Hand Surgery & Rehabilitation最新文献

{"title":"Prevalence of asymptomatic TFCC tears on MRI: A systematic review","authors":"Brandon Portnoff,&nbsp;Jack C. Casey,&nbsp;Jeyvikram Thirumavalavan,&nbsp;Erin Abbott,&nbsp;Rachel North,&nbsp;Joseph A. Gil","doi":"10.1016/j.hansur.2024.101684","DOIUrl":"10.1016/j.hansur.2024.101684","url":null,"abstract":"<div><h3>Background</h3><p>Recent studies show a high prevalence of triangular fibrocartilage complex (TFCC) tears in asymptomatic wrists. While a TFCC tear may be identified when evaluating ulnar sided wrist pain, this could be incidental and not the true cause of pain. The purpose of this review was to (1) examine the frequency of which TFCC tears are diagnosed on MRI in asymptomatic versus symptomatic wrists and (2) determine whether rates of asymptomatic TFCC tears are higher in two important subgroups commonly at risk for this pathology: elderly patients and high-impact athletes.</p></div><div><h3>Methods</h3><p>Articles of level IV or higher evidence were selected from PubMed, Ovid MEDLINE, and Cochrane Central Register of Controlled Trials Database to compare patient demographics, study parameters, and clinical outcomes.</p></div><div><h3>Results</h3><p>Seven studies met inclusion criteria with a total of 501 wrists (205 symptomatic and 296 asymptomatic). All studies included asymptomatic patients with wrist MR imaging and included information on the structural integrity of the TFCC. Variability in outcome measures reported across studies prevented the conduction of a meta-analysis.</p></div><div><h3>Conclusions</h3><p>TFCC abnormalities are present in patients of all ages, symptomatology, and levels of involvement in high-impact sports. Although, there are differences in tear and abnormality prevalence when comparing these three factors, the difference was not significant. Given these findings, using MRI to assess ulnar-sided wrist pain should be fortified with clinical suspicion, physical exam, and physician judgment.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101684"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144897","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":"ChatGPT Earns American Board Certification in Hand Surgery","authors":"Diane Ghanem ,&nbsp;Joseph E. Nassar ,&nbsp;Joseph El Bachour ,&nbsp;Tammam Hanna","doi":"10.1016/j.hansur.2024.101688","DOIUrl":"10.1016/j.hansur.2024.101688","url":null,"abstract":"<div><h3>Purpose</h3><p>Artificial Intelligence (AI), and specifically ChatGPT, has shown potential in healthcare, yet its performance in specialized medical examinations such as the Orthopaedic Surgery In-Training Examination and European Board Hand Surgery diploma has been inconsistent. This study aims to evaluate the capability of ChatGPT-4 to pass the American Hand Surgery Certifying Examination.</p></div><div><h3>Methods</h3><p>ChatGPT-4 was tested on the 2019 American Society for Surgery of the Hand (ASSH) Self-Assessment Exam. All 200 questions available online (<span>https://onlinecme.assh.org</span><svg><path></path></svg>) were retrieved. All media-containing questions were flagged and carefully reviewed. Eight media-containing questions were excluded as they either relied purely on videos or could not be rationalized from the presented information. Descriptive statistics were used to summarize the performance (% correct) of ChatGPT-4. The ASSH report was used to compare ChatGPT-4’s performance to that of the 322 physicians who completed the 2019 ASSH self-assessment.</p></div><div><h3>Results</h3><p>ChatGPT-4 answered 192 questions with an overall score of 61.98%. Performance on media-containing questions was 55.56%, while on non-media questions it was 65.83%, with no statistical difference in performance based on media inclusion. Despite scoring below the average physician’s performance, ChatGPT-4 outperformed in the ‘vascular’ section with 81.82%. Its performance was lower in the ‘bone and joint’ (48.54%) and ‘neuromuscular’ (56.25%) sections.</p></div><div><h3>Conclusions</h3><p>ChatGPT-4 achieved a good overall score of 61.98%. This AI language model demonstrates significant capability in processing and answering specialized medical examination questions, albeit with room for improvement in areas requiring complex clinical judgment and nuanced interpretation. ChatGPT-4’s proficiency is influenced by the structure and language of the examination, with no replacement for the depth of trained medical specialists. This study underscores the supportive role of AI in medical education and clinical decision-making while highlighting the current limitations in nuanced fields such as hand surgery.