Simon Ammanuel, Daniel Burkett, Jason J Kim, Evalina S Bond, Amgad S Hanna
{"title":"Peroneal Nerve Repair with Cross-Bridge Ladder Technique: Parallel End-to-Side Neurorrhaphies.","authors":"Simon Ammanuel, Daniel Burkett, Jason J Kim, Evalina S Bond, Amgad S Hanna","doi":"10.1055/s-0043-1768996","DOIUrl":"https://doi.org/10.1055/s-0043-1768996","url":null,"abstract":"<p><p><b>Background</b> Multiple nerve transfer techniques are used to treat patients with nerve injuries when a primary repair is not possible. These techniques are categorized to end-to-end, end-to-side, and side-to-side neurorrhaphy. Our study aims to explore the utility of the cross-bridge ladder technique (H-shaped), which has shown promising results in animal models and probably underutilized clinically. <b>Methods</b> Four patients with significant loss of ankle dorsiflexion were seen in the clinic and underwent evaluation, including electrodiagnostic studies. A cross-bridge ladder repair technique was used between the tibial nerve as the donor and the common peroneal nerve as the recipient via one or two nerve grafts coapted in parallel with end-to-side neurorrhaphies. Dorsiflexion strength was measured preoperatively using the Medical Research Council (MRC) grading system and at each postoperative follow-up appointment. <b>Results</b> All four patients had suffered persistent and severe foot drop (MRC of 0) following trauma that had occurred between 6 and 15 months preoperatively. Three of the four patients improved to an MRC of 2 several months postoperatively. The last patient had an immediate improvement to an MRC of 2 by his first month and had a complete recovery of ankle dorsiflexion within 4 months from surgery. <b>Conclusion</b> We demonstrate the utility and clinical outcomes of the cross-bridge ladder technique in patients with persistent and prolonged foot drop following trauma. Both early and late recovery were seen while all patients regained motor function, with some patients continuing to improve up to the most recent follow-up. IRB Approval: Obtained 2013-1411-CP005.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10205393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9527036","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}
Ioannis Antonopoulos, Margarita- Michaela Ampadiotaki, George Tsikouris, Ioannis Chiotis, Georgios Tsakotos, Ioannis Pathiakis, Theodore G. Troupis
{"title":"Fusion of the Median and Musculocutaneous Nerves Masquerading as Biceps' Innervation from the Median Nerve","authors":"Ioannis Antonopoulos, Margarita- Michaela Ampadiotaki, George Tsikouris, Ioannis Chiotis, Georgios Tsakotos, Ioannis Pathiakis, Theodore G. Troupis","doi":"10.1055/s-0043-1767674","DOIUrl":"https://doi.org/10.1055/s-0043-1767674","url":null,"abstract":"Abstract Embryologically, the musculocutaneous nerve (MCN) comes from the lateral root of the median nerve, and thus numerous anatomical variations concerning the formation and branching pattern of these two nerves of the brachial plexus have been described. In this case study, we describe a relatively uncommon case of fusion of the median and MCNs that was identified during routine teaching dissection of a male human cadaver. The identification of this anatomical variation requires awareness of the embryological background, as it may be confused with biceps innervation from the median nerve or the existence of a communicating branch between the two nerves. In addition, awareness of such anatomical variations is of undisputable significance for the safety of surgical operations in the brachial plexus and the arm in general.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135758441","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":"Bilateral Thoracic Outlet Syndrome from Anomalous 8th Cervical Vertebrae Ribs.","authors":"Scott Ferris, Sarah Lonie","doi":"10.1055/s-0042-1753541","DOIUrl":"https://doi.org/10.1055/s-0042-1753541","url":null,"abstract":"<p><p>Thoracic outlet syndrome (TOS) is a group of diverse disorders resulting from compression of neurovascular structures as they pass from the lower neck to upper limb. Neurological symptoms, such as pain, weakness, or paraesthesia, are much more common than vascular symptoms such as pallor or venous congestion. Anatomical abnormalities can contribute to this condition. Thirty percent of patients with TOS can have a cervical rib, arising from the transverse process of the 7th cervical vertebra, compared with 1% of the general population. We report the first case in the literature of neurogenic TOS from a cervical rib arising from a supernumerary 8th cervical vertebra. This patient had immediate improvement in TOS symptoms following scalene muscle surgery and resection of cervical and first thoracic ribs.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40622069","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}
