Prosthetics and Orthotics International最新文献

{"title":"Benefits and durability of an affordable prosthetic silicone cushion liner locally manufactured in a resource-limited environment: Enabling adoption of total surface bearing sockets and silicone cushion liners.","authors":"Claudia Ghidini, Shova Kanta Sharma, Saloman Shrestha, Dhan Prasad, Clément D Favier, Jeffrey Erenstone, Anthony M J Bull, Suraj Maharjan","doi":"10.1097/PXR.0000000000000433","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000433","url":null,"abstract":"<p><strong>Introduction: </strong>Prosthetic silicone liners improve comfort and skin protection and allow the use of total surface bearing (TSB) sockets, which provide enhanced proprioception and comfort. Unfortunately, silicone liners are cost-prohibitive in resource-limited environments (RLEs) where patellar tendon bearing (PTB) sockets with PE-lite liners remain standard, leading to patient discomfort and skin issues.</p><p><strong>Objective: </strong>This study evaluates the benefits and durability of an affordable silicone liner locally manufactured in an RLE to promote TSB socket adoption, aiming to enhance prosthetic care and patient outcomes.</p><p><strong>Methods: </strong>Ethical approval was granted by the Nepal Health Research Council. Twelve people with a unilateral transtibial amputation who were using a PTB socket with PE-lite participated in the study and received a new prosthesis (TSB socket with an affordable silicone liner). Participants performed mobility tests (2-Minute Walking Test, Timed Up and Go Test) and completed self-reported questionnaires for both prostheses. Liner durability was assessed.</p><p><strong>Results: </strong>Participant mobility improved while wearing the TSB socket and silicone liner. The new prosthesis was found to be comfortable, and there were no major problems identified although excessive sweating, typical with silicone liners, was reported. Liners were replaced after 6.1 (±3.1) months.</p><p><strong>Conclusion: </strong>A locally manufactured liner provided increased mobility and high levels of satisfaction. This affordable liner may be suitable for use in RLEs, enabling adoption of TSB sockets and improving rehabilitation outcomes of people with a transtibial amputation. However, durability concerns and excessive sweating would suggest that improvements can still be made.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025355","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":"Computational methodology to study the effect of cable-stabilized knee brace on anterior cruciate ligament strain during single-leg jump landing.","authors":"Pratishtha Gupta, Harish Rao, Naveen Chandrashekar","doi":"10.1097/PXR.0000000000000432","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000432","url":null,"abstract":"<p><p>Knee bracing is commonly used for rehabilitation after ligament surgery. However, the effectiveness of knee bracing in preventing ligament injuries is not widely studied. This study aimed to develop a computational methodology to investigate the effectiveness of a novel type of cable-stabilized knee brace on anterior cruciate ligament (ACL) strain during single-leg jump landing. The brace features a compliant design with nonextensible pretensioned cables integrated within a compression tight garment. A combined in vivo/in silico method was developed for this purpose. A computational model of the cable-stabilized knee brace was developed with linked truss elements used to simulate the cable. The cables were integrated into an existing computational model of the knee. Subsequently, single-leg jump landing simulations were conducted on the model, using muscle forces and joint kinematic/kinetic profiles from 10 participants. Anterior cruciate ligament strain behaviors were then compared between the braced and unbraced configurations. The computational methodology was successful in simulating the differences in ACL strain because of the brace. The average peak ACL strain in the braced configuration was 4.99% ± 2.36% and in the unbraced configuration was 3.23% ± 2.31% (p = 0.091). The methodology developed lays the groundwork for future advancements in optimizing the cable-stabilized knee brace design and refining its potential in preventing ligament injuries.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014884","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":"The development of the profession and education of Prosthetics and Orthotics in South Africa.","authors":"Mariette Deist, Chanelle Ribeiro-Wagener, Terry Jeremy Ellapen","doi":"10.1097/PXR.0000000000000434","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000434","url":null,"abstract":"<p><p>The history of a profession is valuable literature as it recognizes the noteworthy contributions of its forerunners and the scientific evolution from its earliest state. The purpose of this paper is to recount the historical developments in the profession of Prosthetics and Orthotics (P & O) in South Africa. An electronic literature search identified 54 Sabinet and 17,400 Google Scholar records. Key search words were \"medical orthotics and prosthetics,\" \"South Africa,\" and \"history.