Pub Date : 2018-08-22DOI: 10.19080/JOCCT.2018.12.555826
A. Magbri
The patient is 72-year-old Caucasian male with history of type-2 diabetes mellitus, coronary artery disease with drug eluting stent, and congestive heart failure with ejection fracture of 40% was admitted to hospital with shortness of breath at rest. The patient noticed swelling of the legs for 4 weeks despite salt restriction and diuretics. His medications include Humalog (75/25) 20 units QD, frusemide 40 mg BID, metolazone 2.5 mg QD, spironolactone 12.5 mg QD, carvedilol 12.5 mg BID, Ramipril 10 mg QD, atorvastatin 40 mg QD, clopidogrel 75 mg QD, and aspirin 81 mg QD. His blood pressure was 100/60 mmHg, pulse 102 beats/ min, The patient had marked jugular venous distention, crackles at the lung bases, an S3 gallop, positive hepato-jugular reflux, and pitting edema up to the knees. His laboratory investigation showed sodium of 134 mEq/L, potassium of 3.8 mEq/L, chloride 90 mEq/L, bicarbonate 28 mEq/L, blood urea nitrogen 46 mg/L, creatinine 1.8 mg/L, with an estimated GFR of <60 mL/minute, and glucose of 100 mg/L. His HgbA1C was 7%. His urinalysis was significant for 2+ proteinuria. EKG showed tachycardia with nonspecific St and T wave changes, His weight was 98 kg.
{"title":"The Elusive Target of Congestive Heart Failure Treatment: delaying the Inevitable","authors":"A. Magbri","doi":"10.19080/JOCCT.2018.12.555826","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555826","url":null,"abstract":"The patient is 72-year-old Caucasian male with history of type-2 diabetes mellitus, coronary artery disease with drug eluting stent, and congestive heart failure with ejection fracture of 40% was admitted to hospital with shortness of breath at rest. The patient noticed swelling of the legs for 4 weeks despite salt restriction and diuretics. His medications include Humalog (75/25) 20 units QD, frusemide 40 mg BID, metolazone 2.5 mg QD, spironolactone 12.5 mg QD, carvedilol 12.5 mg BID, Ramipril 10 mg QD, atorvastatin 40 mg QD, clopidogrel 75 mg QD, and aspirin 81 mg QD. His blood pressure was 100/60 mmHg, pulse 102 beats/ min, The patient had marked jugular venous distention, crackles at the lung bases, an S3 gallop, positive hepato-jugular reflux, and pitting edema up to the knees. His laboratory investigation showed sodium of 134 mEq/L, potassium of 3.8 mEq/L, chloride 90 mEq/L, bicarbonate 28 mEq/L, blood urea nitrogen 46 mg/L, creatinine 1.8 mg/L, with an estimated GFR of <60 mL/minute, and glucose of 100 mg/L. His HgbA1C was 7%. His urinalysis was significant for 2+ proteinuria. EKG showed tachycardia with nonspecific St and T wave changes, His weight was 98 kg.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44907077","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 : 2018-08-22DOI: 10.19080/JOCCT.2018.12.555827
J. Butany
Aisling Kinsella1, Annamalar Muthu2, Cusimano RJ3, Eric Horlick4 and Jagdish Butany5* 1Department of Cardiac Surgery, Toronto General Hospital -Peter Munk Cardiac Centre, Canada 2Interventional Cardiology, Toronto General Hospital -Peter Munk Cardiac Centre, Canada 3Cardiac Surgeon, University of Toronto, Canada 4Interventional Cardiologist, University of Toronto, Canada 5Pathologist, University Health Network and Canada
{"title":"Aortic Stenosis: Causes and Management","authors":"J. Butany","doi":"10.19080/JOCCT.2018.12.555827","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.12.555827","url":null,"abstract":"Aisling Kinsella1, Annamalar Muthu2, Cusimano RJ3, Eric Horlick4 and Jagdish Butany5* 1Department of Cardiac Surgery, Toronto General Hospital -Peter Munk Cardiac Centre, Canada 2Interventional Cardiology, Toronto General Hospital -Peter Munk Cardiac Centre, Canada 3Cardiac Surgeon, University of Toronto, Canada 4Interventional Cardiologist, University of Toronto, Canada 5Pathologist, University Health Network and Canada","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45258856","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 : 2018-08-21DOI: 10.19080/jocct.2018.11.555823
L. Kapoor
{"title":"The Perils of Left Anterior Descending Artery Dissection in Off Pump Coronary Artery Bypass Grafting -Bends from Diving Deep after the Left Anterior Descending Artery","authors":"L. Kapoor","doi":"10.19080/jocct.2018.11.555823","DOIUrl":"https://doi.org/10.19080/jocct.2018.11.555823","url":null,"abstract":"","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42250957","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 : 2018-08-21DOI: 10.19080/JOCCT.2018.11.555825
S. Mukherjee
