Journal of Clinical Orthopaedics and Trauma最新文献

{"title":"Extended oral antibiotics in primary and revision total joint arthroplasty: An update","authors":"Charlie Yoo ,&nbsp;R. Michael Meneghini","doi":"10.1016/j.jcot.2025.103011","DOIUrl":"10.1016/j.jcot.2025.103011","url":null,"abstract":"<div><div>Periprosthetic joint infections (PJI) are a significant healthcare and economic burden after joint replacement surgery. Extended oral antibiotic prophylaxis (EOAP) has been highlighted as a safe, efficacious, and cost-effective measure to mitigate the risk of infection against the increasing demands for total joint arthroplasty (TJA). Several studies have demonstrated substantial reductions in PJI rates, particularly among high-risk populations receiving a 7-day course of antibiotics, mainly with use of cefadroxil. Conversely, other studies have found no significant differences or even increased infection rates, highlighting concerns over antimicrobial resistance, Clostridium difficile infections (CDI), and other antibiotic-related adverse events. Additionally, recent trends show a substantial rise in EOAP utilization across the United States, demonstrating need for clear and evidence-based guidelines. There is a need for high quality randomized controlled trials to help identify optimal patient selection criteria, antibiotic type, and duration to effectively balance the benefits of EOAP against potential risks. Although there is limited evidence of significant antibiotic associated complications with the use of EOAP, care should be utilized prior to widespread adoption with antibiotic stewardship in mind.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103011"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833439","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":"Identifying risk factors for one-year mortality after surgical treatment of periprosthetic femoral fractures around hip arthroplasty","authors":"Maud A.M. Vesseur ,&nbsp;Eva H.M. van Beurden ,&nbsp;Lee H. Bouwman ,&nbsp;Martijn G.M. Schotanus ,&nbsp;Raoul van Vugt ,&nbsp;Bert Boonen","doi":"10.1016/j.jcot.2025.103012","DOIUrl":"10.1016/j.jcot.2025.103012","url":null,"abstract":"<div><h3>Background</h3><div>The increasing number of hip arthroplasties (HA) worldwide, including hemi- and total hip arthroplasties, has led to a rise in periprosthetic femoral fractures (PPFF). These fractures are technically complex, linked to high morbidity and mortality, and impose a burden on healthcare systems. However, clinical guidelines for managing PPFF are lacking, and data on factors affecting postoperative outcomes remain limited. This study aimed to identify risk factors for one-year mortality in surgically treated PPFF patients.</div></div><div><h3>Methods</h3><div>A retrospective single-center cohort study was conducted on patients with surgically treated PPFF. Data on patient-, implant-, fracture-, surgical- and perioperative characteristics were collected. Univariate and multivariable logistic regression analyses were used to identify independent predictors of one-year mortality.</div></div><div><h3>Results</h3><div>Among 157 patients (median age was 83 years, 59.2 % ASA III), the one-year overall mortality rate was 16.6 %. Multivariable analyses suggested that residency in a nursing home [OR 4.1 (95 %CI 1.20–14.25) p = 0.025], use of a walking aid [OR 3.6 (95 %CI 1.07–12.36) p = 0.039], initial uncemented stem fixation [OR 4.08 (95 %CI 1.25–13.35) p = 0.020], preoperative urinary bladder catheter (UBC) [OR 4.5 (95 %CI 1.33–15.25) p = 0.016] and lower Body Mass Index (BMI) (Kg/m²) [OR 0.87 (95 %CI 0.75–1.00) p = 0.049) were independently associated with one-year mortality.</div></div><div><h3>Conclusion</h3><div>PPFF patients are frail and highly comorbid. Risk factors such as low BMI, nursing home residency, walking aid use, uncemented stem fixation, and preoperative UBC highlight the need for targeted strategies to improve outcomes.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103012"},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839301","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":"Fatigue failure of constrained total knee replacement: A case report","authors":"Whisper Grayson,&nbsp;Nicholas M. Brown","doi":"10.1016/j.jcot.2025.102953","DOIUrl":"10.1016/j.jcot.2025.102953","url":null,"abstract":"<div><div>Hinged implants for total knee arthroplasty (TKA) improve stability and joint function in a ligamentously compromised knee, but potentially at the cost of reduced implant longevity due to increased mechanical stress on the construct. This report details the case of an 83-year-old woman who underwent a revision total knee arthroplasty for a chronically dislocated hinged knee prosthesis in August 2024 at our institution. The patient presented with a several month history of pain and instability with reported self-reduction of the prosthesis to aid in ambulation. The revision surgery revealed that the axle had fractured into three pieces. This finding represents a unique case of hinged TKA failure. The primary purpose of this case report is to describe the patient presentation and revision technique to contribute to the literature available on causes of hinged TKA mechanical failure.