Frontiers in pain research (Lausanne, Switzerland)最新文献

{"title":"Editorial: Insight in non-pharmacological treatment of pain-2023.","authors":"Geoffrey Dover","doi":"10.3389/fpain.2024.1512987","DOIUrl":"10.3389/fpain.2024.1512987","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1512987"},"PeriodicalIF":2.5,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142857102","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":"Non-oral pharmacological interventions in the management of herpes zoster-related pain: a review of current research.","authors":"Yaojun Wang, Yanxia Shen, Haixue Guo, Dongcai You, Shimin Jia, Ge Song, Xiaobing You","doi":"10.3389/fpain.2024.1485113","DOIUrl":"10.3389/fpain.2024.1485113","url":null,"abstract":"<p><p>Herpes zoster-associated pain is a difficult-to-treat pathologic pain that seriously affects patients' quality of life. In recent years, emerging therapeutic techniques such as autologous platelet-rich plasma, sympathetic nerve block and pulsed radiofrequency have been gradually applied in the field of pain with the advantages of less trauma, quicker recovery and significant efficacy. These therapeutic options have become a new hope for the treatment of herpes zoster-associated pain. This article reviews the studies on herpes zoster-associated pain in non-oral drug therapy, summarizes the efficacy, safety, and possible mechanisms, and provides a reference basis for clinical treatment.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1485113"},"PeriodicalIF":2.5,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815110","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":"Paclitaxel triggers molecular and cellular changes in the choroid plexus.","authors":"Alemeh Zamani, Parisa EmamiAref, Lucie Kubíčková, Klaudia Hašanová, Ondřej Šandor, Petr Dubový, Marek Joukal","doi":"10.3389/fpain.2024.1488369","DOIUrl":"10.3389/fpain.2024.1488369","url":null,"abstract":"<p><p>Paclitaxel is a widely used chemotherapeutic agent for treating various solid tumors. However, resulting neuropathic pain, often a lifelong side effect of paclitaxel, can limit dosing and compromise optimal treatment. The choroid plexus, located in the brain ventricles, spreads peripheral inflammatory reactions into the brain. Our study is the first to analyze the effects of paclitaxel on inflammatory alterations in the choroid plexus. We hypothesized that the choroid plexus could respond <i>directly</i> to paclitaxel and simultaneously be <i>indirectly</i> altered via circulating damage-associated molecular patterns (DAMPs) produced by paclitaxel application. Using immunohistochemical and Western blot analysis, we examined the levels of toll-like receptor 9 (TLR9) and formyl peptide receptor 2 (FPR2), along with the pro-inflammatory cytokines interleukin 6 (IL6) and tumor necrosis factor α (TNFα) in choroid plexus epithelial cells of male Wistar rats following paclitaxel treatment. Moreover, we utilized an <i>in vitro</i> model of choroid plexus epithelial cells, the Z310 cells, to investigate the changes in these cells in response to paclitaxel and DAMPs (CpG ODN). Our results demonstrate that paclitaxel increases TLR9 and FPR2 levels in the choroid plexus while inducing IL6 and TNFα upregulation in both acute and chronic manners. <i>In vitro</i> experiments further revealed that paclitaxel <i>directly</i> interacts with epithelial cells of the choroid plexus, leading to increased levels of TLR9, FPR2, IL6, and TNFα. Additionally, treatment of cells with CpG ODN, an agonist of TLR9, elicited upregulation of IL6 and TNFα. Our findings determined that paclitaxel influences the choroid plexus through both <i>direct</i> and <i>indirect</i> mechanisms, resulting in inflammatory profile alterations. Given the pivotal role of the choroid plexus in brain homeostasis, a compromised choroid plexus following chemotherapy may facilitate the spread of peripheral inflammation into the brain, consequently exacerbating the development of neuropathic pain.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1488369"},"PeriodicalIF":2.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803616","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 involvement of the dysfunctional insulin receptor signaling system in long COVID patients with diabetes and chronic pain and its implications for the clinical management using taVNS.","authors":"Riwang Li, Wenguo Liu, Dahai Liu, Xu Jin, Shuxing Wang","doi":"10.3389/fpain.2024.1486851","DOIUrl":"10.3389/fpain.2024.1486851","url":null,"abstract":"<p><p>In clinical terms, chronic pain is the most prevalent sequela resulting from COVID-19, which is induced by the novel coronavirus (SARS-CoV-2), while type 2 diabetes mellitus (T2D) is the most common comorbidity. This triangular relationship can be attributed to the dysfunction of the insulin receptor signaling system (IRSS) in both central and peripheral systems. Patients