Journal of Hand Therapy最新文献

{"title":"Extensor mechanism dysfunction and hand deformities caused by Dupuytren's disease: Surgical and rehabilitation perspectives.","authors":"Jean Paul Brutus, Alison Taylor, Natasha Barone, Elisabet Hagert","doi":"10.1016/j.jht.2024.12.017","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.017","url":null,"abstract":"<p><p>Dupuytren's disease is a common fibroproliferative disorder that primarily affects the palm of the hand. While the disease is known for its characteristic palmar contractures, it also has a potential impact on the extensor mechanism of the hand, resulting in the development of boutonniere deformity, swan-neck deformity, and persistent metacarpophalangeal joint contracture due to extensor capsule stretching and tendon instability. These imbalances are challenging to correct under general or regional anesthesia. Wide awake local anesthesia without a tourniquet allows active range of motion and intraoperative patient collaboration. By understanding the underlying mechanisms and structures involved in these deformities and correcting them under local anesthesia without a tourniquet, hand surgeons can become more confident in correcting the deformity, demonstrating it to the patient, optimizing the rehabilitation protocol, and improving patient outcomes.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469921","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":"Prioritize proximal interphalangeal joint extension, a cadaver study clarifying PIPJ neutral position and joint capsular behavior.","authors":"Vicenç Punsola-Izard, Karen S Schultz, Manuel Llusà-Perez, Aroa Casado","doi":"10.1016/j.jht.2024.12.015","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.015","url":null,"abstract":"<p><strong>Background: </strong>Dysmobility of the proximal interphalangeal joint (PIPJ) often arises following trauma, inflammation, or surgery, leading to joint stiffness and reduced range of motion. This condition results from capsular shortening and the development of arthrofibrosis, which restricts mobility and contributes to contracture formation.</p><p><strong>Purpose: </strong>This study investigates the influence of joint position on capsular space volume distribution in the PIPJ, hypothesizing that the mid-flexion position maximizes capsular space, contributing to ligament shortening and arthrofibrosis. This study investigates the influence of joint position on capsular space volumen distribution in PIPJ, hypothesizing that the mid- flexion position maximizes capsular space, contributing to ligament shortening and arthrofibrosis.</p><p><strong>Study design: </strong>A cadaveric study examining capsuloligamentous dynamics of the PIPJ across various joint positions.</p><p><strong>Methods: </strong>Fifteen fingers from five fresh frozen cadaver specimens were evaluated through three studies: RESULTS: 1. The PIPJ demonstrated close-packed positions at full flexion and extension, with maximum capsular space volume observed in the mid-flexion position (30°-40° flexion). 2. Silicone injection consistently held the joint in a mid-flexion position, indicating maximal capsular volume. 3. Latex distribution varied with joint position, concentrating dorsally in extension, spreading equally volar-dorsal in mid-flexion and shifting volarly in flexion.</p><p><strong>Conclusions: </strong>We propose call to call the mid-flexion position (of 30º-40º flexion) the \"neutral\" position. This position maximizes capsular space volume, facilitating ligament shortening and arthrofibrosis. Extension minimizes volar capsularspace volume and may be essential for preventing flexion contractures. Clinically, immobilizing the proximal interphalangeal joint in extension with dorsal compression may help prevent contracture and reduce edema, while manual therapy should target the mid-flexion position to enhance joint mobilization.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469924","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 arm curl score is the best indicator of reduced upper extremity exercise capacity in women with fibromyalgia: A cross-sectional study.","authors":"Habibe Durdu, Ulku Kezban Sahin, Ilker Fatih Sari","doi":"10.1016/j.jht.2024.12.012","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.012","url":null,"abstract":"<p><strong>Background: </strong>Unsupported upper extremity exercise capacity (UUEEC) is crucial for sustaining everyday functions; whether it is compromised in the fibromyalgia (FM) population is unknown.</p><p><strong>Purpose: </strong>The study aimed to assess UUEEC in women with FM and to determine associated factors.</p><p><strong>Study design: </strong>This is a cross-sectional study.</p><p><strong>Methods: </strong>This study was conducted with 48 women with FM and 48 healthy women between the ages of 18-65. UUEEC, muscle strength, flexibility and disability of upper extremity, disease severity, pain catastrophizing, and quality of life assessed with the Six Minute Pegboard and Ring Test (6PBRT), arm curl test, hand grip strength test, back-scratch test, Disability of Arm, Shoulder, and Hand (DASH), Fibromyalgia Impact Questionnaire (FIQ) and Pain Catastrophizing Scale and Short-form 36 questionnaires, respectively.