Mark A Feger, Jonathan Isaacs, Satya Mallu, Dorne Yager, Mary Shall, Gaurangkumar Patel, Omar Protzuk, Akhil S Bokkisam
{"title":"Follistatin Protein Enhances Satellite Cell Counts in Reinnervated Muscle.","authors":"Mark A Feger, Jonathan Isaacs, Satya Mallu, Dorne Yager, Mary Shall, Gaurangkumar Patel, Omar Protzuk, Akhil S Bokkisam","doi":"10.1055/s-0042-1748535","DOIUrl":"10.1055/s-0042-1748535","url":null,"abstract":"<p><p><b>Background</b> Muscle recovery following peripheral nerve repair is sup-optimal. Follistatin (FST), a potent muscle stimulant, enhances muscle size and satellite cell counts following reinnervation when administered as recombinant FST DNA via viral vectors. Local administration of recombinant FST protein, if effective, would be more clinically translatable but has yet to be investigated following muscle reinnervation. <b>Objective</b> The aim of this study is to assess the effect of direct delivery of recombinant FST protein on muscle recovery following muscle reinnervation. <b>Materials and Methods</b> In total, 72 Sprague-Dawley rats underwent temporary (3 or 6 months) denervation or sham denervation. After reinnervation, rats received FST protein (isoform FS-288) or sham treatment via a subcutaneous osmotic pump delivery system. Outcome measures included muscle force, muscle histomorphology, and FST protein quantification. <b>Results</b> Follistatin treatment resulted in smaller muscles after 3 months denervation ( <i>p</i> = 0.019) and reduced force after 3 months sham denervation ( <i>p</i> < 0.001). Conversely, after 6 months of denervation, FST treatment trended toward increased force output ( <i>p</i> = 0.066). Follistatin increased satellite cell counts after denervation ( <i>p</i> < 0.001) but reduced satellite cell counts after sham denervation ( <i>p</i> = 0.037). <b>Conclusion</b> Follistatin had mixed effects on muscle weight and force. Direct FST protein delivery enhanced satellite cell counts following reinnervation. The positive effect on the satellite cell population is intriguing and warrants further investigation.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391503","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}
Jonathan A Sorkin, Ziv Rechany, Mara Almog, Nina Dietzmeyer, Yuval Shapira, Kirsten Haastert-Talini, Shimon Rochkind
{"title":"A Rabbit Model for Peripheral Nerve Reconstruction Studies Avoiding Automutilation Behavior.","authors":"Jonathan A Sorkin, Ziv Rechany, Mara Almog, Nina Dietzmeyer, Yuval Shapira, Kirsten Haastert-Talini, Shimon Rochkind","doi":"10.1055/s-0042-1747959","DOIUrl":"https://doi.org/10.1055/s-0042-1747959","url":null,"abstract":"<p><p><b>Background</b> The rabbit sciatic nerve injury model may represent a valuable alternative for critical gap distance seen in humans but often leads to automutilation. In this study, we modified the complete sciatic nerve injury model for avoiding autophagy. <b>Materials and Methods</b> In 20 adult female New Zealand White rabbits, instead of transecting the complete sciatic nerve, we unilaterally transected the tibial portion and preserved the peroneal portion. Thereby loss of sensation in the dorsal aspect of the paw was avoided. The tibial portion was repaired in a reversed autograft approach in a length of 2.6 cm. In an alternative repair approach, a gap of 2.6 cm in length was repaired with a chitosan-based nerve guide. <b>Results</b> During the 6-month follow-up period, there were no incidents of autotomy. Nerve regeneration of the tibial portion of the sciatic nerve was evaluated histologically and morphometrically. A clear difference between the distal segments of the healthy contralateral and the repaired tibial portion of the sciatic nerve was detectable, validating the model. <b>Conclusion</b> By transecting the isolated tibial portion of the rabbit sciatic nerve and leaving the peroneal portion intact, it was possible to eliminate automutilation behavior.