Indian Journal of Medical Research最新文献

{"title":"What will it take to expand the pre-exposure prophylaxis to prevent new HIV infections in India?","authors":"Aditya Gaur, Natella Rakhmanina","doi":"10.25259/IJMR_2102_2024","DOIUrl":"10.25259/IJMR_2102_2024","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"527-529"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364592","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":"Assessing second-hand smoke exposure among non-smoking youth in India: Insights from GATS I & II.","authors":"Mansi Chopra, Amrita Gupta, Bhavya Sharma, Narendra Kakade, Monika Arora","doi":"10.25259/IJMR_388_2024","DOIUrl":"10.25259/IJMR_388_2024","url":null,"abstract":"<p><p>Background & objectives This study aimed to compare the prevalence and identify the patterns of second-hand smoke (SHS) exposure among non-smoking Indian youth (ages 15-24 and 25-29 yr) in various settings-homes, workplaces, public places, and a combination of these locations-based on sociodemographic factors and knowledge about the health implications of smoking. The purpose of the study was to identify the factors influencing SHS exposure in India between the Global Adult Tobacco Survey (GATS) I and II. Methods Secondary data analysis was conducted utilising GATS I and II data to analyse the prevalence and patterns of SHS exposure at home, workplace, public place and all the places combined among non-smoking youths aged 15-29 yr. The study sample included 20,604 and 20,927 individuals for GATS I and II, respectively. The predictor variables included the sociodemographic variables and the knowledge regarding the ill effects of smoking. Weighted prevalence was calculated using survey weights, and multivariate logistic regression analyses were utilised to examine the adjusted relationships between SHS exposure and predictors. Results Between GATS I and II, there was a notable decline in the weighted prevalence of SHS exposure at home and in public places among non-smoking youth aged 15-29 yr. The study also indicates an increase in workplace SHS exposure between the two rounds of GATS among non-smoking youth who had knowledge about the ill effects of SHS exposure on health. Multivariate regression analyses revealed significant associations between SHS exposure and gender, education level, employment status, place of residence, and wealth index, affecting exposure in one or more locations. Interpretation & conclusions Our secondary analysis of GATS data from 2009-10 to 2016-17 reveals a decline in SHS exposure at home and public places but an increase in workplaces among non-smoking youth. Factors like female gender, higher education, and wealth were linked to lower SHS exposure, while rural residence and self-employment indicated higher risks. These findings underscore the need for targeted, community-based interventions and stricter enforcement of anti-tobacco laws to protect non-smoking youth in India.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"578-591"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364495","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":"Intervention strategy for Rapid Grower Mycobacteria outbreak among post-laparoscopic surgical site infection patients in a tertiary care hospital.","authors":"Nupur Pal, Raja Ray, Somenath Kundu, Prasanta Kumar Maiti","doi":"10.25259/ijmr_138_24","DOIUrl":"10.25259/ijmr_138_24","url":null,"abstract":"<p><p>Background & objectives The emergence of Rapid Grower Mycobacteria (RGM) infections recently produced a great challenge among surgeons following laparoscopic surgical site infection. Infections caused by atypical mycobacteria may be overlooked due to limitations of proper diagnostic infrastructure and unawareness in the resource-limited set-up. In this study, we proposed an intervention strategy for RGM infection among patients having post-laparoscopic surgical site infections in our hospital. Methods Five hundred sixty-five samples were collected within one year (April 2018- March 2019) from the surgery outpatient department (OPD), suspecting atypical mycobacteria infection following surgery. Samples were processed in the microbiology department by conventional staining and culture. RGM was diagnosed up to the species level by both conventional and molecular methods [line probe assay (LPA)]. The antibiogram was performed by the microbroth dilution method on the RAPMYCOI kit as per Clinical and Laboratory Standard Institute (CLSI) guidelines. Simultaneous source identification was carried out. Results A biofilm-producing Mycobacterium abscessus strain was detected from the plastic disinfection tray of the surgical operation theatre (OT), which may be the continuous source of iatrogenic post-surgical infection. RGM prevalence among suspected patients was 19.47 per cent, and around 92 per cent of them were from laparoscopic surgery. Antibiotic sensitivity, as per CLSI guidelines, showed most of them (88.8%) were resistant to commonly given antibiotic clarithromycin. Most sensitivity was to antibiotics amikacin, tobramycin, moxifloxacin, and doxycycline. The game-changing intervention related to this outbreak scenario was the introduction of gas-plasma sterilization and maintaining strict asepsis in surgical operation theatre. Interpretation & conclusions Based on the analysed data, we proposed an intervention strategy in our hospital for treating and preventing RGM infection. Such an approach will help arrest the RGM-outbreaks in future.