{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:03Z","timestamp":1780131903726,"version":"3.54.0"},"reference-count":62,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The objective of this study was to measure the incidence of concussion (scaled relative to number of athlete exposures) and recurrent concussion within 2 teams of fourth-tier junior ice hockey players (16\u201321 years old) during 1 regular season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cohort study called the Hockey Concussion Education Project was conducted during 1 junior ice hockey regular season (2009\u20132010) involving 67 male fourth-tier ice hockey players (mean age 18.2 \u00b1 1.2 years, range 16\u201321 years) from 2 teams. Prior to the start of the season, every player underwent baseline assessments using the Sideline Concussion Assessment Tool 2 (SCAT2) and the Immediate Post-Concussion Assessment and Cognitive Test (ImPACT). The study protocol also required players who entered the study during the season to complete baseline SCAT2 and ImPACT testing. If the protocol was not followed, the postinjury test results of a player without true baseline test results would be compared against previously established age and gender group normative levels. Each regular season game was observed by a qualified physician and at least 1 other neutral nonphysician observer. Players who suffered a suspected concussion were evaluated at the game. If a concussion diagnosis was made, the player was subsequently examined in the physician's office for a full clinical evaluation and the SCAT2 and ImPACT were repeated. Based on these evaluations, players were counseled on the decision of when to return to play. Athlete exposure was defined as 1 game played by 1 athlete.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-one concussions occurred during the 52 physician-observed games (incidence 21.5 concussions per 1000 athlete exposures). Five players experienced repeat concussions. No concussions were reported during practice sessions. A concussion was diagnosed by the physician in 19 (36.5%) of the 52 observed games. One of the 5 individuals who suffered a repeat concussion sustained his initial concussion in a regular season game that was not observed by a physician, and as a result this single case was not included in the total of 21 total concussions. This initial concussion of the player was identified during baseline testing 2 days after the injury and was subsequently medically diagnosed and treated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of game-related concussions (per 100 athlete exposures) in these fourth-tier junior ice hockey players was 7 times higher than the highest rate previously reported in the literature. This difference may be the result of the use of standardized direct physician observation, diagnosis, and subsequent treatment. The results of this study demonstrate the need for follow-up studies involving larger and more diverse sample groups to reflect generalizability of the findings. These follow-up studies should involve other contact sports (for example football and rugby) and also include the full spectrum of gender, age, and skill levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2010.9.focus10186","type":"journal-article","created":{"date-parts":[[2010,11,1]],"date-time":"2010-11-01T10:59:42Z","timestamp":1288609182000},"page":"E4","source":"Crossref","is-referenced-by-count":71,"title":["A prospective study of physician-observed concussions during junior ice hockey: implications for incidence rates"],"prefix":"10.3171","volume":"29","author":[{"given":"Paul Sean","family":"Echlin","sequence":"first","affiliation":[{"name":"AIM Health Group Family Medicine, London, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Tator","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Cusimano","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, University of Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C.","family":"Cantu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Boston University Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack E.","family":"Taunton","sequence":"additional","affiliation":[{"name":"Division of Sports Medicine, Faculty of Medicine and School of Human Kinetics, University of British Columbia, Vancouver;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross E. G.","family":"Upshur","sequence":"additional","affiliation":[{"name":"Departments of Family and Community Medicine, University of Toronto, Ontario;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig R.","family":"Hall","sequence":"additional","affiliation":[{"name":"School of Kinesiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorie A.","family":"Forwell","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University of Western Ontario, London, Ontario, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine N.","family":"Skopelja","sequence":"additional","affiliation":[{"name":"School of Medicine Library, Indiana University, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-0290004","series-title":"J Athl Train","first-page":"249","article-title":"Descriptive epidemiology of collegiate women's ice hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 2000\u20132001 through 2003\u20132004","volume":"42","author":"Agel","year":"2007"},{"key":"b2-0290004","series-title":"J