Journal of Cartilage & Joint Preservation最新文献

{"title":"Complement system dysregulation in synovial fluid from patients with persistent inflammation following anterior cruciate ligament reconstruction surgery","authors":"Laura E. Keller ,&nbsp;Lisa A. Fortier ,&nbsp;Christian Lattermann ,&nbsp;Emily R. Hunt ,&nbsp;Sheng Zhang ,&nbsp;Qin Fu ,&nbsp;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^low and IL-6^high 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^high and IL-6^low 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> &lt; .05) differentially regulated between groups. Proteins associated with the classical and alternative complement cascade pathways were increased in the IL-6^high compared to IL-6^low group. Insulin-like growth factor-binding protein 6 (IGFBP-6) was increased by nearly 60-fold in the IL-6^low 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}

{"title":"Force plate testing is correlated with jumping performance in elite Nordic skiers","authors":"Kinjal D. Vasavada ,&nbsp;Dhruv S. Shankar ,&nbsp;Charles C. Lin ,&nbsp;Nicole D. Rynecki ,&nbsp;Amanda Avila ,&nbsp;Scott Buzin ,&nbsp;Andrew L. Chen ,&nbsp;Cordelia W. Carter ,&nbsp;Lauren E. Borowski ,&nbsp;Heather A. Milton ,&nbsp;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> &gt; .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> &lt; .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}

{"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 ,&nbsp;Reece Rosenthal ,&nbsp;Daniel Song ,&nbsp;Natalya McNamara ,&nbsp;Travis Maak ,&nbsp;Stephen Aoki ,&nbsp;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}

{"title":"Multiligament knee injuries in winter sports athletes","authors":"Matthew P. Corsi ,&nbsp;Adam B. Thompson ,&nbsp;Nicholas I. Kennedy ,&nbsp;Robert F. LaPrade ,&nbsp;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}

{"title":"Patellofemoral disorders in winter sports","authors":"Maria V. Velasquez Hammerle MD ,&nbsp;Emily Doolan Roy PT, DPT ,&nbsp;Annabel R. Gerber ,&nbsp;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}

{"title":"Corrigendum to “Double-blinded prospective randomized clinical trial in knee joint osteoarthritis treatment: safety assessment and performance of trehalose hyaluronic acid versus standard infiltrative therapy based on medium-weight sodium hyaluronate” [Journal of Cartilage & Joint Preservation 2 (2022) 100043]","authors":"Alberto Gobbi ,&nbsp;Macarena Morales ,&nbsp;Giulia Avio ,&nbsp;Riccardo D’Ambrosi","doi":"10.1016/j.jcjp.2023.100137","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100137","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100137"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological readiness to return to the slopes following serious injury among competitive skiers and snowboarders","authors":"Leslie Podlog ,&nbsp;Jeffrey G. Caron ,&nbsp;Bradley Fawver ,&nbsp;John J. Fraser ,&nbsp;Quinn Johnsson ,&nbsp;Miriam H. Beauchamp ,&nbsp;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}

{"title":"Guest editorial: special edition on ski and snowboarding injuries and related conditions","authors":"Alexander Golant ,&nbsp;Michael Alaia ,&nbsp;Brian Waterman","doi":"10.1016/j.jcjp.2023.100145","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100145","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100145"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracing burnout during adolescence to past sports experiences: a retrospective analysis of sport-specific antecedents among alpine ski racers","authors":"Bradley Fawver ,&nbsp;Sarah Taylor ,&nbsp;Brady S. DeCouto ,&nbsp;Rhiannon L. Cowan ,&nbsp;Keith R. Lohse ,&nbsp;A. Mark Williams ,&nbsp;Les Podlog","doi":"10.1016/j.jcjp.2023.100142","DOIUrl":"https://doi.org/10.1016/j.jcjp.2023.100142","url":null,"abstract":"<div><h3>Introduction</h3><p>Previous theoretical frameworks focusing on burnout have identified numerous antecedents and psychosocial risk factors; however, the influence of early sport-specific experiences on burnout in developmental athlete populations remains less understood.</p></div><div><h3>Objectives</h3><p>We explored the associations between burnout and prior sports engagement (ie, milestones, practice time, performance, injury history) in a sample of subelite academy alpine ski racers in the United States (N = 169, M age = 15.82 ± 1.80).</p></div><div><h3>Methods</h3><p>Participants completed retrospective practice history profiles (milestones, practice time, injury), while their respective performance data were collected using an online national ranking registry. Simple and mixed-effect regressions were implemented to assess the associations between these measures and subscales of the Athlete Burnout Questionnaire.</p></div><div><h3>Results</h3><p>The results indicated that greater participation in the coach-led group and individual practice during adolescence mitigated burnout responses (ie, greater sense of accomplishment, less sport devaluation), whereas more play earlier in development was associated with greater devaluation. Furthermore, poorer performance and more injury incidences were associated with increased burnout (ie, reduced sense of accomplishment).</p></div><div><h3>Conclusions</h3><p>The structure of training and past experiences during early career years appear to influence burnout among alpine ski racing during their adolescent years, the implications of which are discussed in relation to sport developmental pipelines.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 3","pages":"Article 100142"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49880133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization of orthobiologic augmentation for meniscal repairs: current concepts and future perspectives","authors":"Kazunori Shimomura ,&nbsp;George Jacob ,&nbsp;Hiroto Hanai ,&nbsp;Norimasa Nakamura","doi":"10.1016/j.jcjp.2022.100090","DOIUrl":"https://doi.org/10.1016/j.jcjp.2022.100090","url":null,"abstract":"<div><h3>Introduction</h3><p>Meniscal tissue is a complex structure and performs a vital role in the normal biomechanical functioning of the knee joint. Unfortunately, meniscal tissue lacks vascularity and therefore demonstrates poor healing potential. To improve meniscal healing biological therapies have been used to enhance meniscal repairs and improve repair outcomes. Newer therapies incorporate growth factors and mesenchymal stem cells (MSCs) to improve the probability of healing and patient treatment outcomes under the term orthobiologics.</p></div><div><h3>Objective</h3><p>To give a narrative review of orthobiologics utilized in meniscal repair therapies and determine their effectiveness and role in treating meniscal tears.</p></div><div><h3>Methods</h3><p>A literature search was conducted using the PubMed (MEDLINE) and EMBASE databases in April 2021 without any date restrictions. Any relevant literature describing orthobiologic therapies utilized in meniscal repair was identified from the clinical databases and a narrative review was undertaken.</p></div><div><h3>Results</h3><p>Currently, orthobiologics used in clinical settings are autologous platelet-rich plasma (PRP) and MSC-based therapies. These demonstrate clinical benefit and enhanced meniscal repair. Standardizing PRP remains challenging and is essential to provide uniformity in treatment. Both therapies appear safe with no significant adverse effects, and MSC-based therapies do not show any increased risk of tumorgenicity.</p></div><div><h3>Conclusion</h3><p>Orthobiologics in meniscal tears have shown mild to moderate clinical benefit, as demonstrated in a small series of clinical studies. However, literature on clinical results is scarce, and preclinical data remains the justification for these therapies. Larger, well-designed trials will determine their true benefit, and combining them with tissue engineering techniques may improve results in the future.</p></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"3 2","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49885072","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}