Advances in wound care最新文献

{"title":"Biosponge-Encased Placental Stem Cells for Volumetric Muscle Loss Repair.","authors":"David Johnson, Amelia Ridolfo, Ryan Mueller, Megan Chermack, Julia Brockhouse, Jamshid Tadiwala, Avantika Jain, Kenneth Bertram, Koyal Garg","doi":"10.1089/wound.2024.0077","DOIUrl":"10.1089/wound.2024.0077","url":null,"abstract":"<p><p><b>Objective:</b> Volumetric muscle loss (VML) leads to permanent muscle mass and functional impairments. While mesenchymal stromal cells (MSCs) and their secreted factors can aid muscle regeneration, MSCs exhibit limited persistence in injured tissue post-transplantation. Human placental-derived stem cells (hPDSCs), sharing surface markers with MSCs, demonstrate superior regenerative potential due to their fetal origin. Previously, a biosponge (BS) scaffold was shown to augment muscle regeneration post-VML. This study aims to coapply BS therapy and hPDSCs to further enhance muscle recovery following VML. <b>Approach:</b> A VML defect was created by removing ∼20% of the tibialis anterior muscle mass in male Lewis rats. Injured muscles were either left untreated or treated with BS or BS-encapsulated hPDSCs cultured under normoxic or hypoxic conditions. On day 28 postinjury, peak isometric torque was measured, and the muscle was harvested for analysis. <b>Results:</b> BS encapsulated hPDSCs subjected to hypoxic preconditioning persisted in larger quantities and enhanced muscle mass at day 28 postinjury. BS encapsulated hPDSCs cultured under normoxic or hypoxic conditions increased small myofibers (<500 µm²) percentage, MyoD protein expression, and both pro- and anti-inflammatory macrophage marker expression. BS encapsulated hPDSCs also reduced fibrosis and BS remodeling rate. <b>Innovation:</b> This study is the first to examine the therapeutic effects of hPDSCs in a rat VML model. A BS carrier and hypoxic preconditioning were investigated to mitigate low cell survival postimplantation. <b>Conclusion:</b> hPDSCs augment the regenerative effect of BS. Combining hPDSCs and BS emerges as a promising strategy worthy of further investigation.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of ON101 for Hard-to-Heal Diabetic Foot Ulcers in a Randomized Phase III Trial: A <i>Post Hoc</i> Analysis.","authors":"Shun-Cheng Chang, Ching-Wen Lin, Jui-Ching Chen, Yi-Hsin Wu, Shyi-Gen Chen, Yu-Yao Huang, Nai-Chen Cheng, Shawn M Cazzell, Hsin-Han Chen, Kuo-Feng Huang, Kwang-Yi Tung, Hsuan-Li Huang, Cherng-Kang Perng, Bimin Shi, Chang Liu, Yujin Ma, Yemin Cao, Yanbing Li, Yaoming Xue, Fang Gao, Ying Cao, Li Yan, Qiu Li, David G Armstrong, Guang Ning","doi":"10.1089/wound.2023.0167","DOIUrl":"10.1089/wound.2023.0167","url":null,"abstract":"<p><p><b>Objective:</b> Hard-to-heal diabetic foot ulcers (DFUs) are associated with higher mortality rates and an increased medical burden for patients. ON101, a new topical cream, exhibited better healing efficacy than the control dressing in a Phase III trial. In this <i>post hoc</i> analysis, we further identify whether ON101 can improve the healing of ulcers with hard-to-heal risk factors in this cohort of DFU patients. <b>Approach:</b> To compare the efficacy of ON101 with absorbent dressing among various hard-to-heal wounds in patients with DFU, a <i>post hoc</i> analysis of a randomized Phase III trial that included 276 DFU patients was performed by subgrouping those patients based on ulcer depth, location, size, duration, and patients' glycated hemoglobin (HbA1c) levels and body mass index (BMI). <b>Results:</b> In the full analysis set, the proportion of patients achieving healing was 61.7% in the ON101 group and 37.0% in the comparator (<i>p</i> = 0.0001). In subgroup analysis according to risk factors, ON101 demonstrated superior healing capacity on Wagner grade 2 ulcers (<i>p</i> < 0.0001); plantar ulcers (<i>p</i> = 0.0016), ulcer size ≥5 cm² (<i>p</i> = 0.0122), ulcer duration ≥3 months (<i>p</i> = 0.0043); for patients with HbA1c ≥9% (<i>p</i> = 0.0285); and patients with BMI ≥25 (<i>p</i> = 0.0005). <b>Innovation:</b> ON101, a novel therapeutic drug, can modulate the functions of macrophages and demonstrate superior healing rates to conventional absorbent dressing in patients with hard-to-heal DFUs. <b>Conclusions:</b> The results of this <i>post hoc</i> study suggest that ON101 is a better therapeutic option than conventional dressing used in treatment for DFU patients with higher HbA1c, BMI, or ulcers with complex conditions such as longer duration, deeper wounds, larger size, and plantar location.