Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...最新文献

{"title":"[Before-and-After Pictures in Aesthetic Plastic Surgery: European Legal Perspectives and an Approach for Germany].","authors":"Jenny Ehrmanntraut, Matthias Aitzetmüller, Melodi Motamedi, Sixtus Allert","doi":"10.1055/a-2787-5156","DOIUrl":"10.1055/a-2787-5156","url":null,"abstract":"<p><strong>Background: </strong>In plastic and aesthetic surgery, before-and-after photographs play a central role in patient education and decision-making. The recent court decision of the German Federal Court of Justice (Bundesgerichtshof, BGH) on the use of before-and-after images in minimally invasive treatments (e. g., hyaluronic acid injections, case no. I ZR 170/24, issued July 31, 2025) highlights an ongoing conflict: according to recent case law in Germany, the publication of before-and-after photographs - particularly for advertising purposes and in procedures \"without medical necessity\" - is prohibited under the German Drug Advertising Act (Heilmittelwerbegesetz, HWG) §11, the Medical Professional Code ((Muster-)Berufsordnung für die in Deutschland tätigen Ärztinnen und Ärzte, MBO), and the Unfair Competition Act (Gesetz gegen den unlauteren Wettbewerb, UWG). Nevertheless, such images can still be found online, as they are legally hosted on foreign servers.</p><p><strong>Methods: </strong>As part of a doctoral dissertation project, the German legal framework was analyzed in international comparison, and a quantitative survey of patients and plastic surgeons was conducted. The survey addressed topics such as sources of information, willingness to consent to the publication of personal images, and the influence of social media. Data were analyzed descriptively and tested for statistical significance.</p><p><strong>Conclusion: </strong>The findings demonstrate a clear demand for before-and-after images among both patients and physicians. Controlled legalization of such photographs could enhance transparency, promote realistic expectations, and increase patient safety. The introduction of a standardized seal or disclaimer is recommended to ensure authenticity and ethical acceptability. Legislative adjustments should safeguard against misleading representations while upholding ethical standards.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"338-343"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147446674","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":"[Correction: A Consensus Statement of the German-speaking Society for Reconstructive Microsurgery (GSRM): What Imaging Modalities are Necessary for Visualisation of Connecting Vessels prior to Microsurgical Transplantation in the Lower Extremity?]","authors":"Lilly Maxine Mengen, Youssra Obeidi, Christoph Köpple, Steffen Ulrich Eisenhardt, Benjamin Thomas, Dirk Johannes Schaefer, Yves Harder, Martin Stierholz, Volker Jürgen Schmidt, Adrien Daigeler, Justus P Beier, Holger Bannasch","doi":"10.1055/a-2758-5704","DOIUrl":"10.1055/a-2758-5704","url":null,"abstract":"","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"e1"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145678675","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 Consensus Statement of the German-speaking Society for Reconstructive Microsurgery (GSRM): What Imaging Modalities are Necessary for Visualisation of Connecting Vessels prior to Microsurgical Transplantation in the Lower Extremity?]","authors":"Lilly Maxine Mengen, Youssra Obeidi, Christoph Köpple, Steffen Ulrich Eisenhardt, Benjamin Thomas, Dirk Johannes Schaefer, Yves Harder, Martin Stierholz, Volker Jürgen Schmidt, Adrien Daigeler, Justus P Beier, Holger Bannasch","doi":"10.1055/a-2697-8968","DOIUrl":"10.1055/a-2697-8968","url":null,"abstract":"<p><strong>Objectives: </strong>At a consensus workshop, the following questions were discussed regarding the preoperative imaging of recipient vessels prior to microsurgical transplantation in the lower extremity: • Is preoperative imaging necessary for patients with clinically intact peripheral vasculature undergoing microsurgical reconstruction of the lower extremity? • Which imaging modality (if required) best visualises the arterial recipient vessels for microsurgical flap reconstruction in the lower extremity? • In which cases is imaging of the venous outflow tract indicated prior to microsurgical flap reconstruction of the lower extremity: should it be performed routinely or only in selected cases, and which modality is best suited for this purpose?