M. A. Sharifudin, Ramzi Ali Saleh Hussen, Mai Nurul Ashikin Taib, Amran Ahmed Shokri
{"title":"Reappraisal of the Use of X-Rays in Acute Ankle and Midfoot Injuries. A Prospective Evaluation of the Ottawa Ankle Rules (OAR) in a Single Tertiary Trauma Centre","authors":"M. A. Sharifudin, Ramzi Ali Saleh Hussen, Mai Nurul Ashikin Taib, Amran Ahmed Shokri","doi":"10.31436/imjm.v23i02.2350","DOIUrl":"https://doi.org/10.31436/imjm.v23i02.2350","url":null,"abstract":"INTRODUCTION: Acute ankle and foot injuries commonly present to the emergency departments, often resulting in routine radiography referrals, despite the fact that less than 15% of cases exhibit clinically significant fractures. The OAR has been designed to reduce the number of unnecessary radiographs ordered for these patients. We evaluated the OAR for predicting ankle and midfoot fractures in a cohort of patients treated in a single tertiary trauma centre. MATERIALS AND METHOD: A prospective study was conducted in the emergency department and orthopaedic clinics of a tertiary trauma centre. 73 patients aged 18 years and older were recruited during a 12-month study period. Radiographs were performed for all patients after clinical evaluation findings were recorded. The main outcomes measured were sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) of the OAR. RESULTS: 41 patients had ankle injuries, 21 around the midfoot, and 11 within both areas. In detecting ankle fractures, OAR had a sensitivity of 100%, a specificity of 73.68%, and a negative predictive value of 100% compared to the detection of midfoot fractures (100%, 84.61%, and 100%, respectively). The OAR had the potential of reducing radiographs by 42.47%. CONCLUSION: OAR is an accurate and highly sensitive tool to detect ankle and midfoot fractures. The implementation would lead to a significant reduction in the request for radiographs without missing any clinically significant fractures, thus, reducing costs, radiation exposures, and waiting times.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"114 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140783149","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":"Prevalence of Antibiotic Use in Hospitalized COVID-19 Patients: An Observational Study in Secondary Healthcare Hospitals in Kosovo","authors":"I. Tolaj, H. Fejza, Fitim Alidema, Lirim Mustafa","doi":"10.31436/imjm.v23i02.2351","DOIUrl":"https://doi.org/10.31436/imjm.v23i02.2351","url":null,"abstract":"INTRODUCTION: Globally, the high use of antibiotics among hospitalized patients diagnosed with COVID-19 has been reported despite evidence that bacterial coinfections are uncommon. This issue raised our concerns, as there was a report on high frequency of antibiotic resistant bacterial infections in COVID-19 patients admitted to the intensive care unit. Thus, we conducted a study to determine the prevalence of antibiotic use for hospitalized acute COVID-19 infection in secondary healthcare hospitals in Kosovo. MATERIALS AND METHODS: A cross sectional study was conducted among patients with acute COVID-19 admitted to secondary healthcare hospitals in Kosovo. A modified Infectious Diseases International Research Initiative (ID-IRI) questionnaire was used to collect information in 460 COVID-19 PCR positive patients. RESULTS: All studied patients (100%) were treated with antibiotics. An empirical antibiotics were used to cover Methicillin-resistant Staphylococcus aureus (MRSA) infections in 136 cases (29.6%), methicillin-susceptible Staphylococcus aureus (MSSA) infections in 86 cases (18.7%), atypical pathogen in 174 cases (37.8%), and Pseudomonas infections in 48 cases (10.4%). The most frequently used antibiotics were ceftriaxone/cefotaxime plus macrolide (149 cases; 31%), ceftriaxone/cefotaxime plus quinolone (85 cases; 17.7%), and co-amoxiclav plus fluoroquinolone (78 cases; 16.3%). Imipenem was most frequently used in the ICU (64 cases; 13.3%). CONCLUSION: Despite the antibiotic guidelines clearly stated that antibiotics should only be used in confirmed case of secondary bacterial infections including the COVID-19 patients, our study revealed that the overused of antibiotics remained unchanged. As the misused and overused of antibacterial has been shown to accelerate the emergence and spread of antibacterial resistant, the inappropriate practice should be changed.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"527 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140784872","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}
Junaidah Yusof, Sakinah Ab. Rahim, Sabariah Mohd Noor, S. Panatik, Wan Nurul Izza Wan Husin, Mohd Sharial Bungsu
