European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"The influence of high doses of vitamin C on functional recovery and postoperative pain in patients with trochanteric fracture after intramedullary nailing during a three-month follow-up: a full-scale study.","authors":"Mirza Sivro, Đemil Omerović, Faruk Lazović, Adnan Papović","doi":"10.1007/s00590-025-04332-2","DOIUrl":"10.1007/s00590-025-04332-2","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effects of high peri- and postoperative doses of vitamin C administration on severity of pain in postoperative period and functional outcome of the patients with trochanteric fracture treated with intramedullary nailing during a three-month follow-up.</p><p><strong>Methods: </strong>A prospective, randomised, full-scale study included 74 patients who were randomly divided into vitamin C (intervention) and control groups. In the intervention group, patients received vitamin C perioperatively by intravenous route for 2 days, and oral vitamin C for 38 days postoperatively. Baseline characteristics, postoperative metamizole consumption, visual analogue scale (VAS) score, Harris hip score (HHS) value, and the prevalence of complications were evaluated in both groups.</p><p><strong>Results: </strong>No significant differences were noted between the groups regarding age, gender, length of hospitalisation, and distribution in fracture type as well as in postoperative HHS values. Postoperative metamizole consumption was notably higher in the control group compared to the vitamin C group (p = 0.003). Postoperative VAS scores were higher in the control group than in the vitamin C group at all time follow-ups (p < 0.05). The group variable significantly contributed to VAS score, and age and gender variables significantly contributed to HHS value.</p><p><strong>Conclusion: </strong>Significant reduction of subjective pain levels and lower analgesic consumption was found in patients who received vitamin C, suggesting that it should be considered as an adjuvant agent for analgesia in patients with hip fracture.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"189"},"PeriodicalIF":1.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042765","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":"Letter to the editor regarding \"the management of critical bone defects: outcomes of a systematic approach\".","authors":"Paul Rodham, Peter Giannoudis","doi":"10.1007/s00590-025-04329-x","DOIUrl":"https://doi.org/10.1007/s00590-025-04329-x","url":null,"abstract":"","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"191"},"PeriodicalIF":1.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057513","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":"Central sensitization inventory score after surgical treatment for distal radius fractures.","authors":"Kiyohito Naito, Norizumi Imazu, Shoichiro Ishi, Yasuhiro Yamamoto, Takamaru Suzuki, Kenjiro Kawamura, So Kawakita, Tatsuki Itoh, Muneaki Ishijima","doi":"10.1007/s00590-025-04310-8","DOIUrl":"https://doi.org/10.1007/s00590-025-04310-8","url":null,"abstract":"<p><strong>Purpose: </strong>Volar locking plate (VLP) fixation for distal radius fractures has relatively stable clinical outcomes. However, surgeons who assess postoperative outcomes as good may have difficulty fully understanding the perspectives of patients who express dissatisfaction. Central sensitization inventory (CSI) score is now thought to assess psychogenic pain. Therefore, clinical evaluation related to CSI score following volar locking plate fixation for distal radius fractures in this study.</p><p><strong>Methods: </strong>Twenty-nine distal radius fracture patients (12 males and 17 females; mean age: 55.2 ± 15.9 years) treated with VLP were included. At final follow up before removal of volar locking plate, wrist joint range of motion (flexion, extension, pronation, and supination), grip strength (% of the healthy side), numerical rating scale (NRS), quick disabilities of the arm, shoulder, and hand (Q-DASH) score, and CSI score were investigated. In addition, the association between each evaluation item and Q-DASH and CSI scores was analyzed using univariate analysis.</p><p><strong>Results: </strong>Wrist range of motion and grip strength were not associated with CSI score (flexion: P = 0.651, r = - 0.089; extension: P = 0.689, r = 0.079; pronation: P = 0.241, r = 0.229; supination: P = 0.864, r = 0.034; grip strength healthy side ratio: P = 0.582, r = - 0.109). On the other hand, NRS (P = 0.038, r = 0.393) and Q-DASH scores (P = 0.012, r = 0.469) were significantly associated with CSI scores.</p><p><strong>Conclusions: </strong>This study suggested that after volar locking plate fixation (before plate removal), patient-reported outcomes (Q-DASH score and CSI score) were not associated with clinician-reported outcomes and impairment measure.