Journal of Nepal Health Research Council最新文献

{"title":"Total extra peritoneal Repair of Inguinal Hernia under General Anesthesia Versus Spinal Anesthesia.","authors":"Udita Mishra, Ghanashyam Thapa","doi":"10.33314/jnhrc.v22i03.5406","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.5406","url":null,"abstract":"<p><strong>Background: </strong>Total extra peritoneal inguinal hernia repair is established approach to inguinal hernia repair usually performed under general anesthesia. Aim of the study was to compare Total extra peritoneal inguinal hernia repair outcome when operated under spinal anesthesia and general anesthesia.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted at Bir hospital on patients undergoing Total extra peritoneal inguinal hernia repair under either spinal anesthesia or general anesthesia for inguinal hernia from September 2022 to August 2023. Operative time, postoperative hospitalization time, postoperative pain, postoperative adverse effects, level of satisfaction and recurrence rate at one year was compared.</p><p><strong>Results: </strong>Fifty-eight patients were included, divided into two groups TEP-GA and TEP-SA, 29 in each arm. All procedures were completed by allocated method of anesthesia. Though pain score was low in TEP-SA in initial four hours, 2.79±1.08 (GA) and 1.99±0.97 (SA) and 2.28±1.09 (GA) and 1.80±0.80 (SA) at one and four hours post-operative respectively, no statistical difference was noted between two groups regarding surgery time, pain score complications, hospital stay, recovery or recurrence.</p><p><strong>Conclusions: </strong>Spinal anesthesia is at par with general anesthesia for total extra peritoneal inguinal hernia repair, if not better. It may be appropriate anesthetic modality in patients considered high risk for general anaesthesia.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"627-631"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374256","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":"Role of Fractional Exhaled Nitric Oxide for Monitoring Bronchial Asthma.","authors":"Buddhi Sagar Lamichhane, Ashesh Dhungana, Prajowl Shrestha, Kamal Raj Thapa, Deepa Kumari Shrestha","doi":"10.33314/jnhrc.v22i03.5303","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.5303","url":null,"abstract":"<p><strong>Background: </strong>Monitoring during treatment of asthma is usually done by various clinical tools, spirometry, sputum eosinophils and fractional exhaled nitric oxide. Fractional exhaled nitric oxide is a simple and noninvasive tool and has a good agreement with asthma control test score. This study aims to correlate fractional exhaled nitric oxide with asthma control test score.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at National Academy of Medical Sciences, Bir hospital, Chest unit, Department of Medicine, over a duration of six months. Patients aged more than 18 years with bronchial asthma diagnosed at least three months prior were included into the study. Those with recent severe exacerbations, known other chronic respiratory disease and smokers were excluded. Asthma control test score was obtained at baseline. All included patients underwent fractional exhaled nitric oxide measurement followed by measurement of Forced vital capacity(FVC) Forced expiratory volume in one second (FEV1) and FEV1/FVC ratio.</p><p><strong>Results: </strong>Forty patients with a mean age of 40.5±11.1 years were included in the study. Majority were females (65%) and the median duration of symptoms was 24 months (Interquartile range= 18-60). Mean fractional exhaled nitric oxide level was 27.8 (±16.0) parts per billion (ppb) and asthma control test score was 19.3 (±4.7). Mean fractional exhaled nitric oxide levels were significantly different across different severity (well controlled, partially controlled and poorly controlled) of asthma (p=0.013). The mean fractional exhaled nitric oxide values and total asthma control test score shows statistically significant negative correlation (Pearson correlation coefficient (r) = -0.462, p=0.003). Asthma control test and FeNO values guided the change of inhaled steroid dose in 17 of the 40 patients.</p><p><strong>Conclusion: </strong>Fractional exhaled nitric oxide can be used when available, along with asthma control test for monitoring control and adjusting the inhaled steroid dose in asthma.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"602-607"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374169","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":"Epidemiological Characteristics of Hepatitis C Patients Attending a Tertiary Care Hospital.","authors":"Hari Prasad Kattel, Sangita Sharma, Kristian Alfsnes, Rahul Pathak, Komal Raj Rijal, Prakash Ghimire, Ashild K Andreassen, Megha Raj Banjara","doi":"10.33314/jnhrc.v22i03.5308","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.5308","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis C infection is a major public health concern in Nepal. Epidemiological information on hepatitis C virus along with the status of co-infection with hepatitis B virus and human immunodeficiency virus is essential to controlling the hepatitis C burden. The objective of this study was to determine the sero-prevalence of hepatitis C virus infections, proportions of co-infections with human immunodeficiency virus and hepatitis B virus, and identify the demographic characters, and routes of transmission.