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101688"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140327516","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":"Computer-simulated TOUCH prosthesis cup malposition and solutions","authors":"Kevin Knappe ,&nbsp;Mareike Schonhoff ,&nbsp;Sebastian Jaeger ,&nbsp;Berthold Bickert ,&nbsp;Leila Harhaus ,&nbsp;Benjamin Panzram","doi":"10.1016/j.hansur.2024.101712","DOIUrl":"10.1016/j.hansur.2024.101712","url":null,"abstract":"<div><h3>Introduction</h3><p>Total joint replacement has become significantly more common as a treatment for advanced trapeziometacarpal joint osteoarthritis in recent years. The latest generation of prostheses with dual-mobility designs leads to very good functional results and low rates of loosening and dislocation in the short and medium term. Biomechanical studies showed that central placement and parallel alignment of the cup with respect to the proximal articular surface of the trapezium are crucial for both cup stability and prevention of dislocation. Despite correct positioning of the guidewire, incorrect placement or tilting of the inserted cup may occur, requiring immediate intraoperative revision.</p></div><div><h3>Methods</h3><p>The existing spherical and conical cup models in sizes 9 mm and 10 mm were transferred to a computer-aided design dataset. Depending on the intraoperative complication (tilting or incorrect placement), the revision options resulting from the various combinations of cup type and size were simulated and analyzed according to the resulting defect area and bony contact area.</p></div><div><h3>Results</h3><p>In well centered cups, a size 9 conical cup could be replaced by a size 9 spherical cup and still be fixed by press-fit. Conversely, a size 9 spherical cup could not be replaced by a size 9 conical cup, but only by a size 10 cup, of whatever shape. When a size 9 conical cup was tilted up to 20°, the best revision option was to resect the sclerotic margin and insert a size 10 conical cup deeper into the cancellous bone, to achieve the largest contact area with the surrounding bone. When a size 9 cup of whatever shape was poorly centered (misplaced with respect to the dorsopalmar or radioulnar line of the trapezium), placement should be corrected using a size 10 cup, combined with autologous bone grafting of the defect. Again, the size 10 conical cup showed the largest bony contact area.</p></div><div><h3>Conclusion</h3><p>Our computer-based measurements suggested options for intraoperative cup revision depending on cup shape and size and on type of misalignment with resulting bone defects. These suggestions, however, need to be confirmed in anatomic specimens before introducing them into clinical practice.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101712"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468122924001014/pdfft?md5=2b1095278d8d987d8b7dac4303c9c5d3&pid=1-s2.0-S2468122924001014-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"En bloc resection and iliac crest bone grafting for giant cell tumor of the finger","authors":"Joseph Saleh ,&nbsp;Dominique Tremblay ,&nbsp;Elie Boghossian","doi":"10.1016/j.hansur.2024.101713","DOIUrl":"10.1016/j.hansur.2024.101713","url":null,"abstract":"<div><p>A case of a rapidly progressing giant cell tumor of the middle phalanx is presented. The patient underwent en bloc resection with iliac crest grafting and distal interphalangeal fusion. Surgical technique and patient’s functional outcomes are described.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101713"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871786","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":"Effectiveness of the static progressive Joint Active System splint in improving upper extremity joint stiffness","authors":"Kobi Steinberg,&nbsp;Danit Langer,&nbsp;Hanna Melchior,&nbsp;Joshua A. Cohen,&nbsp;Gershon Zinger","doi":"10.1016/j.hansur.2024.101710","DOIUrl":"10.1016/j.hansur.2024.101710","url":null,"abstract":"<div><h3>Purpose</h3><p>Injuries to the upper extremity often result in stiffness. The joint capsule may lose its elastic properties, limiting motion. Most modalities for increasing motion are based on capsule stretching, and usually involve physical or occupational therapy. We tested the hypothesis that the Joint Active System static-progressive splint is helpful in increasing range of motion in stiff joints after failure of other treatments.</p></div><div><h3>Methods</h3><p>Candidates for the Joint Active System splint were mostly patients with upper extremity trauma that required surgery, if they plateaued after therapy but still had stiffness. A retrospective review was performed of all patients from 2015 to 2019 that met our inclusion criteria. Etiologies of stiffness and patient demographics were documented. Range of motion was recorded before and after treatment and, when available, functional scores were calculated.</p></div><div><h3>Results</h3><p>Forty-four patients were treated with the Joint Active System splint; 5 were excluded, leaving 39 for analysis: 15 elbow, 14 wrist and 10 proximal interphalangeal joints. All patients had received therapy before using the Joint Active System and 11 had tried a dynamic splint in addition to therapy. All joints showed significant improvement in motion after treatment: from 66.5° to 95.7° in the elbow, 63.5° to 81.1° in the wrist and 33.2° to 51.8° in the proximal interphalangeal joint. When functional scores were available before and after treatment, there was significant improvement for both elbow and wrist. Even when the Joint Active System was started many months after injury, it was effective.