The international journal of lower extremity wounds最新文献

{"title":"Comparison of Safe Laser 1800 Infra and Standard Treatment for Chronic Non-Healing Wounds.","authors":"Szabó Tamás, Hegedűs György, Mérai András, Molnár Karsa, Molnár Szabolcs Lajos","doi":"10.1177/15347346261461464","DOIUrl":"https://doi.org/10.1177/15347346261461464","url":null,"abstract":"<p><p>IntroductionThe treatment of chronic non-healing wounds represents a great challenge in healthcare, especially in rehabilitation medicine, as it contributes significantly to increased patient mortality and morbidity. Various types of laser therapies have shown to enhance wound- healing potential while remaining safe and easy to administer.ObjectiveThis prospective comparative study aimed to evaluate the efficacy of the Safe Laser 1800 Infra therapy compared with conventional wound treatment protocols in cases of patient with impaired wound healing.MethodsPatients in the control group received conventional wound care, consisting of wound toilette and the application of hydro- responsive wound dressings (Hydro- Clean Advance, Hartmann) for both groups. Patients in the Safe Laser group received laser treatment at least three times per week, with 1-3 minof exposure per treatment point.ResultsIn the Safe Laser group 7 out of 10 patients became free of inflammation, while inflammation was markedly reduced in the remaining 3 cases. In 90% of patients in the Safe Laser group wound dimensions were substantially reduced or complete wound healing was achieved. Wound depth decreased in all cases. In contrast, in the control group inflammation did not improve, while wound dimensions showed only minimal reduction in only one case.ConclusionDespite the small sample size and heterogeneous wound characteristics, Safe Laser 1800 Infra therapy demonstrated significant benefits in reducing both wound dimensions and inflammation when compared to conventional treatment protocols used in our facility.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261461464"},"PeriodicalIF":1.5,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148280630","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":"Er:YAG laser Therapy for Diabetic Foot Ulcers: A Pilot Study with Hyperspectral Imaging Assessment.","authors":"Sebastián Flores-Escobar, Francisco Javier Álvaro-Afonso, Yolanda García-Álvarez, Mateo López-Moral, Irene Sanz-Corbalán, José Luis Lázaro-Martínez","doi":"10.1177/15347346261459556","DOIUrl":"https://doi.org/10.1177/15347346261459556","url":null,"abstract":"<p><p>Diabetic foot ulcers (DFU) are associated with impaired wound healing and high morbidity. Er:YAG laser therapy has been proposed as an adjunctive treatment due to its ablative and biostimulatory properties. The aim of this study was to explore the feasibility and preliminary clinical and physiological responses to adjunctive Er:YAG laser therapy in DFUs using hyperspectral imaging (HSI). A pilot study including five patients with DFU was conducted. All patients received Er:YAG laser therapy once weekly for 8 weeks in addition to standard of care. Clinical outcomes included wound area and wound-bed quality assessed using the Wollina wound score. Physiological responses were evaluated using HSI-derived parameters, including tissue oxygen saturation, oxyhemoglobin, deoxyhemoglobin, and total hemoglobin, measured before and after laser treatment sessions. Wound area showed a progressive reduction during follow-up, with a mean percentage wound area reduction of 33.06 ± 44.9% at week 8. Wound-bed condition improved significantly over time, with the Wollina wound score increasing from a median of 5 at baseline to 7 at week 8 (p = 0.024). HSI analysis demonstrated significant and sustained increases in THb and OxyHb at weeks 4 and 8 compared with baseline values (p < 0.05), indicating improved tissue perfusion and oxygen delivery. These preliminary findings suggest that adjunctive Er:YAG laser therapy was feasible and showed promising improvements in wound-bed quality and perfusion-related HSI parameters, alongside clinically meaningful wound size reduction. HSI appears to be a promising tool for the objective assessment of physiological responses to therapy.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261459556"},"PeriodicalIF":1.5,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261323","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":"Pedal Acceleration Time as a Marker of Limb Perfusion: A Systematic Review and Correlation Meta-Analysis.","authors":"Nikolaos Papatheodorou, Pavle Pavlovic, Jose Salcedo, Mihaela Ioana Maris","doi":"10.1177/15347346261459550","DOIUrl":"https://doi.org/10.1177/15347346261459550","url":null,"abstract":"<p><p>Pedal acceleration time (PAT) has recently attracted clinical interest for assessing peripheral arterial disease (PAD), particularly in patients in whom ankle-brachial index (ABI) or toe pressure measurements are unreliable or not feasible, yet its diagnostic worth has not been systematically evaluated. We searched MEDLINE, Embase, ScienceDirect, and the Cochrane Library from inception to January 2026 for studies that included adults with suspected or confirmed PAD and used PAT or other acceleration-based duplex measurements, aiming to synthesize