The most common pathophysiologic cause of Mitral Stenosis (MS) is rheumatic disease [1]. Generally Left Ventricular (LV) systolic function is well preserved in isolated MS. LV chamber typically is normal or small. However, coexisting Mitral Regurgitation (MR), aortic valve disease, ischaemic heart disease, systemic hypertension, cardiomyopathy all may be responsible for elevation of Left Ventricular End Diastolic Pressure (LVEDP) [2]. Left Ventricular (LV) dysfunction has been described in pure Mitral Stenosis (MS), which may be a due to change in interaction between right and left ventricles, myocardial fibrosis or a chronic decrease in preload [3]. Even with normal ejection fraction (indicating preserved global left ventricular function), there can be impairment in long-axis function (measured by tissue Doppler echocardiography) [4]. Altered LV long-axis movement has been shown to be a sensitive indicator of early myocardial dysfunction. Atrial fibrillation has shown to cause impairment of LV function. Pulsed-wave Doppler tissue velocities have been proven to be a good tool for assessment of long-axis ventricular shortening and lengthening. In the echocardiographical assessment of LV function, the Ejection Fraction (EF), Tissue Doppler Imaging (TDI), Doppler strain, and 2D strain have been widely used [5]. EF is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective and has high inter-observer variability [6]. TDI and Doppler strain are characterized by limitations of angle dependence, limited spatial resolution and deformation analysis in one dimension [7]. 2D strain is a novel technique which evaluates LV systolic functions more objectively and quantitatively, and does not have the limitations seen in EF, TDI, and Doppler strain; thus, it has become more commonly used in recent years [8]. In the diagnosis of LV dysfunction due to MS, some studies have shown EF, TDI, and Doppler strain to be useful however there is paucity of data. There are also very few studies combining both conventional and 2D strain echo for evaluation of LV systolic function after successful Percutaneous Balloon Mitral Valvotomy (PBMV). There are also lack of evidences comparing LV systolic function before and after the above-mentioned procedure in patients with severe rheumatic MS.
{"title":"Left Ventricular Function in Patients with Rheumatic Mitral Stenosis","authors":"S. Mukherjee","doi":"10.19080/JOCCT.2018.11.555825","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.11.555825","url":null,"abstract":"The most common pathophysiologic cause of Mitral Stenosis (MS) is rheumatic disease [1]. Generally Left Ventricular (LV) systolic function is well preserved in isolated MS. LV chamber typically is normal or small. However, coexisting Mitral Regurgitation (MR), aortic valve disease, ischaemic heart disease, systemic hypertension, cardiomyopathy all may be responsible for elevation of Left Ventricular End Diastolic Pressure (LVEDP) [2]. Left Ventricular (LV) dysfunction has been described in pure Mitral Stenosis (MS), which may be a due to change in interaction between right and left ventricles, myocardial fibrosis or a chronic decrease in preload [3]. Even with normal ejection fraction (indicating preserved global left ventricular function), there can be impairment in long-axis function (measured by tissue Doppler echocardiography) [4]. Altered LV long-axis movement has been shown to be a sensitive indicator of early myocardial dysfunction. Atrial fibrillation has shown to cause impairment of LV function. Pulsed-wave Doppler tissue velocities have been proven to be a good tool for assessment of long-axis ventricular shortening and lengthening. In the echocardiographical assessment of LV function, the Ejection Fraction (EF), Tissue Doppler Imaging (TDI), Doppler strain, and 2D strain have been widely used [5]. EF is the most widely used index of contractile function, but due to the visual component, assessment of endocardial excursion is subjective and has high inter-observer variability [6]. TDI and Doppler strain are characterized by limitations of angle dependence, limited spatial resolution and deformation analysis in one dimension [7]. 2D strain is a novel technique which evaluates LV systolic functions more objectively and quantitatively, and does not have the limitations seen in EF, TDI, and Doppler strain; thus, it has become more commonly used in recent years [8]. In the diagnosis of LV dysfunction due to MS, some studies have shown EF, TDI, and Doppler strain to be useful however there is paucity of data. There are also very few studies combining both conventional and 2D strain echo for evaluation of LV systolic function after successful Percutaneous Balloon Mitral Valvotomy (PBMV). There are also lack of evidences comparing LV systolic function before and after the above-mentioned procedure in patients with severe rheumatic MS.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48730629","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 : 2018-08-17DOI: 10.19080/jocct.2018.11.555822
Marie-Laure Névoret
{"title":"What Can Sudorimetry Tell us about Somatic and Autonomic Function","authors":"Marie-Laure Névoret","doi":"10.19080/jocct.2018.11.555822","DOIUrl":"https://doi.org/10.19080/jocct.2018.11.555822","url":null,"abstract":"","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41949280","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 : 2018-08-14DOI: 10.19080/jocct.2018.11.555820
R. Cerrud-Rodriguez