with T2D are essentially more susceptible to SARS-CoV-2 infection due to the widespread expression of angiotensin converting enzyme 2 (ACE2) in their pancreatic beta cells, which serves as the cellular port for the SARS-CoV-2 to infect and enter the cell. This infection can exacerbate chronic pain and insulin resistance for various reasons. Peripherally, once infected, the virus can cause damage to peripheral nerves and pancreatic β-cells, further exacerbating pain and glucose metabolism conditions. Additionally, in the central nervous system, dysfunctional IRSS is closely linked to chronic pain. Over the past few years of the COVID-19 pandemic, an increasing body of evidence suggests that insulin and other medications currently used in clinical practice for hyperglycemia control may not be safe for treating these patients. Therefore, we need a proper approach for the treatment of chronic pain in long COVID patients, especially patients with T2D. This review presents evidence that transcutaneous auricular vagal nerve stimulation (taVNS) may provide a viable treatment option for chronic pain and metabolic dysfunction by improving the function of IRSS in both the central nervous system and peripheral tissues.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1486851"},"PeriodicalIF":2.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803692","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":"Cannabis combined with oxycodone for pain relief in fibromyalgia pain: a randomized clinical self-titration trial with focus on adverse events.","authors":"Cornelis Jan van Dam, Cornelis Kramers, Arnt Schellekens, Marcel Bouvy, Eveline van Dorp, Mikael A Kowal, Erik Olofsen, Albert Dahan, Marieke Niesters, Monique van Velzen","doi":"10.3389/fpain.2024.1497111","DOIUrl":"10.3389/fpain.2024.1497111","url":null,"abstract":"<p><strong>Objectives: </strong>We determined whether adding cannabis to oxycodone for chronic non-cancer pain management could reduce treatment-related adverse effects (AEs) while maintaining effective analgesia.</p><p><strong>Methods: </strong>In this open-label study, fibromyalgia patients aged ≥18 years were randomized to receive 5 mg oxycodone tablets (max. four times/day), 150 mg of inhaled cannabis containing 6.3% Δ⁹-tetrahydrocannabinol and 8% cannabidiol (max. times inhalation sessions/day), or a combination of both for 6 weeks. The primary endpoint was treatment-related adverse events, assessed using a 10-point composite adverse event (cAE) score; additionally, we recorded daily reported pain relief and daily tablet and cannabis consumption.</p><p><strong>Results: </strong>In total, 23 patients were treated with oxycodone, 29 with cannabis, and 29 with the oxycodone/cannabis combination. Three patients from the oxycodone group (13%) and 18 patients from the cannabis groups (31%, 9 in each group) withdrew from the trial within 2-3 weeks because of the severity of AEs. There were no differences in treatment-related cAE scores among the three groups that completed the study (<i>p</i> = 0.70). The analgesic responder rate showed a ≥1- point reduction in pain in 50% and a ≥2-point reduction in 20% of patients, while 50% of patients experienced no treatment benefit. The combination treatment reduced oxycodone tablet consumption by 35% (<i>p</i> = 0.02), but it did not affect the number of cannabis inhalation sessions.</p><p><strong>Conclusions: </strong>Cannabis combined with oxycodone offered no advantage over either treatment alone, except for a reduction in opioid tablet intake; however, the overall drug load was the highest in the combination group. Moreover, cannabis was poorly tolerated and led to treatment discontinuation in one-third of participants treated with cannabis.</p><p><strong>Clinical trial registration: </strong>The trial was registered at the WHO International Clinical Trials Registry Platform (trialsearch.who.int) on July 26, 2019, identifier NL7902.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1497111"},"PeriodicalIF":2.5,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803613","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":"Arginine supplementation improves lactate dehydrogenase levels in steady-state sickle cell patients: preliminary findings from Kinshasa, the Democratic Republic of Congo.","authors":"Ange C M Ngonde, Philippe N Lukanu, Ange Mubiala, Michel N Aloni","doi":"10.3389/fpain.2024.1391666","DOIUrl":"10.3389/fpain.2024.1391666","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease (SCD) disrupts oxygen transport due to the abnormal shape and rigidity of red blood cells, leading to hemolysis. Hemolysis, a major co-morbidity in SCD, is indicated by elevated levels of lactate dehydrogenase (LDH). Arginine depletion, which is essential for nitric oxide (NO) synthesis, contributes to various complications in SCD. L-arginine supplementation may increase NO levels and reduce oxidative stress. Research on its benefits in SCD, which is prevalent in sub-Saharan Africa, is limited. This study evaluates the effect of arginine supplementation on LDH levels in patients with steady state SCD.