Pub Date : 2019-02-18DOI: 10.24203/ajpnms.v7i1.5661.g2978
F. Dinçoğlan, O. Sager, S. Demiral, M. Beyzadeoğlu
Background: Cerebral arteriovenous malformations (AVMs) are rarely seen congenital vascular anomalies. AVMs may lead to intracranial hemorrages due to disorganized tangle of vessels. Lifetime risk of bleeding from AVMs may be significant given the diagnosis at typically earlier ages of the lifespan, and complications associated with hemorrhage may lead to substantial morbidity or mortality. Management of AVMs aims at eliminating or reducing the risk of subsequent bleeding. In this context, microvascular surgical resection, endovascular embolization and radiosurgical treatment may be used for management of AVMs.Objective: In this study, we assessed the incorporation of Magnetic Resonance Imaging (MRI) in treatment planning for AVM radiosurgery. Methods: We identified 25 patients receiving radiosurgery for AVMs at our institution. Radiosurgery target volumes generated by using CT-only based imaging and CT-MR fusion based imaging for each patient were evaluated.Results: Twenty five patients undergoing SRS for AVMs were evaluated for target volume determination in this study. Mean target volume was 4.9 cc (range: 1.3-15.9 cc) on CT-only imaging, 5.7 cc (range: 1.4-16.7 cc) on CT-MR fusion based imaging, and 5.9 cc (range: 1.4-16.9 cc) on consensus decision of all treating physicians with colleague peer review. Target definition based on CT-MR fusion based imaging was identical to the consensus decision of all treating physicians in majority of patients.Conclusions: Treatment planning for AVM radiosurgery may be improved by incorporating CT-MR fusion based imaging, which clearly should be supplemented with additional data from angiography. There is need for additional studies to establish a consensus on optimal target definition by multimodality imaging for SRS of AVMs.
{"title":"Multimodality Imaging for Radiosurgical Management of Arteriovenous Malformations","authors":"F. Dinçoğlan, O. Sager, S. Demiral, M. Beyzadeoğlu","doi":"10.24203/ajpnms.v7i1.5661.g2978","DOIUrl":"https://doi.org/10.24203/ajpnms.v7i1.5661.g2978","url":null,"abstract":"Background: Cerebral arteriovenous malformations (AVMs) are rarely seen congenital vascular anomalies. AVMs may lead to intracranial hemorrages due to disorganized tangle of vessels. Lifetime risk of bleeding from AVMs may be significant given the diagnosis at typically earlier ages of the lifespan, and complications associated with hemorrhage may lead to substantial morbidity or mortality. Management of AVMs aims at eliminating or reducing the risk of subsequent bleeding. In this context, microvascular surgical resection, endovascular embolization and radiosurgical treatment may be used for management of AVMs.Objective: In this study, we assessed the incorporation of Magnetic Resonance Imaging (MRI) in treatment planning for AVM radiosurgery. Methods: We identified 25 patients receiving radiosurgery for AVMs at our institution. Radiosurgery target volumes generated by using CT-only based imaging and CT-MR fusion based imaging for each patient were evaluated.Results: Twenty five patients undergoing SRS for AVMs were evaluated for target volume determination in this study. Mean target volume was 4.9 cc (range: 1.3-15.9 cc) on CT-only imaging, 5.7 cc (range: 1.4-16.7 cc) on CT-MR fusion based imaging, and 5.9 cc (range: 1.4-16.9 cc) on consensus decision of all treating physicians with colleague peer review. Target definition based on CT-MR fusion based imaging was identical to the consensus decision of all treating physicians in majority of patients.Conclusions: Treatment planning for AVM radiosurgery may be improved by incorporating CT-MR fusion based imaging, which clearly should be supplemented with additional data from angiography. There is need for additional studies to establish a consensus on optimal target definition by multimodality imaging for SRS of AVMs.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85383386","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 : 2018-12-19DOI: 10.24203/AJPNMS.V6I4.5624
E. Nakagawa
Background: There are several reported results. Hazard ratios for suicide tended to increase with dose for selective serotonin reuptake inhibitors (SSRIs). The suicide rate in the first three months following initiation of paroxetine exposure was 799 per 100,000 person-years, while, annual suicide rates for depression and anxiety were 81.8 and 76.7, respectively. SSRIs serum concentrations were significantly associated with increases of triglyceride (TG) levels. SSRIs inhibited insulin signaling and beta cell function by a dose-dependent manner.Objective: Based on symptoms and blood lipid levels indicated by a young patient who committed suicide, my objective is to propose that higher TG concentrations above the normal range, normal high-density lipoprotein cholesterol (HDL-C) concentrations, and