</p><p><strong>Methods: </strong>At an interdisciplinary expert workshop held by the German-speaking Society for Reconstructive Microsurgery (GSRM) in Aachen in 2024, the experiences of the participating experts were discussed in the context of the current literature addressing these questions. The workshop aimed to develop recommendations for applying imaging diagnostics that take into account individual patient characteristics, and to establish a consensus-based diagnostic algorithm.</p><p><strong>Results: </strong>Regarding the above-mentioned questions, the participants reached the following consensus: • Routine baseline assessment of the arterial recipient vessels by means of clinical examination and duplex ultrasonography is recommended prior to free flap transfer in the lower extremity. • If additional imaging is required, CT angiography (CTA) or MR angiography (MRA) should be used. In younger patients, MRA should be preferred. Additionally, dynamic imaging using duplex ultrasonography should be performed. Digital subtraction angiography (DSA) should primarily be reserved for cases where intervention is anticipated; diagnostic DSA without intervention should be limited to specific indications. • The evaluation of the venous recipient vessels using duplex ultrasonography is considered useful. If venous pathology is present, further imaging - preferably MR phlebography - should be performed.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"311-321"},"PeriodicalIF":0.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544724","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":"Late-Onset Digital Ischaemia after WALANT: Successful Reversal with Off-Label Urapidil.","authors":"Andrea Frey, Lukas Mathys, Christine Kammerhofer","doi":"10.1055/a-2739-3810","DOIUrl":"10.1055/a-2739-3810","url":null,"abstract":"<p><strong>Background: </strong>WALANT (Wide Awake Local Anaesthesia No Tourniquet) has revolutionised hand surgery by enabling procedures with a combination of lidocaine and epinephrine, thereby eliminating the need for sedation or a tourniquet. Although epinephrine is now considered safe in low concentrations, rare ischaemic complications may still occur.</p><p><strong>Case report: </strong>This report concerns a 74-year-old woman who developed delayed-onset digital ischaemia after WALANT-assisted excision of a Dupuytren's nodule. Phentolamine, the standard reversal agent, was unavailable. Local infiltration with urapidil (12.5 mg), a selective α₁-adrenergic antagonist, rapidly restored perfusion and sensation. The patient recovered fully without sequelae.</p><p><strong>Conclusion: </strong>This case highlights a rare but critical complication of WALANT. Urapidil may represent a safe and effective alternative to phentolamine in the management of epinephrine-induced vasospasm.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"273-276"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746533","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":"[Precise corrective osteotomy for scaphoid malunion using computer-assisted planning].","authors":"Marc Wieckenberg, Jan Henkel, Andreas Stettinger, Konrad Mader","doi":"10.1055/a-2778-4963","DOIUrl":"10.1055/a-2778-4963","url":null,"abstract":"","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"265-272"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314560","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":"[Garbage In, Benchmark Out: A Case for the Courage to Publish Average Results].","authors":"Kai Megerle","doi":"10.1055/a-2843-7502","DOIUrl":"https://doi.org/10.1055/a-2843-7502","url":null,"abstract":"","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":"58 3","pages":"192-193"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221614","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":"Comparative Outcomes of Oblique vs. Transverse Bone Tunnels in Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis.","authors":"Sevinç Ödül Oruç, Osman Orman, Hakan Ertem, Ethem Ayhan Ünkar, Mehmet Baydar, İbrahim Faruk Adıgüzel","doi":"10.1055/a-2777-9614","DOIUrl":"10.1055/a-2777-9614","url":null,"abstract":"<p><strong>Abstract: </strong>This retrospective non-randomized study aimed to compare the clinical and radiological outcomes of oblique versus transverse tunnels in ligament reconstruction and tendon interposition arthroplasty. This study included 15 patients with oblique tunnels (Group 1) and 13 patients with transverse tunnels (Group 2), all of whom had been diagnosed with Eaton stage 3 or 4 carpometacarpal arthritis and