Eplasty最新文献

{"title":"Rare Case of Pediatric Lower Limb Verrucous Venous Malformation: Treatment Approach and Considerations.","authors":"Annie Chen-Carrington, Adam Goodreau, Brian J Strife, Laurie Shinn, Jennifer Rhodes","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Verrucous venous malformation (VVM) is a rare, congenital, low-flow vascular anomaly composed of capillaries and veins in the dermis and subcutaneous tissues. Diagnosis is difficult because knowledge of cases is rare and typically identified with sonographic imaging and elevated GLUT-1. Treatment is mired by high rates of recurrence and residual pain, with further enlargement upon resection or injury. Current management strategies include a combination of laser therapy, surgery, cryotherapy, and topical steroids, each with varying rates of success.</p><p><strong>Methods: </strong>The authors examine a case of confirmed VVM, which was initially treated with a candela pulsed dye laser and propranolol to no avail. A combination of surgical approaches were chosen.</p><p><strong>Conclusions: </strong>We now look to topical sirolimus 1% as an adjunct for this patient with residual lesions. Questions remain as to the effectiveness, optimal dose, and duration of topical sirolimus and whether this combination of surgical and topical intervention will be effective in the treatment for VVM.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228054","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":"Augmenting the Breast Reconstruction: Core Projection With Hybrid Microsurgical Breast Reconstruction With Flap and Stacked Prepectoral Acellular Dermal Matrix.","authors":"Anna E Daytz, Julia B Silverman, Raquel A Minasian, Susana Benitez Sanchez, Jina Yom, Christopher Aiello, Emma Robinson, Mark L Smith, Neil Tanna","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Many patients who require breast reconstruction prefer a flap-based approach for various reasons, including the permanence and aesthetic benefit of a breast that looks and feels natural. For patients who desire autologous breast reconstruction following mastectomy but lack adequate donor site volume, the authors utilize the novel hybrid flap, prepectoral acellular dermal matrix (HyPAD) approach. In this technique, the deep inferior epigastric perforator (DIEP) flap is augmented with a stacked acellular dermal matrix (ADM). The purpose of this study is to quantify the soft tissue augmentation and core projection achieved with this technique during autologous flap-based breast reconstruction.</p><p><strong>Methods: </strong>Consecutive patients who underwent the HyPAD technique during the study period (August 2021 to December 2022) were identified. All patients lacked adequate donor site volume and wished to avoid the placement of implants during their reconstruction. Demographic information and outcomes were assessed. Intraoperatively, the weights (g) of the mastectomy specimen, the flap donor site, and the stacked ADM were recorded.</p><p><strong>Results: </strong>During the study period, 21 patients (n = 21) were identified. The mean age of patients at the time of surgery was 48.9 ± 7.85 years. The mean body mass index was 24.1 kg/m² ± 3.3 kg/m². The mean mastectomy specimen weight was 436.35 g, and the mean flap weight was 370.73 g, posing an average discrepancy of 15.04% or 65.62 g. The average weight of the ADM used to augment the flap was 81.76 g. This weight accounted for an average of 18.07% of the total reconstructed breast weight.</p><p><strong>Conclusions: </strong>The use of ADM during autologous breast reconstruction provides patients with an alternative to implants that allows them to obtain their desired breast volume. Given the aesthetic impact that ADM has on the total amount of flap weight and projection, it is recommended that the HyPAD technique be considered for patients who desire a breast that cannot be restored with their own flap weight and wish to avoid implants.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"25 ","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228051","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":"Collagen Matrix and Staged Skin Grafting for Plantar Reconstruction: Lessons Learned in Treatment of Palmoplantar Keratoderma.","authors":"Joowon Choi, Matthew A Applebaum, Mark E Feldmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Tissue defects of the weight-bearing surface of the foot are challenging wounds to reconstruct. Traditionally, skin grafting has had limited success in achieving both a durable and functional construct for ambulation. This case series describes a 2-staged approach to using a collagen bilayer matrix with subsequent skin grafting for plantar reconstruction in 3 sisters with palmoplantar keratoderma (PPK).