the TG/HDL-C concentration (mg/dL) ratios ≥ 3.5 to estimate insulin resistance are potentially useful in identifying individuals who are developing higher paroxetine concentrations.Methods: The glucose and lipid levels in the blood examination which was performed in an emergency hospital to where the patient was delivered by ambulance after his abnormal behaviors on the 14th day after the start of paroxetine treatment, were used for calculation and examination. Fasting TG levels were estimated by calculating TG values (TG-Cal) using the measured value of TG and a formula reported by Hitze et al., or the measured values of total cholesterol (TC), HDL-C, and low-density lipoprotein cholesterol (LDL-C), and nine formulas referred and reported by Dansethakul et al. Paroxetine levels in the patient’s serum were estimated by calculation using the regression coefficient of TG 46.49 mg/dL, with which the paroxetine serum concentration 75 ng/mL was associated in the results reported by Fjukstad et al.   Results: The 20-year-old patient free of recent suicidal ideation developed intense violent suicidal preoccupation, and exhibited abnormal behaviors in the first 41 days after the start of paroxetine treatment 10 mg twice daily. He sent emails with advanced notice of suicide to his friend on the 7th, 17th, and 18th days, drank alcohol alone and exhibited abnormal behaviors in a market place around noon, blacked out, and was ambulanced to the emergency hospital on the 14th day. Finally, he carried out suicide on the 41st day after three days of abrupt discontinuation of paroxetine. He never exhibited these abnormal behaviors before paroxetine exposure. The levels of glucose, TG, TC, HDL-C, and LDL-C measured in the blood examination at 15:56 on the 14th day after the start of paroxetine treatment were 111, 498, 185, 53, and 92 mg/dL, respectively. The levels of TC, HDL-C, and LDL-C were in the normal ranges, respectively, probably suggesting metabolic normality of the patient before paroxetine exposure. In order to estimate the fasting TG level, TG-Cal values were calculated to be 278, 200, 258, 240, 268, 272, 310, 308, 311, and 250 mg/dL in the range of 200
{"title":"Higher Triglyceride and Normal HDL-C Concentrations, the Triglyceride/HDL-C Concentration Ratios ≥ 3.5, and Insulin Resistance as Potential Predictors of Developing Higher Paroxetine Concentrations and Suicide in the Early Months of Medication","authors":"E. Nakagawa","doi":"10.24203/AJPNMS.V6I4.5624","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I4.5624","url":null,"abstract":"Background: There are several reported results. Hazard ratios for suicide tended to increase with dose for selective serotonin reuptake inhibitors (SSRIs). The suicide rate in the first three months following initiation of paroxetine exposure was 799 per 100,000 person-years, while, annual suicide rates for depression and anxiety were 81.8 and 76.7, respectively. SSRIs serum concentrations were significantly associated with increases of triglyceride (TG) levels. SSRIs inhibited insulin signaling and beta cell function by a dose-dependent manner.Objective: Based on symptoms and blood lipid levels indicated by a young patient who committed suicide, my objective is to propose that higher TG concentrations above the normal range, normal high-density lipoprotein cholesterol (HDL-C) concentrations, and the TG/HDL-C concentration (mg/dL) ratios ≥ 3.5 to estimate insulin resistance are potentially useful in identifying individuals who are developing higher paroxetine concentrations.Methods: The glucose and lipid levels in the blood examination which was performed in an emergency hospital to where the patient was delivered by ambulance after his abnormal behaviors on the 14th day after the start of paroxetine treatment, were used for calculation and examination. Fasting TG levels were estimated by calculating TG values (TG-Cal) using the measured value of TG and a formula reported by Hitze et al., or the measured values of total cholesterol (TC), HDL-C, and low-density lipoprotein cholesterol (LDL-C), and nine formulas referred and reported by Dansethakul et al. Paroxetine levels in the patient’s serum were estimated by calculation using the regression coefficient of TG 46.49 mg/dL, with which the paroxetine serum concentration 75 ng/mL was associated in the results reported by Fjukstad et al.   