JAAOS Global Research & Reviews最新文献

{"title":"#lowbackpain on TikTok: A New Frontier for Orthopaedic Medical Education","authors":"Sazid Hasan, Conner D. Ahlgren, Matthew Lipphardt, Alexandria Chrumka, Razeen Zaman, Ridwana Khan, Muhammad Waheed, Devan O. Higginbotham, Ehab Saleh, Scott A. McCarty","doi":"10.5435/JAAOSGlobal-D-23-00181","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00181","url":null,"abstract":"Introduction: Low back pain has become a substantial health problem in all developed countries. Many healthcare professionals and content creators have begun sharing their treatment methods and opinions through social media, especially the video-based platform TikTok. TikTok has been downloaded more than 2.6 billion times with over a billion daily users. Its influence on public health makes it imperative that information be accurate and safe. This study aims to analyze TikTok's most popular content on lower back pain and how orthopaedic surgeons contribute on this growing platform. Objectives: To analyze TikTok's most popular content on lower back pain and how orthopaedic surgeons are and can contribute on this growing platform. Methods: A TikTok search conducted on April 22, 2023, using the terms ‘#lowerbackpain'and ‘#lowbackpainrelief,’ resulted in numerous videos, 100 of which met inclusion criteria. Videos were included if they were related to the content, had more than 1000 views, were in English, and were not duplicates. Video characteristics were recorded and evaluated for quality by two reviewers using DISCERN. A two-sample t-test was used to assess differences. Results: Overall, the top videos on lower back pain had an average of 2,061,396 views, with a mean DISCERN score of 34. The mean total DISCERN score was 36 and 34 for physicians and nonphysicians, respectively, while the video by the orthopaedic surgeon (n = 1) scored 31. The most recommended treatments included at-home exercises (n = 75) and visiting a chiropractor (n = 4). Conclusion: We find that the information presented by nonphysicians offered quick, at-home fixes to medical problems without offering any research or proven data to support their claims. We cannot overlook Tiktok's immense influence in the realm of orthopaedic health as it has become a sphere of information dissemination and education. Thus, we suggest that there is not necessarily a need for a greater number of surgeons and/or resident physicians to involve themselves on the platform, but rather the involvement of governing bodies and spine societies to put out position statements for our patients.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"509 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773307","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":"Sex-based Differences in Patient Perspectives and Experiences With Shoulder, Hip, and Knee Arthroplasty","authors":"Hannah Chi, Katherine A. Woolley, Sachin Allahabadi, Angelina Fluet, Colin Roach, Derek T. Ward, Stephanie E Wong","doi":"10.5435/JAAOSGlobal-D-24-00083","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00083","url":null,"abstract":"Introduction: Sex disparities in presentation of osteoarthritis and utilization of joint replacement surgery (JRS) have been demonstrated. The role of patients' unique perspectives on JRS on their treatment decisions is poorly understood. Methods: JRS candidates who were offered JRS but declined surgical treatment completed this survey. Survey questions included demographic information, patient experiences and current opinions around JRS, patient experiences with providers, goals and concerns, and barriers to JRS. Results: More women experience barriers to undergoing JRS compared with men (53% versus 16%; P = 0.014). While both men and women indicated pain relief as their primary goal for treatment, women were significantly more likely to prioritize regaining the ability to complete daily tasks and responsibilities when compared with men (P = 0.007). Both men and women indicated that low symptom severity and nonsurgical treatment options were the reasons for not undergoing JRS (P = 0.455). Compared with men, women trended toward feeling that they were not sufficiently educated about JRS (P = 0.051). Conclusion: Women have unique perspectives and goals for JRS that may pose sex-specific barriers to care. A better understanding of how patients' gendered experiences affect their decision making is necessary to improve treatment of osteoarthritis and decrease disparities in care.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"45 34","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796255","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":"Radiographic Fusion Outcomes for Trinity Cellular Based Allograft versus Local Bone in Posterolateral Lumbar Fusion","authors":"Aatif Sayeed, Ali Jawad, Philip Zakko, Maximillian Lee, Daniel K Park","doi":"10.5435/JAAOSGlobal-D-23-00196","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00196","url":null,"abstract":"Introduction: Cellular-based autograft (CBA) is being used in posterolateral lumbar arthrodesis as a fusion supplementation alternative. Objective: To assess radiographic fusion in patients undergoing posterolateral lumbar fusion with unilateral Trinity CBA compared with contralateral local bone autograft as an internal control. Methods: A single surgeon's practice database