Revista Brasileira de Ortopedia最新文献

{"title":"Predictive Model for Complications in Total Hip Arthroplasty: Development of a Clinical Tool.","authors":"Andrea Moreira Candido, Conrado Torres Laett, Alanna Martins Soares de Palma, Lourenço Pinto Peixoto, Sidnei Cavalcante da Silva","doi":"10.1055/s-0046-1824726","DOIUrl":"10.1055/s-0046-1824726","url":null,"abstract":"<p><strong>Objective: </strong>To develop a predictive model to estimate complications up to 30 days after total hip arthroplasty (THA), based on clinical and functional variables, aiming at the creation of a practical tool for clinical use.</p><p><strong>Methods: </strong>Prospective cohort study conducted in a public referral hospital, with patients undergoing primary and elective THA between November 2021 and April 2022. The sample included 122 patients (mean age: 56 years, 59.8% men). Clinical, sociodemographic, and functional capacity variables were evaluated and estimated by the Duke Activity Status Index (DASI). Outcomes included clinical complications, early readmission, prolonged hospitalization (> 6 days), and intensive care unit (ICU) stay for more than one day. A logistic regression model was used, with performance evaluated by the C-statistic (area under the curve, AUC), and the model was incorporated into an online tool.</p><p><strong>Results: </strong>The most prevalent comorbidities were hypertension (61%), diabetes (23%), and dyslipidemia (15%). Complications within 30 days occurred in 13.1% of patients, with surgical wound infection and anemia being the most common events. Dyslipidemia (odds ratio [OR]: 4.70; <i>p</i>  = 0.010), sedentary lifestyle (OR: 4.71; <i>p</i>  = 0.026), high ASA classification (OR: 3.67; <i>p</i>  = 0.035), and functional capacity < 4 metabolic equivalents of task (METs) (OR: 4.08; <i>p</i>  = 0.040) were significant risk factors. The tool is available at https://upneuro.shinyapps.io/atq-pred .</p><p><strong>Conclusion: </strong>Dyslipidemia, sedentary lifestyle, low functional capacity, and high ASA classification were associated with a higher risk of post-THA complications. The preoperative evaluation should include functional and cardiovascular aspects. The model showed good accuracy, and further studies are needed to validate its clinical application.</p><p><strong>Level ii – moderate level evidence: </strong>This is a prospective cohort study without a control group aimed at identifying prognostic factors for complications after total hip arthroplasty.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824726"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114419","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":"Lumbar Disc Herniation: What's New in Surgical Treatment.","authors":"Fábio Antônio Vieira, Breno Augusto Giese Ribeiro, Renato Hiroshi Salvioni Ueta, Eduardo Barros Puertas","doi":"10.1055/s-0046-1824521","DOIUrl":"10.1055/s-0046-1824521","url":null,"abstract":"<p><p>Lumbar disc herniation is one of the main causes of root pain and disability in the adult population, with a significant impact on the healthcare system and labor productivity. Initial management is predominantly conservative, but a portion of patients may evolve with refractory symptoms or progressive neurological deficit, requiring surgical intervention. Over the past few decades, minimally invasive techniques, such as endoscopic surgery, have revolutionized treatment with less tissue damage, accelerated recovery, and lower complication rates. This article reviews the evolution of surgical techniques, highlighting comparative evidence among them and the emerging role of new technologies.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824521"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114413","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":"[Lumbar Disc Herniation: What's New in Surgical Treatment].","authors":"Fábio Antônio Vieira, Breno Augusto Giese Ribeiro, Renato Hiroshi Salvioni Ueta, Eduardo Barros Puertas","doi":"10.1055/s-0046-1824522","DOIUrl":"10.1055/s-0046-1824522","url":null,"abstract":"<p><p>Lumbar disc herniation is one of the main causes of root pain and disability in the adult population, with a significant impact on the healthcare system and labor productivity. Initial management is predominantly conservative, but a portion of patients may evolve with refractory symptoms or progressive neurological deficit, requiring surgical intervention. Over the past few decades, minimally invasive techniques, such as endoscopic surgery, have revolutionized treatment with less tissue damage, accelerated recovery, and lower complication rates. This article reviews the evolution of surgical techniques, highlighting comparative evidence among them and the emerging role of new technologies.