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 102953"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833532","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":"Minimum 10-year follow-up of mobile bearing medial unicompartmental arthroplasty: Does the presence of preoperative radiographic patellofemoral arthritis influence patient outcomes?","authors":"Todd E. Bertrand ,&nbsp;Patricia R. Melvin ,&nbsp;Jacob Alexander ,&nbsp;David A. Crawford ,&nbsp;Adolph V. Lombardi Jr. ,&nbsp;Keith R. Berend","doi":"10.1016/j.jcot.2025.103008","DOIUrl":"10.1016/j.jcot.2025.103008","url":null,"abstract":"<div><h3>Background</h3><div>Medial unicompartmental knee arthroplasty (UKA) has become an accepted means of treating end stage anteromedial osteoarthritis of the knee. However, the presence of patellofemoral osteoarthritis on preoperative radiographs has proven to be confusing for orthopaedic surgeons in terms of candidacy for unicompartmental arthroplasty. The purpose of this study is to assess whether the presence of preoperative radiographic patellofemoral joint (PFJ) arthritis influences implant survivability or clinical outcomes at minimum 10-year follow-up.</div></div><div><h3>Methods</h3><div>Preoperative radiographs of 502 knees treated between 2004 and 2010 with medial mobile-bearing UKA and minimum 10-year follow-up (mean 13.3 years ± 2.0) were assessed by an observer blinded to the clinical outcome, and the patellofemoral joint (PFJ) was graded using the modified Altman classification. In the analyzed cohort there were 310 (61.8 %) grade 0, 135 (26.9 %) grade 1, 51 (10.2 %) grade 2, and 6 (1.2 %) grade 3 knees. Clinical outcomes were assessed using Knee Society pain, clinical and functional scores, and the University of California Los Angeles (UCLA) activity rating.</div></div><div><h3>Results</h3><div>There were 66 (12.7 %) knees revised for overall survival of 86.9 %. The most common reason for revision was arthritic progression, in 27 (40.9 %) knees. There was no difference in Kaplan-Meier survival based on preoperative patellofemoral grade (p = 0.8047) and mean time to revision was similar between groups (p = 0.6330). When analyzing outcomes for the entire cohort there was significant improvement from preoperative to postoperative range of motion (ROM) (p = 0.0002) and Knee Society pain, clinical, and functional scores (all p &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>This study demonstrates that at long term follow-up there is not a significant difference in overall implant survival or patient reported outcome scores based upon preoperative radiographic PFJ arthritic state. Thus, the radiographic appearance of the patellofemoral joint alone should not be a deciding factor when considering patients as candidates for medial UKA.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103008"},"PeriodicalIF":0.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839348","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":"Sclerotherapy with polidocanol as a treatment for aneurysmal bone cyst: A systematic review","authors":"Yogi Prabowo,&nbsp;Anissa Feby Canintika,&nbsp;Randhi Maulana,&nbsp;Winona Andrari Mardhitiyani,&nbsp;Natan Kevin Partogu Siagian","doi":"10.1016/j.jcot.2025.103009","DOIUrl":"10.1016/j.jcot.2025.103009","url":null,"abstract":"<div><h3>Background</h3><div>Sclerotherapy with polidocanol is a minimally invasive treatment for smaller Aneurysmal bone cysts (ABCs), offering safety and lower recurrence rates compared to surgery. Treatment choice depends on ABC size and location, with denosumab and titanium elastic nails as alternatives. To our knowledge, there are no systematic reviews regarding sclerotherapy with polidocanol as a treatment for ABCs. We aim to elucidate the effects of polidocanol in patients with ABCs.</div></div><div><h3>Methods</h3><div>This systematic review included studies involving patients with aneurysmal bone cyst treated with sclerotherapy using polidocanol as its agent. Literature search from database such as Pubmed, Cochrane, and Scopus resulted in 14 studies included in this review.</div></div><div><h3>Results</h3><div>Multiple studies have examined the effectiveness of percutaneous sclerotherapy with polidocanol as a primary treatment for ABCs. Most studies favored this approach without comparisons, while some compared it to extended curettage or other methods. Results varied, with some showing successful healing and pain relief, while others noted minor complications. Sequential polidocanol instillations were found to reduce cyst volume and minimize recurrence. Other interventions, like absolute alcohol gel and Denosumab, showed potential but with varying outcomes.</div></div><div><h3>Conclusion</h3><div>While percutaneous sclerotherapy with polidocanol has been prominently effective in managing aneurysmal bone cysts, further studies are required to identify the most effective and least invasive treatment strategies to optimize outcomes and minimize complications in clinical practice.