Hand Therapy最新文献

{"title":"What are the barriers to upper limb splint adherence, and how is adherence measured? A systematic review.","authors":"Emma Bamford, Jamie A Mawhinney, Nick Johnson, Ian Shelton, Anna Selby, Avril Drummond","doi":"10.1177/17589983241268069","DOIUrl":"10.1177/17589983241268069","url":null,"abstract":"<p><strong>Introduction: </strong>Non-adherence to splint wearing following an upper limb traumatic injury is a significant medical issue. Optimal outcome following such injuries relies on people adhering to the prescribed splint, and a failure to do so can negatively impact outcome and increase healthcare burden and costs. This systematic review aims to compare and synthesise the evidence related to measuring adherence to wear recommendations and the barriers to splint wearing following upper limb trauma in adults.</p><p><strong>Methods: </strong>Databases (EBSCO, PubMed, EMBASE and Science Direct) were systematically searched for articles that met the pre-agreed eligibility criteria between February and May 2023. Data on study characteristics and reported outcomes relating to measuring and quantifying splint adherence and barriers to adherence were extracted.</p><p><strong>Results: </strong>A total of 16 articles were included for final review. Several methods were used to measure adherence, with no single tool used predominantly. These included patient or therapist reported data, preexisting classification systems and an electronic device. Methods used to quantify adherence was also heterogenous in nature, and a range of investigator and patient reported barriers to splint wearing were reported.</p><p><strong>Conclusion: </strong>This review demonstrates heterogeneity in both classifying and measuring splint adherence, as well as in the barriers to splint wearing reported. Moving forward, using agreed measurement and reporting practices for splint adherence will enable researchers to complete high quality trials to determine splinting outcomes, and may ultimately enable health care professionals to improve adherence and, subsequently, outcomes in clinical practice.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 4","pages":"161-174"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567836","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":"Exploring patient perception of decision-making in carpal tunnel release surgery: A systematic review and thematic synthesis of qualitative studies.","authors":"Bing Chun Lui, Christina Jerosch-Herold","doi":"10.1177/17589983241278746","DOIUrl":"10.1177/17589983241278746","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome is a common condition, but some controversies remain regarding diagnostics and the most effective treatments. As a result, patients often experience decisional conflicts, especially when considering carpal tunnel release surgery. Understanding factors that influence decision-making in surgery can help clinicians better grasp patient treatment preferences and priorities, reducing decisional conflicts, and enabling patients to make informed, value-aligned choices through shared decision-making. This qualitative evidence synthesis aims to explore patient perceptions of carpal tunnel release, examine the decision-making factors, and critically appraise and synthesise the existing evidence.</p><p><strong>Methods: </strong>A systematic search was conducted across four electronic databases (MEDLINE, EMBASE, CINAHL Ultimate, PsycINFO) from inception to August 2023, supplemented by referencing and citation searching to identify eligible qualitative studies. Thematic synthesis was adopted as synthesis methodology, involving a line-by-line coding of the primary study findings, and the development of descriptive and analytical themes. Quality appraisal was conducted using the modified Critical Appraisal Skills Programme checklist, supplemented with the COnsolidated criteria for REporting Qualitative research checklist.</p><p><strong>Results: </strong>Synthesis of six qualitative studies encompassing 66 participants generated five analytical themes: (1) Journey to normalcy, (2) Patient-centred care, (3) Work and life considerations, (4) Weighing up alternatives, and (5) Shaping the expectations, highlighting the complexity of patient decision-making in carpal tunnel release.</p><p><strong>Discussion: </strong>In the management of carpal tunnel syndrome, therapists should consider various decision-making factors, prioritising communication and shared decision-making. This, along with personalised interactions, achieves patient-centred care and enhances patient care quality and therapeutic alliance.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 4","pages":"145-160"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11503846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510015","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":"Rehabilitation of stage-one scapholunate instability (ReSOS): An online survey of UK practice.","authors":"Martin K Holmes, Caroline Miller, Michael Mansfield","doi":"10.1177/17589983241268056","DOIUrl":"10.1177/17589983241268056","url":null,"abstract":"<p><strong>Introduction: </strong>Scapholunate instability is one of the most frequent types of wrist instability, but optimal management is not established. This research aims to identify current conservative management strategies for stage-one scapholunate instability and how these interventions are evaluated in the UK.