</p><p><strong>Methods: </strong>In a retrospective study, we evaluated the effect of arginine supplementation on LDH levels in a cohort of 31 patients. We divided the study into three phases: pre-HU treatment, HU treatment, and combined HU and arginine supplementation.</p><p><strong>Results: </strong>The cohort had a median age of 12 years, ranging from 2 to 43 years. Throughout all three phases of the study, lactate dehydrogenase (LDH) levels were consistently above the established normal ranges, with elevations of 216.7%, 220.3% and 176.6% above the normative values for baseline, Phase 1 (HU) and Phase 2 (HU + Arg), respectively. Specifically, LDH levels were 649.7 ± 364.2 U/L in Baseline Phase, 661.6 ± 367 U/L in Phase 1, and 529.9 ± 346.3 U/L in Phase 2. When comparing these discrete study intervals, it is noteworthy that LDH levels were significantly lower in Phase 2 compared to the previous phases (<i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>Preliminary findings revealed a significant lower LDH levels among sickle cell patients receiving combined arginine supplementation and hydroxyurea (HU). Although these findings are promising, their credibility and applicability require further and more extensive research.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1391666"},"PeriodicalIF":2.5,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803610","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":"Classifying chronic pain using ICD-11 and questionnaires-reported characteristics in Japanese patients with chronic pain.","authors":"Hiroki Igari, Shuichi Aono, Hani M Bu-Omer, Chie Kishimoto, Aya Nakae, Takahiro Ushida","doi":"10.3389/fpain.2024.1430870","DOIUrl":"https://doi.org/10.3389/fpain.2024.1430870","url":null,"abstract":"<p><strong>Introduction: </strong>The new ICD-11 code for chronic pain indicates a direction to divide chronic pain into two categories: chronic secondary pain, which has a clear underlying disease, and chronic primary pain, which is associated with significant emotional distress or functional disability and cannot be explained by another chronic condition. Until now, epidemiological studies have been hampered by the lack of a clear classification, but we believe that this new code system will provide a new perspective on the diagnosis and treatment of chronic pain, and we have begun work on this code system.</p><p><strong>Methods: </strong>We studied 2,360 patients at Aichi Medical University, the largest pain center in Japan, and asked them to answer questionnaires on pain severity (NRS), pain-related functional impairment (PDAS, Locomo25), quality of life (EQ-5D), and psychological state and pain cognition (HADS, PCS, PSEQ, AIS) while their attending physicians were giving diagnoses according to ICD-11 and the results of the study were used to determine the coding of pain severity.</p><p><strong>Results and discussion: </strong>The ratio of primary to chronic secondary pain was almost 50%, and the group of patients with MG30.01 classification, which included fibromyalgia, had the highest severity among chronic primary pain. The MG30.01 classification of patients was also found to experience more severe pain compared to other classifications of chronic primary pain patients. The classification of patients with a major psychiatric component was not always clear, and some patients in the secondary category also had a clear psychiatric component, suggesting the need to develop complementary tools to support pain diagnosis.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1430870"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775219","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 mutually reinforcing dynamics between pain and stress: mechanisms, impacts and management strategies.","authors":"Nour Aboushaar, Natalia Serrano","doi":"10.3389/fpain.2024.1445280","DOIUrl":"https://doi.org/10.3389/fpain.2024.1445280","url":null,"abstract":"<p><p>While distinct, pain and stress share complex biological and psychological mechanisms that-despite their protective functions-can lead to clinically maladaptive changes requiring therapeutic intervention when they recur or persist. Recognized as \"worldwide epidemics\" of modern life, both conditions significantly affect an individual's quality of life, functioning, and well-being; without timely intervention, they can become chronic, leading to substantial economic costs via healthcare expenses, lost wages, and reduced productivity. Evidence suggests that pain and stress not only feed into but exacerbate each other through a \"vicious cycle,\" driven by overlapping physiological, cognitive, and social mechanisms, indicating mutually reinforcing