</p></div><div><h3>Conclusions</h3><p>Despite reaching a plateau with therapy, the Joint Active System static-progressive splint is effective in improving range of motion in elbow, wrist and finger joints with stiffness following injury or surgery.</p></div><div><h3>Type of study</h3><p>Retrospective case series.</p></div><div><h3>Level of evidence</h3><p>Therapeutic, level IV.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101710"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875030","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 quality and readability comparison of artificial intelligence and popular health website education materials for common hand surgery procedures","authors":"Nicholas B. Pohl ,&nbsp;Evan Derector ,&nbsp;Michael Rivlin ,&nbsp;Abdo Bachoura ,&nbsp;Rick Tosti ,&nbsp;Amir R. Kachooei ,&nbsp;Pedro K. Beredjiklian ,&nbsp;Daniel J. Fletcher","doi":"10.1016/j.hansur.2024.101723","DOIUrl":"10.1016/j.hansur.2024.101723","url":null,"abstract":"<div><h3>Introduction</h3><p>ChatGPT and its application in producing patient education materials for orthopedic hand disorders has not been extensively studied. This study evaluated the quality and readability of educational information pertaining to common hand surgeries from patient education websites and information produced by ChatGPT.</p></div><div><h3>Methods</h3><p>Patient education information for four hand surgeries (carpal tunnel release, trigger finger release, Dupuytren’s contracture, and ganglion cyst surgery) was extracted from ChatGPT (at a scientific and fourth-grade reading level), WebMD, and Mayo Clinic. In a blinded and randomized fashion, five fellowship-trained orthopaedic hand surgeons evaluated the quality of information using a modified DISCERN criteria. Readability and reading grade level were assessed using Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) equations.</p></div><div><h3>Results</h3><p>The Mayo Clinic website scored higher in terms of quality for carpal tunnel release information (p = 0.004). WebMD scored higher for Dupuytren’s contracture release (p &lt; 0.001), ganglion cyst surgery (p = 0.003), and overall quality (p &lt; 0.001). ChatGPT - 4th Grade Reading Level, ChatGPT - Scientific Reading Level, WebMD, and Mayo Clinic written materials on average exceeded recommended reading grade levels (4th–6th grade) by at least four grade levels (10th, 14th, 13th, and 11th grade, respectively).</p></div><div><h3>Conclusions</h3><p>ChatGPT provides inferior education materials compared to patient-friendly websites. When prompted to provide more easily read materials, ChatGPT generates less robust information compared to patient-friendly websites and does not adequately simplify the educational information. ChatGPT has potential to improve the quality and readability of patient education materials but currently, patient-friendly websites provide superior quality at similar reading comprehension levels.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101723"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087005","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":"De Quervain tendinitis after total trapeziometacarpal joint arthroplasty: Biomechanical evaluation of tendon excursion in the first extensor tendon compartment","authors":"T. Philips ,&nbsp;L. Van Melkebeke ,&nbsp;L. Popleu ,&nbsp;B. Van Hove ,&nbsp;P. Caekebeke ,&nbsp;J. Duerinckx","doi":"10.1016/j.hansur.2024.101686","DOIUrl":"10.1016/j.hansur.2024.101686","url":null,"abstract":"<div><p>De Quervain’s tenosynovitis is the most common complication after total trapeziometacarpal joint replacement. Etiology is unclear. Implantation of a ball-in-socket implant changes the biomechanics of the normal trapeziometacarpal saddle joint and increases its range of motion. The present study demonstrates that this procedure also significantly increases excursion of the abductor pollicis longus and extensor pollicis brevis tendons during thumb flexion-extension, and not during thumb abduction-adduction. Increased tendon gliding under the retinaculum of the first extensor tendon compartment could predispose to the development frictional tenosynovitis and play a role in the development of de Quervain’s syndrome after total trapeziometacarpal joint replacement.</p></div><div><h3>Level of evidence</h3><p>Not applicable (laboratory study).</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 3","pages":"Article 101686"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140759162","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":"3D printed splint designed by 3D surface scanner for patients with hand allodynia","authors":"Sami Schranz ,&nbsp;Lorenzo Campana ,&nbsp;Martine Giroud ,&nbsp;Stephane Hertig ,&nbsp;Coraline Egger","doi":"10.1016/j.hansur.2024.101646","DOIUrl":"10.1016/j.hansur.2024.101646","url":null,"abstract":"<div><p>Allodynia is a neuropathic pain triggered by a normally painless stimulus: for example, a slight touch on the skin or slight sensation of hot or cold is extremely painful. Rehabilitation is long and uncertain. Protecting the painful area from stimuli is a priority of care. This type of care is complex and challenging for the care team: the pain caused in manufacturing a classic molded orthosis is unbearable for the patient, and the orthosis has a limited lifetime, and experience shows that it is not possible to produce two identical splints. The present study consisted in creating protective splints by 3D printing, designed from data collected with the 3D surface scanner used in our forensic imaging and anthropology unit. The pros and cons of the 3D orthosis versus standard molded orthoses from the point of view of the patient and the practitioner are discussed, with evaluation of related indications of this technology.