</p><p><strong>Results: </strong>The 6PBRT score was significantly decreased in the women with FM compared to healthy women (p < 0.001, Cohen d: 1.28). The multivariate linear regression analysis revealed that the model incorporating the arm curl score, hand grip strength, DASH, and FIQ scores was explained 68% of the variance in 6PBRT score (R² = 0.672, p < 0.001). The results indicated that all variables in the model were independent predictors of 6PBRT score, with the arm curl score was the strongest predictor (β = 6.36, p = 0.015).</p><p><strong>Conclusions: </strong>This study suggests that UUEEC measured by 6PBRT is reduced in women with FM, and the upper extremity muscle strength is closely related to the 6PBRT score. Accordingly, strengthening the biceps brachii muscle in women with FM, whose muscle weakness is common, may be effective in improving UUEEC, which is directly associated to daily activities.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426765","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":"Finger flexor tendon injuries repaired surgically followed by an early active motion program: A prospective cohort study of clinician- and patient-reported outcomes.","authors":"Nicola Williams, Madelaine Carey, Kathy Stiller","doi":"10.1016/j.jht.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.011","url":null,"abstract":"<p><strong>Background: </strong>Finger flexor tendon injuries are usually surgically repaired followed by early active motion rehabilitation. Studies have focussed on clinician-reported outcomes after these injuries.</p><p><strong>Purpose: </strong>To measure clinician- and patient-reported outcomes after finger flexor tendon repair.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Adult patients with traumatic, finger flexor tendon injuries who underwent surgical repair were recruited. An individualized, early active motion rehabilitation program was provided, including an orthosis, progressive active/passive range of motion (ROM) and strengthening exercises. Clinician-reported outcomes, namely total active motion (TAM), Strickland-Glogovac ROM, flexor/extensor deficits, and grip strength, were recorded 3 months post-injury. Patient-reported outcomes, namely the Michigan Hand Questionnaire (MHQ) and 36-item Short Form Health Survey (SF-36), were measured at baseline (pre-injury) and 3 months, and return to work/leisure and level of adherence at 3 months.</p><p><strong>Results: </strong>Data from 32 participants (20 male, mean age 39.8 years, 61 repaired tendons) were analyzed. At 3 months post-injury, mean ROM was 83.5% and 73.8%, compared to the unaffected hand, for total active motion and Strickland-Glogovac ROM, respectively, and grip strength 68.4%. All MHQ scores were statistically significantly worse at 3 months compared to pre-injury (p ≤ 0.012), as were the physical role limitations and physical component summary scores of the SF-36 (p ≤ 0.023). All participants (100.0%) had returned to work by 3 months, and virtually all (96.6%) to leisure activities, although not always at pre-injury levels. The number of digits involved statistically significantly affected Strickland-Glogovac ROM (p ≤ 0.049), flexor deficit (p = 0.042) and SF-36 summary and total scores (p ≤ 0.049). The number of tendons involved statistically significantly affected flexor deficit (p = 0.042). Participant's adherence statistically significantly affected MHQ total score (p = 0.028).</p><p><strong>Conclusions: </strong>The use of patient-reported outcomes, in addition to clinician-reported outcomes, provided deeper insight into patients' perceptions of their recovery after flexor tendon injury.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416255","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":"Hand function and quality of life with a 3D-printed prosthesis: A case report.","authors":"Regina Rossi, Gregory Chown","doi":"10.1016/j.jht.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>People throughout the world have amputations but cannot obtain prosthetic devices. 3D-printing can be a cost-effective tool to create prostheses.</p><p><strong>Purpose: </strong>The study's purpose is to examine the impact that a 3D-printed prosthetic hand has on function and quality of life.</p><p><strong>Study design: </strong>This case report collected data from a single subject.</p><p><strong>Methods: </strong>For function and quality of life, the Orthotics Prosthetics Users Surveys (OPUS) Upper Extremity Functional Status (UEFS) and the OPUS Health-Related Quality of Life Index (HRQOL) were completed before and after receiving a 3D-printed prosthetic hand.</p><p><strong>Results: </strong>The UEFS pre-test score was 31, while post-test was 50. This 19-point difference exceeds the minimal detectable change (MDC) of 14.8, denoting a positive change. The HRQOL pre-test score was 58 and the post-test was 61. Since the MDC for this survey is 7.4, there is no substantial improvement.</p><p><strong>Conclusions: </strong>Function improved for this participant by nearly two standard deviations, while quality of life was maintained. 