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 103009"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143833540","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":"Implementing Three-Dimensional Printed Pelvises with Idealized Acetabular Fractures to Improve Resident Education","authors":"Omar A. Manzur BS ,&nbsp;Angel Valencia MD ,&nbsp;Richard Samade MD, PhD ,&nbsp;Alexandra Callan MD ,&nbsp;Robert C. Weinschenk MD","doi":"10.1016/j.jcot.2025.102996","DOIUrl":"10.1016/j.jcot.2025.102996","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The complex anatomy of the acetabulum makes preoperative planning a challenging topic in orthopedic education. Effectively interpreting plain radiographs of acetabular fractures is important for time-sensitive cases and remains an initial step for guiding downstream care. Modern implementations of 3D printing include physical reconstructions from CT scans but is not easily accessible. This study aims to evaluate the value of cost-effective generic 3D printed models to improve resident performance on classifying real patient acetabular fracture examples.</div></div><div><h3>METHODS</h3><div>22 orthopaedic surgery residents (PGY 1-5) were selected as participants to classify acetabular fractures in the pre-test and post-test surveys. Participants classified 10 acetabulum fracture examples using only the five standard X-ray views in the pre-test survey, then had 3 minutes at each of 10 stations to review the 3D models and X-rays of acetabular fractures, and finally at the end completed a post-test survey. The total number of correct answers and average perceived confidence were calculated at the participant level for both pre-test and post-test.</div></div><div><h3>RESULTS</h3><div>Results showed significantly different total scores between PGY cohorts for both total score (p = 0.00729) and average confidence (p = 0.0034). Factorial ANOVA of total score against PGY and test type displayed a significant improvement in PGY test scores from pre-test to post-test (p = 0.0453), as well as a significant difference between each PGY year (p = 0.00418). Factorial ANOVA of average confidence against PGY and test type displayed no significant improvement from pre-test to post-test (0.372), however PGY cohorts were shown to be significantly different in their average confidence (0.00677).</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"66 ","pages":"Article 102996"},"PeriodicalIF":0.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143839300","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":"Direct anterior approach for femoral neck fractures: Why and how?","authors":"Rajiv S. Vasudevan,&nbsp;Andrzej Brzezinski,&nbsp;Stephanie Kaszuba,&nbsp;Lidia Ani,&nbsp;Maritza D. Essis,&nbsp;Lee E. Rubin","doi":"10.1016/j.jcot.2025.102995","DOIUrl":"10.1016/j.jcot.2025.102995","url":null,"abstract":"<div><div>Femoral neck fractures are among the most common orthopedic injuries, often managed using closed reduction internal fixation (CRIF), hemiarthroplasty, or total hip arthroplasty (THA). While several approaches have been utilized in the surgical management of femoral neck fractures, the direct anterior approach (DAA) has emerged as a popular approach for hip arthroplasty given its smaller incision, muscle sparing technique, and robust outcomes. Several studies and meta-analyses have demonstrated that the DAA has fewer complications, dislocations, and better early functional outcomes compared to other approaches when performing hip arthroplasty for femoral neck fractures. Furthermore, studies have demonstrated promising outcomes with the utilization of the DAA approach for femoral neck fracture visualization and anatomic reduction, which is particularly important when caring for younger high-energy trauma patients. Given the notable morbidity and mortality associated with geriatric femoral neck fractures in particular, the DAA may be yet another technique that can further reduce the incidence of adverse outcomes seen in this population as we anticipate a rising elderly patient population in the coming years.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"67 ","pages":"Article 102995"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143928480","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":"Impact of femoral head size on the localization of proximal femur fractures: Retrospective analysis of 400 cases","authors":"Nele Wagener ,&nbsp;Gregor Giebel ,&nbsp;Felix Rarreck ,&nbsp;Torsten Diekhoff ,&nbsp;Sebastian Hardt","doi":"10.1016/j.jcot.2025.103007","DOIUrl":"10.1016/j.jcot.2025.103007","url":null,"abstract":"<div><h3>Background</h3><div>Proximal femur fractures are prevalent among the elderly, leading to high mortality, reduced quality of life, and significant healthcare burdens. The incidence is rising with demographic ageing, with osteoporotic fractures projected to reach 6 million annually by 2050, costing $25.4 billion. A 351 % increase in proximal femur fractures among individuals over 85 years is expected. Accurate fracture localization through imaging, combined with understanding femoral head size and patient-specific factors, improves preoperative planning and outcomes. This study explores the relationship between femoral head size and fracture localization.