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of D33 Sealed Foam in Preventing Skin Injury from Surgical Positioning: Randomized Clinical Trial.","authors":"Camila de Assunção Peixoto, Maria Beatriz Guimarães Raponi, Márcia Marques Dos Santos Felix, Maíla Fidalgo de Faria, Isadora Braga Calegari, Patrícia da Silva Pires, Maria Helena Barbosa","doi":"10.1089/wound.2023.0100","DOIUrl":"10.1089/wound.2023.0100","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy of density-33 (D33) sealed foam in preventing skin injuries from surgical positioning. <b>Approach:</b> The study, reported according to the Consolidated Standards of Reporting Trials, is characterized as a randomized clinical trial, double mask, with 64 adult patients undergoing elective surgery, 35 allocated to the control group (CG), positioned on a conventional surgical table, and 29 to the experimental group (EG), positioned on a conventional surgical table overlaid with a D33 sealed foam support surface (SS) in the occipital, sacral, and heel regions. Simple randomization was carried out, as was masking of the researcher who evaluated the skin of the patient and the statistician. Data collection was carried out immediately preoperatively, intraoperatively, and postoperatively until the third day or until patient discharge. Statistical analysis included measures of association in contingency tables, <i>χ</i>², and relative risk to compare the incidence of injuries between groups. <b>Results:</b> Skin injuries were greater in the CG, with blanchable erythema being the main injury. The use of D33 sealed foam reduced the incidence of injury in the EG by 61.2% (relative risk: 0.39; 95% confidence interval: 0.220-0.684; <i>p</i> < 0.001). <b>Innovation:</b> One of the first clinical studies to demonstrate that using a D33 sealed foam SS decreased the incidence of blanchable erythema from surgical positioning. <b>Conclusion:</b> D33 sealed foam was effective in preventing skin injury from surgical positioning in patients undergoing elective surgeries.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Sequence Antifibrotic Treatment and Rehabilitation after Volumetric Muscle Loss Injury.","authors":"Peter R Nicholson, Christiana J Raymond-Pope, Thomas J Lillquist, Angela S Bruzina, Jarrod A Call, Sarah M Greising","doi":"10.1089/wound.2024.0109","DOIUrl":"10.1089/wound.2024.0109","url":null,"abstract":"","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141905563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound pH-Modulating Strategies for Diabetic Wound Healing.","authors":"Léo-Paul Tricou, Marie-Lynn Al-Hawat, Katia Cherifi, Gabriela Manrique, Benjamin R Freedman, Simon Matoori","doi":"10.1089/wound.2023.0129","DOIUrl":"10.1089/wound.2023.0129","url":null,"abstract":"<p><p><b>Significance:</b> Chronic diabetic wounds on the lower extremities (diabetic foot ulcers, DFU) are one of the most prevalent and life-threatening complications of diabetes, responsible for significant loss of quality of life and cost to the health care system. Available pharmacologic treatments fail to achieve complete healing in many patients. Recent studies and investigational treatments have highlighted the potential of modulating wound pH in DFU. <b>Recent Advances:</b> Data from <i>in vitro</i>, preclinical, and clinical studies highlight the role of pH in the pathophysiology of DFU, and topical administration of pH-lowering agents have shown promise as a therapeutic strategy for diabetic wounds. In this critical review, we describe the role of pH in DFU pathophysiology and present selected low-molecular-weight and hydrogel-based pH-modulating systems for wound healing and infection control in diabetic wounds. <b>Critical Issues:</b> The molecular mechanisms leading to pH alterations in diabetic wounds are complex and may differ between <i>in vitro</i> models, animal models of diabetes, and the human pathophysiology. Wound pH-lowering bandages for DFU therapy must be tested in established animal models of diabetic wound healing and patients with diabetes to establish a comprehensive benefit-risk profile. <b>Future Directions:</b> As our understanding of the role of pH in the pathophysiology of diabetic wounds is deepening, new treatments for this therapeutic target are being developed and will be tested in preclinical and clinical studies. These therapeutic systems will establish a target product profile for pH-lowering treatments such as an optimal pH profile for each wound healing stage. Thus, controlling wound bed pH could become a powerful tool to accelerate chronic diabetic wound healing.