Orthopedic Research and Reviews最新文献

{"title":"Trends and Outcomes in Patients with Rib Fractures, 2016-2020: A Retrospective Cohort Study from the Nationwide Readmissions Database.","authors":"Jarva Chow, Elizabeth R Hall, Hua She, Sajid Shahul","doi":"10.2147/ORR.S563977","DOIUrl":"10.2147/ORR.S563977","url":null,"abstract":"<p><strong>Purpose: </strong>Readmissions are associated with worse patient outcomes, higher length of stay, and increased costs. Reducing unnecessary readmissions represents a significant opportunity for improving patient outcomes and healthcare delivery.</p><p><strong>Patients and methods: </strong>This was a retrospective cohort study utilizing the Nationwide Readmissions Database (NRD), part of the United States Healthcare Cost and Utilization Project (HCUP). The NRD was queried to identify all adult (>18 years old) trauma patients with an admission diagnosis of rib fractures. Demographic and hospital data, comorbidities, as well as morbidity and mortality outcomes were collected.</p><p><strong>Results: </strong>The 2016-2020 NRD identified 553,810 patients admitted with a diagnosis of rib fractures, with 65,244 of those patients readmitted within 30 days of discharge. Patients with rib fractures who were readmitted within 30 days were associated with 9-fold higher mortality over six months than if they were not readmitted. Patients with rib fractures were more likely to be readmitted from small or medium-sized hospitals (p<0.001), had underlying depression (OR 1.42, 95% CI [1.34-1.51]), drug abuse (OR 1.23, 95% CI [1.13,1.35]), chronic pulmonary disease (OR 1.49, 95% CI [1.41,1.57]), and obesity (OR1.22, 95% CI [1.13-1.31]). There was an association with higher readmission rates in patients with a single rib fracture compared with multiple rib fractures.</p><p><strong>Conclusion: </strong>Patients readmitted within 30 days of discharge with rib fractures are associated with higher six-month mortality. Rib fractures are a common injury in trauma patients. Reducing unnecessary readmissions in this patient population may improve patient outcomes, satisfaction, and decrease healthcare costs.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"563977"},"PeriodicalIF":2.0,"publicationDate":"2026-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Omics Bioinformatic Analyses Linking LOXL4 with Spondylolisthesis.","authors":"Hui Wang, Peng Niu, Xiu Yang, Xin Lin, Jinquan Li, Guangyin Wu, Xiaotang Sun, Jianghu Huang, Feiyue Lin","doi":"10.2147/ORR.S551680","DOIUrl":"10.2147/ORR.S551680","url":null,"abstract":"<p><strong>Purpose: </strong>Spondylolisthesis is a spinal disorder characterized by abnormal vertebral displacement, primarily affecting the lumbar region. Understanding the genetic factors underlying its progression is critical.</p><p><strong>Patients and methods: </strong>This study aimed to identify key genes influencing spondylolisthesis progression. The summary-data-based Mendelian randomization (SMR) analysis was conducted to evaluate gene expression quantitative trait (eQTL) and DNA methylation QTL (mQTL) data that were causally associated with spondylolisthesis. Subsequently, key genes were discerned by Bayesian colocalization analysis. To validate the findings, Quantitative real time polymerase chain reaction (qRT-PCR) experiments were conducted using human osteosarcoma cells (SW-1353). Additionally, enrichment analysis, small molecule compounds prediction and molecular docking were performed to investigate how the key genes might impact spondylolisthesis.</p><p><strong>Results: </strong>SMR analysis identified 841 cis-eQTLs and 3,224 mQTLs potentially linked to spondylolisthesis (P < 0.05). Bayesian colocalization revealed LOXL4 as a key gene, with posterior probabilities (PPH4) exceeding 0.90 for both eQTL (ENSG00000138131) and mQTL (cg09335911). LOXL4 is implicated in pathways like \"protein oxidation\" and \"collagen-containing extracellular matrix\", which are critical for tissue integrity. Molecular docking suggested that LOXL4 binds strongly to estradiol and progesterone, pointing to a potential mechanism of hormonal regulation in spondylolisthesis. However, this remains a hypothesis requiring further experimental validation. Additionally, qRT-PCR experiments in hydrogen peroxide-treated SW1353cells showed that LOXL4 expression changes were consistent with our bioinformatics predictions, although this in vitro model may not fully reflect the gene's role in spondylolisthesis.</p><p><strong>Conclusion: </strong>This findings suggest LOXL4 as a candidate gene involved in spondylolisthesis progression and a potential therapeutic target. Nevertheless, out results are preliminary and further research is needed to confirm LOXL4's role in this condition.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"551680"},"PeriodicalIF":2.