. Barredo, Joselito B. Diaz, Ma. Lourdes P Corrales-Joson
{"title":"Spontaneous extensive spinal epidural methicillin-resistant Staphylococcus aureus (MRSA) abscess at the level of the cervical and thoracic area in a 21-year-old female: A case report","authors":"Manuelito L. Barredo, Joselito B. Diaz, Ma. Lourdes P Corrales-Joson","doi":"10.1097/md9.0000000000000280","DOIUrl":"https://doi.org/10.1097/md9.0000000000000280","url":null,"abstract":"","PeriodicalId":325445,"journal":{"name":"Medicine: Case Reports and Study Protocols","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128745401","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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