Journal of Spine Practice (JSP)最新文献

{"title":"The morbidity and mortality rates following surgery in metastatic spine disease patients","authors":"S. Aleissa, F. Konbaz, Firas M. Alsebayel, A. Eissa, Nawaf Alogayyel, A. Alhandi, Muath Almajed, A. Bourghli, Fahad H. Alhelal, M. Abaalkhail","doi":"10.18502/jsp.v1i2.9902","DOIUrl":"https://doi.org/10.18502/jsp.v1i2.9902","url":null,"abstract":"Background: Metastasis is one of the most frequent causes of cancer-related deaths globally. Several studies have investigated the surgical outcome of a metastatic spine; however, the results are discordant. This research aims to study the mortality and morbidity rates of surgical intervention for metastatic spine disease and the predictors of postoperative complications in a tertiary care center. Materials and Methods: A retrospective chart review was conducted. The population consisted of patients who underwent surgical intervention for metastatic spine disease in a tertiary-care hospital from 2016 to 2020. The primary outcomes were intraoperative and postoperative complications, 30- day mortality, 90-day mortality, and the 1-year survival rates. Results: A total of 47 patients underwent a surgical intervention during the period. Breast cancer was the most frequent primary lesion for the metastasis, followed by multiple myeloma and lung cancer. Postoperative surgical complications occurred in 34% of the sample, and 41% reported marked neurological improvement following surgery. The 30-day and 90-day mortality rates were 2% and 12%, respectively. The overall one-year survival rate was 64%. Conclusion: The current study indicated that despite the risk and complexity of the surgical intervention to the metastatic spine, the surgery resulted in an acceptable rate of morbidity and mortality.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127175059","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":"Occupational therapy treatment time during inpatient traumatic spinal cord injury rehabilitation: A retrospective study from a tertiary center in Riyadh","authors":"F. Konbaz, Khalid Alsheik, Yazeed Timraz, Aishah Alsharif, Teif Almohimeed, Fatimah Othman","doi":"10.18502/jsp.v1i2.9965","DOIUrl":"https://doi.org/10.18502/jsp.v1i2.9965","url":null,"abstract":"Background: Occupational therapy (OT) is a part of the rehabilitation process which facilitates and enables individuals with spinal cord injuries (SCI) to be as independent as possible in their activities of daily living (ADLs). Little is known about the OT treatment plan and the duration of the selected treatment intervention during SCI rehabilitation. This study aims to describe the duration of OT treatment that patients with SCI Received during their inpatient rehabilitation stay. \u0000Materials and Methods: A chart review of patients with SCI who attended inpatient rehabilitation at King Abdulaziz Medical City between 2016 and 2020 was conducted. The documented rehabilitation session, including the treatment duration and the type of therapeutic intervention, were extracted from each patient’s electronic medical file. \u0000Results: A total of 50 eligible patients have been included in this analysis. The median age of the study population was 28, and the majority were male patients (82%). The most common reason for the SCI was a motor vehicle accident (94%), in which 56% required ICU admission. The median total time spent over the patient’s stay was 1785 min, approximately 43.7 hr of OT rehabilitation. \u0000Conclusion: Differentiation between and within traumatic SCI patient level in the length of stay (LOS). Differentiation in time intensity was explained by patient and injury characteristics. Also, we identified a significant variation in time spent among traumatic SCI for all OT interventions when examining the median of the total number of hours. Specifically, we found that lower body dressing training was the most time-consuming ADL.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134252119","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":"Olfactory Mucosal Auto-transplantation in Spinal Cord Injury: A Clinical Trial, Saudi Arabia","authors":"Ahmad Najib Ashraf, A. Shebreen","doi":"10.18502/jsp.v1i1.9771","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9771","url":null,"abstract":"Introduction: Spinal cord injury (SCI) results in loss of nervous tissue and consequently loss of motor and sensory function. Despite significant improvements in the early medical and surgical management of SCI, there is no effective treatment available that restores the injury-induced loss of function to a degree that an independent life can be guaranteed. Restoration of function and reversal of paralysis following SCI is among the most daunting challenges in all of neuroscience research. \u0000Methodology: We decided to study the outcomes in chronic SCI (CSCI) after autologous olfactory mucosal transplantation into the spinal cord following detethering of the cord. The human surgical procedure of autologous olfactory mucosal transplantation was first developed by Carlos Lima and his colleagues. These investigators provided guidance for the surgical procedures in this study and the procedures on the first six participants were performed in their presence. \u0000Result: Patients were screened at different centers in the kingdom. A stringent inclusion and exclusion criteria were applied. Patients for this clinical trial were selected from individuals that suffered an SCI at least 12 months before their assessment and were chronically paraplegic or tetraplegic. The final twenty participants were selected after screening more than 125 patients.  