Bulletin of the Hospital for Joint Disease (2013)最新文献

{"title":"Feasibility of opportunistic osteoporosis screening using ankle CT Hounsfield units in older adults with ankle fractures.","authors":"Alexander Lashgari, Brian T Bueno, Sanjit R Konda, Kenneth A Egol, Abhishek Ganta","doi":"10.1097/bh9.0000000000000062","DOIUrl":"https://doi.org/10.1097/bh9.0000000000000062","url":null,"abstract":"<p><strong>Background: </strong>Fragility fractures reveal osteoporosis, but ankle fractures are not consistently defined as fragility fractures. CT-derived Hounsfield unit measurements may provide an opportunistic method to identify patients at risk for osteoporosis.</p><p><strong>Purpose: </strong>This study investigated the relationship between Hounsfield units (HU) from ankle CT scans and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DEXA), with the aim of determining whether sufficient signal exists between ankle HU and DEXA-derived BMD to justify a larger prospective validation study, rather than to establish a definitive diagnostic tool.</p><p><strong>Study design/level of evidence: </strong>Retrospective correlation study. Level III.</p><p><strong>Methods: </strong>Patients aged 55 years or older, who underwent open reduction and internal fixation for OTA/AO 44 A-C ankle fractures between 2012 and 2024 and had both a preoperative ankle CT and a DEXA scan within 1 year of injury, were reviewed. HU values of the distal tibia and fibula were measured using standardized elliptical regions of interest. Multivariate linear regression was performed with the lowest DEXA T-score as the dependent variable, with HU values, and BMI as independent variables.</p><p><strong>Results: </strong>A total of 57 patients (87.7% female, mean age 69.67 ± 9.24 years) were included. The average ankle HU was 192.43 ± 60.04, and the mean T-score was -1.73 ± 0.96. Regression analysis demonstrated that HU values (B = 0.005, P = .021) and BMI (B = 0.064, P = .007) were positively correlated with the T-score.The regression model was lowest T-score = 0.005*Ankle HU + 0.064*BMI-4.422.Based on this equation, an HU measurement of 106.64 or less, assuming a BMI of 21.7, correlated with osteoporosis.</p><p><strong>Conclusions: </strong>Ankle HU values from CT scans demonstrated a positive association with DEXA-derived BMD, supporting proof-of-concept for ankle HU as a preliminary screening tool and providing methodological groundwork for future prospective validation. Given the high prevalence of osteopenia or osteoporosis in this population, ankle fractures should prompt formal bone health evaluation.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of cancellation and rescheduling of elective shoulder arthroscopy: Experiences at an urban academic medical center.","authors":"Sirjanhar Singh, Vishal Shankar, Savino Stallone, Yungtai Lo, Elilary Montilla, Konrad I Gruson","doi":"10.1097/bh9.0000000000000059","DOIUrl":"10.1097/bh9.0000000000000059","url":null,"abstract":"<p><strong>Background: </strong>Cancellation of elective shoulder arthroscopy negatively affects the surgical scheduling process and results in significant financial loss for a health care institution. Despite this, the patient-related and surgical-related risk factors of cancellation remain undefined.</p><p><strong>Methods: </strong>A retrospective review at a single inner-city urban tertiary-care medical center was undertaken, including consecutive non-instability shoulder arthroscopy procedures from January 2016 through March 2024. Patient demographics and surgical data, including age at booking, marital status, diagnosed depression and/or anxiety, insurance type, distance from home to clinic, socioeconomic status, and history of ipsilateral and contralateral shoulder surgery, were tabulated. Cases were categorized as noncancelled, cancelled rescheduled, and cancelled not rescheduled. The time between booking and cancellation, in addition to the specific reason for cancellation, was documented.</p><p><strong>Results: </strong>A total of 756 consecutive cases were reviewed, of which 210 (27.8%) were cancelled before the planned surgical date. The cohort consisted of 399 women (52.8%) with a median age at booking of 56 years (IQR 51, 62). Of the cancellations, 90 (42.8%) rescheduled and underwent arthroscopy after a median of 111 days (IQR 23, 134). A history of ipsilateral cancellation (odds ratio [OR] 14.80, 95% confidence interval [CI] 4.88-44.89, P < .001), missing an outpatient visit before surgery (OR 1.57, 95% CI 1.10-2.24, P = .013), and having an ED visit within 12 months before the planned surgery (OR 1.50, 95% CI 1.05-2.14, P = .025) were significantly associated with cancellation. An ED visit within 12 months before planned surgery (OR 2.42, 95% CI 1.27-4.63, P = .008) was associated with a higher risk of not rescheduling after cancellation, whereas Workers' Compensation status trended toward a lower risk of not rescheduling (OR 0.28, 95% CI 0.08-1.06, P = .06).