evidence on the diagnostic accuracy of PAT for PAD and chronic limb-threatening ischaemia (CLTI) classification and staging, and to explore the association between PAT and established hemodynamic indices via meta-analysis.Nine articles were eligible, including 1115 patients and 1748 limbs. PAT across all studies illustrated strong inverse correlations with existing haemodynamic indices, with correlation coefficients typically ranging from -0.78 to -0.89, while reported diagnostic performance differed but was typically decent (AUC=0.79-0.99). A correlation meta-analysis, based on five of the included studies, revealed significant reciprocal correlations between PAT and ABI in three studies (pooled r ≈ -0.80; I² = 0%), whereas three studies showed a statistically significant association (pooled r ≈ -0.76) between PAT and Toe-Brachial Index (TBI), with significant heterogeneity (I² = 97%). Two studies reported inverse correlations of PAT with toe pressure (r = -0.74 and -0.41).This study highlights that PAT consistently correlates with established perfusion indices, and appears to be a valuable measure for detecting CLTI and grading PAD.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261459550"},"PeriodicalIF":1.5,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148255265","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":"Lactate-to-Albumin Ratio for Predicting Intensive Care Unit Admission in Patients with Diabetic Foot Infection.","authors":"Kaan Yusufoglu, Omer Yonga","doi":"10.1177/15347346261460272","DOIUrl":"https://doi.org/10.1177/15347346261460272","url":null,"abstract":"<p><p>BackgroundEarly identification of diabetic foot infection (DFI) patients at risk for clinical deterioration is critical for timely intervention. Serum lactate reflects tissue hypoperfusion, whereas hypoalbuminemia indicates systemic inflammation and poor nutritional status. The aim of this study is to evaluate the ability of the lactate-to-albumin ratio (LAR) to predict ICU admission in patients with DFI.MethodsThis retrospective study was conducted in the emergency department of a tertiary care center between 01.01.2022 and 01.01.2025. Adult patients (≥18 years) with confirmed DFI were included. DFI diagnosis was established <b>in accordance with IWGDF/IDSA 2023 criteria.</b>¹ Patients with chronic liver failure, nephrotic syndrome, pregnancy, or incomplete records were excluded. LAR was calculated as lactate (mmol/L) divided by albumin (g/dL). The primary outcome was ICU admission, <b>defined as direct admission from the emergency department based on clinical severity assessment.</b> ROC analyses assessed the predictive performance of LAR compared with lactate and albumin. Multivariable logistic regression identified independent predictors of ICU admission.ResultsAmong 494 patients (median age, 64 years; 40.3% female), 91 (18.4%) required ICU admission. ICU patients had higher lactate (2.5 vs 1.8 mmol/L, P < .001), lower albumin (3.2 vs 3.4 g/dL, P < .001), and higher LAR (0.8 vs 0.5, P < .001). LAR demonstrated the best discrimination for ICU admission (AUC, 0.717; 95% CI, 0.658-0.777), outperforming albumin (AUC, 0.626; P = .009) and similar to lactate (AUC, 0.702; P = .134). A cut-off of ≥0.73 yielded 57.1% sensitivity and 78.2% specificity. LAR (OR, 1.36; 95% CI, 1.16-1.58; P < .001), older age, lower mean arterial pressure, and lower ankle-brachial index were independent predictors of ICU admission.ConclusionsThe lactate-to-albumin ratio is a simple, cost-effective biomarker that independently predicts ICU admission in DFI patients and may aid early risk stratification. Although LAR did not demonstrate statistically superior discrimination over lactate alone, it integrates systemic metabolic stress with the host's inflammatory and nutritional reserve, offering a composite measure of physiological vulnerability in this high-risk population.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261460272"},"PeriodicalIF":1.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221500","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":"Letter to the Editor: Commentary on \"M.O.I.S.T. Concept for the Local Therapy of Chronic Wounds: An International Update\".","authors":"Muhammed Said Aydin, Gökay Özler","doi":"10.1177/15347346261458640","DOIUrl":"https://doi.org/10.1177/15347346261458640","url":null,"abstract":"","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261458640"},"PeriodicalIF":1.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214124","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 of Blood Cadmium and Lead with the Risk of Diabetic Foot Ulcers: The Suppression Effect of Hemoglobin (NHANES 1999-2004).","authors":"Yiming Yang, Zunwang Li, Yunyi Chang, Dongxiao Li, Junde Wu, Zhaojun Chen","doi":"10.1177/15347346261458155","DOIUrl":"https://doi.org/10.1177/15347346261458155","url":null,"abstract":"<p><p>BackgroundDiabetic foot ulcer (DFU) is one of the most severe complications of diabetes, with hemoglobin (HGB) and inflammatory markers playing pivotal roles in its pathogenesis. However,the modifying effects of interactions between blood cadmium (Cd) and lead (Pb) exposure and these biological indicators on the risk of DFU remain unclear. This study evaluates how Cd