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"187"},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of malignancy in surgically removed foot and ankle masses: a retrospective multi-center study.","authors":"Enes Kanay, Halil Bulut, Mehmed Nuri Tutuncu, Sefa Batibay, Serdar Demiröz, Erhan Okay, Korhan Ozkan","doi":"10.1007/s00590-025-04338-w","DOIUrl":"https://doi.org/10.1007/s00590-025-04338-w","url":null,"abstract":"<p><strong>Purpose: </strong>Foot and ankle masses, though uncommon, are an important subset of musculoskeletal tumors, encompassing benign and malignant forms. Malignant tumors often necessitate aggressive treatment, including amputation, and unplanned resections can worsen outcomes by increasing recurrence risk. Identifying predictors of malignancy and functional deficits is vital for improving treatment strategies.</p><p><strong>Methods: </strong>A retrospective review of 120 tumors in 112 patients (2017-2024) assessed demographics, tumor characteristics, size, surgical approach, and outcomes. Interventions included excision, curettage, and amputation, with reconstruction when needed. Predictors of malignancy and functional outcomes were statistically analyzed.</p><p><strong>Results: </strong>Malignancy was observed in 9.8% of cases, with tumor size > 45 mm and age > 45 years identified as significant predictors. The majority of surgeries were excisions (83.9%), followed by curettage in 13.3% and amputation in 2.8%. Complete resection (R0) was achieved in 94.5% of cases. Early-term (0-180 days) wound complications occurred in 5.4%, while late-term recurrence (median 22 months) was observed in 4.5% CONCLUSION: Tumor size and patient age are key malignancy predictors. Complete resection improves outcomes, highlighting the importance of tailored surgical planning.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"188"},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042755","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":"Extracapsular hip fractures are more prone to perioperative thrombosis than intracapsular hip fractures in elderly patients undergoing arthroplasty for hip fractures: a retrospective cohort study.","authors":"Min Sun, Chengbin Long, Yinshuang Zou, Yong Hu, Cheng Chen, Ning Hu","doi":"10.1007/s00590-025-04288-3","DOIUrl":"https://doi.org/10.1007/s00590-025-04288-3","url":null,"abstract":"<p><strong>Purpose: </strong>Whether fracture site has any effect on perioperative deep vein thrombosis (DVT) in elderly patients with hip fractures undergoing arthroplasty is still controversial. This study aimed to evaluate the association between fracture site and perioperative DVT in elderly patients undergoing hip arthroplasty.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted on elderly hip fracture patients who underwent hip arthroplasty and were admitted between January 2015 and December 2021. Patient data, including demographics, comorbidities, injury-related information, laboratory test results at admission, and surgery-related information, were collected. Univariate and multivariate regression analyses, along with subgroup analyses and sensitive analysis, were performed to identify the association between fracture site and DVT.</p><p><strong>Results: </strong>The study included 593 patients, consisting of 353 patients with intracapsular hip fractures (ICF) and 240 patients with extracapsular hip fractures (ECF), with an average age of 80.7 ± 7.6. The incidence of DVT diagnosed by ultrasonography was 16.9% in all patients. The prevalence of DVT for ECF patients and ICF patients was 22.5% and 13.0%, respectively. In all adjusted multivariate regression analysis model, ECF patients exhibited an increased risk of DVT compared to ICF patients (OR 2.03; 95% CI 1.19-3.47, p = 0.009). Subgroup analyses revealed that female patients with ECF had a higher likelihood of DVT than those with ICF (OR 2.25; 95% CI 1.22-4.13), as did patients aged 65 to 80 years (OR 4.06; 95% CI 1.44-11.41), patients with hemoglobin levels above 110 g/L (OR 2.30; 95% CI 1.08-4.92), and patients with albumin levels above 35 g/L (OR 2.47; 95% CI 1.29-4.73). Sensitivity analysis found similar results.</p><p><strong>Conclusion: </strong>The findings indicate a significant association between fracture site and perioperative DVT in elderly hip fracture patients undergoing hip arthroplasty, with ECF patients demonstrating a higher likelihood of developing DVT than ICF patients.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"186"},"PeriodicalIF":1.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996435","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":"Short-term outcomes of outpatient total joint arthroplasty in morbidly obese patients.","authors":"Mohammad Daher, Jonathan Liu, Nathaniel Smith, Alan Daniels, Thomas Barrett, Eric Cohen","doi":"10.1007/s00590-025-04325-1","DOIUrl":"https://doi.org/10.1007/s00590-025-04325-1","url":null,"abstract":"<p><strong>Purpose: </strong>The prevalence of obesity and morbid obesity in the U.S. has reached record levels, with over 50% of adults affected. Obese patients undergoing total joint arthroplasty (TJA) face increased post-operative complications, yet studies on optimizing outcomes for this population are limited. The COVID-19 pandemic accelerated the shift towards same-day discharge (SDD) for TJA, but the impact on morbidly obese patients remains understudied. This study aims to fill this gap by examining outcomes and costs for morbidly obese patients undergoing SDD TJA.