Orthopedics最新文献

{"title":"Understanding the Carbon Footprint of the American Academy of Orthopaedic Surgeons Annual Meeting.","authors":"Trevor G Simcox, Abtahi Tishad, Reed Popp, Jeffrey Dela Cruz, Gennaro DelliCarpini, Joseph J King, Jonathan O Wright, Thomas W Wright, Ryan P Roach","doi":"10.3928/01477447-20250731-01","DOIUrl":"10.3928/01477447-20250731-01","url":null,"abstract":"<p><strong>Background: </strong>This study's aim was to quantify the carbon footprint of the 2023 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting and compare it to an alternative meeting structure.</p><p><strong>Materials and methods: </strong>We conducted a retrospective analysis of estimated greenhouse gas emissions from the AAOS 2023 Annual Meeting in Las Vegas, NV. We also modeled theoretical meetings held in locations including Chicago, IL, New Orleans, LA, and New York City, NY, as well as a hybrid meeting occurring across four regional hubs. Emissions for air travel were determined by computing emissions of direct flights to Las Vegas and the closest major airport for each state, using an emissions calculator. Attendees were assumed to use ground travel if they lived within a 250-mile radius of the meeting location. Travel by international attendees was also calculated. We also determined the geographic density of surgeons by state using data from the Association of American Medical Colleges workforce report.</p><p><strong>Results: </strong>The 2023 AAOS Annual Meeting was estimated to have generated 9,458 metric tons of travel-related CO₂ equivalents compared with 7,073 (Chicago), 7,678 (New York City), and 7,396 (New Orleans) metric tons. The hybrid regional hub model, which excluded intercontinental travel, was estimated to generate only 1,368 metric tons.</p><p><strong>Conclusion: </strong>Total miles traveled had the most significant impact on carbon emissions. This may aid meeting planners in selection of future meeting locations that minimize air travel. In addition, adoption of a regional hub structure with interactive videoconferencing is a potential option for reducing the carbon footprint of the AAOS Annual Meeting.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e193-e199"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963693","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":"Pathological Rupture of the Quadriceps Tendon in a Patient With Osteogenesis Imperfecta With Leg-length Discrepancy: A Case Report.","authors":"Dong Nyoung Lee, Chang Hyun Nam, Ji-Hoon Baek, Suengryol Ryu, Hye Sun Ahn, Su Chan Lee","doi":"10.3928/01477447-20250729-01","DOIUrl":"10.3928/01477447-20250729-01","url":null,"abstract":"<p><p>Quadriceps tendon rupture is typically caused by severe trauma, such as a fall, leading to substantial restriction of knee joint movements. However, pathological ruptures (one third of all quadriceps ruptures) can occur spontaneously or caused by minor trauma. Pathological ruptures are usually caused by chronic systemic diseases, such as systemic lupus erythematosus, chronic renal failure, and rheumatoid arthritis, and rarely by osteogenesis imperfecta (OI), a genetic disorder that affects the musculoskeletal system. Defective type 1 collagen formation in OI leads to bone fragility, ligamentous laxity, tendon rupture, and short stature. Here, we report the case of a 55-year-old man diagnosed with OI who experienced a pathological rupture of the right quadriceps tendon. The patient also had a leg-length discrepancy in the left leg due to the malunion of several femoral fractures. The rupture was repaired using the Krackow suture technique. The patient regained preinjury range of motion within 3 months postoperatively and could walk without pain.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e228-e230"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822170","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":"Prescription Trends by Orthopedic Surgery Provider: Review of the Medicare Part D Prescribers - by Provider and Drug, 2013-2021.","authors":"John Bartoletta, Sanjay Kubsad, Navin Fernando, Howard Chansky, Paul Manner, Nicholas Hernandez","doi":"10.3928/01477447-20250702-03","DOIUrl":"10.3928/01477447-20250702-03","url":null,"abstract":"<p><strong>Background: </strong>We characterize outpatient prescribing trends of orthopedic surgery providers in the United States.</p><p><strong>Materials and methods: </strong>A retrospective analysis of the Medicare Part D Prescribers - by Provider and Drug was conducted between 2013 and 2021, including anti-osteoporotic medications (AOMs), antibiotics, opioids, and nonsteroidal anti-inflammatory drugs (NSAIDs). Outcomes included claims, claims per 1,000 prescribers, combined annual growth rate, and percentage growth.