The Journal of Hip Surgery最新文献

{"title":"Hip Resurfacing is Associated with Significantly Shorter Length of Stay and Increased Postoperative Mobilization than Total Hip Arthroplasty","authors":"Akram A. Habibi, David N. Kugelman, Thomas Bieganowski, W. Macaulay, R. Schwarzkopf, S. Marwin","doi":"10.1055/s-0043-1769083","DOIUrl":"https://doi.org/10.1055/s-0043-1769083","url":null,"abstract":"Abstract Metal-on-metal hip resurfacing (HRA) is performed as an alternative for total hip arthroplasty (THA) for symptomatic hip osteoarthritis in young, active male patients. This article seeks to determine if there is a difference in postoperative pain, mobilization, and opioid consumption between HRA and THA. A single-institution total joint arthroplasty database was utilized to identify adult patients who underwent elective HRA or THA between 2016 and 2019. Baseline demographic data along with operative time and Charlson Comorbidity Index (CCI) were collected. Patients were matched by age, sex, race, smoking status, body mass index (BMI), and CCI. Morphine milligram equivalents (MME) and visual analog scale scores were collected. Activity Measure for Post-Acute Care (AM-PAC) was used to determine physical therapy progress. A total of 7,387 cases were identified: 96.59% THA (7,135) and 3.41% HRA (252). HRA patients were significantly younger (52.52 vs. 64.04 years; p  < 0.001), had higher BMI (30.03 vs. 29.40; p  = 0.029), and were almost exclusively male as compared with the THA cohort (98.8% vs. 42.2%; p  < 0.001). HRA patients had lower CCI scores (0.36 vs. 1.14; p  < 0.001). Surgical time was greater for HRA (124.81 vs. 103.82 minutes; p  < 0.001). HRA patients had significantly shorter length of stay (LOS) than THA patients (1.17 vs. 1.48 days; p  < 0.001) and had significantly better AM-PAC scores (21.52 vs. 20.65; p  = 0.032). HRA patients exhibited a trend toward home discharge (0.4% vs. 2.4%; p  = 0.057). Aggregate opioid consumption (23.63 vs. 27.89 MME; p  = 0.321) and pain scores (3.47 vs. 3.28; p  = 0.438) were not different between matched cohorts. HRA patients are younger, almost exclusively male, and have lower CCI scores at time of surgery. HRA is associated with significantly shorter LOS and greater mobilization measures. They tended to have a higher rate of home discharge. Both groups had similar pain scores and opioid consumption. Level III  Retrospective Cohort Study.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"07 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128804078","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":"Decreasing Patient Radiation Exposure from Computed Tomography for Hip Preservation Surgery","authors":"J. Marland, Jason J. Smythe, Daniel Barlow, Daniel Whiting, Brayden Payne, Hugh S. West, J. Wylie","doi":"10.1055/s-0043-1769086","DOIUrl":"https://doi.org/10.1055/s-0043-1769086","url":null,"abstract":"Abstract This article describes how we were able to decrease patient radiation exposure from hip computed tomography (CT) for hip preservation evaluation without a degradation of image quality. This is a retrospective review of a quality improvement project. The study included patients who underwent hip CT at a single center as part of a clinical evaluation for young adult hip pain. Four distinct protocols were used during the study period. All protocols included at CT scan of the hip with slices through the distal femur to evaluate femoral version. Patient variables collected included age, gender, and body mass index (BMI). The dose–length product was collected and the effective dose in millisieverts (mSv) was calculated. Differences in dose between protocols were compared using analysis of variance with appropriate post hoc tests and multivariate general linear regression. A total of 613 patients underwent hip CT during the study period with 304 patients in protocol 1, 83 in protocol 2, 136 in protocol 3, and 91 in protocol 4. When controlling for age, gender, and BMI there was a significant decrease in effective dose of radiation from protocol 1 (3.63 mSv) to protocol 2 (3.06 mSv) ( p  = 0.002) and protocol 2 (3.06 mSv) to protocol 3 (2.16 mSv) ( p  < 0.001). There was no difference between protocol 3 (2.16 mSv) and protocol 4 (2.10 mSv) ( p  = 0.269) but protocol 4 was easier to administer. In regression modeling, BMI ( p  < 0.001) and protocol used ( p  < 0.001) were independent predictors of effective radiation dose (model R 2  = 0.585). Through a longitudinal clinical quality improvement project, we were able to decrease the effective radiation exposure to patients undergoing hip CT for hip preservation evaluation by close to 50%. Only CT protocol used and patient's BMI were predictors of ionizing radiation exposure. Level of Evidence  Level 3, retrospective comparative study.