The international journal of lower extremity wounds最新文献

{"title":"Effects of Wound Localisation on Balance, Performance, Muscle Strength, and Gait Speed in Individuals with Diabetic Foot Ulcer: A Cross-Sectional Study.","authors":"Tezel Yıldırım Şahan, Simay Akyüz, Binnaz Bozkurt, Buse Kılınç, Gözde Tekin, Büşra Nur Fındık, Derya Çağlar, Betül Erbay, Kerim Bora Yılmaz","doi":"10.1177/15347346251315867","DOIUrl":"10.1177/15347346251315867","url":null,"abstract":"<p><p>Muscle strength, balance, performance, and gait speed of individuals diagnosed with diabetic foot wound are negatively affected. This study aimed to investigate the effects of wound localisation on balance, performance, muscle strength, and gait speed in individuals with diabetic foot wounds. Individuals (n = 48) with a mean age of 59.35 ± 11.28 years and were divided into two groups according to wound localisation as group 1 (n = 24) with forefoot wounds and group 2 (n = 24) with hindfoot wounds. Four Step Square Test was used for dynamic balance assessment, Timed Up and Go Test for performance, Manual Muscle Tests for muscle strength, and 10 Meter Walk Test for gait speed assessment. When compared in terms of muscle strength, there was a difference only between the injured side Gluteus Medius (p = 0.02), Gastrosoleus (p = 0.00), and Tibialis Anterior (p = 0.03) muscles. Other muscle groups strength, balance, performance, and gait speed were similar (p > 0.05). Loss of muscle strength can lead to serious negative consequences such as deformity and new wound formation if not intervened in time. The effects on balance and performance are similar in different wound localizations.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"952-959"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124262","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":"SGLT-2 Inhibitors and Lower-limb Amputations in Diabetes: A Misunderstood Relationship? Insights from a Retrospective Study.","authors":"Dimitrios Pantazopoulos, Prashanth Rj Vas, Kittipan Rerkasem, Nikolaos Papanas","doi":"10.1177/15347346261460129","DOIUrl":"10.1177/15347346261460129","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"655-658"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311125","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":"Construction and Validation of a Predictive Nomogram Model for Patients with Type 2 Diabetes Complicated by Diabetic Foot Ulcers.","authors":"Yaojuan Gao, Min Fei, WenJin Gong, MingJie Zhang, JinQian Sheng, YiWei Yang, Qiong Fang, Min Cai","doi":"10.1177/15347346251316948","DOIUrl":"10.1177/15347346251316948","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the risk factors for diabetic foot ulcers (DFU) in patients with type 2 diabetes (T2DM), to create a nomogram prediction model, and to further validate the nomogram model. 500 T2DM patients treated at Shanghai Integrated Traditional Chinese and Western Medicine Hospital were retrospectively analyzed from April 2023 to November 2023. Patients were categorized into groups based on the presence of DFU (n = 64) and T2DM (n = 436). Clinical data were analyzed, and relevant parameters were assessed using a receiver operating curve (ROC) analysis. A risk prediction model was created using the R language software 4.0 \"rms\" and validated using calibration and decision curves. Age, diabetes duration, coronary heart disease, cerebrovascular disease, diabetic nephropathy, HbA1c, and fasting blood glucose were significantly higher in the DFU group (OR = 1.598,1.444,1.101,1.210,1.414,2.132,1.935，all P＜0.001). Gender, family history of diabetes, hypertension, peripheral neuropathy, drug regimen, and lipid levels showed no significant differences (P > 0.05). Logistic regression analysis identified age, diabetes duration, athlete's foot infection, HbA1c, and fasting blood glucose as independent risk factors for DFU in T2DM. The nomogram model yielded a C-index of 0.822 (95% CI: 0.813-0.882), indicating a net clinical benefit. The constructed nomogram prediction model based on age, diabetes duration, athlete's foot infection, HbA1c, and fasting blood glucose provides a simple assessment method for DFU in T2DM patients. Further validation of this model is warranted.