JSES InternationalPub Date : 2026-03-01Epub Date: 2025-12-24DOI: 10.1016/j.jseint.2025.101606
Natalie M. Loewen BESc , James A. Johnson PhD , George S. Athwal MD, FRCSC , G. Daniel G. Langohr PhD
{"title":"Superior glenoid inclination in shoulder arthroplasty: a comparison of standard to superiorly augmented glenoid implants","authors":"Natalie M. Loewen BESc , James A. Johnson PhD , George S. Athwal MD, FRCSC , G. Daniel G. Langohr PhD","doi":"10.1016/j.jseint.2025.101606","DOIUrl":"10.1016/j.jseint.2025.101606","url":null,"abstract":"<div><h3>Background</h3><div>The success of anatomic total shoulder arthroplasty depends on glenoid component stability, with loosening responsible for nearly half of revision surgeries. Superior glenoid inclination exacerbates component loosening by promoting unbalanced loading by the humeral head. This study investigates a novel superiorly augmented glenoid component designed to correct excessive superior inclination. We hypothesized that increasing augmentation would limit superior humeral head migration and asymmetric loading, thereby increasing compressive rather than tensile stresses at the implant–bone interface.</div></div><div><h3>Methods</h3><div>Finite element models of 8 scapulae with glenohumeral osteoarthritis were fitted with a standard 4-peg component and 3 superiorly augmented components (5°, 10°, and 15° augment angles). Loads angled 25° inferiorly to 25° superiorly were applied. Outcomes included superior–inferior humeral head position and implant–bone interface stresses.</div></div><div><h3>Results</h3><div>For every 5° increase in augmentation, the humeral head translated inferiorly by 0.4 ± 0.1 mm for the 15° native inclination group, 0.3 ± 0.1 mm for 10°, and 0.2 ± 0.1 mm for 5°. Translations ranged between 0.2 mm and 1.0 mm, consistent with previous findings. The humeral head position in the fully corrected state differed significantly from uncorrected states in each native inclination group (<em>P</em> < .01). The percentage of implant–bone interface area in compression increased by 4.3 ± 0.6% per 5° correction for the 15° native inclination group, 2.6 ± 0.6% for 10°, and 1.8 ± 1.9% for 5°.</div></div><div><h3>Discussion</h3><div>Superior augmentation restored humeral head centralization and increased the proportion of the implant–bone interface in compression, decreasing liftoff potential and reducing mechanical risk factors for loosening in patients with excessive superior inclination.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101606"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Structural abnormalities of the elbow joint in high school baseball players exposed to the COVID-19 pandemic during their elementary and junior high school years: a sonographic analysis of 354 players at high school entry","authors":"Ryosuke Nishi RPT, MSc , Takahisa Ogawa MD, MPH, PhD , Yuki Obokata RPT, MSc , Atushi Kubota PhD , Masashi Aoyagi RPT, PhD , Kozo Furushima MD, PhD , Kunio Kamatani MD","doi":"10.1016/j.jseint.2025.101605","DOIUrl":"10.1016/j.jseint.2025.101605","url":null,"abstract":"<div><h3>Background and Hypothesis</h3><div>Previous studies have shown that increased pitching load during growth is associated with medial epicondyle hypertrophy and ulnar collateral ligament thickening. The COVID-19 pandemic caused prolonged restrictions on sports activities among youth, especially during their elementary and junior high school years. We hypothesized that pandemic-related reductions in pitching opportunities would result in a lower prevalence of these structural adaptations in high school baseball players.</div></div><div><h3>Methods</h3><div>Of the 354 high school baseball players enrolled between 2015 and 2025, 119 were pitchers and 235 were fielders. All participants had undergone ultrasound screening at the time of high school enrollment. We categorized them into a Pandemic group (entered high school between 2021 and 2025) and a pre-pandemic group (entered high school in 2020 or earlier). Medial elbow structures were assessed for 5 abnormalities: hypertrophy, irregularity, bone fragment, hypoechoic findings, and thickening. Group differences were analyzed using chi-square tests and odds ratios. Stepwise multivariable logistic regression was conducted to identify independent factors associated with medial epicondyle hypertrophy.