Malaysian Orthopaedic Journal最新文献

{"title":"Ultrasound-guided Reduction of Colle's fracture does not assist in Achieving Better Radiographic Indices - Results of a Randomised Controlled Trial.","authors":"M P Bhatt, S K Nema, M Ayyan","doi":"10.5704/MOJ.2407.010","DOIUrl":"10.5704/MOJ.2407.010","url":null,"abstract":"<p><strong>Introduction: </strong>Ultrasound-guided manipulation and reduction (M&R) of the distal radius fractures (DRF) is believed to improve radiographic indices due to real-time feedback of fracture alignment. The objective of this trial was to compare volar tilt, radial inclination, and radial height on radiographs between Ultrasound guided and conventional (landmark-guided) M&R.</p><p><strong>Materials and methods: </strong>A total of 79 distal radius extraarticular fractures in adults were randomised to Ultrasound guided and conventional (landmark-guided) M&R. The radiograph parameters described above were compared before and after M&R in both groups.</p><p><strong>Results: </strong>Except for volar tilt (P=0.05 difference in difference), there was no difference in both the groups on radiograph parameters i.e. radial inclination and radial height. We estimated a reduction in the incidence of malreduction by 49% (Risk ratio 0.51) and an absolute risk reduction of 22% through USG-guided reduction. We evaluated a number needed to treat 4 through USG-directed M&R of DRF to prevent one unacceptable reduction. There were 9 (22%) and 18 (46%) (P=0.70) unacceptable reductions in USG-guided and landmark-guided M&R.</p><p><strong>Conclusion: </strong>Adding USG guidance to conventional landmark-based closed reduction methods is not beneficial for the accuracy of fracture reduction in Colle's fracture. However, improved volar tilt in sonographic-directed M&R needs further studies to determine the clinical significance.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917706","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":"Use of Fibrin Glue as a Surgical Adjunct in Bone Grafting of Fracture Non-unions.","authors":"R Kunnasegaran, J W Ng, Ebk Kwek","doi":"10.5704/MOJ.2407.007","DOIUrl":"10.5704/MOJ.2407.007","url":null,"abstract":"<p><strong>Introduction: </strong>Non-union of long bones is a common challenge in the treatment of fractures. Bone grafting is commonly used to treat atrophic non-union, but mechanical displacement of the graft may occur, resulting in delay or failure of treatment. Fibrin glue has demonstrated positive results in management of bone defects in neurosurgery and oromaxillary facial surgery, however, there has yet to be any study on its use in long bone fractures.</p><p><strong>Materials and methods: </strong>We conducted a prospective randomised controlled trial at a single tertiary centre involving adult patients with long bone fractures that had undergone non-union and requiring bone grafting only. Autologous iliac crest bone graft was applied to the debrided non-union site, with additional fibrin glue applied for the intervention arm. Patients were followed-up with serial radiographs until clinical and radiographical union.</p><p><strong>Results: </strong>Ten patients (3 male, 7 female), of mean age 41.7 (19 - 63) were recruited over five years, with one drop out. Eight out of nine fractures united after treatment. One patient underwent hypertrophic non-union requiring re-fixation and bone grafting. There was no difference in the time to union for patients in the fibrin glue group (19.5 weeks) versus the control group (18.75 weeks) (p=0.86). There were no complications sustained from usage of fibrin glue.</p><p><strong>Conclusion: </strong>Fibrin glue appears to be a safe adjunct for treatment of non-union of long bone fractures across varying fracture sites by holding the bone graft in place despite not demonstrating a faster time to union.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917707","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":"Deafening Silence of Malaysian Medical and Surgical Fraternities to the Gaza Genocide.","authors":"Z F Zairul-Nizam, N A Ibrahim","doi":"10.5704/MOJ.2407.015","DOIUrl":"10.5704/MOJ.2407.015","url":null,"abstract":"","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917680","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":"Functional Outcomes and a Review of Management Options for Revision Shoulder Arthroplasty.","authors":"A K Rai, K Kumar","doi":"10.5704/MOJ.2407.003","DOIUrl":"10.5704/MOJ.2407.003","url":null,"abstract":"<p><strong>Introduction: </strong>Increase in the number of primary shoulder arthroplasty has led to an increase in the number of revisions which presents many complex challenges and often has inferior outcomes.</p><p><strong>Materials and methods: </strong>Data was collected retrospectively, and patients were classified using Dines classification. Comprehensive case reviews were done to identify preoperative and intra-operative challenges. The primary outcome measure was Oxford shoulder score (OSS). The secondary measures were range of motion (ROM) and patient satisfaction (very satisfied, satisfied, not satisfied or worse).