</p><p><strong>Methods: </strong>This study is a retrospective review of the PearlDiver Mariner Database. Based on the procedure and their body mass index (BMI), the patients were divided into 4 SDD groups: Total knee arthroplasty (TKA)-BMI > 40, TKA-BMI < 40, total hip arthroplasty (THA)-BMI > 40, and THA-BMI < 40. The two TKA groups were matched based on age, gender, and the Charlson comorbidity index (CCI). The THA groups were matched similarly. Outcomes at 30 and 90 days post-operatively were compared between the groups.</p><p><strong>Results: </strong>5588 patients were included in each TKA group, and 1675 patients in each THA group. When compared to individuals with a BMI of less than 40, patients with morbid obesity receiving SDD TKA had greater incidence of deep vein thrombosis (DVT) (p < 0.05), urinary tract infection (UTI) (p < 0.05), readmissions (p < 0.05), superficial surgical site infection (SSSI) (p < 0.05), and higher costs (p < 0.05). Regarding SDD THA, patients with morbid obesity had greater incidence of DVT (p < 0.05), UTI (p < 0.05), emergency department visits (p < 0.05), readmissions (p < 0.05), intensive care unit admission (p < 0.05), prosthetic joint infection (p < 0.05), SSSI (p < 0.05), and higher costs (p < 0.05).</p><p><strong>Conclusion: </strong>This study highlights the considerable challenges faced by morbidly obese patients undergoing SDD TJA. Patient optimization prior to undergoing total joint replacement may benefit morbidly obese patients undergoing same day discharge. Further research is needed.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"185"},"PeriodicalIF":1.4,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025053","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":"Anterior hip fracture-dislocation resembling a Hill-Sachs lesion: a case report and review of this special clinical entity.","authors":"Vasileios Giannatos, Panagiotis Antzoulas, Vasileios Papathanidis, Anargyros Roumeliotis, Theodoros Stavropoulos, Vasileios Athanasiou","doi":"10.1007/s00590-025-04299-0","DOIUrl":"10.1007/s00590-025-04299-0","url":null,"abstract":"<p><strong>Purpose: </strong>Anterior hip fracture-dislocation is a rare high energy injury with poor long-term prognosis. A Hill-Sachs-like hip fracture-dislocation is only scarcely described in the literature.</p><p><strong>Case: </strong>We report the case of a 57-year-old suffering an anterior hip fracture-dislocation after a self-inflicted collision with his motorcycle. Knee impaction on the ground with hip abduction and external rotation led to a Hill-Sachs type of lesion in the hip and anterior wall fracture of the acetabulum. Relocation of the hip was possible only under general anesthesia, and gross persistent instability was revealed after reduction. Poor post-operative outcomes by non-operative solutions or ORIF are widely described in the literature, and thus, we performed a total hip arthroplasty in the primary setting, with excellent post-operative outcome in 1-year follow-up and a forgotten joint.</p><p><strong>Conclusion: </strong>In the rare occurrence of Hill-Sachs-like fracture-dislocation lesion of the hip, we recommend an operative solution in the primary setting, taking into consideration patient's age, intraoperative stability and defect's depth, with total hip arthroplasty being the mainstay of treatment.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"182"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051382","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":"A new human spine model for use in cinematographic gait analysis.","authors":"Piotr Tabor, Iwona Palczewska, Rafał Grygiel, Elżbieta Olszewska, Wiesław Chwała, Andrzej Mastalerz","doi":"10.1007/s00590-025-04269-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04269-6","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to compare the accuracy of two spine models: the broken curve model and a new four tangent circles model. The modification concerns the adaptation of data acquisition to kinematic methods used in, e.g., gait and running analysis.</p><p><strong>Method: </strong>Plastic, movable spine model of human with flexible intervertebral disks (manufactured by Erler Zimmer GE3014) was used as the study material. Markers with a diameter of 5 mm were glued to each spinous process (from C₇ to L₅). The recording was performed with a 6-camera Vicon system. Two spine models were created: a broken curve model used, among others, in the Diers scanner, and an own model of 4 circles, similar to the model of circles used in X-ray and CT analysis.