\" The selection criteria of literature were accomplished in the subsequent 3 phases: (1) the title review, (2) the abstract review, and (3) the full-text review. The records were screened by all 3 authors. Records were excluded if they were unrelated to the history and/or development of P & O in South Africa, the history and development of other medical professions in South Africa, the historical development of P & O in other countries, the historical development of other medical professions of other countries, and records that were non-English. No peer-reviewed record was found describing the history of P & O in South Africa. Faced with the paucity of peer-reviewed evidence, the authors browsed Tshwane University of Technology, Durban University of Technology, and Walter Sisulu University websites to secure historical context. The analyses of these P & O training institutions websites provide a glimpse of the history of P & O in South Africa. The authors had identified the following areas noteworthy to be reported on (1) the historical account of the profession in South Africa, (2) the recognized tertiary training institutions, (3) the minimum admission criteria to South Africa P & O training institutions, and (4) regulatory and statutory bodies of the profession of P & O in South Africa.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014906","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":"Is the subischial socket better than others in subjects with transfemoral amputation? A systematic review of randomized and controlled clinical trials.","authors":"Nicolas Bevacqua, Ticiana E Navarro, Gabriela B Dell Elce, Leonardo Intelangelo","doi":"10.1097/PXR.0000000000000435","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000435","url":null,"abstract":"<p><p>Rehabilitation is often complex for persons with transfemoral amputation, and poor socket fit is one of the main factors affecting gait re-education, rehabilitation, and quality of life. The present study systematically reviewed the literature to test whether the subischial socket provides better outcomes in comfort, quality of life, and mobility than other transfemoral sockets. Systematic review and meta-analysis. We searched MEDLINE, Physical Therapy Evidence Database Scale, Epistemonikos, Cochrane, BIREME, Web of Science, and Scopus from inception to January 2024 to identify randomized and controlled trials. Two authors independently screened records and assessed the risk of bias. We performed a narrative synthesis of the evidence and used the standardized mean difference and mean difference for meta-analyses and the Grading of Recommendations, Assessment, Development, and Evaluation approach for recommendations. We identified 7 randomized and controlled clinical trials. Five studies compared the subischial socket with the ischial containment socket (IC), 1 study compared the IC with the Marlo anatomical socket, and 1 study compared the IC with the quadrilateral. Very low certainty showed a difference in comfort (1 study: mean difference = 1.4 [95% CI 0.61, 2.19]), but no in quality of life (2 studies: standardized mean difference = 1.28 (95% CI -1.04, 3.59), and mobility (2 studies: mean difference = 0.11 (95% CI -1.08, 1.29). We observed differences between the subischial socket and the IC in comfort but not in quality of life, mobility, and stability. Furthermore, we found a very low certainty that the subischial socket provides better outcomes than the IC in comfort, quality of life, and mobility.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014889","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":"A physiotherapeutic approach to a baby with right disgenesis of thumb and left agenesis of upper extremity: A case report.","authors":"Habibe Serap Inal, Osman Reis","doi":"10.1097/PXR.0000000000000430","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000430","url":null,"abstract":"<p><p>A boy with bilateral congenital anomalies of the upper extremities with transverse absence of the left arm (agenesis) and absence of right thumb (disgenesis), fixed elbow in extension due to humeroradial synostosis thought that the humerus was intact. His wrist could move passively with 50° flexion, 0° extension, and 70° radial deviation. The other 4 fingers were intact, 4-5 metatarsal bones were in synostosis, and the fifth finger was clinodactyly. He was born by normal delivery. The physiotherapist started sensorimotor training to achieve functional movements of the right upper extremity. The exercises for the trunk muscles were emphasized to prevent the future possible thoracolumbar curve due to the absence of loading of the left arm on trunk muscles. Serial splinting was performed to position the wrist and fingers for functional purposes and abduction and internal rotation of the index finger to perform the opposition position until the pollicization surgery. At 1 and a half, his trunk was straight, and the wrist was partially corrected (15° extension; 35° radial deviation). He was able to play with toys and eat food. The mother rated his performance as 8/10 and 10/10, respectively. Both mother and father were satisfied with his performance in activities of daily living according to his age compared with his peers (9/10; 10/10, respectively). Thus, the physiotherapist's sensorimotor training and the positioning splints may be considered as feasible interventions in this case.