</div></div><div><h3>Results</h3><div>The Pandemic group demonstrated a significantly higher prevalence of medial epicondyle hypertrophy compared with the pre-pandemic group (41.1% vs. 28.3%, <em>P</em> = .01), as well as a significantly lower prevalence of ulnar collateral ligament thickening (51.5% vs. 67.5%, <em>P</em> = .01) and hypoechoic findings (23.9% vs. 34.5%, <em>P</em> = .01). Stepwise logistic regression identified membership of the Pandemic group as the sole independent predictor of medial epicondyle hypertrophy (OR = 1.78, 95% CI: 1.14–2.78, <em>P</em> = .01).</div></div><div><h3>Discussion and Conclusion</h3><div>High school baseball players who experienced the COVID-19 pandemic during crucial growth periods exhibited a paradoxical increase in medial epicondyle hypertrophy along with a decrease in ligamentous abnormalities. Supplemental questionnaire data from a subset of participants suggested that abrupt increases in pitching volume after restrictions, rather than total cumulative load, may have contributed to hypertrophy. These findings indicate that sudden changes in throwing load and inadequate physiological adaptation during pandemic-related restrictions may have disrupted normal remodeling processes in the developing elbow. To prevent elbow abnormalities in growing baseball players, comprehensive throwing load management—including frequency and intensity, not just pitch count—is essential, with particular attention to gradual return-to-throwing programs after prolonged inactivity.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101605"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JSES InternationalPub Date : 2026-03-01Epub Date: 2025-12-29DOI: 10.1016/j.jseint.2025.101615
David Karimi MD , Peter Bremholm MD , Kasper Eriksen MD , Line Houkjær MD , Martin Hochheim MD , Kristoffer Hare MD, PhD , Joakim Jensen MD , Bjarke Viberg MD, PhD , Dennis Karimi MD PhD
{"title":"Age does not affect reliability of the Radiographic Union Score for HUmeral fractures score","authors":"David Karimi MD , Peter Bremholm MD , Kasper Eriksen MD , Line Houkjær MD , Martin Hochheim MD , Kristoffer Hare MD, PhD , Joakim Jensen MD , Bjarke Viberg MD, PhD , Dennis Karimi MD PhD","doi":"10.1016/j.jseint.2025.101615","DOIUrl":"10.1016/j.jseint.2025.101615","url":null,"abstract":"<div><h3>Background</h3><div>A key challenge of humeral shaft fracture management is nonunion after nonsurgical treatment. The Radiographic Union Score for HUmeral fractures (RUSHU) assesses early fracture healing; however, the effect of patient age on its reliability remains unclear.</div></div><div><h3>Methods</h3><div>In this validation study, 143 adult patients with nonsurgically managed humeral shaft fracture were included (nonelderly 18-64 years, n = 71; elderly ≥65 years, n = 72). Six raters with varying experience (medical students, residents, consultants) independently scored 6-week radiographs using RUSHU. Intra-rater and inter-rater reliability were evaluated for total scores, a binary RUSHU (<8 vs. ≥ 8), and individual cortices using weighted Cohen's kappa, Fleiss' kappa, and intraclass correlation coefficients.</div></div><div><h3>Results</h3><div>Mean RUSHU scores were similar between nonelderly (6.9 ± 2.0) and elderly patients (7.0 ± 1.9; <em>P</em> = .95). Intra-rater reliability was excellent for total RUSHU scores (κ = 0.92, 95% confidence interval (CI): 0.88-0.95) and moderate to excellent for the binary RUSHU (κ = 0.82, 95% CI: 0.72-0.91), with no age-related differences. Inter-rater reliability for total RUSHU was fair by Fleiss' kappa (κ = 0.24, 95% CI: 0.22-0.26) and moderate to good by intraclass correlation coefficient (0.69, 95% CI: 0.52-0.77). Binary scoring improved agreement (κ = 0.59-0.61). Inter-rater reliability also increased significantly with Cohen's kappa across rater pairs (κ = 0.45-0.82), experience levels (κ = 0.66-0.81), and within individual cortices (κ = 0.33-0.54). No significant differences were observed between age groups by experience level or individual cortices.</div></div><div><h3>Conclusion</h3><div>Age did not influence RUSHU reliability. Intra-rater reliability was moderate to excellent, and inter-rater reliability was fair to excellent depending on the statistical method utilized. Agreement improved with binary RUSHU and stratifying raters by experience and pairs. This indicated that RUSHU had measurable reliability. Reliabilities were consistent across age groups, cortices, and levels of clinical experience.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101615"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JSES InternationalPub Date : 2026-03-01Epub Date: 2026-03-18DOI: 10.1016/j.jseint.2025.101448
