Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"Factores de riesgo para complicaciones en artroplastia total de cadera","authors":"L.A. Hoyos-Velasco ,&nbsp;J.C. Palacio ,&nbsp;W.P. Stangl ,&nbsp;C.L. Chacón-Castillo ,&nbsp;V. Palacio-Aragón ,&nbsp;J.P. Pulgarín","doi":"10.1016/j.recot.2024.06.006","DOIUrl":"10.1016/j.recot.2024.06.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Hip arthroplasty represents a significant advancement in the treatment of refractory chronic joint pain, improving quality of life and functionality. The objective of this study is to identify the risk factors associated with local and systemic complications in patients treated with total hip arthroplasty.</div></div><div><h3>Methods</h3><div>Observational, analytical, retrospective cohort study, which included 304 participants treated with total hip replacement. Comparison of variables between two groups was performed; 38 participants in the group with complications and 266 participants in the group without complications.</div></div><div><h3>Results</h3><div>The mean age in the complication group was 66 years (SD 18.7) and in the uncomplicated group it was 67,1 years (SD 15.1) (p 0,686). Female sex was observed in 73.3% of the group with complications and 65% in the group without complications. (p 0.292). Risk factors were: hip fracture as an indication for arthroplasty RR 1.33 [95% CI 1.004;1.775 p 0.047], coronary heart disease RR 1.31 [95% CI 1.067;1.616 p 0.010] and surgical bleeding equal to or greater than 400 cc RR 1.11 [95% CI 1.012;1.218 p 0.028].</div></div><div><h3>Conclusions</h3><div>The risk factors for complications in total hip arthroplasty were: hip fracture as the indication for arthroplasty, coronary artery disease, and surgical bleeding equal to or greater than 400 cc.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages 239-246"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332126","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":"[Artículo traducido] La fibroartrólisis artroscópica y movilización bajo anestesia es un método simple, reproducible y satisfactorio para el tratamiento de pacientes con artrofibrosis postraumática severa de la rodilla","authors":"N. Franulic ,&nbsp;J. Laso ,&nbsp;C. del Pino ,&nbsp;C. Brito ,&nbsp;R. Olivieri ,&nbsp;N. Gaggero","doi":"10.1016/j.recot.2025.02.009","DOIUrl":"10.1016/j.recot.2025.02.009","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the range of motion (ROM) of the knee in patients with severe post-traumatic knee arthrofibrosis after being treated with arthroscopic fibroarthrolysis (AFA) and manipulation under anesthesia (MUA).</div></div><div><h3>Methods</h3><div>Case series of patients with severe post-traumatic knee arthrofibrosis who underwent AFL<!--> <!-->+<!--> <!-->MUA in a national referral center. The primary outcome to be assessed was ROM before and after surgery and then at 3-month intervals until a minimum follow-up of one year was completed.</div></div><div><h3>Results</h3><div>51 patients were included. The main injuries preceding the stiffness were tibial plateau fracture (37.3%), distal femur fracture (27.5%), and femoral shaft fracture (15.7%). Forty-five patients had severe flexion deficits with a median preoperative flexion of 70°. Intraoperative flexion significantly improved to 110°. Significant loss of flexion was observed at 3 and 6 months, however, patients regained ROM in the 9 and 12-month follow-ups. At discharge, 80% of the patients achieved flexion of 90° or more. There were 4 intraoperative complications and 3 reinterventions were performed.</div></div><div><h3>Conclusion</h3><div>AFA<!--> <!-->+<!--> <!-->MUA can help patients with severe post-traumatic knee arthrofibrosis to recover ROM in most cases. However, this procedure is not without risks and complications, therefore, careful consideration should be given to its indication and execution.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages T247-T253"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469536","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":"[Artículo traducido] Evaluación funcional después de la fijación con botón cortical para roturas del bíceps distal: ¿existe alguna diferencia entre trabajadores manuales y no manuales?","authors":"A. Batista ,&nbsp;N. Moura ,&nbsp;M. Sarmento ,&nbsp;T. Coelho ,&nbsp;D. Gomes ,&nbsp;R. Ramos ,&nbsp;A. Cartucho","doi":"10.1016/j.recot.2025.02.012","DOIUrl":"10.1016/j.recot.2025.02.012","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to compare clinical and functional results after distal biceps tendon repair in manual workers vs. non-manual workers.</div></div><div><h3>Methods</h3><div>This is a retrospective comparative study which refers to 57 cases with distal biceps tendon rupture, divided in manual workers (24 elbows) and non-manual workers (33), that were treated by a single incision with cortical button and interference screw fixation. Included cases have a minimum of 3 months follow-up, post-operative X-ray and signed informed consent for the investigation.