was interrogated for consecutive patients undergoing primary posterolateral lumbar fusion with Trinity from 2018 to 2021. Patients had Trinity applied unilaterally, with local bone autograft applied contralaterally. Fusion was assessed postoperatively by using CT after 9 months. Demographics and patient-reported outcome measures were collected preoperatively and up to 12 months postoperatively. Results: Thirty-nine patients were included. There were 81 attempted fusion levels. Overall fusion rate, defined as bony bridging on at least one side of a given level for all levels fused, was 85.2% of patients. No statistically significant difference was observed in fusion rates between CBA versus local bone (79.0% versus 76.54% of levels attempted, respectively, P = 0.3527). Oswestry Disability Index improved by 3 months (P = 0.0152) and was maintained. Two patients required revision for symptomatic nonunion. Conclusions: Similar radiographic fusion rates were achieved with Trinity and local bone. Trinity is a viable alternative to local bone in posterolateral lumbar fusion.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"288 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140773292","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":"Natural History of Opioid Use in Naive and Tolerant Patients in Revision Total Hip Arthroplasty","authors":"Zachary C. Lum, Daniel T. O’Connor, Christopher T. Holland, Arta Gharib-Parsa, Analucia Barragan-Trejo, Jeannie Y Park, Mauro Giordani, John P. Meehan","doi":"10.5435/jaaosglobal-d-23-00165","DOIUrl":"https://doi.org/10.5435/jaaosglobal-d-23-00165","url":null,"abstract":"Background: Opioid use after revision total hip arthroplasty (rTHA) has not been well characterized. The purpose of this study was to characterize preoperative, perioperative, and postoperative opioid use during rTHA. Methods: Patients undergoing revision THA from 2010 to 2018 were screened for opioid use 3 months before revision surgery and tracked 24 months postoperatively. Patients were categorized as naïve or tolerant. Opioid prescriptions and average morphine milligram equivalents (MME) were compared between the two groups. Results: One hundred twenty-four of 247 patients (50%) in the tolerant group averaged a preoperative MME of 23.7 mg/day. Postoperatively, tolerant patients received significantly higher daily MME at all time points, including at 3 months 31.4 versus 18.1 mg/day (P < 0.001), 6 months 19.9 versus 2.95 mg/day (P < 0.001), 12 months 14.3 versus 3.5 mg/day (P < 0.001), and 24 months 10.7 versus 2.17 mg/day (P < 0.001). Tolerant patients were more likely to have a prescription at 6 months (44% versus 22%), 12 months (41.4% versus 24%), and 24 months (38% versus 19.3%) (P < 0.001, P = 0.002, P < 0.001, respectively) Discussion: Opioid-tolerant patients had higher postoperative MME requirements for longer recovery duration. Both groups reduced opioid use at 3 months and plateaued at 6 months. These findings can help the revision surgeon counsel patients and expectations.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"1130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774243","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":"Acute Patellar Tendon Ruptures: An Update on Management","authors":"Joseph C. Brinkman, Emily Reeson, A. Chhabra","doi":"10.5435/JAAOSGlobal-D-24-00060","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-24-00060","url":null,"abstract":"Patellar tendon ruptures can be debilitating injuries. When incomplete, partial tears can be managed nonsurgically with immobilization and progressive rehabilitation. Although complete ruptures remain a relatively uncommon injury, they portend a high level of morbidity. Ruptures typically result from an acute mechanical overload to the extensor mechanism, such as with forced quadriceps contraction and knee flexion. However, chronically degenerated tendons are also predisposed to failure from low-energy injuries. Diagnosis can often be made clinically with recognition of a palpable defect to the tendon, localized patellar tendon tenderness, and inability to actively extend the knee. Diagnosis and surgical planning can be established with radiograph, ultrasonography, or magnetic resonance imaging. Surgical repair is the mainstay of treatment, and there have been many recent advances in repair technique, optimal reconstruction strategies, and supplemental fixation. Time to surgery for complete tears remains the most important prognosticator for success. Direct primary repair can be completed with transosseous tunnels, suture anchor repair, or end-to-end repair. Tendon reconstruction can be achieved with or without mechanical or biologic augments. Rehabilitation programs vary in specifics, but return to sport can be expected by 6 months postoperatively.