Pub Date : 2023-07-07DOI: 10.1097/JPO.0000000000000475
Rafael Isac Vieira, G. J. da Silva Honório, Kadine Priscila Bender dos Santos, Ruy Luiz Lorenzetti Branco, Joaquim Henrique Lorenzetti Branco, S. C. Tonon da Luz
ABSTRACT Introduction Prosthesis fixation is considered the central point for functionality, which promotes social reintegration of the individual with amputation. The deficits in the making of the prosthetic socket may trigger excessive friction on the residual limb and socket discomfort, possibly leading to a poor adaptation and consequent reduction of activity. Thermography is an evaluation and diagnostic method that may aid in the verification of the functionality of the prosthesis. The objective of the study was to analyze the superficial thermal distribution characteristics, the skin sensitivity of the residual limb, and the adaptation to the prosthesis of individuals with lower-limb amputation with prostheses provided by the Universal Health System. Materials and Methods Sixteen individuals of both genders with unilateral lower-limb amputation with ages between 18 and 64 years were recruited. The data collection protocol was composed of completing the physiotherapeutic evaluation form, assessment of residual limb skin sensitivity, application of the Prosthesis Evaluation Questionnaire (PEQ), treadmill walk for 10 minutes, thermographic evaluation immediately after the removal of the prosthesis, and lastly postacclimatization thermographic assessment. Results Before the acclimatization, the region of the L3 dermatome of those who had altered sensitivity, the maximum (31.43°C), mean (28.97°C), and minimum (28.27°C) temperatures were significantly lower compared with those who had normal sensitivity (32.81°C, 29.68°C, and 28.91°C, respectively) (P < 0.05). Regarding the period after the acclimatization, there was no significant difference in the comparison performed between temperature and sensitivity. The individuals with transtibial amputation obtained results above the overall median for the PEQ items, whereas the individuals with transfemoral amputation obtained results above the overall median for the “total score.” There is a strong negative relationship between the mean temperature of the residual limb extremity with item “utility” in the preacclimatization moment and a strong negative relationship between the mean and minimum temperatures at the residual limb extremity with the “residual limb health” item at the moment after the acclimatization. There is no association between the PEQ items and residual limb sensitivity. Conclusions One may conclude that high temperatures at the postacclimatization moment indicate areas of friction that trigger a poor adaptation of the residual limb with the prosthetic socket, in which case the development of new strategies for improving the quality of the prostheses supplied is suggested. Clinical Relevance Thermography helps in evaluating the residual limb and adapting the prosthesis, as it is a noninvasive clinical assessment tool. Thermography aids health professionals for management of the patient with amputation in the preprosthesis and postprosthesis phases.
{"title":"Thermographic Evaluation, Residual Limb Skin Sensitivity, and Adaptation to the Prosthesis of Individuals with Lower-Limb Amputation with Prosthesis Provided by the Universal Health System","authors":"Rafael Isac Vieira, G. J. da Silva Honório, Kadine Priscila Bender dos Santos, Ruy Luiz Lorenzetti Branco, Joaquim Henrique Lorenzetti Branco, S. C. Tonon da Luz","doi":"10.1097/JPO.0000000000000475","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000475","url":null,"abstract":"ABSTRACT Introduction Prosthesis fixation is considered the central point for functionality, which promotes social reintegration of the individual with amputation. The deficits in the making of the prosthetic socket may trigger excessive friction on the residual limb and socket discomfort, possibly leading to a poor adaptation and consequent reduction of activity. Thermography is an evaluation and diagnostic method that may aid in the verification of the functionality of the prosthesis. The objective of the study was to analyze the superficial thermal distribution characteristics, the skin sensitivity of the residual limb, and the adaptation to the prosthesis of individuals with lower-limb amputation with prostheses provided by the Universal Health System. Materials and Methods Sixteen individuals of both genders with unilateral lower-limb amputation with ages between 18 and 64 years were recruited. The data collection protocol was composed of completing