Background Stroke is one of the most common causes of morbidity and disability in South Africa, with the burden of stroke particularly high in rural South Africa. Objectives The aim of this study was to collate South African (SA) physiotherapy stroke rehabilitation research. Method A narrative review of physiotherapy stroke rehabilitation research conducted within the last 10 years in South Africa. Results Stroke survivors in South Africa have poor functional ability at discharge from the hospital and have poor access to transport, work and education. Their caregivers experience strain and have a poor quality of life. Inpatient rehabilitation services focus on the medical model approach and patients are discharged into family care because of limited rehabilitation facilities. Physiotherapy interventions found to be effective in SA studies: longitudinal shoulder strapping, balance exercises in the community, task-orientated circuit gait training, saccadic eye movement training with visual scanning exercises for unilateral spatial neglect and workplace intervention programmes to increase return to work after stroke. Caregiver education alone and use of pictorial exercise programmes does not improve patients’ functional ability and adherence to home exercise programmes, respectively. Conclusion There is a need to focus physiotherapy stroke rehabilitation on barriers that hinder full social integration of the patient, including return to work and improving carer support. Most research reviewed focused on description of the problems experienced; however, more intervention studies are now underway to develop context-specific interventions with feasible treatment intensity, frequencies and equipment requirements. Future research should explore new ways of improving post-discharge rehabilitation services. Examples of intervention research that may be beneficial in a SA context are mirror therapy, mental practice and patient-directed activities in rehabilitation. Clinical implications Knowledge of interventions that were found to be effective in this context will encourage clinicians to translate these findings into practice. Noting that outcome measures that are core for stroke rehabilitation are not included in some projects may remind researchers to consider them to make comparisons between different research projects.
{"title":"Current stroke rehabilitation services and physiotherapy research in South Africa","authors":"M. V. Ntsiea","doi":"10.4102/sajp.v75i1.475","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.475","url":null,"abstract":"Background Stroke is one of the most common causes of morbidity and disability in South Africa, with the burden of stroke particularly high in rural South Africa. Objectives The aim of this study was to collate South African (SA) physiotherapy stroke rehabilitation research. Method A narrative review of physiotherapy stroke rehabilitation research conducted within the last 10 years in South Africa. Results Stroke survivors in South Africa have poor functional ability at discharge from the hospital and have poor access to transport, work and education. Their caregivers experience strain and have a poor quality of life. Inpatient rehabilitation services focus on the medical model approach and patients are discharged into family care because of limited rehabilitation facilities. Physiotherapy interventions found to be effective in SA studies: longitudinal shoulder strapping, balance exercises in the community, task-orientated circuit gait training, saccadic eye movement training with visual scanning exercises for unilateral spatial neglect and workplace intervention programmes to increase return to work after stroke. Caregiver education alone and use of pictorial exercise programmes does not improve patients’ functional ability and adherence to home exercise programmes, respectively. Conclusion There is a need to focus physiotherapy stroke rehabilitation on barriers that hinder full social integration of the patient, including return to work and improving carer support. Most research reviewed focused on description of the problems experienced; however, more intervention studies are now underway to develop context-specific interventions with feasible treatment intensity, frequencies and equipment requirements. Future research should explore new ways of improving post-discharge rehabilitation services. Examples of intervention research that may be beneficial in a SA context are mirror therapy, mental practice and patient-directed activities in rehabilitation. Clinical implications Knowledge of interventions that were found to be effective in this context will encourage clinicians to translate these findings into practice. Noting that outcome measures that are core for stroke rehabilitation are not included in some projects may remind researchers to consider them to make comparisons between different research projects.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121551149","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}
J. Quartey, M. Ernst, A. Bello, Bertha Oppong-Yeboah, Emmanuel Bonney, Kow Acquaah, Felix Asomaning, Margaret Foli, Sandra Asante, Astrid Schaemann, C. Bauer
Background Neck pain is a common complaint worldwide and ranked seventh in 2010 as the cause of ‘years lived with disability’ in Ghana. Proprioceptive dysfunction, measured by joint position error (JPE) tests, indicates an association with neck pain frequency, dizziness and balance problems in patients. Objectives To examine proprioceptive deficits of the neck using a laser pointer attached to the head. Methods Twenty patients within the age group 21–60 years, with at least five points on the neck disability index (NDI), and 20 age- and sex-matched controls with less than five points on the NDI were recruited for this study. The JPE was determined wearing a headlight laser pointer directed towards a Cartesian coordinate system adjusted to x/y = 0/0, placed on a wall after returning from left and right rotation, flexion and extension. From starting in an upright sitting position, facing the Cartesian coordinate system, each participant performed five repetitions for each movement direction. The mean of five repetitions for each movement direction was calculated as absolute error (AE), constant error (CE) and variable error (VE). Results Control participants showed larger JPE values for nearly all AE, CE and VE. After repositioning from flexion controls showed an approximately 0.6 ° larger median JPE, and the opposite for extension, with median differences between 1 ° and 2 °. Conclusion The results of this study do not reveal any meaningful differences between patients with mild disabled neck movement compared with controls. Clinical implications Joint position error testing does not seem useful for patients with mild neck disability.