</div></div><div><h3>Results</h3><div>Supination and flexion strength was higher in manual workers vs. non-manual workers (<em>p</em>-value<!--> <!-->=<!--> <!-->0.192 and 0.878, respectively). Nine patients showed loss of range of motion, concerning supination and pronation, and this was correlated to worse functional scores. Functional scores tend to be superior in non-manual workers. Ten patients had heterotopic ossification and 20 patients reported lateral antebrachial cutaneous nerve neuropraxia; one had both. Most of them had a full recovery.</div></div><div><h3>Conclusion</h3><div>According to clinical evaluation and post-operative scores, the performed surgical procedure provides good to excellent mid-term functional results. Nevertheless, there were not any differences between manual or non-manual workers.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages T274-T279"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469541","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":"Ciencia abierta. ¿Negocio u oportunidad?","authors":"E. Guerado Parra","doi":"10.1016/j.recot.2025.03.010","DOIUrl":"10.1016/j.recot.2025.03.010","url":null,"abstract":"","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages 225-227"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923732","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":"[Translated article] Concurrent upper limb and hip fracture in the elderly: Experience at our centre","authors":"L. del Baño-Barragán ,&nbsp;Á. Martínez-García ,&nbsp;D. Garríguez-Pérez ,&nbsp;J. Mora-Fernández ,&nbsp;J. García-Coiradas ,&nbsp;J.A. Valle-Cruz ,&nbsp;F. Marco","doi":"10.1016/j.recot.2025.02.014","DOIUrl":"10.1016/j.recot.2025.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>The incidence of hip fracture in the elderly is on the rise, occasionally accompanied by concurrent upper limb fractures. Our investigation aims to determine whether these patients experience poorer functional outcomes, prolonged hospitalisation, or higher mortality rates when compared to those with isolated hip fracture.</div></div><div><h3>Material and methods</h3><div>We retrospectively reviewed 1088 elderly patients admitted to our centre with hip fracture between January 2017 and March 2020. We recorded the presence of concomitant fractures and their treatment. We analysed the duration of hospital stay, in-hospital mortality and function.</div></div><div><h3>Results</h3><div>We identified 63 patients with concomitant upper limb fracture (5.6%). Among them, 93.7% were women, and the average age was 86.4 years. 80.9% of the upper limb fractures were distal radius or proximal humerus. Patients with concomitant fracture had increased length of stay (mean, 19.6 vs. 12.8, <em>p</em> <!-->=<!--> <!-->0.002), decreased proportion of patients returning to their own home at discharge (23.6% vs. 26.3%, <em>p</em> <!-->=<!--> <!-->0.042) and increased in-hospital mortality rate (9.5% vs. 5.9%, <em>p</em> <!-->=<!--> <!-->0.003).</div></div><div><h3>Conclusions</h3><div>Patients with concomitant upper limb fracture require a longer length of stay and exhibit an elevated in-hospital mortality rate. Furthermore, this condition is associated with a reduced short-term functional recovery, thereby decreasing the chances of the patient returning home upon hospital discharge.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages T233-T238"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473304","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":"Silicone kyphoplasty (elastoplasty) versus traditional cement kyphoplasty for osteoporotic vertebral fractures. Does this new technique reduce the complications?","authors":"R. Luque,&nbsp;D. Garríguez,&nbsp;P. Checa Betegon,&nbsp;M. Sanchez,&nbsp;J.L. Perez Gonzalez,&nbsp;I. Dominguez Esteban","doi":"10.1016/j.recot.2025.02.016","DOIUrl":"10.1016/j.recot.2025.02.016","url":null,"abstract":"<div><h3>Introduction</h3><div>Stiffness is increased in vertebrae after kyphoplasty with bone cement is performed, which cause an increase in subsequent fractures in adjacent levels. This has led to increased interest in alternative filling materials such as bioactive calcium phosphate ceramics or silicon-based polymers. This study's objective is to compare the results between kyphoplasty with bone cement and with the VK100 silicone.</div></div><div><h3>Materials and methods</h3><div>This is a comparative, prospective study involving 64 patients 64 patients, 23 treated using VK100 and 41 with PMMA. Clinical, radiological and functional results (Oswestry) and quality of life and (EQ-5D) were analyzed and compared between both groups, focusing on differences in subsequent fractures in adjacent levels.