Journal of the American Podiatric Medical Association最新文献

{"title":"Early versus Delayed Plate Fixation in Pilon Fractures.","authors":"İsmail Güzel, İbrahim Ulusoy, Mehmet Yılmaz, Mehmet Fırat Tantekin, Aybars Kıvrak","doi":"10.7547/25-087","DOIUrl":"https://doi.org/10.7547/25-087","url":null,"abstract":"<p><strong>Background: </strong>Pilon fractures refer to distal tibial fractures that may involve extra-articular, partial articular, or complete intra-articular components, most commonly caused by high-energy trauma. The choice between early (<72 hours) and delayed (>7 days) surgical fixation significantly impacts clinical outcomes. This study aimed to compare the effects of early vs. delayed plate fixation on fracture healing time, functional outcomes, and complication rates.</p><p><strong>Materials and methods: </strong>This retrospective study analyzed 80 patients who underwent surgical treatment for pilon fractures between 2018 and 2023. Patients were divided into two groups: Early surgery (<72 hours, n=40) Delayed surgery (>7 days, n=40) Additionally, patients were categorized based on the fixation method: Single plate fixation (n=40) Double plate fixation (n=40) Outcome Measures: Fracture healing time (weeks) - Defined as cortical continuity on radiographs Functional outcomes (AOFAS score) Complication rates (infection, malunion, implant failure) Results: Shorter healing time was observed in the early surgery group (14.2 vs. 16.8 weeks, p<0.05). Better functional outcomes were recorded in the early surgery group (AOFAS score: 82.3±6.5 vs. 78.1±7.2, p<0.05). Lower infection rates were noted in the delayed surgery group (7.5% vs. 12.5%, p<0.05). Double plate fixation provided better mechanical stability but resulted in higher soft tissue complication rates. Single plate fixation preserved soft tissue integrity but had higher malunion and implant failure rates.</p><p><strong>Conclusion: </strong>Early surgery is associated with shorter healing time and better functional outcomes, but increased soft tissue complications require careful management. Delayed surgery offers a safer approach for soft tissue healing but may prolong functional recovery. While double plate fixation ensures greater stability, it may increase soft tissue morbidity, whereas single plate fixation reduces soft tissue complications but may compromise stability. A personalized surgical approach is recommended for optimal outcomes in pilon fracture management.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-34"},"PeriodicalIF":0.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Evaluation of Human Amniotic Allografts for Diabetic Foot Ulcers and Venous Leg Ulcers Treated by an In-Home Mobile Wound Clinic.","authors":"David Kay, Marta Sandres-Corwin, Michael Bayever, Harry H Matundan","doi":"10.7547/24-210","DOIUrl":"https://doi.org/10.7547/24-210","url":null,"abstract":"<p><strong>Background: </strong>The objective is to evaluate the differences in the efficacy of wound care algorithms for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) treated by a mobile wound clinic. Most patients requiring home treatment performed worse with the standard of care (SOC) compared to those in traditional outpatient clinics, especially chronic wounds associated with multiple comorbidities.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on one year's data from patient records of a mobile wound clinic (July 2022 - June 2023) involving patients suffering from DFU and VLU. Patients were divided into a control group receiving SOC with debridement and a group receiving SOC plus placental-based tissue grafts. The wound area and depth were assessed weekly. The SOC plus grafting group was monitored for the duration and number of graft applications per wound. Wounds were also scored for granulation-epithelialization (G+E) and eschar-slough (E+S). Statistical analysis included paired t-tests and ANOVA for multiple comparisons.</p><p><strong>Results: </strong>In the interventional group, the average reduction in wound area was 39%, compared to a 10% reduction in the SOC with debridement cohort (p < 0.05). The average wound depth decreased by 33% in the interventional group and by 2% in the SOC with debridement cohort (p<0.05). The interventional group improved their positive wound scores by 8% (G+E), while negative wound scores decreased by 55% (E+S) compared to SOC with debridement patients. The mean grafting period was 94 days (±10 days) per patient, with a mean of 15 grafts (±2.6) applied per wound.</p><p><strong>Conclusion: </strong>Despite severe comorbidities, we observed improved wound healing in a home-based care setting for most DFU and VLU patients who underwent SOC with debridement and grafting compared to SOC with debridement alone. Patients receiving SOC alone showed poorer performance at home compared to those receiving SOC plus grafting, consistently showing improvement over time.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-33"},"PeriodicalIF":0.