Pub Date : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1129
R. Puthumana, C. J. Trujillo
{"title":"Who's Responsible? Diffuse Alveolar Hemorrhage with Multiple Potential Culprits","authors":"R. Puthumana, C. J. Trujillo","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1129","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1129","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115564120","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1130
L. Meece, J. P. Morán, H.M. McConville, S. Velani
INTRODUCTION: E-cigarette or vaping associated lung injury (EVALI) is an uncommon complication of e-cigarettes or vaping. 96% of these cases require hospitalization. The condition is especially associated with tetrahydrocannabinol (THC) products, frequent use, and is found primarily in young adults. “Dabbing” refers to the process of heating THC containing oils or waxes with butane solvents to vaporize cannabinoids for inhalation. CASE REPORT: An obese 20-year-old college male with a history of prematurity and anxiety presented with cough, dyspnea, nausea, vomiting and diarrhea that began 3 days prior. He reported smoking marijuana, but denied vaping. Multiple PCR tests for SARS-CoV-2 were negative. Initial chest radiograph demonstrated multifocal pneumonia. He was hypoxic on presentation requiring two liters of oxygen via nasal cannula. Broad spectrum antibiotics for pneumonia and steroids were initiated. Oxygen requirements rapidly increased and humidified high flow oxygen was instituted and escalated to 60 liters per minute and 90 % FiO2. He remained hypoxic, prompting intubation 48 hours from presentation. His ventilatory settings were steadily escalated to a positive end expiratory pressure of 15 cm H2O with 100% FiO2. Despite this, the patient had oxygenation saturations as low as 57% requiring transition to venovenous extracorporeal membrane oxygenation (VV-ECMO). Computed tomography angiography ruled out pulmonary embolism but redemonstrated extensive alveolar and interstitial infiltrates bilaterally. Bronchoscopy with alveolar lavage was performed with negative cultures and cytology. Blood cultures were also negative and antibiotic therapy was stopped. Extensive laboratory investigation for autoimmune vasculitis was performed and found to be negative. Discussion with family revealed that the patient regularly inhaled concentrated THC wax with butane as a solvent. Treatment continued with high dose intravenous steroids and supportive care. The patient received a total of 5 days of ventilator support after which he was extubated, and an additional 5 days of VV-ECMO. At discharge, the patient required 2 liters of continuous oxygen at rest and 4 liters with activity. He was otherwise asymptomatic and at his baseline level of function. He was discharged on daily steroids with taper and close outpatient follow up. DISCUSSION: While the majority of hospitalized patients with EVALI require intubation, the necessity of VV-ECMO utilization represents a rare severe presentation. Dabbing remains a rare cause of acute respiratory distress syndrome and EVALI, however, dabbing is emerging as a trend among young adults and represents an under-investigated cause of severe inhalational lung injury.