While some of them were rejected for medical reasons, some refused to participate upon receiving a full briefing and some of them were unable to fulfill the required psychosocial criteria. \u0000Conclusion: The details of the patients and the changes observed in their conditions post olfactory mucosal auto-transplantation will be discussed in detail in oral presentation with graphic results with marked significant improvement in motor and sensory levels of SCI patients as compared to before transplantation of olfactory mucosa. Olfactory unsheathing cells (OECs) are glia cells and continuous axon extension and successful topographic targeting of the olfactory receptor neurons responsible for the sense of smell (olfaction). Due to this distinctive property, OECs have been trialed in human cell transplant therapies to assist in the repair of central nervous system injuries, particularly those of the spinal cord. Although many studies have reported neurological improvement, therapy remains inconsistent and requires further improvement.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115544415","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":"Management of Low Back Pain in Primary Healthcare Settings: Physician’s Knowledge and Practices Based on Red Flags of Low Back Pain in Jazan Region – A Cross-sectional Study","authors":"Alshaymaa M. Arishy","doi":"10.18502/jsp.v1i1.9780","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9780","url":null,"abstract":"Introduction: This study assessed the primary healthcare physicians’ knowledge and practices toward the red flags of low back pain (LBP) and factors associated with awareness. \u0000Methodology: This cross-sectional study was conducted between October 2020 and June 2021 in primary healthcare (PHC) settings in Jazan, Kingdom of Saudi Arabia. Questionnaires were electronically distributed among 261 primary physicians with a 96.1% response rate. \u0000Result: Of the 261 physicians included, 56% were male, 49.4% were aged between 35 and 44 years, and 76.9% were non-Saudi. Moreover, 49% of the physicians had one to nine years of experience and 33.1% indicated that they deal with >30 patients with back pain per month. Furthermore, it was found that 86.9% of the participants were aware of the overall red flags of LBP. Job category and the number of cases were significant factors of perceived awareness. The highest level of self-reported awareness was among consultants. The rate of referral patients with nonspecific back pain was highest among general practitioners. More than 95% of the participants would refer patients to hospital if they noticed the presence of red flags for LBP. \u0000Conclusion: Awareness of physicians practicing in PHCs through the red flags of LBP in Jazan is good, and recognition of the need for the referral of a patient with suspected critical illness is good as well.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124122602","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":"Editorial – Born to Lead","authors":"Ahmed Q Alturkistany","doi":"10.18502/jsp.v1i1.9841","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9841","url":null,"abstract":"On the 9th of September 2015, the Saudi Spine Society (SSS) was birthed. Now, the society is six years old and, despite its comparative youth, it has become a regional and global leader in the field of spine care. \u0000The Saudi Spine Society is a multidisciplinary scientific association which aims to promote spine care in the Kingdom of Saudi Arabia. Its membership includes a wide range of specialist fields concerning the prevention, management and rehabilitation of all spine related ailments. \u0000To read the full text, please download the PDF or view the article HTML.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114816895","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":"Knowledge and Attitude Toward Lumbar Puncture Among Medina Population","authors":"Asma Alshanqiti","doi":"10.18502/jsp.v1i1.9788","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9788","url":null,"abstract":"Introduction: Lumbar puncture (LP) is one of the invasive procedures performed to obtain information about cerebrospinal fluid. It has diagnostic and therapeutic purposes for various neurological cases. Previous studies among different populations have indicated that there is a lack of research focusing on individuals’ knowledge and attitude toward LP. Patient who refuse LP may be exposed to unneeded hospital admission, or unnecessary empirical antibiotic treatment. A literature search found a lack of studies regarding LP knowledge and perception among Al-Medina residents. To address that gap, this study aimed at assessing the knowledge and attitude toward LP among the Al-Medina population. \u0000Methodology: A cross-sectional study was conducted among adults 18 years of age residing in Medina, Saudi Arabia. An online survey using a self-administrated questionnaire that included demographic characteristics, knowledge, and attitude questions was randomly distributed from January 2020 to August 2020. The questionnaire was pretested and validated (Cronbach’s alpha = 0.701). \u0000Result: A total of 512 participants were included: 51.3% of the participants were aged between 18 and 25 years; 85.5% were female; and 68.6% had a bachelor’s degree. Most participants (65.6%) showed a poor knowledge of LP. Of the total participants, 29.7% had a poor attitude toward LP, while 69.7% had a good attitude. A significant positive correlation was found between knowledge and attitude toward lumbar procedures (r = 0.186, p < 0.001). Respondents who received their information from a healthcare worker had the