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126379810","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":"Resection of Femoral Head–Neck Junction Osteoid Osteoma via Minimally Invasive Direct Anterior Approach: A Case Series and Review of Literature","authors":"S. Mortazavi, A. Moharrami, M. Razzaghof, M. Kaseb, H. Shafiei, M. Ghasemi, Seyed Mir Mansoor Moazen Jamshidi","doi":"10.1055/s-0042-1750051","DOIUrl":"https://doi.org/10.1055/s-0042-1750051","url":null,"abstract":"Our aim was to introduce a new minimally invasive approach for surgical excision of femoral head–neck junction osteoid osteoma (FHNJOO) and review the available literature regarding its clinical manifestations and treatment methods. We included nine patients with FHNJOO in this series, who underwent resection via the minimally invasive direct anterior approach (DAA), from January 2010 to 2013. The functional outcomes were hip range of motion (ROM), visual analogue scale for pain (VAS), and Harris hip score (HHS), which were assessed pre- and postoperatively at 3 months at the last follow-up. We had nine patients with a mean age of 17.25 ± 6.75 years. The mean diagnosis delay was 23.56 ± 4.67 months. We had a mean follow-up of 93.67 ± 18.02 months. The hip ROM, VAS, and HHS were significantly improved from 97.78 ± 8.70 degrees to 121.11 ± 4.86 degrees, 63.93 ± 10.47 to 99.11 ± 1.76 degrees, and 7.3 ± 1.5 to 0.1 ± 0.3 degrees at 3-month and the last follow-up, respectively (p < 0.001). We observed no recurrence or complications. The minimally invasive DAA approach for surgical resection of FHNJOO can provide immediate pain relief and improve hip functional scores with no complication or recurrence on long-term follow-up. It provides easy and complete access to the lesion and causes no morbidity due to minimal dissection.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"171 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120971858","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":"Lateral Femoral Cutaneous Nerve Injury Using an Anterior-Based Muscle-Sparing Approach to the Hip: A Clinical and Cadaveric Analysis with Review of Literature","authors":"A. Zuskov, Michael E. Seem, D. Pollock, Maxwell K. Langfitt, T. D. Luo, J. Plate","doi":"10.1055/s-0042-1756274","DOIUrl":"https://doi.org/10.1055/s-0042-1756274","url":null,"abstract":"The alternative anterior hip approach between the tensor fascia lata and gluteus medius (the modified Watson-Jones approach, Röttinger approach, anterior-based muscle-sparing [ABMS] approach, and ABLE approach) may decrease the risk of lateral femoral cutaneous nerve (LFCN) palsy. A retrospective case study, systematic literature review, and cadaveric study were performed to assess the risk for LFCN palsy with the ABMS compared with the direct anterior (DA) approach. Consecutive patients who underwent total hip arthroplasty (THA) using ABMS were identified and assessed for LFCN palsy. A systematic review of LFCN injury with ABMS and DA approaches was conducted. In four fresh cadavers (eight hips), ABMS and DA approaches were performed and the LFCN identified. The proximity of the LFCN to the fascial incision was measured and compared between ABMS and DA approaches. In 64 consecutive ABMS THA (mean age: 57.3 ± 13.5 years, 42% female, mean body mass index: 30.2 ± 5.3 kg/m2), two hips (3.2%) had an LFCN palsy. In combination with the systematic literature review, the risk of LFCN palsy was less with ABMS (0.3%, 7/2,609 hips) compared with DA (3.1%, 638/20,402 hips, p < 0.001). In eight cadaveric hip dissections, the LFCN was significantly further away from the ABMS fascial incision (mean: 67.6 ± 9.1 mm), compared with the fascial incision of the DA approach (mean: 18.5 ± 3.5 mm, p < 0.0001). The risk of LFCN palsy was found to be 10-fold greater with the DA approach compared with the ABMS approached in this combined retrospective case series and systematic literature review. The anatomic location of the ABMS fascial incision was significantly farther from the LFCN, contributing to the decreased risk of LFCN injury.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127531038","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":"NLR as a Prognostic Tool in Orthopaedic Surgery in Elderly Extra-Articular Hip Fracture: A Significant Increase in NLR 24 Hours after Surgical Intervention","authors":"L. Tomaino, Simone Pansieri, L. Vigna, C. la Vecchia, L. Da Lio, Gianluca Moroncini, A. Gigante","doi":"10.1055/s-0042-1756278","DOIUrl":"https://doi.org/10.1055/s-0042-1756278","url":null,"abstract":"Neutrophil-to-lymphocyte ratio (NLR) was developed as a diagnostic and prognostic tool in many medical conditions, and its use is spreading as a predictor of postoperative outcome in orthopaedic surgery. The aim of this study is to investigate the improvement of NLR 24 hours after surgical intervention in a cohort of 91 patients (F/M = 68/23) with hip fracture who underwent femur intramedullary fixation. Patients were 84.7 ± 7.9 years old, and the mean hospital stay was 13.4 ± 4.7 days, with a mean delay to surgery of 1.9 ± 1.4 days. A significant increase in NLR between baseline (T0) and 24 hours after surgical intervention (T1) was observed in the study sample overall and on subgroup analysis by gender. Nevertheless, no significant effect of NLR on the length of hospital stay was observed.