{"title":"Comparative joint position error in patients with non-specific neck disorders and asymptomatic age-matched individuals","authors":"J. Quartey, M. Ernst, A. Bello, Bertha Oppong-Yeboah, Emmanuel Bonney, Kow Acquaah, Felix Asomaning, Margaret Foli, Sandra Asante, Astrid Schaemann, C. Bauer","doi":"10.4102/sajp.v75i1.568","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.568","url":null,"abstract":"Background Neck pain is a common complaint worldwide and ranked seventh in 2010 as the cause of ‘years lived with disability’ in Ghana. Proprioceptive dysfunction, measured by joint position error (JPE) tests, indicates an association with neck pain frequency, dizziness and balance problems in patients. Objectives To examine proprioceptive deficits of the neck using a laser pointer attached to the head. Methods Twenty patients within the age group 21–60 years, with at least five points on the neck disability index (NDI), and 20 age- and sex-matched controls with less than five points on the NDI were recruited for this study. The JPE was determined wearing a headlight laser pointer directed towards a Cartesian coordinate system adjusted to x/y = 0/0, placed on a wall after returning from left and right rotation, flexion and extension. From starting in an upright sitting position, facing the Cartesian coordinate system, each participant performed five repetitions for each movement direction. The mean of five repetitions for each movement direction was calculated as absolute error (AE), constant error (CE) and variable error (VE). Results Control participants showed larger JPE values for nearly all AE, CE and VE. After repositioning from flexion controls showed an approximately 0.6 ° larger median JPE, and the opposite for extension, with median differences between 1 ° and 2 °. Conclusion The results of this study do not reveal any meaningful differences between patients with mild disabled neck movement compared with controls. Clinical implications Joint position error testing does not seem useful for patients with mild neck disability.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130761789","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}
B. Morrow, Lauren Angelil, J. Forsyth, Ashleigh Huisamen, Erin Juries, L. Corten
Background Approximately one in every 1200 South Africans is affected by a neuromuscular disease (NMD). Weak respiratory muscles and ineffective cough contribute to the development of respiratory morbidity and mortality. Early identification of individuals at risk of respiratory complications, through peak expiratory cough flow (PCF) measurement, may improve patient outcomes through timely initiation of cough augmentation therapy. Objectives The aim of this study was to investigate the relationship between peak expiratory flow (PEF), forced vital capacity (FVC) and PCF in South African children with neuromuscular disorders. Methods A retrospective descriptive study of routinely collected data was conducted. Results Forty-one participants (aged 11.5 ± 3.6 years; 75.6% male) were included. There was a strong linear correlation between PCF and PEF (R = 0.78; p = 0.0001) and between PCF and FVC (R = 0.61; p = 0.0001). There was good agreement between PCF and PEF, with intraclass correlation coefficient of 0.8 (95% confidence interval, 0.7–0.9; p < 0.0001). Peak expiratory flow < 160 L.min−1 and FVC < 1.2 L were significantly predictive of PCF < 160 L.min−1 (suggestive of cough ineffectiveness), whilst PEF < 250 L.min−1 was predictive of PCF < 270 L.min−1, the level at which cough assistance is usually implemented. Conclusion PEF and FVC may be surrogate measures of cough effectiveness in children with neuromuscular disorders. Clinical implications PEF and FVC may be considered for clinical use as screening tools to identify patients at risk for pulmonary morbidity related to ineffective cough.