</p><p><strong>Methods: </strong>Outcomes of 3 patients (ages 7, 13, and 15 years) who underwent plantar excisions of both feet for treatment of PPK were reviewed retrospectively. Data collection included tissue defect size, duration of non-weight-bearing activity, skin grafting technique, surgical complications, incidence of graft loss, total inpatient stay, and long-term functional status. Sensory outcomes were measured using Semmes Weinstein monofilament testing, along with patient-reported outcomes utilizing the Manchester-Oxford Foot Questionnaire (MOXFQ).</p><p><strong>Results: </strong>All 3 patients, totaling 6 feet, underwent plantar excisions of PPK. A collagen bilayer matrix was applied, followed by staged skin grafting (mean = 25.5 days between stages). Average total inpatient stay across treatment course was 2.6 days. There were 2 surgical site infections and 2 unanticipated returns to the operating room for excision of PPK recurrence. There were no incidences of graft loss. At an average of 6.9 years follow-up, all 3 patients had an intact reconstruction, preserved protective sensation, and normal gait and shoe-wear. Patient-reported ratings for foot pain varied from poor to excellent.</p><p><strong>Conclusions: </strong>A method of plantar reconstruction utilizing a collagen bilayer matrix and staged skin grafting is presented, demonstrating excellent long-term durability and functional outcomes.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e67"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217921","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":"Performance of ChatGPT on the Plastic Surgery In-Training Examination.","authors":"Brielle E Raine, Katherine A Kozlowski, Cody C Fowler, Jordan D Frey","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Recently, the artificial intelligence chatbot Chat Generative Pre-Trained Transformer (ChatGPT) performed well on all United States Medical Licensing Examinations (USMLE), demonstrating a high level of insight into a physician's knowledge base and clinical reasoning ability.^1,2 This study aims to evaluate the performance of ChatGPT on the American Society of Plastic Surgeons (ASPS) Plastic Surgery In-Training Examination (PSITE) to assess its clinical reasoning and decision-making ability and investigate its legitimacy related to plastic surgery competencies.</p><p><strong>Methods: </strong>PSITE questions from 2015 to 2023 were included in this study. Questions with images, charts, and graphs were excluded. ChatGPT 3.5 was prompted to provide the best single letter answer choice. Performance was analyzed across test years, question area of content, taxonomy, and core competency via chi-square analysis. Multivariable logistic regression was performed to identify predictors of ChatGPT performance.</p><p><strong>Results: </strong>In this study, 1850 of 2097 multiple choice questions were included. ChatGPT answered 845 (45.7%) questions correctly, performing the highest on breast/cosmetic topics (49.6%) (<i>P</i> = .070). ChatGPT performed significantly better on questions requiring the lowest level of reasoning (knowledge, 55.1%) compared with more complex questions such as analysis (41.4%) (<i>P</i> = .001). Multivariable analysis identified negative predictors of performance including the hand/lower extremity topic (OR = 0.73, <i>P</i> = .038) and taxonomy levels beyond knowledge (<i>P</i> < .05). Performance on the 2023 exam (53.4%) corresponded to a 4th percentile score when compared with all plastic surgery residents.</p><p><strong>Conclusions: </strong>While ChatGPT's performance has shown promise in other medical domains, our results indicate it may not be a reliable source of information for plastic surgery-related questions or decision-making.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e68"},"PeriodicalIF":0.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217923","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":"Rapid Response to Sirolimus in Patients with PIK3CA-Related Overgrowth Spectrum.","authors":"Jessica R Nye, Jackson C Green, Michael Talanker, Jose Barrera, Kate Richardson, Neethu M Menon, Adelaide A Hebert, Matthew R Greives, Autumn A Atkinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p><i>PIK3CA</i>-related overgrowth spectrum (PROS) is an umbrella term used to unify a heterogenous group of vascular overgrowth disorders by a shared genetic cause. Given that patients with PROS have a known, or likely, gene mutation in the PI3K/AKT/mTOR cascade, we hypothesize they experience a rapid response to inhibitors of this pathway, including sirolimus. In the following case series, we describe 3 patients with PROS and their response to sirolimus therapy. Despite their unique clinical presentations, insight into the genetic origin of their vascular overgrowth allowed for their successful treatment with the same medication.