{"title":"Activity of Cefotaxime versus Ceftriaxone against Pathogens Isolated from Various Systemic Infections: A Prospective, Multicenter, Comparative, In vitro Indian Study","authors":"Ajitkumar A. Gondane, Dattatray B. Pawar","doi":"10.1055/s-0043-1772564","DOIUrl":"https://doi.org/10.1055/s-0043-1772564","url":null,"abstract":"Abstract Objectives To determine the susceptibility of isolated pathogens with different samples collected from patients taking cefotaxime as compared with ceftriaxone. Methods In vitro susceptibility study was conducted at microbiology laboratories of east (Bhubaneshwar), west (Ahmedabad), north (Delhi), and south (Srikakulam) India. Samples of treatment naïve patients with various clinical infections were included if they were positive for bacterial culture. Minimum inhibitory concentration (MIC) and zone of inhibitions (ZoIs) for each isolate were determined using Ezy MIC strip test and disk diffusion methods, respectively. Findings of MIC and ZoI were interpreted as per the Clinical and Laboratory Standards Institute guidelines. Appropriate statistical tests were used. Results Four hundred clinical samples of urinary tract infection (42.75%), lower respiratory tract infection (20.75%), skin and soft tissue infection (16.75%), and sepsis (12.75%) were evaluated. Escherichia coli (47.75%) was the most common organism isolated followed by Klebsiella (26%), Salmonella (7.75%), and Proteus mirabilis (3.75%). The mean MIC values for E. coli , Klebsiella , Staphylococcus , Citrobacter koseri , and Serratia marcescens were found to be lower when treated with cefotaxime compared with ceftriaxone, although the difference was not statistically significant. However, cefotaxime produced significantly ( p < 0.05) more ZoI for E. coli , Klebsiella , and Salmonella as compared with ceftriaxone. Conclusion Cefotaxime has shown better sensitivity profile in terms of MIC and ZoI to most of the isolated organisms as compared with ceftriaxone and thus can be preferred for empirical treatment of such patients.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41248960","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}
S. Patel, Diksha Chandrakar, P. Wasnik, R. Nanda, E. Mohapatra
{"title":"Clinical Implication of Changes in Serum Cations and Anions on Clinical Severity in Sickle Cell Disease: A Case–Control Study in a Tertiary Center","authors":"S. Patel, Diksha Chandrakar, P. Wasnik, R. Nanda, E. Mohapatra","doi":"10.1055/s-0043-1772684","DOIUrl":"https://doi.org/10.1055/s-0043-1772684","url":null,"abstract":"Abstract Introduction Vaso-occlusive crisis in sickle cell disease (SCD) is related to disproportionate serum ions distribution. The objective was to evaluate the influence of changes in serum cations and anions on clinical severity in SCD patients. Materials and Methods The case–control study included 26 SCD cases and 27 apparently healthy control individuals. The cases were further grouped as crisis state and steady state cases. Each participant was assigned a disease severity score. All study participants were evaluated for serum electrolytes, osmolality, calcium, magnesium, phosphorus, total protein, and albumin. Results The mean serum sodium (135.65 mmol/L), chloride (99.88 mmol/L), calcium (2.28 mmol/L), magnesium (0.76 mmol/L), osmolality (285.19 mOsm/kg), and albumin (0.59 mmol/L) were grossly reduced in cases than the control group. The SCD crisis group recorded low serum sodium ( p = 0.01), calcium ( p = 0.011), total cations ( p = 0.023), anions ( p = 0.008), and cation–anion ratio ( p = 0.041). Of all the cations, serum calcium correlated inversely with disease severity score ( r = –0.367, p = 0.033), whereas serum albumin among the serum anions influenced severity the most ( r = –0.338, p = 0.046). The cutoff values for serum calcium and albumin were, respectively, 2.41 and 0.63 mmol/L, with a sensitivity of 83.3 and 88.9%. A calculated ratio of serum sodium–albumin revealed a positive relationship with the severity score ( r = 0.328, p = 0.05) with a sensitivity of 94.4% for a cutoff value of 208.45. Conclusion Low serum sodium, calcium, albumin, and raised sodium–albumin ratio were linked to the crisis state, and routine estimation of these parameters will help in the early assessment of the clinical severity and initiate appropriate fluid management.