</p><p><strong>Discussion: </strong>Identification of the independent factors associated with cancellation of shoulder arthroscopy may help direct finite health care resources toward intervening among those patients with a high likelihood of rescheduling.</p><p><strong>Level of evidence: </strong>Level III (Prognostic).</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"121-128"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003051","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":"Is psoas muscle index an effective predictor of outcomes following robotic total hip arthroplasty?","authors":"Olivia Schaffer, Braden V Saba, Bryce A Saba, Anna Cohen-Rosenblum, Ran Schwarzkopf, Diren Arsoy","doi":"10.1097/bh9.0000000000000056","DOIUrl":"10.1097/bh9.0000000000000056","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia, the loss of muscle mass and function, is closely linked to poor health and has been associated with inferior outcomes in total hip arthroplasty (THA). Psoas Muscle Index (PMI) is a radiographic metric inversely correlated with sarcopenia. It was hypothesized that low PMI patients would have worse outcomes following THA.</p><p><strong>Methods: </strong>A retrospective review of 515 patients who underwent robotic primary THA between 2014 and 2022 at a single, urban, academic health system with 2-year follow-up data was performed. Psoas Muscle Index was calculated from preoperative computed tomography imaging of the pelvis. Patient baseline demographics, laboratory values, perioperative data, and outcomes were collected from chart review.</p><p><strong>Results: </strong>Low PMI occurred in 56 (10.8%) of 515 patients. There were no differences in readmissions or reoperations ( P = 0.51; P = 0.58). Low PMI was associated with higher HOOS, JR score at 2 weeks and greater improvement from baseline ( P = 0.034; P = 0.037), as well as lower Patient-Reported Outcomes Measurement Information System Pain Intensity at 3 months and greater reductions from baseline ( P = 0.038; P = 0.013).</p><p><strong>Conclusion: </strong>Psoas Muscle Index did not reliably predict surgical outcomes following THA, and low PMI was associated with better patient-reported outcome measures after surgery. Further investigation into other means of diagnosing sarcopenia may be warranted.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"135-140"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450858","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":"Cytokine panels in the treatment and diagnosis of rheumatic diseases: current practices and future promise.","authors":"Elliot A Philips, Sara Stream, Michael H Pillinger, Jonathan Samuels","doi":"10.1097/bh9.0000000000000060","DOIUrl":"10.1097/bh9.0000000000000060","url":null,"abstract":"<p><strong>Abstract: </strong>Cytokine panels measure plasma levels of a set of soluble cell-effector biomarkers and are designed to provide a snapshot of the inflammatory milieu present in a patient at the time of sampling. During the uncertainty of the COVID-19 pandemic, patients demonstrated an inflammatory response with unequivocal marked cytokine storm. Thus, physicians and investigators ordered a superfluity of cytokine panels to gain mechanistic understanding of the pathology driven by the deadly viral infection. Although cases of COVID-19 have since waned, physicians continue to send cytokine panels with evolving evidence-based indications to evaluate other inflammatory syndromes. Cytokine panels hold diagnostic utility and promise, but more research is needed to determine the extent to which these panels can be used and the clinical contexts in which they can improve diagnostic and management capabilities.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"117-120"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984366","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":"Cephalomedullary nail fixation of subtrochanteric femur fractures in older adults: Is 1 distal locking screw enough?","authors":"Manasa L Kadiyala, Lauren A Merrell, Abhishek Ganta, Sanjit R Konda, Steven M Rivero, Kenneth A Egol","doi":"10.1097/bh9.0000000000000058","DOIUrl":"10.1097/bh9.0000000000000058","url":null,"abstract":"<p><strong>Background: </strong>Subtrochanteric (ST) fractures are proximal femur fractures with strong deforming muscular forces, which complicate anatomical reduction and treatment. These fractures are fixed with intramedullary nails with 2 distal locking screws, although the need for both screws has never been researched.</p><p><strong>Purpose: </strong>This study's purpose was to investigate the use of 1 versus 2 distal locking screws on clinical and radiographic outcomes and complications.</p><p><strong>Study design/level of evidence: </strong>Retrospective cohort, Level of Evidence III.