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e66"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217924","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":"Results of a Single-Institution Quality Improvement Initiative to Reduce Perioperative Blood Transfusion During Open Complex Cranial Vault Reconstruction.","authors":"Joshua M Wright, Molly F MacIsaac, S Alex Rottgers, Alexandra Miller, Jamie Fierstein, Lillian Zamora, Allison Fernandez","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Craniosynostosis repair via open complex cranial vault remodeling (OCCVR) is a complicated surgical procedure associated with morbidity and blood loss, often requiring blood transfusion. The Pediatric Craniofacial Collaborative group created the Pediatric Craniofacial Surgery Perioperative Registry (PCSPR) to capture data relating to the perioperative management of children undergoing craniofacial surgery. A tertiary pediatric hospital implemented its own quality improvement (QI) initiative with the aim of reducing blood transfusion volumes and exposures in patients undergoing OCCVR. The initiative included preoperative iron supplementation, intraoperative use of cell saver and tranexamic acid, maintenance of normothermia, and restrictive transfusion protocols.</p><p><strong>Methods: </strong>Patients were included in the study if they had a diagnosis of craniosynostosis, were younger than 18 years, and underwent OCCVR. Patient demographics, comorbidities, and perioperative data were recorded using the PCSPR. Outcomes included blood transfusion volume, number of blood donor exposures, and intra and postoperative complications. Outcomes before and after the initiative were compared.</p><p><strong>Results: </strong>The median perioperative allogenic blood transfusion volume decreased from 35 mL/kg pre-QI to 24 mL/kg post-QI (<i>P</i> < .001). There was a significant decrease in the number of blood donor exposures, and the number of patients who experienced a transfusion-free perioperative period increased from 10.9% to 19.6% (<i>P</i> = .037). There were no observed differences in perioperative complications, hospital and intensive care unit length of stay, or mortality.</p><p><strong>Conclusions: </strong>This QI initiative has resulted in reduced blood transfusion volumes and reduced blood donor exposures without an increase in perioperative complications related to blood loss. Further multi-institutional research is necessary to create national standards for the anesthetic care of all patients undergoing OCVR.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e65"},"PeriodicalIF":0.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217925","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":"Use of Continuous Topical Oxygen Therapy in Combination to Optimize the Chronic Wound Environment Prior to Cellular, Acellular, and Matrix-Like Product Application: A Retrospective Case Series.","authors":"Naz Wahab, Windy Cole, Emma Woodmansey","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>This retrospective case series details the use of a continuous topical oxygen therapy (cTOT) device for wound bed preparation prior to the application of cellular, acellular, and matrix-like products (CAMPs) on lower extremity wounds.</p><p><strong>Methods: </strong>A retrospective records review was conducted in a single outpatient wound care center. Treatment consisted of 2 weeks of cTOT followed by CAMP application. Weekly wound photos and measurements were obtained through chart review. Patients included in this study did not achieve complete wound closure within the 2-week cTOT treatment period and were transitioned to application of a CAMP as per standard practice at the lead author's clinic.</p><p><strong>Results: </strong>This study included 4 patients (5 wounds). The mean patient age was 71.8 years, and wound types included 3 diabetic foot ulcers (DFUs) and 2 venous leg ulcers (VLUs). The mean wound area reduction seen in this patient cohort was 74.7% and 76.1% at 4 and 6 weeks, respectively. Overall, a mean healing time of 8 weeks was noted across all wounds with a mean number of 6 CAMP applications.</p><p><strong>Conclusions: </strong>Wound healing should be approached in an algorithmic manner, starting with wound bed optimization. In this patient cohort cTOT proved to be an effective way to improve the quality of the wound bed, in addition to the standard cleansing and debridement, prior to CAMP application. The authors believe that this combination of topical methods might have synergistic effects and improve wound healing, and the results of this study support this assumption.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e64"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217928","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":"Pedicled Bilateral Deep Inferior Epigastric Perforator Flap With Intraflap Anastomosis for Hip/Thigh Reconstruction.","authors":"Aria Nisco, Mahsa Taskindoust, Jenny Yu, Duane Wang","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"QA25"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319015","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":"Effects of Screening Hemoglobin A1C on Complications in Implant-Based Breast Reconstruction.","authors":"Anthony E Capito, Nikitha Potturi, Christina N Canzoneri, Matthew A Applebaum, Stephanie Hamlin, Joowon Choi, Alicia J Lozano, Wenyan Ji, Kurtis E Moyer","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Many institutions have implemented universal hemoglobin A1c (HbA1c) screening for all preoperative patients in an effort to reduce rates of surgical complications. However, the usefulness of HbA1c screening for predicting complications after implant-based breast reconstruction has yet to be determined. The purpose of this study was to investigate the predictive value of HbA1c screening on postoperative complications following implant-based breast reconstruction.