</p><p><strong>Methods: </strong>A cross-sectional online survey of UK physiotherapists and occupational therapists with self-reported experience in the rehabilitation of stage-one scapholunate instability (ReSOS), was developed using the CROSS guideline and a clinical vignette. The frequency of treatment strategies was collated via a five-point Likert-type scale and evaluation strategies via fixed-response answers at three-to-six, seven-to-eleven and after 12 weeks post-injury. Data were analysed descriptively.</p><p><strong>Results: </strong>Forty-three electronic surveys were completed and analysed. Thirty physiotherapists and 13 occupational therapists responded, with 90% working in the NHS. Activity advice and education was the most frequently used treatment at all time-points (100%, 98%, 98%). Quick-DASH was most frequently used region-specific patient reported outcome measure at all time-points (72%, 60%, 67%).</p><p><strong>Discussion: </strong>Despite some identified themes, including neuromuscular rehabilitation strategies, the supporting evidence is limited in the ReSOS. It is unclear what rehabilitation and evaluation strategies are optimal and the development of a consensus on best practice is recommended.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 4","pages":"175-187"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510016","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":"Production time and practicability of 3D-Printed wrist orthoses versus low temperature thermoplastic wrist orthoses.","authors":"Marianne von Haller, Louise Couchman, Philipp Honigmann","doi":"10.1177/17589983241287069","DOIUrl":"10.1177/17589983241287069","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, three-dimensional (3D) printing has emerged as a new manufacturing technique for orthoses, showing comparable stability and wearing comfort to traditional orthoses. However, the lengthy designing and printing process is assumed to take more time than the common practice of manufacturing low-temperature thermoplastic orthoses (LTTOs). The aim of this prospective cross-sectional study was to compare the production time of 3D-printed orthoses (3DPO) to LTTOs.</p><p><strong>Methods: </strong>The active and passive time needed to manufacture the orthoses was measured in a clinical setting. 17 orthoses (8 3DPOs and 9 LTTOs) were included in the data analysis.</p><p><strong>Results: </strong>The mean total production time of a 3DPO (12:14:50h total time; 0:44:35h active production time) was significantly longer than in LTTOs (0:14:14h; <i>p</i> < 0.001).</p><p><strong>Discussion: </strong>The longer production time might be a hurdle regarding the implementation of 3DPOs in hand therapy. Although 3D-printing might become more cost- and time-efficient due to future developments in technology and growing experience, some practical advantages of LTTOs prevail, such as the fast and efficient provision of orthoses and the adaptability of the material if subsequent changes are needed. A combination of both manufacturing techniques may be a feasible solution to provide patient-centred orthosis provision in future hand therapy practice.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 4","pages":"188-194"},"PeriodicalIF":0.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567454","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":"The role of early orthotic intervention in the management of post-traumatic elbow contractures: Study protocol for phase II double-blinded randomised controlled trial.","authors":"Germaine Sim, Jennifer Fleming, Celeste Glasgow","doi":"10.1177/17589983241292827","DOIUrl":"10.1177/17589983241292827","url":null,"abstract":"<p><strong>Background: </strong>Restoration of full elbow extension following trauma is difficult and influenced by the injury profile, surgeon preference, patient and environmental factors. The literature suggests that orthotic interventions are effective in improving contractures when movement plateaus despite normal therapeutic interventions. It is not known if extension orthotic intervention is more superior to standard treatment regardless of when it is commenced. The literature lacks patient-reported considerations to contracture management using elbow orthoses.</p><p><strong>Methods and analysis: </strong>This protocol describes a Phase II double blinded randomised controlled feasibility trial (RCT) and mixed methods study, aimed to examine outcome with extension in an orthotic intervention group (OG) versus control (CG). All participants will undergo six weekly therapy sessions, which include a standardised therapeutic program. OG participants will be provided with an additional extension orthosis and the outcome is assessed according to the change in elbow extension motion after 6 weeks of intervention. Data will be collected via questionnaires, logbooks, feedback forms, and semi-structured interviews at baseline and final assessments for descriptive statistical analysis. Under the guidance of a statistician, all quantitative data will be evaluated using the appropriate parametric or non-parametric analyses to evaluate for systematic differences between groups. Preliminary extension gains are used to determine the final sample size required to achieve adequate power for a full-scaled RCT. Interview data on OG participants will be qualitatively analysed using the \"five-factorial dimensions of adherence\" framework to identify key differences in the influencers between adherent or non-adherent groups.</p><p><strong>Trial registration number: </strong>ANZCTR ACTRN12619001402134p.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":" ","pages":"17589983241292827"},"PeriodicalIF":0.