电子烟或电子烟相关肺损伤(EVALI)是一种罕见的电子烟或电子烟并发症。其中96%的病例需要住院治疗。这种情况与四氢大麻酚(THC)产品的频繁使用特别相关，主要发生在年轻人身上。“涂抹”是指用丁烷溶剂加热含四氢大麻酚的油或蜡，使大麻素蒸发以供吸入的过程。病例报告:一名肥胖的20岁大学男性，有早产和焦虑史，3天前开始出现咳嗽、呼吸困难、恶心、呕吐和腹泻。他说自己吸食大麻，但否认吸电子烟。SARS-CoV-2多重PCR检测均为阴性。最初胸片显示多灶性肺炎。他入院时缺氧需要通过鼻插管吸入两升氧气。开始使用广谱抗生素治疗肺炎和类固醇。氧气需求迅速增加，湿化高流量氧气被建立并升级到每分钟60升和90%的FiO2。他仍然缺氧，在出现48小时后需要插管。他的呼吸设置稳步上升到呼气末正压15 cm H2O和100% FiO2。尽管如此，患者的氧合饱和度低至57%，需要过渡到静脉-静脉体外膜氧合(VV-ECMO)。计算机断层血管造影排除肺栓塞，但再次显示广泛的肺泡和间质浸润双侧。支气管镜及肺泡灌洗行阴性培养及细胞学检查。血培养也呈阴性，并停止抗生素治疗。对自身免疫性血管炎进行了广泛的实验室调查，结果为阴性。与家人讨论后发现，患者经常吸入以丁烷为溶剂的浓缩四氢大麻酚蜡。治疗继续给予大剂量静脉注射类固醇和支持性护理。患者总共接受了5天的呼吸机支持，之后拔管，并额外接受了5天的VV-ECMO。出院时，患者静息时需连续供氧2升，活动时需连续供氧4升。其他方面无症状，功能处于基线水平。出院时每日服用类固醇，逐渐减少剂量，门诊随访密切。讨论:虽然大多数EVALI住院患者需要插管，但使用VV-ECMO的必要性代表了罕见的严重表现。轻拍仍然是一种罕见的急性呼吸窘迫综合征和EVALI的原因，然而，轻拍在年轻人中正在成为一种趋势，并且代表了一种未充分研究的严重吸入性肺损伤的原因。
{"title":"Pneumonitis Due to \"Dabbing\" Successfully Managed via Extracorporeal Membrane Oxygenation","authors":"L. Meece, J. P. Morán, H.M. McConville, S. Velani","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1130","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1130","url":null,"abstract":"INTRODUCTION: E-cigarette or vaping associated lung injury (EVALI) is an uncommon complication of e-cigarettes or vaping. 96% of these cases require hospitalization. The condition is especially associated with tetrahydrocannabinol (THC) products, frequent use, and is found primarily in young adults. “Dabbing” refers to the process of heating THC containing oils or waxes with butane solvents to vaporize cannabinoids for inhalation. CASE REPORT: An obese 20-year-old college male with a history of prematurity and anxiety presented with cough, dyspnea, nausea, vomiting and diarrhea that began 3 days prior. He reported smoking marijuana, but denied vaping. Multiple PCR tests for SARS-CoV-2 were negative. Initial chest radiograph demonstrated multifocal pneumonia. He was hypoxic on presentation requiring two liters of oxygen via nasal cannula. Broad spectrum antibiotics for pneumonia and steroids were initiated. Oxygen requirements rapidly increased and humidified high flow oxygen was instituted and escalated to 60 liters per minute and 90 % FiO2. He remained hypoxic, prompting intubation 48 hours from presentation. His ventilatory settings were steadily escalated to a positive end expiratory pressure of 15 cm H2O with 100% FiO2. Despite this, the patient had oxygenation saturations as low as 57% requiring transition to venovenous extracorporeal membrane oxygenation (VV-ECMO). Computed tomography angiography ruled out pulmonary embolism but redemonstrated extensive alveolar and interstitial infiltrates bilaterally. Bronchoscopy with alveolar lavage was performed with negative cultures and cytology. Blood cultures were also negative and antibiotic therapy was stopped. Extensive laboratory investigation for autoimmune vasculitis was performed and found to be negative. Discussion with family revealed that the patient regularly inhaled concentrated THC wax with butane as a solvent. Treatment continued with high dose intravenous steroids and supportive care. The patient received a total of 5 days of ventilator support after which he was extubated, and an additional 5 days of VV-ECMO. At discharge, the patient required 2 liters of continuous oxygen at rest and 4 liters with activity. He was otherwise asymptomatic and at his baseline level of function. He was discharged on daily steroids with taper and close outpatient follow up. DISCUSSION: While the majority of hospitalized patients with EVALI require intubation, the necessity of VV-ECMO utilization represents a rare severe presentation. Dabbing remains a rare cause of acute respiratory distress syndrome and EVALI, however, dabbing is emerging as a trend among young adults and represents an under-investigated cause of severe inhalational lung injury.","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128240947","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1137
S. Jarrett, A. Matta, S. Benzaquen