and Pb exposure contributes to DFU risk, with a specific focus on the potential mediating role of HGB.MethodsData were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2004. A total of 1633 participants (including 132 with DFU and 1501 Non-DFU) were included in the final analysis. Weighted logistic regression and restricted cubic splines (RCS) assessed associations between blood cadmium (Cd), lead (Pb), HGB, and DFU. Mediation analysis explored HGB's regulatory role in the Cd-DFU pathway, supplemented by subgroup analyses.ResultsAfter adjusting for all covariates, Blood Cd level was significantly associated with DFU risk (OR = 1.84; 95% CI:1.17-2.90, P = 0.01).RCS revealed a potential non-linear dose-response relationship with a risk threshold at 1.268 nmol/L, beyond which risk escalated sharply. In contrast,HGB served as an independent protective factor for DFU(OR = 0.73; 95% CI:0.60-0.87, P < 0.001).Notably, a positive correlation was observed between Blood Cd and HGB levels(β = 0.33, P < 0.001). Mediation analysis demonstrated that HGB exerted a significant suppression effect on the Cd-DFU association, accounting for -35.79% of the total effect (P = 0.04). Subgroup analyses identified higher DFU susceptibility among smokers (OR = 2.63;95%CI: 1.78-3.78), males, and individuals with elevated HbA1c levels.ConclusionBlood Cd is a significant risk factor for the development of DFU, while HGB provides a compensatory suppression effect that partially buffers Cd-induced toxicity. These findings suggest that elevated HGB levels in people with diabetes may mask the true risks associated with blood Cd, potentially leading to a significant underestimation of DFU risk in clinical practice.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261458155"},"PeriodicalIF":1.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148214089","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":"Outcomes of Self-Administered Outpatient Parenteral Antibiotic Therapy in Patients with Osteomyelitis of the Foot.","authors":"Arthur Tarricone, Allen Gee, Nitish Thirugnanasambandam, Dane K Wukich, Prakash Krishnan, Lawrence A Lavery","doi":"10.1177/15347346261458188","DOIUrl":"https://doi.org/10.1177/15347346261458188","url":null,"abstract":"<p><p>The objective of this paper is to compare outcomes for patients treated with healthcare administered Outpatient Parenteral Antimicrobial Therapy (H-OPAT) versus S-OPAT (self-administered antibiotics) for the treatment of foot osteomyelitis. This was a retrospective cohort study of 202 subjects with osteomyelitis that were admitted to the hospital for moderate or severe foot infections and followed for 1 year. There were 134 subjects in the H-OPAT group and 68 in the S-OPAT group. Diabetes was prevalent in 157/202 (77.7%) subjects in the study cohort. The primary outcomes were reinfection, wound healing, time until wounds healed, amputation (minor and major), mortality, rehospitalization of the same foot, and length of stay. Reinfection was defined as infection of the same site from index procedure. S-OPAT patients were more likely to require rehospitalization (O.R = 2.10 [1.11, 3.70]) and less likely to have complete wound healing within 90 days (O.R = 0.49 [0.25, 0.96]). When Kaplan Meier survival analysis was evaluated, S-OPAT patients had longer times to heal (H-OPAT; 136.0 ± 105.2 days vs S-OPAT; 183.7 ± 118.9 days, p = 0.01. There were no differences between S-OPAT and H-OPAT for 1-year wound healing, amputation, rate of reinfection, mortality, or length of stay. Overall, S-OPAT subjects demonstrated an increased association with binary wound healing at 90 days, hospitalization, and require longer antibiotic duration.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261458188"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152958","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":"Predictors of Healing and Limb Salvage Following Partial Calcanectomy for Refractory Heel Ulcers: A Retrospective Cohort Analysis of 156 Patients.","authors":"Mohammed Shahat, Sahar H Ali, Ashraf Elnaggar","doi":"10.1177/15347346261456409","DOIUrl":"10.1177/15347346261456409","url":null,"abstract":"<p><p>BackgroundPartial calcanectomy is a limb-salvage procedure for recalcitrant heel ulcers; however, predictors of outcome remain poorly defined. This study aimed to evaluate healing rates, limb salvage, and prognostic factors.MethodsA retrospective review was conducted of 156 patients who underwent partial or subtotal calcanectomy. The primary outcome was complete healing within 6 months. Secondary outcomes included limb salvage, recurrence, ambulation, and complications. Univariate and multivariate analyses were performed to identify predictors of healing failure.ResultsThe 6-month healing rate was 87.2% (136/156), and the limb salvage rate was 89.7% (140/156). Recurrence occurred in 6.4% (10/156), and 79.5% (124/156) achieved independent ambulation. On multivariate analysis, HbA1c > 9% (OR 3.4, 95% CI 1.2-9.6; p = 0.02), CKD stage 5 (OR 4.1, 95% CI 1.4-12.2; p < 0.01), high medial arterial calcification (MAC) (OR 2.9, 95% CI 1.1-7.9; p = 0.03), and high pedal acceleration time (PAT) (OR 2.7, 95% CI 1.1-6.9; p = 0.04) were independent predictors of healing failure.ConclusionsPartial calcanectomy is an effective limb-salvage procedure. Poor glycemic control, end-stage renal disease, severe medial arterial calcification, and abnormal pedal perfusion are significant independent predictors of healing failure and should be considered in preoperative patient selection and counseling<b>.