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630043","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":"Trapeziometacarpal total joint arthroplasty, with or without supervised hand rehabilitation: A quasi-experimental trial.","authors":"Elske Edj Bonhof-Jansen, Sander M Brink, Tjeerd R de Jong, Jeroen H van Uchelen, Eric Wp Bakker","doi":"10.1177/17589983241287084","DOIUrl":"10.1177/17589983241287084","url":null,"abstract":"<p><strong>Introduction: </strong>Aim of this study was to determine whether postoperative supervised rehabilitation improves functional outcomes after trapeziometacarpal (TMC) total joint arthroplasty (TJA), compared to education alone.</p><p><strong>Method: </strong>A quasi-experimental before-after trial included 31 women (≥40 years) per group diagnosed with trapeziometacarpal osteoarthritis who underwent TJA. A cohort (<i>n</i> = 31) who was given education alone was compared to a cohort (<i>n</i> = 31) who were subjected to supervised rehabilitation. Primary outcome was the difference in hand function 3 months postoperatively, measured by the Michigan Hand Outcomes Questionnaire (MHOQ). Other outcomes were the MHOQ subscale scores, the active range of motion, strength, time to return to work, satisfaction and complications.</p><p><strong>Results: </strong>Patients in the education group had a significantly higher median delta MHOQ score when compared to the rehabilitation group at 3 months; 28.5 (20.5-31.3) versus 15.8 (1.9-21.1), (<i>p</i> = <0.01) and at 12 months 36.6 (26.8 - 47.2) versus 27.4 (14.5 - 33.0), (<i>p</i> = 0.01). Only the secondary outcomes the MHOQ subscales hand function, ADL and satisfaction revealed significant differences in favor of the education group. The education method reduced the median number of hand therapy sessions with eight visits.</p><p><strong>Conclusion: </strong>The present study does not show a significant or clinically relevant benefit from supervised rehabilitation in terms of functional outcomes following TJA compared to education alone. Based on this, it seems safe to leave patients unsupervised in their recovery following TJA and to suffice with just education, however further exploration of effectiveness and safety of this intervention is recommend in larger trials.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":" ","pages":"17589983241287084"},"PeriodicalIF":0.9,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630047","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":"A scoping review to map public-facing websites for non-traumatic wrist disorders with quality evaluation.","authors":"Thomas Mitchell, Michael Bircumshaw, Clare Cryan, Dawid Kotwica, Nick Hamilton, Ben Dean, Sionnadh McLean","doi":"10.1177/17589983241287082","DOIUrl":"10.1177/17589983241287082","url":null,"abstract":"<p><strong>Introduction: </strong>Public-facing resources for non-traumatic wrist disorders (NTWD) exist, but care recipients and healthcare professionals alike are uncertain where to access the most useful resources and have raised concerns over the quality of information provided. Previous studies involving stakeholders highlight a need for quality evaluation of these resources. The aim of this study was to identify website resources accessible to UK-based online health seekers and explore their content through quality assessment.</p><p><strong>Methods: </strong>A scoping review of public-facing websites was conducted in accordance with Joanna Briggs Institute guidelines and PRISMA-ScR checklist. An <i>a-priori</i> search strategy was performed of publicly accessible websites using lay terms were entered into a simple Google search. The DISCERN tool was used to appraise the quality of health information with additional data charted to pre-determined criteria.</p><p><strong>Results: </strong>The 82 websites meeting inclusion criteria scored an average of 2/5 DISCERN. Nine funding categories existed with private service websites were the most common. 18 different diagnoses were found with twenty different management interventions were recommended.</p><p><strong>Conclusion: </strong>Considerable variation was found in the quality of websites providing information which people with NTWD are likely to access. Quality and trustworthiness of website information on NTWD are not the preserve of any sector or organisation and we identified potential for improvements across the board.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":" ","pages":"17589983241287082"},"PeriodicalIF":0.9,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630138","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":"Are occupational therapists in hand therapy working in an occupation-centered way? A cross sectional survey.","authors":"Thea Birch Ransby, Nicolaj Schøler Jacobsen, Alice Ørts Hansen","doi":"10.1177/17589983241268188","DOIUrl":"10.1177/17589983241268188","url":null,"abstract":"<p><strong>Introduction: </strong>The dominance of the biomedical approach has previously caused a limited focus on occupation within hand therapy. This study aimed to investigate the rehabilitation offered to patients with a hand-related disorder (HRD) in Denmark including to determine the extent to which occupation-focused and/or occupation-based assessments and interventions are used and to identify barriers against their use.</p><p><strong>Methods: </strong>A cross-sectional survey with 45 questions was conducted among members of the Danish Association for Hand Therapy. Data were analysed with descriptive statistics. Categorical variables were reported with frequency and percentage, and continuous variables with average and standard deviation.