Marina Petrevska, Jennifer L Ryan, Selvi Sert, Sarah Munce, F Virginia Wright, Elaine Biddiss
{"title":"Using interactive computer play in physical therapy and occupational therapy clinical practice: an explanatory sequential mixed methods study.","authors":"Marina Petrevska, Jennifer L Ryan, Selvi Sert, Sarah Munce, F Virginia Wright, Elaine Biddiss","doi":"10.3389/fmedt.2024.1381165","DOIUrl":"10.3389/fmedt.2024.1381165","url":null,"abstract":"<p><strong>Introduction: </strong>This study explored the extent to which an interactive computer play system, Bootle Blast, supports motor learning in a clinical context and examined clinicians' perceptions of their therapeutic role in the system's use as an intervention tool.</p><p><strong>Methods: </strong>In this observational sequential explanatory mixed methods study, five children with cerebral palsy [mean age 9.4 years (SD, 0.5), Gross Motor Function Classification System Levels I-III] used Bootle Blast during a single video-recorded therapy session with their treating clinicians (physical therapists, occupational therapists, and therapy assistants). Children played one Bootle Blast mini game independently (without clinician involvement) before clinicians carried out therapy sessions with the game as per usual care. The type and extent of motor learning strategies (MLS) delivered by Bootle Blast and clinicians were rated from video recordings by a trained assessor using the 22-item Motor Learning Strategies Rating Instrument. Semi-structured interviews with clinicians were conducted to gain insights into MLS use and clinicians' perceived role during Bootle Blast use. Interviews were audio recorded, transcribed verbatim, and analyzed independently by two researchers using thematic analysis. Quantitative and qualitative data were merged and reported using narrative and joint display approaches.</p><p><strong>Results: </strong>Bootle Blast provided eight MLS, with clinicians adding or enhancing another eight. Four themes reflected clinicians' perspectives: (1) Bootle Blast disguises therapy as play, (2) clinicians give Bootle Blast the human touch; (3) home use of Bootle Blast is promising; and (4) Bootle Blast is not always the right fit but some shortcomings could be addressed. Agreement was found for nine MLS and disagreement for four MLS when quantitative and qualitative findings were merged.</p><p><strong>Discussion: </strong>Bootle Blast delivers several MLS as part of game play and clinicians can enhance and provide additional MLS to suit the child's needs/abilities. Further game refinements that were identified in this study may optimize its clinical use.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1381165"},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142383059","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":"Celiac disease gut microbiome studies in the third millennium: reviewing the findings and gaps of available literature.","authors":"Vanessa C C Luz, Sónia Gonçalves Pereira","doi":"10.3389/fmedt.2024.1413637","DOIUrl":"10.3389/fmedt.2024.1413637","url":null,"abstract":"<p><p>Celiac disease is an autoimmune enteropathy caused by the ingestion of minute amounts of gluten in a subset of genetically predisposed individuals. Its onset occurs at different ages and with variable symptoms. The gut microbiome may contribute to this variability. This review aims to provide an overview of the available research on celiac disease gut microbiome and identify the knowledge gap that could guide future studies. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews (PRISMA-ScR), four electronic databases were searched for literature from January 2000 to July 2023 addressing celiac disease gut microbiome characterization using next-generation sequencing (NGS) approaches. From the 489 publications retrieved, 48 publications were selected and analyzed, focusing on sample characterization (patients, controls, and tissues) and methodologies used for NGS microbiome analysis and characterization. The majority of the selected publications regarded children and adults, and four were randomized clinical trials. The number of participants per study greatly varied and was typically low. Feces were the most frequently tested sample matrix, and duodenal samples were analyzed in one-third of the studies. Incomplete and diverse information on the methodological approaches and gut microbiome results was broadly observed. While similar trends regarding the relative abundance of some phyla, such as Pseudomonadota (former Proteobacteria), were detected in some studies, others contradicted those results. The observed high variability of technical approaches and possibly low power and sample sizes may prevent reaching a consensus on celiac disease gut microbiome composition. Standardization of research protocols to allow reproducibility and comparability is required, as interdisciplinary collaborations to further data analysis, interpretation, and, more importantly, health outcome prediction or improvement.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1413637"},"PeriodicalIF":2.7,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362597","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}
Andrew T McKenzie, Ariel Zeleznikow-Johnston, Jordan S Sparks, Oge Nnadi, John Smart, Keith Wiley, Michael A Cerullo, Aschwin de Wolf, Francesca Minerva, Ramón Risco, George M Church, João Pedro de Magalhães, Emil F Kendziorra