the physiotherapeutic evaluation form, assessment of residual limb skin sensitivity, application of the Prosthesis Evaluation Questionnaire (PEQ), treadmill walk for 10 minutes, thermographic evaluation immediately after the removal of the prosthesis, and lastly postacclimatization thermographic assessment. Results Before the acclimatization, the region of the L3 dermatome of those who had altered sensitivity, the maximum (31.43°C), mean (28.97°C), and minimum (28.27°C) temperatures were significantly lower compared with those who had normal sensitivity (32.81°C, 29.68°C, and 28.91°C, respectively) (P < 0.05). Regarding the period after the acclimatization, there was no significant difference in the comparison performed between temperature and sensitivity. The individuals with transtibial amputation obtained results above the overall median for the PEQ items, whereas the individuals with transfemoral amputation obtained results above the overall median for the “total score.” There is a strong negative relationship between the mean temperature of the residual limb extremity with item “utility” in the preacclimatization moment and a strong negative relationship between the mean and minimum temperatures at the residual limb extremity with the “residual limb health” item at the moment after the acclimatization. There is no association between the PEQ items and residual limb sensitivity. Conclusions One may conclude that high temperatures at the postacclimatization moment indicate areas of friction that trigger a poor adaptation of the residual limb with the prosthetic socket, in which case the development of new strategies for improving the quality of the prostheses supplied is suggested. Clinical Relevance Thermography helps in evaluating the residual limb and adapting the prosthesis, as it is a noninvasive clinical assessment tool. Thermography aids health professionals for management of the patient with amputation in the preprosthesis and postprosthesis phases.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"272 - 282"},"PeriodicalIF":0.6,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46455423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-01DOI: 10.1097/JPO.0000000000000472
C. Ng, Kin Fong Wong, King-Pong Yu, K. Chan, Sin-Wa Ng
ABSTRACT Introduction Poliomyelitis has been considered a statutory notifiable infectious disease in Hong Kong since 1948. Approximately 15% to 80% of patients suffer from post-polio syndrome (PPS) with an increased risk of falling and chronic pain. Most of them relied on the use of knee lock-type orthoses as aids. This study aimed to evaluate the effect of using a custom-fit knee robotic orthosis on their gait performance. Materials and Methods A case series report was used for this study on a group of individuals suffering from chronic PPS who used orthoses and had a history of falling. A knee robotic orthosis was custom-fit for eight sessions of walking practice. Assessments included laboratory gait analysis, functional measures, and subjective ratings of exertional level. Pain responses were recorded to evaluate the effect of using the knee robotic orthosis on participants’ gait performance. Results Five participants completed the study in using the knee robotic orthosis. All achieved reduction in shoulder tilting and trunk swaying movement on walking at the anterior-posterior and the medial-lateral direction. A total of 80% of the study participants achieved reduction in trunk rotation movement, lower-limb circumduction, and hip hiking movement on the affected side on walking. All study participants were able to demonstrate improvement in their gait symmetry after using the knee robotic orthosis as reflected by the symmetric index improvement of kinematics. The rate of perceived exertion and the visual analog scale of pain in all study participants were reported lower when they used the knee robotic orthosis. However, the 10-m walking time achieved was longer. Conclusions The knee robotic orthosis had a positive effect on remediating the abnormal kinematics of PPS patients using conventional lock-knee orthosis after eight sessions of training practice. Reduction in the limping gait pattern and improvement in gait symmetry was achieved in using a knee robotic orthosis for walking. The chronic pain response and the physical exertional level on walking were also reduced. However, the walking speed achieved was slower. Clinical Relevance The application of the knee robotic orthosis for walking assist is new to most of the PPS patients. The positive outcomes achieved merit further research for future clinical practice.