This is an 80-year-old Hispanic male, former smoker with 30+ pack-years, COPD, ischemic cardiomyopathy with reduced Left Ventricular Ejection Fraction (LVEF) of 15-20% refractory to an appropriate trial of optimal medical therapy, requiring upgrade to Biventricular Implantable Cardioverter-Defibrillator (BIV-ICD) implantation. Five months after BIV-ICD implantation, the LVEF had improved to 55%. During routine lung cancer screening a left upper lobe mass measuring 1.5x1.1 cm was found. A biopsy was done, and further histology showed a spiculated squamous cell carcinoma. Given his frail clinical condition it was decided that he was to receive radiotherapy only, for which the AICD generator had to be relocated away from the radiation target. To extend the DF-4 ICD lead, we used a specialized 27-cm-long DF-4 Y splitter/adaptor (Medtronic Model 5019 HV Splitter/Adaptor) which allowed enough length to extend the DF-4 ICD lead from upper chest to Left Upper Quadrant (LUQ) of the abdomen. The procedure was tolerated well by the patient, after which he made a satisfactory recovery with no postoperative complications. The patient then, in due course, underwent radiotherapy for his lung cancer. Our technique of using a DF-4 Y Splitter/Adaptor as a DF4 lead extender could be used in any patient needing an extender, such as those in which the leads had to be tunneled to the contralateral side, and not only for patients requiring radiotherapy.
{"title":"A Novel Approach to Extending DF-4 AICD Leads using A DF-4 Y Splitter/Adaptor as Preparation for Stereotactic Radiosurgery to The Chest - A Case Report","authors":"R. Cerrud-Rodriguez","doi":"10.19080/jocct.2018.11.555820","DOIUrl":"https://doi.org/10.19080/jocct.2018.11.555820","url":null,"abstract":"This is an 80-year-old Hispanic male, former smoker with 30+ pack-years, COPD, ischemic cardiomyopathy with reduced Left Ventricular Ejection Fraction (LVEF) of 15-20% refractory to an appropriate trial of optimal medical therapy, requiring upgrade to Biventricular Implantable Cardioverter-Defibrillator (BIV-ICD) implantation. Five months after BIV-ICD implantation, the LVEF had improved to 55%. During routine lung cancer screening a left upper lobe mass measuring 1.5x1.1 cm was found. A biopsy was done, and further histology showed a spiculated squamous cell carcinoma. Given his frail clinical condition it was decided that he was to receive radiotherapy only, for which the AICD generator had to be relocated away from the radiation target. To extend the DF-4 ICD lead, we used a specialized 27-cm-long DF-4 Y splitter/adaptor (Medtronic Model 5019 HV Splitter/Adaptor) which allowed enough length to extend the DF-4 ICD lead from upper chest to Left Upper Quadrant (LUQ) of the abdomen. The procedure was tolerated well by the patient, after which he made a satisfactory recovery with no postoperative complications. The patient then, in due course, underwent radiotherapy for his lung cancer. Our technique of using a DF-4 Y Splitter/Adaptor as a DF4 lead extender could be used in any patient needing an extender, such as those in which the leads had to be tunneled to the contralateral side, and not only for patients requiring radiotherapy.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48401841","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 : 2018-08-09DOI: 10.19080/jocct.2018.11.555819
V. Kumar
A four-and-a-half-year-old female toddler reported to our hospital with the history of undergone bidirectional glenn shunt at one year of age outside for UAVSD. Child had not undergone cardiac catheterization before glenn surgery. She was severely symptomatic for the past one and half years with class III symptoms and worsening cyanosis. On examination she weighed 15kg, her vital parameters were within normal limits and she had severe cyanosis (oxygen saturation 65%) and grade III clubbing. Cardiovascular examination showed single S1 and S2 with no murmur. Patient was planned for diagnostic catheterization to find out the cause for severe desaturation and to assess the suitability for final stage of palliation. Investigation showed hemoglobin of 18gm% with 60% hematocrit and normal biochemical parameters. Patient cardiac catheterization was done after heparinisation at 100U/kg. It showed functional glenn shunt with adequate branch pulmonary arteries and a large levoatrial cardinal vein (10.4mm) connecting left brachiocephalic vein to left atrium (Figure 1), (Video 1). Atrial pressures were 13mmHg, while mean pulmonary artery pressure was 16-17mmHg. It was decided to plug the vein presently with Amplatzer Vascular Plug II (AVPII). Left subclavian vein access was taken with a 5Fr short sheath and a super stiff amplatz wire was parked in the Left atrium. Now a 8Fr long cook sheath was exchanged over the wire and a 14mm AVP II was deployed at the junction of brachiocephalic vein with LACV. Repeat contrast injection showed device in place with no flow across the plug (Figure 2). Saturation on table improved to 80%, repeat mean PA pressures were 16-17mmHg. Patient was observed for a day and discharged on medical management (Aspirin and iron) as the high PA pressure precluded from performing fontan completion. Patient reported after 6 months for review, she had class II symptoms and saturated 76-80%. Repeat cardiac cath data to our surprise, showed reduced mean PA pressure of 13mmHg and atrial pressures as 11mm Hg. She underwent successful extra cardiac fontan completion. On follow-up at one month she had no complaints and doing well.