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from December 2019 to February 2024 at Tribhuvan University Teaching Hospital. The serological tests were performed by enzyme-linked immunosorbent assays from 25133 patients' serum in four years.</p><p><strong>Results: </strong>The sero-prevalence of hepatitis C virus -infected patients was 0.8% (211/25133). Among them, 6.6% (14/211) were co-infected with human immunodeficiency virus and 1.4% (3/211) with hepatitis B virus. Among 211 hepatitis C virus patients, 174 (82.5%) were male, 156 (73.9%) were young aged 15-47 years with various professions, 167 (79.1%) were literate, and almost one-third of the patients (33.2%, 70/211) were regular alcoholics. Needle sharing among intravenous drug users (45.5%, 96/211) and sexual intercourse (28%, 59/211) were the most common modes of transmission.</p><p><strong>Conclusions: </strong>Although the prevalence of hepatitis C infections is less than 1%, it is more common among young male intravenous drug users. Awareness of the spread of hepatitis C infections among this population needs to be emphasized to control hepatitis C in Nepal.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"608-615"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374253","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":"Health-Seeking Behavior and Community Perception of Chhaupadi Practices.","authors":"Ganga Laxmi Awal, Kuaanan Techato, Saroj Gyawali, Bishnu Prasad Dahal, Indra Mali Malakar","doi":"10.33314/jnhrc.v22i03.5280","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.5280","url":null,"abstract":"<p><strong>Background: </strong>The Chhaupadi system, mainly in the Western part of Nepal, forces women and girls to stay in huts or cowsheds during menstruation, barring them from their homes. This study aims to analyze the health-seeking behavior and community perception of Chhaupadi practices and examine their relationship with ecology in Tanjakot Rural Municipality of Humla District, Nepal.</p><p><strong>Methods: </strong>A mixed methods design employed ethnography with extended participation in daily lives for data collection through participant observation, field visits, FGD, KII, and non-participation observation. Purposively, Tanjakot Rural Municipality in Humla district, known for its high Chhaupadi practice, was chosen with 143 girls and women aged 18-49 who had experienced menstruation and stayed in Chhau goth.</p><p><strong>Results: </strong>This study found that 97.9% altered their food habit during the mensuration period. The weighted average of 3.94 and standard deviation of 0.32 evidenced the low consumption of inclusion food in menstruation time. Some women were found consuming contraceptive pills to suppress menstruation for ritual participation and water fetching. During menstruation, 70.6% stayed in tents, noting these places were unsafe, especially among the less literate (9.1%) compared to the literate (7.0%), and used cloth as a means during menstruation time. Most of them in the present time seek medical care at health posts (95.8%) during illness, contrasting with historically depended on traditional healers (6.3%) or no treatment (35.7%). Many participants (65.0%) perceived an ecological link to Chhaupadi, and nearly half (49.0%) considered menstruation natural and not sinful (76.9%).</p><p><strong>Conclusions: </strong>The study highlights significant changes in menstruation practices, with reduced food intake, contraceptive use for delaying menstruation for societal duties, unsafe living conditions, improved healthcare access, and shifting attitudes toward its naturalness, though some still link it to Chhaupadi. Therefore, this study emphasizes raising awareness about safer homestays during menstruation and improving economic opportunities in these areas to meet basic needs.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"592-601"},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373547","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":"Junk Food Consumption Behavior among Young Children.","authors":"Sanju Banstola, Nirmala Shrestha, Bimala Sharma","doi":"10.33314/jnhrc.v22i03.4744","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.4744","url":null,"abstract":"<p><strong>Background: </strong>Consumption of junk food degrades the health status of people and is associated with low consumption of nutritious foods, which are essential for physical and mental growth. This study was carried out to find out the junk food consumption and its associated factors among young children.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 352 school going children aged 5 to 9 years in Pokhara Metropolitan. Face to face interviews were done with one of the parents of the selected children with the help of a structured questionnaire. The study was done from March to October, 2020. Three or more consumption per week was categorized as high consumption of junk food. A descriptive and multivariate statistical analysis was performed. All inferential analyses were conducted at a 5% level of significance. Ethical approval was taken from the Nepal Health Research Council.