{"title":"Understanding the Motives and Intention of Blood Donation during the Pandemic","authors":"Junaidah Yusof, Sakinah Ab. Rahim, Sabariah Mohd Noor, S. Panatik, Wan Nurul Izza Wan Husin, Mohd Sharial Bungsu","doi":"10.31436/imjm.v23i02.2271","DOIUrl":"https://doi.org/10.31436/imjm.v23i02.2271","url":null,"abstract":"INTRODUCTION: In every country, an adequate and reliable blood supply can be assured by a stable base of regular, voluntary, and unpaid blood donors. However, with the strike of COVID-19 around the world, fewer donors have come forward to donate blood since the government's movement control order. Therefore, to ensure the blood supply is always sufficient, this study discussed the Malaysians' motivation and intention to donate blood during the COVID-19. MATERIALS AND METHODS: The structural focus group discussion was conducted among nine informants. The informants are classified into four groups, which are non, first-time, regular, and lapsed (repeated/occasional) blood donors. RESULTS: It indicated that the regular and lapsed group of blood donors were motivated by the satisfaction of donating blood. Meanwhile, first-time donors are motivated to donate blood because of extrinsic rewards. However, the donors attested that the movement control order restricted their movement to go to the blood transfusion center. On the other hand, the non-donor group admitted that they do intend to donate blood. Still, several factors such as work commitment, location, and fear of being infected by COVID-19, hold them from doing so. CONCLUSIONS: These findings will serve as insights for future blood donation disruption remediation, especially during unexpected situations, as well as the success of the Malaysian blood campaign.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"213 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140755615","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}
Maisarah Abdul Mutalib, S. Ruhi, Mohamad Halim Mohamad Shariff, Win Win May, Dhani Ramachandran
{"title":"Protective Mechanism Pathway of Cinnamomum Zeylanicum at High Dosage against Liver and Renal Damage in STZ-Induced Diabetic Rats","authors":"Maisarah Abdul Mutalib, S. Ruhi, Mohamad Halim Mohamad Shariff, Win Win May, Dhani Ramachandran","doi":"10.31436/imjm.v23i01.2359","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2359","url":null,"abstract":"INTRODUCTION: Cinnamon zeylanicum (CZ) bark is widely used as supplement for diabetic management, there are concerns about its safety and potential toxicity at high doses, and limited evidence to support its efficacy. To investigate this further, this study examines the effects of Cinnamon zeylanicum aqueous extract (CZAE) on various factors in diabetic rats, including body weight, blood glucose level, biochemical parameters, histological changes, and gene expression. MATERIALS AND METHODS: In the study, 30 male Sprague Dawley rats were divided into five groups of six animals each. Type 2 diabetes mellitus (T2DM) was induced in all groups except the negative control by a single intraperitoneal injection of streptozotocin (STZ). The rats in the intervention groups (Groups C, D, and E) were given CZAE at 1000, 1500, and 2000 mg/kg, dose respectively, for 28 days. The body weight and fasting blood glucose were monitored weekly, and their liver and renal profiles were analyzed. Histology was assessed with hematoxylin and eosin stain, and apoptotic gene expression was examined in liver and renal tissues. RESULTS: The body weight of rats in intervention groups increased compared to the control group. There was a significant decrease (P<0.001) in blood glucose levels. The extract significantly reduced (P<0.05) liver biochemical markers in the intervention groups compared to the control group. The histology of the liver & kidney improved (p<0.001) with upregulated Bcl-2 and down-regulated BAX genes in preventing apoptosis in the intervention groups. CONCLUSIONS: High doses of CZAE are safe and effective for T2DM.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139124942","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}
Lim Qiu Xin, Siti Nor Assyuhada Mat Ghani, N. Rasudin, Noraini Abdul Ghafar, Nur Haslindawaty Abd Rashid, Dennis Choon Yung Ten, Salman Saaban, H. Edinur, Mohd Tajuddin Abdullah
{"title":"Characterisation of Human-Wildlife Conflict and Casualties Caused by Wildlife Attacks in Peninsular Malaysia","authors":"Lim Qiu Xin, Siti Nor Assyuhada Mat Ghani, N. Rasudin, Noraini Abdul Ghafar, Nur Haslindawaty Abd Rashid, Dennis Choon Yung Ten, Salman Saaban, H. Edinur, Mohd Tajuddin Abdullah","doi":"10.31436/imjm.v23i01.2283","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2283","url":null,"abstract":"INTRODUCTION: This study examines human-wildlife conflict (HWC) in Peninsular Malaysia, a consequence of human population expansion, natural resource demand, deforestation, resettlement, infrastructure development, urbanization, and agricultural land growth. We analyze HWC incidents and human casualty statistics from wildlife attacks recorded by the Department of Wildlife and National Parks, Peninsular Malaysia, between 2011-2018 and 2008-2019, respectively. MATERIALS AND METHODS: Data were collected on HWC cases reported to the Department of Wildlife and National Parks, Peninsular Malaysia (locally known as PERHILITAN), from 2011 to 2018. This