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127273116","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":"Increased Postoperative Pseudosubluxation after Total Hip Arthroplasty: A Complication Accelerated by the COVID-19 Pandemic","authors":"Daniel C. Sun, J. Bono","doi":"10.1055/s-0042-1756273","DOIUrl":"https://doi.org/10.1055/s-0042-1756273","url":null,"abstract":"The severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019) has accelerated the utilization of spinal anesthesia for total hip arthroplasty. Subsequently, an increase in postoperative prosthetic subluxation has been noted at our institution. We report on our experience with this complication in six patients. We also reviewed the literature for similar cases and potential risk factors. This complication may be treated by either closed reduction or watchful waiting. However, no modifications to postoperative protocols are necessary.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130264768","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":"Work Relative Value Units for Total Hip Replacement Performed for Osteoarthritis Compared to Fracture","authors":"Theodore Quan, M. Best, S. Nayar, R. Kreulen, J. Manzi, U. Srikumaran, S. Thakkar","doi":"10.1055/s-0042-1756276","DOIUrl":"https://doi.org/10.1055/s-0042-1756276","url":null,"abstract":"Total hip arthroplasty (THA) performed in the setting of fracture is associated with greater case complexity, worse outcomes, and increased costs when compared with THA performed for osteoarthritis. Despite the increased complexity, the work relative value units (wRVUs) assigned to THA may not adequately compensate for this difference in surgical effort and time. The purpose of this study was to determine the wRVU per minute rates and reimbursement in dollars per minute for THA performed for fracture compared with THA performed for osteoarthritis. Data were collected through the National Surgical Quality Improvement Program database from 2006 to 2018 to identify all patients who underwent primary THA for osteoarthritis or for fractures. Total wRVU, operation time, wRVU per minute, and dollars per minute were assessed between the osteoarthritis and fracture cohorts. Bivariate and multivariate analyses were utilized for the study. The mean operation times for primary THA for osteoarthritis and for fractures were 91.96 and 99.43 minutes, respectively (p < 0.001), resulting in 0.26 versus 0.25 wRVU/min (p < 0.001). THA for osteoarthritis was also valued higher at $9.22/min versus $8.83/min for fracture (p < 0.001). This study shows that wRVU rates and reimbursement in dollars per minute for THA performed in the setting of fracture were lower than THA performed for osteoarthritis. Although patient care remains the number one priority, these findings have important implications in establishing adequate compensation for more complex cases. Level of evidence is III.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129222139","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":"Midterm Outcomes of a Monoblock Dual-Mobility Cup Cemented into a Fully Porous Acetabular Component in Revision Total Hip Arthroplasty","authors":"Nishanth Muthusamy, I. Shichman, C. Sicat, S. Marwin, M. Meftah, R. Schwarzkopf","doi":"10.1055/s-0042-1756277","DOIUrl":"https://doi.org/10.1055/s-0042-1756277","url":null,"abstract":"Utilization of dual-mobility (DM) constructs has been a promising management option to address the risk of hip instability after complex revision total hip arthroplasty (rTHA). The aim of this study is to report a minimum 2-year outcome and survivorship of a monoblock DM cup cemented in a fully porous acetabular shell in complex acetabular rTHA cases. A retrospective review of 76 patients who underwent rTHA with a novel construct that utilized an inner DM cup cemented into a fully porous outer acetabular metal shell was conducted. Demographics, radiographic, and clinical outcomes such as readmissions, dislocation, and revisions were collected. Survivorship was analyzed by the Kaplan–Meier (KM) method. Thirty cases with a minimum of 2-year follow-up were included. Patients were, on average, 65.17 ± 10.26 years old with a mean body mass index of 28.55 ± 6.33 kg/m2. Seven patients (23.3%) required reoperations. Four patients underwent acetabular revision (periprosthetic joint infection: n = 2 [6.7%]; dislocation: n = 1 [3.3%]; aseptic loosening [fully porous cup]: n = 1[3.3%]). Three patients underwent reoperation without acetabular implant revision (debridement, antibiotics, and implant retention for prosthetic joint infection: n = 2 [6.7%]; femoral periprosthetic fracture: n = 1 [3.3%]). KM survivorship analysis of all-cause acetabular revision showed survival rates of 96.7% at 6 months, 93.3% at 1 year, and 89.7% at 2 years. KM survivorship of aseptic acetabular revision showed rates of 96.7% at 1 year and 92.9% at 2 years. KM analysis of acetabular cup fixation showed rates of 100% at 1 year and 96.2% at 2 years. The rate of dislocation in our cohort was 3.3% (1 out of 30). The use of a DM acetabular cup cemented into a fully porous acetabular revision shell in complex rTHA cases has a low risk of instability and loosening at 2 years with excellent mid-term implant survivorship. The use of this construct is a good option in patients with complex acetabular reconstruction and an elevated risk for instability. This was a retrospective cohort study with a level III evidence.