Results: The 20-year-old patient free of recent suicidal ideation developed intense violent suicidal preoccupation, and exhibited abnormal behaviors in the first 41 days after the start of paroxetine treatment 10 mg twice daily. He sent emails with advanced notice of suicide to his friend on the 7th, 17th, and 18th days, drank alcohol alone and exhibited abnormal behaviors in a market place around noon, blacked out, and was ambulanced to the emergency hospital on the 14th day. Finally, he carried out suicide on the 41st day after three days of abrupt discontinuation of paroxetine. He never exhibited these abnormal behaviors before paroxetine exposure. The levels of glucose, TG, TC, HDL-C, and LDL-C measured in the blood examination at 15:56 on the 14th day after the start of paroxetine treatment were 111, 498, 185, 53, and 92 mg/dL, respectively. The levels of TC, HDL-C, and LDL-C were in the normal ranges, respectively, probably suggesting metabolic normality of the patient before paroxetine exposure. In order to estimate the fasting TG level, TG-Cal values were calculated to be 278, 200, 258, 240, 268, 272, 310, 308, 311, and 250 mg/dL in the range of 200","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"275 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80020201","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 : 2018-12-15DOI: 10.24203/AJPNMS.V6I4.5540
G. Park, J. Choi, Myung Ha Kim
Postoperative myasthenic crisis is common after thymectomy; the incidence ranges from 12 to 34%. Several factors are known to predict myasthenic crisis and increased risk necessitating postoperative mechanical ventilation, but incomplete postoperative reversal cannot be prevented perfectly. Sugammadex is a medicine that reverses neuromuscular blockade, and can be used to facilitate the return of spontaneous respiration in myasthenic patients. It was recently reported that myasthenic patients rapidly recovered neuromuscular function when sugammadex was used. An 81-year-old, 49 kg woman diagnosed with myasthenia gravis one month previously was admitted for intravenous immunoglobulin G treatment and thymectomy. After thymectomy the patient suffered a myasthenic crisis and respiratory arrest, despite administration of sugammadex to reverse the neuromuscular blockade.This case suggests that more careful and strict evaluation and management should be conducted perioperatively in myasthenic patients, and that the recovery time (time to obtain a train-of-four [TOF] value > 0.9) and spontaneous breathing trial results should be obtained to accurately predict the success of spontaneous breathing.
{"title":"Respiratory Arrest after Postoperative Extubation in a Myasthenic Patient who Received Sugammadex to Reverse Neuromuscular Blockade","authors":"G. Park, J. Choi, Myung Ha Kim","doi":"10.24203/AJPNMS.V6I4.5540","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I4.5540","url":null,"abstract":"Postoperative myasthenic crisis is common after thymectomy; the incidence ranges from 12 to 34%. Several factors are known to predict myasthenic crisis and increased risk necessitating postoperative mechanical ventilation, but incomplete postoperative reversal cannot be prevented perfectly. Sugammadex is a medicine that reverses neuromuscular blockade, and can be used to facilitate the return of spontaneous respiration in myasthenic patients. It was recently reported that myasthenic patients rapidly recovered neuromuscular function when sugammadex was used. An 81-year-old, 49 kg woman diagnosed with myasthenia gravis one month previously was admitted for intravenous immunoglobulin G treatment and thymectomy. After thymectomy the patient suffered a myasthenic crisis and respiratory arrest, despite administration of sugammadex to reverse the neuromuscular blockade.This case suggests that more careful and strict evaluation and management should be conducted perioperatively in myasthenic patients, and that the recovery time (time to obtain a train-of-four [TOF] value > 0.9) and spontaneous breathing trial results should be obtained to accurately predict the success of spontaneous breathing.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78101920","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}
Objective: The aim of this study is to determine the effect of marital adjustment on the quality of sex life in married women.Method: As a descriptive study, the universe of the present study consists of married women consulting to an education and research hospital and primary care clinics in a province while the sample is composed of 365 voluntary married women that are open to dialogue. In collecting the data, “Information form†containing socio-demographic background, “Marriage Adjustment form (MAF) and sexual life quality scale for woman (SFQSW) were used. In analysing the data, arithmetic mean, percentage, frequency, Mann Whitney-U test, Kruskall Wallis Analysis and Spearman Correlation Analysis were employed.Findings: Arithmetic score of the MAF is 43.58±9.83 and that of SFQSW is 79.88±19.57 while significant relation between the scores was found in positive direction (p<0.05).Results: The more marital adjustment increases in women, the better the sexual life quality is. In order to increase the level of well-being and life quality in marriage, nurses are suggested to counsel the couples and family consultants are advised to inform the families on sexual issues and improve their communication skills.