</p><p><strong>Results: </strong>A total of 32 patients were identified with a mean age of 67.64 years and the most common cause of revision was a combination of bone and soft tissue failure (39.3%). All patients (n=8) with hemiarthroplasty had rotator cuff deficiency while patients with resurfacing had both rotator cuff failure and bony erosion. Four patients needed a proximal humeral osteotomy and six patients needed allograft reconstruction of the glenoid for bone loss. Twenty-one shoulders were revised to reverse total shoulder arthroplasty (TSA), 2 to anatomical TSA and 5 were left with cement spacer in situ. Mean duration of follow-up was 41.6 months. Mean OSS at the last follow-up was 26.88 with statistically significant improvement in ROM. There was no statistical difference in clinical outcomes (p>0.05) based on the type of primary prosthesis or cause of revision. A total of 70% patients were pain free. Patients with infection had inferior outcomes with a mean OSS of 17.</p><p><strong>Conclusion: </strong>Management of patients with failed shoulder arthroplasty is often challenging but has good clinical outcome except in infections.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917681","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":"Water Temperature Effect on Flexural Strength of Posterior Ankle Splint: An Experimental Study.","authors":"C Pirot, N Sirimahatthanakul, A Naowanirut, T Sirithiantong","doi":"10.5704/MOJ.2407.011","DOIUrl":"10.5704/MOJ.2407.011","url":null,"abstract":"<p><strong>Introduction: </strong>Plaster of Paris splints are commonly utilised for foot and ankle injuries. However, during follow-ups, some of these splints were found to be broken. Various methods, including splint form or augmentation changes, have been explored to enhance flexural strength. However, the impact of water temperature on the splint's flexural strength still needs to be studied. This research aimed to investigate the effect of water temperature on the flexural strength of the Plaster of Paris splint.</p><p><strong>Materials and methods: </strong>Three groups were set up based on different water temperatures: cold, hot, and room temperature. Posterior ankle splints were created and immersed in water at these varying temperatures, with five pieces tested per group. The splints were then allowed to harden fully over three days. Each splint underwent a tensile strength test using an axial pressure machine, which recorded their flexural strength data.</p><p><strong>Results: </strong>There were no statistically significant differences in the general characteristics of the splints. The flexural strengths of the three splint groups (pre-cooled, pre-heated, and room temperature) were 182.6N, 162.45N, and 228.91N, respectively. Statistical analysis revealed that room-temperature splints demonstrated a statistically significant increase in flexural strength compared to pre-heated splints (p<0.05). However, they did not differ significantly from pre-cooled splints.</p><p><strong>Conclusion: </strong>The highest flexural strength was observed in splints immersed in room-temperature water.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11315946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917708","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":"Effectiveness of Pamidronate Infusion in the Treatment of Charcot Arthropathy.","authors":"M Y Bajuri, N H Md-Noorpi, M K Yin, I Azman, N S Adib-Adham","doi":"10.5704/MOJ.2403.009","DOIUrl":"https://doi.org/10.5704/MOJ.2403.009","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this case series is to investigate the efficacy and safety of intravenous infusion of Pamidronate, a second generation bisphosphonate, in the treatment of active Charcot arthropathy.</p><p><strong>Materials and methods: </strong>All patients with active Charcot arthropathy treated at the medical centre from 1 January 2013 to 30 June 2020 were included in the study. Efficacy outcome was evaluated based on time to consolidate findings observed through radiographic examination, while safety outcome was evaluated based on the incidence of adverse event (AE) occurrence.</p><p><strong>Results: </strong>A total of 81 patients (37 male, 44 female) diagnosed with active Charcot arthropathy were included. 64.2% of patients were at stage 1 of Charcot arthropathy whereas 35.8% were at stage 2. The mean time to consolidate for stage 1 and stage 2 was 6.50 ± 4.21 months and 3.63 ± 2.92 months respectively (p-value = 0.139). No significant association was observed between gender, ethnicity and disease stage with the consolidation time (p-value >0.05). The rate of AE incidence was 2.5%, observed in 2 patients who developed a fever during the treatment. No other serious AE was observed in the study.</p><p><strong>Conclusion: </strong>Intravenous Pamidronate infusion is a safe and effective treatment option for Charcot arthropathy.