The international journal of lower extremity wounds最新文献

{"title":"Cold Environment-Associated Extremity Lesions or Severe Hypothermia Help Differentiate Between Frostbitten and Trench Foot (Immersion Foot).","authors":"Motomu Suito, Takuya Yanagida, Miho Ohtsubo, Kazuhiro Tsunekawa, Niro Kikuchi","doi":"10.1177/15347346241273138","DOIUrl":"10.1177/15347346241273138","url":null,"abstract":"<p><p>Cold associated foot injuries, such as frostbite and trench foot (immersion foot) are relatively common in cold environments. The former is classified as a freezing cold injury, and the latter as a nonfreezing cold injury. Trench foot is sometimes misdiagnosed as frostbite, and rapid rewarming exacerbates the condition. This paper aims to help differentiate between frostbitten foot and trench foot. This study included patients with frostbitten foot or trench foot treated at our hospital between December 2005 and May 2023. The differences in sex, age, month of injury, conditions at the time of injury, injury distribution, foot lesion laterality, other complications upon arrival (finger frostbite, immersion hand, or hypothermia), and presence and distribution of sensory disturbance at discharge were noted among the groups. A total of 16 patients (14 men) with frostbitten foot and 3 patients (3 men) with trench foot were identified. Finger frostbite observed in nine and zero patients with frostbitten foot and trench foot, respectively; and severe hypothermia on arrival observed in five and zero patients with frostbitten foot and trench foot, respectively. Physical findings at the initial examination showed that the frostbitten feet were dry, and the lesions were distal and clearly demarcated, whereas feet with trench foot were wet, and the lesions covered the entire sole and were not clearly demarcated. Accurate differentiation between frostbitten foot and trench foot and appropriate initial treatment are important. The presence of finger frostbite, immersion hand or severe hypothermia may help to differentiate between frostbitten foot and trench foot.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"809-816"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373966","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":"Application of Continuous Care Pattern Based on Information-Motivation-Behavioral Skills Model in out-of-Hospital Rehabilitation of Diabetic Foot Ulceration Patients: A Randomized Controlled Trial.","authors":"Zhenxue Zhao, Wenchao Xu, Suxia Wang, Dandan Zhang, Yuqi Wang","doi":"10.1177/15347346241275243","DOIUrl":"10.1177/15347346241275243","url":null,"abstract":"<p><p>ObjectiveTo explore the effect of information-motivation-behavioral skills model (IMB)-based continuous nursing model on the out-of-hospital rehabilitation of diabetic foot ulceration (DFU) patients, and to provide a theoretical basis for long-term disease management of DFU patients.MethodsA total of 88 patients with DFU admitted to our Hospital were included in this prospective study. The patients were divided into control and study groups using the random number table method, with 44 cases in each group. Patients in the study group received both routine care and IMB-based continuing care, and the control group received only routine care.ResultsAt week 1, FBS, PBG (2 h) and HbA1c were significantly decreased in the study group compared with that in the control group (<i>P </i>< .05). At week 3 and 6, blood glucose indicators were significantly improved in both groups compared with week 1 (<i>P </i>< .05). In additional, the number of non-infected patients at week 1 and week 3 in the study group was significantly higher than that in the control group (<i>P </i>< .05). At week 3, the number of cured patients was significantly higher in the study group than that in the control group (<i>P </i>< .05). And the area of ulcer healing in the study group was significantly larger than that in the control group at week 1 and week 3 (<i>P </i>< .05).ConclusionIn conclusion, the continuous nursing mode based on IMB can help DFU patients manage blood glucose level, reduce wound infection, and accelerate wound healing, which is worthy of wide clinical application and promotion.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"762-772"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038079","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":"Randomized Controlled Trial to Compare AmnioExcel Human Amniotic Allograft in Weekly Versus Biweekly Treatment of Diabetic Foot Ulcers.","authors":"Lawrence A Lavery, Mehmet A Suludere, Kathryn Raspovic, Peter Andrew Crisologo, Matthew J Johnson, Arthur N Tarricone","doi":"10.1177/15347346241276697","DOIUrl":"10.1177/15347346241276697","url":null,"abstract":"<p><p>Our objective was to compare clinical outcomes in diabetic foot ulcers (DFU) treated with AmnioExcel^® applied weekly (AMX1) or biweekly (AMX2) over a 12-week evaluation period. This randomized clinical trial evaluated 40 people with UT 1A and 1D DFUs >30 days but less than 6 months duration and age >21 years. We excluded patients with untreated