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"971-978"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412235","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":"Replicating Success in Conservative Surgery for Diabetes-Related Forefoot Osteomyelitis: A Comparative Study Between Two Diabetic Foot Units in Spain and Costa Rica.","authors":"Gerardo Víquez-Molina, José María Rojas-Bonilla, Javier Aragón-Sánchez","doi":"10.1177/15347346251323104","DOIUrl":"10.1177/15347346251323104","url":null,"abstract":"<p><p>To evaluate whether the adoption of conservative surgical techniques in Costa Rica, facilitated by international collaboration and training, achieved outcomes comparable to those in a reference unit in Spain. This retrospective study included 199 patients with histologically confirmed diabetes-related forefoot osteomyelitis: 110 from Costa Rica and 89 from Spain. Data were extracted from two standardized databases. Infection severity was classified according to IWGDF/IDSA criteria. Surgical procedures were categorized as conservative surgery, minor amputation, or major amputation. Antibiotic use and hospitalization rates were compared between cohorts. Statistical analyses included Chi-squared and Mann-Whitney U tests. Patients in Costa Rica were younger and exhibited poorer metabolic control, while patients in Spain had higher rates of comorbidities. Despite more severe infections in Costa Rica, characterized by higher inflammatory markers and soft tissue involvement, 39.1% of Costa Rican patients were treated without postoperative antibiotics, and the median antibiotic duration was significantly shorter (14 vs 30 days, p < 0.001). The rates of conservative surgery were similar in both groups (62.7% in Costa Rica vs 65.2% in Spain, p = 0.63). When excluding cases with soft tissue involvement, conservative surgery was performed in 86.0% of Costa Rican cases and 96.0% of Spanish cases (p = 0.167). This study demonstrates that structured training and international collaboration enabled the adoption of surgical strategies comparable to those in a reference unit in Spain, achieving similar clinical outcomes. The findings highlight the potential for conservative surgery and antibiotic stewardship to optimize care in resource-limited settings while reducing unnecessary interventions.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"988-996"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517769","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":"Association Between Systemic Immune-Inflammatory Index (SIRI) and Diabetic Foot Ulcers in Individuals with Diabetes: Evidence from the NHANES.","authors":"Bei Liu, Lin Wang, Yufeng He","doi":"10.1177/15347346241309180","DOIUrl":"10.1177/15347346241309180","url":null,"abstract":"<p><p><b>Background:</b> Diabetic Foot Ulcer (DFU) is a common and challenging complication of diabetes mellitus, associated with high recurrence, hospitalization, disability, and mortality rates. The Systemic Immune Inflammatory Index (SIRI) based on complete blood counts has been shown to correlate with several diseases but has not been widely studied in DFU.This study aimed to explore the relationship between SIRI and the presence of DFU in individuals with diabetes using data from the National Health and Nutrition Examination Survey (NHANES). <b>Methods:</b> A cross-sectional analysis was conducted on 1246 individuals with diabetes from NHANES cycles 1999-2000, 2001-2002, and 2003-2004. DFUs were identified through patient self-reported data. Multivariate logistic regression models assessed the association between SIRI and DFU, adjusting for potential confounders. Subgroup and interaction analyses were also performed. <b>Results:</b> A total of 117 patients were identified as having DFU. Elevated SIRI levels were significantly associated with DFU presence. In fully adjusted models, a 1-unit increase in SIRI was associated with 24.0% higher odds of DFU prevalence (OR = 1.24; 95% CI: 1.07, 1.43) Subgroup analyses revealed consistent associations across different groups of age, gender, body mass index (BMI), HbA1c, blood glucose, and hemoglobin levels. <b>Conclusion:</b> The findings indicate a positive correlation between SIRI and DFUpresence. Further research is warranted to elucidate the mechanistic links and explore the clinical utility of SIRI in DFU management.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"861-869"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857268","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":"The Efficacy of Low-Temperature Atmospheric-Pressure Plasma (LTAPP) in the Multicenter Treatment of Pressure Ulcers: A Randomized Controlled Trial.","authors":"Warangkana Tonaree, Sitthichoke Taweepraditpol, Natthapong Kongkunnavat, Nattanit Poungjantaradej, Boonyaporn Kotistienkul, Min Yongsuvimol, Kusuma Chinaroonchai, Pitawan Rachata, Pattana Ongkasuwan, Orawan Chansanti, Atthawit Mongkornwong, Chonlathorn Chaichote, Apirag Chuangsuwanich","doi":"10.1177/15347346251323940","DOIUrl":"10.1177/15347346251323940","url":null,"abstract":"<p><p>IntroductionThis study is to examine the reduction in wound size between the LTAPP and the