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11023355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872453","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":"The Association between \"Knee Movement\" Method and Traditional Radiograph Positioning Procedure with the Incidence of True Lateral Knee Radiograph Achieved.","authors":"Cpb John, S Wendell, L Kevin, T S Earlene, A R Dio","doi":"10.5704/MOJ.2403.017","DOIUrl":"https://doi.org/10.5704/MOJ.2403.017","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to find the association between the Knee Movement or KM method versus the traditional lateral knee radiograph positioning procedure and the incidence of true lateral knee radiographs achieved.</p><p><strong>Materials and methods: </strong>A cross-sectional study of patients with knee problems that underwent lateral knee radiograph using the knee movement method (KM method), starting from March 2022 until August 2022. Fifty knee radiograph results using the KM method (KM group) were compared to retrospective data from fifty knee radiograph from the patients before March 2022 using the traditional method of lateral knee radiograph as the control (TM group). The data were analysed using the Chi-Square test to see if the KM method is associated with more true lateral knee radiograph results achieved compared to the traditional procedure.</p><p><strong>Results: </strong>Fifty patients in the KM method group had 80% (n=40) true lateral knee radiographs and 20% (n=10) untrue lateral knee radiographs, while in the Traditional Procedure group from the retrospective data of 50 patients had 44% (n=22) true lateral knee radiographs and 56% (n=28) untrue lateral knee radiographs (P<0.05). There is no significant association between the type of procedure applied with the types of error (P=0.432). Nevertheless, it helps us as it gives a gross picture that most of the errors are under-rotation of the knee, either from the KM method Group 90% (n=9) or the Traditional procedure Group 79% (n=22).</p><p><strong>Conclusion: </strong>The KM method was associated with achievement of a more true and accurate lateral knee radiograph. Additional studies with a larger sample should be done to evaluate the reliability of this method.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11023352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854003","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":"A Randomised Controlled Trial Comparing Ketamine <i>versus</i> Fentanyl for Procedural Sedation in the Emergency Department for Adults with Isolated Extremity Injury.","authors":"M Srinivasarangan, S Jagadeesh, A Bheemanna, A Sivasankar, A Patil, B Basavaraju, A Sattur","doi":"10.5704/MOJ.2403.015","DOIUrl":"https://doi.org/10.5704/MOJ.2403.015","url":null,"abstract":"<p><strong>Introduction: </strong>Alleviating pain and anxiety of patients during procedures is an essential skill for an Emergency Physician (EP). Several sedatives and dissociative agents are used for PSA (Procedural Sedation and Analgesia). In this study, we aimed to compare two drugs that is, ketamine and fentanyl for procedural sedation in adults with isolated limb injuries in the Emergency Department (ED).</p><p><strong>Materials and methods: </strong>In this prospective, randomised controlled interventional trial, patients aged between 18 to 65 years with isolated extremity injury requiring PSA in the ED were recruited. A total of 200 subjects were included in the study and randomly allocated to either the fentanyl (n=100) or the ketamine (n=100) group. Patients were blinded to the intervention and subsequently premedicated with Midazolam. Following this, they received either ketamine or fentanyl based on the group they were allocated to. Vital signs, including but not limited to the level of sedation, were measured at predetermined time intervals. A Modified Aldrete Score of >8 was used as a criterion for disposition from the ED. Data were collected in a pre-designed proforma. We aimed to compare the effectiveness as well as ascertain the safety profile of the two drugs for PSA in the ED.</p><p><strong>Results: </strong>There was no significant difference between the two groups when age, gender, mechanism of injury and comorbidities were compared. We found that there was no statistically significant difference between the two groups when blood pressure, respiratory rate and depth of sedation were compared. In both groups, there was a significant decrease in pain on the Numerical Rating Scale (NRS) following drug administration from 8 to 3 (p<0.001). Patients in the fentanyl group had an increased incidence of transient oxygen desaturation (p<0.001). Vomiting was more common in the ketamine group (p<0.001).</p><p><strong>Conclusion: </strong>PSA is a safe and efficacious procedure for patients undergoing painful procedures in ED. Patients in both the groups maintained hemodynamic stability throughout the procedure. From our study, we were able to conclude that both ketamine and fentanyl are similar in efficacy for PSA in the ED for adults with isolated limb injuries. In addition, no significant cardiovascular adverse events were noted in either group in our study.