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"625-629"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364568","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":"Recent HCMV infection in early pregnancy associates with congenital transmission & adverse pregnancy outcome: A prospective cohort study.","authors":"Harsha Chandrashekhar Palav, Varsha Sakharam Padwal, Shilpa Milind Velhal, Sapna Yadav, Gauri Sanjay Bhonde, Varsha Kalsurkar, Sachee Agrawal, Reena Set, Jayanthi Shastri, Forum Shah, Ira Shah, Purnima Satoskar, Vainav Patel, Vikrant Madhukar Bhor","doi":"10.25259/IJMR_89_2024","DOIUrl":"10.25259/IJMR_89_2024","url":null,"abstract":"<p><p>Background & objectives Human Cytomegalovirus (HCMV) infection, leading to >90 per cent seropositivity in women of reproductive age from India, is the largest cause of congenital infections worldwide. HCMV infection status was prospectively monitored together with congenital transmission (cCMV) and adverse pregnancy outcomes (APO) in a public health setting where maternal or neonatal screening was not in practice. Methods Eighty three pregnant women, with (n=45) and without (n=38) bad obstetric history (BOH), were monitored for HCMV infection by ELISA-(IgM, IgG, IgG avidity) for all TORCH (Toxoplasma, Rubella, HCMV, HSV 1 & 2) pathogens along with HCMV-specific chemiluminescent microparticle immunoassay (CMIA) and nested polymerase chain reaction (PCR). Descriptive statistics were applied on data sets to determine associations between maternal infection status, pregnancy outcome and cCMV in 52 mother-neonate dyads. Results Combined avidity, PCR-based and HCMV IgM screening, compared to the latter alone, was successful in identifying incident infection during early pregnancy. Pregnancy loss was associated strongly with BOH and concurrent HCMV infection. Features associated with APO and cCMV, were high PCR positivity (first trimester) and high rates of HCMV-specific IgM and intermediate IgG avidity (P=0.0211, 0.0455). Also, recent HCMV infection (intermediate IgG avidity), observed mainly in the BOH group, but not recurrent infection (IgM positivity), in first and second trimesters, was associated with neonatal saliva positivity and adverse outcomes, including neonatal death (P=0.0762). Exposure to other TORCH pathogens, while detected, did not include IgM positivity or low/intermediate IgG. Conclusion This study highlights the significance of conducting early, multi-pronged screening for maternal HCMV infection during pregnancy, especially in public health settings with high HCMV seroprevalence.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"614-624"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364575","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":"Awareness & perceptions about organ donation among patient attendants in a tertiary-care hospital in South India: An observational study.","authors":"Neha Joe, Shinto Teni Chakala, Farah Fathima, Nachiket Shankar","doi":"10.25259/IJMR_473_2024","DOIUrl":"10.25259/IJMR_473_2024","url":null,"abstract":"<p><p>Background & objectives Numerous barriers like lack of awareness, fear of misuse and sociocultural beliefs contribute towards low rates of organ donation. In 2019, India had a donation rate of only 0.52 per million. Hence, this study was undertaken to determine the awareness levels and perceptions about organ donation among patient attendants in a tertiary-care hospital in South India. Methods This cross-sectional study, 'passing on the torch of life', with a sample size of 110 was conducted in a tertiary care hospital from June to October 2022. Beds across were selected by simple random sampling and the attendants of patients were interviewed using a face-validated structured interview schedule. Data was analysed using SPSS v.20 using the independent sample t test and ANOVA. Results The majority of the participants were Hindus (62%), married (68%), living in urban areas (62%) and gainfully employed (60%). The mean awareness score was 7.86±2.64 (out of 13). About 70 per cent of the participants were regarded to have adequate knowledge. The mean perception score was 67±9.41 (out of 86). A total of 95 per cent of the participants supported organ donation, however only 51 per cent were willing to donate. Males, participants with higher education and income and those residing in urban areas had significantly higher awareness scores (P<0.05). Multiple linear regression analysis showed that higher education levels was a predictor of increased awareness (P=0.036). Interpretation & conclusions The majority of participants had adequate awareness, positive perceptions and supported organ donation, however, only 51 per cent were willing to donate their organs. Education levels was a significant predictor of awareness levels. A further qualitative study is recommended to explore the reasons behind the unwillingness to donate, despite strong support for organ donation.