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13016404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Recent Advances in Managing Periprosthetic Joint Infection After Total Knee Arthroplasty: DAIR Technique.","authors":"Hamza Warda, Jameel Suliman, Maria Chakhide, Michel Samaan","doi":"10.2147/ORR.S567611","DOIUrl":"10.2147/ORR.S567611","url":null,"abstract":"<p><p>Periprosthetic joint infection (PJI) is a significant complication that can arise after joint arthroplasty. The Debridement, Antibiotics, and Implant Retention (DAIR) approach is gaining popularity as a treatment to preserve the joint, especially in cases of early or acute infections. This review compiles recent evidence to assess the effectiveness, prognostic factors, and limitations of the DAIR method in managing PJI. Success rates for DAIR vary widely, ranging from 41% to 92%. These rates are significantly influenced by several factors, including the timing of the infection, the microbial profile, patient characteristics, and the surgical techniques used. Success rates for DAIR are generally highest (over 70-90%) when performed within 4-6 weeks of symptom onset, along with the exchange of modular components, particularly for patients who present a lower risk. Staphylococcus aureus infections, when coupled with delayed presentation and comorbidities like advanced age and chronic kidney disease, are associated with higher rates of treatment failure. The use of rifampin, especially when combined with fluoroquinolones, improves patient outcomes. However, the optimal antibiotic regimens have yet to be clearly established. Emerging techniques like DAPRI and novel antiseptic irrigation solutions (eg, Bactisure^®) show promise but need further clinical validation. While DAIR offers significant benefits, its variable success highlights the importance of careful patient selection and the urgent need for high-quality clinical research to establish standardized protocols and enhance long-term outcomes.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"567611"},"PeriodicalIF":2.0,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of Mucoid Degeneration in the Cruciate Ligament: Role of Denatured Aggrecan Accumulation and Tissue Dysfunction.","authors":"Akira Inoue","doi":"10.2147/ORR.S562853","DOIUrl":"10.2147/ORR.S562853","url":null,"abstract":"<p><strong>Purpose: </strong>The frequency of detecting mucoid degeneration of the cruciate ligament (MD-CL) as an abnormal finding on magnetic resonance imaging in daily orthopedic practice is increasing. However, much about its pathogenesis remains unknown. This study investigated the pathophysiology of MD-CL by examining biochemical and physiological aspects in addition to traditional orthopedic approaches.</p><p><strong>Results: </strong>Previous studies have shown that mucoid degeneration of the anterior CL (MD-ACL) and posterior CL (MD-PCL) varies widely in incidence and clinical presentation, but both share similar pathology, marked by histological changes from the accumulation of sulfated glycosaminoglycan. This suggests a common etiology, with anatomical differences between CLs influencing clinical manifestations. Furthermore, MD-CL lesions resolved after debulking surgery, which normalized intraligamentous pressure and circulatory dynamics, suggesting a potential role of altered intraligamentous circulation in MD-CL pathogenesis.</p><p><strong>Conclusion: </strong>MD-CL is a pathological condition caused by an imbalance between the production and efflux of denatured aggrecan, possibly due to impaired matrix turnover or interstitial fluid drainage. In active-age groups, MD-CL is induced by altered intraligamentous circulation and lymphatic drainage dysfunction, combined with denatured aggrecan overproduction linked to inflammation from various proinflammatory factors. Mechanical stress may contribute to local inflammation through mechanotransduction pathways involving neuropeptides. In older adults, age-related dysfunction of nutrient vessels and increased inflammatory cytokines lead to denatured aggrecan accumulation, while age-related impaired lymphatic drainage reduces its clearance. Both age groups may exhibit abnormal deposition of denatured aggrecan within the ligament matrix, impairing CL integrity, altering viscoelasticity, and possibly resulting in osteoarthritis and meniscus damage.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"562853"},"PeriodicalIF":2.0,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic Management of Primary Synovial Chondromatosis of the Ankle: A Case Report and Review of the Literature.","authors":"Antoine Saber, Hafez Saade, Firas Hassan, Hady Ezzeddine, Wendy Ghanem, Ramzi Moucharafieh, Riad R Fakih","doi":"10.2147/ORR.S544850","DOIUrl":"10.2147/ORR.S544850","url":null,"abstract":"<p><p>Synovial chondromatosis (SC) is a rare, benign condition characterized by the formation of cartilaginous nodules within the synovial membrane of joints. We present a case of primary SC of the ankle in a 49-year-old female who experienced persistent ankle pain and restricted range of motion. She was successfully treated with arthroscopic removal of loose bodies and synovial debridement. A review of the literature since 2010 was conducted to compare outcomes between open and arthroscopic management of ankle SC. The findings suggest that while both approaches are effective and have similar long term outcomes, arthroscopy may offer slight advantage in terms of reduced morbidity, faster rehabilitation, and improved patient satisfaction.