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"141 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140760738","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":"Failure of Surgical Equipoise in Posterior Cord Syndrome Myelopathy","authors":"Drew A. Bednar, Mohamed Sarraj, Alina Rose Nanji","doi":"10.5435/JAAOSGlobal-D-23-00027","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00027","url":null,"abstract":"We suggest that a clinical diagnosis of posterior cord syndrome indicates primary posterior decompression in cervical spondylotic myelopathy cases. We present two unique cases of failed anterior decompression in neutrally aligned necks with compressive myelopathy and a literature review. Two recent cases of cervical spondylotic myelopathy that failed to respond after anterior surgical decompression and fusion surgery were observed at our institution. Both patients had motor strength preservation but were unable to stand and walk independently and had other clinical findings consistent with posterior cord syndrome rather than the more common anterior or central cord syndromes, and both responded well to staged posterior decompression. Posterior cervical decompression successfully relieved posterior cord syndrome symptoms after a failed anterior decompression in both of our cases. Posterior cord syndrome is a rare syndrome best diagnosed clinically and should be considered in cases of cervical spondylotic myelopathy in which motor strength testing is preserved.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"125 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138621435","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":"From Hip Screening to Hip Surveillance: Transforming Care for Patients With Cerebral Palsy: An Analysis of a Single Institution","authors":"Alana Sadur, Curt Martinez, Sarah Dance, Ryan Travers, Ariana Gonzalez, Sean A. Tabaie","doi":"10.5435/JAAOSGlobal-D-23-00236","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00236","url":null,"abstract":"Introduction: Surveillance programs aimed at monitoring hip displacement in patients with cerebral palsy have been demonstrated to decrease the incidence of hip dislocations and properly time surgical intervention, ultimately improving patient outcomes. The objective of this study was to determine whether the implementation of a hip screening to surveillance program at a tertiary academic teaching hospital in 2017 increased the frequency of radiographic evaluations and changed the timing of surgical intervention. Methods: A total of 592 patients with cerebral palsy were identified, and 468 of these patients had initial radiograph date data available. In this analysis, 246 patients with initial radiograph dates after 2012 were included. The study population was divided into two groups based on the initial radiograph date, 2012 to 2016 versus 2017 to 2022. One hundred sixty patients (65%) were in the 2012 to 2016 group, and 86 (35%) were in the 2017 to 2022 group. Statistical analysis was conducted using various techniques, such as two-sample Student t-test, Mann-Whitney U test, chi square/Fisher exact test, and multivariable linear regression analysis. Results: The average number of radiographs per year in the 2017 to 2022 group was 0.11 (95% CI: 0.02, 0.20, P = 0.017) higher than the 2012 to 2016 group. After adjusting for confounders using multivariable linear regression analysis, this difference was even larger (difference 0.16, 95% CI: 0.06, 0.25, P = 0.001). The surgical intervention rate was significantly lower in the 2017 to 2022 group compared with the 2012 to 2016 group (12.9% versus 40.6%, P < 0.001). Discussion: The results of this study suggest that the implementation of a hip screening to surveillance program results in more frequent radiographic evaluations and possibly a reduced need for surgical intervention from 2017 to 2022. In the 2012 to 2016 group, more surgical interventions were performed likely because of the lack of any hip surveillance or screening program in place.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617075","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":"Virtual Reality Is an Effective Tool for Learning Techniques in Arthroplasty: A Systematic Review and Meta-Analysis","authors":"Nicholas Pettinelli, Amy Y. Lee, Michael S. Lee, Ronak J. Mahatme, S. Gillinov, Andrew E. Jimenez","doi":"10.5435/JAAOSGlobal-D-23-00078","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00078","url":null,"abstract":"Background: There is a scarcity of aggregate literature reporting on the efficacy of virtual reality (VR) concerning surgical skill development within the realm of arthroplasty. The purpose of this study was to evaluate the effect of VR on the training of orthopaedic surgery residents and medical students learning surgical techniques in arthroplasty. Methods: A systematic review was conducted querying PubMed, Cochrane Trials, and Embase in September 2022. Studies were included if they involved education or training of orthopaedic surgery residents/students, used VR, and reported on outcomes measuring surgical skills related to arthroplasty. Outcomes present in a minimum of three studies underwent additional statistical analysis with forest plots. Results: Seven studies met inclusion criteria and included a total sample size of 148 residents/students between MS4-PGY6. Five of the seven included studies showed VR to be an effective training modality, with two studies demonstrating that VR reduced the error rate (P < 0.05). The two most reported outcomes were procedure duration and objective structured assessment of technical skills. Orthopaedic trainees using VR conducted procedures in markedly less time than control groups (SMD, −0.81 minute; 95% confidence interval, [−1.45 to −0.17 minutes]; P = 0.01). No significant difference was found comparing objective structured assessment of technical skills between VR and control groups (SMD, 0.44; 95% confidence interval, [−1.05 to 1.93]; P = 0.56). Conclusion: Although the extent to which VR can outright replace standard learning modalities is unclear at this time, its usefulness as a supplemental learning modality in arthroplasty, especially in the absence of available on-demand resources, may be of value. A paucity of literature exists to evaluate the effect of a longitudinal VR curriculum on direct patient care performance by orthopaedic surgery residents learning techniques in arthroplasty, necessitating additional study.