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Diabetic Limb Preservation Initiative.","authors":"Paul Han","doi":"10.7547/25-108","DOIUrl":"https://doi.org/10.7547/25-108","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcers (DFUs) and lower extremity amputations are major contributors to morbidity and mortality in individuals with diabetes. Among patients undergoing active cancer treatment, the risks are compounded by immunosuppression, peripheral neuropathy, and vascular complications. Even minor foot infections or wounds in these patients can necessitate the suspension of cancer therapy, with potentially life-threatening consequences. This study evaluated the impact of integrating symptom-focused patient education with coordinated podiatric care to reduce DFUs and amputations in this high-risk population with concurrent cancer and diabetes.</p><p><strong>Methods: </strong>A five-year retrospective review was conducted at a National Cancer Institute (NCI)-designated comprehensive cancer center as part of the Novel Limb Preservation Initiative. The cohort included patients with Type II diabetes undergoing treatment for prostate, breast, colorectal, lymphoma, leukemia, thyroid, or lung cancers. Patients were assigned targeted educational modules based on self-reported diabetic foot symptoms. Podiatric care was individualized according to each patient's signs and symptoms, including routine diabetic foot examinations and close, timely monitoring when indicated.</p><p><strong>Results: </strong>The intervention yielded a DFU incidence of 2.8% and an amputation rate of 0.43%, both lower than national benchmarks. Enhanced patient engagement through diabetic foot symptom-focused education and earlier detection of foot complications-including diabetic foot issues that may appear minor to laypersons-contributed to these improved outcomes.</p><p><strong>Conclusion: </strong>Integrating diabetic foot symptom-focused education with proactive podiatric monitoring significantly reduced DFUs and amputations in this high-risk population. This model, developed under the Novel Limb Preservation Initiative, offers a scalable strategy for broader implementation, particularly in high-risk communities, including Hispanic, African American, low socioeconomic, and rural populations across the United States.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-21"},"PeriodicalIF":0.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Surgical Correction of Hindfoot and Ankle Deformities in Charcot Neuroarthropathy: A Proof-of-Concept in Five Patients.","authors":"Mathieu M Gevers, Maxim K Gevers, Frank Nobels, Wahid Rezaie","doi":"10.7547/24-024","DOIUrl":"https://doi.org/10.7547/24-024","url":null,"abstract":"<p><strong>Background: </strong>Charcot neuroarthropathy (CN) of the hindfoot or ankle often results in important deformity, instability, chronical ulceration and infection that, without adequate treatment, could lead to trans-tibial amputation. Several surgical procedures for the reconstruction of hindfoot- and ankle CN deformities have been described in literature. Their main disadvantage is the extensive soft tissue dissection, which could lead to infection, necrosis and implant failure.</p><p><strong>Methods: </strong>We introduce a novel technique of minimally invasive surgery (MIS) for correction of CN deformities, followed by retrograde intramedullary nailing of the hindfoot for stabilization. This retrospective limited case-series reports the outcome of 5 patients (3 women, 2 men, 5 feet) with unstable hindfoot Charcot deformities and neuropathic ulcers who underwent MIS.</p><p><strong>Results: </strong>Mean age was 54.5 years ; the median American Society of Anesthesiologists score was 3. Three patients underwent a single-stage procedure and two patients underwent a two-stage treatment. No postoperative infections occurred. Healing of ulcerations was achieved at average of 5 weeks. Hindfoot angle improved from 33.6 to 6.2 degrees (p<.05). At a mean follow-up of 20.6 months, limb preservation was achieved for all patients. There was no failure of correction or fixation. The mean American Orthopedic Foot & Ankle Society (AOFAS) score improved from 45.0 to 79.8 (p<.05). The mean Euroqol EQ-5D-5L score improved from 0.23 to 0.82 (p<.05).</p><p><strong>Conclusion: </strong>This proof-of-concept shows that MIS of CN hindfoot and ankle deformities can be a safe and efficient procedure, providing short-term healing of neuropathic ulcers and long-term improvement of function and quality of life.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":" ","pages":"1-30"},"PeriodicalIF":0.6,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Adolescent Subungual Osteochondroma of the Hallux.","authors":"Kerry Clark","doi":"10.7547/22-117","DOIUrl":"https://doi.org/10.7547/22-117","url":null,"abstract":"<p><p>A 17-year-old male presented with a painful subungual mass, which was clinically diagnosed as a subungual exostosis prior to surgical referral. Few reported cases of subungual osteochondroma exist in the literature, and those published describe skin or nail deformities resulting from the lesion. These deformities can easily be misdiagnosed as subungual exostosis by clinical examination alone. The characteristic findings in this case resulted in a diagnosis of subungual osteochondroma, which was successfully resolved following surgical excision. This report highlights the clinical, radiographic, and histopathologic characteristics of subungual osteochondroma, and differentiates it from subungual exostosis. The results report on the success of a 2-year post-surgical audit of patient-related outcomes.