</div></div><div><h3>Results</h3><div>There are no differences between the two treatments in terms of epidemiological factors (age and sex) or hospital management. A significant difference is observed in the gain of vertebral body height, with greater improvement in those treated with PMMA. There is also a higher fracture rate in the PMMA group, the difference is not significant. Finally, both treatments show similar outcomes in pain relief and quality of life.</div></div><div><h3>Conclusion</h3><div>Both VK100 elastoplasty and PMMA kyphoplasty are effective treatments for vertebral fractures. VK100 has a lower rate of complications and adjacent fractures. However, long-term results in terms of pain relief and quality of life are similar, making both treatments equally valid.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"69 3","pages":"Pages T287-T296"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473310","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":"Clinical Outcomes of Closuring Technique in Total Hip Arthroplasty and Total Knee Arthroplasty: A Comparative Study of Staples technique vs Triclosan-coated Barbed Sutures.","authors":"Benkovich Vadim, Abialevich Artsiom, Benkovich Guy","doi":"10.1016/j.recot.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>The demand for total joint arthroplasty (TJA) continues to rise due to an aging population, increased life expectancy, and expanding surgical indications. Medicare projections estimate a 176% increase in total hip arthroplasty (THA) and a 139% increase in total knee arthroplasty (TKA) by 2040, reaching 659% and 469%, respectively, by 2060.</p><p><strong>Methods: </strong>From January 2014 to October 2024, our arthroplasty database was categorized into two groups by closure method: Group 1 (with staples), Group 2 (with barbed sutures). Data included demographics, BMI, comorbidities, wound complications, hospital stay, and readmissions.</p><p><strong>Results: </strong>This retrospective study of 3,110 hip and knee arthroplasty patients with osteoarthritis found no significant differences in age (P = 0.26) or sex distribution (P = 0.778) between groups, though the second group had a higher BMI (28.43 ± 4.43 vs. 29.15 ± 3.44; P < 0.001) and a more balanced operated limb distribution (P = 0.040). Comorbidities were lower in the second group for arterial hypertension (48.48% vs. 57.63%; P < 0.001), diabetes mellitus (20.8% vs. 26.21%; P = 0.0004), and hyperlipidemia (26.8% vs. 33.28%; P < 0.001), with no significant differences in ischemic heart disease (P = 0.668), atrial fibrillation (P = 0.725), or hypothyroidism (P = 0.827). Operative time was longer in the second group (82.7 ± 7.44 vs. 78.4 ± 13.62 minutes; P < 0.001), while hospital stay was marginally shorter (23.33 ± 4.53 vs. 23.3 ± 5.16 hours; P = 0.039). Postoperative complication rates, including bleeding, wound dehiscence, falls, stitch abscess, and readmission, showed no significant differences. There was no observed incidence of deep infections (PJI) in the study cohort at all.</p><p><strong>Conclusions: </strong>The study demonstrated that there were no statistically significant differences in the frequency of wound complications between the two wound closure methods in THA and TKA surgeries, indicating comparable surgical outcomes in terms of wound healing and complication rates.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744121","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":"Gender and diabetes mellitus do not influence the outcomes of patients with proximal humeral fractures treated with a reverse shoulder arthroplasty.","authors":"Francisco Antonio Miralles Muñoz, Emilio Sebastiá Forcada, Luis Albero Catalá","doi":"10.1016/j.recot.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.008","url":null,"abstract":"<p><strong>Background and objective: </strong>Some studies have described that gender and the diabetes mellitus may impact the outcomes of reverse shoulder arthroplasty (RSA). The objective of this study was to compare the functional outcomes and survival of RSA based on the patient's gender and the presence or absence of diabetes mellitus as independent variables.</p><p><strong>Materials and methods: </strong>This retrospective study included all patients who underwent RSA for acute proximal humeral fracture with a minimum follow-up of 2 years. Two independent stratifications were conducted to assess the influence of female gender and diabetes on RSA outcomes. The primary outcome variable was the Constant score. Additionally, the quickDASH and UCLA functional scales were evaluated, as well as estimated survival using the Kaplan-Meier method.</p><p><strong>Results: </strong>The final sample comprised 131 patients. The final Constant scores were 47.0 in women and 51.8 in men (p=0.198), and 48.4 in diabetics and 45.3 in non-diabetics (p=0.347). There were also no significant differences in the secondary functional scales. The estimated 12-year survival rate was 94.4% in women and 94.7% in men (p=0.543); and 80.2% in diabetics and 97.8% in non-diabetics (p=0.141).