Indian Journal of Medical Research最新文献

{"title":"Systematic review of medical audits of hysterectomy practices in India.","authors":"Archana Kumari, Reeta Mahey, Hemali Heidi Sinha, Mukta Agarwal, Piyush Ranjan, Aditi Verma, Divjyot Kaur, Roopal Jyoti Singh, Sapna Desai, Neerja Bhatla","doi":"10.25259/IJMR_338_2026","DOIUrl":"10.25259/IJMR_338_2026","url":null,"abstract":"<p><p>Background and objectives The utilisation of hysterectomy has emerged as a public health concern in India. The Ministry of Health's National Guidelines aim to reduce unnecessary hysterectomies by promoting adherence to recommended indications, age, and extent of surgery. Although audits are routinely conducted in tertiary hospitals, their findings have not been synthesised. We present a synthesis of medical audits of hysterectomy practices in India to identify patterns, gaps, and opportunities to improve the quality of care. Methods This systematic review included medical audits of hysterectomies in India published between 2010 and 2024 across PubMed, Scopus, and EMBASE. Using PRISMA guidelines, a systematic search and narrative synthesis were conducted to examine clinical indications, surgical route, complications, and histopathological correlations. Study selection and quality assessment were carried out independently by two reviewers using the Joanna Briggs Institute critical appraisal tool. Results The review included 89 medical audits, mostly of moderate quality. Hysterectomies were predominantly performed in premenopausal women, with one-fourth in women under 40 years. The leading indications were abnormal uterine bleeding and fibroids, commonly managed by abdominal surgery. Oophorectomy was frequently performed without documented ovarian pathology. Reported complications included haemorrhage, postoperative fever, and urinary tract infections. Interpretation and conclusions This review identified benign gynaecological conditions, particularly fibroids, as the predominant indication for hysterectomy. It also revealed substantial gaps in standardised reporting, clinicopathological documentation, and sociodemographic data. Strengthening audit systems, ensuring adherence to evidence-based guidelines, and expanding access to conservative and minimally invasive treatments are essential to support rational surgical decision-making and improve the quality of gynaecological care.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"377-384"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability, benefits, and challenges of teleconsultation: A qualitative study among doctors in Manipur.","authors":"K Dhinu, Brogen Singh Akoijam, Kshetrimayum Birendra Singh","doi":"10.25259/IJMR_614_2026","DOIUrl":"10.25259/IJMR_614_2026","url":null,"abstract":"<p><p>Background and objectives Teleconsultation through eSanjeevani can reduce the burden on secondary and tertiary hospitals and meet healthcare delivery challenges in rural and remote areas. This study explored doctors' perspectives to assess the acceptability of teleconsultation and to identify perceived benefits and challenges of teleconsultation services in Manipur. Methods A qualitative study was conducted from January to May 2024 among doctors registered with eSanjeevani in Manipur. In-depth interviews were conducted with purposively selected doctors from different districts, and data were analysed thematically using an abductive approach. Thematic saturation was achieved after 11 interviews. Results Involved doctors perceived teleconsultation as acceptable to patients, doctors, and the health system. Participants reported improved access to general and specialist care in remote areas, with reduced travel, costs, and time for patients. Key benefits included early case identification, timely referral, follow up of chronic diseases, and maintenance of electronic medical records. Community health officers (CHOs) played an important role in enhancing consultation quality and acceptability. Major challenges included poor network connectivity, limited direct physical examination, limited public awareness, unclear guidelines, increased workload due to the absence of designated telemedicine doctors, the absence of regular review mechanisms, and limited availability of medicines and diagnostic facilities at peripheral facilities. Interpretation and conclusions Teleconsultation was acceptable and beneficial in improving access to healthcare, despite persistent operational challenges. Designating dedicated telemedicine doctors with structured rosters, regular specialist scheduling, capacity-building for CHOs, improved dissemination of guidelines, IEC-based awareness generation, and stakeholder motivation are essential for sustaining teleconsultation services.