</p><p><strong>Results: </strong>Among the study participants, 70.7% consumed junk food three or more times per week; 66.5% energy dense food, 20.7% consumed noodles; and 9.7% sugary drinks. Consumption of junk food was associated with presence of conventional shop near home,ways type of food provision at school and, food at home after school. Consumption of junk food was found higher among those who got money for food at school (AOR, 2.31), and those who took snacks at home after school (AOR, 12.86).</p><p><strong>Conclusions: </strong>Consumption of junk food among young children was remarkably high in the study area; concerned authorities should pay attention to dissociating such foods through policies and programs.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"484-493"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373929","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":"Prediction and Estimation of Postoperative Refractive Error in Phacoemulsification: Using Ultrasound A-Scan and Intra Ocular Lens Master.","authors":"Sabitri Bhatta, Sagun Narayan Joshi, Madhu Thapa, Suresh Awasthi, Gauri Shankar Shrestha, Niraj Dev Joshi","doi":"10.33314/jnhrc.v22i03.4854","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.4854","url":null,"abstract":"<p><strong>Background: </strong>This study aims to predict and estimate the postoperative refractive outcome in participants undergoing phacoemulsification using IOL Master and A-scan biometry.</p><p><strong>Methods: </strong>A cross-sectional study was done where ninety eyes of 90 participants undergone phacoemulsification using SRK/T formula were included in longitudinal research. Each participant underwent axial length (AL) measurement by IOL Master and A-scan, and keratometry reading (k- reading) by manual TOPCON keratometer and automated keratometer on IOL master for IOL power calculation. All the pre-operative measurements between A-scan and IOL master and two keratometers were compared using paired-t tests. The four-week postoperative refractive error was estimated using univariate analysis and its prediction was compared with the ocular biometry parameters using quadratic regression.</p><p><strong>Results: </strong>Preoperative findings were higher for AL and ACD by IOL master and A-scan (0.27±0.14mm; p<0.001, 0.14±0.31mm, p<0.001) respectively. The AL and K-reading were found to be strong predictors of IOL power calculation (β = -1.07; p<0.001, β = 0.75; p<0.001), respectively. The AL, K-reading were found to be strong predictors for four-week postoperative refractive error (β = -1.563; p = 0.012, β = 1.052; p = 0.012) where postoperative error was found to be higher (F = 7.521, p<0.001) in A-scan than IOL Master. For K-reading, the two keratometer's and for AL by A-scan and IOL Master's level of agreement (95% LoA) was comparable (-0.15 to 0.12mm and -0.01 to 0.54mm).</p><p><strong>Conclusions: </strong>IOL Master is more reliable for ocular biometry and minimizes postoperative refractive error.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"494-501"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374219","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":"Incidence, Clinical Characteristics and Outcomes Associated with Acute Kidney Injury in Patients Hospitalized with COVID-19.","authors":"Sanjay Shrestha, Kijan Maharjan, Milan Bajracharya, Bimal Sharma Chalise, Pujan Balla, Shambhu Adhikari, Soni Shrestha, Bishwodip Baral, Jenish Neupane, Manu Poudel, Anup Bastola","doi":"10.33314/jnhrc.v22i03.4616","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.4616","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney Injury associated with Coronavirus disease COVID-19 appeared to negatively influence clinical outcomes and is found to be associated with significant risk of death. This retrospective study aimed to describe the incidence of Acute Kidney Injury, its associations with clinical characteristics and outcomes among COVID-19 patients in Sukraraj Tropical and Infectious Disease Hospital, a tertiary infectious disease hospital in Nepal.</p><p><strong>Methods: </strong>A cross-sectional study was done where. Medical and lab records of reverse transcriptase Polymerase chain reaction positive COVID-19 inpatients, admitted between April 2021 to July 2021 were reviewed. It represented the second wave of wave of coronavirus pandemic caused by the delta strain. Patients aged less than 18 years, pregnant females and patients with known chronic kidney disease were excluded Results: Of 393 admissions, 83 (21.1%) patients developed Acute Kidney Injury. Characteristics found to have significant association with development of AKI was age (p <0.001), multiple co morbidities (2 or more) (p <0.001), use of mechanical ventilation (p <0.001), lymphopenia (p<0.001), Neutrophil to Lymphocyte Ratio (p =0.001) and d-dimer levels (p <0.001). Mortality was found to be significantly higher in COVID-19 patients with AKI compared to COVID-19 patients without AKI ((36.14% vs 15.8%, p value <0.01)). The median duration of hospital stay for patients with AKI was higher than for patients without AKI (10 days vs 6 days,p <0.01).