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46091426","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":"In-vitro Activity of Isepamicin against Gram-negative Bacteria in Comparison to Other Aminoglycosides Routinely used at a Teaching Hospital in Northern India.","authors":"Tasneem Siddiqui, Mitra Kar, Akanksha Dubey, Sangram Singh Patel, Chinmoy Sahu","doi":"10.1055/s-0043-1761928","DOIUrl":"10.1055/s-0043-1761928","url":null,"abstract":"<p><p><b>Background</b> Isepamicin is a 1-N-S-a-hydroxy-b-aminopropionyl derivative of gentamicin B and the spectrum of pathogenic microorganisms covered by it and its effectiveness is similar to that of amikacin except the action of aminoglycoside inhibitor enzymes is ineffectual on it. <b>Material and Methods</b> We performed a prospective study in the Bacteriology section of the Department of Microbiology at a 1,600-bedded hospital in Northern India from Jan 2022 to March 2022. Isepamicin was tested for susceptibility against gram-negative bacteria, identified by routine biochemicals and matrix-assisted-desorption/ionization -time of flight-mass spectrometry (MALDI-TOF-MS) assay. The antibiotic susceptibility testing for each of the isolates was performed by Kirby Bauer's disc diffusion method, according to the CLSI 2019 guidelines. <b>Results</b> The majority of isolates were obtained from blood samples (50, 39.1%). Among the non-inducible <i>Enterobacteriaceae</i> , <i>Escherichia coli</i> was least susceptible to amikacin (8/27, 29.63%) and most susceptible to isepamicin (18/27, 66.67%). <i>Klebsiella pneumoniae</i> followed the same pattern of susceptibility as <i>E. coli</i> and was least susceptible to Amikacin (20/46, 43.48%) and most susceptible to isepamicin (24/46, 52.17%). <i>Enterobacter cloacae</i> (6/7, 85.71%) was most susceptible to both amikacin and isepamicin, followed by 71.43% (5/7, 71.43%) susceptibility to gentamicin and tobramycin each. <i>Enterobacter aerogenes</i> was equally 53.33% (8/15) susceptible to all antibiotics. <i>Pseudomonas aeruginosa</i> was the most susceptible isolate to all antibiotics (18/21, 85.71%). <b>Conclusion</b> Isepamicin is a potential antimicrobial agent for treating an array of gram-negative bacteria-associated infections and shows better in vitro activity than older aminoglycoside agents.</p>","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/53/2c/10-1055-s-0043-1761928.PMC10411113.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9969635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Divya Bhushan, Jayanthi Yadav, A. Arora, Dhruv Agrawal, Achala Apte
{"title":"Validated Ultraviolet High-Performance Liquid Chromatography Method for Post-mortem 5-Hydroxy-indoleacetic Acid Measurement in Human Cerebrospinal Fluid","authors":"Divya Bhushan, Jayanthi Yadav, A. Arora, Dhruv Agrawal, Achala Apte","doi":"10.1055/s-0043-1774378","DOIUrl":"https://doi.org/10.1055/s-0043-1774378","url":null,"abstract":"Abstract Objective The objective of this study was to develop an ultraviolet high-performance liquid chromatography (UV-HPLC) method for the measurement of 5-hydroxyindoleacetic acid (5-HIAA) in human cerebrospinal fluid (CSF) as a potential biomarker for neurological and psychiatric illnesses, including depressive disorders with suicidal behavior. Methods The study utilized CSF samples from individuals brought for medicolegal autopsy. The 5-HIAA concentration was measured using a UV-HPLC method with three mobile-phase solvents. The most effective mobile phase solvent was then used to measure 5-HIAA in the CSF samples. Materials The materials used in the study included CSF samples obtained from individuals brought for medico-legal autopsy, UV-HPLC equipment, and mobile phase solvents, including 5-hydroxyindole-3-acetic acid (Merck/sigma), acetonitrile, concentrated formic acid, concentrated acetic acid, methanol, and phosphoric acid. Statistical Analysis This was done using R Studio (version 4.2.0). Results The study found that the UV-HPLC method utilizing formic acid (0.05–0.1%): acetonitrile in a 1:9 as mobile phase was the most effective for measuring 5-HIAA in human CSF. The method exhibited excellent linearity, accuracy, and precision. Conclusion The study concludes that the developed UV-HPLC method is reliable and effective for measuring 5-HIAA in human CSF. Measuring 5-HIAA levels in CSF can serve as a potential biomarker for neurological and psychiatric illnesses, including depressive disorders with suicidal behavior. This method is promising for clinical and forensic practice to diagnose suicidal cases. Further research is needed to determine the clinical significance of these findings and the potential for broader application in psychiatry. This article helps to give a practical, cost-effective methodology to detect CSF 5-HIAA.