A. Misir , O. Hancerli
{"title":"Impact of Pectoralis Minor Release on Neuropathic Pain and Shoulder Function in Frozen Shoulder Surgery","authors":"A. Misir , O. Hancerli","doi":"10.1016/j.jseint.2025.101448","DOIUrl":"10.1016/j.jseint.2025.101448","url":null,"abstract":"","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101448"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147538188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JSES InternationalPub Date : 2026-03-01Epub Date: 2025-12-02DOI: 10.1016/j.jseint.2025.101423
Yiwen Tan MD , Zhao Tan MD , Hu Zhang PhD , Fangfang Mou MD
{"title":"Biomechanical evaluation of different screw fixation methods for Ogawa type I coracoid process base fracture","authors":"Yiwen Tan MD , Zhao Tan MD , Hu Zhang PhD , Fangfang Mou MD","doi":"10.1016/j.jseint.2025.101423","DOIUrl":"10.1016/j.jseint.2025.101423","url":null,"abstract":"<div><h3>Background</h3><div>The internal fixation of Ogawa type I coracoid fractures is relatively difficult, and there is no consensus on the fixation method, which is also prone to screw cutout. This study aims to evaluate the biomechanical properties of 5 different screw internal fixation methods for Ogawa type I coracoid process base fracture through biomechanical experiments.</div></div><div><h3>Hypothesis</h3><div>The biomechanical effects of the 5 fixation methods are different.</div></div><div><h3>Methods</h3><div>Fifteen fresh adult scapula specimens were randomly selected to create models of Ogawa type I coracoid process base fracture. Five fixation methods were used: single hollow screw fixation entirely within the bone (M1), single hollow screw fixation partially exiting below the vertical part of the coracoid process (M2), single hollow screw fixation partially exiting above the vertical part of the coracoid process and extending to the scapular spine (M3), dual hollow screw fixation entirely within the bone (M4), and dual hollow screw fixation combining M1+M3 (M5). All specimens were randomly divided into 5 groups of 3, each corresponding to a fixation method. Biomechanical experiments of compression, tension, and rotation were conducted to assess the stability of each fixation method.</div></div><div><h3>Results</h3><div>There was no significant difference in bone mineral density among the groups (<em>P</em> = .873). At the compression end point, M2 sustained the lowest force and M4 the highest, with the ranking M2 < M3 < M1 < M5 < M4; the intergroup difference was statistically significant (<em>P</em> = .022). At the tension end point, M3 sustained the lowest force and M5 the highest, with the ranking M3 < M2 < M1 < M4 < M5; the intergroup difference was statistically significant (<em>P</em> = .019). At the torsion end point, M2 showed the lowest torque and M5 the highest, with the ranking M2 < M3 < M1 < M4 < M5; the intergroup difference was statistically significant (<em>P</em> = .032).</div></div><div><h3>Conclusion</h3><div>The dual-screw fixation methods (M4 and M5) demonstrated the best stability in treating Ogawa type I coracoid process base fracture, with no significant difference between M5 and M4. For single-screw fixation, the entirely intraosseous method (M1) was more stable than the “in-out-in” methods, and the mode with partial downward exit (M2) should be avoided.