osteomyelitis, gangrene, widespread malignancy, or active substance abuse. Patients received amniotic tissue either once a week or every other week. We used a 3D measurement device (inSight, eKare, Fairfax, Virginia)\". There was no difference in the incidence of healing (AMX1 30.0% vs AMX2 50.0%, p = 0.20), time to heal (69.3 ± 30.3 vs 45.8 ± 25.6 days, p = 0.15), or incidence of infection (AMX1 35.0% vs AMX2 25.0%, p = 0.49). The mean wound area reduction was 0.18 ± 0.48 cm² per week for AMX1 and 0.15 ± 0.63 cm² week for AMX2 (p = 0.42). When we compared wound healing trajectories in healers and non-healers. There were no differences in the mean wound area reduction for healers (0.26 ± 0.40 cm² per week) and non-healers (0.14 ± 0.52 cm² per week, p = 0.20). Our results suggested there is no difference in the incidence of healing, time to heal or incidence of infection based on weekly or biweekly application of amniotic tissue.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"891-898"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960896","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":"Assessing the scientific impact of scientists and the role of altmetrics: Realistic goal or utopia?","authors":"Miltos K Lazarides, Nikolaos Papanas","doi":"10.1177/15347346261483733","DOIUrl":"https://doi.org/10.1177/15347346261483733","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261483733"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877061","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":"Overweight yet Undernourished: A Common Juxtaposition in the Specialist Diabetes Foot Service.","authors":"Wrivu Niezel Martin, Hayley Katherine Wigmore, Leanne Caroline Gregory, Cheryl Mei Yee Lum, Joel Willem Johan Lasschuit","doi":"10.1177/15347346241310266","DOIUrl":"10.1177/15347346241310266","url":null,"abstract":"<p><p>AimsTo describe the nutritional status of people with diabetes-related foot complications and explore the association between nutrition and ulceration healing.MethodsThis retrospective cohort study included attendees of a diabetes foot service who completed a dietary questionnaire. Diet was compared to guideline recommendations and biochemical measures were recorded. Associations between dietary intake and biochemical measures were analysed using non-parametric tests, and their relationship with being ulcer-free at 12 weeks analysed by binary logistic regression.ResultsOf 102 participants, 83% were men, mean age 68 (SD 12), body mass index 28.6 (SD 6.1) kg/m², and 86% had type 2 diabetes. Complications included 154 ulcerations and 7 active Charcot feet. Recommended fruit, vegetable and protein intake was seldom attained. Common insufficiencies were 25-hydroxy-vitamin D (40%), zinc (27%), iron (23%) and vitamin C (21%). Vitamin C was higher in the upper (vs lower) tertile of fruit/vegetable intake (62 [95%CI 33-88] vs 30 [13-46] umol/L, p = 0.04), and zinc higher in those meeting protein requirements (12.3 [95%CI 11.1-12.8] vs 10.6 [9.8-11.5] umol/L, p = 0.04). Haemoglobin was the only predictor of becoming ulcer-free (OR 1.03 [95%CI 1.00-1.06], p = 0.03).ConclusionNutritional inadequacies are common in people with diabetes-related foot complications; however, the benefit of assessing nutrition remains uncertain.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"929-937"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054765","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":"Investigating Nonadherence in an Integrated Diabetic Limb Salvage Programme: Reasons, Associated Factors, and Impacts on Care Outcomes.","authors":"Lixia Ge, Yee Gary Ang, Joseph Molina, Yan Sun, Elaine Tan, Huiling Liew, Jeremy Hoe, Jaime Hui Xian Lin, Hui Yan Koo, Kai Qiang Low, Julia Choo, Theophilus Yap, Nur Aberleen Syafirah Bte Azmi, Donna Tan, Yi Bing Loh, Xiaoli Zhu, Enming Yong, Qiantai Hong, Tiffany Chew, Dexter Yak Seng Chan, Claris Shi, Chelsea Law, Wai Han Hoi, James Siow, Jo Ann Lim, John Arputhan Abisheganaden, Daniel Chew, Zhiwen Joseph Lo","doi":"10.1177/15347346241294178","DOIUrl":"10.1177/15347346241294178","url":null,"abstract":"<p><p>Adherence to treatment plans is crucial for patients with diabetic foot ulcers (DFUs) to achieve positive outcomes. With limited understanding of nonadherence and its impacts on care outcomes, this study aimed to explore the reasons and factors associated with nonadherence in an integrated diabetic limb salvage (DLS) programme and evaluate its effects on care outcomes. This study included 2798 DFU patients who were enrolled in an integrated DLS programme across multiple institutions in central and northern Singapore from 2020 to 2021. Reasons for nonadherence were obtained via telephone interviews. Factors associated with nonadherence were identified using multiple logistic regression. Differences in one-year outcomes, including minor and major lower extremity amputation (LEA), mortality, LEA-free survival, and healthcare utilisation between adherent and nonadherent patients, were examined based on a significance level of <i>P</i> < .05. Nonadherence was observed