Journal of hospital medicine最新文献

{"title":"Preparing for the unthinkable: The resurgence of vaccine-preventable diseases","authors":"Samir S. Shah MD, MSCE, MHM,&nbsp;Erin E. Shaughnessy MD, MSHCM,&nbsp;Benjamin Kinnear MD, MEd","doi":"10.1002/jhm.13589","DOIUrl":"10.1002/jhm.13589","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 4","pages":"333-334"},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967668","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":"Factoring neighborhood context into readmission risk: An outstanding question for health systems and policymakers","authors":"Anna Morenz MD, MPH,&nbsp;Joshua M. Liao MD, MSc","doi":"10.1002/jhm.13587","DOIUrl":"10.1002/jhm.13587","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 5","pages":"532-533"},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health conditions seen frequently in hospitalized United States Veterans who served after 9/11/2001: A scoping review","authors":"Joel C. Boggan MD, MPH,&nbsp;Nazima Allaudeen MD,&nbsp;Heather Shaw MD,&nbsp;Sarah Cantrell MLIS,&nbsp;Joyce Akwe MD, MPH","doi":"10.1002/jhm.13586","DOIUrl":"10.1002/jhm.13586","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospitalists working outside the Veterans Affairs (VA) system frequently will serve Veterans receiving care for acute conditions and/or awaiting transfer to VA facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To perform a scoping review of health conditions and associated outcomes relevant to hospital medicine in US Veterans who served in active duty or reserve deployed roles after November 9, 2001.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search of MEDLINE and Embase was performed using a combination of terms related to military service period and health conditions, yielding 5634 citations published after January 1, 2013.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Selection and Data Extraction</h3>\u0000 \u0000 <p>Two reviewers performed independent screening at the title/abstract and later at the full-text levels. Conflicts at both stages were resolved through discussion. Single reviewers extracted data and synthesized results into three categories: (1) mental health and nonblast trauma, (2) neurologic outcomes, and (3) other conditions, including cardiovascular and respiratory outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 85 included studies, 19 focused on cardiovascular, respiratory, autoimmune, and multisystem outcomes; 38 focused on mental health and nonblast trauma; and 28 focused on traumatic brain injury and neurologic outcomes. Studies showed high rates of comorbid mental health diagnoses and suicide-related behaviors relative to non-Veteran populations, as well as relatively younger incidence of cardiovascular and respiratory chronic conditions, such as atrial fibrillation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most studied health conditions among Veterans of post-9/11 conflicts have focused on areas of particular importance to the VA. However, significant gaps remain, particularly in understanding the correlation between specific exposures and clinical outcomes currently observed and to be anticipated in the future in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"740-767"},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of burnout and impact of workload on physician wellness: A cross-sectional survey of hospitalists in British Columbia, Canada","authors":"Vandad Yousefi MD, CCFP, FHM, DRCPSC","doi":"10.1002/jhm.13577","DOIUrl":"10.1002/jhm.13577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospitalists in British Columbia care for a large percentage of hospitalized patients across 21 acute care facilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to characterize the demographic and work attributes of the workforce and to understand levels of burnout and the relationship between workload and job satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional survey of individuals participating in hospitalist programs in BC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Almost all individuals (96%) were involved in the care of patients with COVID-19 in 2021, the height of the pandemic. High rates of burnout were demonstrated among hospitalists, with a large number of providers planning to significantly reduce or stop their involvement in acute care. Regression analysis identified workload as an important factor associated with burnout. Older physicians, those who had been practising for longer, and those with moderate to high number of shifts were more likely to consider reducing their involvement with their programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>High levels of burnout are associated with a desire to reduce work involvement among BC hospitalists. Health system leaders need to consider factors contributing to burnout as a key aspect of broader health human resource planning efforts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"688-700"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916451","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":"Psychology insights on apologizing to patients","authors":"Donald A. Redelmeier MD, FRCPC, MS(HSR), FACP,&nbsp;Jada Roach BKin","doi":"10.1002/jhm.13585","DOIUrl":"10.1002/jhm.13585","url":null,"abstract":"&lt;p&gt;A clinician will make many mistakes during a career practicing medicine. Some mistakes will result in patient harm, wasted resources, or hurt feelings. The adverse consequences of a mistake will also extend back to the clinician and ultimately increase the risk of burnout if not mitigated.