{"title":"Investigation of the Effects of Marital Adjustment on Sexual Life Quality of Married Women","authors":"Sevinç Köse Tuncer, Emin Aydin, Necla Kasımoğlu, Burcu Ağdemir, Sebahat Atalikoğlu Başkan","doi":"10.24203/AJPNMS.V6I4.5622","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I4.5622","url":null,"abstract":"Objective: The aim of this study is to determine the effect of marital adjustment on the quality of sex life in married women.Method: As a descriptive study, the universe of the present study consists of married women consulting to an education and research hospital and primary care clinics in a province while the sample is composed of 365 voluntary married women that are open to dialogue. In collecting the data, “Information form†containing socio-demographic background, “Marriage Adjustment form (MAF) and sexual life quality scale for woman (SFQSW) were used. In analysing the data, arithmetic mean, percentage, frequency, Mann Whitney-U test, Kruskall Wallis Analysis and Spearman Correlation Analysis were employed.Findings: Arithmetic score of the MAF is 43.58±9.83 and that of SFQSW is 79.88±19.57 while significant relation between the scores was found in positive direction (p<0.05).Results: The more marital adjustment increases in women, the better the sexual life quality is. In order to increase the level of well-being and life quality in marriage, nurses are suggested to counsel the couples and family consultants are advised to inform the families on sexual issues and improve their communication skills.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85061719","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 : 2018-10-24DOI: 10.24203/AJPNMS.V6I3.5384
Rana M Ibrahim, O. M. Ibrahim
Contrast-induced nephropathy (CIN) is related to substantial economic and clinical consequences, including extended hospitalization, the necessity for dialysis, and an amplified risk of death. As radiographic diagnostic testing becomes commonplace, a significant concern among practitioners is the prevention of radiographic contrast-induced nephropathy. Radiographic contrast agents are used most often in tests such as coronary angiography, percutaneous coronary angioplasty, atherectomy, and stent placement, computer-aided tomography (CAT) scanning, and magnetic resonance imaging (MRI). 1 Administration of these contrast agents often cause acute changes in renal function ranging from an acute reduction of renal function to the transient need for hemodialysis. Early studies assessing the renal effects of radiocontrast administration in dogs proved a reduction in renal perfusion lasting up to 20 hours after radiocontrast administration. 8 Although no randomized controlled trial (RCT) has studied the benefits of hydration alone, it appears reasonable that sufficient hydration may offset some of the presumed hemodynamic effects that could lead to contrast-induced nephropathy. Various preventative strategies have been studied with mixed results. This paper constitutes reviewing current and old practices and developing a tentative simple protocol for prevention of Contrast induced nephropathy in nearby hospitals.