3D-printing is a viable, adaptable, and cost-effective alternative that aided the participant's function. This technology in the clinic can meet unique client needs when considering financial limitations or multiple prostheses for growing children.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416261","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":"Total active range of movement after treatment using a traction orthotic for extra-articular phalangeal fractures: A case series.","authors":"Daniel Harte, Lucia Ramsey, Lynn Wilson, Suzanne Martin","doi":"10.1016/j.jht.2025.01.005","DOIUrl":"https://doi.org/10.1016/j.jht.2025.01.005","url":null,"abstract":"<p><strong>Background: </strong>The use of traction orthoses for complex finger fractures is not a common intervention though some research purports its efficacy as an alternative treatment approach to surgery in some scenarios.</p><p><strong>Purpose: </strong>This study examined total active of range of movement (TAROM) outcomes achieved by patients on discharge from hand therapy after being treated using a traction orthotic following an extra-articular displaced proximal or middle phalangeal fracture.</p><p><strong>Study design: </strong>A retrospective, consecutive longitudinal case series.</p><p><strong>Methods: </strong>Data was collected on the time from injury to traction, duration of traction, injury location (hand, digit, phalanx), fracture classification, age, sex, hand dominance, number of therapy sessions (mobilization phase of rehabilitation), duration from injury to discharge from hand therapy and TAROM at discharge. TAROM outcomes are categorized using the criteria recommended by the American Society of Surgery of the Hand. Categorical variables are summarized using frequency and percentages. Continuous data is summarized as mean and standard deviation or median and interquartile range. Any potential correlations between TAROM and time from injury to discharge were analyzed using Pearson's correlation (two-tailed).</p><p><strong>Results: </strong>Twenty-three patients were referred for traction (14 male: nine female). Three people went on to have surgery and two patients were lost to follow-up. Mean TAROM was 230.9º (SD 22.6º) indicating a good outcome using the American Society of Surgery of the Hand criteria. Mean time from injury to discharge was 65.6 (SD 30.4) days. There was no correlation observed between time from injury to discharge and TAROM on discharge (r = -0.18, p = 0.48).</p><p><strong>Conclusions: </strong>Good and excellent TAROM was achieved following treatment using traction orthoses for extra-articular phalangeal fractures though further studies are necessary. Larger sample sizes will allow for more granular analysis of different fracture classifications.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371136","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":"Hand therapy referral for hand fractures and dislocations: A multicenter snapshot study.","authors":"Louise de Haas, Veronique van de Lücht, Charlotte Lameijer, Marco Ritt, Niels Schep, Rolf Groenwold, Mark van Heijl","doi":"10.1016/j.jht.2024.12.014","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.014","url":null,"abstract":"<p><strong>Background: </strong>It is unclear which patients with fractures and dislocations of the hand necessitate hand therapy referral, which can lead to practice variation.</p><p><strong>Purpose: </strong>The study aimed to evaluate hand therapy referral patterns following non-operative and operative treatments of hand fractures and dislocations and to identify practice variations.</p><p><strong>Study design: </strong>This multicenter, observational snapshot study was conducted across 12 hospitals in the Netherlands over a 3-month period in 2020.</p><p><strong>Methods: </strong>Adult patients admitted to the emergency department with metacarpal and phalangeal fractures or dislocations were included. Analyses were stratified by hand therapy referral status for different injury categories following non-operative and operative treatment. Determinants for hand therapy referral, including patient and injury characteristics, hospital setting, and medical specialty, were assessed using multivariable logistic regression.</p><p><strong>Results: </strong>Of 1654 included patients, 22% (306/1405) were referred to hand therapy after non-operative treatment, and 72% (178/249) after operative treatment. Among the 10 most prevalent injuries treated non-operatively, referral rates were highest for dislocations of digits two to five (43% [48/112]), followed by middle phalanx shaft fractures (34% [11/32]), and mallet fractures (33% [23/70]). The referral rates across hospitals significantly differed for metacarpal shaft fractures, dislocations of digits two to five, and proximal interphalangeal joint palmar plate avulsion fractures. Among the five most prevalent injuries treated operatively, middle and proximal phalanx shaft fractures were most frequently referred (90% [9/10] and 87% [33/38]), and referral rates across hospitals varied between 28% (95% confidence interval: 13%-50%) and 89% (95% confidence interval: 51%-100%). In multivariable logistic regression, hospital setting and medical specialty were determinants of hand therapy referral (p < 0.001 and p < 0.001).