{"title":"The utility of using peak expiratory flow and forced vital capacity to predict poor expiratory cough flow in children with neuromuscular disorders","authors":"B. Morrow, Lauren Angelil, J. Forsyth, Ashleigh Huisamen, Erin Juries, L. Corten","doi":"10.4102/sajp.v75i1.1296","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1296","url":null,"abstract":"Background Approximately one in every 1200 South Africans is affected by a neuromuscular disease (NMD). Weak respiratory muscles and ineffective cough contribute to the development of respiratory morbidity and mortality. Early identification of individuals at risk of respiratory complications, through peak expiratory cough flow (PCF) measurement, may improve patient outcomes through timely initiation of cough augmentation therapy. Objectives The aim of this study was to investigate the relationship between peak expiratory flow (PEF), forced vital capacity (FVC) and PCF in South African children with neuromuscular disorders. Methods A retrospective descriptive study of routinely collected data was conducted. Results Forty-one participants (aged 11.5 ± 3.6 years; 75.6% male) were included. There was a strong linear correlation between PCF and PEF (R = 0.78; p = 0.0001) and between PCF and FVC (R = 0.61; p = 0.0001). There was good agreement between PCF and PEF, with intraclass correlation coefficient of 0.8 (95% confidence interval, 0.7–0.9; p < 0.0001). Peak expiratory flow < 160 L.min−1 and FVC < 1.2 L were significantly predictive of PCF < 160 L.min−1 (suggestive of cough ineffectiveness), whilst PEF < 250 L.min−1 was predictive of PCF < 270 L.min−1, the level at which cough assistance is usually implemented. Conclusion PEF and FVC may be surrogate measures of cough effectiveness in children with neuromuscular disorders. Clinical implications PEF and FVC may be considered for clinical use as screening tools to identify patients at risk for pulmonary morbidity related to ineffective cough.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115173466","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}
Background Despite unclear evidence of effectiveness or safety, airway clearance therapy (ACT) is frequently performed in infants and children with acute pulmonary disease. Objectives The aim of this review was to critically synthesise published evidence, expert opinion and pathophysiological principles to describe the indications, effects, precautions and application of commonly used ACT modalities for managing infants and children with acute pulmonary disease. Method A comprehensive narrative review of published literature was conducted. Articles describing paediatric populations were prioritised, but adult and animal studies were also considered where appropriate. Results There is a dearth of high-level evidence supporting the use of ACT in acutely ill infants and children. Conversely, studies have highlighted the lack of effect of different modalities for a variety of conditions, and in some cases serious associated complications have been reported. Airway clearance therapy may be considered when there is retention of pulmonary secretions, and the consequential airway obstruction impacts either acutely on respiratory mechanics and gaseous exchange and/or has the potential for long-term adverse sequelae [a condition that is the consequence of a previous disease or injury]. However, it should not be considered a routine intervention. Conclusion Airway clearance therapy should not be performed routinely in children admitted to hospital with acute respiratory conditions. Patients should be clinically assessed and treatment planned according to individual presentation, in those with signs and symptoms that are potentially amenable to ACT. Clinical implications This review can serve as a guide for physiotherapists in the respiratory management of children with acute respiratory illness, as well as identifying areas for clinical research.
