Bulletin of Tokyo Dental College最新文献

{"title":"Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer.","authors":"Masashi Iwamoto,&nbsp;Takamichi Morikawa,&nbsp;Masato Narita,&nbsp;Takahiko Shibahara,&nbsp;Akira Katakura","doi":"10.2209/tdcpublication.2018-0069","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0069","url":null,"abstract":"<p><p>During dissection for oral cancer, there is a high probability of bacteria indigenous to the oral cavity migrating to the surgical field in the neck due to the opening of new pathways of communication with the oral cavity. The risk of postoperative surgical site infection (SSI) in such patients is high due to malnutrition arising from perioperative eating disorders and dysphagia. Neck infections after neck dissection in oral cancer patients were investigated to elucidate the development of SSIs and their relationship with the results of bacterial culture.A total of 86 patients with oral squamous cell carcinoma who underwent neck dissection between January 2012 and December 2016 were enrolled. Ten factors were selected for investigation: (1) sex; (2) age; (3) primary site; (4) type of dissection; (5) whether or not there was a new pathway of communication between the oral cavity and the neck; (6) operative time; (7) blood loss; (8) number of drainage days; (9) amount of drainage at the time of drain removal; and (10) whether or not there was an SSI. Bacteria isolated from the catheter tip on drain removal were also investigated. Significant differences were observed between patients with and without SSIs (p-0.010) according to the presence of a new pathway of communication between the oral cavity and the neck (p-0.004); operative time (p-0.007); number of drainage days (p-0.029); or the amount of drainage at the time of drain removal. The present results indicate that selecting antibiotics appropriate to each patient and administering perioperative oral care are important in preventing SSIs.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"1-7"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37657296","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":"A Case of Fibrolipoma of the Hard Palate.","authors":"Kamichika Hayashi,&nbsp;Sachi Yamada,&nbsp;Takeshi Onda,&nbsp;Takahiko Shibahara","doi":"10.2209/tdcpublication.2019-0010","DOIUrl":"https://doi.org/10.2209/tdcpublication.2019-0010","url":null,"abstract":"<p><p>An extremely rare case of fibrolipoma in the hard palate is presented and discussed with reference to the literature. An 85-year-old woman visited the Tokyo Dental College Chiba hospital in September 2016 with the chief complaint of a mass in the hard palate. The patient had first become aware of this mass several years earlier. An examination at another hospital in June 2009 resulted in a clinical diagnosis of lipoma. Regular examinations followed every 6 months until September 2014, at which time she stopped attending these appointments because there was no change. In August 2016, however, the patient realized that the tumor was increasing in size. Although there was no pain, awareness of a foreign body in the oral cavity when eating or talking was increasing, so she decided to visit our clinic for detailed examination and treatment. At this point, the mass extended from the center to the left side of the hard palate. It measured 15 mm along the major axis, and had a clear border; nearly spherical, its surface was smooth and glossy, and was of a slightly yellowish color. The mass was painless, elastic, and soft. Computed tomography and magnetic resonance imaging revealed a tumorous lesion. Based on a clinical diagnosis of lipoma, it was subsequently excised under general anesthesia in January 2017. The tumor lay under the palatal mucosa, extending from the center to the left side of the hard palate. It was surrounded by a single-layered membranous structure, and had not adhered to the surrounding tissues. Healthy palatal mucosa and periosteum were also removed en bloc with the tumor within a safety margin of approximately 5 mm. No pressure absorption of palatine bone was seen. Histopathologically, proliferation of mature adipose tissue was observed. This was surrounded by a thin, single-layer membrane within the subepithelial connective tissue, which was covered by stratified squamous epithelium. Proliferation of fibrotic connective tissue was seen between the adipocytes. The final diagnosis was fibrolipoma. To date, at 18 months postoperatively, no recurrence has been observed and progress has been satisfactory.