Journal of the Pediatric Orthopaedic Society of North America最新文献

{"title":"The Role of Psychology in Emergent Pediatric Limb Salvage and Reconstruction.","authors":"Whitney M Herge, Mikhail Samchukov, Emily Elerson, Alexander Cherkashin, Elizabeth Hubbard, David Podeszwa","doi":"10.1016/j.jposna.2024.100110","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100110","url":null,"abstract":"<p><p>Similar to elective pediatric limb lengthening and reconstruction (LLR) cases, treatment of pediatric patients undergoing emergent limb salvage and reconstruction (LSR) is approached as a multidisciplinary process. Unlike elective pediatric LLR, however, where the patient's individual interest in and motivation for LLR drives treatment decisions, emergent LSR treatment must be approached differently. In particular, the timing of emergent LSR treatment is driven by the risks associated with the patient's medical diagnosis and the potential consequences of nonintervention. Multidisciplinary treatment shifts from optimizing the patient's preoperative physical and psychological health to triaging and stabilizing the patient's physical and psychological health concurrent with LSR treatment. Without the luxury of preoperative time, the team must instead focus on physical and psychological risk mitigation, as well as the implementation of trauma-informed care, as appropriate.This work reviews the application of pediatric LLR preparation principles to emergent LSR scenarios. Our team's established six-step preparation workflow is adapted such that the timing, location, and focus of each step are individualized to the LSR patient's care needs. The team psychologist plays a particularly important role in this process in educating the multidisciplinary care team regarding the patient's specific psychological trauma symptoms, as appropriate, as well as ensuring the medical team takes a trauma-informed approach in their treatment provision and planning.</p><p><strong>Key concepts: </strong>(1)Pediatric patients undergoing emergent LSR rarely have time for preoperative treatment preparation and, instead, typically must be evaluated after the index surgery.(2)Rather than focusing on preoperative physical and psychological optimization, the multidisciplinary team focuses on physical and psychological triage and stabilization concurrent with LSR intervention.(3)Treatment should be provided through a trauma-informed lens in recognition of the enormous stress that emergent LSR treatment often places on pediatric patients and families.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"9 ","pages":"100110"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164502","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":"Erratum Regarding Missing Patient Consent Statements in Previously Published Articles.","authors":"","doi":"10.1016/j.jposna.2024.100102","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100102","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.jposna.2024.100062.][This corrects the article DOI: 10.1016/j.jposna.2024.100049.][This corrects the article DOI: 10.1016/j.jposna.2024.100032.][This corrects the article DOI: 10.1016/j.jposna.2024.100031.][This corrects the article DOI: 10.1016/j.jposna.2024.100054.][This corrects the article DOI: 10.1016/j.jposna.2024.100008.][This corrects the article DOI: 10.1016/j.jposna.2024.100034.][This corrects the article DOI: 10.1016/j.jposna.2024.100061.][This corrects the article DOI: 10.1016/j.jposna.2024.100020.][This corrects the article DOI: 10.1016/j.jposna.2024.100064.][This corrects the article DOI: 10.1016/j.jposna.2024.100051.][This corrects the article DOI: 10.1016/j.jposna.2024.100048.][This corrects the article DOI: 10.1016/j.jposna.2024.100042.][This corrects the article DOI: 10.1016/j.jposna.2024.100018.][This corrects the article DOI: 10.1016/j.jposna.2024.100047.][This corrects the article DOI: 10.1016/j.jposna.2024.100044.][This corrects the article DOI: 10.1016/j.jposna.2024.100046.][This corrects the article DOI: 10.1016/j.jposna.2024.100030.][This corrects the article DOI: 10.1016/j.jposna.2024.100055.][This corrects the article DOI: 10.1016/j.jposna.2024.100017.][This corrects the article DOI: 10.1016/j.jposna.2024.100015.][This corrects the article DOI: 10.1016/j.jposna.2024.100016.][This corrects the article DOI: 10.1016/j.jposna.2024.100050.][This corrects the article DOI: 10.1016/j.jposna.2024.100059.][This corrects the article DOI: 10.1016/j.jposna.2024.100057.][This corrects the article DOI: 10.1016/j.jposna.2024.100011.][This corrects the article DOI: 10.1016/j.jposna.2024.100010.][This corrects the article DOI: 10.1016/j.jposna.2024.100033.][This corrects the article DOI: 10.1016/j.jposna.2024.100058.][This corrects the article DOI: 10.1016/j.jposna.2024.100056.][This corrects the article DOI: 10.1016/j.jposna.2024.100043.][This corrects the article DOI: 10.1016/j.jposna.2024.100039.][This corrects the article DOI: 10.1016/j.jposna.2024.100037.][This corrects the article DOI: 10.1016/j.jposna.2024.100063.][This corrects the article DOI: 10.1016/j.jposna.2024.100053.][This corrects the article DOI: 10.1016/j.jposna.2024.100029.][This corrects the article DOI: 10.1016/j.jposna.2024.100052.][This corrects the article DOI: 10.1016/j.jposna.2024.100060.][This corrects the article DOI: 10.1016/j.jposna.2024.100038.].