control group and also investigate the wound healing effect factor.MethodsA randomized controlled trial was conducted at five study centers. Participated patients were between 18-80 years old who had pressure ulcer wound(s) and excluded patients with high risk or receiving other treatment such as previous radiation therapy in the affected area, pregnancy, sepsis, and immunocompromised host. The study divided participant into LTAPP group and standard of care (SOC) group, the LTAPP group would received a dressing of non-Ag materials and administer LTAPP for 1 min per 1 cm² (maximum of 20 min). The SOC group would received standard dressing wound protocol. Both groups would be followed until the end of study (ninth visit) or until the wound healed.ResultsWhen considering patients who attended follow-up ≥4 visits, only 45 ulcers were eligible, of which consisted of 21 ulcers in the LTAPP group and 24 ulcers in the SOC group. The results showed significant healing rate of the LTAPP group, whether to be the wound size: wound area and wound volume, wound healing: exudate reduction, granulation and lesser necrotic tissue or Pressure Ulcer Scale for Healing (PUSH) score. The LTAPP group had better bacterial load reduction without the use of tropical antibiotic, this also signified the quality in bacterial eradication of LTAPP.ConclusionLTAPP showed outstanding performance in treating pressure ulcer wounds. The LTAPP gave greater outcome in wound size, wound healing indicators, microbiological analyses and cost-effective comparison. Although, the absence of statistical significance, it did not affect the outcome trends. This study suggested further investigation of the potential role of LTAPP therapy in different wound types in near future.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"1015-1027"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652942","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":"Diabetic Foot Osteomyelitis in Patients with and without Peripheral Arterial Disease: Two Different Diseases?","authors":"Marco Meloni, Ermanno Bellizzi, Aikaterini Andreadi, Michela Di Venanzio, Luca Mazzeo, Laura Giurato, Alfonso Bellia, Luigi Uccioli, Davide Lauro","doi":"10.1177/15347346241264383","DOIUrl":"10.1177/15347346241264383","url":null,"abstract":"<p><p>The aim of the current study was to evaluate the outcomes of patients with diabetic foot osteomyelitis (DFO), comparing subjects with and without peripheral arterial disease (PAD). The study is a prospective study including a population of patients affected by a DFO located in the forefoot. All patients were managed by a surgical conservative approach defined by the removal of the infected bone, in association with the antibiotic therapy. Patients were divided into two groups: those with PAD (neuro-ischaemic DFO) and those without (neuropathic DFO). After 1 year of follow-up, the following outcome were evaluated and compared between groups: healing, healing time, minor amputation, major amputation, hospitalization, need for surgical re-intervention. Overall, 166 patients were included, 87(52.4%) of them had neuro-ischaemic DFO and 79 (47.6%) neuropathic DFO. Patients with neuro-ischaemic DFO in comparison to neuropathic DFO were older (72.5 ± 9 vs 64.1 ± 15.5 years, <i>P</i> < .0001), had longer diabetes duration (21.8 ± 5.6 vs 16.4 ± 7.6 years, <i>P</i> < .0001), higher rate of dialysis (13.8 vs 1.3%, <i>P</i> = .001) and ischaemic heart disease (79.3 vs 12.7%, <i>P</i> < .0001). Outcomes for neuro-ischaemic DFO and neuropathic DFO were: healing (96.5 vs 97.5%, <i>P</i> = .7), healing time (7.8 ± 6.2 vs 5.7 ± 3.7 weeks, <i>P</i> = .01), minor amputation (16.1 vs 3.8%, <i>P</i> = .006), major amputation (0 vs 0%, ns), hospitalization (90.8 vs 51.9%, <i>P</i> < .0001), surgical re-intervention (14.9 vs 8.8%, <i>P</i> = .004) respectively. In addition, PAD resulted in an independent predictor of minor amputation, hospitalization, and surgical re-intervention. DFO in patients with PAD was characterized by longer healing time, more cases of minor amputation, hospitalization, and surgical re-intervention. PAD independently predicted the risk of minor amputation, hospitalization, and surgical re-intervention, while it was not associated with the healing rate.