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"53-60"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2019-0010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37657300","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":"Temporomandibular Joint Hypofunction Secondary to Unilateral Partial Discectomy Attenuates Degeneration in Murine Mandibular Condylar Cartilage.","authors":"Mamoru Yotsuya,&nbsp;Jose Iriarte-Diaz,&nbsp;David A Reed","doi":"10.2209/tdcpublication.2019-0008","DOIUrl":"https://doi.org/10.2209/tdcpublication.2019-0008","url":null,"abstract":"<p><p>Mechanical overloading of the temporomandibular joint (TMJ) promotes both the initiation and progression of TMJ osteoarthritis (OA). New preclinical animal models are needed for the evaluation of the molecular basis of cellular load transmission. This would allow a better understanding of the underlying mechanisms of TMJ-OA pain and disability, and help identify new therapeutics for its early diagnosis and management. The purpose of this study was to evaluate the role of mechanical loading in the progression of TMJ-OA in surgical instability arising from unilateral partial discectomy (UPD) in a murine model. In the theoretical modelling employed, lower joint reaction forces were observed on the chewing (working) side of the TMJ in the murine craniomandibular musculoskeletal system. Hypofunction was induced secondary to UPD through surgically manipulating the working side using an unopposed molar model. When the working side was restricted to the same side as that on which UPD was performed, late-stage degeneration of the cartilage showed a significant reduction (p<0.05), with diminished fibrillation and erosion of the articular cartilage, cell clustering, and hypocellularity. Condylar remodelling and proteolysis of proteoglycans were less affected. Thus, select and specific late-stage changes in TMJ-OA were contextually linked with the local mechanical environment of the joint. These data underscore the value of the UPD mouse model in studying mechanobiological pathways activated during TMJ-OA, and suggest that therapeutically targeting mechanobiological stimuli is an effective strategy in improving long-term biological, clinical, and patient-based outcomes.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"9-19"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2019-0008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37680622","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":"Anxiety and Sleep Quality in Dental Students at a Private Brazilian University.","authors":"Amanda V Machado,&nbsp;Camila O Castro,&nbsp;Carlos R Botelho Filho,&nbsp;Carolina D Bruzamolin,&nbsp;Rafaela Scariot,&nbsp;Eduardo Pizzatto,&nbsp;Marilisa C L Gabardo","doi":"10.2209/tdcpublication.2018-0072","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0072","url":null,"abstract":"<p><p>The aim of this cross-sectional study was to evaluate the impact of anxiety and quality of sleep on quality of life (QOL) in undergraduate dental students. A total of 141 students were enrolled. All were required to answer the following questionnaires: the State-Trait Anxiety Inventory (STAI) subscale state (S) (STAI-S); the Sleep Assessment Questionnaire (SAQ); and the simplified World Health Organization Quality of Life survey (WHO QOL-bref). The statistical analysis included univariate and bivariate analyses and Poisson regressions. The mean age of the participants was 22.9 (SD=5.2) years; 81.6% were women, and 37.6% studied during the morning shift. The mean STAI-S score was 50.3 (SD=9.4). Sleep problems, classified as \"always\" or \"frequently\", were reported by 11.3% and 18.4% of the sample, respectively. Quality of life had a mean score of 13.2 (SD=2.0). The STAI-S and SAQ scores showed a significant association with all WHOQOL-bref dimensions (p<0.05). Analyses performed using multivariate regression and the highest STAI-S score (RR=1.46, 95%CI=1.03-2.06) and SAQ (RR=1.39, 95%CI=1.02-1.90) demonstrated significant sleep problems, even when other variables were controlled to prevent confounding biases. In conclusion, the dental students evaluated showed high levels of anxiety and sleep disorders impacting on QOL.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"27-36"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37657297","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":"Plaque-removing Effects of Interdental Instruments in Molar Region.","authors":"Ryuichi Hisanaga,&nbsp;Akimasa Shinya,&nbsp;Toru Sato,&nbsp;Syuntaro Nomoto,&nbsp;Mamoru Yotsuya","doi":"10.2209/tdcpublication.2019-0005","DOIUrl":"https://doi.org/10.2209/tdcpublication.2019-0005","url":null,"abstract":"<p><p>Many types of interdental instrument, such as dental floss and interdental brushes, can be purchased easily and sell in large numbers. Many studies have compared the effects of such instruments. Few studies have investigated their relationship with regions of residual plaque, however. The purpose of this study was to compare rates of plaque removal from the mesial and distal surfaces of the bilateral maxillary and mandibular premolars and molars among 3 types of interdental instrument: finger-winding-dental floss, holder-type dental floss, and an interdental brush. Prior to the experiment, the artificial teeth in a jaw model were removed for application of artificial plaque. The teeth were then replaced and the model attached to a phantom. An operator brushed the teeth in a posture close to that adopted in actual tooth brushing with each type of instrument, after which the plaque removal rate was compared among them. The rate of plaque removal using finger-winding floss was the highest, although this type of instrument is less easy to hold than the others. The rate with a handle-equipped interdental instrument showed a decrease in some regions, although it is easy to hold. The results of this study suggest that the type of interdental instrument used should differ depending on the region to be cleaned.