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985267","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":"Assessing walking speed in persons with a lower-limb amputation: Test-retest reliability of the 10-m walk test.","authors":"Luciano Fernandes Crozara, Dain Patrick LaRoche, Nise Ribeiro Marques, Spencer Luiz Marques Payão","doi":"10.1097/PXR.0000000000000419","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000419","url":null,"abstract":"<p><strong>Background: </strong>Preferred walking speed (PWS), maximal walking speed (MWS), and walking speed reserve (WSR)-the difference between MWS and PWS-can be easily obtained from the 10-m walk test (10MWT) to assess walking ability and function. However, their test-retest reliability has not been determined in persons with unilateral lower-limb amputation (LLA).</p><p><strong>Objectives: </strong>To determine the reliability of the PWS, MWS, and WSR obtained from the 10MWT in persons with LLA.</p><p><strong>Study design: </strong>Test-retest with a 48- to 120-h interval between test days.</p><p><strong>Methods: </strong>Test-retest relative and absolute reliability was assessed by the intraclass correlation coefficient (ICC) and the %change in mean (%CM) and coefficient of variation (CV), respectively.</p><p><strong>Results: </strong>Preferred walking speed showed excellent reliability between day 1 (familiarization day) and day 2 (ICC = 0.97; %CM = -1.8; CV = 7.7) and a significant speed increase from day 2 to day 3 (ICC = 0.96; %CM = 8.5, p < 0.003; CV = 7.4). Maximal walking speed showed excellent reliability between day 1 and day 2 (ICC = 0.94; %CM = 2.9; CV = 8.3) and between day 2 and day 3 (ICC = 0.94; %CM = 1.8; CV = 8.6). Overall, WSR was poorly reliable between day 1 and day 2 (ICC = 0.65; %CM = 39.2; CV = 39.2) and between day 2 and day 3 (ICC = 0.74; %CM = 30.0; CV = 30.0).</p><p><strong>Conclusions: </strong>Preferred walking speed obtained from a single 10MWT and MWS obtained after a 10MWT familiarization day are reliable walking speed measures for persons with LLA with similar characteristics to those of our sample. Nonetheless, it is critical that both PWS and MWS are obtained after a 10MWT familiarization to obtain a reliable WSR.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985268","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":"Spatiotemporal gait parameters influencing functional mobility of people with lower limb amputation.","authors":"Anat Kristal, Ignacio Gaunaurd, Neva Kirk-Sanchez, Steven Gard, Natali Clark, Emika Da Silva, Forrest Stieg, Robert Gailey","doi":"10.1097/PXR.0000000000000417","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000417","url":null,"abstract":"<p><strong>Background: </strong>Walking speed is a measure of functional mobility that is relatively easy to quantify. In people with lower limb amputation, reduced walking speed has been linked with specific atypical spatiotemporal gait parameters. However, the influence of atypical spatiotemporal gait parameters on the walking speed of people with unilateral transtibial amputation (TTA) and transfemoral amputation (TFA) remains unclear.</p><p><strong>Objectives: </strong>To identify spatiotemporal gait parameters influencing walking speed of people with unilateral TTA or TFA.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Methods: </strong>The 10-meter walk test (10mWT) was used to measure walking speed, and an instrumented walkway was used to record spatiotemporal gait parameters. Regression analyses were used to determine the best subset of spatiotemporal gait parameters that influence the walking speed of people with TTA and TFA.</p><p><strong>Results: </strong>The study included 43 people with TTA and 49 with TFA. In the TTA group, spatiotemporal gait parameters accounted for 65.5% of the variance in walking speed, with prosthetic single limb support accounting for 52.2%, prosthetic terminal double limb support accounting for 8.9%, and stride width accounting for 4.4%. In the TFA group, intact swing accounted for 46.7% of the variance in walking speed. There was no significant difference in walking speed between the TTA and the TFA groups (p > 0.05).</p><p><strong>Conclusions: </strong>The study's results highlight specific spatiotemporal gait parameters that affect the walking speed of people with unilateral TTA and TFA. In addition, results suggest that walking speed over short distances is not confounded by amputation level (i.e., TTA and TFA).</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985269","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":"Feasibility study of a game-based virtual reality intervention for functional prosthesis use training: A preclinical assessment.","authors":"Jing Mu, Ricardo Garcia-Rosas, Raphael Maria Mayer, Daniel Meise, Jim Lavranos, Mark Graf, Ying Tan, Denny Oetomo, Peter Choong","doi":"10.1097/PXR.0000000000000390","DOIUrl":"10.1097/PXR.0000000000000390","url":null,"abstract":"<p><strong>Objective: </strong>This paper presents a preclinical feasibility study to investigate the efficacy of a game-based virtual reality (VR) intervention in the functional training of upper-limb prosthesis use.