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9213117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391502","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":"Commentary to \"Morphometry and Contents of the Suprascapular Notch with Potential Clinical Implications: A Cadaveric Study\".","authors":"Azzat Al-Redouan, David Kachlik","doi":"10.1055/s-0042-1747960","DOIUrl":"https://doi.org/10.1055/s-0042-1747960","url":null,"abstract":"We article “ Morphometry and contents of the suprascapular notch with potential clinical implications: a cadaveric study ” by Tsikouris et al. 1 However, we would like to point out several data that we fi nd contra-dictory to our fi ndings in previous studies and we have differing point of view. The aforementioned study brought up an interesting hy-pothesis which discussed whether there is a correlation of an ossi fi ed superior scapular transverse ligament, also called suprascapular ligament (SL), 2 to a dimensioned middle-trans-verse diameter of the suprascapular notch (SSN) in the SSN Type-IVaccording to Polguj et al SSN morphometric classi fi cation, 3 which is also referred to as suprascapular foramen. 2 The presented study suggested that an ossi fi cation process in the SL was correlated to SSN space narrowing in its horizontal plane and contributing to suprascapular nerve (SN) compres-sion, but thispremise does not seem to bethe case. A SSNwith a middle-transverse diameter mean of 5.10mm can still accommodate the passing SN. The study by Tubbs et al dem-onstrating a compressed SN in 5 SSN out of 50 cadaveric studies was evidenced by histolopathological examination of the SN, and the diameter of those SSN was at critical stenosed range of 1.8","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9208910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40225527","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}
Anita Singh, T. Majmudar, R. Magee, B. Gonik, Sriram Balasubramanian
{"title":"Effects of Prestretch on Neonatal Peripheral Nerve: An In Vitro Study","authors":"Anita Singh, T. Majmudar, R. Magee, B. Gonik, Sriram Balasubramanian","doi":"10.1055/s-0042-1743132","DOIUrl":"https://doi.org/10.1055/s-0042-1743132","url":null,"abstract":"Background Characterizing the biomechanical failure responses of neonatal peripheral nerves is critical in understanding stretch-related peripheral nerve injury mechanisms in neonates. Objective This in vitro study investigated the effects of prestretch magnitude and duration on the biomechanical failure behavior of neonatal piglet brachial plexus (BP) and tibial nerves. Methods BP and tibial nerves from 32 neonatal piglets were harvested and prestretched to 0, 10, or 20% strain for 90 or 300 seconds. These prestretched samples were then subjected to tensile loading until failure. Failure stress and strain were calculated from the obtained load-displacement data. Results Prestretch magnitude significantly affected failure stress but not the failure strain. BP nerves prestretched to 10 or 20% strain, exhibiting significantly lower failure stress than those prestretched to 0% strain for both prestretch durations (90 and 300 seconds). Likewise, tibial nerves prestretched to 10 or 20% strain for 300 seconds, exhibiting significantly lower failure stress than the 0% prestretch group. An effect of prestretch duration on failure stress was also observed in the BP nerves when subjected to 20% prestretch strain such that the failure stress was significantly lower for 300 seconds group than 90 seconds group. No significant differences in the failure strains were observed. When comparing BP and tibial nerve failure responses, significantly higher failure stress was reported in tibial nerve prestretched to 20% strain for 300 seconds than BP nerve. Conclusion These data suggest that neonatal peripheral nerves exhibit lower injury thresholds with increasing prestretch magnitude and duration while exhibiting regional differences.","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48329761","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}
Jasmine J Lin, Gromit Y Y Chan, Cláudio T Silva, Luis G Nonato, Preeti Raghavan, Aleksandra McGrath, Alice Chu
{"title":"Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy.","authors":"Jasmine J Lin, Gromit Y Y Chan, Cláudio T Silva, Luis G Nonato, Preeti Raghavan, Aleksandra McGrath, Alice Chu","doi":"10.1055/s-0041-1731748","DOIUrl":"https://doi.org/10.1055/s-0041-1731748","url":null,"abstract":"<p><p><b>Background</b> The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. <b>Method</b> An 18-year-old female with extended upper trunk (C5-6-7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. <b>Results</b> All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. <b>Conclusion</b> In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8548257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579772","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}