in 40.2% of patients, with higher rates among younger patients, Malays and Indians, and those with higher HbA1c levels. Patient-related factors were the most commonly reported reasons for missed appointments (50.4%). Compared to adherent patients, nonadherent patients exhibited a relatively higher minor LEA rate (13.0% vs 10.2%, OR = 1.18, 95% CI: 0.93, 1.51), lower mortality rate (8.6% vs18.1%, OR = 0.50, 95% CI: 0.39, 0.65), higher overall LEA-free survival (76.4% vs 71.1%, OR = 1.27, 95% CI: 1.06, 1.53), and more hospitalisations (IRR = 1.22, 95% CI: 1.11, 1.33) and emergency visits (IRR = 1.27, 95% CI: 1.16, 1.39). While nonadherent patients showed relatively higher minor LEA rates and more healthcare utilisation, they also exhibited lower mortality and higher LEA-free survival. This suggests that nonadherence in this population may be associated with complex patient characteristics and behaviours that warrant further investigation to tailor interventions effectively.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"823-834"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577345","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 Impact of Low-Power Therapeutic Lasers at 904 nm on the Healing Process of Wounds and the Relationships Between Extracellular Matrix Components and Myofibroblasts.","authors":"Zahra Al Timimi","doi":"10.1177/15347346241273179","DOIUrl":"10.1177/15347346241273179","url":null,"abstract":"<p><p>The goal of the study was to further our understanding of the functions that myofibroblasts do, how they interact with the matrix's extracellular elements, and how laser therapy at 904 nm works. Thirty Wistar rats with superficial wounds on the backs were used in this study. The laser therapy device used two energy levels of a 904 nm laser with an output power of 60 mW. The outcomes had been evaluated for one, three, five, seven, and fourteen days following laser therapy. Numerous methods, including as histology, immunohistochemistry, and scanning electron microscopy, have been used to evaluate the tissues.There was a statistically important (<i>P</i> ≤ .05) decrease in the number of inflammatory cells and the degree of edema after laser therapy. On the other hand, the amounts of elastic fiber as well as collagen slightly increased. On the third post-laser treatment day, there was a statistically significant distinction (<i>P</i> < .05) in the number of myofibroblasts with the desmin; smooth muscle alpha-actin phenotype between the laser-treated and control groups.These results suggest that, compared to a higher energy of 5.6 J, laser therapy at a lower energy of 3.6 J may be more effective in stimulating myofibroblast differentiation during the initial phases of wound healing. These findings show how low-power laser therapy promotes wound healing.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"745-751"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899315","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":"Protocolized Foot Exercises Help in Improvement of Diabetic Foot Ulcers and Quality of Life When Added to Standard Therapy-A Randomized Clinical Trial.","authors":"Deepak Nayak, Rubik Ray, Chetan Anand, Tridip Dutta Baruah, Ashok Goyal","doi":"10.1177/15347346241262591","DOIUrl":"10.1177/15347346241262591","url":null,"abstract":"<p><p>ContextDiabetic foot disease is the major cause of nontraumatic limb amputations worldwide causing a high socioeconomic and psychological toll and a huge burden to the healthcare system. Currently, standard treatment of diabetic foot ulcer is through multidisciplinary therapy. Foot exercises have been shown to improve healing in diabetic ulcers although evidence is limited and applicability is non-uniform. Our study aimed to generate more evidence regarding the benefit of addition of protocolized foot exercises so that it can be instituted as a standard of care.Methods and MaterialIt was an open label Randomized controlled trial with seventy-two patients and study duration of one and half years Patients with diabetic foot ulcers were randomized into two groups. Both groups received standard therapy for diabetic foot ulcer. The intervention group in addition received three months of protocolized foot exercises. At the end of three months ulcer healing and quality of life were m compared among both the groups.ResultsRegular exercises for three months caused significant reduction in ulcer area compared to the non-intervention group [100% versus 45.22%, 95% CI =36.30(16.04-56.56), P-value = 0.001]. Quality of life analyzed by SF-36 score showed significant improvement in components like physical function [69.4 ± 8.9 versus 63.7 ± 11.0, 95% CI = 5.73 (0.97-10.48), P-value = 0.01], emotional well-being [65.2 ± 7.6 versus 60.8 ± 7.9, 95% CI = 4.44 (0.79-8.10), P-value = 0.01], and pain components [55.4 ± 18.5 versus 47.5 ± 14.5, 95% CI = 7.99 (0.16-15.81), P-value = 0.04) at 3 months although change in social functioning, physical health limitation, health change, energy and general health improvement were not significant.ConclusionsAddition of protocolized foot exercises are beneficial for patients of diabetic foot ulcers in terms of ulcer healing as well as improvement of quality of life provided compliance to exercises can be ensured.