Athl Train","first-page":"241","article-title":"Descriptive epidemiology of collegiate men's ice hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 1988\u20131989 through 2003\u20132004","volume":"42","author":"Agel","year":"2007"},{"key":"b3-0290004","series-title":"Br J Sports Med","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1136\/bjsm.36.1.27","article-title":"The impact of face shield use on concussions in ice hockey: a multivariate analysis","volume":"36","author":"Benson","year":"2002"},{"key":"b4-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1227\/01.NEU.0000280000.03578.B6","article-title":"Longterm and cumulative effects of sports concussion on motor cortex inhibition","volume":"61","author":"De Beaumont","year":"2007"},{"key":"b5-0290004","series-title":"Brain","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1093\/brain\/awn347","article-title":"Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood","volume":"132","author":"De Beaumont","year":"2009"},{"key":"b6-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1097\/00042752-200110000-00005","article-title":"Concussions among university football and soccer players: a pilot study","volume":"11","author":"Delaney","year":"2001"},{"key":"b7-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/00042752-200001000-00003","article-title":"Concussions during the 1997 Canadian Football League season","volume":"10","author":"Delaney","year":"2000"},{"key":"b8-0290004","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1001\/jama.2010.755","article-title":"Risk of injury associated with body checking among youth ice hockey players","volume":"303","author":"Emery","year":"2010"},{"key":"b9-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1177\/0363546506290061","article-title":"Injury rates, risk factors, and mechanisms of injury in minor hockey","volume":"34","author":"Emery","year":"2006"},{"key":"b10-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1177\/0363546504267349","article-title":"American collegiate men's ice hockey: an analysis of injuries","volume":"33","author":"Flik","year":"2005"},{"key":"b11-0290004","series-title":"Am J Public Health","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.2105\/AJPH.73.12.1370","article-title":"Concussion incidences and severity in secondary school varsity football players","volume":"73","author":"Gerberich","year":"1983"},{"key":"b12-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1227\/01.NEU.0000175725.75780.DD","article-title":"Association between recurrent concussion and late-life cognitive impairment in retired professional football players","volume":"57","author":"Guskiewicz","year":"2005"},{"key":"b13-0290004","series-title":"Med Sci Sports Exerc","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1249\/mss.0b013e3180383da5","article-title":"Recurrent concussion and risk of depression in retired professional football players","volume":"39","author":"Guskiewicz","year":"2007"},{"key":"b14-0290004","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2549","DOI":"10.1001\/jama.290.19.2549","article-title":"Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study","volume":"290","author":"Guskiewicz","year":"2003"},{"key":"b15-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1177\/03635465000280050401","article-title":"Epidemiology of concussion in collegiate and high school football players","volume":"28","author":"Guskiewicz","year":"2000"},{"key":"b16-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00042752-199801000-00010","article-title":"Brain injury in ice hockey","volume":"8","author":"Honey","year":"1998"},{"key":"b17-0290004","series-title":"ESPN Magazine","article-title":"Reporting from the National Academy of Neuropsychology's Sports Concussion Symposium: The NHL releases the first data from its concussion program. But what do the numbers mean?","author":"Keating"},{"key":"b18-0290004","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/088307380101600203","article-title":"Incidence of concussion in high school football players of Ohio and Pennsylvania","volume":"16","author":"Langburt","year":"2001"},{"key":"b19-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/JSM.0b013e3181a501db","article-title":"Consensus statement on concussion in sport: 3rd International Conference on Concussion in Sport held in Zurich, November 2008","volume":"19","author":"McCrory","year":"2009"},{"key":"b20-0290004","series-title":"J Neuropathol Exp Neurol","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/NEN.0b013e3181a9d503","article-title":"Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury","volume":"68","author":"McKee","year":"2009"},{"key":"b21-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1227\/01.NEU.0000166663.98616.E4","article-title":"Prolonged effects of concussion in high school athletes","volume":"57","author":"Moser","year":"2005"},{"key":"b22-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00042752-199904000-00005","article-title":"Prospective analysis of ice hockey injuries at the Junior A level over the course of one season","volume":"9","author":"Pinto","year":"1999"},{"key":"b23-0290004","series-title":"Arch Clin Neuropsychol","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/arclin\/acp025","article-title":"Concussion symptom inventory: an empirically derived scale for monitoring resolution