</p><p><strong>Results: </strong>Claims for AOMs decreased from 29,024 in 2013 to 12,500 in 2021. Claims for alendro-nate, ibandronate, risedronate, and teriparatide all significantly decreased, whereas claims for abaloparatide and romosozumab significantly increased (<i>P</i><0.05). Antibiotic claims increased from 304,817 (2013) to 580,736 (2021). Claims for amoxicillin, amoxicillin/clavulanic acid, cefadroxil, cephalexin, clindamycin, doxycycline, mupirocin, penicillin V, and sulfamethoxazole/trimethoprim significantly increased, whereas use of azithromycin, ciprofloxacin, levofloxacin, and vancomycin significantly decreased (<i>P</i><0.05). Claims for opioids decreased from 3,224,572 (2013) to 2,070,423 (2021). Use of hydrocodone/acetaminophen, oxycodone/acetaminophen, and tramadol/acetaminophen also significantly decreased (<i>P</i><0.05). Use of oxycodone and oxycodone myristate significantly increased (<i>P</i><0.05). Claims for fentanyl, methadone, and morphine all significantly decreased (<i>P</i><0.05). Claims for NSAIDs increased from 1,300,279 (2013) to 1,796,419 (2021). Claims for celecoxib, diclofenac, ibuprofen, ketorolac, and meloxicam all significantly increased, whereas claims for etodolac, indomethacin, nabumetone, naproxen, piroxicam, and sulindac all significantly decreased (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>In line with national guidelines, claims for NSAIDs are increasing and claims for opioid pain medications and AOMs are decreasing. Claims for outpatient antibiotics are increasing, which is of significant concern, given renewed focus on antibiotic stewardship.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"297-304"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822171","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":"No Difference in 90-day Complication Rates Between Patients With and Without Obstructive Sleep Apnea Undergoing Total Joint Arthroplasty.","authors":"Brooke Birbara, Jordan A Bauer, Alexander K Hahn, Barrett B Torre, Dorothy B Wakefield, Matthew J Grosso","doi":"10.3928/01477447-20250811-02","DOIUrl":"https://doi.org/10.3928/01477447-20250811-02","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) has shown significant effects on complication rates in total joint arthroplasty (TJA) patients. Current research lacks appropriate propensity score matching of this comorbidity as well as data surrounding treated OSA compared to untreated OSA among TJA patients. This study examined if patients with treated and untreated OSA were at higher risk for 90-day postoperative complications following TJA.</p><p><strong>Materials and methods: </strong>17,272 patient charts were retrospectively examined, with 3,876 having OSA and 13,396 not. Following propensity score matching of 7,014 patients, 3,507 were identified to have OSA and 3,507 not. Patients were matched based on age, sex, body mass index, American Society of Anesthesiologists (ASA) class, and type of surgery, then further divided into untreated versus treated OSA based on continuous positive airway pressure use. Chi-square analyses compared patient characteristics, and a multivariable logistic regression model assessed the effect of OSA on 90-day complication rates.</p><p><strong>Results: </strong>OSA alone was not an indicator for 90-day postoperative complications in our propensity-matched sample. Higher ASA classes (<i>P</i><0.01) and higher Charlson Comorbidity Index (CCI; <i>P</i><0.01) were associated with a significant increase in 90-day complication rates compared with patients with ASA classes I-II and lower CCI, respectively. There was no significant difference in complications between patients with untreated and treated OSA (<i>P</i>=0.29).</p><p><strong>Conclusion: </strong>Using propensity score matching, this study indicates that OSA alone is not associated with an increased risk of 90-day postoperative complications in primary TJA. While associated comorbidities of OSA may contribute to increased complication rates, surgeons can be reassured that OSA alone may not be a significant factor in short-term postoperative outcomes.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":"48 5","pages":"e209-e214"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075800","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":"Fluoroscopy Use and Radiation Exposure in Distal Radius Fracture Fixation.","authors":"Christina Liu, Dafang Zhang, Cassandra M Chruscielski, Kyra Benavent, Philip Blazar, Brandon E Earp","doi":"10.3928/01477447-20250702-01","DOIUrl":"10.3928/01477447-20250702-01","url":null,"abstract":"<p><strong>Background: </strong>The primary aim of this study was to quantify radiation exposure during the surgical fixation of distal radius fractures (DRF). Secondary aims included determining patient and surgeon factors associated with higher intraoperative fluoroscopic use.</p><p><strong>Materials and methods: </strong>This retrospective study included 342 patients with DRF who underwent acute surgical fixation between January 1, 2017, and June 1, 2019. Inclusion criteria were patient age older than 18 years with acute DRF undergoing surgical fixation. Exclusion criteria were patient age younger than 18 years, additional fractures undergoing simultaneous fixation, and bilateral DRF requiring fixation. Patient demographics, surgeon factors, and fluoroscopy data were collected through chart reviews. Univariate and bivariate analyses were performed, and <i>P</i><0.05 was considered significant.