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45372809","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":"Clinical and Microbiology Profile of Typhoidal and Nontyphoidal Salmonella Blood Stream Infection: An Observational Study from a University Hospital","authors":"Tasneem Siddiqui, R. Sinha, S. Patel, C. Sahu","doi":"10.1055/s-0043-1772216","DOIUrl":"https://doi.org/10.1055/s-0043-1772216","url":null,"abstract":"Abstract Background Species distribution and antibiotic resistance pattern of Salmonella varies with time and place. Rapid and correct use of antibiotics requires understanding of the distribution and drug resistance patterns. Therefore, we aimed to study the clinical profile of patients along with speciation and antibiogram of Salmonella isolates from blood. Material and Methods It is an observational study, conducted from December 2019 to December 2021 at our university hospital. Blood cultures were processed by automated blood culture system. Salmonella isolates were identified by their morphological properties, biochemical reaction, and serological tests. Antibiotic susceptibility pattern was assessed by Kirby–Bauer's disc diffusion method and Phoenix automated system. Results The male-to-female ratio of the patients in the study was 2.5:1 and the mean age of the patients was 11.7 years (1–27 years). Salmonella spp. was isolated from 21 patients out of 1,350 positive blood cultures. Nine isolates were identified as S. Typhi seven as S. Choleraesuis three as S. Paratyphi A and two as S. Paratyphi B. Immunocompromised conditions were significantly associated in nontyphoidal Salmonella bacteremia ( p = 0.0253). Isolates showed maximum resistance toward nalidixic acid (100%) followed by fluoroquinolones (52.4%). Multidrug resistance, extreme drug resistance, and azithromycin resistance was seen in 14.3, 4.8, and 4.8% isolates, respectively. Posttreatment recovery was observed in 20 patients. Conclusion Emergence of S. Choleraesuis among Salmonella spp. in blood stream infection, next only to S. Typhi was noted. Rising drug resistance is a matter of concern.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44860610","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":"Platelets-Leucocyte Satellitism: Love Is in the EDTA!","authors":"Bashundhara Lata, Tirumala Sripathi, Mona Lisa","doi":"10.1055/s-0042-1751316","DOIUrl":"https://doi.org/10.1055/s-0042-1751316","url":null,"abstract":"","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/64/10-1055-s-0042-1751316.PMC10104708.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9310050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ambreen Aman, Kavitha B Lingappa, Deepika G Sujatha, Subhan Ali Rajasab, Siddapa Shantala
{"title":"Acute Myeloid Leukemia with Concurrent Inversion 16 and Trisomy 9: A Case Report.","authors":"Ambreen Aman, Kavitha B Lingappa, Deepika G Sujatha, Subhan Ali Rajasab, Siddapa Shantala","doi":"10.1055/s-0042-1750070","DOIUrl":"https://doi.org/10.1055/s-0042-1750070","url":null,"abstract":"Abstract Acute myeloid leukemia (AML) are a diverse group of hematological malignancies, each with a distinct clinical, morphological, immunophenotypic, and molecular profile. The World Health Organization (WHO) classifies AML into various subtypes based on recurrent genetic abnormalities, each of which has clinico-pathological and prognostic significance. Inversion(16)(p13q22) or t(16;16)(p13q22) is a balanced structural chromosomal abnormality associated with complete remission and a favorable response to treatment. Trisomy 9 is a numerical chromosomal abnormality with an intermediate risk and is often seen in association with other cytogenetic abnormalities. We describe a case of a 36-year-old female patient who was diagnosed as AML-M4 on peripheral smear and bone marrow evaluation. Cytogenetic studies revealed concurrent presence of inv(16) and trisomy 9. To the best of our knowledge, this is the first case in published literature with simultaneous presence of inv(16)(p13q22) and trisomy 9 in de novo AML.","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/9b/10-1055-s-0042-1750070.PMC10104711.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9310056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Heavy Load of Intestinal Fluke in a Four-Year-Old Child with Severe Acute Malnutrition: A Case Report.","authors":"Sangeeta Deka, Deepjyoti Kalita, Naba Kumar Hazarika","doi":"10.1055/s-0042-1748830","DOIUrl":"https://doi.org/10.1055/s-0042-1748830","url":null,"abstract":"<p><p>Fasciolopsiasis, a food-borne intestinal parasitosis, occurs focally, and remains a significant public health problem in endemic areas. However, due to the wide spectrum of clinical presentation and unclear diagnosis or even misdiagnosis, it often goes unreported. The correlation between trematode infection and malnutrition is also often debated. We report a case of heavy infection of <i>Fasciolopsis buski</i> in a 4-year-old girl with severe acute malnutrition (SAM). The patient presented with a passage of many adult worms per stool following the consumption of some herbal concoction. A wet mount of the stool revealed ova of <i>Fasciolopsis buski.