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101423"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146188556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Optimizing tendon-to-bone healing: a comparative study of intratunnel and anatomical repairs in rotator cuff tears","authors":"Muzaffer Agir MD , Koray Sahin MD , Anil Pulatkan MD , Mehmet Kapicioglu MD , Fatih Yamak PhD , Ergun Bozdağ PhD , Ayse Nur Toksoz Yildirim MD , Kerem Bilsel MD","doi":"10.1016/j.jseint.2025.101425","DOIUrl":"10.1016/j.jseint.2025.101425","url":null,"abstract":"<div><h3>Background</h3><div>Rotator cuff tears are a leading cause of shoulder pain, with high rerupture rates despite advancements in surgical techniques. Tendon-to-bone healing failure is often attributed to insufficient fibrocartilage regeneration at the repair site. Intratunnel repair (TR) has been proposed as an alternative approach to enhance healing by increasing tendon-bone contact and exposure to marrow-derived stem cells. However, its effectiveness in chronic rotator cuff tears remains unclear. This study aims to compare the biomechanical and histological outcomes of TR and surface repair (SR) in a rabbit model. We hypothesized that TR might offer advantages in tendon-to-bone healing compared to SR, particularly through enhanced contact area and marrow exposure.</div></div><div><h3>Methods</h3><div>A chronic rotator cuff tear model was created in 36 New Zealand White rabbits by tenotomizing the subscapularis tendon and preventing spontaneous healing for 8 weeks. The right shoulders underwent TR, while the left shoulders received SR. Biomechanical and histological evaluations were performed at 4, 8, and 12 weeks postrepair. Biomechanical testing assessed failure load, stiffness, and elongation. Histological assessments included collagen fiber organization, fibrocartilage formation, vascularity, and tendon maturation using Modified Watson tendon maturation scoring. Statistical analyses were conducted using nonparametric tests with a significance level of <em>P</em> < .05.</div></div><div><h3>Results</h3><div>Biomechanical results showed no significant differences in failure load between TR and SR at any time point (<em>P</em> = .423, <em>P</em> = .423, <em>P</em> = .631). However, at 12 weeks, the stiffness of TR was significantly higher than SR (<em>P</em> = .005). Early histological findings showed similar tendon maturation, collagen alignment, and vascularity in both groups. By 12 weeks, the SR group exhibited significantly better collagen organization (<em>P</em> = .006), vascularity (<em>P</em> = .002), and Modified Watson tendon maturation score (<em>P</em> = .004) compared to TR. The tidemark line, a key indicator of fibrocartilage development, was observed in all SR samples at 12 weeks but was absent in most TR specimens.</div></div><div><h3>Discussion</h3><div>Contrary to our hypothesis, TR did not demonstrate superior healing outcomes compared to SR. While TR provided similar biomechanical properties, its histological outcomes were inferior over time. We speculate that increased inflammatory response and tendon micromotion within the tunnel may have contributed to the inferior histological healing observed in the TR group.</div></div><div><h3>Conclusion</h3><div>These findings suggest that TR does not offer significant advantages over SR in chronic rotator cuff tears. Further studies are needed to optimize healing strategies within the bone tunnel.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101425"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Humeral head deviation and velocity in multidirectional instability of the glenohumeral joint: a cine magnetic resonance imaging study","authors":"Kazuhisa Matsui PT, PhD, MSc , Takashi Tachibana PT , Katsuya Nobuhara MD, PhD , Yasushi Uchiyama PT, PhD","doi":"10.1016/j.jseint.2025.101419","DOIUrl":"10.1016/j.jseint.2025.101419","url":null,"abstract":"<div><h3>Background</h3><div>Manual clinical tests for shoulder instability rely heavily on subjective assessments of humeral head translation, making objective quantification challenging. This study hypothesized that patients with multidirectional glenohumeral instability (MDI) would demonstrate greater humeral head deviation and faster deviation velocity than healthy controls during active shoulder rotation, as assessed using cine magnetic resonance imaging (MRI).</div></div><div><h3>Methods</h3><div>Fourteen participants (eight shoulders with MDI and 20 healthy shoulders) underwent cine MRI while performing active shoulder rotation with the arm at the side. Humeral head deviation, deviation amplitude, and deviation velocity were calculated and compared between the groups using Welch's <em>t</em>-test.