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"735-744"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141736237","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":"Adherence to Wearing Therapeutic Footwear Among People at High-Risk of Diabetes-Related Foot Ulcers in Jordan.","authors":"Anas Ababneh, Christina Parker, Sameh Moosa, Qusai Aljarrah, Samiha Jarrah, Peter A Lazzarini","doi":"10.1177/15347346241307723","DOIUrl":"10.1177/15347346241307723","url":null,"abstract":"<p><p>This study aimed to investigate the levels of adherence to wearing therapeutic footwear, and the factors associated, among people at high-risk of diabetes-related foot ulcers (DFUs) in Jordan. This was a secondary analysis of data from a multi-centre cross-sectional study of participants at high-risk of DFU in Jordan who had therapeutic footwear. Participants had socio-demographic, health, limb, and psychosocial variables collected, plus self-reported their proportion of adherence time wearing therapeutic footwear on an average day (excluding sleeping time) using a visual analogue scale. Participants were categorized into high (≥60%) or low (<60%) adherence levels, plus users (1%-100% adherence) or non-users (0% adherence) of therapeutic footwear. Of 104 included participants (mean age 58 ± 13 years, 68% males), 65 (62.5%) self-reported low adherence levels and 44 (42.3%) as non-users. No variables were independently associated with low adherence levels (<i>P</i> > .05). Whereas participants with lower self-reported foot care outcome expectation scores were independently associated with non-use of therapeutic footwear (<i>P</i> = .05). Most people at high-risk of DFUs in Jordan self-reported low adherence or total non-use of their therapeutic footwear. Perceived low footcare outcome expectations was the only factor found associated with non-use of therapeutic footwear and further research is needed to explore other potential factors.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"870-877"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866872","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":"Study on the Microbiological Characteristics of Infection in Diabetic Foot Ulcers (Wagner Grades 2-4) and Their Impact on Outcomes.","authors":"Huanxiang Guan, Yaodong Wang, Hairui Fang, Yafeng Zhang, Tao Ding, Zewen Qiao","doi":"10.1177/15347346261480191","DOIUrl":"https://doi.org/10.1177/15347346261480191","url":null,"abstract":"<p><p>ObjectiveTo evaluate the influence of microbiological characteristics on Wagner grade and 12-month outcomes in hospitalized patients with Wagner grade 2-4 diabetic foot ulcers (DFUs).MethodsThis single-center retrospective cohort included 205 culture-positive infected DFUs with complete 12-month follow-up. Grade 4 was the severity outcome; nonhealing/readmission was adverse. Associations between each major organism and Wagner grade 4 were assessed using hierarchical logistic regression with sequential adjustment for host characteristics, HbA1c and WBC, and CRP, PCT, and ESR. Results were interpreted jointly across models, with Benjamini-Hochberg correction applied to the 11 organism-specific tests within each model.ResultsGrades 2/3/4 comprised 49/59/97 patients; 162 healed, 22 were unhealed, and 21 readmitted. <i>Staphylococcus aureus</i> was most frequent but not robustly associated. Of 19 <i>Enterococcus</i>-positive patients, 16 had grade 4. Enterococcus detection showed a positive association with grade 4 after adjustment for host characteristics, HbA1c, and WBC count (OR, 8.02; 95% CI, 2.11-30.46; q = 0.024). After additional adjustment for CRP, PCT, and ESR, the estimate remained positive but was attenuated (OR, 5.27; 95% CI, 1.16-23.89; raw P = 0.031) and did not meet the prespecified false-discovery-rate criterion (q = 0.172). No individual organism was robustly associated with the composite adverse outcome. Compared with one organism, two and ≥3 organisms yielded ORs 2.50 (95% CI, 1.09-5.72) and 4.89 (95% CI, 1.40-17.11); ≥3 organisms remained associated in sensitivity analysis (OR, 5.02; 95% CI, 1.42-17.76).ConclusionsAmong hospitalized patients with culture-positive Wagner grade 2-4 DFUs, Staphylococcus aureus was most common but showed limited independent associations with severity or 12-month outcomes. Enterococcus spp. clustered in grade 4 wounds, although its independent association was inconsistent across adjusted models. Detection may mark severe wound complexity but should not independently guide grading or treatment. Detection of ≥3 organisms was associated with increased risk of the 12-month composite adverse outcome, but the imprecise estimate requires prospective multicenter validation.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261480191"},"PeriodicalIF":1.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148835899","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}