Journal of the West African College of Surgeons最新文献

{"title":"\"Weighing it Down\": Technique to Reduce the Weight of an Obturator.","authors":"Aditi Nanda, Harsimran Kaur, Dheeraj Koli","doi":"10.4103/jwas.jwas_155_23","DOIUrl":"10.4103/jwas.jwas_155_23","url":null,"abstract":"<p><strong>Objective: </strong>The objective during the obturator fabrication (interim or definitive) should be to reduce the weight of the obturator prosthesis. This is because the increased weight of the maxillary obturator is detrimental to the success of the prosthesis due to decreased retention (pulled by gravity), constant rubbing of prosthesis on mucosa and increased patient discomfort.</p><p><strong>Design and interventions: </strong>Of the many simple baby-steps to ensure enhanced retention of the prosthesis, a simple method to reduce the weight has been described using the subtractive technique of obturator fabrication.</p><p><strong>Results: </strong>Reduced weight of the obturator prosthesis which makes the prosthesis more acceptable to the patient and more successful overall.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302716","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":"Popliteal Pterygium Syndrome with a Family History of Van der Woude Syndrome: A Case Report.","authors":"Jiten Kumar Mishra, Shamendra Anand Sahu, Aparajita Saha, Abi Sindhuja, Jalaz Joezer Rahmi, Abhijith Valsalan","doi":"10.4103/jwas.jwas_173_23","DOIUrl":"10.4103/jwas.jwas_173_23","url":null,"abstract":"<p><p>Popliteal pterygium syndrome (PPS) is a rare inherited disorder involving the face, limbs, and genitalia. The most prominent and handicapping deformity associated with this syndrome is Popliteal pterygium. Popliteal pterygium is a contracture band that extends from ischial tuberosity to calcaneum. It is a dense fibrous band difficult to correct surgically. We report a case of PPS with her two other family members diagnosed with Van der Woude syndrome. Single-stage surgical release is ineffective due to shortened neurovascular and surrounding soft tissues. Multimodality treatment with surgical release and motivated parents may help these children to rehabilitate.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302730","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":"Neuroschistosomiasis: A Case Report and Review of Literature.","authors":"Kwadwo Poku Yankey, Ronald Awoonor-William, Derrick Nyantakyi Owusu, Arthur Sackeyfio, Veneranda Nyarko, Liudmila Gross-Fenandez, Francis Addai, Irene Wulff, Oheneba Boachie-Adjei","doi":"10.4103/jwas.jwas_174_23","DOIUrl":"10.4103/jwas.jwas_174_23","url":null,"abstract":"<p><p>Spinal cord involvement is a rare complication of the schistosomiasis manifesting as myeloradiculopathy, medullary or conus-cauda equina syndrome which can lead to potentially serious long-term disability. Computed tomography and magnetic resonance imaging coupled with biochemical parameters have become the mainstay of diagnosis. Biopsy which is the gold standard of diagnosis demonstrating the organism is usually reserved for cases of diagnostic challenge. We report a rare case of upper thoracic spinal cord schistosomiasis diagnosed by biopsy in an 18-year-old male migrant presenting to a spine and orthopaedic centre in Ghana with complaints of upper back pain and associated myeloradiculopathy symptoms. Initial suspicion of intramedullary cord tumour was made based on magnetic resonance imaging findings warranting biopsy which revealed <i>schistosoma</i> spp. He was treated with anthelminthics and corticosteroids with a resolution of symptoms.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302727","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":"Metachronous Tumours in the Head and Neck in a Retroviral Disease Positive Patient: A Case Report and Review of Literature.","authors":"Nurudeen Adebola Shofoluwe, Halima Oziohu Aliyu, Balarabe Kabir, Ibrahim Babatunde Mohammed, Manir Anka Hamza, Amina Mohammed Abdullahi, Saadat Titilayo Yahaya","doi":"10.4103/jwas.jwas_141_23","DOIUrl":"10.4103/jwas.jwas_141_23","url":null,"abstract":"<p><p>Patients diagnosed with head and neck squamous cell carcinoma (HNSCC), particularly those seropositive for human immunodeficiency virus (HIV), face a heightened risk of second primary malignancies (SPMs), with common regions being the head, neck, lung, and oesophagus. This risk amplifies the severity of their clinical condition, as these SPMs contribute significantly to the mortality rates in patients with HNSCC. We detail a case of a young woman, seropositive for HIV, who developed a second squamous cancer in the nasopharynx after achieving remission from her initial oropharyngeal squamous cell carcinoma through chemo-radiotherapy. This case study highlights the increased vulnerability of HIV-positive HNSCC patients to SPMs, with an observed association of HIV infection leading to a lower overall survival rate. As a result, we recommend long-term follow-up in HNSCC patients with HIV for early detection of SPMs. Our findings emphasize the importance of regular screening for HNSCC, particularly in people living with HIV, to ensure timely detection and treatment, which can significantly improve their prognosis.