highest level of knowledge (p < 0.001). A positive significant correlation was found between attitude and age; younger participants had a better attitude (p < 0.001). \u0000Conclusion: This study assessed the knowledge and attitude toward LP, and the relation between them which leads to a great impact on diagnosis and treatment. The study demonstrated that few participants had a previous experience with LP. There is a crucial need to know how these personal LP experiences affect the decisions and attitude toward LP in the future. The study also showed that the level of knowledge about LP is relatively poor among the public. The level of awareness should be raised to improve patient’s understanding toward LP. Interventions are needed to scale up the level of knowledge about LP. Some potential interventions include: intensifying health promotion campaigns, increasing involvement of physicians in patients’ education to improve knowledge, as well as maintaining the quality and reliability of information provided concerning LP and carrying out further research to evaluate the effect of intervention programs on the knowledge and attitude.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131504166","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":"Spontaneous Regression of Disc Prolapse – An Underlooked Phenomena: A Case Report and Literature Review","authors":"M. Alrayes","doi":"10.18502/jsp.v1i1.9806","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9806","url":null,"abstract":"Introduction: Intervertebral disc prolapse is a very common abnormality found in the population, that can manifest in a variety of complaints like back pain, radiculopathy, and even to the extent that it might lead to more adverse neurological deficits. Symptoms improve in majority of patients only with conservative treatment. However, some patients may require surgical intervention. In some cases, spontaneous regression of herniated disc can be seen. Thus, the interest in the phenomenon of spontaneous resorption of the herniated discs has increased, which raised the controversy regarding managing such patients. Here, we report a case of a huge lumbosacral spontaneous disc resolution at the level of L5-S1 in which clinical improvement was associated with a significant decrease in the size of a huge, herniated disc. In addition, we performed a comprehensive review of literature of all reported cases of spontaneous disc resolution to provide an updated discussion of such an underlooked phenomena. \u0000Case Report: A 53-year-old female not known to have any medical illness presented at the Neurosurgery Clinic with complaints of chronic back pain for six years which was progressing and radiating to both of her lower extremities (right more than left) and had become more intense in the last year. It was slightly relieved by simple analgesics and aggravated by sitting or lying down. There was no history of trauma, weaknesses, or sphincteric disturbances. Upon evaluation in our clinic, local exam revealed lower back midline tenderness at the level of L5-S1 vertebrae. No tenderness was observed in the paravertebral area or facets. Straight leg raising test was positive at 70º in the right side and 90º in the left, normal power, intact sensation, normal tone, and reflexes. Negative Babinski and clonus was noted in both limbs. MRI lumbar spine showed significant right paracentral L5-S1 disk prolapse indenting the thecal sac compressing the root. A full-course and effective medical treatment was initiated as the patient was never treated properly before for her back pain, along with physical therapy and regular OPD follow-ups. A follow-up MRI a year later revealed significant reduction in the size of the disk prolapse as compared to the initial imaging study. Overall, patient’s symptoms significantly improved, and she was kept on conservative management. \u0000Conclusion: To conclude, the case presented here shows the efficacy and validity of conservative management for patients who are diagnosed with a herniated disc in the absence of neurological deficits. This shows the importance of not pushing surgical treatment for patient with lumbar disc herniation without neurological deficits, each patient should receive a trial of conservative therapy and close OPD follow-ups and repeated MRI scans for further assessment of any advancement or improvement, because herniated discs can regress spontaneously. Radiological changes alone should not be the main target for assess","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"256 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133282037","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":"Predictors and Risk Factors of Surgical Site Infection (SSI) Following Adult Spine Surgery: A Cross-sectional Study","authors":"W. Awwad, A. AlNasser, Abdulrahman Almalki, Rohail Mumtaz, Bander Alsubaie, A. Almaawi, Abdulaziz N Aljurayyan, K. Alsaleh","doi":"10.18502/jsp.v1i1.9766","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9766","url":null,"abstract":"Introduction: Surgical site infection (SSI) is a major cause of morbidity and mortality as it is known to increase the length of hospital stay, revision surgery, and re-operation. Identifying patients at risk of developing SSI before surgery is the key to prevent SSI. \u0000Methodology: This cross-sectional study was performed at the orthopedic department in King Khalid University Hospital, Riyadh, Saudi Arabia. SSIs were defined according to the Centers for Disease Control (CDC) case definition for SSI. Potential risk factors for postoperative wound infection were collected. Data were analyzed using the SPSS, version 23.0, and p-value < 0.05 was considered to be statistically significant. \u0000Result: A total of 214 patients were included in the study and the incidence of SSI following spine surgery was 9.81% (N = 21). Obesity, diabetes, location of surgery, ASA score, duration of surgery, length of hospital stay, and location/level of operated vertebrae were all found to have a significant correlation with the SSI (p < 0.05). \u0000Conclusion: Having a strong background of SSI risk factors and predictors is core to preventing the incidence of SSI and further enhance and optimize operative outcomes, as well as increasing the cost-effectiveness of the surgical intervention.