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"544850"},"PeriodicalIF":2.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Causal Effects of CCL19, CCL23, and IL17A on Achilles Tendinitis: Insights from Bidirectional Mendelian Randomization and Metabolite-Mediated Pathway Analysis.","authors":"Lu Wei, Wenqiang Wang, Xiang Chen, Shunan Dong, Hongjie Su, Puxiang Zhen, Xinyu Nie, Qikai Hua","doi":"10.2147/ORR.S574286","DOIUrl":"10.2147/ORR.S574286","url":null,"abstract":"<p><strong>Background: </strong>Achilles tendinitis (AT) is a prevalent musculoskeletal disorder with unclear etiology. This study aimed to investigate the causal relationships between circulating inflammatory cytokines (ICs), metabolites, and AT risk using bidirectional Mendelian randomization (MR), and to identify potential metabolite-mediated pathways.</p><p><strong>Methods: </strong>A bidirectional MR design was implemented, integrating genetic instruments for 91 ICs and 1400 metabolites with GWAS summary statistics from the FinnGen consortium. Causal inferences were drawn using inverse variance weighting (IVW), MR-Egger regression, and weighted median approaches, accompanied by sensitivity and mediated analyses.</p><p><strong>Results: </strong>CCL19, CCL23, and IL17A were identified as protective factors for AT, with CCL23 demonstrating consistent associations across multiple MR methods. 65 metabolite traits were significantly associated with disease risk. Glycochenodeoxycholate glucuronide showed a protective effect (P = 0.002), whereas the alpha-tocopherol to glycerol ratio increased risk (P = 0.011). Mediation analysis indicated six pathways: CCL19 - pantothenate - AT; CCL19 - Picolinate - AT; CCL19 - X-21845- AT; CCL23 - X-12822 - AT; CCL23 - X-18921 - AT; IL17A - cysteinylglycine disulfide - AT.</p><p><strong>Conclusion: </strong>This is the first MR study to systematically assess the causal roles of ICs and metabolites in AT, identifying CCL19, CCL23, and IL17A as protective factors and highlighting multiple metabolite signatures linked to disease risk, offering novel insights for mechanistic research and targeted intervention.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"574286"},"PeriodicalIF":2.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extensile Posterolateral Novel Approach Through the Anconeus Muscle for an Atypical Coronal Shear Fracture of the Capitellum with Associated Lateral Epicondyle and Olecranon Fractures: A Case Report.","authors":"Abdulaziz Ahmed Abdulaziz, Osama Mohammed Qasim, Abdullah Hesham Alsawaf, Abdulraheem A Almokhtar, Khalid Jubran Idris, Atif Ahmed Labban, Khalid Ibrahim Najjar","doi":"10.2147/ORR.S549745","DOIUrl":"10.2147/ORR.S549745","url":null,"abstract":"<p><p>A 70-year-old female with a history of hypertension presented with a complex elbow injury following a fall. Imaging revealed fractures of the capitellum, lateral epicondyle, and olecranon. The fractures were managed using an extensile posterolateral approach through the anconeus muscle, achieving anatomical reduction and satisfactory functional outcomes 110° of flexion and full pronation/supination and Mayo Elbow Performance Score (MEPS) indicated an excellent outcome. This approach preserved the extensor origin and facilitated access for fixation, suggesting its potential as an alternative for managing such rare injuries.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"549745"},"PeriodicalIF":2.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open Tibial Fractures Part 2: A Narrative Review of Definitive Treatment and Potential Applicability to the Southern African Context.","authors":"Erik Hohmann, Maketo Molepo, Maritz Laubscher, Kevin Tetsworth","doi":"10.2147/ORR.S553515","DOIUrl":"10.2147/ORR.S553515","url":null,"abstract":"<p><p>The purpose of this study was to conduct a review of contemporary definitive treatment options, potential complications and clinical outcomes for open tibial shaft fractures and while assessing their relevance and applicability within South African context. Treatment options available in high-income countries may not be accessible in low-resource settings, requiring adaptations to the treatment approach based on local conditions. Only one African country has attempted to establish principal guidelines for the treatment of open tibial fractures through a