</p><p><strong>Methods: </strong>An IRB-approved retrospective review of a consecutive series of ST femoral fractures was performed. Each patient's medical record was reviewed for demographics, injury and treatment information, perioperative details, radiographic parameters, hospital quality measures, and outcomes. Patients were divided into 2 cohorts: 1 distal locking screw (1-screw cohort) and 2 distal locking screws (2-screw cohort). Distal screw number (1 vs. 2 screws) was chosen by surgeon preference. Comparative and multivariable analyses were conducted.</p><p><strong>Results: </strong>Two hundred thirty-two patients met inclusion criteria with a mean age of 71.18 ± 19.05 years and average follow-up of 11 months. All fractures were treated with a long antegrade, reamed cephalomedullary nail. Fifty (21.6%) patients were fixed with one 5 mm distal locking screw, and 182 (78.4%) patients had 2 screws. Patients with 1 screw had a shorter operative time in minutes (156.64 ± 47.06 vs. 176.06 ± 41.32, P = .005), but there were no further perioperative differences. Patients treated with 1 screw were more frequently associated with being fixed in a valgus coronal alignment (20% 1 distal screw vs. 5% 2 distal screws, P = .003) and had higher degree of apex anterior angulation (19.7° ± 8.2° 1-screw vs. 10.6° ± 6.3° 2-screw, P = .011). However, this did not significantly affect healing outcomes because both cohorts experienced similar rates of fracture healing, medical and mechanical complications, mortality, and readmission (all P > .050).</p><p><strong>Conclusion: </strong>Clinically, a single distal locking bolt is sufficient for ST femur fractures fixed with a cephalomedullary nail. A second distal locking screw may be reserved for situations in which the first screw may not have achieved adequate fixation.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"129-134"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076842","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":"Diagnostic yield and outcomes of hand surgery referrals to rheumatology.","authors":"Ryan Seltzer, Sam Kavarana, Naadir Jamal, Logan Locascio, Reagan Mead, Kevin Byram, Jed Maslow","doi":"10.1097/bh9.0000000000000057","DOIUrl":"10.1097/bh9.0000000000000057","url":null,"abstract":"<p><strong>Background: </strong>Hand and upper extremity complaints frequently prompt evaluation for systemic inflammatory conditions, leading surgeons to refer patients to rheumatology. However, referral patterns are highly variable and not standardized, and access to rheumatologic care is often limited by prolonged wait times and workforce constraints. Existing literature on rheumatology referrals has largely focused on access and disease-specific pathways, with little attention to referral patterns within surgical subspecialties. Concordance between referral indication and confirmed rheumatologic diagnosis is reported to be low, underscoring the need to better define which referral triggers demonstrate true diagnostic yield.</p><p><strong>Purpose: </strong>To quantify and characterize referrals from hand surgery to rheumatology and identify predictors of diagnostic yield.</p><p><strong>Study design/level of evidence: </strong>Retrospective cohort/3.</p><p><strong>Methods: </strong>We analyzed 183 hand surgery referrals to rheumatology (2018-2024) in this retrospective cohort study. Referral reasons were classified as laboratory-based, history-based, examination-based, or imaging-based. Outcomes were categorized as \"low-yield\" (Group 1: no rheumatologic diagnosis), \"intermediate-yield\" (Group 2: diagnosed without need for therapy or follow-up), and \"high-yield\" (Group 3: diagnosed, requiring systemic therapy or specialty follow-up). Descriptive statistics and multivariable logistic regression (high-yield vs low-yield) were performed.</p><p><strong>Results: </strong>Sixty-six percent of referrals were evaluated. Laboratory abnormalities were the most common referral reason (40%), followed by history (27%), examination findings (24%), and imaging (9%). Thirty-five percent (95% confidence interval [CI], 26.4%-44.0%) of referrals were high-yield, while 49% (95% CI, 39.6%-58.0%) were low-yield and 17% (95% CI, 10.6%-24.6%) were intermediate-yield. Across major referral indications (antinuclear antibodies, synovitis, and polyarthralgia), low-yield outcomes exceeded high-yield outcomes. Imaging-based referrals were significantly more likely to be high yield than laboratory-based referrals (adjusted OR 6.1, 95% CI, 1.5-31.5, P = .016). Examination-based and history-based referrals were not associated with increased diagnostic yield, and age and sex were not independent predictors.</p><p><strong>Conclusions: </strong>One-third of referrals produced a high-yield rheumatologic diagnosis, whereas half resulted in no rheumatologic diagnosis. Laboratory-based and history-based referrals were common but low-yield, whereas those supported by radiographic findings were significantly more likely to be high-yield. Prioritizing referrals with objective clinical or imaging findings may improve diagnostic efficiency in the hand surgery population.