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"405-411"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body composition changes and nutritional challenges in children with acute lymphoblastic leukaemia: Perspectives from low-resource settings.","authors":"Deepa Puttaswamy, Rebecca Kuriyan","doi":"10.25259/IJMR_3730_2025","DOIUrl":"10.25259/IJMR_3730_2025","url":null,"abstract":"<p><p>Acute lymphoblastic leukaemia (ALL) is the most common childhood cancer in India; despite improving survival in low-and middle-income countries (LMICs), outcomes remain inferior to those in high-income countries and are further complicated by the dual burden of undernutrition and treatment-related obesity. This narrative review synthesises evidence on nutritional status, body composition changes, and related challenges in children with ALL in low-resource settings, focusing on India. During treatment, weight and body mass index (BMI) may fluctuate, yet body-composition studies indicate that even when weight/BMI are stable or increase, lean mass can decline with concurrent fat gain. These alterations often persist into survivorship, increasing cardiometabolic and functional risks, highlighting the limitations of relying solely on anthropometric measurements, which may miss clinically important shifts in body composition. This issue is particularly relevant in South Asian children, who exhibit a 'thin fat' phenotype with relatively greater adiposity at a given BMI. Both undernutrition and overnutrition are associated with higher infection rates, chemotherapy toxicity, treatment delays, relapses, and mortality, yet nutritional care often remains peripheral within oncology services in LMICs. This review outlines the limitations of conventional anthropometry, summarises the feasibility and constraints of available body-composition techniques, and describes complementary biochemical, clinical, and dietary indicators to refine nutritional risk stratification. It also discusses health-system, socioeconomic, and cultural barriers, including gaps in caregiver nutrition knowledge. Collectively, the findings highlight the need to integrate routine nutrition screening, longitudinal body-composition monitoring, and individualised, culturally sensitive dietary interventions into standard paediatric ALL care, particularly in resource-limited settings.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"435-444"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' response.","authors":"Nandini Vallath, Parvathy V, Pratyasa Padhi, Angelin Johny T, Mathangi Krishnakumar, Varghese P S","doi":"10.25259/IJMR_3096_2026","DOIUrl":"10.25259/IJMR_3096_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"498-499"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of 5G frequencies on sperm parameters, mating success, and offspring outcomes in rats.","authors":"Atikah Hairulazam, Siti Fatimah Ibrahim, Khairul Osman, Mohd Helmy Mokhtar, Aini Farzana Zulkefli, Mohd Farisyam Mat Ros, Norazurashima Jamaludin, Syed Muhamad Asyraf Syed Taha, Sivasatyan Vijay, Zahriladha Zakaria, Amyrul Azuan Mohd Bahar, Farah Hanan Fathihah Jaffar","doi":"10.25259/IJMR_3658_2025","DOIUrl":"10.25259/IJMR_3658_2025","url":null,"abstract":"<p><p>Background and objectives The advancement of 5G technology is highly anticipated due to its faster data transmission, yet its potential impact on male fertility remains unclear. This study evaluated the effects of 5G frequencies at 3.5 GHz and 24 GHz on sperm parameters, mating success, and offspring outcomes. Methods A total of 18 male Sprague Dawley rats (n=18) were divided into three groups: a Control group, a 3.5 GHz group, and a 24 GHz group (n=6). The Control group was sham-exposed. In contrast, the 3.5 GHz and 24 GHz groups were exposed to their respective frequencies for 7 h daily over 60 d. Following 46 d of exposure, a 1:1 mating procedure was conducted. Female rats (n=18) were monitored until gestation d 28 to assess pregnancy rates and birth metrics. Later, the male rats were sacrificed, and sperm quality was evaluated. Results Both exposed groups exhibited a significant decrease in sperm concentration and motility (P<0.001) compared to the Control group. The 24 GHz group had a lower pregnancy rate, whereas the 3.5 GHz group showed a lower live birth rate. Congenital anomalies were observed in the 3.5 GHz group, whereas the 24 GHz group presented significantly lower birth weights (P< 0.001). Interpretation and conclusions The findings suggest prolonged exposure to 5G frequencies may have a negative impact on male fertility, pregnancy outcomes, and the birth metrics.