</b></p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"15347346261456409"},"PeriodicalIF":1.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145456","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":"Therapeutic Effect of Silver Nanoparticles in the Management of Diabetic Ulcers: A Systematic Review and Meta-Analysis on RCTs.","authors":"Reza Shah Hosseini, Kiana Hasanpour, Mehrnoosh Khoshnevis, Masoud Saadat Fakhr, Esra Derin, Alireza Ghaffarian, Cagdas Kement","doi":"10.1177/15347346241241836","DOIUrl":"10.1177/15347346241241836","url":null,"abstract":"<p><p>AimsThe skin, as the body's largest organ, plays vital roles in sensory functions, temperature regulation, and protection against pathogens and injuries. Skin wounds, which disrupt its integrity, can result from various factors, including diseases such as diabetes. Diabetic foot ulcers are a severe complication of diabetes, often leading to amputations. This systematic review explores the therapeutic potential of silver nanoparticles in the management of diabetic ulcers.MethodsSeven studies published between 2016 and 2023 were included in this review. Also, 4 studies were included in the meta-analysis. These studies investigated the application of silver nanoparticles, primarily in dressing forms, for diabetic ulcer treatment. A systematic search strategy was employed, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.ResultsThe results show that silver nanoparticles do not have a significant difference in improving DFU healing rates. SilvrSTAT Gel, a dressing containing silver nanoparticles, outperformed traditional dressings, leading to a substantial percentage of ulcers healing within weeks. Comparative studies also indicated that silver nanoparticles were at least as effective as alternative treatments, such as nano-chitosan dressings, and showed potential for combination therapy with growth factors.DiscussionThis review underscores the promise of silver nanoparticles, a nanotechnology-based approach, in accelerating the healing of diabetic ulcers while providing antimicrobial benefits. Despite some limitations, including variations in treatment regimens and a lack of long-term outcome data, these findings show there is no clinical evidence for using Nanosilver for the healing process of DFU.ConclusionSilver nanoparticles currently do not have sufficient clinical evidence for healing the DFU; however, in some studies, they had noticeable effects on the rate of wound healing.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"331-343"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308440","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":"Integrating Artificial Intelligence in Medical Writing: Balancing Technological Innovation and Human Expertise, with Practical Applications in Lower Extremity Wounds Care.","authors":"Pak Thaichana, Myo Zin Oo, Gabriel Leiden Thorup, Chayatorn Chansakaow, Supapong Arworn, Kittipan Rerkasem","doi":"10.1177/15347346241312814","DOIUrl":"10.1177/15347346241312814","url":null,"abstract":"<p><p>Artificial Intelligence (AI) is revolutionizing medical writing by enhancing the efficiency and precision of healthcare communication and health research. This review explores the transformative integration of AI in medical writing, highlighting its dual role of enhancing efficiency while maintaining the crucial elements of human expertise. AI technologies, including natural language processing and AI-driven literature review tools, have significantly advanced, facilitating rapid draft generation, literature summarization, and consistency in medical documentation. Key applications include aiding study design, enhancing content drafting, and optimizing literature reviews through specific AI tools. Moreover, this review delves into practical applications of AI in the context of lower extremity wounds, specifically ischemic leg ulcers, demonstrating how AI can streamline the synthesis of relevant literature. While AI presents notable advantages, it also raises ethical concerns, such as potential biases and data privacy issues, highlighting the need for human oversight in the writing process. A proposed future framework suggests that AI could take over routine tasks, allowing medical writers to devote more attention to analytical and ethical aspects. Additionally, there is a strong need for further research on the cost-effectiveness of both clinical trials utilizing AI interventions and the incorporation of AI in medical writing. Ultimately, balancing the integration of AI in medical writing promises to improve both healthcare communication and health research, ensuring the production of high-quality, patient-centric and research-focused content.</p>","PeriodicalId":94229,"journal":{"name":"The international journal of lower extremity wounds","volume":" ","pages":"407-413"},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974231","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}