of symptoms following sport-related concussion","volume":"24","author":"Randolph","year":"2009"},{"key":"b24-0290004","series-title":"Med Sci Sports Exerc","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/00005768-199901000-00009","article-title":"Youth ice hockey tournament injuries: rates and patterns compared to season play","volume":"31","author":"Roberts","year":"1999"},{"key":"b25-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1177\/03635465030310011901","article-title":"Injury rates and profiles in female ice hockey players","volume":"31","author":"Schick","year":"2003"},{"key":"b26-0290004","series-title":"New York Times","article-title":"Former Bengal Henry found to have had brain damage","author":"Schwarz","year":"2010"},{"key":"b27-0290004","series-title":"New York Times","article-title":"Brain damage found in hockey player","author":"Schwarz","year":"2009"},{"key":"b28-0290004","series-title":"Arch Clin Neuropsychol","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.acn.2008.07.002","article-title":"Central or peripheral? A positional stance in reaction to the Prague statement on the role of neuropsychological assessment in sports concussion management","volume":"23","author":"Shuttleworth-Edwards","year":"2008"},{"key":"b29-0290004","series-title":"Can J Neurol Sci","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1017\/S0317167100002596","article-title":"National Hockey League reported concussions, 1986\u201387 to 2001\u201302","volume":"30","author":"Wennberg","year":"2003"},{"key":"b30-0290004","series-title":"Br J Sports Med","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1136\/bjsm.2005.021832","article-title":"Converging evidence for the under-reporting of concussions in youth ice hockey","volume":"40","author":"Williamson","year":"2006"},{"key":"b31-0290004","series-title":"Am J Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1097\/01.PHM.0000083666.74494.BA","article-title":"Two-year prospective study of relative risk of a second cerebral concussion","volume":"82","author":"Zemper","year":"2003"},{"key":"b1-0290004","series-title":"J Athl Train","first-page":"249","article-title":"Descriptive epidemiology of collegiate women's ice hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 2000\u20132001 through 2003\u20132004","volume":"42","author":"Agel","year":"2007"},{"key":"b2-0290004","series-title":"J Athl Train","first-page":"241","article-title":"Descriptive epidemiology of collegiate men's ice hockey injuries: National Collegiate Athletic Association Injury Surveillance System, 1988\u20131989 through 2003\u20132004","volume":"42","author":"Agel","year":"2007"},{"key":"b3-0290004","series-title":"Br J Sports Med","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1136\/bjsm.36.1.27","article-title":"The impact of face shield use on concussions in ice hockey: a multivariate analysis","volume":"36","author":"Benson","year":"2002"},{"key":"b4-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1227\/01.NEU.0000280000.03578.B6","article-title":"Longterm and cumulative effects of sports concussion on motor cortex inhibition","volume":"61","author":"De Beaumont","year":"2007"},{"key":"b5-0290004","series-title":"Brain","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1093\/brain\/awn347","article-title":"Brain function decline in healthy retired athletes who sustained their last sports concussion in early adulthood","volume":"132","author":"De Beaumont","year":"2009"},{"key":"b6-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1097\/00042752-200110000-00005","article-title":"Concussions among university football and soccer players: a pilot study","volume":"11","author":"Delaney","year":"2001"},{"key":"b7-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/00042752-200001000-00003","article-title":"Concussions during the 1997 Canadian Football League season","volume":"10","author":"Delaney","year":"2000"},{"key":"b8-0290004","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2265","DOI":"10.1001\/jama.2010.755","article-title":"Risk of injury associated with body checking among youth ice hockey players","volume":"303","author":"Emery","year":"2010"},{"key":"b9-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"1960","DOI":"10.1177\/0363546506290061","article-title":"Injury rates, risk factors, and mechanisms of injury in minor hockey","volume":"34","author":"Emery","year":"2006"},{"key":"b10-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1177\/0363546504267349","article-title":"American collegiate men's ice hockey: an analysis of injuries","volume":"33","author":"Flik","year":"2005"},{"key":"b11-0290004","series-title":"Am J Public Health","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.2105\/AJPH.73.12.1370","article-title":"Concussion incidences and severity in secondary school varsity football players","volume":"73","author":"Gerberich","year":"1983"},{"key":"b12-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1227\/01.NEU.0000175725.75780.DD","article-title":"Association between recurrent concussion and late-life cognitive impairment in retired professional football players","volume":"57","author":"Guskiewicz","year":"2005"},{"key":"b13-0290004","series-title":"Med Sci Sports Exerc","doi-asserted-by":"publisher","first-page":"903","DOI":"10.1249\/mss.0b013e3180383da5","article-title":"Recurrent concussion and risk