{"title":"Application of Knee Robotic Orthosis to Improve the Walking Performance of People with Post-Polio Syndrome","authors":"C. Ng, Kin Fong Wong, King-Pong Yu, K. Chan, Sin-Wa Ng","doi":"10.1097/JPO.0000000000000472","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000472","url":null,"abstract":"ABSTRACT Introduction Poliomyelitis has been considered a statutory notifiable infectious disease in Hong Kong since 1948. Approximately 15% to 80% of patients suffer from post-polio syndrome (PPS) with an increased risk of falling and chronic pain. Most of them relied on the use of knee lock-type orthoses as aids. This study aimed to evaluate the effect of using a custom-fit knee robotic orthosis on their gait performance. Materials and Methods A case series report was used for this study on a group of individuals suffering from chronic PPS who used orthoses and had a history of falling. A knee robotic orthosis was custom-fit for eight sessions of walking practice. Assessments included laboratory gait analysis, functional measures, and subjective ratings of exertional level. Pain responses were recorded to evaluate the effect of using the knee robotic orthosis on participants’ gait performance. Results Five participants completed the study in using the knee robotic orthosis. All achieved reduction in shoulder tilting and trunk swaying movement on walking at the anterior-posterior and the medial-lateral direction. A total of 80% of the study participants achieved reduction in trunk rotation movement, lower-limb circumduction, and hip hiking movement on the affected side on walking. All study participants were able to demonstrate improvement in their gait symmetry after using the knee robotic orthosis as reflected by the symmetric index improvement of kinematics. The rate of perceived exertion and the visual analog scale of pain in all study participants were reported lower when they used the knee robotic orthosis. However, the 10-m walking time achieved was longer. Conclusions The knee robotic orthosis had a positive effect on remediating the abnormal kinematics of PPS patients using conventional lock-knee orthosis after eight sessions of training practice. Reduction in the limping gait pattern and improvement in gait symmetry was achieved in using a knee robotic orthosis for walking. The chronic pain response and the physical exertional level on walking were also reduced. However, the walking speed achieved was slower. Clinical Relevance The application of the knee robotic orthosis for walking assist is new to most of the PPS patients. The positive outcomes achieved merit further research for future clinical practice.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"229 - 236"},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48690799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-11DOI: 10.1097/JPO.0000000000000471
S. Spaulding, Joshua B. Utay, Sheryl N. Sachs
ABSTRACT Introduction Prosthetic and orthotic (P&O) education summits and strategic planning meetings have been held periodically since 1970 to review the current state of practice and education and to advance the profession. These meetings typically included a panel of acknowledged experts from the ranks of educators, researchers, consumers, industry representatives, and practitioners. Materials and Methods A narrative review of education summit and strategic planning meeting reports was performed. The authors defined concrete aims and specific questions before conducting the review. The authors independently reviewed the reports to identify the purpose of each meeting and the perceived challenges of the time. Lastly, the authors performed a qualitative thematic analysis to clarify the findings. Results The recurring themes identified from the five education summit reports, joint task force report, and three National Commission on Orthotic and Prosthetic Education (NCOPE) strategic planning meeting reports include 1) workforce shortages, 2) continuous development and oversight of uniform, recognized, national academic standards, 3) sustainability of P&O academic programs, 4) development and oversight of uniform, recognized, national residency standards, 5) communication with stakeholders, including related health professionals, and 6) data collection and usage. Conclusions Recurring themes and challenges that existed previously in P&O education still exist today. Communication between academic programs and community partners (e.g., clinical practitioners, paraprofessionals, patients, payers, and interdisciplinary professionals) is a continuing priority to clarify the expectations of P&O professionals and to advance the profession. Use of a systematic approach could help map the patterns and needs of the profession to demonstrate progress over time and to facilitate future strategic planning. Clinical Relevance P&O education is designed to meet the needs of practitioners and paraprofessionals who implement P&O services (i.e., fitting, fabrication, and patient management). Maintaining communication between academia and its community partners is critical to advancing the profession.
{"title":"Recurring Themes in Prosthetic and Orthotic Education: A Narrative Review of Prosthetic and Orthotic Education Summit Meetings","authors":"S. Spaulding, Joshua B. Utay, Sheryl N. Sachs","doi":"10.1097/JPO.0000000000000471","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000471","url":null,"abstract":"ABSTRACT Introduction Prosthetic and orthotic (P&O) education summits and strategic planning meetings have been held periodically since 1970 to review the current state of practice and education and to advance the profession. These meetings typically included a panel of acknowledged experts from the ranks of educators, researchers, consumers, industry representatives, and practitioners. Materials and Methods A narrative review of education summit and strategic planning meeting reports was performed. The authors defined concrete aims and specific questions before conducting the review. The authors independently reviewed the reports to identify the purpose of each meeting and the perceived challenges of the time. Lastly, the authors performed a qualitative thematic analysis to clarify the findings. Results The recurring themes identified from the five education summit reports, joint task force report, and three National Commission on Orthotic and Prosthetic Education (NCOPE) strategic