{"title":"Airway clearance therapy in acute paediatric respiratory illness: A state-of-the-art review","authors":"B. Morrow","doi":"10.4102/sajp.v75i1.1295","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.1295","url":null,"abstract":"Background Despite unclear evidence of effectiveness or safety, airway clearance therapy (ACT) is frequently performed in infants and children with acute pulmonary disease. Objectives The aim of this review was to critically synthesise published evidence, expert opinion and pathophysiological principles to describe the indications, effects, precautions and application of commonly used ACT modalities for managing infants and children with acute pulmonary disease. Method A comprehensive narrative review of published literature was conducted. Articles describing paediatric populations were prioritised, but adult and animal studies were also considered where appropriate. Results There is a dearth of high-level evidence supporting the use of ACT in acutely ill infants and children. Conversely, studies have highlighted the lack of effect of different modalities for a variety of conditions, and in some cases serious associated complications have been reported. Airway clearance therapy may be considered when there is retention of pulmonary secretions, and the consequential airway obstruction impacts either acutely on respiratory mechanics and gaseous exchange and/or has the potential for long-term adverse sequelae [a condition that is the consequence of a previous disease or injury]. However, it should not be considered a routine intervention. Conclusion Airway clearance therapy should not be performed routinely in children admitted to hospital with acute respiratory conditions. Patients should be clinically assessed and treatment planned according to individual presentation, in those with signs and symptoms that are potentially amenable to ACT. Clinical implications This review can serve as a guide for physiotherapists in the respiratory management of children with acute respiratory illness, as well as identifying areas for clinical research.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122445039","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}
Background The roles of doctors and nurses in clinical supervision and clinical education are well defined. The role of the physiotherapist in clinical education has not been clearly defined. Objectives The aim of this study was to define and clarify the views and experiences of physiotherapy clinical supervisors regarding clinical education and their role in contributing to student learning. Methods This qualitative exploratory study targeted 17 physiotherapy clinical supervisors, employed in a physiotherapy department, at a local university in the Western Cape. Twelve of the 17 participants agreed to participate in the study. Data were collected by means of in-depth audio-taped interviews, at a time convenient for the participants. Each transcript was read individually by the first author and notes made in the margins to highlight interesting concepts that emerged. The different types of concepts were listed and categorised, while common categories were grouped into themes. Results Based on the results, the clinicians’ role is viewed as a valuable asset in clinical education, embodying the role of an educator, mentor, role model and communicator. Clinical supervisors discussed their roles in terms of understanding the importance of clinical supervision, providing guidance within a clinical setting, role modelling and professionalism. Although clinical supervisors play a significant role, they experienced a few challenges including role clarification and students’ lack of knowledge. Conclusion This study highlights that clinical supervisors and clinicians fulfil significant roles in assisting students to integrate theoretical and clinical knowledge. Clinical implications Understanding the expectations of clinical supervisors in supporting clinical education is important for higher education institutions and the clinical sector.
{"title":"Clarifying the role of clinical supervisors according to physiotherapists at a higher education institution","authors":"Taryn-Lee Voges, J. Frantz","doi":"10.4102/sajp.v75i1.523","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.523","url":null,"abstract":"Background The roles of doctors and nurses in clinical supervision and clinical education are well defined. The role of the physiotherapist in clinical education has not been clearly defined. Objectives The aim of this study was to define and clarify the views and experiences of physiotherapy clinical supervisors regarding clinical education and their role in contributing to student learning. Methods This qualitative exploratory study targeted 17 physiotherapy clinical supervisors, employed in a physiotherapy department, at a local university in the Western Cape. Twelve of the 17 participants agreed to participate in the study. Data were collected by means of in-depth audio-taped interviews, at a time convenient for the participants. Each transcript was read individually by the first author and notes made in the margins to highlight interesting concepts that emerged. The different types of concepts were listed and categorised, while common categories were grouped into themes. Results Based on the results, the clinicians’ role is viewed as a valuable asset in clinical education, embodying the role of an educator, mentor, role model and communicator. Clinical supervisors discussed their roles in terms of understanding the importance of clinical supervision, providing guidance within a clinical setting, role modelling and professionalism. Although clinical supervisors play a significant role, they experienced a few challenges including role clarification and students’ lack of knowledge. Conclusion This study highlights that clinical supervisors and clinicians fulfil significant roles in assisting students to integrate theoretical and clinical knowledge. Clinical implications Understanding the expectations of clinical supervisors in supporting clinical education is important for higher education institutions and the clinical sector.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124218140","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}
A. Pelegrinelli, L. D. Dela Bela, M. Silva, Lucas C.R. Rodrigues, J. P. Batista, L. C. Guenka, Josilainne M Dias, L. Brown, R. Carregaro, F. Moura, J. Cardoso
Background Many studies have investigated isokinetic performance in volleyball players but not through surface maps. Objectives The goals of this study were to assess velocity-specific isokinetic knee extensor–flexor muscle strength and to compare the isokinetic knee extensor–flexor muscles between professional (PRO) and under-17 (U17) female volleyball players. Method This cross-sectional laboratory study was developed with two groups: PRO (n = 12), medianage = 21.3 years, and U17 (n = 9), medianage = 15 years. Peak torque, total work, mean power, angle of peak torque, hamstring–quadriceps torque ratio (H–Q ratio) and torque–angle–velocity surface maps were analysed from knee extension–flexion at 60, 120 and 300 degrees per second (°/s). Results Significant differences were identified for extensor peak torque between PRO x = 202.3 Newton metre (N·m) (standard deviation [SD] = 24.4) and U17 x = 141.6 N·m (30.1) at 60 °/s (p < 0.001; d = 2.21) as well as flexor peak torque (PRO x = 75.7 N·m [10.3] and U17 x = 57.7 N·m [11.4]) at 120 °/s (p < 0.001; d = 1.65) for the dominant limb. There were also significant group differences for total work and mean power at all velocities for extension and flexion. Surface maps demonstrated higher torque at lower speeds for both groups with smaller torque changes across velocities for flexion. Conclusion Different groups of female volleyball players showed contrasting concentric knee muscle strength across isokinetic velocities. Clinical implications These results demonstrate the importance of specific strength training for different age groups, even within the same sport, and provide insight into muscle strength.