had undergone trapeziectomy with the ligament reconstruction and tendon interposition surgery. The visual analogue scale was used to assess pain levels, while the Quick Disabilities of the Arm, Shoulder and Hand questionnaire was used to evaluate functional limitations in activities of daily living. Preoperative and postoperative radiological findings as well as the thumb range of motion, grip strength, key pinch strength, and tip pinch strength were measured. Demographic data and complications were also documented. The change in Quick Disabilities of the Arm, Shoulder and Hand scores in Group 1 was significantly greater than that in Group 2. No significant differences were found between the two groups in visual analogue scale changes, range of motions, pinch strength assessments, or any radiological outcomes. In the treatment of thumb carpometacarpal joint arthritis with the ligament reconstruction and tendon interposition surgery, the oblique tunnel orientation in the ligament reconstruction and tendon interposition surgery for thumb carpometacarpal arthritis improves the Quick Disabilities of the Arm, Shoulder and Hand score, but does not significantly affect pain, complications, or radiological outcomes. These findings provide important insights for the selection of tunnel orientation in ligament reconstruction and tendon interposition applications.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"214-219"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147314554","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":"Umfrage zur Anwendung von WALANT in der ambulanten Handchirurgie und zum Kenntnisstand von Handchirurgen über Phentolamin als Antidot bei ischämischen Komplikationen.","authors":"Lara-Sophie Kluwe, Jene Weichenthal, Luis Barros Navarro, Niks Gulbis, Laura Maria Suhr, Moritz Rudolf Milewski, Lisa Lorbeer, Doha Obed, Peter M Vogt, Anieto Onochie Matthias Enechukwu","doi":"10.1055/a-2852-6481","DOIUrl":"10.1055/a-2852-6481","url":null,"abstract":"<p><strong>Introduction: </strong>Wide Awake Local Anesthesia No Tourniquet (WALANT) is an established method of local anesthesia in hand surgery. In rare cases, ischemic complications may occur due to the adrenaline contained in the tumescent solution. The vasoconstrictive effect of adrenaline can be antagonized by the local injection of phentolamine. To date, little is known in Germany about the incidence and treatment of ischemic complications, as well as the state of knowledge regarding phentolamine.</p><p><strong>Material and methods: </strong>An online survey of hand surgeons in Germany was used to evaluate their knowledge of the management and incidence of ischemic complications associated with the use of the WALANT technique in the hand. Among other things, the survey was designed to assess knowledge of and access to phentolamine as an antidote to the adrenaline contained in the WALANT solution.</p><p><strong>Results: </strong>A total of 124 surgeons participated in the study. 8.3% of the surgeons had experience with ischemic complications when using the WALANT technique. Ischemic complications were observed mainly after surgical annular ligament release, but also after Dupuytren's contracture surgery and carpal tunnel release. In none of the cases was the antidote phentolamine used. 47.7% of the users had no knowledge of the antidote phentolamine, and accordingly, phentolamine was only available in 53.2% of the hospitals. There was an interest in training in the form of continuing education, specialist literature and workshops to improve the use of phentolamine.</p><p><strong>Conclusion: </strong>Although WALANT is recognized as a very safe procedure, ischemic complications can occur in hand surgery in rare cases. The present study shows an insufficient level of knowledge regarding the antidote phentolamine in the treatment of ischemic complications associated with the WALANT technique. Users of the WALANT technique must be familiar with the procedure and its potential risks in order to be able to respond appropriately in an emergency. Even rare complications may, in case of doubt, lead to functional impairment and medikolegal consequences, particularly when phentolamine is not available. We therefore recommend always maintaining a stock of phentolamine and providing regular training sessions to ensure optimal patient safety.