</div></div><div><h3>Methods</h3><div>A retrospective cohort study analyzed data from 400 patients with proximal femur fractures treated between 2010 and 2022. Fractures were classified as medial, lateral, pertrochanteric, or subtrochanteric. Radiographs measured femoral head morphology, and statistical analyses, including chi-square tests, t-tests, ANOVA, and logistic regression, identified predictors of fracture localization.</div></div><div><h3>Results</h3><div>Femoral head area (FHA) varied significantly across fracture types, with lateral fractures having the largest mean FHA (2355.95 mm²/cm², <em>p</em> = 0.047). Osteoarthritis prevalence differed (<em>p</em> = 0.028), being highest in subtrochanteric fractures (17 %, Kellgren &amp; Lawrence grade 3–4). Lateral fractures had a younger mean age of 71.05 years (<em>p</em> &lt; 0.001), while pertrochanteric fractures averaged 79.52 years (<em>p</em> &lt; 0.001). Vertical (<em>p</em> &lt; 0.001) and horizontal (<em>p</em> = 0.028) femoral head diameters also differed significantly.</div></div><div><h3>Conclusion</h3><div>Larger femoral heads are associated with lateral fractures, whereas pertrochanteric fractures occur in older patients. Subtrochanteric fractures correlate with smaller femoral heads and advanced osteoarthritis.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 103007"},"PeriodicalIF":0.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784025","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 structured review instrument in journal club meeting during orthopaedic residency: A prospective interventional study","authors":"Raghuraman Tarunprasad ,&nbsp;Ilavarasan Dhamu ,&nbsp;Adhithyan Anbu Selvam ,&nbsp;Zara Keyi ,&nbsp;Munis Ashraf ,&nbsp;Navin Balasubramanian","doi":"10.1016/j.jcot.2025.102997","DOIUrl":"10.1016/j.jcot.2025.102997","url":null,"abstract":"<div><h3>Background</h3><div>Journal Club (JC) meetings are a traditional and effective method of teaching evidence-based medicine in many orthopaedic residency programs. The key objectives are to develop critical appraisal skills, facilitate the application of evidence in clinical practice, and foster a lifelong habit of staying updated with current literature. A structured checklist may help ensure these objectives are met consistently. This study aimed to evaluate the effectiveness of using a Structured Review Instrument (SRI) during JC meetings.</div></div><div><h3>Methodology</h3><div>We conducted a prospective interventional study from June 2023 to June 2024 at a 1000-bedded tertiary care medical college hospital. Junior orthopaedic residents who attended the monthly JC meetings were included. Outcomes were assessed using a resident feedback questionnaire scored on a Likert scale, and the results were compared using an unpaired <em>t</em>-test.</div></div><div><h3>Results</h3><div>Residents using the SRI demonstrated significantly higher mean Likert scores in several domains: the ability to draw conclusions from the article (3.7 ± 0.27, <em>p</em> = 0.0002), identify various components of the article (3.8 ± 0.29, <em>p</em> = 0.0013), apply take-home messages to clinical practice (3.7 ± 0.21, <em>p</em> = 0.0151), and understand research methodology (3.5 ± 0.28, <em>p</em> = 0.0094). In terms of personal qualities, the SRI group showed significantly higher satisfaction with JC meetings (4.1 ± 0.31, <em>p</em> = 0.001), enthusiasm (3.9 ± 0.34, <em>p</em> = 0.0019), and peer discussion (3.8 ± 0.24, <em>p</em> = 0.0017). The overall mean score across all questionnaire domains was also significantly higher in the SRI group (3.68 ± 0.22, <em>p</em> = 0.0009).</div></div><div><h3>Conclusion</h3><div>A successful JC meeting should provide educational value to all participants while being efficient for faculty. This study demonstrates that incorporating a Structured Review Instrument enhances the quality, engagement, and effectiveness of Journal Club sessions.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102997"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767495","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":"Cementless total knee arthroplasty: Why, when, and how","authors":"Elizabeth G. Lieberman","doi":"10.1016/j.jcot.2025.102993","DOIUrl":"10.1016/j.jcot.2025.102993","url":null,"abstract":"<div><div>The use of cementless implants in total knee arthroplasty (TKA) has increased in recent years due to improvements in implants and materials, surgical technique, and increasing knowledge of ideal patient characteristics. The benefit of cementless TKA can be decreased surgical time and increased implant survival free from aseptic loosening, however long term data is needed. In this review we discuss the current state of cementless TKA including tips for patient selection and surgical technique.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102993"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837881","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}