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; One protective strategy is to reduce the frequency of mistakes to zero, but such utopian ideals are not realistic.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Another strategy is to learn how to apologize effectively after a mistake; however, most advice on how to apologize stems from popular press, legal recommendations, ethics analyzes, religious theology, social norms, or community standards and not from scientific evidence.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Psychology is the science that explores how people perceive, think about, and act toward other people. This science recognizes that interpersonal offenses can occur between a transgressor (also called wrongdoer, harmdoer, offender) and victim (also called sufferer, casualty, target, offended). Examples can include a hurtful comment, betrayal of trust, or interpersonal unfairness. The damaging effects on relationships can be mitigated by an apology, defined as a statement expressing remorse, acknowledging responsibility, and potentially offering restitution. Despite the power of an apology in conflict management, professionals often do not apologize or do not apologize well.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Traditional training and consensus guidelines encourage clinicians to tackle difficult conversations, including the disclosure of upsetting information.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; These fundamentals rarely mention how to apologize effectively.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt; The purpose of this article is to review three unfamiliar findings from psychological science on how to apologize effectively (Table 1). An effective apology, we propose, is an essential clinical skill that does not necessarily materialize from years of clinical practice but might be informed by scientific insights.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; Apologies are hard, yet an awareness of these insights might lead to increased clinician motivation, greater patient satisfaction, and ultimately more healing.&lt;span&gt;&lt;sup&gt;9-11&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The purpose of presenting evidence from psychological science is not to dissuade clinicians from apologizing by highlighting basic pitfalls; instead, the purpose is exactly the opposite.&lt;span&gt;&lt;sup&gt;32&lt;/sup&gt;&lt;/span&gt; Moreover, a general failure to apologize often occurs because a transgressor does not recognize the offense or morally disengages from the wrongful action.&lt;span&gt;&lt;sup&gt;33&lt;/sup&gt;&lt;/span&gt; The patterns in clinicians include denying responsibility, characterizing the incident as justifiable, minimizing the loss, or blaming events as outside control.&lt;span&gt;&lt;sup&gt;34&lt;/sup&gt;&lt;/span&gt; Of course, developing skills toward making more effective apologies is difficult since talented clinicians may have few opportunities","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"878-881"},"PeriodicalIF":2.3,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13585","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911310","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":"Physician inpatient handoffs—Patient and physician outcomes: A systematic review","authors":"Joshua Allen-Dicker MD, MPH,&nbsp;Matthew Kerwin MD,&nbsp;Joseph S. Wallins MD, MPH,&nbsp;Nisha Rao MD,&nbsp;Rezana Mara MD,&nbsp;Marina Chilov MLS,&nbsp;Chanan Batra DO, MHSA,&nbsp;Susan Chimonas PhD,&nbsp;Deborah Korenstein MD","doi":"10.1002/jhm.13583","DOIUrl":"10.1002/jhm.13583","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prior reviews have shown that interventions to improve inpatient handoffs are inconsistently associated with improvement in patient outcomes. This systematic review examines the effectiveness of inpatient handoff interventions on outcomes affecting patients and physicians, including objective measures when reported (PROSPERO ID: CRD42022309326).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pubmed, Embase, and Cochrane Central Register of Controlled Trials were searched on January 13th, 2022. We included experimental or quasi-experimental studies that examined handoff communication between inpatient physicians and reported patient clinical, patient experiential, physician experiential, or cost and utilization outcomes. Studies were excluded if they examined handoffs between facilities or levels of care, or only reported subjective measures of patient safety or physician experience. Risk of bias was assessed using the ROBINS-1 and RoB-2 tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 42 included studies, six were randomized controlled trials. Most studies were conducted at academic centers (67%) and involved only residents (64%). An educational intervention was used in 52% of studies and a structural intervention was used in 43%, with 9% using both. Adverse events were significantly improved in three of 16 studies, medical errors in three of seven studies, and length of stay in three of seven studies. Four studies examined mortality, and none reported a significant improvement. Studies that used both structural and educational components reported significant improvements more frequently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The literature is mixed on the impact of efforts to improve handoffs, though there are few randomized trials. Few studies reported patient experiential or cost/utilization outcomes, or involved hospitalist