{"title":"Structural brain preservation: a potential bridge to future medical technologies.","authors":"Andrew T McKenzie, Ariel Zeleznikow-Johnston, Jordan S Sparks, Oge Nnadi, John Smart, Keith Wiley, Michael A Cerullo, Aschwin de Wolf, Francesca Minerva, Ramón Risco, George M Church, João Pedro de Magalhães, Emil F Kendziorra","doi":"10.3389/fmedt.2024.1400615","DOIUrl":"10.3389/fmedt.2024.1400615","url":null,"abstract":"<p><p>When faced with the prospect of death, some people would prefer a form of long-term preservation that may allow them to be restored to healthy life in the future, if technology ever develops to the point that this is feasible and humane. Some believe that we may have the capacity to perform this type of experimental preservation today-although it has never been proven-using contemporary methods to preserve the structure of the brain. The idea is that the morphomolecular organization of the brain encodes the information required for psychological properties such as personality and long-term memories. If these structures in the brain can be maintained intact over time, this could theoretically provide a bridge to access restorative technologies in the future. To consider this hypothesis, we first describe possible metrics that can be used to assess structural brain preservation quality. We next explore several possible methods to preserve structural information in the brain, including the traditional cryonics method of cryopreservation, as well as aldehyde-stabilized cryopreservation and fluid preservation. We focus in-depth on fluid preservation, which relies on aldehyde fixation to induce chemical gel formation in a wide set of biomolecules and appears to be a cost-effective method. We describe two theoretical recovery technologies, alongside several of the ethical and legal complexities of brain preservation, all of which will require a prudent approach. We believe contemporary structural brain preservation methods have a non-negligible chance of allowing successful restoration in the future and that this deserves serious research efforts by the scientific community.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1400615"},"PeriodicalIF":2.7,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309473","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}
Ambuj Yadav, Himanshu Dandu, Gaurav Parchani, Kumar Chokalingam, Pooja Kadambi, Rajesh Mishra, Ahsina Jahan, Jean-Louis Teboul, Jos M Latour
{"title":"Early detection of deteriorating patients in general wards through continuous contactless vital signs monitoring.","authors":"Ambuj Yadav, Himanshu Dandu, Gaurav Parchani, Kumar Chokalingam, Pooja Kadambi, Rajesh Mishra, Ahsina Jahan, Jean-Louis Teboul, Jos M Latour","doi":"10.3389/fmedt.2024.1436034","DOIUrl":"10.3389/fmedt.2024.1436034","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of continuous contactless vital signs monitoring with an automated Early Warning System (EWS) in detecting clinical deterioration among patients in general wards.</p><p><strong>Methods: </strong>A prospective observational cohort study was conducted in the medical unit of a tertiary care hospital in India, involving 706 patients over 84,448 monitoring hours. The study used a contactless ballistocardiography system (Dozee system) to continuously monitor heart rate, respiratory rate, and blood pressure. The study assessed total, mean, and median alerts at 24, 48, 72, 96, 120 h, and length of stay (LOS) before patient deterioration or discharge. It analyzed alert sensitivity and specificity, average time from initial alert to deterioration, and healthcare practitioners (HCP) activity. Study was registered with the Clinical Trials Registry-India CTRI/2022/10/046404.</p><p><strong>Results: </strong>Out of 706 patients, 33 (5%) experienced clinical deterioration, while 673 (95%) did not. The deterioration group consistently had a higher number of alerts compared to those who were discharged normally, across all time-points. On average, the time between the initial alert and clinical deterioration was 16 h within the last 24 h preceding the event. The sensitivity of the Dozee-EWS varied between 67% and 94%. HCP spend 10% of their time on vital signs check and documentation.</p><p><strong>Conclusions: </strong>This study suggests that utilizing contactless continuous vital signs monitoring with Dozee-EWS in general ward holds promise for enhancing the early detection of clinical deterioration. Further research is essential to evaluate the effectiveness across a wider range of clinical settings.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1436034"},"PeriodicalIF":2.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335094","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}
Lariza María de la Caridad Portuondo-Mallet, Niurka Mollineda-Diogo, Rubén Orozco-Morales, Juan Valentín Lorenzo-Ginori
{"title":"Detection and counting of <i>Leishmania</i> intracellular parasites in microscopy images.","authors":"Lariza María de la Caridad Portuondo-Mallet, Niurka Mollineda-Diogo, Rubén Orozco-Morales, Juan Valentín Lorenzo-Ginori","doi":"10.3389/fmedt.2024.1360280","DOIUrl":"10.3389/fmedt.2024.1360280","url":null,"abstract":"<p><strong>Problem: </strong>Leishmaniasis is a disease caused by protozoan parasites of the genus <i>Leishmania</i> and has a high prevalence and impact on global health. Currently, the available drugs for its treatment have drawbacks, such as high toxicity, resistance of the parasite, and high cost. Therefore, the search for new, more effective, and safe drugs is a priority. The effectiveness of an anti-leishmanial drug is analyzed through <i>in vitro</i> studies in which a technician manually counts the intracellular form of the parasite (amastigote) within macrophages, which is slow, laborious, and prone to errors.</p><p><strong>Objectives: </strong>To develop a computational system that facilitates the detection and counting of amastigotes in microscopy images obtained from <i>in vitro</i> studies using image processing techniques.