Foot & ankle international最新文献

{"title":"Age-Related Differences in Postoperative Outcomes After Arthroscopic Lateral Ligament Repair for Chronic Lateral Ankle Instability.","authors":"Dan Moriwaki, Siang Yew Yeo, Yasuyuki Jujo, Tomoyuki Nakasa, Nobuo Adachi, Masato Takao","doi":"10.1177/10711007261471526","DOIUrl":"10.1177/10711007261471526","url":null,"abstract":"<p><strong>Background: </strong>Although arthroscopic lateral ankle ligament repair for chronic lateral ankle instability (CLAI) is widely performed, the association between patient age and postoperative outcomes remains unclear. This study aimed to investigate the clinical outcomes of arthroscopic lateral ankle ligament repair across a broad age spectrum.</p><p><strong>Methods: </strong>We retrospectively reviewed 934 patients who underwent arthroscopic lateral ankle ligament repair for CLAI with a modified lasso-loop stitch using a suture anchor; all procedures were performed by a single surgeon. Patients were classified into 5 age groups: skeletally immature (SI; <13 years), adolescents (AD; 13-19 years), young adults (YA; 20-39 years), middle-aged adults (MA; 40-59 years), and elderly people (EP; ≥60 years). Clinical outcomes were assessed preoperatively and at 1 year postoperatively using the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Times to free gait, jogging, and return to full sports activities were also evaluated. Multivariable linear regression analyses were performed with postoperative SAFE-Q scores as dependent variables and age group, sex, and corresponding preoperative SAFE-Q scores as independent variables.</p><p><strong>Results: </strong>Postoperative SAFE-Q scores improved significantly in all subscales across all age groups (all <i>P</i> < .001). Time to free gait (<i>P</i> = .004), jogging (<i>P</i> < .001), and return to full sports activities (<i>P</i> < .001) differed significantly among groups; older patients tended to require longer recovery times. SI, AD, and YA groups demonstrated higher postoperative SAFE-Q scores than the EP group in several subscales, particularly in physical and social functioning. In contrast, no age-related differences were observed in the sports activity subscale.</p><p><strong>Conclusion: </strong>The association between age and postoperative outcomes after arthroscopic lateral ankle ligament repair varied across outcome domains. Younger patients demonstrated better outcomes in several functional subscales and achieved faster recovery milestones; however, advanced age alone should not be considered a contraindication to arthroscopic lateral ankle ligament repair.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1328-1337"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820748","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":"Response to \"Letter Regarding: Does Platelet-Rich Plasma Speed Recovery After Acute Lateral Ankle Sprain? A Prospective Comparative Study Among Athletes\".","authors":"Gil Genuth, Peter Stavrou, Chris Brown, Lukas D Iselin","doi":"10.1177/10711007261484155","DOIUrl":"https://doi.org/10.1177/10711007261484155","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":"47 10","pages":"1363"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168480","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":"Platelet-Rich Plasma vs Corticosteroid Injection for Morton Neuroma: A Prospective Unblinded Randomized Comparative Study.","authors":"Gil Genuth, Peter Stavrou, Chris Brown, Lukas D Iselin","doi":"10.1177/10711007261471156","DOIUrl":"10.1177/10711007261471156","url":null,"abstract":"<p><strong>Background: </strong>Morton neuroma is a common cause of forefoot pain, often refractory to conservative treatment. Corticosteroid injections provide variable and often temporary relief. Platelet-rich plasma (PRP) has emerged as a potential biologic alternative; however, comparative evidence remains limited.</p><p><strong>Methods: </strong>This prospective unblinded randomized comparative study included 60 patients with clinically and magnetic resonance imaging (MRI)-confirmed Morton neuroma treated with either a single corticosteroid injection (n=30) or 3 leukocyte-poor PRP injections (n=30). All patients had failed ≥6 months of conservative treatment. Primary outcomes were PROMIS Physical Function (PF) and Pain Interference (PI) scores at baseline and 3, 6, and 12 months. Secondary outcomes included neuroma size on MRI at 6 months and complications.</p><p><strong>Results: </strong>Baseline characteristics and PROMIS scores were comparable between groups. Both groups demonstrated significant improvement; however, PRP was associated with better outcomes at all time points. At 12 months, PROMIS PF was 61.8 ± 6.2 vs 55.2 ± 6.8 (<i>P</i> < .001), and PROMIS PI was 38.4 ± 6.1 vs 44.2 ± 6.8 (<i>P</i> = .001), favoring PRP. At 6 months, neuroma size was smaller in the PRP group (4.2 ± 1.1 vs 5.8 ± 1.4 mm; <i>P</i> < .001). Complication rates were low and comparable between groups. Post-injection pain rates were comparable between groups; Minor complications occurred only in the corticosteroid group, although differences did not reach statistical significance.