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"341-348"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of metabolic variables of serum uric acid beyond polycystic ovary syndrome (PCOS) phenotypes.","authors":"Megha Haresh Raheja","doi":"10.25259/IJMR_806_2026","DOIUrl":"10.25259/IJMR_806_2026","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"500"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the web of neglect in elderly cancer care in South India: A grounded theory approach.","authors":"Viswanath Narendiran, Sonali Sarkar, Mahalakshmy Thulasingam, Gunaseelan Karunanithi","doi":"10.25259/IJMR_3433_2025","DOIUrl":"10.25259/IJMR_3433_2025","url":null,"abstract":"<p><p>Background and objectives Elder neglect, characterised by unmet care needs, social isolation, and emotional distress, has been consistently reported in epidemiological studies, yet it continues to be insufficiently acknowledged as a major public health concern in India. Existing frameworks inadequately explain how factors interact to produce neglect and abandonment. This study aimed to explore the circumstances leading to neglect among elderly cancer patients in Puducherry and Tamil Nadu. Methods A qualitative grounded theory design was used. Data were collected through five in-depth interviews, six key informant interviews, and 156 narrative accounts from 52 patient-caregiver-community triads using the SENILE-C tool. Transcribed interviews were analysed through open, axial, and selective coding using constant comparative methods, supported by theoretical sampling, member checking, and multi-coder triangulation. Theory triangulation with the theory of planned behaviour, Maslow's hierarchy, broken windows theory, and the interplay theory helped contextualise how neglect develops and escalates. Results Neglect emerges as a dynamic, progressive process that begins with subtle lapses in care and can escalate to overt abandonment. Vulnerability was shaped by individual factors (self-neglect, emotional distress, functional decline), family-level pressures (caregiver burnout, economic strain, substance use, exploitation), and community influences (stigma, discrimination, weak social support, limited palliative care). The interplay theory showed how combined pressures across these domains can push families beyond their coping threshold, leading to worsening neglect. Interpretation and conclusions The study highlights neglect as a cumulative, socially reinforced process requiring multi-level interventions. Strengthening caregiver support, addressing financial and social barriers, and expanding community-based palliative care services may help prevent escalation of neglect and improve outcomes for elderly cancer patients.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"474-481"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and diagnostic variability of sarcopenia in India: A systematic review and meta-analysis.","authors":"Mogan Kaviprawin, Gnanaprakash Gurusamy, Carolin Elizabeth George, Alexander Thomas, Mohan Babu Saminathan, Lalithambigai Kathiresan, Deepa C, Aswathy P, Aravind P Gandhi, Shanmuganathan Rajasekaran","doi":"10.25259/IJMR_881_2026","DOIUrl":"10.25259/IJMR_881_2026","url":null,"abstract":"<p><p>Background and objectives Sarcopenia is a recognised determinant of adverse health outcomes yet remains insufficiently quantified in India. We conducted a systematic review and meta-analysis to estimate the prevalence of sarcopenia and document the diagnostic criteria used across community and hospital-based populations in India. Methods We searched PubMed, EMBASE, Web of Science, and Scopus databases from their inception to December 2, 2025 (PROSPERO registration: CRD420251252940). Cross-sectional and cohort studies reporting prevalence were included. The primary outcome was the prevalence of different types of sarcopenias (probable, confirmed, or severe). Risk of bias was assessed using the Joanna Briggs Institute tool. Pooled prevalence with 95% confidence intervals (CI) was calculated using a random-effects model in R software. Results Of the 5,486 records retrieved, we included 44 studies for final review. Consensus-based definitions, such as Asian and European working group criteria, were used in 54.5% (n= 24) studies, while the remaining used heterogeneous, nonuniform operational criteria. The pooled prevalence of probable, confirmed, and severe sarcopenia was 36.3% (95% CI: 26-48%, 18 studies), 35.4% (95% CI: 28.8-42.5%, 38 studies), and 9.9% (95% CI: 5.6-16.7%, 11 studies), respectively. Interpretation and conclusions Over one in three individuals in India had sarcopenia. We documented an inconsistency in diagnostic criteria across studies, limiting comparability and hindering accurate burden estimation. Our review recommends the need for standardised, setting-specific definitions to enable timely identification, and strengthen evidence-informed public health planning in India.