</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100102"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164722","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":"With a Little Help from My Friends: Tips for Coding Common Pediatric Orthopaedic Procedures with Co-Surgeons and Assistant Surgeons.","authors":"Kevin M Neal, Ryan Muchow, Craig Louer, Christine Banks","doi":"10.1016/j.jposna.2024.100097","DOIUrl":"10.1016/j.jposna.2024.100097","url":null,"abstract":"","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100097"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164705","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":"Erratum Regarding Missing Patient Consent Statements in Previously Published Articles.","authors":"","doi":"10.1016/j.jposna.2024.100104","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100104","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.jposna.2024.100027.].</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100104"},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164721","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":"Erratum Regarding Missing Patient Consent Statements in Previously Published Articles.","authors":"","doi":"10.1016/j.jposna.2024.100103","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100103","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1016/j.jposna.2024.100019.].</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100103"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164720","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":"Panel Discussion: Profiles in Surgical Innovation & Entrepreneurship.","authors":"R Carter Clement, Kevin G Shea","doi":"10.1016/j.jposna.2024.100098","DOIUrl":"https://doi.org/10.1016/j.jposna.2024.100098","url":null,"abstract":"<p><p>Innovation is crucial to the field of pediatric orthopaedic surgery. However, the process of developing a new surgical technology is complex and can be daunting. In this panel discussion, 5 surgeons who have successfully developed new technologies share their personal stories as well as mistakes made, lessons learned, and reflections on key questions related to innovation and entrepreneurship in the modern healthcare landscape.</p><p><strong>Key concepts: </strong>(1)There are many paths to successful innovation and entrepreneurship.(2)Building a capable team is key to success, especially for a practicing surgeon.(3)Fundraising typically benefits the entrepreneur by growing the overall pie.(4)Pediatric specialties are generally underserved by the medical device industry.(5)The Food and Drug Administration has taken steps to address this discrepancy.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100098"},"PeriodicalIF":0.0,"publicationDate":"2024-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164727","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":"Factors Associated with Failed Closed Reduction in Flexion and Gartland Type III Pediatric Supracondylar Humerus Fractures.","authors":"Pablo Coello, Nathaniel Grey Loyd, David A Hsiou, Rachel S Silverstein, Scott B Rosenfeld","doi":"10.1016/j.jposna.2024.100079","DOIUrl":"10.1016/j.jposna.2024.100079","url":null,"abstract":"<p><strong>Background: </strong>Most displaced supracondylar humerus fractures (SCHFs) are treated with closed reduction and percutaneous pinning. While there are only a few possible indications for converting to an open reduction, a failed closed reduction is a common cause. This study aims to elucidate possible risk factors for failed closed reductions of SCHF.</p><p><strong>Methods: </strong>A retrospective review of SCHF from 2010 to 2020 at a pediatric tertiary medical center, which underwent operative fixation, was conducted. Exclusion criteria were open fractures and reasons for open reduction other than failed closed reduction. Rates of open reduction were assessed by preoperative fracture classification and assessed for respective associations with the factors of interest using Student's t-test, χ², or Fisher exact tests as indicated.</p><p><strong>Results: </strong>Seven hundred sixteen patients (age range 1-15 years old) met the inclusion criteria. Failed closed reductions were more likely in flexion-type fractures (15/37) compared to type III extension fractures (31/480) (OR: 9.88, 95% CI: 4.66-20.92). For flexion-type fractures, failed closed reduction occurred at a lower rate for anteriorly displaced fractures (5/22) when compared to other displacement directions (10/15) (OR: 0.15, 95% CI: 0.034-0.637). Age, race, social deprivation index, BMI, associated injuries, comminution, and nerve palsy were not significant. For type III extension fractures, older age (>8 years) (OR: 5.22, 95% CI: 1.56-17.43) and nerve injury (OR: 2.23, 95% CI: 1.00-5.10) were associated with failed closed reduction. No other factors of interest were significant.