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"552-559"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364507","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":"Effect of internet shutdown on postgraduate trainees in Manipur: A qualitative study.","authors":"S Jyothi, Sneha Dhali, Brogen Singh Akoijam, Pangambam Amrita Devi","doi":"10.25259/IJMR_206_2024","DOIUrl":"10.25259/IJMR_206_2024","url":null,"abstract":"<p><p>Background & objectives Internet shutdowns, although rare can be imposed by governments or affiliated entities and can intentionally disrupt online information and communication systems. While justified for maintaining public order, these shutdowns cause substantial economic losses, public suffering, and reputational damage. The internet shutdown in Manipur, initiated on May 3, 2023, due to civil unrest, has affected various sectors. The impact on doctors, amidst an era where internet access is considered as an integral part of practice, warrants deeper exploration of the challenges faced during such a prolonged shutdown period. Therefore, this study was conducted to explore the impact of internet shutdown among postgraduate trainees from two tertiary care hospitals in Manipur. Methods A study was conducted in two tertiary healthcare centers in Manipur from July to August 2023 among medical postgraduate trainees. Participants were selected using purposive sampling. Twenty-two in-depth interviews (IDIs) were conducted, recorded, and transcribed verbatim. Thematic analysis was done to identify codes, categories and themes. Results This qualitative study was undertaken among postgraduate trainees in two different academic institutes. A total of 21 IDIs were carried out. The major themes emerged from the study, namely, impact on professional life, impact on personal life, social consequences and coping. Internet shutdown affected patient care such as seeking timely opinions from consultants, delays in sharing patient reports and inconveniences in the hand-off process and the academic performance of postgraduate trainees like unavailability of study materials or keeping up with recent advancements. On a personal level, it negatively affected communication with family and friends, mental well-being and caused inconvenience in shopping and transactions. The study also found some positive impacts, such as less screen time leading to better sleep and increased physical activities. Interpretation & conclusions The findings of this study suggest that the internet shutdown significantly affected both the professional and personal aspects of postgraduate trainees' lives in Manipur. The implementation of a targeted ban on social media platforms and the establishment of designated internet access points are proposed as potential alternatives.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"630-636"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364563","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":"Erratum: Management of T cell responses by anesthetic drugs-propofol & isoflurane in perioperative breast cancer patients: A prospective hospital-based study.","authors":"","doi":"10.25259/ijmr_2382_23_ER","DOIUrl":"10.25259/ijmr_2382_23_ER","url":null,"abstract":"","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"642"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364566","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":"Use, knowledge, & attitudes on core outcome sets among trialists & systematic reviewers in India: A survey.","authors":"Soumyadeep Bhaumik, Inika Sharma, Jyoti Tyagi, Samiksha Pradeep Ingale","doi":"10.25259/IJMR_758_2024","DOIUrl":"10.25259/IJMR_758_2024","url":null,"abstract":"<p><p>Background & objectives Core Outcome Sets (COS) are consensus-derived standardized outcomes that improve the transparency, consistency, homogeneity, and usefulness of outcomes. While COS are being increasingly developed, not much is known about their awareness, use, knowledge, and attitudes among trialists and systematic reviewers. This study aimed to examine the use, knowledge, and attitudes about COS among clinical trialists and systematic reviewers in India. Methods We conducted an anonymous online survey between August 2023 to November 2023, using a questionnaire hosted on REDCap including trialists and/or systematic reviewers as participants. The survey tool evaluated awareness, use and attitudes on COS, including through a couple of open-ended questions. Results A total of 523 trialists/ systematic reviewers participated in this survey. Of these, only 51.4 per cent indicated that they were aware of COS. Only 13.9 per cent trialists and 10.5 per cent systematic reviewers were using them, while mere 6 per cent had been involved in COS development. Lack of available COS for conditions of interest in an Indian context was identified as one of the barriers in its uptake. Even among participants who were aware, many were not clear about COS concepts, and although they expressed positive attitudes about the benefits of COS usage, they also indicated that they perceived COS as restrictive, costly, blocking innovation, and increasing patient burden. We identified health conditions relevant to India, where there is no COS available or where COS is present but were mentioned to be not relevant or valid for the Indian context. Interpretation & conclusions As per our knowledge, this study is the largest survey on this domain globally. Through this study several barriers for enhancing COS awareness and uptake were identified indicating the need for resources and systematic efforts to address these barriers in India and globally. We also identify COS which need to be developed or updated to be relevant to Indian context.