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302726","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 Close Supervision by a Senior Surgeon Necessary During the Initial Days of Performing Endoscopic Lumbar Discectomy? A Retrospective Comparative Study between Two Fellowship Trained Surgeons to Assess the Learning Curve.","authors":"Syed Ifthekar, Shih-Min Lee, Sang-Ho Lee, Sang-Ha Shin, Junseok Bae","doi":"10.4103/jwas.jwas_170_23","DOIUrl":"10.4103/jwas.jwas_170_23","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic lumbar discectomy is a minimally invasive technique with a steep learning curve. The studies in the literature base the learning curve on the operative duration. We conducted this study to determine the learning curve based on the presence or absence of supervision by an experienced surgeon.</p><p><strong>Materials and methods: </strong>This study involved two spine surgeons (surgeon A and surgeon B), who after their fellowship training from the same institute started practising in two different hospitals with different settings. The data of the first 80 patients operated by these two surgeons were extracted, and the patients were followed up for a minimum of 1 year. The data were split into first 30 cases and late 50 cases, which were compared to see the difference between the two surgeons.</p><p><strong>Results: </strong>The first 30 cases were evaluated between the two surgeons, and the most significant difference between the two was the operative duration. There was difference between the two surgeons in approach towards migrated and foraminal/extra foraminal discs (<i>P</i> = 0.02). The surgeon B started operating on upper lumbar levels in his later 50 cases, but the foraminal and extraforaminal disc herniations were rarely treated by surgeon B.</p><p><strong>Conclusions: </strong>Endoscopic discectomy when supervised by senior faculty helps to reduce the operative duration especially in the initial phases of a surgeon's career. The surgeon under the supervision of a senior faculty performs more of migrated and foraminal herniated discs.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302723","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":"Open Versus Laparoscopic Appendectomy: A Comparison of Outcome in a Teaching Hospital, Northeast Nigeria.","authors":"Emmanuel Louis Mba, Mohammed Ibrahim Guduf, Nuhu Musa Mshelia, Usman Deba Babayo, Michael Ayedima Misauno, Felix Markus Wina","doi":"10.4103/jwas.jwas_165_23","DOIUrl":"10.4103/jwas.jwas_165_23","url":null,"abstract":"<p><strong>Background: </strong>Appendectomy could be open or laparoscopic. Laparoscopic appendectomy (LA) is gradually gaining ground in Nigeria, but its outcome is not entirely known.</p><p><strong>Objective: </strong>This study compared the outcomes of LA with those of open appendectomy (OA) in terms of the surgical site infection rate, post-operative pain, time to return of bowel sounds, length of hospital stay, return to normal activities and direct cost of treatment.</p><p><strong>Patients and methods: </strong>This was a prospective randomised study. All patients above 18 years who were diagnosed with acute appendicitis in Federal Teaching Hospital, Gombe, were recruited after adequate counselling and consent obtained over the 18 months of the study.</p><p><strong>Results: </strong>Forty (40) patients were recruited with 20 on each arm. The average age was 25 years (±) 6 years and M:F was 1:1.9. The rates of surgical site infection and post-operative pain between both methods were not statistically different, while the time to return of bowel sound, the length of hospital stay and the return to normal activity were significantly reduced in LA compared to OA. However, OA was cheaper in terms of direct cost compared to LA.</p><p><strong>Conclusion: </strong>This study showed that LA may be the preferred method when a quicker recovery from treatment is anticipated, provided the patient can afford the direct cost of the procedure.