许多研究调查了排球运动员的等速运动表现，但没有通过表面地图。目的本研究的目的是评估特定速度的等速膝关节伸屈肌力量，并比较专业(PRO)和17岁以下(U17)女子排球运动员的等速膝关节伸屈肌。方法采用横断面实验室研究分为两组:PRO组(n = 12)，中位年龄21.3岁;U17组(n = 9)，中位年龄15岁。峰值扭矩、总功、平均功率、峰值扭矩角、腿筋-股四头肌扭矩比(H-Q比)和扭矩-角-速度表面图分别从每秒60度、120度和300度(°/s)的膝关节伸展-屈曲进行分析。结果在60°/s时，PRO x = 202.3牛顿米(N·m)(标准差[SD] = 24.4)和U17 x = 141.6牛顿米(30.1)之间的伸肌峰值扭矩存在显著差异(p < 0.001);d = 2.21)以及屈肌峰值扭矩(PRO x = 75.7 N·m[10.3]和U17 x = 57.7 N·m[11.4])在120°/s时(p < 0.001);D = 1.65)为优势肢。在伸展和屈曲的所有速度下，总功和平均功率也有显著的组差异。表面图显示，在较低的速度下，两组的扭矩变化较小，弯曲速度较小。结论不同组女排运动员在等速运动中表现出不同的同心圆膝关节肌力。这些结果表明，即使在同一项运动中，对不同年龄组进行特定力量训练的重要性，并提供了对肌肉力量的深入了解。
{"title":"Velocity-specific knee strength between professional and under-17 female volleyball players","authors":"A. Pelegrinelli, L. D. Dela Bela, M. Silva, Lucas C.R. Rodrigues, J. P. Batista, L. C. Guenka, Josilainne M Dias, L. Brown, R. Carregaro, F. Moura, J. Cardoso","doi":"10.4102/sajp.v75i1.478","DOIUrl":"https://doi.org/10.4102/sajp.v75i1.478","url":null,"abstract":"Background Many studies have investigated isokinetic performance in volleyball players but not through surface maps. Objectives The goals of this study were to assess velocity-specific isokinetic knee extensor–flexor muscle strength and to compare the isokinetic knee extensor–flexor muscles between professional (PRO) and under-17 (U17) female volleyball players. Method This cross-sectional laboratory study was developed with two groups: PRO (n = 12), medianage = 21.3 years, and U17 (n = 9), medianage = 15 years. Peak torque, total work, mean power, angle of peak torque, hamstring–quadriceps torque ratio (H–Q ratio) and torque–angle–velocity surface maps were analysed from knee extension–flexion at 60, 120 and 300 degrees per second (°/s). Results Significant differences were identified for extensor peak torque between PRO x = 202.3 Newton metre (N·m) (standard deviation [SD] = 24.4) and U17 x = 141.6 N·m (30.1) at 60 °/s (p < 0.001; d = 2.21) as well as flexor peak torque (PRO x = 75.7 N·m [10.3] and U17 x = 57.7 N·m [11.4]) at 120 °/s (p < 0.001; d = 1.65) for the dominant limb. There were also significant group differences for total work and mean power at all velocities for extension and flexion. Surface maps demonstrated higher torque at lower speeds for both groups with smaller torque changes across velocities for flexion. Conclusion Different groups of female volleyball players showed contrasting concentric knee muscle strength across isokinetic velocities. Clinical implications These results demonstrate the importance of specific strength training for different age groups, even within the same sport, and provide insight into muscle strength.","PeriodicalId":150074,"journal":{"name":"The South African Journal of Physiotherapy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124037159","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}
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