</p><p><strong>Results: </strong>The errors in the position of the spinous processes were significantly smaller in the 4-circle model than in the broken curve model. They ranged from 0.01 to 6.5 mm in the lumbar section, from 0.004 to 3.1 mm in the thoracic section. The practical possibilities of using the four-circle model during the cinematographic analysis of gait and run should be checked.</p><p><strong>Conclusion: </strong>The four-circle model is more accurate than the broken curve model and can be used in the cinematographic analysis of the human spine movement.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"183"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993111","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":"Intra-articular hyaluronic acid injections for hip osteoarthritis: a level I systematic review.","authors":"Filippo Migliorini, Marco Pilone, Manuel Giovanni Mazzoleni, Luise Schäfer, Dragana Katusic, Nicola Maffulli","doi":"10.1007/s00590-025-04292-7","DOIUrl":"10.1007/s00590-025-04292-7","url":null,"abstract":"<p><strong>Purpose: </strong>The present systematic review investigated the efficacy of intra-articular hyaluronic acid (HA) viscosupplementation for hip osteoarthritis (OA) in patient-reported outcome measures (PROMs) and whether different molecular weights of HA are associated with different outcomes.</p><p><strong>Methods: </strong>This study was conducted according to the 2020 PRISMA statement. In January 2025, PubMed, Web of Science, Google Scholar, and Embase were accessed. All the randomised controlled trials (RCTs) evaluating the efficacy of intra-articular HA injections in the hip for OA were included.</p><p><strong>Results: </strong>Nine hundred and eighty-two patients (56% women, mean age 62.2 ± 4.0 years, mean follow-up 6.4 ± 2.7 months, mean BMI 27.5 ± 2.1 kg/m²) were analysed. Patients receiving high molecular weight (HMW) and low molecular weight (LMW) HA showed significant improvements in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analogue scale (VAS) scores (P < 0.05). No significant differences in VAS or WOMAC were observed among groups at 3-4 months of follow-up. However, at 4-6 months, the HMW HA group exhibited significantly lower VAS scores compared to the medium molecular weight (MMW) (mean difference, MD - 1.4, 95% CI - 2.1 to - 0.7, P < 0.0001), placebo (MD - 1.6, 95% CI - 2.1 to - 1.1, P < 0.0001), and control (MD - 1.3, 95% CI - 1.8 to - 0.8, P < 0.0001) groups. WOMAC scores at 4-6 months demonstrated that both HMW and MMW HA performed better than the control group (P < 0.0001), but no significant difference was observed between HMW and MMW (P = 1.0).</p><p><strong>Conclusion: </strong>Intra-articular injections of HA effectively reduce knee OA symptoms. Moreover, HMW HA performs better than MMW HA at a mean of 4-6 months of follow-up.</p><p><strong>Level of evidence: </strong>Level I, systematic review of RCTs.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"180"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994352","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":"Intra- and inter-rater reliability of range of motion, muscle strength and proprioception measurements in patients with total shoulder arthroplasty.","authors":"Anke Claes, Annelien De Mesel, Geert Verbeke, Filip Struyf, Olivier Verborgt","doi":"10.1007/s00590-025-04293-6","DOIUrl":"https://doi.org/10.1007/s00590-025-04293-6","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study is to evaluate the inter- and intra-reliability of measurements for shoulder range of motion, muscle strength, and proprioception in patients with shoulder arthroplasty, assessing both the prosthetic and healthy sides.</p><p><strong>Methods: </strong>A test-retest design assessing intra- and inter-rater reliability within a single session of measurements for shoulder range of motion, strength, and proprioception. The study included 24 total shoulder arthroplasty patients, 12 months post-operative.</p><p><strong>Results: </strong>Intraclass correlation coefficients (ICCs) for shoulder range of motion (ROM) and shoulder muscle strength measurements ranged from 0.73 to 0.94 for inter-rater reliability, reflecting moderate to excellent reliability. Weighted Kappa values for functional internal and external rotation showed moderate to almost perfect agreement, ranging from 0.57 to 0.85. For intra-rater reliability, ICCs values for ROM and muscle strength ranged from 0.86 to 0.97, reflecting good to excellent reliability and weighted kappa values showed moderate to perfect agreement, ranging from 0.52 to 1. Measurements for proprioception were largely unreliable, with ICCs ranging from 0 to 0.71.</p><p><strong>Conclusion: </strong>Thus, the measurements demonstrate strong reliability for ROM and muscle strength, making it a valuable tool for clinical follow-up. The proprioception component, however, requires further research and development.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"181"},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038813","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}