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"256 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122072991","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":"Incidental Findings in Low-Dose Full-Body Imaging Taken for Total Hip and Knee Arthroplasty","authors":"Katherine A. Lygrisse, Nishanth Muthusamy, Jerry Arraut, Vivek Singh, M. Meftah, Dana J. Lin, R. Schwarzkopf","doi":"10.1055/s-0042-1756280","DOIUrl":"https://doi.org/10.1055/s-0042-1756280","url":null,"abstract":"Detection of incidental findings (IFs) in preoperative imaging for total joint arthroplasty (TJA) patients may lead to additional testing, cost, and surgical delay. The purpose of this study is to identify the incidence and clinical significance of IFs on preoperative low-dose full-body imaging (LFI) in the total joint population. Furthermore, we aim to determine whether these findings lead to additional imaging, delay, or cancelation in TJA cases. A retrospective review of 2,183 patients planned for total hip arthroplasty or total knee arthroplasty, who had preoperative LFI imaging obtained from 2013 to 2020 was conducted. LFI radiographic reports were reviewed to identify any flagged radiographs. Flagged IFs were divided into thoracic, spinal, lower limb, and abdominal IFs. Charts were reviewed to identify if any additional imaging was completed, the case was delayed or canceled, or a new pathology requiring continued follow-up or treatment was discovered. Of the 2,183 LFI images taken prior to TJA, 41 cases qualified as having IF (1.9%, 41/2,183), 18 thoracic, 11 spinal, 11 lower limb, and 1 abdominal. Overall, 15 (0.7%, 15/2,183) IF cases were clinically determined to require at least one additional form of imaging. Two had a significant finding; a schwannoma near the distal femoral shaft and a squamous cell carcinoma of the lung. Three TJA cases were delayed, and no cases were cancelled due to the IFs. The possible increase in IF detection by preoperative LFI does not greatly impact TJA case completion. Though rare, providers should pay close attention as clinically significant IFs can be discovered and lead to early treatment. This was a retrospective cohort study with level III evidence.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"142 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116542171","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":"Mid-Term Outcomes of Modular Dual Mobility Bearings in Total Hip Arthroplasty","authors":"Jerry Arraut, S. Ward, Christian T. Oakley, R. Schwarzkopf, W. Macaulay","doi":"10.1055/s-0043-1771248","DOIUrl":"https://doi.org/10.1055/s-0043-1771248","url":null,"abstract":"Abstract Modular dual mobility (MDM) prostheses in which a cobalt–chromium liner is inserted into a titanium acetabular shell have the potential for corrosion. This has raised concern. While these constructs have been shown to effectively reduce the risk of dislocation in revision and high-risk primary total hip arthroplasty (THA), previous studies have been limited by the length of follow-up. The purpose of the study is to review the mid-term clinical outcomes of MDM implants with a minimum of 5-year follow-up. A retrospective, observational study was conducted on all consecutive patients who underwent THA with a MDM implant from June 2011 and March 2017 at an urban, tertiary academic medical center. Descriptive statistics were used to describe baseline patient characteristics. Primary endpoints included revision rates, dislocations rates, and implant component survivorship. Implant survival was analyzed using the Kaplan–Meier method. A total of 92 cases (61 primary, 31 revision) underwent THA with a MDM implant at an average follow-up of 6.90 ± 1.48 years (range: 5.01–10.53 years). The mean patient age at the time of surgery was 58.20 ± 11.85 years. Six patients were revised (6.5%, 6/92), two for periprosthetic joint infection (2.2%, 2/92), one due to aseptic loosening (1.1%, 1/92), one due to periprosthetic fracture (1.1%, 1/92), and the remaining two for metallosis (2.2%, 2/92). Kaplan–Meier survivorship analysis showed a 93.5% survival rate for all-cause revisions and 98.9% survival for acetabular component revision. MDM components reliably decrease the risk of dislocation after THA. However, the occurrence of two revisions due to metallosis demonstrates the necessity for continued surveillance in this cohort. Larger trials with long-term follow-up may be required to further elucidate the long-term outcomes and performance of these bearings.","PeriodicalId":427844,"journal":{"name":"The Journal of Hip Surgery","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123309558","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}