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"202-213"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059473","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":"Die Unité Rhumatologique des Affections de la Main (URAM)-Skala und deren Gütekriterien bei der Dupuytren’schen Kontraktur.","authors":"Sonja Elisabeth Pelzmann","doi":"10.1055/a-2833-9848","DOIUrl":"10.1055/a-2833-9848","url":null,"abstract":"<p><strong>Introduction: </strong>Various questionnaires are used to measure limitations in Dupuytren's disease (DD), including the Unité Rhumatologique des Affections de la Main (URAM) scale. This first Dupuytren-specific questionnaire is hardly known or used in German-speaking countries. The aim of this review is to highlight the measurement properties of the URAM scale and thus establish its use in clinical practice and research in German-speaking countries.</p><p><strong>Methods: </strong>This review was conducted using the COSMIN methodology (COnsensus-based Standards for the selection of health Measurement INstruments) for systematic reviews of Patient-Reported Outcome Measures (PROMs). Relevant and available data were searched for in various electronic databases (PubMed, CINAHL, Embase), specific journals, and additional sources. The included publications were analyzed using the COSMIN checklist and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach.</p><p><strong>Results: </strong>The results of the 9 included publications showed that the URAM scale has good construct validity (r=0,21-0,807), excellent retest reliability (ICC=0,35-0,96), excellent internal consistency (Cronbach's alpha=0,81-0,91), moderate to high responsiveness (ES: 0,56-0,96), and high specificity (86-88%), but low sensitivity (52-56%) for DD. The evidence was high in terms of responsiveness, moderate in terms of construct validity and reliability, and of low quality in terms of content validity.</p><p><strong>Conclusion: </strong>However, these data, which are based on a small number of publications, show that the well-accepted and easy-to-use URAM scale can be used as a decision-making aid and research tool for this disease.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"225-235"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849052","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":"[Results of the Intramedullary Elevation Technique for Unstable Middle Phalanx Base Impression Fractures].","authors":"Daniel Vergote, Martin Mentzel, Michael Lebelt, Richard-Tobias Moeller, Simon Bauknecht","doi":"10.1055/a-2809-2244","DOIUrl":"10.1055/a-2809-2244","url":null,"abstract":"<p><strong>Background: </strong>Impression fractures of the base of the middle phalanx represent a therapeutic challenge due to central joint incongruity and a tendency towards dorsal subluxation. This study aimed to present the clinical and radiological outcomes of a larger patient cohort treated using the intramedullary tamping technique described by Hintringer and Ender.</p><p><strong>Material and methods: </strong>A retrospective analysis of 92 patients (2012-2024) with unstable fractures of the base of the middle phalanx base was performed. Reduction was achieved percutaneously using a pre-bent intramedullary Kirschner wire, followed by retention with additional wires. Clinical and radiological endpoints, functional outcomes according to the classification of the American Society for Surgery of the Hand (ASSH), as well as complications were recorded.</p><p><strong>Results: </strong>Median impression depth was reduced from a median of 2.6 mm (0.6-5.5 mm) preoperatively to 0.7 mm (0-2.9 mm) postoperatively. The median total range of motion (ROM) was 210° (90°-335°). Outcome was excellent in 19 patients, good in 37 patients, fair in 32 patients, and poor in 4 patients based on the criteria of the American Society for Surgery of the Hand (ASSH). Patient age had a significant influence on ROM, whereas fracture type, timing of surgery, and residual impression did not reach statistical significance. Median operative time was 18 minutes. Three clinically relevant complications occurred.</p><p><strong>Conclusion: </strong>The intramedullary tamping technique according to Hintringer and Ender is a safe, time-efficient and cost-effective treatment option with low complication rates and good functional outcomes. It allows direct reduction of centrally impacted fragments and remains feasible even in cases of delayed presentation.</p>","PeriodicalId":520635,"journal":{"name":"Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V...","volume":" ","pages":"236-242"},"PeriodicalIF":0.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147470765","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}