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 2","pages":"Article 101646"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246812292400015X/pdfft?md5=4428ba21be23098413ff38b8399932fe&pid=1-s2.0-S246812292400015X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139718144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nail cosmetology","authors":"Christel Scheers ,&nbsp;Josette Andre ,&nbsp;Bertrand Richert","doi":"10.1016/j.hansur.2024.101657","DOIUrl":"10.1016/j.hansur.2024.101657","url":null,"abstract":"<div><p>Nail cosmetics is enjoying growing success due to recent technological advances. Manicures can be responsible for mechanical, infectious or allergic adverse effects. Nail cosmetics (e.g., nail varnishes, acrylic false nails, light-curing gels, and adhesive false nails) incorporate substances that harden after solvent evaporation or after polymerization. Allergic reactions can occur, remotely with conventional varnishes and locally with polymerizing substances. Artificial nails incur a risk of carrying infectious agents which can cause serious infection, and should not be used by caregivers.</p><p>Recently, there has been a worrisome increase in the frequency of acrylate allergy, due to the appearance of home kits and lack of information in the general public. The infectious, allergic and toxic risks incurred by consumers and professionals regarding manicure or pedicure treatments and the application of nail cosmetics are the subject of recommendations and monitoring measures.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 ","pages":"Article 101657"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139825115","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":"Complications of prosthesis versus trapeziectomy in trapeziometacarpal joint arthritis: A systematic review","authors":"Benoît Latelise ,&nbsp;Estelle Ben Brahim ,&nbsp;Laure Prasil ,&nbsp;Morgan Freslon","doi":"10.1016/j.hansur.2024.101672","DOIUrl":"10.1016/j.hansur.2024.101672","url":null,"abstract":"<div><h3>Objective</h3><p>Thumb osteoarthritis is a frequent pathology, mainly affecting the elderly. The surgical treatment initially described and having proved its worth is total trapeziectomy. Since the advent of trapeziometacarpal prostheses, several studies showed the non-inferiority of this technique on clinical criteria, with superiority in bone sparing, although neither technique demonstrated overall superiority. We therefore examined the specific complications of each surgical technique by analyzing their nature and prevalence through a review of the literature to compare them on these new parameters.</p></div><div><h3>Methods</h3><p>Seventy-four of the 320 articles reviewed were included, 38 of which concerned trapeziectomy, and 36 concerned prostheses, for a total of 4,865 patients. They were original studies, involving adults undergoing trapeziometacarpal arthroplasty or trapeziectomy, published after 2015, reporting at least one well-described complication.</p></div><div><h3>Results</h3><p>6.13% of trapeziectomies presented severe complications (in particular thumb collapse and metacarpophalangeal hyperextension), 3.31% moderate complications and 1.90% minor complications, leading to a 2.0% revision rate. 23.88% of prostheses had severe complications (loosening, dislocation and wear), 5.06% moderate complications and 1.36% minor complications, leading to a 12.8% revision rate. In addition, we analyzed more recent prosthesis designs separately, and found lower prevalence of severe complications (16.56%) and revision surgery (4.3%).</p></div><div><h3>Conclusion</h3><p>Revision surgery for trapeziometacarpal prostheses is usually only a standard trapeziectomy with the same follow-up as first-line trapeziectomy, whereas revision surgery for trapeziectomies is much more complex and the results are uncertain. For this reason, we would reserve total trapeziectomy for revision surgeries and patients with low functional demand for whom a second surgery is not desirable. Further studies could confirm this attitude, especially focusing on the latest generation of dual mobility implants.</p></div><div><h3>Level of evidence</h3><p>1.</p></div>","PeriodicalId":54301,"journal":{"name":"Hand Surgery & Rehabilitation","volume":"43 2","pages":"Article 101672"},"PeriodicalIF":1.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975099","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}