data underwent processing, analysis, and presentation in tables and bar charts. RESULTS: There was an increasing trend in reported HWC cases from 2012 to 2018 (5,602 to 7,967 cases). The majority of these incidents in Peninsular Malaysia involved mammalian species such as the long-tailed macaque (Macaca fascicularis), wild boar (Sus scrofa), elephant (Elephas maximus), civets (Viverridae family), and pig-tailed macaque (Macaca nemestrina), totaling 33,198, 6,614, 3,797, 3,219, and 2,232 cases respectively. Notably, snakes accounted for over 80% of fatalities and injuries. CONCLUSION: This report is the first to provide a comprehensive overview of HWC cases and casualties due to wildlife attacks in Peninsular Malaysia. Our findings highlight the urgent need for policy evaluation and improved inter-agency coordination for effective HWC management, wildlife conservation, and reduction of wildlife attack casualties","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"68 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125231","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}
Siti Sarah Razak, Asma Abdullah, N. Hashim, Azizi Abu Bakar, R. Sutan, Abdullah Sani
{"title":"Surgical outcome of Acoustic Neuroma Surgery in a Malaysian Tertiary Hospital","authors":"Siti Sarah Razak, Asma Abdullah, N. Hashim, Azizi Abu Bakar, R. Sutan, Abdullah Sani","doi":"10.31436/imjm.v23i01.2236","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2236","url":null,"abstract":"INTRODUCTION: Acoustic neuroma (AN) or vestibular schwannoma, is a benign, slow-growing tumour that arises from the Schwann cell of the vestibular branch of the vestibulocochlear nerve. Treatment options are mainly conservative or surgical excision. The aim of this study is to describe the clinical characteristics of AN and the surgical outcomes in a Malaysian tertiary hospital. MATERIALS AND METHOD: Records of 73 patients who were diagnosed with AN from January 2008 until December 2019 were retrieved. All patients were analyzed for demographic data and clinical characteristics. In all 52 patients underwent AN surgery and had normal preoperative facial nerve function. A descriptive analysis was used for the surgical outcomes of each patient. RESULTS: The median age of patients was 51.5 (15.8 SD). Hearing levels pre-operatively were severe to profound in 74.0% of the patients, followed by moderate to severe in 15.1%, mild to moderate in 6.8%, and mild hearing loss in 2.7%. Retrosigmoid (48.1%) was the most common surgical approach used, followed by translabyrinthine (44.2%) and middle cranial fossa (MCF) (7.7%). The translabyrinthine approach is associated with the least incidence of facial nerve paresis postoperatively (21.2%) when compared to the retrosigmoid and middle cranial fossa approaches (40.4%). However, there was no significant association between surgical approaches and facial nerve outcome (p=0.07). CONCLUSION: AN surgery is a safe procedure, regardless of the surgical approach used. There was a significant relationship between tumour size and facial nerve outcome.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"49 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125490","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}
P. Hoo, Ahmad Amir Ismail, Nik R Afendi, Erinna Mohamad Zon, Mohd Pazudin Ismail, R. Rahim
{"title":"Peritoneal Tuberculosis Mimicking Ovarian Malignancy","authors":"P. Hoo, Ahmad Amir Ismail, Nik R Afendi, Erinna Mohamad Zon, Mohd Pazudin Ismail, R. Rahim","doi":"10.31436/imjm.v23i01.2178","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2178","url":null,"abstract":"Peritoneal tuberculosis is an uncommon site of extrapulmonary infection caused by Mycobacterium tuberculosis (TB). It occurs mostly in immunocompromised patients such as malignancy, elderly or renal failure patients. We present a case of pelvic TB which appear to mimic an ovarian malignancy with acute onset of ascites. A 59 years old, para 3 presented with 2 weeks history of abdominal ascites with ovarian tumour. Ovarian cancer was suspected. Total abdominal bilateral salpingo-oophorectomy was performed. Histo pathology confirmed TB. She was started with an-TB therapy, she was improved after 2 weeks of therapy and she is well until now. Peritoneal TB is a rare condition which can mimick ovarian malignancy or peritoneal malignancy, especially in patient without pulmonary manifestation and negative TB investigations. This will cause dilemma in diagnosis hence delay in management.