</p><p><strong>Results: </strong>One hundred and six occupational therapists working as hand therapists (<i>n</i> = 106) completed the survey. They reported common use of assessments measuring range of motion, pain, edema, and occupational performance. Occupational performance was assessed by non-standardized occupation-focused assessments, such as informal conversations. Exercise, pain management, and occupation-focused informal conversations were reported as the most frequently used interventions. Out of 82 respondents, 74 (91.4%) reported that they used interventions focused on body function and structures to the extent they wanted. Only 41 (50.0%) used occupation-focused or occupation-based interventions to the extent they wanted.</p><p><strong>Discussion: </strong>Assessments and interventions reporting body function and structure were used most frequently whereas assessments and interventions reporting activity and participation were used to a lesser extent. Occupation-focused assessments and interventions were used more commonly than occupation-based. Hand therapists considered occupation-based assessments and interventions to be important in rehabilitation after HRD, despite using them with few patients. Several barriers were reported regarding the implementation of an occupation-centered approach: habit, workload, time constraints, and setting.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 3","pages":"124-134"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156261","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":"Effectiveness of dry needling to treat lateral epicondylosis: A case report.","authors":"Nathan Short, Jill Linder, Ethan Stump","doi":"10.1177/17589983241268218","DOIUrl":"10.1177/17589983241268218","url":null,"abstract":"<p><strong>Purpose: </strong>This study presents the use of dry needling (DN) as an intervention to support functional rehabilitation for an adult diagnosed with lateral epicondylosis.</p><p><strong>Methods: </strong>A retrospective, single subject, AB design was implemented. A 50-year-old male with a six-month history of dominant left lateral epicondylosis received traditional interventions for 4 weeks (baseline phase; A) followed by the same interventions with the addition of DN (intervention phase; B). The QuickDASH assessment, numeric rating scale (NRS) for pain, grip strength (elbow flexed and neutral), and Maudsley's test were used as measures of effectiveness along with patient self-report of ability to perform activities of daily living (ADLS), instrumental ADLs, work, and leisure occupations.</p><p><strong>Results: </strong>The patient made minimal progress for the initial 4 weeks of traditional treatment. There were no changes to his initial pain rating of 7/10 on the NRS, left hand grip strength (67 lbs.), or initial QuickDASH score. DN was initiated at week five with a reduction in pain from 7/10 to 2/10 from weeks six to eight. He was discharged at week 12 with no pain, a score of 0/100 on the QuickDASH, non-painful grip of 83 lbs., and a self-report of the ability to perform all ADLs, instrumental ADLs, work, and leisure occupations independently.</p><p><strong>Conclusions: </strong>Dry needling appears to have been an effective intervention when integrated with a holistic approach for an individual with chronic lateral epicondylosis. More research is needed to evaluate dry needling as an intervention to support functional rehabilitation with a larger sample size and randomization.</p>","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"29 3","pages":"135-139"},"PeriodicalIF":0.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156262","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":"Mental and behavioural disorders increase the risk of tendon rupture after flexor tendon repair in zone I and II","authors":"Jonas Svingen, Marianne Arner","doi":"10.1177/17589983231222832","DOIUrl":"https://doi.org/10.1177/17589983231222832","url":null,"abstract":"The effect of mental and behavioural disorders (MBD) on the risk of tendon ruptures after flexor tendon repair is not well understood. This study aimed to analyse the association between MBD and tendon rupture after flexor tendon repair in zones I and II. Data from the Swedish National Registry for Hand Surgery (HAKIR) on patients with a complete flexor tendon repair at our department between 2012 and 2019 were followed for a minimum of 2 years to assess the rate of rupture. Independent variables were collected from HAKIR and clinical records: prevalence MBD based on ICD-10 codes F0-F99, age, sex, injured tendon, number of injured fingers, day to surgery, core suture, digital nerve injury, smoking, injury mechanism, and rehabilitation method. Multiple logistic regression was used to assess the association between variables. A cohort of 593 patients with 49 ruptures (8.2%) was identified. Potential causes of rupture were non-adherence behaviour in 16 (33%), accidents in seven (14%), infections in six (12%), and no clear cause in 20 (41%) patients. Patients with MBD had an association to rupture (OR 3.6), 17.7% ruptures compared to 7.2% in patients with no diagnosed disorders. Patients >50 years of age had a higher risk compared to patients <25 years (OR 4.3), 15% compared to 3.9%' respectively. Men had a higher risk compared to women (OR 2.9), 10% compared to 4.3%' respectively. We identified an association between the prevalence of mental and behavioural disorders and rupture after flexor tendon repair.","PeriodicalId":43971,"journal":{"name":"Hand Therapy","volume":"52 42","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138995504","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}