</p><p><strong>Conclusion: </strong>PRP was associated with improved clinical outcomes and reduction in neuroma size at 12 months compared with corticosteroid injection. Although these findings support further investigation of PRP for symptomatic Morton neuroma, they should be interpreted cautiously and considered hypothesis generating pending confirmation in larger, methodologically rigorous studies.</p><p><strong>Level of evidence: </strong>Level II, lesser quality RCT or prospective comparative study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1305-1313"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868681","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":"Techniques and Strategies for Managing Complex Failures in Total Ankle Arthroplasty: A Contemporary Review.","authors":"Jensen K Henry, Elena Karas, Constantine A Demetracopoulos","doi":"10.1177/10711007261471832","DOIUrl":"10.1177/10711007261471832","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"1251-1261"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148858028","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":"Plate-Based Operative Management of Medial Malleolar Stress Fractures in High-Level Basketball Players: A Short Report.","authors":"Emmett O'Malley, Jaeyoung Kim, Martin O'Malley","doi":"10.1177/10711007261484949","DOIUrl":"https://doi.org/10.1177/10711007261484949","url":null,"abstract":"<p><strong>Background: </strong>Medial malleolar stress fractures (MMSFs) are uncommon but potentially high-risk injuries in athletes. In basketball players, repetitive jumping, landing, and cutting may expose the characteristic vertical fracture pattern to substantial shear, yet sport-specific operative data remain limited. This study reports the outcomes of plate-based fixation for MMSFs in high-level basketball players.</p><p><strong>Methods: </strong>A retrospective case series was performed of 10 high-level basketball players treated surgically for MMSF between 2007 and 2025. All patients underwent radiography, magnetic resonance imaging, and computed tomography (CT). Operative treatment consisted of shear resisting plate-based fixation (one-third tubular anti-glide or hook plate) with fracture-perpendicular screws, selective bone grafting, biologic augmentation, and treatment of associated anterior impingement when indicated. Primary outcomes were radiographic union, return to play, and need for additional surgery.</p><p><strong>Results: </strong>All patients were male, with a median age of 20.5 years (range, 18-26). Median height was 205.5 cm (IQR, 198-213), and the median weight was 103.5 kg (IQR, 93-113). Eight players were professional and 2 were collegiate athletes later drafted professionally. CT demonstrated a vertically oriented fracture arising from the anteromedial tibial plafond in all cases. Union was achieved in all players. Nine returned to full team activities by 12 weeks and to competitive play at a median of 4 months (range, 3-4 months). One player sustained a traumatic refracture 8 months after index fixation, required 2 revision procedures, ultimately healed after supplemental anterior plating, and returned to play at 6 months.</p><p><strong>Conclusion: </strong>Plate-based fixation was associated with reliable union and return to play, although revision surgery was required in 1 of 10 players. Given the consistent vertical fracture morphology and substantial sport-specific loading demands, shear resisting plating may be considered in this population.</p><p><strong>Level of evidence: </strong>Level IV, case series.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261484949"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077077","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":"Tibiotalocalcaneal Arthrodesis: Deformity Correction in Medically Comorbid Patients.","authors":"Austin G Alecxih, Christina B Klouda, Joseph R Duff, Robert P Parker, Andrew W Wilson, Jesse F Doty","doi":"10.1177/10711007261484160","DOIUrl":"https://doi.org/10.1177/10711007261484160","url":null,"abstract":"<p><strong>Background: </strong>Tibiotalocalcaneal (TTC) arthrodesis is a common orthopaedic procedure used to manage end-stage pathologies of the ankle and hindfoot. A variety of surgical techniques exist to accomplish TTC arthrodesis. We retrospectively reviewed and compared postoperative outcomes of 2 different TTC arthrodesis constructs, including intramedullary nail (IMN) and open plating (OP) with a plate/screw construct, in high-risk patients with a wide range of deformity and comorbidities.</p><p><strong>Methods: </strong>A retrospective review was conducted on 73 ankles of 69 consecutive patients who underwent TTC arthrodesis by a fellowship-trained foot and ankle orthopaedic surgeon at a tertiary referral academic center between 2014 and 2025. Diagnoses, patient characteristics and comorbidities, postoperative outcomes, and operative data were recorded and evaluated.