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132270878","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":"Spinal Surgery During COVID-19 Pandemic in Saudi Arabia","authors":"F. Konbaz, Taif Alqahtani, Nada Alharthi, Mohammad Baraja, Nazish Masud, S. Aleissa, Fahad H. Alhelal, Majed S. Abalkhail","doi":"10.18502/jsp.v1i1.9772","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9772","url":null,"abstract":"Introduction: The COVID-19 pandemic has challenged the healthcare system’s capacities around the world. Due to the alarming situation, medical activities have been restricted to allocate resources to treat COVID-19-infected patients. However, medical emergencies still need urgent medical intervention. Considering the lack of reliable data regarding spinal surgeries during the COVID-19 pandemic, the present study sought to analyze the pattern of spinal surgeries in KSA. \u0000Methodology: A case series of patients who had urgent spine surgeries during COVID-19 pandemic was conducted in a tertiary care hospital. Data on patients’ demographics, COVID-19 test result, American Society of Anesthesia Score, SSS grade, diagnosis, and data related to surgery and postoperative findings were collected. All collected data were then processed and analyzed. Surgical outcomes based on source of admission were compared using Chi-square test. \u0000Result: A total of 63 patients who underwent spine surgery during the COVID-19 pandemic were included. The mean age of the patients was 53 ± 18 years and males were predominant (59%). The positive COVID-19 patients were 3%. Almost half of the patients were classified into ASA II. The majority were categorized into grade B (65%) according to SSS. The frequently diagnosed condition was fracture (33%), followed by spinal stenosis (18%) and metastatic (10%), while the most mentioned location was lumbar (61%). Postoperative complications were found in 11% of the patients. The readmission rate within 30 days, unplanned return to OR and ICU admission were 19%, 13%, and 11%, respectively. While the mean duration between admission and surgery was 8 ± 20 days, the mean duration of length of stay was 20 ± 29 days. Further, a significant association was seen between the admission source and the surgical procedure performed and surgical indication. \u0000Conclusion: It has been demonstrated that the surgical intervention was only provided to patients requiring immediate or urgent spinal management. However, the length of hospitalization and duration between hospital admission and surgery was substantially prolonged. Further studies are warranted to determine the factors leading to prolonged hospitalization and time between hospital admission and surgery.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125847664","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":"Facet Joint Injections for the Management of Low Back Pain: A Clinical Review","authors":"Aboud AlJabari","doi":"10.18502/jsp.v1i1.9774","DOIUrl":"https://doi.org/10.18502/jsp.v1i1.9774","url":null,"abstract":"Introduction: Lumbar facet joints have been implicated in chronic low back pain (LBP) in up to 45% of patients with LBP. Facet joint pain (FJP) diagnosis and management are always challenging for pain physicians. FJP is not diagnosed by specific demographic features, pain characteristics, or physical findings, despite the electrodiagnostic studies and imaging modalities being available. Although comparative local anesthetics or placebo saline injections can be used, diagnostic blocks are the only reliable diagnostic measures according to the current literature. \u0000Methodology: A randomized, controlled clinical trial was conducted to evaluate the effectiveness of lumbar facet joint injections. A total of 229 participants were enrolled to receive facet injections with bupivacaine and steroid, medial branch blocks, or saline. \u0000Result: The results of this study showed that facet joint injections had little long-term therapeutic utility, but had a prognostic value compared to control injections before radiofrequency ablation. Thus, the results of this study emphasized the diagnostic value of facet joint injections. \u0000Conclusion: FJP is not diagnosed by demographic features, pain characteristics, physical findings, electrodiagnostic studies, or radiological evaluation as other types of LBP. Diagnostic blocks using comparative local anesthetic blocks or placebo injections are the only reliable diagnostic measures according to the current literature. Their validity, specificity, and sensitivity are considered reliable in the diagnosis of FJP. Facet joint-related anatomical, clinical, and technical knowledge is essential for successful pain management. Pain physicians should embrace all aspects of FJP management, from diagnosis to interventional management.","PeriodicalId":199836,"journal":{"name":"Journal of Spine Practice (JSP)","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132081156","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}