Dexter Seow , Jin Hean Koh , Hannah L.X. Cheang , Gin Way Law , Glenys Poon , Li Yi Tammy Chan , Keng Lin Wong , James Hui
{"title":"Noninferiority meta-analysis of autologous vs allogeneic osteochondral transplantation for the treatment of osteochondral defects of the knee confounded by defect size differences","authors":"Dexter Seow , Jin Hean Koh , Hannah L.X. Cheang , Gin Way Law , Glenys Poon , Li Yi Tammy Chan , Keng Lin Wong , James Hui","doi":"10.1016/j.jcjp.2023.100130","DOIUrl":"10.1016/j.jcjp.2023.100130","url":null,"abstract":"<div><h3>Background</h3><p>Autologous and allogeneic osteochondral transplantations are widely employed for knee osteochondral defects (OCDs). However, there has been a lack of consensus on the efficacy of autografts vs allografts.</p></div><div><h3>Objectives</h3><p>To evaluate the complication profile following autologous vs allogeneic osteochondral transplantation for knee OCDs.</p></div><div><h3>Data sources</h3><p>PubMed and Embase.</p></div><div><h3>Study eligibility criteria, participants, and interventions</h3><p>Clinical studies that reported complication rates following autologous or allogeneic osteochondral transplantation for knee OCDs.</p></div><div><h3>Study appraisal and synthesis methods</h3><p>Meta-analysis of proportions using the restricted maximum-likelihood method after the Freeman-Tukey double-arcsine transformation.</p></div><div><h3>Results</h3><p>There were 35 studies with 2647 and 2569 OCDs included before and after lost to follow-up, respectively. Graft failure rates were not significantly lower in autografts vs allografts in all analyses: as reported (6.23% vs 10.81%, respectively; <em>P = .</em>63), best-case (6.00% vs 10.24%, respectively; <em>P = .</em>66) and worst-case analyses (7.46% vs 14.43%, respectively; <em>P = .</em>42). In the subgroup of mean follow-up time <36 months, graft failure rates were significantly lower in autografts vs allografts in all analyses.</p></div><div><h3>Limitations</h3><p>The meta-analysis was confounded by the inherent differences in mean defect sizes of the autograft and allograft arms.</p></div><div><h3>Conclusions and implications of key findings</h3><p>Overall graft failure and revision rates were lower in autograft vs allograft for the treatment of knee OCDs but this may have been confounded by the inherent differences in mean defect sizes between the groups. Further studies on autografts for larger-sized knee OCDs and allografts for smaller-sized knee OCDs are warranted to better complete the noninferiority analysis.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 4","pages":"Article 100130"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254523000355/pdfft?md5=d2c4758f20fadca93f223a29858e8078&pid=1-s2.0-S2667254523000355-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121672449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Welcome to the final issue of the Journal of Cartilage & Joint Preservation in 2023","authors":"Miranda Manfre, Rachel M. Frank","doi":"10.1016/j.jcjp.2023.100156","DOIUrl":"10.1016/j.jcjp.2023.100156","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 4","pages":"Article 100156"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254523000628/pdfft?md5=a4fac3f17d314cdb3396ba6ffead50b3&pid=1-s2.0-S2667254523000628-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135663638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacqueline M. Chevalier , Garett B. Pearson , Nicole Nixon , Carl R. Flannery , Luis Campoy , Lisa A. Fortier
{"title":"Destabilization of the medial meniscus to induce post-traumatic osteoarthritis in domestic pigs","authors":"Jacqueline M. Chevalier , Garett B. Pearson , Nicole Nixon , Carl R. Flannery , Luis Campoy , Lisa A. Fortier","doi":"10.1016/j.jcjp.2023.100139","DOIUrl":"10.1016/j.jcjp.2023.100139","url":null,"abstract":"<div><h3>Introduction</h3><p>Post-traumatic osteoarthritis (PTOA) develops following traumatic articular insult. One model system used to study the progression and treatment of PTOA is the destabilization of the medial meniscus (DMM) as first described by Glasson et al performed in mini-pigs. Miniature pigs are less available, more expensive, and have synovial fluid sampling limitations, limiting the availability of osteoarthritis biomarkers compared to domestic pigs.</p></div><div><h3>Objectives</h3><p>The following technical note details stepwise procedures and animal welfare strategies for the use of Yorkshire pigs as a large animal PTOA model.</p></div><div><h3>Methods</h3><p>The following technical note details stepwise procedures to perform peroperative saphenous nerve block, DMM, and subsequent postoperative management in Yorkshire pigs as a large animal PTOA model.</p></div><div><h3>Results</h3><p>At 4 weeks post-operatively, all pigs develop mild-moderate PTOA based on postmortem joint dissections.</p></div><div><h3>Conclusions</h3><p>This technical note provides further details on the arthrotomy approach to destabilize the medial meniscus of domestic pigs as a model of PTOA.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 4","pages":"Article 100139"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254523000458/pdfft?md5=ea8f7ca097b21496005ddfbe36c38f6f&pid=1-s2.0-S2667254523000458-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129909528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura E. Keller , Lisa A. Fortier , Christian Lattermann , Emily R. Hunt , Sheng Zhang , Qin Fu , Cale A. Jacobs