Introduction: Acute interstitial pneumonia (AIP) also known as Hamman-Rich Syndrome is an uncommon, acute, and rapidly progressive idiopathic pulmonary disease that often leads to acute respiratory distress syndrome (ARDS). We present a case of a 52-year-old male who developed this condition. Case: A 52-year-old male with no past medical history presented to the emergency department with a 3-day history of progressively worsening dyspnea, dry cough, and chills. Prior to symptom onset, he was in his usual state of health but did report having polyarthralgia mainly involving large joints with no other associated symptoms. He denied a history of sick contacts including COVID exposure, sexually transmitted infections, incarceration, intravenous drug abuse, or travel to tuberculosis endemic countries. He denied tobacco use and any other form of illicit drug use. On physical examination, he was afebrile, tachycardic, and hypoxic on room air. He appeared to be in no respiratory distress and chest was clear to auscultation. There were no joint abnormalities, skin rashes, or lymphadenopathy. Lab workup revealed elevated D-Dimer (2140 ng/mL), CRP (50 mg/L), lactate dehydrogenase (296 IU/L), ferritin (578 ng/mL). His SARSCoV2 PCR was negative. Chest X-ray and CT chest both revealed right pleural effusion and diffuse reticular and ground-glass opacities. He underwent thoracentesis and fluid analysis revealed lymphocytic exudate with negative cultures. Antibiotics and steroids were initiated. He underwent a complete rheumatologic workup including myositis panel, due to concern for possible autoimmune etiologies and it was negative. His respiratory status worsened, and he eventually required intubation. At this point given unclear etiology, he underwent bronchoscopy with transbronchial cryobiopsy. Cryobiopsy revealed evidence of organizing phase of diffuse alveolar damage (Figure 1) and in the setting of negative cultures, COVID-19 and autoimmune panel, there was a growing concern for acute interstitial pneumonia. The patient was started on pulse dose of steroids and transferred to a transplant center for lung transplantation evaluation. Discussion: Acute interstitial pneumonia is a rare idiopathic clinicopathological condition that is characterized clinically by rapid onset of respiratory failure in patients with no past medical history of pre-existing lung disease. Histopathological findings are identical to those of diffuse alveolar damage. Closely resembling ARDS, it is frequently confused with other clinical entities characterized by rapidly progressive interstitial pneumonia. Considering this a high index of suspicion is required to diagnose these patients and institute appropriate management as mortality is as high as 70%. (Figure Presented).
{"title":"A Case of Acute Interstitial Pneumonia (AIP)","authors":"S. Jarrett, A. Matta, S. Benzaquen","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1137","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1137","url":null,"abstract":"Introduction: Acute interstitial pneumonia (AIP) also known as Hamman-Rich Syndrome is an uncommon, acute, and rapidly progressive idiopathic pulmonary disease that often leads to acute respiratory distress syndrome (ARDS). We present a case of a 52-year-old male who developed this condition. Case: A 52-year-old male with no past medical history presented to the emergency department with a 3-day history of progressively worsening dyspnea, dry cough, and chills. Prior to symptom onset, he was in his usual state of health but did report having polyarthralgia mainly involving large joints with no other associated symptoms. He denied a history of sick contacts including COVID exposure, sexually transmitted infections, incarceration, intravenous drug abuse, or travel to tuberculosis endemic countries. He denied tobacco use and any other form of illicit drug use. On physical examination, he was afebrile, tachycardic, and hypoxic on room air. He appeared to be in no respiratory distress and chest was clear to auscultation. There were no joint abnormalities, skin rashes, or lymphadenopathy. Lab workup revealed elevated D-Dimer (2140 ng/mL), CRP (50 mg/L), lactate dehydrogenase (296 IU/L), ferritin (578 ng/mL). His SARSCoV2 PCR was negative. Chest X-ray and CT chest both revealed right pleural effusion and diffuse reticular and ground-glass opacities. He underwent thoracentesis and fluid analysis revealed lymphocytic exudate with negative cultures. Antibiotics and steroids were initiated. He underwent a complete rheumatologic workup including myositis panel, due to concern for possible autoimmune etiologies and it was negative. His respiratory status worsened, and he eventually required intubation. At this point given unclear etiology, he underwent bronchoscopy with transbronchial cryobiopsy. Cryobiopsy