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139039365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Therapeutic RNAs to Accelerate Wound Healing in Diabetic Rabbit Wounds.","authors":"Brandon J Sumpio, Anne Dallas, Adam G Berger, Zhuqing Li, Enya Wang, Ikram Mezghani, Mauricio Contreras, Georgios Theocharidis, Heini Ilves, Paula T Hammond, Brian H Johnston, Aristidis Veves","doi":"10.1089/wound.2023.0056","DOIUrl":"10.1089/wound.2023.0056","url":null,"abstract":"<p><p><b>Introduction:</b> Diabetes mellitus (DM) affects over 422 million people globally. Patients with DM are subject to a myriad of complications, of which diabetic foot ulcers (DFUs) are the most common with ∼25% chance of developing these wounds throughout their lifetime. <b>Innovation:</b> Currently there are no therapeutic RNAs approved for use in DFUs. Use of dressings containing novel layer-by-layer (LbL)-formulated therapeutic RNAs that inhibit PHD2 and miR-210 can significantly improve diabetic wound healing. These dressings provide sustained release of therapeutic RNAs to the wounds locally without systemic side effects. <b>Clinical Problem Addressed:</b> Diabetic foot wounds are difficult to heal and often result in significant patient morbidity and mortality. <b>Materials and Methods:</b> We used the diabetic neuroischemic rabbit model of impaired wound healing. Diabetes was induced in the rabbits with alloxan, and neuroischemia was induced by ligating the central neurovascular bundle of each ear. Four 6-mm full-thickness wounds were created on each ear. A LbL technique was used to conformally coat the wound dressings with chemically modified RNAs, including an antisense oligonucleotide (antimiR) targeting microRNA-210 (miR-210), an short synthetic hairpin RNA (sshRNA) targeting PHD2, or both. <b>Results:</b> Wound healing was improved by the antimiR-210 but not the PHD2-sshRNA. Specific knockdown of miR-210 in tissue as measured by RT-qPCR was ∼8 Ct greater than nonspecific controls, and this apparent level of knockdown (>99%) suggests that delivery to the tissue is highly efficient at the administered dose. <b>Discussion:</b> Healing of ischemic/neuropathic wounds in diabetic rabbits was accelerated upon inhibition of miR-210 by LbL delivery to the wound bed. miR-210 inhibition was achieved using a chemically modified antisense RNA.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139110665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophage and Neutrophil Dysfunction in Diabetic Wounds.","authors":"Shannon M Clayton, Sasha H Shafikhani, Athena M Soulika","doi":"10.1089/wound.2023.0149","DOIUrl":"10.1089/wound.2023.0149","url":null,"abstract":"<p><p><b>Significance:</b> The incidence of diabetes continues to rise throughout the world in an alarming rate. Diabetic patients often develop diabetic foot ulcers (DFUs), many of which do not heal. Non-healing DFUs are a major cause of hospitalization, amputation, and increased morbidity. Understanding the underlying mechanisms of impaired healing in DFU is crucial for its management. <b>Recent Advances:</b> This review focuses on the recent advancements on macrophages and neutrophils in diabetic wounds and DFUs. In particular, we discuss diabetes-induced dysregulations and dysfunctions of macrophages and neutrophils. <b>Critical Issues:</b> It is well established that diabetic wounds are characterized by stalled inflammation that results in impaired healing. Recent findings in the field suggest that dysregulation of macrophages and neutrophils plays a critical role in impaired healing in DFUs. The delineation of mechanisms that restore macrophage and neutrophil function in diabetic wound healing is the focus of intense investigation. <b>Future Directions:</b> The breadth of recently generated knowledge on the activity of macrophages and neutrophils in diabetic wound healing is impressive. Experimental models have delineated pathways that hold promise for the treatment of diabetic wounds and DFUs. These pathways may be useful targets for further clinical investigation.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Serum Protein Measurements as Biomarkers that Can Predict the Outcome of Diabetic Foot Ulceration.","authors":"Georgios Theocharidis, Brandon Sumpio, Enya Wang, Ikram Mezghani, John M Giurini, Nikolaos Kalavros, Eleftheria-Angeliki Valsami, Ioannis Vlachos, Mahyar Heydarpour, Aristidis Veves","doi":"10.1089/wound.2023.0126","DOIUrl":"10.1089/wound.2023.0126","url":null,"abstract":"<p><p><b>Objectives:</b> To identify proteins that are prognostic for diabetic foot ulcer (DFU) healing and may serve as biomarkers for its management, serum samples were analyzed from diabetic mellitus (DM) patients. <b>Approach:</b> The serum specimens that were evaluated in this study were obtained from DM patients with DFU who participated in a prospective study and were seen biweekly until they healed their ulcer or the exit visit at 12 weeks. The group was divided into Healers (who healed their DFU during the study) and Non-Healers. <b>Results:</b> Interleukin (IL)-10, IL-4, IL-5, IL-6, and IL-13 and interferon-gamma were higher in the Healers while Fractalkine, IL-8, and TNFα were higher in the Non-Healers. The trajectory of IL-10 levels remained stable over time within and across groups, resulting in a strong prognostic ability for the prospective DFU healing course. Classification and Regression Tree analysis created an 11-node decision tree with healing status as the categorical response. <b>Innovation:</b> Consecutive measurements of proteins associated with wound healing can identify biomarkers that can predict DFU healing over a 12-week period. IL-10 was the strongest candidate for prediction. <b>Conclusion:</b> Measurement of serum proteins can serve as a successful strategy in guiding clinical management of DFU. The data also indicate likely superior performance of building a multiprotein biomarker score instead of relying on single biomarkers.