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11023337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874916","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":"Topical Application of Vancomycin Powder to Prevent Infections after Massive Bone Resection and the implantation of Megaprostheses in Orthopaedic Oncology Surgery.","authors":"L Andreani, E Ipponi, G Varchetta, A D Ruinato, S De-Franco, F R Campo, A D'Arienzo","doi":"10.5704/MOJ.2403.016","DOIUrl":"https://doi.org/10.5704/MOJ.2403.016","url":null,"abstract":"<p><strong>Introduction: </strong>Periprosthetic joint infection (PJI) represents a serious burden in orthopaedic oncology. Through the years, several local expedients have been proposed to minimise the risk of periprosthetic infection. In this study, we report our outcomes using topical vancomycin powder (VP) with the aim to prevent PJIs.</p><p><strong>Materials and methods: </strong>Fifty oncological cases treated with massive bone resection and the implant of a megaprosthesis were included in our study. Among them, 22 [(GGroup A) received one gram of vancomycin powder on the surface of the implant and another gram on the surface of the muscular fascia]. The remaining 28 did not receive such a treatment (Group B). The rest of surgical procedures and the follow-up were the same for the two groups. Patients underwent periodical outpatient visits, radiographs and blood exams' evaluations. Diagnosis of PJIs and adverse reactions to topical vancomycin were recorded.</p><p><strong>Results: </strong>None of the cases treated with topical vancomycin developed infections, whereas 6 of the 28 cases (21.4%) who did not receive the powder suffered from PJIs. These outcomes suggest that cases treated with VP had a significantly lower risk of post-operative PJI (p=0.028). None of our cases developed acute kidney failures or any other complication directly or indirectly attributable to the local administration of VP.</p><p><strong>Conclusions: </strong>The topical use of vancomycin powder on megaprosthetic surfaces and the overlying fascias, alongside with a correct endovenous antibiotic prophylaxis, can represent a promising approach in order to minimise the risk of periprosthetic infections in orthopaedic oncology surgery.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11023351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865303","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":"Clinico-radiological outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction with Augmentation of Dehydrated Human Amnion Chorion Allograft Membrane using Peroneus Longus Autograft.","authors":"P B Tonape, Jvs Kishore, R M Kopparthi, T Tonape, D S Bhamare, S Desireddy","doi":"10.5704/MOJ.2403.005","DOIUrl":"https://doi.org/10.5704/MOJ.2403.005","url":null,"abstract":"<p><strong>Introduction: </strong>For many sportsmen, anterior cruciate ligament (ACL) tears are unfortunate but common injuries. Several growth factors, cytokine, chemokine, and protease inhibitors functions in stimulation of paracrine reactions in fibroblast, endothelial, and stem cells thereby promoting the tissue restorative processes. Augmented with dehydrated Human Amnion Chorion Membrane (dHACM) allograft reinforces the reconstructed ligament and aids in effective restoration.</p><p><strong>Materials and methods: </strong>In this case control study 15 patients undertaking ACL reconstruction with tripled peroneus augmented dHACM (G1) were prospectively monitored up for a period of 8 months along with 15 control patients (G2) without dHACM augmentation. Clinical and radiological outcomes were analysed and assessed about effect of augmenting the peroneus longus graft using dHACM. Clinical analysis included pre-operative two, four, six, and eight months post-operative Tegnor-Lysholm score, and radiological analysis included the 6th month postoperative MRI signal-to-noise ratio (SNR) measurements by mean signal-value at femoral insertion, midsubstance and tibial insertion of ACL graft.</p><p><strong>Results: </strong>Clinically, as a mean Lysholm score of all patients, they were revealed to be consecutively high in G1 than in Group 2 at four, six, and eight months. The signal-to-noise ratio from the MRI results showed majority having good healing in G1 group.</p><p><strong>Conclusions: </strong>Based on 6-month MRI, an effective ligamentization (SNR<75) was noticed in 53.33% of patients in the dHACM allograft enhanced group on comparison with 33% in the controls. The overall results show that the augmentation of dHACM allograft to ACL reconstruction yields in good patient outcomes at post-operative follow-up.</p>","PeriodicalId":45241,"journal":{"name":"Malaysian Orthopaedic Journal","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11023350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855496","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}