revealed evidence of organizing phase of diffuse alveolar damage (Figure 1) and in the setting of negative cultures, COVID-19 and autoimmune panel, there was a growing concern for acute interstitial pneumonia. The patient was started on pulse dose of steroids and transferred to a transplant center for lung transplantation evaluation. Discussion: Acute interstitial pneumonia is a rare idiopathic clinicopathological condition that is characterized clinically by rapid onset of respiratory failure in patients with no past medical history of pre-existing lung disease. Histopathological findings are identical to those of diffuse alveolar damage. Closely resembling ARDS, it is frequently confused with other clinical entities characterized by rapidly progressive interstitial pneumonia. Considering this a high index of suspicion is required to diagnose these patients and institute appropriate management as mortality is as high as 70%. (Figure Presented).","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127947212","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1141
A. Soleiman, G. Eman, M. Islam
{"title":"Acute Monocytic Leukemia: A Rare but Devastating Cause of ARDS","authors":"A. Soleiman, G. Eman, M. Islam","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1141","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1141","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133881937","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1143
J.M. Zapata -Canivilo, F. Amin, E. Belley‐Cote, A. Alsagheir, A. Fox-Robichaud, V. Chu, S. Tang
{"title":"Plastic Bronchitis After Minimally Invasive Mitral Valve Replacement: An Unusual Etiology of Acute Respiratory Failure After Cardiac Surgery","authors":"J.M. Zapata -Canivilo, F. Amin, E. Belley‐Cote, A. Alsagheir, A. Fox-Robichaud, V. Chu, S. Tang","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1143","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1143","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114818980","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1133
I.A. Martinez Avalos, V. Hoytfox
{"title":"A Rare Cause of Acute Throat Pain: Acute Aortic Dissection","authors":"I.A. Martinez Avalos, V. Hoytfox","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1133","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1133","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129576206","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1120
K. Nelson McMillan, V. Dorsey, F. Yousaf, S. Kane, A. Waas, C. Urbas, C. E. El Zein, N. Hibino, J. Sherman, L. Vricella
{"title":"Use of Perfluorocarbon for Pediatric Pulmonary Hemorrhage","authors":"K. Nelson McMillan, V. Dorsey, F. Yousaf, S. Kane, A. Waas, C. Urbas, C. E. El Zein, N. Hibino, J. Sherman, L. Vricella","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1120","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1120","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133957635","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1122
A. Davis, J. Kanne, H. Faust
{"title":"Hidden Between the Lines: Acute Eosinophilic Pneumonia Masquerading as Heart Failure","authors":"A. Davis, J. Kanne, H. Faust","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1122","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1122","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115224946","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1126
Y. Medik, C. Schooff, W. Khan
{"title":"Cardiac Tamponade - A Rare Complication of Sjogren's Syndrome","authors":"Y. Medik, C. Schooff, W. Khan","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1126","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1126","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116136249","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 : 2022-05-01DOI: 10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1131
C. Kang, P. Khamooshi, V. Reyes Pinzon, N. Haghani Rad
{"title":"A Rare Case of Left-Sided Unilateral Pulmonary Edema in Acute Mitral Regurgitation","authors":"C. Kang, P. Khamooshi, V. Reyes Pinzon, N. Haghani Rad","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1131","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1131","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122953296","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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