</p><p><strong>Methodology: </strong>Segmentation of objects in the microscope image that might be <i>Leishmania</i> amastigotes was performed using the multilevel Otsu method on the saturation component of the <i>hue, saturation, and intensity</i> color model. In addition, morphological operations and the watershed transform combined with the weighted external distance transform were used to separate clustered objects. Then positive (amastigote) objects were detected (and consequently counted) using a classifier algorithm, the selection of which as well as the definition of the features to be used were also part of this research. MATLAB was used for the development of the system.</p><p><strong>Results and discussion: </strong>The results were evaluated in terms of sensitivity, precision, and the F-measure and suggested a favorable effectiveness of the proposed method.</p><p><strong>Conclusions: </strong>This system can help researchers by allowing large volumes of images of amastigotes to be counted using an automatic image analysis technique.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1360280"},"PeriodicalIF":2.7,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142157048","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}
J S van Haren, F L M Delbressine, M Monincx, T Hoveling, N Meijer, C Bangaru, J Sterk, D A A van der Woude, S G Oei, M B van der Hout-van der Jagt
{"title":"From intra- to extra-uterine: early phase design of a transfer to extra-uterine life support through medical simulation.","authors":"J S van Haren, F L M Delbressine, M Monincx, T Hoveling, N Meijer, C Bangaru, J Sterk, D A A van der Woude, S G Oei, M B van der Hout-van der Jagt","doi":"10.3389/fmedt.2024.1371447","DOIUrl":"10.3389/fmedt.2024.1371447","url":null,"abstract":"<p><strong>Introduction: </strong>Extra-uterine life support technology could provide a more physiologic alternative for the treatment of extremely premature infants, as it allows further fetal growth and development ex utero. Animal studies have been carried out which involved placing fetuses in a liquid-filled incubator, with oxygen supplied through an oxygenator connected to the umbilical vessels. Hence, by delaying lung exposure to air, further lung development and maturation can take place. This medical intervention requires adjustments to current obstetric procedures to maintain liquid-filled lungs through a so-called transfer procedure.</p><p><strong>Methods: </strong>Our objective was to develop obstetric device prototypes that allow clinicians to simulate this birth procedure to safely transfer the infant from the mother's uterus to an extra-uterine life support system. To facilitate a user-centered design, implementation of medical simulation during early phase design of the prototype development was used. First, the requirements for the procedure and devices were established, by reviewing the literature and through interviewing direct stakeholders. The initial transfer device prototypes were tested on maternal and fetal manikins in participatory simulations with clinicians.</p><p><strong>Results & discussion: </strong>Through analysis of recordings of the simulations, the prototypes were evaluated on effectiveness, safety and usability with latent conditions being identified and improved. This medical simulation-based design process resulted in the development of a set of surgical prototypes and allowed for knowledge building on obstetric care in an extra-uterine life support context.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1371447"},"PeriodicalIF":2.7,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11368740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127746","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":"Trends in the market for drug delivery devices categorized as combination drugs and medical devices and regulatory challenges for autoinjectors in Japan.","authors":"Makiko Mochizuki, Hideki Maeda","doi":"10.3389/fmedt.2024.1461460","DOIUrl":"10.3389/fmedt.2024.1461460","url":null,"abstract":"<p><strong>Background: </strong>Although a variety of drug delivery devices have been launched in recent years, few studies have comprehensively investigated the market trends of combination drugs and medical devices approved or certified in Japan and the regulatory challenges related to their approval. Among the drug delivery devices, autoinjectors are more convenient than traditional prefilled syringes and are designed with safety features to prevent needlestick accidents, allowing self-injection by patients. Therefore, autoinjectors have been incorporated into the treatment of various diseases and have shown significant growth among drug delivery devices.</p><p><strong>Aim: </strong>This study aimed to investigate the market trends of combination drugs approved in Japan, especially those with autoinjector formulations, and to explore the challenges in the regulatory aspects of combination drugs.</p><p><strong>Methods: </strong>Information on the number of marketed drugs and medical devices was obtained from the Pharmaceuticals and Medical Devices Agency (PMDA) database using specific definitions. We looked at the annual changes in the number of drug delivery devices approved and certified as combination drugs or medical devices and the number of canceled certifications. We also examined the classification and main certification criteria for Japanese medical device nomenclature.