dynamics between pain and stress. In this review, we highlight the importance of recognizing the overlapping mechanisms that promote the persistence of pain and stress: (1) key physiological processes like maladaptive neuroplasticity, neuroendocrine dysfunction, and chronic inflammation; (2) cognitive and behavioral patterns such as fear avoidance, hypervigilance, and catastrophizing; along with (3) social, lifestyle, and environmental influences, such as socioeconomic status, lack of social support, and lifestyle choices. Through a case study, we illustrate the real-world implications of this vicious cycle perpetuating both conditions. We call for a paradigm shift in pain and stress management, advocating for a holistic management strategy encompassing pharmacological, psychological, and lifestyle interventions that address the underlying biopsychosocial factors. By fostering greater awareness among primary care practitioners and healthcare professionals, it is possible to better support individuals in breaking the cycle of pain and stress, thereby enhancing their quality of life and overall well-being.</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1445280"},"PeriodicalIF":2.5,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609167/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775222","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":"Editorial: Mechanisms of orofacial pain.","authors":"Shivani B Ruparel, Armen N Akopian","doi":"10.3389/fpain.2024.1496188","DOIUrl":"https://doi.org/10.3389/fpain.2024.1496188","url":null,"abstract":"","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1496188"},"PeriodicalIF":2.5,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775220","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":"Ultrasound-guided suprascapular nerve block with lidocaine vs. saline combined with physical exercises for the rehabilitation of supraspinatus tendinitis: a randomized double-blind controlled trial.","authors":"Pericles Tey Otani, Roberto Del Valhe Abi Rached, Fabio Marcon Alfieri, Raymundo Soares de Azevedo Neto, Wu Tu Hsing, Linamara Rizzo Battistella, Marta Imamura","doi":"10.3389/fpain.2024.1490320","DOIUrl":"10.3389/fpain.2024.1490320","url":null,"abstract":"<p><strong>Introduction: </strong>Shoulder pain is the third leading cause of musculoskeletal complaints in primary care clinics. Its prevalence varies from 14% to 34%. Among all the structures that can cause shoulder pain, the most vulnerable to injury is the tendon of the supraspinatus muscle. The ideal management protocol is still unknown. To date, little is known in the literature about the use of ultrasound-guided suprascapular nerve block as a treatment for supraspinatus muscle tendinitis. Our objective was to assess the effects of the association of a single ultrasound-guided suprascapular nerve block combined with home-based rotator cuff exercises to reduce pain and improve shoulder functioning in patients with supraspinatus tendinitis.</p><p><strong>Methods: </strong>We evaluated the effect of a single ultrasound-guided suprascapular nerve block on pain and functioning of people with supraspinatus tendinitis. Diagnosis was performed using the positive Jobe test. Due to large disparity between clinical and radiological findings, only clinical diagnostic criteria were used to select patients. This was a double-blind, randomized, controlled, clinical study in which patients in the intervention group (<i>n</i> = 42) received a single injection of 5 ml of 2% lidocaine, while in the control group (<i>n</i> = 41) patients underwent the same procedure receiving saline solution 0.9%. All patients received face to face instructions by an experienced physiotherapist and a leaflet explaining home-based exercises. Pain and functioning were assessed using the Shoulder Pain and Disability Index (SPADI) questionnaire before the procedure, one week and 12 weeks after the procedure.</p><p><strong>Results: </strong>Patients in both groups improved significantly since the initial evaluation until the 12th week. Intervention group SPADI (pre, 1 week, 12 weeks): 75.80 ± 18.96, 56.25 ± 31.37, 46.31 ± 31.41 (<i>p</i> < 0.001); Control group SPADI: 75.49 ± 16.67, 50.51 ± 27.58, 49.37 ± 30.90 (<i>p</i> < 0.001). However, there were no significant differences between groups (<i>p</i> = 0.291).</p><p><strong>Discussion/conclusion: </strong>We concluded that both lidocaine and saline ultrasound-guided suprascapular nerve blocks reduce pain and improve shoulder functioning in patients with supraspinatus tendinitis. Unexpectedly, the same block performed with saline showed similar results and effects.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier [NCT02495818].</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1490320"},"PeriodicalIF":2.5,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735188","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}