</p><p><strong>Conclusions: </strong>There is considerable practice variation in hand therapy referral within injury categories, which seems to be largely attributed to hospital setting and medical specialty. This highlights the knowledge gap in this field.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371165","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":"Patient-centered care in the conservative management of an unstable proximal phalanx fracture: A case report.","authors":"Tanya Cole, Evania Lok, Kerryn Parfett, Sally Ng, Melissa Hirth","doi":"10.1016/j.jht.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>Proximal phalangeal fractures are common yet challenging due to their inherent instability.</p><p><strong>Purpose: </strong>This study presents a case for patient-centered care and a nonsurgical management pathway.</p><p><strong>Study design: </strong>Case report.</p><p><strong>Methods: </strong>M, a 56-year-old male, sustained a comminuted oblique proximal phalanx fracture to his left nondominant small finger while playing football. Five days post injury, the fracture was reduced with local anesthetic and manipulation (LAMP). The injury was managed conservatively with a full-time hand-based orthosis with metacarpophalangeal joint flexion, and buddy taping. One week later, the fracture had lost reduction and significantly displaced. Instead of converting to surgery, a further LAMP (LAMP2) was performed, and conservative management continued. Outcomes were collected at baseline, 6, 12, and 15 weeks, and 10 months following LAMP2.</p><p><strong>Results: </strong>By 12 weeks, M had a full range of motion, minimal pain, no difficulty with personal daily activities, and resumed full manual labor work duties and gym workouts. Quality of life was reported as high from 6 weeks. M was extremely satisfied.</p><p><strong>Conclusions: </strong>Conservative management of an initially unstable proximal phalanx reduced by LAMP, with a second LAMP one week later, demonstrated excellent outcomes and could be a possible management pathway for similar patients.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371172","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":"Patients' perspectives on Dupuytren's disease: A scoping review and categorization using the WHO International Classification of Functioning, Disability and Health Framework (ICF).","authors":"Sonja Elisabeth Pelzmann","doi":"10.1016/j.jht.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.007","url":null,"abstract":"<p><strong>Background: </strong>Dupuytren's disease (DD) often has an underestimated impact on the lives of those effected.</p><p><strong>Purpose: </strong>This study aimed to provide a holistic overview of the available evidence regarding the patient perspectives (PP) on DD, which can help to better understand both the patients and the disease itself.</p><p><strong>Study design: </strong>Scoping Review.</p><p><strong>Methods: </strong>Based on the framework of Arksey and O'Malley and enhanced by the recommendations of Levac et al., a scoping review was used to locate the available material about PP on DD. Data collection was performed using the electronic databases PubMed, CINAHL and Embase, and additional sources. The included publications were classified using the Oxford Level of Evidence (LoE), and their findings were linked to the components, domains and corresponding codes of the International Classification of Functioning, Disability and Health (ICF).</p><p><strong>Results: </strong>Of the total 2.127 search results, eight publications published between 2009 and 2020 were included. They have a sample size of seven to 85 patients and a LoE of IV. Data, clustered into 61 topics could be linked to the components 'Activities and Participation', 'Body Function and Structures', 'Environmental Factors' and 13 domains of the ICF. The results show that DD primarily affects patients in 'global mental functions' (n = 21), the 'mobility' (n = 18), 'community, social and civic life' (n = 10) and, 'self-care' (n = 10). The individual topics could be linked to up to eight ICF codes (second to third level category). The impact is perceived in general situations and clearly defined activities.</p><p><strong>Conclusions: </strong>The results of this review illustrate the existence of the known functional impairments, limitations on self-care, and major impacts on psychosocial area. Due to the quality and lack of evidence, no generalized statement can be made about the value of PP on DD. Nevertheless, it has been shown that PP are essential for understanding both those affected and the disease itself thus be involved in diagnostic and treatment decisions in DD.</p>","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371176","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":"Squegg demonstrates good interdevice reliability in measuring grip strength in healthy volunteers.","authors":"Lidia Iannarelli, Tara Packham","doi":"10.1016/j.jht.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.jht.2024.12.010","url":null,"abstract":"","PeriodicalId":54814,"journal":{"name":"Journal of Hand Therapy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371192","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}