{"title":"Complement system dysregulation in synovial fluid from patients with persistent inflammation following anterior cruciate ligament reconstruction surgery","authors":"Laura E. Keller , Lisa A. Fortier , Christian Lattermann , Emily R. Hunt , Sheng Zhang , Qin Fu , Cale A. Jacobs","doi":"10.1016/j.jcjp.2023.100114","DOIUrl":"10.1016/j.jcjp.2023.100114","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with anterior cruciate ligament injury are at high risk of posttraumatic osteoarthritis and their response to reconstructive surgery and rehabilitation vary. Proteins identified in the orchestration of the acute inflammatory response may be predictive of patient outcomes.</p></div><div><h3>Objective</h3><p>An unbiased, bottom-up proteomics approach was used to discover novel targets for therapeutics in relation to dysregulation in the orchestration of inflammatory pathways implicated in persistent joint inflammation subsequent to joint trauma.</p></div><div><h3>Methods</h3><p>Synovial fluid was aspirated from patients at 1 week and 4 weeks after anterior cruciate ligament reconstruction (ACLR) and interleukin 6 (IL-6) concentrations were quantified by enzyme-linked immunosorbent assay. Patients were segregated into IL-6<sup>low</sup> and IL-6<sup>high</sup> groups based on IL-6 concentrations in synovial fluid at 4-weeks postoperation and proteins in synovial fluid were analyzed using qualitative, bottom-up proteomics. Abundance ratios were calculated for IL-6<sup>high</sup> and IL-6<sup>low</sup> groups as 4 weeks postoperation:1 week postoperation.</p></div><div><h3>Results</h3><p>A total of 291 proteins were detected in synovial fluid, 34 of which were significantly (<em>P</em> < .05) differentially regulated between groups. Proteins associated with the classical and alternative complement cascade pathways were increased in the IL-6<sup>high</sup> compared to IL-6<sup>low</sup> group. Insulin-like growth factor-binding protein 6 (IGFBP-6) was increased by nearly 60-fold in the IL-6<sup>low</sup> group.</p></div><div><h3>Conclusions</h3><p>Patients segregated by IL-6 concentration in synovial fluid at 4 weeks post-ACLR demonstrated differential regulation of multiple pathways, providing opportunities to investigate novel targets, such as IGFBP-6, and to take advantage of therapeutics already approved for clinical use in other diseases that target inflammatory pathways, including the complement system.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 4","pages":"Article 100114"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667254523000161/pdfft?md5=4a1cd353ab3f882cecab891d47eee8b1&pid=1-s2.0-S2667254523000161-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114652860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kinjal D. Vasavada , Dhruv S. Shankar , Charles C. Lin , Nicole D. Rynecki , Amanda Avila , Scott Buzin , Andrew L. Chen , Cordelia W. Carter , Lauren E. Borowski , Heather A. Milton , Guillem Gonzalez-Lomas
{"title":"Force plate testing is correlated with jumping performance in elite Nordic skiers","authors":"Kinjal D. Vasavada , Dhruv S. Shankar , Charles C. Lin , Nicole D. Rynecki , Amanda Avila , Scott Buzin , Andrew L. Chen , Cordelia W. Carter , Lauren E. Borowski , Heather A. Milton , Guillem Gonzalez-Lomas","doi":"10.1016/j.jcjp.2023.100144","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100144","url":null,"abstract":"<div><h3>Introduction</h3><p>Ski jumping (SJ) and Nordic combined (NC) athletes are at higher risk for femoroacetabular impingement (FAI) compared to the general population.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to determine the relationship between force plate testing metrics, Functional Movement Screen (FMS) scores, and radiographic signs of FAI and SJ performance.</p></div><div><h3>Methods</h3><p>Elite SJ and NC athletes were prospectively recruited. FMS testing was performed to assess muscular imbalance, instability, and immobility. Vertical jump testing was performed using a commercially available force plate device. Ski jump score and distance score were measured on a single jump for each athlete.</p></div><div><h3>Results</h3><p>Twenty-one athletes (10 SJ, 11 NC) with competition scores were included. On FMS testing, most SJ (67%) and NC (73%) athletes demonstrated core instability. There were higher rates of hip instability and ankle stiffness among SJ athletes, although not statistically significant (<em>P</em> > .05). Ski jump distance score was significantly positively correlated with force plate vertical jump height, maximum acceleration, maximum velocity, concentric impulse, counter-movement depth, and flight time (<em>P</em> < .05). FMS testing results and radiographic FAI were not significantly associated with competition scores.</p></div><div><h3>Conclusions</h3><p>Our results show significant positive correlations between competition scores and force plate jump testing performance as measured by jump height, acceleration, maximum velocity, counter-movement depth, and concentric impulse in elite SJ and NC athletes. Our findings suggest that ski jumpers may benefit from training that emphasizes stretch-shortening cycles and eccentric-to-concentric contraction transition, which may optimize their performance and promote joint stability.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100144"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880132","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}