</p><p><strong>Conclusions: </strong>Flexion-type SCHFs have significantly higher rates of failed closed reduction compared to extension-type fractures. For flexion-type fractures, anterior displacement predicts a lower rate of failed closed reduction compared to other displacement directions. For type III extension fractures, risk factors include older age and a nerve injury on preoperative exam.</p><p><strong>Key concepts: </strong>(1)Most operative supracondylar humerus fractures (SCHFs) can be treated with closed reduction and percutaneous pinning.(2)Surgeons need to be aware of possible reasons for having to convert to open reduction of pediatric SCHFs.(3)Flexion-type fracture patterns had a higher rate of an open procedure compared to extension-type fractures.(4)Patients who sustained an extension-type injury were more likely to require an open reduction if they had a nerve injury or were older at the time of injury or pinning (>8 years old).</p><p><strong>Level of evidence: </strong>III, Retrospective Cohort Study.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100079"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164724","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":"Estimated Incidence of Pediatric Distal Radius Buckle Fractures in the United States.","authors":"Evan P Sandefur, Mosufa Zainab, Nicholas J Peterman, Mehmet E Kilinc, Andrea A Yu-Shan, Peter J Apel","doi":"10.1016/j.jposna.2024.100075","DOIUrl":"10.1016/j.jposna.2024.100075","url":null,"abstract":"<p><strong>Background: </strong>Distal radius buckle fracture care has been extensively studied, yet the incidence in the United States is unknown. This study aims to determine the incidence of pediatric buckle fractures using geospatial analysis.</p><p><strong>Methods: </strong>Pediatric distal radius buckle fractures (patients aged <18) from 2018 to 2022 were identified via a retrospective chart review from a single health care organization. The catchment area was defined as all of the home ZIP codes of verified buckle fracture patients. Corrections were made for buckle fractures treated at institutions with overlaying catchment areas. Adjusted incidence was then used to calculate annual buckle fractures nationally. Pediatric Orthopaedic Society of North America member rolls were used to identify and locate pediatric orthopaedic surgeons. It was assumed that each pediatric orthopaedic surgeon would treat up to 20 buckle fractures annually from a 25-mile radius of the primary office. Based on this, the percentage of buckle fractures nationally that are able to be treated by pediatric Orthopaedic surgeons was estimated.</p><p><strong>Results: </strong>A total of 594 distal radius buckle fractures over 5 years were confirmed in an estimated catchment area of 866,238 population. With adjustments for overlapping institutions, the estimated annual incidence was 17.3 per 100,000 people (95% CI [14.5, 20.1]). In the United States, there are an estimated 66,513 buckle fractures annually, with 1,182 pediatric orthopaedic surgeons potentially able to treat 26.5% of these cases.</p><p><strong>Conclusions: </strong>This investigation estimates the incidence of pediatric buckle fractures in the United States, allowing for estimates of expected volumes and implications for care. Based on the geographic distribution of pediatric orthopaedic surgeons and estimated incidence, it is impractical for buckle fracture care to be delivered exclusively by pediatric orthopaedic surgeons.</p><p><strong>Key concepts: </strong>(1)The estimated annual incidence of distal radius buckle fracture is 17.3 per 100,000 people.(2)Pediatric orthopaedic surgeons are able to treat up to 26.5% of these cases.(3)Buckle fractures cannot be the exclusive domain of pediatric orthopaedic surgeons, as the number of pediatric Orthopaedic surgeons is too small for them to be the sole providers of care.