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"19 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129733","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":"The Effect of Horticultural Therapy on Increased Self-Esteem for Mental Disorders in the Community","authors":"Widyo Subagyo, Dyah Wahyuningsih","doi":"10.31436/imjm.v23i01.2337","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2337","url":null,"abstract":"INTRODUCTION: The increasing number of mental disorders causes various problems, so treatment and rehabilitation programs are needed to increase adaptability and prevent recurrences in the community. MATERIAL AND METHODS: This study used a quasi-experimental method with a pre-post test between the intervention and control groups. Effects of horticultural therapy on self-esteem were analysed using paired t-tests. RESULTS: The results showed a significant difference in the self-esteem scores of patients with mental disorders before and after treatment in the intervention group with horticultural therapy (p-value of 0.00). CONCLUSION: A significant difference exists in the self-esteem scores of patients with mental disorders before and after treatment in the intervention group given horticultural therapy marked. The participants in the study had various mental disorders, including schizophrenia and depression. Both schizophrenia and depression are associated with symptoms of low self-esteem. Horticultural therapy positively enhances self-esteem regardless of specific mental disorders.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"8 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127146","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}
Khairul Bariah Chi Adam, Nabilah Rashida Jamali, Nor Adilah Harun, Nor Aszlitah Burhanudin, Asmah Hanim Hamdan
{"title":"Subcutaneous Panniculitis-like T-cell Lymphoma: A Case Report of A Solved Conundrum","authors":"Khairul Bariah Chi Adam, Nabilah Rashida Jamali, Nor Adilah Harun, Nor Aszlitah Burhanudin, Asmah Hanim Hamdan","doi":"10.31436/imjm.v23i01.1985","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.1985","url":null,"abstract":"Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare primary cutaneous lymphoma which often be very complexed to be diagnosed. Here we reported a case of a 38-year-old lady with wax and wane course of left facial swelling associated with prolonged pyrexia of unknown origin, lethargy and prominent weight loss. Multiple investigations were conducted to reach to the conclusive diagnosis. Histopathological showed infiltration of neoplastic lymphoid cells within the adipocyte clusters with hyperchromatic nuclei, small nucleoli and scant cytoplasm. Immunohistochemical analysis were immunoreactive to CD3, CD8 & TIA and negative to CD20, CD4 & CD56. Based on clinical findings, histopathology report and immunohistochemical analysis, the patient diagnosed with SPTCL. Hence, any suspicious maxillofacial swelling without obvious sign of infection and trauma shall be investigated until a final diagnosis is reached.","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"33 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129855","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}
Devby Ulfandi, Ibrahim Labeda, Erwin Syarifuddin, Andi Alfian Zainuddin, Muhammad Faruk
{"title":"The Effect of Doxycycline on Matrix Metalloproteinase-9 Levels in the Colon of Wistar Rats with Obstructive Ileus","authors":"Devby Ulfandi, Ibrahim Labeda, Erwin Syarifuddin, Andi Alfian Zainuddin, Muhammad Faruk","doi":"10.31436/imjm.v23i01.2370","DOIUrl":"https://doi.org/10.31436/imjm.v23i01.2370","url":null,"abstract":"INTRODUCTION: Obstructive ileus after colonic anastomosis resection can increase leakage up to 2.5-fold. One possibility could be the extracellular matrix degradation, where matrix metalloproteinase-9 (MMP-9) negatively influences anastomotic healing. This study aimed to determine the effect of doxycycline on MMP-9 levels in the colon of experimental rats with obstructive ileus. MATERIALS AND METHODS: In this study, 28 male Wistar rats were selected randomly in a post-test control-group design comprising: Group A - control group, Group B - group without obstructive ileus given doxycycline, Group C - group with obstructive ileus not given doxycycline, and Group D - group with obstructive ileus given doxycycline. Doxycycline was given at a dose of 30 mg/kg. Groups C and D underwent anastomotic resection 24 hours following obstructive ileus procedure. Groups A and B underwent anastomotic resection at the same time as Groups C and D. Colonic tissue was collected to examine MMP-9 levels using an enzyme-linked immunosorbent assay (ELISA). Data were compared using Shapiro–Wilk tests, ANOVA, and Mann–Whitney U tests, and p<0.05 was considered significant. RESULTS: The results showed that the average MMP-9 levels increased with doxycycline treatment, [Group C (4.294 ± 0.226)], with significantly higher MMP-9 levels than Group A (1.017 ± 1.569, p<0.001). Group B did not differ significantly from Group A (p=0.848). MMP-9 levels differed significantly between Groups B and D (p<0.001), and between Groups C and D (p<0.001). CONCLUSION: Oral administration of doxycycline can attenuate increasing MMP-9 levels in Wistar rats with obstructive ileus","PeriodicalId":13474,"journal":{"name":"IIUM Medical Journal Malaysia","volume":"31 39","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125626","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}