planning meeting reports include 1) workforce shortages, 2) continuous development and oversight of uniform, recognized, national academic standards, 3) sustainability of P&O academic programs, 4) development and oversight of uniform, recognized, national residency standards, 5) communication with stakeholders, including related health professionals, and 6) data collection and usage. Conclusions Recurring themes and challenges that existed previously in P&O education still exist today. Communication between academic programs and community partners (e.g., clinical practitioners, paraprofessionals, patients, payers, and interdisciplinary professionals) is a continuing priority to clarify the expectations of P&O professionals and to advance the profession. Use of a systematic approach could help map the patterns and needs of the profession to demonstrate progress over time and to facilitate future strategic planning. Clinical Relevance P&O education is designed to meet the needs of practitioners and paraprofessionals who implement P&O services (i.e., fitting, fabrication, and patient management). Maintaining communication between academia and its community partners is critical to advancing the profession.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"139 - 148"},"PeriodicalIF":0.6,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43537736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"CRANIAL ORTHOSES","authors":"","doi":"10.1097/01.jpo.0000921044.36618.b4","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921044.36618.b4","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):p 1-3, April 2023. | DOI: 10.1097/01.JPO.0000921044.36618.b4","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"336 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.1097/JPO.0000000000000469
C. Faldini, A. Mazzotti, G. Geraci, S. Zielli, Simone Bonelli, A. Panciera
ABSTRACT Introduction Transtibial amputation represents a definitive treatment of several pathological conditions. Historically, immediate postoperative prosthetic protocols have been developed to improve recovery; however, concerns still limit their widespread application. Materials and Methods The aim of this article is to present a step-by-step approach to a revised, inexpensive, and easy technique that allows early postoperative prosthetic use and rehabilitation. Results The technique appears to provide optimal patient care levels at reasonable costs and could be applied also in low-resource settings. Conclusions Early ambulation allows to avoid postoperative complications (such as thromboembolism, pneumonia, etc.) and facilitates definitive prosthetic substitution and conservation of gait patterns as well as better psychological results. Clinical Relevance This technique can provide a solution for allowing early ambulation in persons with amputations, facilitating the postoperative management of these patients.
{"title":"Early Postoperative Prosthesis After Transtibial Amputation: Step-By-Step Approach","authors":"C. Faldini, A. Mazzotti, G. Geraci, S. Zielli, Simone Bonelli, A. Panciera","doi":"10.1097/JPO.0000000000000469","DOIUrl":"https://doi.org/10.1097/JPO.0000000000000469","url":null,"abstract":"ABSTRACT Introduction Transtibial amputation represents a definitive treatment of several pathological conditions. Historically, immediate postoperative prosthetic protocols have been developed to improve recovery; however, concerns still limit their widespread application. Materials and Methods The aim of this article is to present a step-by-step approach to a revised, inexpensive, and easy technique that allows early postoperative prosthetic use and rehabilitation. Results The technique appears to provide optimal patient care levels at reasonable costs and could be applied also in low-resource settings. Conclusions Early ambulation allows to avoid postoperative complications (such as thromboembolism, pneumonia, etc.) and facilitates definitive prosthetic substitution and conservation of gait patterns as well as better psychological results. Clinical Relevance This technique can provide a solution for allowing early ambulation in persons with amputations, facilitating the postoperative management of these patients.","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"35 1","pages":"219 - 223"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43667457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"UPPER-LIMB PROSTHESES","authors":"","doi":"10.1097/01.jpo.0000921064.11529.b8","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921064.11529.b8","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):p 53-61, April 2023. | DOI: 10.1097/01.JPO.0000921064.11529.b8","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"2023 Annual Meeting Clinical Content Committee/Academy Board","authors":"","doi":"10.1097/01.jpo.0000921032.07583.d3","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921032.07583.d3","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):10.1097/01.JPO.0000921032.07583.d3, April 2023. | DOI: 10.1097/01.JPO.0000921032.07583.d3","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"337 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"SPINAL ORTHOSES","authors":"","doi":"10.1097/01.jpo.0000921060.81167.6a","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921060.81167.6a","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):p 51-52, April 2023. | DOI: 10.1097/01.JPO.0000921060.81167.6a","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"LOWER-LIMB ORTHOSES","authors":"","doi":"10.1097/01.jpo.0000921052.70905.eb","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921052.70905.eb","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):p 9-18, April 2023. | DOI: 10.1097/01.JPO.0000921052.70905.eb","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Welcome Letter from the Chair of the Clinical Content Committee","authors":"","doi":"10.1097/01.jpo.0000921040.70970.58","DOIUrl":"https://doi.org/10.1097/01.jpo.0000921040.70970.58","url":null,"abstract":"Journal of Prosthetics and Orthotics 35(2S):10.1097/01.JPO.0000921040.70970.58, April 2023. | DOI: 10.1097/01.JPO.0000921040.70970.58","PeriodicalId":53702,"journal":{"name":"Journal of Prosthetics and Orthotics","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135017200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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