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"21-26"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2019-0005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37657298","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":"Luminal, Intramural Unicystic Ameloblastoma with Marked Fluid-Fluid Level: Validity of CT and MRI Findings.","authors":"Mamoru Wakoh,&nbsp;Kenichi Matsuzaka,&nbsp;Kenichi Imoto,&nbsp;Tazuko Goto,&nbsp;Takashi Kamio,&nbsp;Takahiko Shibahara","doi":"10.2209/tdcpublication.2018-0064","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0064","url":null,"abstract":"<p><p>We report herein a case of a luminal and intramural unicystic ameloblastoma (UA) with a marked fluid-fluid level. The validity of imaging findings in diagnosing UA in the present case is discussed in reference to the literature. The patient was a 50-year-old woman who presented with swelling of the gingiva in the region of the left mandibular third molar and numbness in the lower lip. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large mass lesion with a unilocular appearance and a biphasic aspect, suggesting liquid content. Contrast-enhanced MRI (CE-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) demonstrated that the biphasic aspect indicated a fluid-fluid level with no blood pooling/flow; it also revealed a thick rim-enhanced margin with mural protrusion. Postoperatively, the lesion was histopathologically diagnosed as a luminal and intramural UA. In conclusion, extensive imaging including both standard CT and MRI together with CE-MRI and DCE-MRI allowed mural protrusions or nodules on a thick cystic wall and liquid content to be correctly identified. This suggests that such imaging can play an important role in diagnosing a UA, even though the results were at first misleading due to the marked fluid-fluid level.</p>","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":"61 1","pages":"61-69"},"PeriodicalIF":0.5,"publicationDate":"2020-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37657295","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":"Expression Profiles of NOS Isoforms in Dental Pulp and Odontoblasts in nNOS Knockout Mice.","authors":"Y. Ishizuka, Mizuki Yoshida, K. Ambe, J. Sasaki, N. Sugihara, Hiroki Watanabe","doi":"10.2209/tdcpublication.2019-0003","DOIUrl":"https://doi.org/10.2209/tdcpublication.2019-0003","url":null,"abstract":"Active oxygen and free radicals are involved in metabolism in cells and tissues. Immunohistological studies of related enzymes are few, and the morphological dynamics of these enzymes in dental pulp and odontoblasts remain to be elucidated. Nitric oxide synthase (NOS) has 3 isoforms: nNOS, iNOS, and eNOS. The aim of this study was to investigate the profiles of NOS isoforms in the absence of nNOS in dental pulp and odontoblasts. Five-week-old male C57BL/6 and nNOS knockout (KO) mice were sacrificed and expression of nNOS, iNOS, and eNOS determined immunohistochemically. Expression of nNOS was positive, whereas that of iNOS was negative and eNOS weakly positive in the dental pulp and odontoblasts of the control mice. In nNOS KO mice, expression of iNOS was positive in dental pulp and strongly positive in odontoblasts, whereas that of eNOS was stronger in fibroblasts, endothelial cells in the vicinity of blood vessels in the dental pulp, and odontoblasts. Expression of nNOS was negative in the nNOS KO mice. This suggests that iNOS and eNOS compensate for nNOS deficiency in vascular endothelial cells and fibroblasts in the dental pulp and odontoblasts.","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2019-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2019-0003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44608506","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":"Vertical Displacement in Unilateral Extension Base Flexible Removable Dentures.","authors":"Nobuyuki Horie, T. Ouchi, Rumiko Nishiyama, S. Usuda, S. Morikawa, S. Asoda, T. Nakagawa","doi":"10.2209/tdcpublication.2018-0068","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0068","url":null,"abstract":"The need for flexible thermoplastic denture base materials has increased due to patient demand for better esthetic outcomes. Designs aimed at improving esthetic outcomes can cause difficulties for prosthodontists, however, from the viewpoint of function and maintenance. Therefore, the purpose of this study was to investigate vertical displacement in unilateral extension base denture models, comparing that obtained by flexible removable dentures with that by conventional metal clasp dentures. Models of unilateral extension base flexible removable dentures for mandibular defects were prepared. Periodontal ligament and jaw mucosa were simulated using a silicone impression material. Four types of flexible removable denture, with or without a metal rest, and two metal clasp dentures made of acrylic resin as