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121572415","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":"Few Runners Return to Running after Total Joint Arthroplasty, While Others Initiate Running","authors":"Brielle Antonelli, Rebecca Teng, R. Breslow, Matthew Jamison, M. Hepinstall, R. Schwarzkopf, W. Moschetti, Antonia F. Chen","doi":"10.5435/JAAOSGlobal-D-23-00019","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-23-00019","url":null,"abstract":"Introduction: This study examines self-reported running practices in total joint arthroplasty (TJA) patients. Methods: This prospective, cross-sectional study of a multi-institutional database identified 4,462 primary total hip arthroplasty (THA) and total or partial knee arthroplasty (TKA/UKA) patients from June 2015 to June 2020. TJA patients completed an online survey capturing pre-TJA running experience and expectations, surgeon recommendations about return to running, postoperative characteristics, revision surgeries, and the Commitment to Exercise Scale and Brief Resilience Scale. Patient-reported follow-up reached 5 years. Logistic regression, the chi square test, and analysis of variance tests were used. Results: Five hundred forty-nine patients (12.2%) self-reported running preoperatively, and 65 patients (11.8%) returned to running after surgery. 67.2% were satisfied with their return to running. 40 patients (1.0%) who were not preoperative runners started running after TJA. Preoperative runners who returned to running had higher mean Brief Resilience Scale (3.9 ± 0.7) scores and the highest Commitment to Exercise Scale scores (46.5 ± 17.6, F[2,510] = 3.88, P = 0.02). Runners who returned to running had a 6.2% revision rate while those who did not run postoperatively had a 4.8% revision rate (P = 0.55). Surgeon recommendations included no return to running (29.5%), maintain low-impact activities (35.2%), return to preoperative levels (5.1%), and no recommendations (30.1%). Discussion: 12% of TJA preoperative runners returned to running, mostly within 1 year, and 67.2% were satisfied with their running ability.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114205551","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":"The Relationship Between Frailty and Clinical and Patient-Reported Outcomes After Hip or Knee Arthroplasty: A Retrospective Cohort Study","authors":"C. McDonough, S. Dunn, A. Bilderback, A. Yates, M. Hogan, Daniel E. Hall","doi":"10.5435/JAAOSGlobal-D-22-00249","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-22-00249","url":null,"abstract":"Introduction: Frailty is associated with increased risks related to surgery. There is emerging consensus that assessment of these risks should include frailty, yet little is known regarding the relationship between prospective frailty measurement and clinical and patient-reported outcomes. Methods: This retrospective cohort study included adults having hip or knee arthroplasty in one health system between April 2016 and April 2021 within a quality improvement initiative to identify frail adults and support preoperative optimization of care and outcomes. The Risk Analysis Index (RAI) was completed, and scores were available at the time of initial consultation. Scores ≤ 29 were considered robust, 30 to 36 normal, 37 to 44 frail, and ≥ 45 very frail. The Hip Disability and Osteoarthritis Outcome Score-Joint Replacement (HOOS-JR) or Knee Injury and Osteoarthritis Outcome Score-Joint Replacement (KOOS-JR) was administered for the affected joint at preoperative and postoperative clinic visits as well as the patient-acceptable symptom state (PASS) and global rating of change. Patients were included if they had diagnosis-related group (DRG) codes for primary (DRG 469, 470) or bilateral (DRG 461, 462) joint arthroplasty, a completed postoperative HOOS-JR or KOOS-JR, and a preoperative RAI score recorded no more than 270 days before the eligible arthroplasty procedure. Postoperative periods were defined as 0 to 3 months and > 3 months. Results: Among 3350 individuals, the mean age for those with hip and knee arthroplasty was 64 and 67 years, respectively. RAI score–based frailty level was not associated with postoperative HOOS-JR and KOOS-JR score change at 0 to 3 months or > 3 months, % reaching substantial clinical benefit, global rating of change, or PASS at either time point. Frailty as measured by RAI was associated with longer hospital length of stay and 30-day but not 7-day readmission. Conclusion: These results suggest that frail patients can and do achieve similar outcomes compared with their more robust counterparts.","PeriodicalId":145112,"journal":{"name":"JAAOS Global Research & Reviews","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129936310","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}