Joseph Featherall , Reece Rosenthal , Daniel Song , Natalya McNamara , Travis Maak , Stephen Aoki , Justin Ernat
{"title":"Concurrent meniscus and chondral injuries after anterior cruciate ligament injury are more common in elite versus recreational alpine skiers: a systematic review","authors":"Joseph Featherall , Reece Rosenthal , Daniel Song , Natalya McNamara , Travis Maak , Stephen Aoki , Justin Ernat","doi":"10.1016/j.jcjp.2023.100141","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100141","url":null,"abstract":"<div><h3>Background</h3><p>The anterior cruciate ligament (ACL) has been extensively studied in those with alpine skiing injuries; however, less focus has been given to meniscal/chondral injuries in this population.</p></div><div><h3>Objectives</h3><p>To perform a systematic review investigating the incidence of meniscal/chondral injuries in alpine skiers who have sustained an ACL injury.</p></div><div><h3>Data sources</h3><p>MEDLINE, Scopus, manual journal searches.</p></div><div><h3>Study eligibility criteria</h3><p>Studies reporting rates of meniscal and/or chondral injuries in alpine skiers with an ACL tear were included. Techniques, revisions, non-alpine skiers, and studies lacking an association between skiing and ACL diagnosis were excluded.</p></div><div><h3>Participants and interventions</h3><p>Alpine skiers with a diagnosis of an ACL tear.</p></div><div><h3>Study appraisal and synthesis methods</h3><p>MINORS criteria.</p></div><div><h3>Results</h3><p>Nine hundred fifty-eight studies were identified. Screening, removal of duplicates, and assessment for inclusion/exclusion criteria resulted in 12 level III/IV studies for review. A total of 1185 skiers with ACL injuries were included (209 elite and 976 recreational). Meniscal tears were present in 47.4% of the skiers, with an increased rate seen in elite versus recreational skiers (61.2% vs 43.2%). Elite skiers were more likely to have a combined medial/lateral meniscal injury and a lateral meniscal tear repair (69.8% vs 19.2% for the latter). There were no differences in medial meniscal tear treatment. Chondral injuries presented at a rate of 11.2% and were more common in elite versus recreational skiers (20.3% vs 5.3%).</p></div><div><h3>Limitations</h3><p>Heterogenous nature of study types included; Did not include larger databases and was limited to alpine skiing studies only; demographics were not part of the analysis.</p></div><div><h3>Conclusions</h3><p>Approximately 47% of the alpine skiers with an ACL injury sustained a concomitant meniscal tear, with 11% having an associated chondral injury. Meniscal/chondral injuries are more common in elite skiers, and they are more likely to have their meniscus repaired.</p></div><div><h3>Implications of key findings</h3><p>Careful consideration of the accompanying pathology is warranted in alpine skiers who present with ACL injury.</p></div><div><h3>Systematic review registration number</h3><p>PROSPERO: CRD42022373207.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100141"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880135","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}
Matthew P. Corsi , Adam B. Thompson , Nicholas I. Kennedy , Robert F. LaPrade , Gilbert Moatshe
{"title":"Multiligament knee injuries in winter sports athletes","authors":"Matthew P. Corsi , Adam B. Thompson , Nicholas I. Kennedy , Robert F. LaPrade , Gilbert Moatshe","doi":"10.1016/j.jcjp.2023.100143","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100143","url":null,"abstract":"<div><p>Multiligament knee injuries (MLKIs) are severe injuries that involve complete or partial tear to multiple ligaments of the knee, such as the cruciate ligaments, collateral ligaments, as well as structures such as the posteromedial and posterolateral corners. These injuries often occur as a result of high-energy trauma in motor vehicle accidents, but can also occur during sports activities such as a fall or collision while skiing or snowboarding. Diagnosis of an MLKI can be challenging due to the multifaceted nature of these injuries, and a comprehensive evaluation, including a thorough history, physical examination, and imaging studies, is necessary. Imaging methods, such as plain and stress radiographs and magnetic resonance imaging, are often used to confirm the diagnosis and assist in the establishment of a treatment plan. Treatment of MLKIs commonly involves surgical repair or reconstruction of torn ligaments and capsular structures, followed by lengthy rehabilitation focused on mobility, strength, and improving knee function. Return to sport is a concern, especially for those with many ligaments torn and those involving both cruciate ligaments and/or those involving the posterolateral corner. Prevention of MLKIs in skiing and snowboarding is important, and proper technique, equipment, risk awareness, and strengthening exercises can help reduce the risk of injury. While much is known about knee injuries in skiers, further research is needed to better understand MLKIs in ski and snowboard athletes, including the incidence, optimal management, and return to sport rates.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100143"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880129","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}