{"title":"Role of Levoatrial Cardinal Vein Plugging in Single Ventricle Palliation","authors":"V. Kumar","doi":"10.19080/jocct.2018.11.555819","DOIUrl":"https://doi.org/10.19080/jocct.2018.11.555819","url":null,"abstract":"A four-and-a-half-year-old female toddler reported to our hospital with the history of undergone bidirectional glenn shunt at one year of age outside for UAVSD. Child had not undergone cardiac catheterization before glenn surgery. She was severely symptomatic for the past one and half years with class III symptoms and worsening cyanosis. On examination she weighed 15kg, her vital parameters were within normal limits and she had severe cyanosis (oxygen saturation 65%) and grade III clubbing. Cardiovascular examination showed single S1 and S2 with no murmur. Patient was planned for diagnostic catheterization to find out the cause for severe desaturation and to assess the suitability for final stage of palliation. Investigation showed hemoglobin of 18gm% with 60% hematocrit and normal biochemical parameters. Patient cardiac catheterization was done after heparinisation at 100U/kg. It showed functional glenn shunt with adequate branch pulmonary arteries and a large levoatrial cardinal vein (10.4mm) connecting left brachiocephalic vein to left atrium (Figure 1), (Video 1). Atrial pressures were 13mmHg, while mean pulmonary artery pressure was 16-17mmHg. It was decided to plug the vein presently with Amplatzer Vascular Plug II (AVPII). Left subclavian vein access was taken with a 5Fr short sheath and a super stiff amplatz wire was parked in the Left atrium. Now a 8Fr long cook sheath was exchanged over the wire and a 14mm AVP II was deployed at the junction of brachiocephalic vein with LACV. Repeat contrast injection showed device in place with no flow across the plug (Figure 2). Saturation on table improved to 80%, repeat mean PA pressures were 16-17mmHg. Patient was observed for a day and discharged on medical management (Aspirin and iron) as the high PA pressure precluded from performing fontan completion. Patient reported after 6 months for review, she had class II symptoms and saturated 76-80%. Repeat cardiac cath data to our surprise, showed reduced mean PA pressure of 13mmHg and atrial pressures as 11mm Hg. She underwent successful extra cardiac fontan completion. On follow-up at one month she had no complaints and doing well.","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45405563","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 : 2018-08-07DOI: 10.19080/JOCCT.2018.11.555818
T. Paterick
41-year old white female presented to the Emergency Department (ED) with sudden onset, sub-sternal chest pressure, which she characterized as 10/10, radiating to her upper back. She experienced associated nausea and diaphoresis. She was vacuuming the living room at her home when symptoms developed. The patient’s only risk factor was cigarette smoking 1ppd. Her initial ECG showed sinus rhythm with ST-segment elevation in lead aVR, with reciprocal ST-segment depression in the anterior and inferior leads (Figure 1). Abstract
{"title":"Left Main Spontaneous Coronary Artery Dissection: The Complexity of Management Considerations","authors":"T. Paterick","doi":"10.19080/JOCCT.2018.11.555818","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.11.555818","url":null,"abstract":"41-year old white female presented to the Emergency Department (ED) with sudden onset, sub-sternal chest pressure, which she characterized as 10/10, radiating to her upper back. She experienced associated nausea and diaphoresis. She was vacuuming the living room at her home when symptoms developed. The patient’s only risk factor was cigarette smoking 1ppd. Her initial ECG showed sinus rhythm with ST-segment elevation in lead aVR, with reciprocal ST-segment depression in the anterior and inferior leads (Figure 1). Abstract","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49305278","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 : 2018-08-06DOI: 10.19080/JOCCT.2018.11.555816
Basumatary Lj
{"title":"Simultaneous Occurrence of Chicken Pox and Herpes Zoster with Facial Nerve Palsy in ImmunocompetentPatient- A Case Report","authors":"Basumatary Lj","doi":"10.19080/JOCCT.2018.11.555816","DOIUrl":"https://doi.org/10.19080/JOCCT.2018.11.555816","url":null,"abstract":"","PeriodicalId":73635,"journal":{"name":"Journal of cardiology & cardiovascular therapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48962372","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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