</p><p><strong>Results: </strong>The study suggested that the number of combination drugs with autoinjector formulations is increasing, replacing previously approved or certified pen-type medication injectors. Moreover, 53% of all drug products were approved for autoinjector formulations after the initial authorization approval in Japan, and more than half of them obtained approval for additional formulations for autoinjectors within five years of the initial authorization approval, with the largest number of cases obtaining approval for additional formulations two years later.</p><p><strong>Conclusion: </strong>The lack of clear regulatory requirements for autoinjectors may lead to confusion among applicants. Furthermore, there are challenges in filing regulatory applications, thus hindering the rapid launch of combination drug-utilizing devices with superior usability.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1461460"},"PeriodicalIF":2.7,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010106","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}
Mariachiara Arminio, Dario Carbonaro, Umberto Morbiducci, Diego Gallo, Claudio Chiastra
{"title":"Fluid-structure interaction simulation of mechanical aortic valves: a narrative review exploring its role in total product life cycle.","authors":"Mariachiara Arminio, Dario Carbonaro, Umberto Morbiducci, Diego Gallo, Claudio Chiastra","doi":"10.3389/fmedt.2024.1399729","DOIUrl":"10.3389/fmedt.2024.1399729","url":null,"abstract":"<p><p>Over the last years computer modelling and simulation has emerged as an effective tool to support the total product life cycle of cardiovascular devices, particularly in the device preclinical evaluation and post-market assessment. Computational modelling is particularly relevant for heart valve prostheses, which require an extensive assessment of their hydrodynamic performance and of risks of hemolysis and thromboembolic complications associated with mechanically-induced blood damage. These biomechanical aspects are typically evaluated through a fluid-structure interaction (FSI) approach, which enables valve fluid dynamics evaluation accounting for leaflets movement. In this context, the present narrative review focuses on the computational modelling of bileaflet mechanical aortic valves through FSI approach, aiming to foster and guide the use of simulations in device total product life cycle. The state of the art of FSI simulation of heart valve prostheses is reviewed to highlight the variety of modelling strategies adopted in the literature. Furthermore, the integration of FSI simulations in the total product life cycle of bileaflet aortic valves is discussed, with particular emphasis on the role of simulations in complementing and potentially replacing the experimental tests suggested by international standards. Simulations credibility assessment is also discussed in the light of recently published guidelines, thus paving the way for a broader inclusion of <i>in silico</i> evidence in regulatory submissions. The present narrative review highlights that FSI simulations can be successfully framed within the total product life cycle of bileaflet mechanical aortic valves, emphasizing that credible <i>in silico</i> models evaluating the performance of implantable devices can (at least) partially replace preclinical <i>in vitro</i> experimentation and support post-market biomechanical evaluation, leading to a reduction in both time and cost required for device development.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1399729"},"PeriodicalIF":2.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11247014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141621969","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}
Vincenzo Vento, Salomé Kuntz, Anne Lejay, Nabil Chakfe
{"title":"Evolutionary trends and innovations in cardiovascular intervention.","authors":"Vincenzo Vento, Salomé Kuntz, Anne Lejay, Nabil Chakfe","doi":"10.3389/fmedt.2024.1384008","DOIUrl":"https://doi.org/10.3389/fmedt.2024.1384008","url":null,"abstract":"<p><p>Cardiovascular diseases remain a global health challenge, prompting continuous innovation in medical technology, particularly in Cardiovascular MedTech. This article provides a comprehensive exploration of the transformative landscape of Cardiovascular MedTech in the 21st century, focusing on interventions. The escalating prevalence of cardiovascular diseases and the demand for personalized care drive the evolving landscape, with technologies like wearables and AI reshaping patient-centric healthcare. Wearable devices offer real-time monitoring, enhancing procedural precision and patient outcomes. AI facilitates risk assessment and personalized treatment strategies, revolutionizing intervention precision. Minimally invasive procedures, aided by robotics and novel materials, minimize patient impact and improve outcomes. 3D printing enables patient-specific implants, while regenerative medicine promises cardiac regeneration. Augmented reality headsets empower surgeons during procedures, enhancing precision and awareness. Novel materials and radiation reduction techniques further optimize interventions, prioritizing patient safety. Data security measures ensure patient privacy in the era of connected healthcare. Modern technologies enhance traditional surgeries, refining outcomes. The integration of these innovations promises to shape a healthier future for cardiovascular procedures, emphasizing collaboration and research to maximize their transformative potential.</p>","PeriodicalId":94015,"journal":{"name":"Frontiers in medical technology","volume":"6 ","pages":"1384008"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11098563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961307","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}