Maria V. Velasquez Hammerle MD , Emily Doolan Roy PT, DPT , Annabel R. Gerber , Miho J. Tanaka MD, PhD
{"title":"Patellofemoral disorders in winter sports","authors":"Maria V. Velasquez Hammerle MD , Emily Doolan Roy PT, DPT , Annabel R. Gerber , Miho J. Tanaka MD, PhD","doi":"10.1016/j.jcjp.2023.100140","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100140","url":null,"abstract":"<div><h3>Introduction</h3><p>Patellofemoral disorders are multifactorial in nature and encompass a wide variety of problems ranging from pain to instability that can affect snow sport athletes.</p></div><div><h3>Objectives</h3><p>We aim to describe the injuries and treatments of the patellofemoral joint in winter sport athletes.</p></div><div><h3>Methods</h3><p>We reviewed and analyzed the current literature on patellofemoral disorders and treatments in winter sport athletes, and additionally report on our own experience in treating these athletes.</p></div><div><h3>Results</h3><p>In addition to the morphologic risk factors that can predispose patients to patellofemoral disorders, multiple extrensic factors related to snow sports should be taken into account when treating skiers and snowboarders with patellofemoral disorders. The unique interactions with equipment and environment can play important roles in either preventing or predisposing toward injury.</p></div><div><h3>Conclusions</h3><p>Knowledge and understanding of injury biomechanics in winter sports and their predisposing factors can allow for the optimal management of patellofemoral disorders in athletes who participate in these sports.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100140"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880134","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}
Leslie Podlog , Jeffrey G. Caron , Bradley Fawver , John J. Fraser , Quinn Johnsson , Miriam H. Beauchamp , Marie-Lyne Nault
{"title":"Psychological readiness to return to the slopes following serious injury among competitive skiers and snowboarders","authors":"Leslie Podlog , Jeffrey G. Caron , Bradley Fawver , John J. Fraser , Quinn Johnsson , Miriam H. Beauchamp , Marie-Lyne Nault","doi":"10.1016/j.jcjp.2023.100118","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100118","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the traditional focus on assessment of athletes’ physical readiness to return to sport, mounting evidence suggests that consideration of psychological readiness is critically important in ensuring that individuals safely and effectively resume competitive activities.</p></div><div><h3>Objectives</h3><p>The primary aims of this article are to: (1) evaluate existing measures assessing psychological readiness; among skiers and snowboarders (the focus of this special issue); (3) discuss biopsychosocial factors that facilitate or undermine psychological readiness; and (4) highlight implications of psychological readiness for return to sport outcomes and articulate future research directions.</p></div><div><h3>Methods</h3><p>A literature search was performed in Scopus, PsycInfo, and PubMed using the keywords “psychological readiness,” “ski injuries,” “snowboard injuries,” “return to sport,” and “concussions.”</p></div><div><h3>Results</h3><p>Existing measures of psychological readiness are limited by conceptual ambiguities and measurement shortcomings. Limited research with skiers and snowboarders suggests that cognitive, affective, and behavioral elements of psychological readiness outlined in past work is apparent among skiers. Physical (issue healing and body system recovery), psychological (personality, recovery motivation), and social (social support, trust in rehabilitation providers) factors can facilitate or undermine psychological readiness. Psychological readiness predicts salient postinjury outcomes, such as the likelihood of returning to sport, reinjury, as well as the quality of postinjury performance.</p></div><div><h3>Conclusions</h3><p>Future research is needed to further delineate the nature of psychological readiness among skiers and snowboarders. Existing evidence, however, suggests a variety of biopsychosocial factors contribute to athletes’ psychological readiness which may be a key predictor of salient postinjury outcomes<strong>.</strong></p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880137","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}