of depression in retired professional football players","volume":"39","author":"Guskiewicz","year":"2007"},{"key":"b14-0290004","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2549","DOI":"10.1001\/jama.290.19.2549","article-title":"Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study","volume":"290","author":"Guskiewicz","year":"2003"},{"key":"b15-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1177\/03635465000280050401","article-title":"Epidemiology of concussion in collegiate and high school football players","volume":"28","author":"Guskiewicz","year":"2000"},{"key":"b16-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1097\/00042752-199801000-00010","article-title":"Brain injury in ice hockey","volume":"8","author":"Honey","year":"1998"},{"key":"b17-0290004","series-title":"ESPN Magazine","article-title":"Reporting from the National Academy of Neuropsychology's Sports Concussion Symposium: The NHL releases the first data from its concussion program. But what do the numbers mean?","author":"Keating"},{"key":"b18-0290004","series-title":"J Child Neurol","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1177\/088307380101600203","article-title":"Incidence of concussion in high school football players of Ohio and Pennsylvania","volume":"16","author":"Langburt","year":"2001"},{"key":"b19-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1097\/JSM.0b013e3181a501db","article-title":"Consensus statement on concussion in sport: 3rd International Conference on Concussion in Sport held in Zurich, November 2008","volume":"19","author":"McCrory","year":"2009"},{"key":"b20-0290004","series-title":"J Neuropathol Exp Neurol","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1097\/NEN.0b013e3181a9d503","article-title":"Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury","volume":"68","author":"McKee","year":"2009"},{"key":"b21-0290004","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1227\/01.NEU.0000166663.98616.E4","article-title":"Prolonged effects of concussion in high school athletes","volume":"57","author":"Moser","year":"2005"},{"key":"b22-0290004","series-title":"Clin J Sport Med","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1097\/00042752-199904000-00005","article-title":"Prospective analysis of ice hockey injuries at the Junior A level over the course of one season","volume":"9","author":"Pinto","year":"1999"},{"key":"b23-0290004","series-title":"Arch Clin Neuropsychol","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/arclin\/acp025","article-title":"Concussion symptom inventory: an empirically derived scale for monitoring resolution of symptoms following sport-related concussion","volume":"24","author":"Randolph","year":"2009"},{"key":"b24-0290004","series-title":"Med Sci Sports Exerc","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1097\/00005768-199901000-00009","article-title":"Youth ice hockey tournament injuries: rates and patterns compared to season play","volume":"31","author":"Roberts","year":"1999"},{"key":"b25-0290004","series-title":"Am J Sports Med","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1177\/03635465030310011901","article-title":"Injury rates and profiles in female ice hockey players","volume":"31","author":"Schick","year":"2003"},{"key":"b26-0290004","series-title":"New York Times","article-title":"Former Bengal Henry found to have had brain damage","author":"Schwarz","year":"2010"},{"key":"b27-0290004","series-title":"New York Times","article-title":"Brain damage found in hockey player","author":"Schwarz","year":"2009"},{"key":"b28-0290004","series-title":"Arch Clin Neuropsychol","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.acn.2008.07.002","article-title":"Central or peripheral? A positional stance in reaction to the Prague statement on the role of neuropsychological assessment in sports concussion management","volume":"23","author":"Shuttleworth-Edwards","year":"2008"},{"key":"b29-0290004","series-title":"Can J Neurol Sci","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1017\/S0317167100002596","article-title":"National Hockey League reported concussions, 1986\u201387 to 2001\u201302","volume":"30","author":"Wennberg","year":"2003"},{"key":"b30-0290004","series-title":"Br J Sports Med","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1136\/bjsm.2005.021832","article-title":"Converging evidence for the under-reporting of concussions in youth ice hockey","volume":"40","author":"Williamson","year":"2006"},{"key":"b31-0290004","series-title":"Am J Phys Med Rehabil","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1097\/01.PHM.0000083666.74494.BA","article-title":"Two-year prospective study of relative risk of a second cerebral concussion","volume":"82","author":"Zemper","year":"2003"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/29\/5\/2010.9.focus10186.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/29\/5\/2010.9.focus10186.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/29\/5\/2010.9.focus10186.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:40:54Z","timestamp":1780130454000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/29\/5\/2010.9.focus10186.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11]]},"references-count":62,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2010.9.focus10186","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11]]}}}