a conventional design were used as dental prostheses. The amount of vertical displacement in the defect areas was measured under a load of 50 N at the first and second molars. Among the 6 types of dentures investigated, the amount of vertical displacement was greater with flexible removable dentures than with metal clasp dentures. This vertical displacement tended to decrease significantly, however, with the use of a metal rest with the flexible removable dentures. Esteshot with a metal rest, in particular, showed the smallest amount of displacement in the flexible removable dentures (first molar, 0.265±0.007 mm; second molar, 0.423±0.008 mm). These results indicate the importance of the application of rests in unilateral extension base flexible removable dentures. It may be useful to employ a metal rest in conjunction with a flexible removable denture to reduce load on the underlying mucosa, as is done with conventional partial dentures.","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2019-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43494908","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":"Expression of Cytokeratin in Experimentally Created Inflammatory Cyst in Vivo and in Vitro.","authors":"Ayano Nakauchi, S. Shintani, E. Kokubu, Kei Nakajima, K. Matsuzaka, Takashi Inoue","doi":"10.2209/tdcpublication.2018-0059","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0059","url":null,"abstract":"The purpose of this study was to investigate the behavior of epithelial lining derived from Malassez's epithelial rest (MER) cells in experimentally created inflammatory cysts in vivo and in vitro. Porcine MER cells were cultured in vitro with or without interleukin (IL)-1β (1 ng/ml) or IL-6 (1 ng/ml). Cell proliferation was assessed and expression levels of CK19 and CK13 mRNA determined using RT-PCR. In vivo, a cavity was created in the first molar of Sprague-Dawley male rats and tissue repair observed using immunohistochemical methods. In vitro, treatment with IL-1β or IL-6 increased proliferation of MER cells and decreased expression of CK19 mRNA, but increased CK13 mRNA at day 1 (p<0.05). In vivo, at 2 weeks, CK19-positive epithelial cells were observed adjacent to the cementum, in the cystic lesion, and in connective tissue. At 3 weeks, they were only detected in cells adjacent to the connective tissue. Cells positive for CK13 were observed throughout the epithelium, except in cells adjacent to connective tissue at weeks 2 and 3. Exposure to IL-1β and/or IL-6 induced proliferation and differentiation of MER cells.","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2019-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42834624","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":"Ten-year Clinical Trends among 575 Consecutive Oral Cancer Patients at Tokyo Dental College Oral Cancer Center.","authors":"Shoichi Sekikawa, A. Kozakai, H. Saito, Homare Kawachi, S. Ogane, M. Takano, T. Nomura, A. Katakura, T. Shibahara, N. Takano","doi":"10.2209/tdcpublication.2018-0067","DOIUrl":"https://doi.org/10.2209/tdcpublication.2018-0067","url":null,"abstract":"The facilities comprising Tokyo Dental College (TDC) -the college itself and its medical institutions at Suidobashi, Ichikawa, and Chiba - have been officially recognized as a center for treating oral cancer. The TDC Oral Cancer Center (OCC) was established on April 1, 2006. It provides comprehensive medical care, including that aimed at recovery of postoperative function, such as restoration of stomatognathic function, dysphagia therapy, and placement of maxillary prostheses. The purpose of this study was to investigate patient trends at TDC-OCC over the 10 years following its establishment in order to determine how the safe and high-quality cancer care already provided might be even further improved. Oral cancer patients attending TDC-OCC between April 2007 and March 2017 were investigated. Clinical information was obtained from medical records and analyzed, including that on patient numbers, age, sex, primary site of tumor, clinical stage, and surgery provided. There were 758 new cases, and the number of new cases showed an annual increase. Among the total number of new patients, 575 (75.9%) represented primary cases. The number of operations also showed an increase, which correlated with the increase in the number of patients. The incidence in oral cancer has increased in several countries, including Japan. Oral cancer can be observed macroscopically and touched. In contrast to with cancers at many other sites, and despite various diagnostic devices for early detection having been developed, however, cases are often advanced when first encountered. Many advanced cases were treated at TDC-OCC, and the number of reconstructive operations following progressive cancer also increased over time.","PeriodicalId":45490,"journal":{"name":"Bulletin of Tokyo Dental College","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2019-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2209/tdcpublication.2018-0067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45002688","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}