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824522"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114017","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":"Combined Intramedullary-External K-Wire Fixation for Phalangeal Fractures: Description of a Surgical Technique.","authors":"Gabriel Ifran Alves, Antônio Lourenço Severo, Marcelo Barretos de Lemos, Osvandré Lech, Felipe Kowaleski, Ivânio Tagliari","doi":"10.1055/s-0046-1824571","DOIUrl":"10.1055/s-0046-1824571","url":null,"abstract":"<p><p>Although early mobilization is essential for functional recovery after phalangeal fractures, many fixation methods still require prolonged immobilization, increasing the risk of joint stiffness. We herein describe a simple, safe, and low-cost technique that combines intramedullary Kirschner wires (K-wires) with external connection, adapted from the Ulson method, which was originally developed for distal radius fractures. The procedure consists of closed reduction under fluoroscopy followed by the insertion of two 1.0-mm intramedullary wires. The external ends of these wires are bent and connected, forming a stable frame that enables immediate mobilization without the need for immobilization. The technique provided stable fixation, reliable bone healing, and early rehabilitation, with a low complication rate. It represents a practical and reproducible option, especially useful in resource-limited settings.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824571"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128572","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":"Femoral Stem Subsidence in Total Hip Arthroplasty: Comparison between Fixation Principles.","authors":"André N B M de Macedo, Lourenço P Peixoto, João A M Guimarães, Conrado T Laett","doi":"10.1055/s-0046-1825542","DOIUrl":"10.1055/s-0046-1825542","url":null,"abstract":"<p><strong>Objective: </strong>To compare the magnitude of subsidence between single- (SW) and double-wedge (DW) femoral stems in primary total hip arthroplasties (THAs), and to identify factors associated with clinically relevant subsidence.</p><p><strong>Methods: </strong>Retrospective cohort study with 82 patients (164 hips) undergoing bilateral THA between 2012 and 2022, each receiving type-I (Corail) and -II (Summit) stems, both manufactured by DePuy Synthes. Subsidence was measured radiographically up to 6 months postoperatively and was considered clinically relevant when greater than 3 mm. Radiographic variables included cortical enlargement index (CEI) and canal fill rate (CFR). Statistical analyses included paired t-test, logistic regression, and Spearman correlation.</p><p><strong>Results: </strong>The mean subsidence was 1.93 ± 1.16 mm in type-I stems and 2.23 ± 1.57 mm in type-II ( <i>p</i>  = 0.181). Clinically relevant subsidence occurred in 18.2% of type-I stems and 31.7% of type-II (OR = 2.07; <i>p</i>  = 0.050). Greater subsidence was observed in the first surgery in bilateral arthroplasties ( <i>p</i>  = 0.006). There was no significant correlation between subsidence, age, body mass index (BMI), CEI, or CFR.</p><p><strong>Conclusion: </strong>The DW stems were associated with a higher risk of clinically relevant subsidence. In bilateral THA, subsidence is more pronounced at first surgery, with no detectable influence of demographic or radiographic factors.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461825542"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114249","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":"[Predictive Model for Complications in Total Hip Arthroplasty: Development of a Clinical Tool].","authors":"Andrea Moreira Candido, Conrado Torres Laett, Alanna Martins Soares de Palma, Lourenço Pinto Peixoto, Sidnei Cavalcante da Silva","doi":"10.1055/s-0046-1824727","DOIUrl":"10.1055/s-0046-1824727","url":null,"abstract":"<p><strong>Objective: </strong>To develop a predictive model to estimate complications up to 30 days after total hip arthroplasty (THA), based on clinical and functional variables, aiming at the creation of a practical tool for clinical use.</p><p><strong>Methods: </strong>Prospective cohort study conducted in a public referral hospital, with patients undergoing primary and elective THA between November 2021 and April 2022. The sample included 122 patients (mean age: 56 years, 59.8% men). Clinical, sociodemographic, and functional capacity variables were evaluated and estimated by the Duke Activity Status Index (DASI). Outcomes included clinical complications, early readmission, prolonged hospitalization (> 6 days), and ICU stay for more than one day. A logistic regression model was used, with performance evaluated by the C-statistic (AUC), and the model was incorporated into an online tool.