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302729","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":"Normal Development of Tibiofemoral Angle in Healthy South-Eastern Nigerian Children: A Clinical Study on 3147 Children.","authors":"Henry Nnyagu, Henry Obinna Obiegbu, Udo Anyaehie, Ikeabbah Emeka Henry","doi":"10.4103/jwas.jwas_172_23","DOIUrl":"10.4103/jwas.jwas_172_23","url":null,"abstract":"<p><strong>Background: </strong>Angular deformities of the lower extremities are common in children and are a frequent reason for orthopaedic referral. These deformities, which are usually encountered when children start to walk are typically measured using the tibiofemoral angle (TFA), which represents the angle formed by the intersection of the anatomical axis of the femur with the anatomical axis of the tibia.</p><p><strong>Objectives: </strong>This study aimed to determine the TFA in healthy South-Eastern Nigerian children, and to determine the effect of gender and age on this angle.</p><p><strong>Materials and methods: </strong>This cross-sectional study was done in Enugu metropolis with 3147 school children and adolescents aged 3-17 years.</p><p><strong>Results: </strong>It was found that the majority of the subjects (97.6%) had valgus TFA. The maximum knee valgus angle from the study was 6.8° ± 0.80° at 4 years. Thereafter, the knee valgus angle declined to a mean of 2° at 17 years.</p><p><strong>Conclusion: </strong>There were physiological changes in TFAs noted, which vary with regards to both age and gender of the subject.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302728","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":"Assessment of the Effects of the COVID-19 Pandemic on Orthopaedic Surgery Training Among Orthopaedic Residents in Southern Nigeria.","authors":"Kelechi Uzodinma Imediegwu, Ekenedilichukwu C Ilo, Chinonso Justin Dimson, Kosisochukwu C Okeke, Somadila T Agulanna, Uchechukwu D Ugwuanyi, Tobi O Omoleye, Ozioma P Igwe, Paschaline C Onwuka, Thomas Uku, Chiamaka Adanna Onwuasoigwe","doi":"10.4103/jwas.jwas_125_23","DOIUrl":"10.4103/jwas.jwas_125_23","url":null,"abstract":"<p><strong>Background: </strong>Surgical training is hands-on, with residents requiring optimal exposure to patients for optimal training and adequate experience. Thus, despite the increased usage of virtual, non-physical resources for medical education during the pandemic, orthopaedic surgical training still suffered adversely.</p><p><strong>Objectives: </strong>To explore the overall impact of the COVID-19 pandemic on Orthopaedic surgery training, teaching and practice amongst residents in southern Nigeria.</p><p><strong>Materials and methods: </strong>This was a cross-sectional prospective study involving 54 senior orthopaedic surgery residents in southern Nigeria. Data were collected using a semi-structured online-based questionnaire created on the Google Forms and sent via online platforms (e.g., WhatsApp and Telegram). Descriptive and inferential analysis was done using Statistical Package for Social Sciences (SPSS). Consent was also obtained from all respondents.</p><p><strong>Results: </strong>A total of 54 orthopaedic surgery residents responded to our questionnaire. About 71.7% of the residents surveyed reported reduced exposure to surgical cases in general, and 70.3% reported reduced operative teaching exposure. About 68.5% of the respondents reported reduced opportunities for surgical skills acquisition training. More than half of respondents (63%) reported no changes in morbidity/mortality of orthopaedic cases witnessed and performed. The majority of the respondents agreed to a slight decrease in the availability of implants and courses (40.7%) whereas 44.4% affirmed an increase in the cost of training. Overall, 70.4% believed that the impact of COVID-19 on orthopaedic surgical training has been slightly negative. The average rating for experience on alternative learning methods - virtual video conferences, pre-recorded lectures, in-person small group meetings and surgical simulation activities was 2.26 on a scale of 1-4 (decreasing order of satisfaction).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic caused significant changes in orthopaedic surgery training, with low cases exposure and reduction in operative teaching being the most significant changes and the resultant increase in alternative forms of training and skill acquisition.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302719","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":"Computed Tomographic Scan for Head Injury Patients: Any Justification for Adapting Routine Cranio-Cervical Examination Irrespective of Clinical Severity?","authors":"Isa Hassan Muhammad, Mohammed Kabir Saleh, Mansur Yahuza Adamu, Anas Ismail","doi":"10.4103/jwas.jwas_81_23","DOIUrl":"10.4103/jwas.jwas_81_23","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to assess the prevalence of concomitant cervical spine and head injury at our University Teaching Hospital in Nigeria and attempted to justify examining patients' head and cervical spine using computed tomography (CT) scan at presentation irrespective of the head injury severity by clinical assessment using Glasgow Coma Scale (GCS).