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"726-734"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736235","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":"Evaluation of CONUT Score and Serum Zinc Levels in Patients with Diabetic Foot Ulcers.","authors":"Hideharu Nakamura, Takaya Makiguchi, Yumi Yamada, Aya Tsunoda, Nana Tomaru, Satoshi Yokoo","doi":"10.1177/15347346251326247","DOIUrl":"10.1177/15347346251326247","url":null,"abstract":"<p><p>BackgroundDiabetic foot ulcer (DFU) is a severe complication of diabetes. Nutritional deficiencies, including poor nutritional status reflected by a high CONUT score and low serum zinc have been implicated in the severity and wound healing failure of DFU. However, the association between these factors and DFU remains unclear.MethodsA retrospective cohort study was performed in 319 patients categorized into three groups: healthy controls (HC, n = 213), patients with diabetes without foot ulcer (DM, n = 67), and patients with diabetes with foot ulcer (DFU, n = 39). Demographic, clinical, nutritional, and biochemical data were collected, including age, sex, body mass index, the presence of chronic limb-threatening ischemia (CLTI), the presence of maintenance dialysis, CONUT score, hemoglobin A1c, hemoglobin (Hb), total protein (TP), and zinc levels. The severity of DFU was assessed using the PEDIS score, while wound healing failure was defined based on specific clinical criteria. Statistical analyses were conducted to identify factors associated with DFU severity and wound healing failure.ResultsDFU cases had significantly lower Hb, TP, and zinc levels and higher CONUT score compared to the HC and DM cases. Within the DFU group, high PEDIS score (>8) was associated with significantly higher CONUT score, lower TP levels, and the presence of CLTI. Patients with wound healing failure had significantly lower zinc and Hb levels and a higher prevalence of CLTI. Multivariable logistic regression identified CONUT score and the prevalence of CLTI as independent factors associated with DFU severity, while serum zinc levels and the prevalence of CLTI were independently associated with wound healing failure.ConclusionsThis study highlighted the critical role of poor nutritional status, as indicated by high CONUT score, and zinc deficiency in the severity and poor healing outcomes of DFU. These findings underscore the critical role of nutritional management in comprehensive treatment of DFU.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"1007-1014"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627220","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":"Real-Life Data on Wound Healing Speed and Duration to Wound Closure by Different Aetiology in a Primary Care Centre in the Netherlands.","authors":"Wouter Brekelmans, Boudewijn L S Borger van der Burg, Bart Fischer, Maartje Hesseling-Kuijpers, Rigo Hoencamp, Harm Jaap Smit","doi":"10.1177/15347346241273327","DOIUrl":"10.1177/15347346241273327","url":null,"abstract":"<p><p>Correct classification of wounds is of paramount importance for diagnostic and therapeutic pathways. The aim of this study was to provide insight in the incidence of different aetiology of wounds and the healing time in a primary care setting. All patients with a wound presented in Primary Care (PC) practice from January 2017 through 2020 were included. A retrospective analysis related to age, sex, duration of wound healing, healing-rates, aetiology and comorbidity of the patients was performed. The prevalence of wounds in primary care was is 3.9 per 1000. In more than 90% of the wounds heal within 37 days. The wound healing speed and duration to closure differ significantly (<i>P</i> = .002) between aetiology. This study shows that 90% of wounds that enter a Dutch GP practice heal within 37 days. This study provides unique data on wound healing rates differentiated by etiology.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"773-779"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142020057","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":"Exploring the Relationship Between SVS WIfI and IWGDF Scoring Systems and Reamputation Risk in Patients With Diabetic Foot and Peripheral Artery Disease.","authors":"Alkan Bayrak, Mustafa Yalın, Mehmet Utku Çiftçi, Malik Çelik, Vedat Öztürk, Serdar Hakan Basaran","doi":"10.1177/15347346251333835","DOIUrl":"10.1177/15347346251333835","url":null,"abstract":"<p><p>Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05, <i>P</i> = .001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88, <i>P</i> = .008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission (<i>P</i> = .03) and mortality rates (<i>P</i> = .01). Male gender (OR: 3.47, 95% CI: 1.45-8.31, <i>P</i> = .005), diabetes (OR: 2.32, 95% CI: 1.10-4.90, <i>P</i> = .027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08, <i>P</i> = .021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43, <i>P</i> < .001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"1028-1037"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060410","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}