</div></div><div><h3>Results</h3><div>The MDI group showed significantly greater humeral head deviation, wider amplitude of deviation, and faster deviation velocity than the control group (<em>P</em> = .008 for anterior deviation, <em>P</em> = .009 for posterior deviation). The deviation amplitude exceeded 35% of the glenoid width in MDI shoulders, surpassing established clinical thresholds.</div></div><div><h3>Conclusion</h3><div>Patients with MDI demonstrated quantifiable dynamic instability on cine MRI. This modality may provide objective support for clinical findings. However, validation in larger cohorts is warranted to confirm these findings, given the limited number of MDI shoulders (n = 8).</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101419"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145904065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JSES InternationalPub Date : 2026-03-01Epub Date: 2026-01-14DOI: 10.1016/j.jseint.2026.101620
Sashrik Sribhashyam BA , Grayson M. Talaski BSE , Shahabeddin Yazdanpanah MS , Carl Edge MD , Matthew S. Smith MD , Andrew S. Cuthbert MD , Jennifer L. Vanderbeck MD
{"title":"Short-term complications following distal humerus open reduction and internal fixation","authors":"Sashrik Sribhashyam BA , Grayson M. Talaski BSE , Shahabeddin Yazdanpanah MS , Carl Edge MD , Matthew S. Smith MD , Andrew S. Cuthbert MD , Jennifer L. Vanderbeck MD","doi":"10.1016/j.jseint.2026.101620","DOIUrl":"10.1016/j.jseint.2026.101620","url":null,"abstract":"<div><h3>Background</h3><div>Distal humerus fractures (DHFs) account for around 2% of all adult fractures. Since nonoperative strategies often lead to loss of motion and disability from prolonged immobilization, open reduction and internal fixation (ORIF) is a commonly employed first-line treatment for reconstructable DHFs and can yield satisfactory outcomes. Surgical recovery, however, is not without complications, with reported rates up to 30%. Prior studies often report ORIF in pooled or comparative settings, leaving a gap in isolated ORIF outcomes. Therefore, this study aims to analyze short-term postoperative complications following DHF ORIF.</div></div><div><h3>Methods</h3><div>The American College of Surgeons National Surgery Quality Improvement Program database was queried using the Current Procedural Terminology code 24579. Patients with missing relevant variables were excluded. Postoperative outcomes included surgical site infection, wound dehiscence, return to the operating room (ROR), and any adverse event (AAE), among others. Continuous variables were reported as mean (standard deviation) and binary variables as number (%). Multivariate logistic regression with Bonferroni correction was used to model associated risk factors. Additionally, threshold analysis was applied to operative time for modeling complication risk.</div></div><div><h3>Results</h3><div>A total of 833 patients were identified (mean age = 53.9 ± 19.9; 71.8% female; 70.1% white; 68.3% outpatient; 50.1% American Society of Anesthesiologists class 2). Cohort comorbidities included smoking (18%) and diabetes (8.9%; 5.3% non-insulin dependent; 3.6% insulin-dependent). Overall, complication rates were low, with AAE occurring at 5.2% within 30 days. Surgical site infection, ROR, and wound dehiscence were all below 2%. Age (odds ratio [OR] = 1.03), operative time (OR = 1.01), hospital length of stay (OR = 1.2), and smoking (OR = 2.07) significantly increased AAE risk. A 97.1-minute significant operative time threshold was calculated, with complication rates of 7.8% and 1.4% above and below this cutoff, respectively (OR = 5.62).</div></div><div><h3>Discussion</h3><div>DHF ORIF demonstrates low short-term complication rates. However, factors such as increased age and smoking elicit reasonable operative concerns. Prolonging operative time was significantly associated with increased risks for AAE, the highest of which was observed beyond a 97-minute threshold for operative time. Targeted counseling is recommended, and future studies are warranted to further granularize outcomes.</div></div>","PeriodicalId":34444,"journal":{"name":"JSES International","volume":"10 2","pages":"Article 101620"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146189219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}