Geoffrey K Seidel, Salma Al Jamal, Eric Weidert, Frederick Carington, Michael T Andary, Scott R Millis, Brian G Loder
{"title":"Predictive Outcome Modeling of Preoperative Clinical Symptoms and Electrodiagnostic Data in Tarsal Tunnel Surgery.","authors":"Geoffrey K Seidel, Salma Al Jamal, Eric Weidert, Frederick Carington, Michael T Andary, Scott R Millis, Brian G Loder","doi":"10.1055/s-0041-1731747","DOIUrl":"10.1055/s-0041-1731747","url":null,"abstract":"<p><p><b>Background</b> The relationship between tarsal tunnel syndrome (TTS), electrodiagnostic (Edx) findings, and surgical outcome is unknown. Analysis of TTS surgical release outcome patient satisfaction and comparison to Edx nerve conduction studies (NCSs) is important to improve outcome prediction when deciding who would benefit from TTS release. <b>Methods</b> Retrospective study of 90 patients over 7 years that had tarsal tunnel (TT) release surgery with outcome rating and preoperative tibial NCS. Overall, 64 patients met study inclusion criteria with enough NCS data to be classified into one of the following three groups: (1) probable TTS, (2) peripheral polyneuropathy, or (3) normal. Most patients had preoperative clinical provocative testing including diagnostic tibial nerve injection, tibial Phalen's sign, and/or Tinel's sign and complaints of plantar tibial neuropathic symptoms. Outcome measure was percentage of patient improvement report at surgical follow-up visit. <b>Results</b> Patient-reported improvement was 92% in the probable TTS group ( <i>n</i> = 41) and 77% of the non-TTS group ( <i>n</i> = 23). Multivariate modeling revealed that three out of eight variables predicted improvement from surgical release, NCS consistent with TTS ( <i>p</i> = 0.04), neuropathic symptoms ( <i>p</i> = 0.045), and absent Phalen's test ( <i>p</i> = 0.001). The <i>R</i> <sup>2</sup> was 0.21 which is a robust result for this outcome measurement process. <b>Conclusion</b> The best predictors of improvement in patients with TTS release were found in patients that had preoperative Edx evidence of tibial neuropathy in the TT and tibial nerve plantar symptoms. Determining what factors predict surgical outcome will require prospective evaluation and evaluation of patients with other nonsurgical modalities.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731747","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273409","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}
Carmen Joanna González Lemus, Fernando Xavier Romero Prieto
{"title":"First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala.","authors":"Carmen Joanna González Lemus, Fernando Xavier Romero Prieto","doi":"10.1055/s-0041-1731746","DOIUrl":"https://doi.org/10.1055/s-0041-1731746","url":null,"abstract":"<p><p><b>Objective</b> This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. <b>Materials and Methods</b> In this cross-sectional descriptive study, 2,923 medical records of patients aged 1 to 64 years who presented at outpatient peripheral nerve unit of the Orthopedic Surgery Department of Hospital Roosevelt, Guatemala, from January 2017 to December 2017, were prospectively analyzed to identify the prevalence and factors associated with brachial plexus injuries. <b>Results</b> The prevalence rate of brachial plexus injuries in patients was 5.74%. This injury is more common in men (90.5%) aged 24 to 64 years. Brachial plexus injuries occurred secondary to motorcycle accident in 72% of the cases, with the majority affecting the dominant upper extremity. In addition, 64.28% of the patients took 1 to 6 months to seek consultation, whereas only 16.07% requested medical assistance <1 month from the onset of symptoms, and this result was associated with early diagnosis and adequate recovery during follow-up. Furthermore, 66.67% presented upper brachial plexus injury with no associated fractures or vascular injury, manifesting distress while performing daily activities that required hand, arm, and elbow movements. <b>Conclusion</b> The risk of suffering BPIs in Guatemala increases in economically active male patients that use motorcycles as main mode of transportation. Patients should consult immediately after injury onset to optimize management results. For this reason, hospitals must develop specialized clinical guidelines to speed up the identification and treatment of BPI injuries.</p>","PeriodicalId":15280,"journal":{"name":"Journal of Brachial Plexus and Peripheral Nerve Injury","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1055/s-0041-1731746","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273410","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}