physicians, which represent potential areas for future research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"607-622"},"PeriodicalIF":2.3,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of neighborhood socioeconomic disadvantage on 30-day readmissions: A systematic review","authors":"Lindsey Garrett MA,&nbsp;Adil Muhammad MPH,&nbsp;Ambar Kulshreshtha MD, PhD","doi":"10.1002/jhm.13581","DOIUrl":"10.1002/jhm.13581","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The area deprivation index (ADI) is a measure of neighborhood disadvantage. It uses census-level information to quantify a person's neighborhood deprivation level based on their address. Recent studies have used ADI to examine the relationship between a patient's address and various health outcomes, including 30-day readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review was conducted to determine the effect of ADI on 30-day readmissions for both medical and surgical conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a comprehensive literature search in scientific databases, including PubMed, Embase, Web of Science, and SCOPUS from 2013 to 2024. Our search included terms related to ADI and 30-day readmissions in adult populations in the United States. Studies were included if they utilized ADI as their primary exposure and examined the risk of readmissions within 30 days as an outcome. Two reviewers independently extracted the data and assessed quality and biases in the studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 66 papers found through database search, 23 (35%) were included. These studies focused on conditions such as cardiac, diabetic, neurological, and pulmonary diseases, as well as postsurgical and septic patients, with three studies examining all patients in general. When examining the highest level of ADI, 15 (65%) studies (6 of which focused on postsurgical patients) found that high ADI (most disadvantaged) is significantly associated with 30-day readmissions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Living in a high ADI area moderately impacts 30-day readmissions, particularly for patients who have undergone surgery or have undifferentiated problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 5","pages":"489-504"},"PeriodicalIF":2.3,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Big brother or big opportunity? Utilization of EHR use metadata in the inpatient setting: A mixed methods study at 16 organizations","authors":"Marisha Burden MD, MBA,&nbsp;Angela Keniston PhD, MSPH,&nbsp;Lauren McBeth BA,&nbsp;Gopi Astik MD, MS,&nbsp;Kirsten N. Kangelaris MD, MAS,&nbsp;Aveena Kochar MD,&nbsp;Michelle Knees DO,&nbsp;Ankur Segon MD,&nbsp;Sara Westergaard MD, MPH,&nbsp;Amy Yu MD,&nbsp;Matthew Sakumoto MD,&nbsp;Romil Chadha MD, MBA, MPH","doi":"10.1002/jhm.13572","DOIUrl":"10.1002/jhm.13572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinician electronic actions within the electronic health record (EHR) are captured seamlessly in real-time during regular work activities in all major EHRs. Analysis of this EHR use metadata, such as audit log data, is increasingly used to understand the impact of work design on critical patient, workforce, and organizational outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Understand experiences and perspectives influencing the use and implementation of audit log data into practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Mixed methods design utilizing focus groups and embedded survey with hospitalist group leaders attending a national society special interest group. Themes and subthemes were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven semistructured virtual focus groups were held with 16 individuals from 16 different organizations on December 12, 2023, with a 100% survey response rate. Survey results highlighted the lack of familiarity with audit log data, the lack of tools and training for use, and the lack of established protocols to respond to insights, with some concerns for the accuracy of the data. Four themes and multiple subthemes were identified and included: (1) Limited, but widely variable use of audit log data driven by a lack of access, resources, skills, and knowledge, (2) mistrust and skepticism about the data, including concerns about potential misuse and a lack of best practices and standards, (3) perspectives around audit log data are culture and context driven, and (4) excitement for the many potential use cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite all major EHRs having audit log data, participants had limited access, training, and knowledge. Although there was mistrust, many opportunities were identified.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"677-687"},"PeriodicalIF":2.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The virtue of vulnerability","authors":"Justin J. Roesch MD, FACP","doi":"10.1002/jhm.13582","DOIUrl":"10.1002/jhm.13582","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"661-662"},"PeriodicalIF":2.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of climate change induced natural disasters on healthcare: Rethinking intravenous fluids","authors":"Elizabeth A. Cerceo MD,&nbsp;Katherine T. Liu MD,&nbsp;Evans K. H. Brown MD,&nbsp;Catherine Chen MD","doi":"10.1002/jhm.13578","DOIUrl":"10.1002/jhm.13578","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"780-783"},"PeriodicalIF":2.3,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.13578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873692","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}