</p><p><strong>Conclusions: </strong>In acute proximal humeral fractures treated with RSA, neither female gender nor the presence of diabetes had an impact on functional outcomes at 2 years postoperative follow-up.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744124","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":"IN VITRO ANALYSIS OF CARPAL KINEMATICS DURING VALIDATION OF A STABILIZED SCAPHOID HEMIARTHROPLASTY.","authors":"Patricia Gómez Barbero, Pau Rey Vidal, Daniel Montaner Alonso, José Luis Rodrigo Pérez","doi":"10.1016/j.recot.2025.03.009","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.009","url":null,"abstract":"<p><strong>Objective: </strong>Pseudoarthrosis and necrosis of the proximal pole of the scaphoid require complex treatment. If primary treatments fail, there are only techniques that sacrifice part of the mobility. We present the design and in vitro results of an anatomical partial prosthesis of the scaphoid bone.</p><p><strong>Material and method: </strong>The kinematics of the carpus are tested in vitro on 6 cadaveric forearms before and after prosthetic replacement, applying active loads on the main muscles. Pre- and post-intervention movements are recorded by Kinescan/IBV®, translating an angular value.</p><p><strong>Results: </strong>After prostheticization, a decrease in the movement of the capitate (-19.36º) and scaphoid (-15.46º) is recorded during flexion-extension, while that of the lunate increases (11.67º). With the radial-ulnar deviation, only the movement of the great muscle decreases (-11.78º), but that of the scaphoid (4.03º) and lunate (5.9º) increases. We find significant differences whenever there is a decrease in movement. In the \"throwing darts\" movement (DTM), the average movement decreases in flexion-extension (-18.44º) and in radial-ulnar deviation (-3.66º), without significant differences. While the descent of the scaphoid in flexion-extension and radio-ulnar deviation of the DTM will affect the kinematics (p<0.05). There is no involvement of the lunate in the DTM.Regarding the relative interosseous movement, significant differences are observed in the main axis of the F-E.</p><p><strong>Conclusions: </strong>The implantation of a stabilized partial scaphoid prosthesis does not significantly modify the movement pattern of a healthy wrist. Therefore, in the future it could be a viable alternative for the treatment of recalcitrant pathology of the carpal scaphoid.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744128","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":"Biomechanical Evaluation and Analysis of a Reused Telescopic Intramedullary Femoral Nail in a Child with Achondroplasia.","authors":"César M Posada, Roberto D'Amato, María Galán-Olleros, Carlos Miranda-Gorozarri, Ángel Palazón-Quevedo, Javier Alonso-Hernández","doi":"10.1016/j.recot.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.recot.2025.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>Telescopic intramedullary nails (CIMT) have represented a significant advancement in limb lengthening procedures. However, their elongation capacity is limited to 5 cm in the bones of patients with achondroplasia. Consequently, techniques involving CIMT reutilization have been developed. This reuse presents mechanical and safety challenges due to material fatigue and repetitive loading, which may compromise the structural integrity of the implant. This study evaluates the biomechanical performance and potential damage of a reused CIMT.</p><p><strong>Methods: </strong>An experimental analysis was conducted on a TIMN removed after two 5 cm lengthening procedures in a patient with achondroplasia. The nail was measured and assessed following non-destructive deconstruction, material analysis, 3D modeling through reverse engineering, and finite element analysis (FEM) to assess its behavior under different loading conditions.</p><p><strong>Results: </strong>Mechanical and chemical damage was identified, compromising the nail's integrity. The aged Ti6Al4V alloy was validated for its resistance to complex loads. The 3D modeling showed that the gear mechanism effectively converted rotational movement into translational motion. The FEM analysis revealed that the safety factor reached its critical limit at angles of 2.44° and 2.25°, suggesting that the nail was nearing its resistance limit. The stem and guide were identified as critical components.</p><p><strong>Conclusions: </strong>CIMT reutilization must be performed with caution due to potential material fatigue. This study provides a foundation for redesigning these implants to improve their capacity to withstand prolonged loading cycles. LEVEL OF EVIDENCE Level IV, Pre-clinical experimental study.</p>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744117","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}