</p><p><strong>Results: </strong>The most prevalent comorbidities were hypertension (61%), diabetes (23%), and dyslipidemia (15%). Complications within 30 days occurred in 13.1% of patients, with surgical wound infection and anemia being the most common events. Dyslipidemia (OR: 4.70; <i>p</i>  = 0.010), sedentary lifestyle (OR: 4.71; <i>p</i>  = 0.026), high ASA classification (OR: 3.67; <i>p</i>  = 0.035), and functional capacity < 4 metabolic equivalents of task (METs) (OR: 4.08; <i>p</i>  = 0.040) were significant risk factors. The tool is available at https://upneuro.shinyapps.io/atq-pred .</p><p><strong>Conclusion: </strong>Dyslipidemia, sedentary lifestyle, low functional capacity, and high ASA classification were associated with a higher risk of post-THA complications. The preoperative evaluation should include functional and cardiovascular aspects. The model showed good accuracy, and further studies are needed to validate its clinical application.</p><p><strong>Level ii – moderate level evidence: </strong>This is a prospective cohort study without a control group aimed at identifying prognostic factors for complications after total hip arthroplasty.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824727"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114051","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":"[Combined Intramedullary-External K-Wire Fixation for Phalangeal Fractures: Description of a Surgical Technique].","authors":"Gabriel Ifran Alves, Antônio Lourenço Severo, Marcelo Barretos de Lemos, Osvandré Lech, Felipe Kowaleski, Ivânio Tagliari","doi":"10.1055/s-0046-1824572","DOIUrl":"10.1055/s-0046-1824572","url":null,"abstract":"<p><p>Although early mobilization is essential for functional recovery after phalangeal fractures, many fixation methods still require prolonged immobilization, increasing the risk of joint stiffness. We herein describe a simple, safe, and low-cost technique that combines intramedullary Kirschner wires (K-wires) with external connection, adapted from the Ulson method, which was originally developed for distal radius fractures. The procedure consists of closed reduction under fluoroscopy followed by the insertion of two 1.0-mm intramedullary wires. The external ends of these wires are bent and connected, forming a stable frame that enables immediate mobilization without the need for immobilization. The technique provided stable fixation, reliable bone healing, and early rehabilitation, with a low complication rate. It represents a practical and reproducible option, especially useful in resource-limited settings.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824572"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113902","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":"[Femoral Stem Subsidence in Total Hip Arthroplasty: Comparison between Fixation Principles].","authors":"André N B M de Macedo, Lourenço P Peixoto, João A M Guimarães, Conrado T Laett","doi":"10.1055/s-0046-1825543","DOIUrl":"10.1055/s-0046-1825543","url":null,"abstract":"<p><strong>Objective: </strong>To compare the magnitude of subsidence between single- (SW) and double-wedge (DW) femoral stems in primary total hip arthroplasties (THA), and to identify factors associated with clinically relevant subsidence.</p><p><strong>Methods: </strong>Retrospective cohort study with 82 patients (164 hips) undergoing bilateral THA between 2012 and 2022, each receiving type I (Corail) and type II (Summit) stems. Subsidence was measured radiographically up to 6 months postoperatively and was considered clinically relevant when greater than 3 mm. Radiographic variables included cortical enlargement index (CEI) and canal fill rate (CFR). Statistical analyses included paired t-test, logistic regression, and Spearman correlation.</p><p><strong>Results: </strong>The mean subsidence was 1.93 ± 1.16 mm in type I stems and 2.23 ± 1.57 mm in type II ( <i>p</i>  = 0.181). Clinically relevant subsidence occurred in 18.2% of type I stems and 31.7% of type II (OR = 2.07; <i>p</i>  = 0.050). Greater subsidence was observed in the first surgery in bilateral arthroplasties ( <i>p</i>  = 0.006). There was no significant correlation between subsidence, age, body mass index (BMI), CEI, or CFR.</p><p><strong>Conclusion: </strong>The double-wedge stems were associated with a higher risk of clinically relevant subsidence. In bilateral THA, subsidence is more pronounced at first surgery, with no detectable influence of demographic or radiographic factors.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461825543"},"PeriodicalIF":0.