</p><p><strong>Results: </strong>Postoperative complications occurred in 23 of 73 ankles overall (32%), including 16 of 55 IMN fusions (29%) and 7 of 18 OP fusions (39%) (OR 0.64, 95% CI 0.21-1.96; <i>P</i> = .56). Revision TTC arthrodesis was required after 2 of 55 IMN TTC fusions (4%) and 5 of 18 OP TTC fusions (28%) (OR 0.10, 95% CI 0.02-0.56; <i>P</i> = .008). IMN revisions were for 2 periprosthetic fractures. OP revisions were for 4 nonunions and 1 periprosthetic fracture. Amputation was performed after 4 IMN fusions (7%) and 1 OP fusion (6%)(OR 1.33, 95% CI 0.14-12.76; <i>P</i> = .99). In 19 ankles that presented with nonunion, the salvage TTC arthrodesis was associated with 2 revision TTC fusions (11%), 1 persistent nonunion (5%), and 1 amputation (5%). In 34 ankles that presented with Charcot arthropathy, the salvage TTC arthrodesis was associated with 4 amputations (12%), 2 nonunions (6%), 2 periprosthetic fractures (6%), and 2 revision TTC fusions (6%). Hardware removal was necessary after 13 surgeries (18%).</p><p><strong>Conclusion: </strong>This study suggested a lower rate of union and an increased rate of revision surgery after open plating arthrodesis compared with intramedullary nail arthrodesis. Overall, intramedullary nailing may be a more reliable construct compared with open plating in high-risk patients with diabetes and severe deformities.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261484160"},"PeriodicalIF":2.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070718","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":"Diagnostic Validity of Ultrasound Imaging After Injection Into the Peroneal Tendon Sheath for Detecting Pseudo-Pouch Formation in Recurrent Peroneal Tendon Dislocation.","authors":"Akinobu Nishimura, Shigeto Nakazora, Yoshiyuki Senga, Naoya Ito, Masahiro Hasegawa","doi":"10.1177/10711007261481166","DOIUrl":"https://doi.org/10.1177/10711007261481166","url":null,"abstract":"<p><strong>Background: </strong>Recurrent peroneal tendon dislocation (RPTD) can be difficult to diagnose when tendon dislocation cannot be reproduced clinically. Most cases are associated with pseudo-pouch formation due to incomplete healing of the superior peroneal retinaculum/fibrocartilaginous ridge complex. We evaluated ultrasound-guided intrasheath fluid injection (US-I) for detecting pseudo-pouch formation and compared it with magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>In this small retrospective diagnostic case-control study, 23 ankles with surgically confirmed RPTD and 11 symptomatic ankles without RPTD underwent MRI and US-I. Pseudo-pouch formation was independently assessed by 3 foot and ankle surgeons. Intraoperative findings served as the reference standard in the RPTD group. For the primary endpoint, sensitivity, specificity, and interobserver agreement for pseudo-pouch detection were calculated for both modalities. As an exploratory analysis, we also assessed the sensitivity of pseudo-pouch positivity on US-I for surgically confirmed RPTD.</p><p><strong>Results: </strong>The study included 23 RPTD ankles (mean age, 29.9 ± 18.1 years) and 11 control ankles (mean age, 38.8 ± 17.3 years). Twenty-one of 23 RPTD cases had an intraoperative pseudo-pouch, all detected by US-I; the remaining 2 had no pseudo-pouch on US-I or at surgery. For pseudo-pouch detection, US-I showed 100% sensitivity (95% CI, 83.9%-100.0%) and 100% specificity (95% CI, 75.3%-100.0%), whereas MRI showed 38.1% sensitivity (95% CI, 18.1%-61.6%) and 100.0% specificity (95% CI, 75.3%-100.0%). In the exploratory RPTD analysis, US-I identified 21 of 23 RPTD ankles (91.3% sensitivity).</p><p><strong>Conclusion: </strong>In this small retrospective cohort, US-I may improve visualization of pseudo-pouch morphology compared with routine MRI in selected patients with suspected RPTD. This technique may provide clinically useful diagnostic information, particularly when tendon dislocation cannot be reproduced during physical examination. Prospective validation in a consecutive suspected-RPTD cohort is needed.</p><p><strong>Level of evidence: </strong>Level III, diagnostic study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261481166"},"PeriodicalIF":2.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032294","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":"Hindfoot Varus Is Not Universally Present in Müller-Weiss Disease: A Clinical and Radiographic Analysis.","authors":"Wenbo Bai, Chen Cheng, Hanyi Zheng, Yinghao Li, Yongzhan Zhu, Guodong Shen","doi":"10.1177/10711007261484951","DOIUrl":"https://doi.org/10.1177/10711007261484951","url":null,"abstract":"<p><strong>Background: </strong>Hindfoot varus has traditionally been considered a characteristic feature of Müller-Weiss disease (MWD), but its universality remains uncertain. This study evaluated hindfoot alignment in MWD using the Saltzman hindfoot alignment view.