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"606-613"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364577","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":"Burkholderia cepacia complex nosocomial outbreaks in India: A scoping review.","authors":"Ankita Saran, Amit Agarwal, Swapna Anandrao Mali, Lipika Singhal, Prabhu B Patil, Vikas Gautam","doi":"10.25259/IJMR_94_2024","DOIUrl":"10.25259/IJMR_94_2024","url":null,"abstract":"<p><p>Burkholderia cepacia complex (Bcc) is an opportunistic pathogen that causes severe infections in immunocompromised individuals. It is a common contaminant of medical drugs, solutions and devices used in healthcare setups. This scoping review aimed to assess Bcc outbreaks in Indian hospital settings and address a wide range of sources to improve outbreak management. As per PRISMA-ScR guidelines, electronic databases 'Embase', 'PubMed' and 'Web of Science' were searched from 1993 to September 2024 to identify studies reporting Burkholderia cepacia complex outbreaks across India. The search identified 22 outbreak reports meeting the inclusion criteria. Bacteremia was the most common presentation in twenty studies, followed by acute-onset post-operative endophthalmitis in two studies. In 14 outbreak studies, B. cepacia was the identified species, whereas five studies had Bcc; one study each had B. cenocepacia, B. multivorans and B. contaminans isolated. Most outbreaks were associated with contaminated pharmaceuticals (45.4%) and medical (18.1%) products in contrast to the environment as a source (13.6%). Multi-locus sequence typing (MLST) was employed to study clonality among isolates in six outbreaks. This review highlights that varied medical products and environmental surfaces/objects can harbour Bcc and act as potential sources of Bcc outbreaks in hospitals. Ensuring immediate identification of Bcc from clinical samples, regular sterility checks, thorough epidemiological investigations, and timely infection control and prevention measures are critical to help manage and prevent these outbreaks and the subsequent mortality.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 6","pages":"593-605"},"PeriodicalIF":2.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364456","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":"Possibility of re-purposing antifungal drugs posaconazole & isavuconazole against promastigote form of Leishmania major.","authors":"Chandra Kanta Bhusal, Pooja Beniwal, Sarman Singh, Davinder Kaur, Upninder Kaur, Sukhbir Kaur, Rakesh Sehgal","doi":"10.25259/IJMR_569_2024","DOIUrl":"10.25259/IJMR_569_2024","url":null,"abstract":"<p><p>Background & objectives The emergence of drug resistance in leishmaniasis has remained a concern. Even new drugs have been found to be less effective within a few years of their use. Coupled with their related side effects and cost-effectiveness, this has prompted the search for alternative therapeutic options. In this study, the Computer Aided Drug Design (CADD) approach was used to repurpose already existing drugs against Leishmania major. The enzyme lanosterol 14-alpha demethylase (CYP51), in L. major, was chosen as the drug target since it is a key enzyme involved in synthesizing ergosterol, a crucial component of the cell membrane. Methods A library of 1615 FDA-approved drugs was virtually screened and docked with modeled CYP51 at its predicted binding site. The drugs with high scores and high affinity were subjected to Molecular Dynamics (MD) simulations for 100 ns. Finally, the compounds were tested in vitro using an MTT [3-(4,5-Dimethylthiazol-2-yl)-2,5-Diphenyltetrazolium Bromide] assay against the promastigotes of L. major. Results Computational screening of FDA-approved drugs identified posaconazole and isavuconazole as promising candidates, as both drugs target the CYP51 enzyme in fungi. Molecular dynamics (MD) simulations demonstrated that both drugs form stable complexes with the target enzyme. In vitro studies of posaconazole and isavuconazole against promastigotes of L. major demonstrated significant efficacy, with IC50 values of 2.062±0.89 µg/ml and 1.202±0.47 µg/ml, respectively. Interpretation & conclusions The study showed that the existing FDA-approved drugs posaconazole and isavuconazole can successfully be repurposed for treating L. major by targeting the CYP51 enzyme, demonstrating significant efficacy against promastigotes.</p>","PeriodicalId":13349,"journal":{"name":"Indian Journal of Medical Research","volume":"160 5","pages":"466-478"},"PeriodicalIF":2.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906972","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}