consensus-based approach. These guidelines cover primary assessment, antibiotics, initial stabilization, referral criteria, debridement and irrigation, documentation, wound closure, soft-tissue management, amputation, and definitive internal fixation. Unfortunately, definitive fracture management recommendations for African low-resource countries are not yet available. There is a lack of data regarding the treatment of open tibial fractures in low-resource countries, particularly in regional and rural areas. Existing guidelines address antibiotic prophylaxis and treatment, debridement and lavage, initial surgical fixation, wound closure (both primary and definitive), soft-tissue management (including flap coverage), and bone fragment retention, all adapted to local resource availability. However, guidelines for definitive treatment remain unavailable. Treatment options recommended by high-income countries are largely unsuitable, and Southern African nations should focus on developing guidelines tailored to their available resources.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"18 ","pages":"553515"},"PeriodicalIF":2.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Clinical Experience with Robotic-Assisted Total Knee Arthroplasty in Indonesia: Early Results and Comparison with Global Evidence.","authors":"Andre Yanuar","doi":"10.2147/ORR.S561904","DOIUrl":"10.2147/ORR.S561904","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated early clinical and radiographic outcomes of robotic-assisted total knee arthroplasty (RA-TKA) in Indonesia using the ROSA^® Knee System, hypothesizing that outcomes would be comparable to high-income countries.</p><p><strong>Methods: </strong>A retrospective observational study was conducted including patients undergoing primary RA-TKA between July 2024 and July 2025. Perioperative variables, radiographic alignment, postoperative mobilization, and patient satisfaction were assessed. Outcomes were compared qualitatively with published benchmarks. All procedures were performed by a single surgeon.</p><p><strong>Results: </strong>A total of 40 patients (44 knees) were included. Median operative time was 110 minutes. Standing long-leg radiographs demonstrated mechanical alignment within ±3° of neutral in all knees. Median time to ambulation was 6 hours (unilateral) and 19.5 hours (bilateral). No intraoperative complications occurred. Overall satisfaction was 95%. Outcomes were consistent with reports from high-income countries.</p><p><strong>Conclusion: </strong>RA-TKA can be safely and effectively implemented within a developing healthcare system, achieving alignment accuracy, mobilization times, and satisfaction rates comparable to global benchmarks.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"593-600"},"PeriodicalIF":2.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peroneal Artery \"Terminal\" Perforator Pedicled Flap for Surrounding Soft Tissue Defects: A Retrospective Cohort Study.","authors":"Yiming Lu, Peng Jin, Bin Wang, Jiaxiang Gu, Hongjun Liu","doi":"10.2147/ORR.S565208","DOIUrl":"10.2147/ORR.S565208","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce a technique to reconstruct soft tissue defects around the space of lateral malleolus by using the peroneal artery \"terminal\" perforator flap (the lowest perforating branch of the peroneal in the posterior compartment artery of lateral malleolus), and to report its effectiveness.</p><p><strong>Methods: </strong>From January 2018 to April 2020, 7 patients with soft tissue defects around the space of lateral malleolus were treated with the peroneal artery \"terminal\" perforator flap. Ultrasound was used to determine the perforating site of the peroneal artery. The lowest perforating branch adjacent to the wound margin was used as the rotation point to design the peroneal artery perforator flap.</p><p><strong>Results: </strong>One case had venous crisis. However, no urgent operative revision was performed. All of the 7 flaps survived completely. The grafted skins at donor site survived, and primary healing of incision was obtained. The follow-up period was 6 to 17 months with an average of 10.7 months. The flaps exhibited favorable color, texture, and overall appearance. The ability to wear shoes remained unaffected, and ankle mobility was not restricted. Surgeries for thinning the flaps were not necessary. All of the patients were satisfied with the cosmetic and functional result.</p><p><strong>Conclusion: </strong>The peroneal artery terminal perforator flap is a useful and reliable choice for coverage of soft tissue defects around the space of lateral malleolus in clinical application.</p>","PeriodicalId":19608,"journal":{"name":"Orthopedic Research and Reviews","volume":"17 ","pages":"601-606"},"PeriodicalIF":2.3,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145850731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}