</i> She was treated successfully with praziquantel and food supplements. It raises the possibility of unidentified cases in this region and necessitates more extensive studies in the targeted population. This will also help raise awareness of fasciolopsiasis among clinicians, especially in vulnerable populations such as malnourished children.</p>","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/1a/10-1055-s-0042-1748830.PMC10104706.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9322352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Histopathological Profile of Central Nervous System Tumors in a Peripheral Tertiary Care Centre of West Bengal.","authors":"Shubham Bhattacharya, Barnali Maiti, Karabi Konar","doi":"10.1055/s-0042-1750067","DOIUrl":"https://doi.org/10.1055/s-0042-1750067","url":null,"abstract":"<p><p><b>Introduction</b> Central nervous system (CNS) tumor incidence is very low in comparison to other organ neoplasm. Recent increase in the incidence may be due to exposure of the population to various risk factors, genetic mutation, or improved diagnosis with advancement in diagnostic modalities. This study aims to observe the histopathological spectrum of CNS tumors with their clinical profile and basic demography at a single center in a peripheral region in West Bengal. <b>Material and Methods</b> A retrospective study was conducted in the department of pathology, Gouridevi Institute of Medical Sciences and Hospital (GIMSH), Durgapur, West Bengal, over a period of 2 years from October 2018 to September 2020 on CNS tumors. Basic demographic data, tumor site, and histopathological profile were obtained from medical records and further analyzed and graded according to the World Health Organization (WHO) classification. <b>Result</b> Among 42 cases of CNS tumors, 29 cases were from different regions of the brain and 13 cases were from the spinal cord, with a male to female ratio (1.21:1); the commonest age group was the sixth decade and most common tumor was meningioma, followed by astrocytic tumors. <b>Conclusion</b> The present study helps provide information regarding the burden of disease in our area. Despite the use of modern imaging techniques that help in the provisional diagnosis of disease, histological examination is the gold standard in diagnosis of varied types.</p>","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/41/73/10-1055-s-0042-1750067.PMC10104699.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gautom Kumar Saharia, Saurav Nayak, Preetam B Mahajan, Manaswini Mangaraj
{"title":"Exploring the Novelty in Lipid Profiling of Patients: A Non-fasting Approach from Eastern India.","authors":"Gautom Kumar Saharia, Saurav Nayak, Preetam B Mahajan, Manaswini Mangaraj","doi":"10.1055/s-0042-1757410","DOIUrl":"https://doi.org/10.1055/s-0042-1757410","url":null,"abstract":"<p><p><b>Objective</b> To date, no reference interval is available for lipid profile, including total cholesterol (TC), triglycerides (TGs), high-density lipoprotein (HDL), or low-density lipoprotein (LDL)-cholesterol, etc., in a non-fasting state. Hence, the study was taken up with the objective of exploring the possibility of establishing a reference interval for non-fasting lipid profile consisting of serum TC, TG, LDL, HDL, and very low-density lipoprotein (VLDL) cholesterol. <b>Materials and Methods</b> A total of 1,350 apparently healthy subjects, including 636 healthy men and 714 healthy women of 18 years and beyond of age, were enrolled in the study. Reference individuals were recruited using cluster sampling method from various villages and semi-urban regions irrespective of their sex, religion, socioeconomic status, or any other demographic profile, and samples were analyzed in Beckman Coulter AU480 analyzer. <b>Results</b> The mean age of 1,350 participants was 38.23 ± 15.94 years. We found that all the test parameters require a different reference interval than the established fasting reference range, except for HDL cholesterol in females. The data were subdivided into subjects below 40 years, between 40 and 60 years, and older than 60 years of age. All five parameters in the lipid profile were individually analyzed and were compared age group-wise and gender-wise with the total study population. Significant differences in the various dataset were found. <b>Conclusion</b> A shift toward non-fasting lipid interval measurement is, thus, a piece of evidence-driven mechanism. Even from a patient's perspective, it sets in ease and convenience in lipid-profile testing, subsequently leading to a more compliant cardiovascular management and monitoring.</p>","PeriodicalId":16149,"journal":{"name":"Journal of Laboratory Physicians","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/cf/10-1055-s-0042-1757410.PMC10104702.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9317265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}