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salvage Surgery with Iliac Wing Autograft Following Total Calcanectomy for Calcaneal Chondrosarcoma.","authors":"Mustafa Alper Incesoy, Amrah Farhadov, Gokcen Gundogdu Unverengil, Volkan Gurkan","doi":"10.7547/24-129","DOIUrl":"https://doi.org/10.7547/24-129","url":null,"abstract":"<p><p>Primary malignancies originating in the calcaneus are rare, constituting fewer than 1% of skeletal tumors. Traditional approaches like amputation, though effective, result in significant morbidity. This study presents a case of a 32-year-old male with calcaneal chondrosarcoma, managed with total calcanectomy and subsequent limb salvage through iliac wing autograft reconstruction. The decision for reconstruction considered tumor characteristics, patient factors, and feasibility of reconstruction methods. Successful recovery and functional outcomes were achieved without evidence of recurrence during the 67-month follow-up. The use of autogenous iliac bone graft demonstrated its suitability for structural reconstruction, emphasizing limb-sparing options in calcaneal chondrosarcomas.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevancy Grading of Outcome-Predicting Factors After Distal Chevron Osteotomy for Hallux Valgus Correction.","authors":"Franz Endstrasser, Gerhard Kaufmann, Moritz Wagner, Dietmar Dammerer, Michael Liebensteiner, Hanno Ulmer, Matthias Braito","doi":"10.7547/23-062","DOIUrl":"https://doi.org/10.7547/23-062","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify radiographic risk factors for loss of correction (LOC) after hallux valgus surgery and to weight their importance for LOC.</p><p><strong>Methods: </strong>We retrospectively assessed the radiographs of 1,082 consecutive chevron osteotomy cases regarding early LOC from initially postoperative to 6 and 12 weeks postoperative. The influence of preoperative and postoperative radiographic parameters on LOC of the hallux valgus angle (HVA) and the intermetatarsal 1-2 angle (IMA) was evaluated using nonparametric Spearman rank correlations and multiple linear regression analyses.</p><p><strong>Results: </strong>Mean ± SD LOC from initially postoperative to 6 and 12 weeks postoperative were 1.4° ± 2.7° and 3.4° ± 2.6° for the IMA and 3.5° ± 5.4° and 7.6° ± 5.6° for the HVA, respectively. Significant correlations were found between LOC of the HVA or IMA for preoperative IMA, HVA, distal metatarsal articular angle, proximal to distal phalangeal articular angle (PDPAA), and joint congruity as well as for postoperative IMA, HVA, PDPAA, joint congruity, and sesamoid position. Categorization of outcome-predicting postoperative radiographic factors revealed the following parameters to be important, in descending order: HVA, sesamoid position, IMA, PDPAA, and joint congruity.</p><p><strong>Conclusions: </strong>Multiple preoperative and postoperative radiographic parameters correlate with early LOC after hallux valgus surgery. Relevancy grading revealed the postoperative HVA and sesamoid position to be the most important parameters, followed by the IMA, PDPAA, and joint congruity. Consequently, total deformity correction, taking all aspects of the hallux valgus deformity into account, seems reasonable.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective Review Evaluating the Relationship Between Radiographic Calcaneal Fat Pad Thickness and Plantar Fasciitis.","authors":"Elizabeth Bonarigo, Ashwin Easow, Steven Cohen, Waleed Faruqi, Austin Carbone","doi":"10.7547/23-126","DOIUrl":"https://doi.org/10.7547/23-126","url":null,"abstract":"<p><strong>Background: </strong>Chronic degeneration of the plantar fascia at its insertion on the plantar calcaneus, known as plantar fasciitis (PF), is the most common cause of heel pain in adults. The calcaneal fat pad (CFP) is a structure superficial to the plantar fascia and calcaneus, serving a critical purpose in shock absorption at heel strike during gait. To our knowledge, the radiographic relationship between the thickness of the CFP and PF has never been evaluated. The purpose of this study was to determine if there is a relationship between the thickness of the CFP, as measured on weightbearing lateral radiographs, and the incidence of PF.</p><p><strong>Methods: </strong>This was a comparative retrospective analysis between a study cohort and a control group performed at our facility. The study cohort consisted of patients diagnosed with PF, whereas the control group consisted of patients who had no known history of PF. All patients involved in this study had weightbearing lateral foot radiographs taken and met study inclusion and exclusion criteria. The CFP thickness of the study participants was measured using the ruler tool in the AccuVueCloud radiography software.