</p><p><strong>Results: </strong>The median patient age was 59 years, and 77.8% were women. The median dose area product (DAP) was 9.24 cGy*cm² per case. The median number of images obtained per case was 36, and the median fluoroscopy time was 60 seconds, equating to a dose of 0.39 mGy/min. Higher radiation exposure was associated with male patients, more complex fracture morphology, type of implant chosen, junior attendings as primary surgeon, surgeon subspecialty, and surgical assistant training level.</p><p><strong>Conclusion: </strong>Intraoperative fluoroscopic use during DRF surgical fixation is associated with both patient injury characteristics as well as surgeon factors. Male patients and fracture morphology, as well as surgeon experience and the presence of trainees, all increase fluoroscopic use and radiation exposure.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e200-e208"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682890","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":"Severe Acute Localized Reaction/Pseudosepsis in Patients With Knee Osteoarthritis Receiving Injections of Hyaluronic Acid: A Targeted Literature Review.","authors":"Seth Lawrence Sherman, Wilson Ngai, Kevin Steele, Jean-Paul Collet, John D A Kelly","doi":"10.3928/01477447-20250715-01","DOIUrl":"10.3928/01477447-20250715-01","url":null,"abstract":"<p><strong>Background: </strong>Hyaluronic acid injections for knee osteoarthritis patients can result in pseudosepsis. A targeted literature review was conducted to determine the rate of pseudosepsis in patients receiving intra-articular hyaluronic acid, particularly hylan G-F 20 (SYNVISC^®).</p><p><strong>Materials and methods: </strong>Articles were identified through Embase using predefined search strategies. Pseudosepsis event rate was calculated by dividing the number of reported events by the total number of intra-articular injections.</p><p><strong>Results: </strong>The pseudosepsis event rate ranged from 0% to 5.6% per injection; most treatment groups had an event rate of ≤2% per injection.</p><p><strong>Conclusion: </strong>Pseudosepsis event rates were low across studies for patients treated with hyaluronic acid, including hylan G-F 20.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"305-314"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822172","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":"Time to Surgical Intervention for Ankle Fractures as a Factor in Perioperative and Prolonged Opioid Use.","authors":"Samira Perez, Charles Laurore, Carolina Stocchi, Mayuri Jain, Brocha Z Stern, Jashvant Poeran, Meghan Kelly, David A Forsh","doi":"10.3928/01477447-20250806-01","DOIUrl":"10.3928/01477447-20250806-01","url":null,"abstract":"<p><strong>Background: </strong>This study examined the association between time to surgery post-ankle fracture and perioperative, subacute, and prolonged opioid use.</p><p><strong>Materials and methods: </strong>This was a retrospective cohort study that used the Merative MarketScan Commercial Claims and Encounters Database. It included patients aged 18 to 64 with an ankle fracture between April 1, 2016, and June 30, 2021, who underwent open reduction and internal fixation within 21 days. Time to surgery was categorized as 0 to 3 days, 4 to 7 days, and 8 to 21 days. Multivariable logistic regression models assessed associations between time to surgery and perioperative (fracture through 7 days after surgery), subacute (31 to 90 days), and prolonged (91 to 180 days) opioid use, adjusting for relevant covariates.</p><p><strong>Results: </strong>The cohort included 20,642 patients (61.7% female, median age 48); 47.5% had surgery 0 to 3 days after fracture, 25.1% 4 to 7 days, and 27.4% 8 to 21 days. Later surgery (versus 0 to 3 days) was associated with increased perioperative opioid use (4 to 7 days: odds ratio [OR] 2.39, 95% CI 2.13-2.69, <i>P</i><0.001; 8 to 21 days: OR 2.53, 95% CI 2.25-2.84, <i>P</i><0.001). Having surgery at 8 to 21 (versus 0 to 3) days was significantly associated with increased prolonged use in those who filled a perioperative opioid prescription after adjusting for perioperative medications (OR 1.20, 95% CI 1.03-1.42, <i>P</i>=0.02).</p><p><strong>Conclusion: </strong>The study highlights the role of surgical timing in opioid use after ankle fractures. Surgery beyond 7 days after fracture was associated with increased perioperative opioid use and slightly elevated prolonged use in those who filled perioperative opioids. Orthopedic surgeons should consider timely interventions to mitigate prolonged opioid use, thus promoting safer postoperative care in ankle fracture patients.