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100075"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164723","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":"What to Cover When You're Covering: Preparing the Sideline Physician for the Season.","authors":"Michael A Beasley, Alexandra Abbott, James Mackie, Joshua T Goldman","doi":"10.1016/j.jposna.2024.100069","DOIUrl":"10.1016/j.jposna.2024.100069","url":null,"abstract":"<p><p>The evolving role of the sideline physician in sports medicine frequently involves comprehensive responsibilities beyond direct medical care. We outline important aspects of sideline preparedness and management, including the development and rehearsal of Emergency Action Plans (EAPs), initial approaches to assessing injured athletes, equipment removal strategies, and return-to-play decision-making processes. Epidemiological insights into sports injuries, particularly catastrophic events, underscore the importance of venue-specific planning within EAPs. We also provide guidance and recommendations for nuanced medical procedures such as IV fluid administration, anesthetic joint injections, and Toradol use, addressing current controversies and evidence-based recommendations. Medicolegal and ethical considerations emphasize the necessity of navigating legal statutes and maintaining patient confidentiality while adhering to ethical principles. Overall, this concept review underscores the multifaceted nature of the sideline physician's role, emphasizing evidence-based practice, transparent communication, and collaboration with stakeholders for optimal athlete care across all levels of play.</p><p><strong>Key concepts: </strong>(1)Evolution of sideline physician role: the manuscript explores the expanded responsibilities of sideline physicians beyond direct medical care, encompassing aspects such as emergency action plan development and return-to-play decisions.(2)Importance of emergency preparedness: emphasizes the crucial role of rehearsed emergency action plans in effectively managing on-field emergencies and optimizing patient outcomes.(3)Nuanced medical procedures: discusses controversies and evidence-based recommendations surrounding procedures like IV fluid administration, anesthetic joint injections, and Toradol use.(4)Medicolegal and ethical considerations: addresses the necessity for navigating legal statutes, maintaining patient confidentiality, and adhering to ethical principles in sports medicine practice.(5)Collaborative care approach: underscores the significance of evidence-based practice, transparent communication, and collaboration with stakeholders for providing optimal athlete care across all levels of play.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100069"},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164642","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":"Hip Dysplasia and Dislocation in Down Syndrome: Is There Evidence to Support Consideration of Routine Hip Surveillance?","authors":"Rikki Koehler, Rubini Pathy, Daniel Gregory, James F Mooney, Mary E Gannotti","doi":"10.1016/j.jposna.2024.100074","DOIUrl":"10.1016/j.jposna.2024.100074","url":null,"abstract":"<p><strong>Background: </strong>Hip instability is associated with Down syndrome (DS). The goal of this review was to examine the existing literature to determine whether there is sufficient evidence to consider the development of standardized hip surveillance guidelines in patients with DS.</p><p><strong>Methods: </strong>A scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines identified English-language, peer-reviewed publications concerning hip instability or dysplasia in people with DS, including diagnosis and imaging, physical examination, other hip pathologies, surgical and nonsurgical interventions, and epidemiology from gestation to adulthood. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases were queried with professional librarian assistance. Two independent reviewers screened abstracts and full texts. Discrepancies were resolved by group consensus. Validated critical appraisal tools were used.</p><p><strong>Results: </strong>Eight hundred seventy-six articles were screened, and 54 full-text articles with case series, cross-sectional, and case-control designs met the criteria. Twenty-six articles have described pelvic morphology in people with DS including increased iliac indices, acetabular retroversion, and global acetabular insufficiency compared to peers. Studies have shown that 1.0% to 14% of pediatric DS patients and up to 28% of adults with DS have evidence of radiographic hip abnormality.</p><p><strong>Conclusions: </strong>A scoping review of the literature demonstrates that the risk of hip pathology among children and adults with DS is increased independent of life stage. Consideration of early and regular radiographic and physical examination of DS patients focused on potential hip pathology, may be warranted.</p><p><strong>Key concepts: </strong>(1)There is evidence of a significant risk of hip pathology in patients with Down syndrome.(2)To date, a focused review of the existing literature has been limited.(3)A scoping review demonstrates that regular and routine hip surveillance in patients with Down syndrome may be indicated.</p><p><strong>Level of evidence: </strong>V.</p>","PeriodicalId":520850,"journal":{"name":"Journal of the Pediatric Orthopaedic Society of North America","volume":"8 ","pages":"100074"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12088349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164726","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}