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"423-434"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapeutic effect of MIP vaccine along with multidrug therapy (MDT) in leprosy: A systematic review and meta-analysis.","authors":"Madhumathi Jayaprakasam, Jigisha Chaudhary, Deenadayalan Boopalan, Rizwan Suliankatchi Abdulkader, Nivedita Gupta","doi":"10.25259/IJMR_538_2026","DOIUrl":"10.25259/IJMR_538_2026","url":null,"abstract":"<p><p>Background and objectives Leprosy is a neglected tropical disease caused by Mycobacterium leprae often resulting in nerve damage, numbness, disfiguring lesions, and disability. India accounts for ∼52% of the world's new leprosy patients. Immunotherapy has been reported to achieve faster bacterial clearance in multi-bacillary (MB) leprosy patients. We conducted this systematic review to synthesise the global evidence available for the efficacy and safety of the MIP vaccine (Mycobacterium indicus pranii), previously known as Mw, as an immunotherapeutic agent along with standard chemotherapy, on the treatment outcomes in patients with multi-bacillary (MB) and pauci-bacillary (PB) leprosy. Methods Three bibliographic databases namely, PubMed, Embase, and Cochrane Library were used for search of articles apart from four clinical trial registries, Google Scholar, and the Google search engine. Articles published between 1980 to 2023 reporting the efficacy of the MIP vaccine for immunotherapy along with standard chemotherapy in leprosy patients were included. Methodological bias was assessed using the RoB2 and ROBIN-I tool. Meta-analysis was carried out from four RCTs and three non-RCTs for the outcomes clinical score and bacterial index following 12 and 24 mo of treatment using the Review Manager 5.4.1 (RevMan). Results The pooled analysis of four RCTs with 12 and 24 mo of follow up showed a significant reduction in clinical scores with mean difference of -1.35 [95% confidence interval (CI): -2.12 to -0.57] and -2.62 (95% CI: -4.28 to -0.96) respectively, while the analysis of three non-RCTs showed a mean difference of -2.97 (95% CI: -4.00 to -1.94) and -3.10 (95% CI: -3.84 to -2.37) at 12 and 24 mo respectively. Subgroup analysis showed a significant reduction in clinical scores and bacterial index among borderline lepromatous (BL) and lepromatous leprosy (LL) types of leprosy. The vaccine was reported to be safe and well-tolerated. Interpretation and conclusions This systematic review and meta-analysis confirms the clinical efficacy of the MIP as an immunotherapeutic vaccine in leprosy patients for rapid bacterial clearance and overall clinical improvement when used as an adjunct to chemotherapy.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"365-376"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with prehospital delay in stroke: A multicentre study from eastern India.","authors":"Arpan Dutta, Arnab Sarkar, Gargi Podder, Babuji Santra, Deepanjan Dutta, Sourav Hazra, Sishir Kumar Naskar, Dhiraj Roy, Atasi Mondal, Nitai Chandra Mandal, Subhransu Sekhar Datta, Asit Kumar Biswas, Swapan Saren, Manimoy Bandyopadhyay, Biman Kanti Ray","doi":"10.25259/IJMR_285_2026","DOIUrl":"10.25259/IJMR_285_2026","url":null,"abstract":"<p><p>Background and objectives Prehospital delay is a significant challenge in stroke management. Our study aims to identify factors associated with prehospital delay in stroke. Methods This cross-sectional study was conducted between March 2024 and May 2024 across thirteen hospitals in West Bengal, India. Patients with acute stroke (both ischaemic and haemorrhagic) aged 18 year or above who consented to participate were consecutively surveyed using a structured questionnaire. Arrival at the study hospitals more than 4.5 h after symptom onset was considered as prehospital delay. Results Out of 683 patients with stroke, 389 (56.9%) arrived more than 4.5 h after symptom onset. Factors linked to delayed arrival included: distance over 15 km [Adjusted Odds Ratio (aOR) 2.55, 95% Confidence interval (CI) 1.56-4.16], lack of awareness about the 'golden hour of stroke' (aOR 11.01, 95% CI 4.29-28.26), nighttime onset (aOR 1.81, 95% CI 1.16-2.82), being alone at symptom onset (aOR 11.33, 95% CI 4.65-27.59), wake-up stroke (aOR 2.06, 95% CI 1.15-3.67), use of public transport (aOR 3.05, 95% CI 1.42-6.55), family history of stroke (aOR 2.01, 95% CI 1.11-3.61), vertigo (aOR 2.3, 95% CI 1.03-5.15), and visiting another treatment facility (aOR 6.52, 95% CI 4.21-10.12). Interpretation and conclusions Over half of stroke patients arrive late due to various factors. Increasing awareness about stroke and the 'golden hour' is vital to reduce prehospital delays.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"164 3","pages":"412-416"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}