</p><p><strong>Methods: </strong>The study compared the skill of 2 able-bodied groups (intervention and control, 5 participants in each group) using a surface electromyography controlled self-experience prosthetic hand and wrist through the Box and Blocks Test (BBT). The Intervention Group followed the game-based VR intervention for 4 weeks and underwent real-life (RL) BBT assessments before and after the intervention using the self-experience prosthesis. The Control Group performed the RL BBT assessments 4 weeks apart with no VR intervention in between. As a follow-on study, the Control Group then underwent the VR intervention for further validation. The VR intervention consisted of 2 games designed to train the control and use of a surface electromyography-controlled prosthetic hand and an assessment (VR BBT). The VR intervention protocol included three 30-minute sessions per week over a period of 4 weeks.</p><p><strong>Results: </strong>A significantly larger improvement was shown in the BBT scores from the Intervention Group (mean 6.375) compared to the Control Group (1.5). The follow-on study further confirmed the result.</p><p><strong>Conclusion: </strong>The study demonstrated promising outcomes in the use of a game-based VR intervention for training functional prosthesis use, with participants showing significant improvements in prosthesis use skills measured with RL BBT. This motivates further development of VR interventions for prosthesis use training and their validation through clinical trials.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717398","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":"Design of semi-open prosthetic socket with constant force for lower limb.","authors":"Minghui Wang, Jianguo Song, Qingjun Nong, Yu Qian, Xianbo Yan, Hongliu Yu","doi":"10.1097/PXR.0000000000000418","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000418","url":null,"abstract":"<p><strong>Background: </strong>Prosthetic socket is a key component of the prosthesis for clinical application; its performance directly affects the adaptation of the residual limb to the prosthetic socket. There are long-term and short-term volume fluctuation of the residual limb. The volume fluctuation of the residual limb will lead to the pressure mismatch at the interface of the residual limb and the prosthetic socket, which will cause a series of skin and fit problems. The volume fluctuation of the residual limb is considered a key factor for the successful application of the prosthetic socket; its solution is imminent. The purpose of this paper is to design a prosthetic socket with a constant force unit to solve the problem of volume fluctuation of the residual limb.</p><p><strong>Methods: </strong>Constant force extrusion for the residual limb is proposed to solve the problem in this paper. A constant force unit is designed based on the superelasticity of shape memory alloy, and a semi-open prosthetic socket embedded in the constant force unit is designed. The constant force property of prosthetic socket is optimized and verified by finite element analysis.</p><p><strong>Results: </strong>The constant force unit obtains a maximum constant force region of 9.36 mm at 13 mm applied displacement, and the minimum stress amplitude is 0.0264%.</p><p><strong>Conclusions: </strong>The semi-open prosthetic socket may achieve constant pressure at the interface between the residual limb and prosthetic socket within a certain range of the residual limb volume change, and it has a lightweight, good heat dissipation, size adjustability, and constant interface pressure.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899865","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":"Designing equipment to allow high-level pararowing for a person with bilateral transfemoral amputation: A case report.","authors":"Guillaume Janvier, Maëva Cotinat, Jean-Michel Viton, Michele Timsit, Laurent Bensoussan, Nicolas Prieur-Blanc","doi":"10.1097/PXR.0000000000000429","DOIUrl":"https://doi.org/10.1097/PXR.0000000000000429","url":null,"abstract":"<p><p>Rowing requires both the upper and lower body to be active for balance, steering, and propulsion, constituting a real challenge for athletes with disabilities. To our knowledge, adapted setups allowing pararowing for people with bilateral transfemoral amputation have not yet been described. This case report describes the adapted setup for Mr S, 24 years old, who underwent bilateral transfemoral amputation in 2019 after a motorcycle accident. He walks with 2 prostheses and practices high-level para-rowing in the Para-Rowing 2 single sculls category. We designed 2 prostheses consisting of a liner (Iceross Seal-In® X5 TF), an adapted socket, a knee (aqua-knee 3WR95), and a prosthetic foot (RushHiPro). We also designed a seat made of Plastazote and thermoplastic polymer foot rests. This equipment allows Mr S to wear his prostheses, which helps him to stabilize in the boat and to use maximum trunk amplitude during the rowing movement. However, the weight of the current equipment limits Mr S's performance. This case study demonstrates that it is possible to adapt equipment to allow an individual with double transfemoral amputation to perform pararowing at competition level.</p>","PeriodicalId":49657,"journal":{"name":"Prosthetics and Orthotics International","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899882","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}