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"141-146"},"PeriodicalIF":0.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13626576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076800","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":"Complications of osteotomies around the knee.","authors":"Charles C Lin, Daniel Kaplan, Alexander Golant, Eric Strauss, Michael Alaia, Laith Jazrawi","doi":"10.1097/bh9.0000000000000046","DOIUrl":"10.1097/bh9.0000000000000046","url":null,"abstract":"<p><strong>Abstract: </strong>Osteotomies around the knee-including distal femoral osteotomies, high tibial osteotomies, and tibial tubercle osteotomies-are technically demanding procedures that are generally safe, with relatively low overall complication rates. However, complications do occur and can pose significant challenges, with substantial implications for patient outcomes. Awareness of potential complications and meticulous surgical technique are, therefore, essential to minimizing risk. This review highlights the most clinically relevant complications unique to knee osteotomies. These include vascular injury, hinge and shingle fractures, delayed union or nonunion, femur and tibia fractures, and infection. For each complication, contributing patient and surgical factors are examined, along with an emphasis on strategies for prevention and proposed treatment management algorithms. By combining preventive strategies with structured management guidance, this review aims to serve as a practical reference for optimizing outcomes and reducing the morbidity associated with knee osteotomies.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"79-89"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790493","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":"Introduction to the \"Chief Resident Grand Rounds\" edition of the Bulletin of the Hospital for Joint Diseases.","authors":"Alexander J Egol, Benjamin Schaffler","doi":"10.1097/bh9.0000000000000053","DOIUrl":"10.1097/bh9.0000000000000053","url":null,"abstract":"","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"27"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950394","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":"Rotator cuff disease, repair and augmentation.","authors":"Andrew Isaac Brash, Laith Jazrawi","doi":"10.1097/bh9.0000000000000045","DOIUrl":"10.1097/bh9.0000000000000045","url":null,"abstract":"<p><strong>Abstract: </strong>Rotator cuff disease (RCD) is the leading cause of shoulder disability, characterized by progressive degeneration of tendon structure and function. Despite advances in surgical techniques that optimize repair biomechanics, biological healing remains a major challenge, leading to high rates of repair failure. Augmentation strategies, including biologic adjuvants, grafts, and bioinductive implants, aim to improve the healing environment and reduce re-tear rates. Although augmentation reliably reduces structural failure, its clinical benefits remain under investigation. Continued advancements in biologic therapies, graft technologies, and long-term clinical studies are needed to optimize outcomes and define best practices for augmentation in rotator cuff repair. This review summarizes the current understanding of RCD pathophysiology, natural history, treatment strategies, surgical repair techniques, healing mechanisms, and the role of augmentation.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"37-42"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965806","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":"The anterior compartment in modern knee arthroplasty.","authors":"Joseph X Robin, Ajit Deshmukh, Morteza Meftah, Vinay K Aggarwal, Ran Schwarzkopf, Joshua C Rozell","doi":"10.1097/bh9.0000000000000051","DOIUrl":"10.1097/bh9.0000000000000051","url":null,"abstract":"<p><strong>Abstract: </strong>While there have been great advancements in total knee arthroplasty (TKA) over the past 50 years, anterior knee pain (AKP) remains the most common concern among patients postoperatively. Despite exhausting evidence supporting no clinical difference in AKP with resurfaced vs. unresurfaced patellae in TKA, 87% of TKAs are resurfaced in the United States, compared with 2% in other countries. These large practice variations underscore a lack of consensus regarding the role of the patella and the approach to the anterior compartment of the knee in TKA. The aim of this review was to go beyond patellar resurfacing and describe the effects that surgical technique and implant design may have on AKP in current TKA.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":" ","pages":"90-95"},"PeriodicalIF":0.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044947","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}