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113821","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":"Is It Necessary to Use Cement Augmentation in Internal Fixation for Trochanteric Fractures in the Elderly? A Systematic Review and Meta-Analysis.","authors":"Adhe Sugandhi, Ni Kadek Saras Dwi Guna, Grace Yulia Alphani Yapson, I Putu Divanaya Suryanov, I Gusti Ngurah Paramartha Wijaya Putra","doi":"10.1055/s-0046-1824532","DOIUrl":"https://doi.org/10.1055/s-0046-1824532","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of cement augmentation in internal fixation of trochanteric fractures in the elderly.</p><p><strong>Methods: </strong>A comprehensive search of the MEDLINE, SpringerLink, CENTRAL, and Scopus databases was conducted up to February 2025 for randomized clinical trials (RCTs) comparing internal fixation with and without cement augmentation. The review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Random-effects models were used to pool effect estimates. The primary outcomes were fixation failure and tip-apex distance (TAD). The secondary outcomes included mortality, reoperation rate, length of hospital stay, blood loss, and operative time. The risk of bias was assessed with the revised version of the Cochrane Risk of Bias tool (RoB 2.0; Cochrane Collaboration), and evidence certainty, with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Five RCTs comprising 509 patients were included. Cement augmentation did not significantly reduce fixation failure (relative risk [RR] = 1.13; 95%CI: 0.20-6.43) but significantly improved the TAD (mean difference [MD] = -2.11 mm; 95%CI: -3.13 to -1.09; <i>p</i>  < 0.0001). There were no significant effects on mortality (RR = 1.10; 95%CI: 0.54-2.22) or reoperation (RR = 0.12; 95%CI: 0.01-2.09). Cement augmentation shortened the hospital stay by 2.5 days (MD = -2.59; 95%CI: -6.87 to 1.69), but it increased blood loss (MD = 49.01; 95%CI: -61.78 to 159.8) and operative time by 11 minutes (MD = 11.8; 95%CI: 5.91-17.69).</p><p><strong>Conclusions: </strong>Cement augmentation improves fixation quality and reduces hospitalization in elderly patients with trochanteric fractures, but it increases blood loss and operative time. Its use should be individualized based on patient risk profiles.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824532"},"PeriodicalIF":0.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765188","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":"[Is It Necessary to Use Cement Augmentation in Internal Fixation for Trochanteric Fractures in the Elderly? A Systematic Review and Meta-Analysis].","authors":"Adhe Sugandhi, Ni Kadek Saras Dwi Guna, Grace Yulia Alphani Yapson, I Putu Divanaya Suryanov, I Gusti Ngurah Paramartha Wijaya Putra","doi":"10.1055/s-0046-1824549","DOIUrl":"https://doi.org/10.1055/s-0046-1824549","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy of cement augmentation in internal fixation of trochanteric fractures in the elderly.</p><p><strong>Methods: </strong>A comprehensive search of the MEDLINE, SpringerLink, CENTRAL, and Scopus databases was conducted up to February 2025 for randomized clinical trials (RCTs) comparing internal fixation with and without cement augmentation. The review adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Random-effects models were used to pool effect estimates. The primary outcomes were fixation failure and tip-apex distance (TAD). The secondary outcomes included mortality, reoperation rate, length of hospital stay, blood loss, and operative time. The risk of bias was assessed with the revised version of the Cochrane Risk of Bias tool (RoB 2.0; Cochrane Collaboration), and evidence certainty, with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.</p><p><strong>Results: </strong>Five RCTs comprising 509 patients were included. Cement augmentation did not significantly reduce fixation failure (relative risk [RR] = 1.13; 95%CI: 0.20-6.43) but significantly improved the TAD (mean difference [MD] = -2.11 mm; 95%CI: -3.13 to -1.09; <i>p</i>  < 0.0001). There were no significant effects on mortality (RR = 1.10; 95%CI: 0.54-2.22) or reoperation (RR = 0.12; 95%CI: 0.01-2.09). Cement augmentation shortened the hospital stay by 2.5 days (MD = -2.59; 95%CI: -6.87 to 1.69), but it increased blood loss (MD = 49.01; 95%CI: -61.78 to 159.8) and operative time by 11 minutes (MD = 11.8; 95%CI: 5.91-17.69).</p><p><strong>Conclusions: </strong>Cement augmentation improves fixation quality and reduces hospitalization in elderly patients with trochanteric fractures, but it increases blood loss and operative time. Its use should be individualized based on patient risk profiles.</p>","PeriodicalId":21536,"journal":{"name":"Revista Brasileira de Ortopedia","volume":"61 3","pages":"s00461824549"},"PeriodicalIF":0.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760249","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}