</p><p><strong>Patients and methods: </strong>All eligible patients, 1-80 years of age who presented with head injuries in the accident and emergency (A&E) unit during the study period, were included if they satisfied the inclusion criteria. Post-resuscitation GCS was assessed clinically, and head and cervical spine injury (CSI) were observed radiologically on cranio-cervical CT scan for all patients. The presence of cervical spine fractures, subluxation or dislocation was considered a confirmation of CSI.</p><p><strong>Results: </strong>There were 143 patients with head injuries studied; 90.2% of them were males. The mean age of the patients was 28.87 ± 15.93 years. The most common cause of injury was road traffic accidents in 110 (76.90%). The prevalence of CSI was 11.2%. Majority of the patients with CSI in this study (56.25%) had a mild head injury, 25% had a moderate head injury, and 18.75% had a severe head injury. The lower cervical spine was the most frequently injured segment in this study, involving 10 patients. Multi-level cervical vertebral body fractures of C3 to C6 were the most common form of CSI in this segment.</p><p><strong>Conclusion: </strong>The prevalence of concomitant cervical spine and head injury was significant in this study. This was confirmed among study subjects with a clinical diagnosis of mild-to-moderate head injury as compared with moderate-to-severe head injury. Therefore, all patients who sustained a head injury irrespective of severity are required to have a complete and rapid evaluation of the cervical spine.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302720","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 Impact of De-Roofing of Lateral Calcaneal wall in Open Reduction and Internal Fixation of Intra-Articular Fractures: Clinico-Radiological Outcomes of a Novel Technique and Review of Literature.","authors":"Mohit Bansal, Nirottam Singh, Amit Singh, Gaurav Siwach, Mukesh Kumar Saini, Kishore Raichandani","doi":"10.4103/jwas.jwas_161_23","DOIUrl":"10.4103/jwas.jwas_161_23","url":null,"abstract":"<p><strong>Background: </strong>Most displaced intra-articular calcaneus fractures need to be treated surgically but postoperative soft tissue complications limit to achieve of optimal functional outcomes. Certain mini-invasive techniques lead to better soft tissue healing but anatomical reduction gets compromised.</p><p><strong>Objectives: </strong>We aim to evaluate the results of lateral wall de-roofing of the calcaneum to achieve good anatomical reduction as well as to minimise soft tissue complications in the internal fixation of calcaneal fractures.</p><p><strong>Materials and methods: </strong>Thirty-two patients (40 ft) with displaced intra-articular calcaneus fractures (10 were of Sanders type II, 16 were of type III, and 14 were of type IV) were treated between January 2018 and September 2021. All patients were managed surgically with open reduction and internal fixation using lateral extensile approach combined with de-roofing of the lateral wall. All patients were followed up for ≥1 year using functional parameters American Orthopaedic Foot and Ankle Score (AOFAS), visual analogue scale (VAS) and radiological parameters (Bohler angle, Gissane angle, height of the calcaneus, width of the calcaneus and pitch of calcaneus).</p><p><strong>Results: </strong>Out of 32 patients, one patient lost to follow-up. At 1 year follow-up, mean AOFAS hindfoot score was 86.2 ± 5 (Sanders type II: 91.2, Sanders type III: 87.6, and Sanders type III: 81.4), mean VAS score was 91.3 ± 2.1, mean Bohler angle (°) was 27.2 ± 4.7, mean Gissane angle (°) was 136.4 ± 5.2, mean calcaneus height was 46.2 ± 2.1 mm and mean calcaneus width was 45.1 ± 3.2 mm. Patients with decreased Bohler angle between postoperative images and follow-up had lower AOFAS hindfoot scores. Complications included persistent swelling (64.10%), stiffness (33.33%), superficial infections (5.12%), and wound dehiscence (10.25%).</p><p><strong>Conclusion: </strong>Lateral wall de-roofing is a useful technique which allows the lateral wall to get flattened reducing soft tissue complications and providing bone graft as well. This approach also adequately exposes fracture fragments, subtalar and calcaneocuboid joints for good anatomical reduction. Hence, it can act as a useful adjunct in the internal fixation of intra-articular calcaneus fractures.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":73993,"journal":{"name":"Journal of the West African College of Surgeons","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302734","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}