</p><p><strong>Results: </strong>The study cohort consisted of ten patients and the average of the radiographic measurements obtained was 0.808 cm, whereas the control group consisted of ten patients and the average of the radiographic measurements obtained was 1.091 cm. A t test was then conducted to determine if there was a significant difference between the means of the two groups, and the results produced a P value of 0.0045.</p><p><strong>Conclusions: </strong>When diagnosing PF, radiographs are typically the first imaging modality used, but prior to our study, they lacked diagnostic practicality. Our study suggests that there is a relationship between CFP thickness and the incidence of PF that can be examined using weightbearing lateral radiographs.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of Circular Ring External Fixation of the Foot and Ankle.","authors":"Cody D Blazek, Nicholas S Powers, Paul R Leatham, Patrick R Burns","doi":"10.7547/22-228","DOIUrl":"https://doi.org/10.7547/22-228","url":null,"abstract":"<p><strong>Background: </strong>Circular ring external fixation has been found to be successful in the treatment of a wide range of foot and ankle pathologies, particularly in patients with multiple comorbidities and soft-tissue compromise, but the procedures are technically demanding, and complications are common. The primary goal of this study was to identify complications associated with circular ring external fixation, and the secondary aim was to identify any independent risk factors associated with them.</p><p><strong>Methods: </strong>Institutional review board approval was obtained, and a retrospective review was performed of 99 consecutive patients undergoing 100 foot or ankle procedures involving circular ring external fixation. Patient demographics, duration of fixator use, indications for the procedures, and outcomes were recorded. Clinical characteristics and indications for circular ring external fixation were tested for association with complications.</p><p><strong>Results: </strong>Sixty-one patients experienced 67 complications. Forty-six complications were minor and 21 were major. Body mass index was the only preoperative variable demonstrating a significant increase in complications (P < .001). Obese patients had 3.2 times the odds of having a complication as nonobese patients (95% confidence interval, 1.4-7.6). Patients with diabetes or Charcot's arthropathy showed an increase in complications.</p><p><strong>Conclusions: </strong>Complications are common with circular ring external fixation of the foot and ankle, and most are minor fine wire complications. There are many variables that may contribute to complications, but obesity was most predictive in this study.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Foot Kinematics and Center of Pressure Trajectory During Gait in Individuals with Flatfoot.","authors":"Wataru Kawakami, Yoshitaka Iwamoto, Yasutaka Takeuchi, Ryosuke Takeuchi, Junpei Sekiya, Yosuke Ishii, Makoto Takahashi","doi":"10.7547/23-050","DOIUrl":"https://doi.org/10.7547/23-050","url":null,"abstract":"<p><strong>Background: </strong>Flatfoot causes the medial shift of ground reaction force during the stance phase of gait, which is associated with various foot disorders. To prevent this shift in flatfoot, it is necessary to understand the characteristics of the loading pattern and what foot joint kinematics influence it. We investigated differences in the center of pressure (COP) position between normal foot and flatfoot, and predictors of COP trajectory during gait.</p><p><strong>Methods: </strong>Fifty healthy females participated. Based on the normalized navicular height truncated score, 27 and 23 participants were classified as having normal foot and flatfoot, respectively. Multisegmental foot kinematic and kinetic data were recorded during three gait trials. The COP trajectory was computed using a plantar local coordinate system defined from the obtained marker positions. COP positions during each phase of stance were compared between normal foot and flatfoot using independent t tests. Multiple regression analyses were performed to identify the relationship between foot joint motion and COP positions during each phase of stance.</p><p><strong>Results: </strong>COP positions in flatfoot were displaced medially throughout the stance phase compared with normal foot. Multiple regression analyses revealed that the frontal and transversal plane motions of the calcaneus were main statistically significant predictors of the COP positions during the stance phase. Transversal plane motion of the calcaneus had greater standardized coefficients than in the frontal plane.</p><p><strong>Conclusions: </strong>To correct the medial shift of the COP position in individuals with flatfoot, it may be important to control not only the eversion but also the adduction motion of the rearfoot throughout the stance phase.</p>","PeriodicalId":17241,"journal":{"name":"Journal of the American Podiatric Medical Association","volume":"115 4","pages":""},"PeriodicalIF":0.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144958849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}