{"title":"Protocol Development for Preventing Contrast-Induced Nephropathy","authors":"Rana M Ibrahim, O. M. Ibrahim","doi":"10.24203/AJPNMS.V6I3.5384","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I3.5384","url":null,"abstract":"Contrast-induced nephropathy (CIN) is related to substantial economic and clinical consequences, including extended hospitalization, the necessity for dialysis, and an amplified risk of death. As radiographic diagnostic testing becomes commonplace, a significant concern among practitioners is the prevention of radiographic contrast-induced nephropathy. Radiographic contrast agents are used most often in tests such as coronary angiography, percutaneous coronary angioplasty, atherectomy, and stent placement, computer-aided tomography (CAT) scanning, and magnetic resonance imaging (MRI). 1 Administration of these contrast agents often cause acute changes in renal function ranging from an acute reduction of renal function to the transient need for hemodialysis. Early studies assessing the renal effects of radiocontrast administration in dogs proved a reduction in renal perfusion lasting up to 20 hours after radiocontrast administration. 8 Although no randomized controlled trial (RCT) has studied the benefits of hydration alone, it appears reasonable that sufficient hydration may offset some of the presumed hemodynamic effects that could lead to contrast-induced nephropathy. Various preventative strategies have been studied with mixed results. This paper constitutes reviewing current and old practices and developing a tentative simple protocol for prevention of Contrast induced nephropathy in nearby hospitals.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85325600","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 : 2018-10-19DOI: 10.24203/AJPNMS.V6I3.5529
H. Seong, N. Kim, Y. Yang, Ju Youn Kim, Seongsik Kang
Anaphylactic reactions during anesthesia can have a high mortality. The most common cause of anaphylaxis during anesthesia is neuromuscular blocking agents and, even though considered intermediate risk, rocuronium is frequently involved, probably due to its greater use. We present the case of a woman with anaphylactic shock secondary to the intravenous administration of rocuronium and recovered without complications by early aggressive management combination with conventional methods and sugammadex.
{"title":"Successful Management of Rocuronium Induced Shock in Combination with Sugammadex and Traditional Therapy","authors":"H. Seong, N. Kim, Y. Yang, Ju Youn Kim, Seongsik Kang","doi":"10.24203/AJPNMS.V6I3.5529","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I3.5529","url":null,"abstract":"Anaphylactic reactions during anesthesia can have a high mortality. The most common cause of anaphylaxis during anesthesia is neuromuscular blocking agents and, even though considered intermediate risk, rocuronium is frequently involved, probably due to its greater use. We present the case of a woman with anaphylactic shock secondary to the intravenous administration of rocuronium and recovered without complications by early aggressive management combination with conventional methods and sugammadex.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87326838","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 : 2018-06-24DOI: 10.24203/AJPNMS.V6I2.5255
Ji Hyoung Park, K. Lee, W. Wang, H. Lim
Duchenne muscular dystrophy (DMD) is a progressive myopathy. The development of respiratory therapy has increased the life expectancy of DMD patients. This change has increased the chances of anesthesia administration in DMD patients with advanced cardiomyopathy. We report a severe cardiomyopathy case in a 14-year-old boy with DMD, adrenal insufficiency, and severe mental retardation, who experienced a sudden cardiac arrest with successful resuscitation. The patient underwent feeding gastrostomy surgery to relieve recurrent aspiration pneumonia, during which cardiac index and heart rate decreased. Cardiomyopathy has emerged as a new challenge in DMD patients; it is important to maintain end organ perfusion by proper function of the left ventricle.
{"title":"Duchenne Muscular Dystrophy (DMD) with Severe Cardiomyopathy","authors":"Ji Hyoung Park, K. Lee, W. Wang, H. Lim","doi":"10.24203/AJPNMS.V6I2.5255","DOIUrl":"https://doi.org/10.24203/AJPNMS.V6I2.5255","url":null,"abstract":"Duchenne muscular dystrophy (DMD) is a progressive myopathy. The development of respiratory therapy has increased the life expectancy of DMD patients. This change has increased the chances of anesthesia administration in DMD patients with advanced cardiomyopathy. We report a severe cardiomyopathy case in a 14-year-old boy with DMD, adrenal insufficiency, and severe mental retardation, who experienced a sudden cardiac arrest with successful resuscitation. The patient underwent feeding gastrostomy surgery to relieve recurrent aspiration pneumonia, during which cardiac index and heart rate decreased. Cardiomyopathy has emerged as a new challenge in DMD patients; it is important to maintain end organ perfusion by proper function of the left ventricle.","PeriodicalId":8530,"journal":{"name":"Asian Journal of Pharmacy, Nursing and Medical Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87315610","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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