</p><p><strong>Conclusions: </strong>AKI develops in a sizeable percentage of patients with COVID-19 and is significantly associated with increasing age, multiple comorbidities, increased biomarkers, use of mechanical ventilation and is associated with poor outcome in terms of mortality and morbidity.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"470-476"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374004","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":"Fear and Experience of Childbirth among Primiparous Women.","authors":"Prajnya Pokhrel, Mamata Bharati, Sushila Bhandari","doi":"10.33314/jnhrc.v22i03.4604","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.4604","url":null,"abstract":"<p><strong>Background: </strong>The fear of childbirth is the feeling of fearfulness, anxiety or worry among women in relation to pregnancy and childbirth process which influence their experience of childbirth which is the subjective feeling of sadness or joyfulness regarding childbirth. The main objective of the study was to identify the relationship between fear and experience of childbirth among primiparous women.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was done where non probability, purposive sampling technique was used to select a sample of 133 primiparous women attending Paropakar Maternity and Woman's Hospital having term pregnancy (37-42 weeks of gestation) without any complications and willing to participate in the study. Data were collected through interview technique. Fear of childbirth was assessed by using standard Wijma Delivery Expectancy/ Experience Questionnaire (WDEQ) and experience of childbirth was assessed by using Childbirth Experiences Questionnaire (CEQ). Data analysis was done by using descriptive statistics like frequency, mean, percentage and standard deviation and inferential statistics i.e. Pearson's correlation and chi square test in Statistical Package for Social Sciences version 16.</p><p><strong>Results: </strong>The study revealed that fear and experience of childbirth were negatively correlated (r= -0.254). The majority of the respondents (64.7%) had a moderate level of fear of childbirth. Most of the respondents (80.5%) had a positive experience of childbirth.</p><p><strong>Conclusions: </strong>This study concludes that there is negative relationship between the fear of childbirth and its experience. Women having higher fear of childbirth have less positive experience of childbirth.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"464-469"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373535","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":"Diagnostic Accuracy of Artificial Intelligence-Based Chest X-Ray reading for screening of Tuberculosis.","authors":"Ruby Maka Shrestha, Ram Chandra Paudel, Puspanjali Adhikari, Ram Hari Ghimire, Karma Gurung, Rajeev Shrestha","doi":"10.33314/jnhrc.v22i03.4637","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.4637","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis remains a public health challenge in Nepal and ranks as the seventh leading cause of death in the country. The END Tuberculosis strategy stresses - the screening for symptoms alone may not suffice; additional screening tools such as a chest radiograph may facilitate referral for diagnosis of tuberculosis. The study aims to evaluate the diagnostic accuracy of artificial intelligence (AI) based Chest X-ray and compare it with the human reading (radiologist), using GeneXpert-MTB RIF Assay for tuberculosis case detection.</p><p><strong>Methods: </strong>Tuberculosis-suspected patients with a history of cough were screened using chest X-rays at two study sites (Dhulikhel Hospital and Nobel Medical College). The reading of AI qXR software was compared with radiologists reading who were blinded of the results generated by the software.</p><p><strong>Results: </strong>The sensitivity of the test by qXR-based AI reading was 100%, (95% CI: 40 - 100%) and specificity 80% (95% CI: 73 - 87%), whereas the sensitivity of the test by the radiologist was 100%, (95% CI: 40 - 100%); and specificity 62% (95% CI: 53 - 70%).</p><p><strong>Conclusions: </strong>Higher sensitivity and specificity were observed for both qXR-based AI and Radiographer readings for the diagnosis of TB.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"477-483"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374230","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 Future of Artificial Intelligence in Healthcare.","authors":"Ganesh Dangal, Ojash Dangal","doi":"10.33314/jnhrc.v22i03.5500","DOIUrl":"https://doi.org/10.33314/jnhrc.v22i03.5500","url":null,"abstract":"<p><p>N/A.</p>","PeriodicalId":16380,"journal":{"name":"Journal of Nepal Health Research Council","volume":"22 3","pages":"i-ii"},"PeriodicalIF":0.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374254","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}