</p><p><strong>Methods: </strong>Patients diagnosed with MWD between January 2015 and December 2025 were retrospectively reviewed. Feet were included if they met minimum diagnostic criteria and had complete clinical hindfoot photographs, Saltzman hindfoot alignment views, and weightbearing anteroposterior and lateral foot radiographs. Saltzman hindfoot alignment, clinical hindfoot alignment angle, Kite angle, and the lateral Meary-Tomeno angle were measured. Agreement between clinical and Saltzman categories was evaluated using Cohen kappa. Linear mixed effects model accounted for bilateral involvement.</p><p><strong>Results: </strong>The cohort comprised 103 patients (160 feet), with a mean age of 58.3 ± 8.8 years; 95 patients (92.2%) were women. Interobserver reliability was good to excellent, whereas intraobserver reliability was excellent. On the Saltzman view, 76 feet (47.5%) were varus, 19 (11.9%) neutral, and 65 (40.6%) valgus; 84 feet (52.5%; 95% CI, 44.8%-60.1%) demonstrated non-varus alignment. Exact 3-category agreement between clinical and Saltzman classifications was 81.3%, with substantial overall agreement (κ = 0.683, <i>P</i> < .001). Clinical hindfoot alignment angle and Kite angle were associated with Saltzman hindfoot alignment, whereas the lateral Meary-Tomeno angle was not significantly associated with Saltzman hindfoot alignment (<i>P</i> = .76).</p><p><strong>Conclusion: </strong>Hindfoot varus was not universal in MWD. Clinical hindfoot appearance and Kite angle were associated with standardized coronal hindfoot alignment, whereas no statistically significant association was detected for the lateral Meary-Tomeno angle. These findings support direct assessment of hindfoot alignment and individualized, multiplanar evaluation before implementing a patient-specific treatment plan in patients with MWD.</p><p><strong>Level of evidence: </strong>Level III, retrospective cohort study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261484951"},"PeriodicalIF":2.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032307","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":"Treatment of Chronic Achilles Tendon Ruptures: A Contemporary Review.","authors":"Avarie Rembert, Benjamin Hershfeld, Brandon Klein, Adam D Bitterman","doi":"10.1177/10711007261481830","DOIUrl":"https://doi.org/10.1177/10711007261481830","url":null,"abstract":"","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261481830"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984320","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":"Ligament Advanced Reinforcement System (LARS) Augmented Repair vs Autograft Reconstruction for Chronic Lateral Ankle Instability: A Retrospective Comparative Study.","authors":"Tong Wu, Zi Li, Jingjing Zhao, Cheng Hao, Wei Xie, Ke Fu, Shenghong Jia, Zhenhua Fang","doi":"10.1177/10711007261481801","DOIUrl":"https://doi.org/10.1177/10711007261481801","url":null,"abstract":"<p><strong>Background: </strong>Both autograft reconstruction and Ligament Advanced Reinforcement System (LARS) augmented repair are used for chronic ankle instability (CAI), but comparative evidence regarding postoperative recovery remains limited. This study compared recovery trajectories and functional outcomes between these techniques over 24 months.</p><p><strong>Methods: </strong>A total of 112 patients with CAI undergoing LARS augmented repair (n = 54) or autograft reconstruction (n = 58) were retrospectively analyzed. Primary outcomes were the Foot and Ankle Outcome Score Sport and Recreation subscale (FAOS-Sport) and Tegner activity score. Secondary outcomes included other FAOS subscales and visual analog scale (VAS) pain scores. Outcomes were assessed preoperatively and at 1, 3, 6, 12, and 24 months postoperatively; VAS was not assessed at 24 months. Longitudinal recovery trajectories were analyzed using generalized estimating equations, and an exploratory FAOS-based minimal clinically important difference (MCID) responder analysis was performed.</p><p><strong>Results: </strong>All outcomes improved significantly over time (all <i>P</i> < .001). Compared with the autograft group, the LARS group demonstrated higher FAOS-Sport and Tegner scores at 1, 3, and 6 months (all <i>P</i> < .001), indicating faster early functional recovery. Similar early advantages were observed in secondary outcomes, but between-group differences were no longer evident at 12 and 24 months. In the exploratory MCID analysis, a greater proportion of LARS patients achieved the FAOS MCID at 3 months, whereas all available patients in both groups reached the threshold by 6 months.</p><p><strong>Conclusion: </strong>Both LARS augmented repair and autograft reconstruction were associated with improved functional outcomes over time. LARS was associated with faster early recovery, whereas differences diminished over time and no significant between-group difference could be detected in the outcomes available by 24 months. LARS may be considered for patients prioritizing early functional recovery.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":94011,"journal":{"name":"Foot & ankle international","volume":" ","pages":"10711007261481801"},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978641","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}