</p><p><strong>Methods: </strong>A retrospective cohort study of patients who underwent implant-based breast reconstruction at a single institution was conducted. All patients required an HbA1c screening preoperatively. Patients were categorized into 2 groups: normal HbA1c (<5.7%) or abnormal HbA1c (≥5.7%). The 2 groups were propensity score matched for baseline characteristics and compared for complication rates after the first- and second-stage procedures.</p><p><strong>Results: </strong>In this study, 203 patients who underwent first-stage breast reconstruction were divided into normal HbA1c (n = 135) and abnormal HbA1c (n = 68) cohorts. A propensity score weighted analysis demonstrated increased risk of incisional dehiscence in the abnormal group (<i>P</i> = .050). Ninety-nine patients who underwent second-stage breast reconstruction were divided into normal HbA1c (n = 55) and abnormal HbA1c (n = 44) cohorts. The abnormal HbA1c group demonstrated marginally higher rates of implant loss (<i>P</i> = .059). Otherwise, no statistically significant differences were noted in rates of surgical site infection, seroma or hematoma formation, or implant rupture.</p><p><strong>Conclusions: </strong>Patients with abnormal HbA1c on preoperative screening demonstrated higher rates of incisional dehiscence after first-stage breast reconstruction and higher rates of implant loss following second-stage breast reconstruction. Obtaining routine preoperative HbA1c screening should be considered as an adjunct to guide discussions about surgical risk for patients undergoing breast reconstruction.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e63"},"PeriodicalIF":0.0,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217922","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":"Statewide Prevalence of Congenital Hand Anomalies: A 6-Year Review of Patients Presenting to Mississippi's Only Children's Hospital.","authors":"Brittany N Corder, Katherine C Benedict, Hannah G Buie, Reagan M Moak, Martin G McCandless, Marc E Walker","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Incidence and prevalence data for congenital upper extremity anomalies in the literature are scarce due to lack of reporting requirements, absence of a centralized database, and insufficient referral networks. As the state's only pediatric hospital and congenital hand clinic, the University of Mississippi Medical Center (UMMC) is uniquely positioned to report the per capita rate of congenital upper extremity anomalies.</p><p><strong>Methods: </strong>Pediatric patients presenting from 2015 to 2020 were identified using International Classification of Diseases codes in the UMMC electronic medical record. Exclusion criteria included age older than 18 years at presentation and defects secondary to trauma. Diagnoses included polydactyly, syndactyly, reduction defects, club hand malformations, and syndromes with upper limb anomalies. Demographic data were collected including age, race, sex, maternal age, family history of extremity anomalies, geographic location, and insurance status. Geographic trends were identified, and results were presented in incidence of disease per 10,000 births.</p><p><strong>Results: </strong>A total of 477 pediatric patients presented with a congenital upper extremity anomaly from 2015 to 2020. The average rate of congenital upper extremity anomalies in Mississippi was 21.5 per 10,000 births. The 3 most common upper extremity anomalies were polydactyly (13.1 per 10,000 births), congenital trigger thumb (2.67 per 10,000 births), and syndactyly (1.66 per 10,000 births). The polydactyly group was further divided into preaxial (1.98 per 10,000 births) and postaxial (10.9 per 10,000 births) polydactyly. There was a male predominance in presentation with 60.4% (n = 288) of patients being male.</p><p><strong>Conclusions: </strong>In the past 5 years, only New York State has published similar findings delineating the incidence of congenital hand anomalies through their Birth Defect Registry. The prevalence of upper extremity defects presenting to UMMC from 2015 to 2020 was 21.5 per 10,000 births; however, 5 specific counties had a significantly higher prevalence, ranging from 53.65 to 63.97 per 10,000 births. To develop effective programs to comprehensively treat these pediatric patients, accurate reporting and data collection mechanisms are critical.</p>","PeriodicalId":93993,"journal":{"name":"Eplasty","volume":"24 ","pages":"e62"},"PeriodicalIF":0.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217927","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}