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139519379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Methodologies for Inducing Aligned Myofibers in Tissue Constructs for Skeletal Muscle Tissue Regeneration.","authors":"Sydnee T Sicherer, Noor Haque, Yash Parikh, Jonathan M Grasman","doi":"10.1089/wound.2024.0111","DOIUrl":"10.1089/wound.2024.0111","url":null,"abstract":"<p><p><b>Significance:</b> Volumetric muscle loss (VML) results in the loss of large amounts of tissue that inhibits muscle regeneration. Existing therapies, such as autologous muscle transfer and physical therapy, are incapable of returning full function and force production to injured muscle. <b>Recent Advances:</b> Skeletal muscle tissue constructs may provide an alternative to existing therapies currently used to treat VML. Unlike autologous muscle transplants, muscle constructs can be cultured <i>in vitro</i> and are not reliant on intact muscle tissue. Skeletal muscle constructs can be generated from small muscle biopsies and could be used to generate skeletal muscle tissue constructs to replace injured tissues. <b>Critical Issues:</b> To serve as effective therapies, muscle constructs must be capable of generating contractile forces that can assist the function of host skeletal muscle. The contractile force of native muscle arises in part as a consequence of the highly aligned, bundled architecture of myofibers. Attempts to induce similar alignment include applications of tension/strain across hydrogels, inducing aligned architectures within scaffolds, casting tissues in straited molds, and 3D printing. While all these methods have demonstrated efficacy toward inducing myofiber alignment, the extent of myofiber alignment, tissue formation, and force production varies. This manusript critically reviews the advantages and limitations of these methods and specifically discusses their ability to impart mechanical and architectural cues to induce alignment within tissue constructs. <b>Future Directions:</b> As tissue-synthesizing techniques continue to improve, muscle constructs must include more cell types than simply myoblasts, such as the addition of neuronal and endothelial cells. Higher-level tissue organization is critical to the success of these constructs. Many of these technologies have yet to be implanted into host tissue to understand engraftment and how they can contribute to traumatic injury, and as such continued collaboration between surgeons and tissue engineers is necessary to ultimately result in clinical translation.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141911351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lineage Mapping of Extracellular Vesicles: What Cells Do They Come from And Where Do They Go?","authors":"Dong Jun Park, Wooil Choi, Hanan Zhang, Brian P Eliceiri","doi":"10.1089/wound.2024.0068","DOIUrl":"10.1089/wound.2024.0068","url":null,"abstract":"<p><p><b>Significance:</b> Release of extracellular vesicles (EVs) by various cell types has been shown to mediate the delivery of biologically active payloads from donor cells to recipient cells; however, it remains unclear what cell types these EVs come from. With a focus on fluorescent reporters to monitor the release of EVs, especially those under the control of cell type-specific promoters, we address the translational relevance of genetic tools in cultured cells, normal tissues, and in models of development, injury, cancer, and wound healing. <b>Recent Advances:</b> It is well established that EVs are released by many cell types in the body via fusion and release processes at the plasma membrane. Since there remains debate about what fraction of EVs are released through regulated endosomal trafficking pathways versus nonspecific mechanisms, the development and validation of novel molecular tools are important to address the cellular source of EVs. <b>Critical Issues:</b> There is a need to develop and characterize new cell type-specific reporter mouse models that build upon the examples detailed here to identify the cellular source of EVs with genetic approaches being useful in addressing these critical limitations. <b>Future Directions:</b> Advances in reporter systems will drive a better understanding of EV subsets to identify compartment-specific EV localization to guide the development of more translationally relevant models for the wound healing field.</p>","PeriodicalId":7413,"journal":{"name":"Advances in wound care","volume":null,"pages":null},"PeriodicalIF":5.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}