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"288-296"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963709","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":"Metastatic Lymphoma of the Ulnar Nerve: A Case Report.","authors":"Simbarashe J Peresuh, Jacob M Johnson, Paul-Hugo Arcand, Michel A Arcand, Joseph A Izzi","doi":"10.3928/01477447-20250708-01","DOIUrl":"10.3928/01477447-20250708-01","url":null,"abstract":"<p><p>Metastatic peripheral nerve lymphomas are rare, often mimicking benign neurogenic tumors or neuropraxic injuries. While some report on the involvement of nerves in the upper and lower extremities, the majority of lymphomas involve the lower extremities, with the sciatic nerve being the most common. Furthermore, involvement of the ulnar nerve is exceedingly rare, with only four reported cases, each of which indicated a primary lesion. In this article, we report a unique case of recurrent B-cell lymphoma with metastatic disease of the ulnar nerve in a nonagenarian with a remote history of diffuse high-grade large B-cell lymphoma. The patient presented with 2 months of numbness, tingling, and weakness in her left ring and small fingers. Additionally, she reported a left distal forearm mass. Examination revealed sensory loss, atrophy, and clawing of the hand. Magnetic resonance imaging showed a mass involving the ulnar nerve, confirmed as lymphoma via biopsy. Treatment included radiotherapy and capsulodeses, given her desire for a functional return to her independent activities of daily living. She was satisfied with the outcome of her management. While uncommon, this case highlights the importance of considering metastatic disease as a presentation mimicking cubital tunnel syndrome for timely diagnosis and improved outcomes. By documenting this presentation, this report aims to raise awareness among orthopedic surgeons to enhance diagnostic and management strategies for similar cases of metastatic nature and advanced patient age.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"316-319"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682891","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":"An Evidence-based Review of Challenges Faced in Personalized Alignment Strategies in Total Knee Arthroplasty.","authors":"Matthew T Geiselmann, John P Stelmach, James A Germano, Giles R Scuderi","doi":"10.3928/01477447-20250811-01","DOIUrl":"10.3928/01477447-20250811-01","url":null,"abstract":"<p><p>Restoring knee alignment is critical to total knee arthroplasty (TKA) success. Mechanical alignment offers reliable outcomes by standardizing component positioning, but it may neglect individual anatomy. In response, personalized alignment techniques-such as kinematic, inverse kinematic, and functional alignment-aim to replicate native biomechanics using technologies like robotics and patient-specific instrumentation. While promising, these approaches raise concerns about alignment precision, long-term outcomes, and technique selection. As personalized alignment techniques gain traction, evidence is needed to determine optimal patient-specific strategies and implant compatibility. Long-term data will clarify the clinical value and durability of these individualized techniques in TKA.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"e220-e227"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963639","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":"Higher Distressed Communities Index Is Associated With Loss to Follow-up Within 6 Months of Ankle Fracture Surgery.","authors":"Mohammed M Bashier, Emily D Ferreri, Andrea M Muñoz, Jessica Chao, Prisco DeMercurio, Edina Gjonbalaj, Leila Mehraban Alvandi, Huai Ming Phen, Lauren Crocco, Mani D Kahn","doi":"10.3928/01477447-20250730-01","DOIUrl":"10.3928/01477447-20250730-01","url":null,"abstract":"<p><strong>Background: </strong>The Distressed Communities Index (DCI) is a metric often used in the assessment of health care disparities. The purpose of this study was to investigate whether DCI correlates with aspects of presentation, clinical course, and postoperative events among adult ankle fracture patients who undergo surgical repair.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included adult ankle fracture patients who underwent primary ankle open reduction internal fixation (ORIF) between August 2015 and June 2023 at a single academic tertiary-care center. Patients were separated into two DCI cohorts determined by ZIP Codes: more distressed (DCI≥75) and less distressed (DCI<75). Primary outcomes were time to presentation and time to definitive surgery. Secondary outcomes including location of presentation, admission rates, length of stay, postoperative complications (eg, infection, hardware failure, reoperation), physical therapy participation, and loss to follow-up were also assessed.</p><p><strong>Results: </strong>A total of 940 patients were included. No differences were observed in time to presentation or time to definitive surgery. However, patients from more distressed communities were more likely to be lost to follow-up during the first 6 months following ankle ORIF compared to those from less distressed communities (95% CI, 1.15-2.67). No differences were found with respect to other secondary outcomes.</p><p><strong>Conclusions: </strong>Higher DCI is associated with loss to follow-up within the 6 months following ankle fracture ORIF. Interventions focused on uncovering and addressing reasons for loss to follow-up among patients from distressed communities may help ensure follow-up completion during the postoperative recovery period.</p>","PeriodicalId":19631,"journal":{"name":"Orthopedics","volume":" ","pages":"269-276"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144963667","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}