Journal of Medicine and Life最新文献

{"title":"The Impact of VCAM-1 expression on left ventricular performance following acute coronary syndromes.","authors":"Ruxandra Copciag, Vladimir Bratu, Roxana Rimbas, Laura Lungeanu, Alexandru Corlan, Alexandru Schiopu, Maya Simionescu, Dragos Vinereanu","doi":"10.25122/jml-2025-0083","DOIUrl":"10.25122/jml-2025-0083","url":null,"abstract":"<p><p>Inflammatory pathways, particularly those involving vascular cell adhesion molecule-1 (VCAM-1), play a central role in post-ischemic myocardial remodeling. However, its relationship with left ventricle (LV) performance or volumetric changes has not been systematically examined. This study aimed to investigate the association between circulating VCAM-1 levels, LV volumes, and LV ejection fraction (LVEF), quantified using three-dimensional echocardiography (3-DE), in patients with acute coronary syndrome (ACS). All patients underwent comprehensive clinical evaluation and 3-DE assessment within the first 24 hours of hospital admission. Concurrently, a full panel of locally available laboratory tests was performed, including serum sampling for VCAM-1 analysis. A follow-up evaluation, comprising repeated biological and echocardiographic measurements, was conducted two months after the index event. A total of 90 patients with ACS (mean age 54 ± 9 years; 75 males) were included in the analysis. Among these, 30 patients (33.3%) had a ≥10% increase in left ventricular end-diastolic volume (LVEDV) at follow-up, indicative of adverse left ventricular remodeling. Baseline VCAM-1 levels were significantly correlated with subsequent changes in LVEDV and LVEF from admission to follow-up (r = -0.42, <i>P</i> < 0.05, and r = -0.43, <i>P</i> < 0.05, respectively). Furthermore, the dynamic changes in VCAM-1 between assessments also showed significant correlations with changes in LVEDV and LVEF (r = 0.41, <i>P</i> < 0.05; r = -0.46, <i>P</i> < 0.05). This study suggests that VCAM-1, an inflammatory biomarker, may be a prognostic indicator of LV remodeling and dysfunction in patients with acute coronary syndromes. The findings support further exploration of VCAM-1 for risk stratification and therapy.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"509-514"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540554","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":"Evaluating plantar correction strategies in pediatric growing pains: a postural and pain analysis in 647 children.","authors":"Cezar Ionita, Stefan Tiron, Summer Abdallah, Silvia-Andreea Gheorghe-Simionesie, Dorin Simionesie, Brindusa Ilinca Mitoiu, Oana Belei, Ileana Enatescu, Felix Bratosin, Adriana Sarah Nica","doi":"10.25122/jml-2025-0084","DOIUrl":"10.25122/jml-2025-0084","url":null,"abstract":"<p><p>Growing pains affect many children, but their underlying mechanisms are not fully understood. Potential contributors include anatomical malalignment and abnormal foot-pressure distribution (FPD). This study evaluated: (1) whether age, sex, and handedness correlate with growing-pain intensity, (2) whether anterior or posterior foot loading predominates in these children, and (3) whether customized plantar insoles improve subjective pain and objective postural or gait parameters. A total of 647 children (ages 3-14 years) underwent baseline stabilometric testing (Freemed platform) and were classified as anterior or posterior loaders. Pain status was recorded (absent, mild, moderate, intense). Custom insoles were prescribed for significant anomalies; 178 children returned for follow-up, including 137 who repeated platform assessments, and 178 who were reassessed for pain. Additional subgroup analyses examined insole compliance (high vs. low) and gait changes (step length, stance width, foot progression angle, single-limb stance, gait velocity). Of the initial 647 children, 87% demonstrated posterior orientation, and 55% reported some level of pain. No significant correlations emerged between pain intensity and age, sex, or handedness. Among the 178 reassessed patients, those with higher insole compliance and posterior orientation showed the greatest pain relief (up to 81.8% improvement), while lower-compliance subgroups reported 54.2-62.5% improvement (<i>P</i> = 0.021). Objective FPD improved in 67.7% of the 'Posterior + High' group versus 46.7% of the 'Anterior + Low' group (<i>P</i> = 0.043). Gait analysis revealed significant improvements in step length, stance width, single-limb stance, and gait velocity (<i>P</i> < 0.05) among children with baseline pain. Posterior foot loading was prevalent in this cohort, and personalized insole therapy was associated with meaningful improvements in subjective pain reports and quantitative gait parameters. While causality cannot be confirmed by this observational design, the findings suggest that targeted plantar corrections may mitigate growing pains and enhance postural stability.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"455-462"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540547","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":"Inflammatory biomarkers for predicting postoperative atrial fibrillation in cardiac surgery.","authors":"Raluca-Elisabeta Staicu, Alina-Ramona Cozlac, Marius Emil Sintean, Alina Gabriela Negru, Florin Gorun, Sebastian Ciurescu, Corina Vernic, Ana Lascu, Petru Deutsch, Florin Horhat, Elena Cecilia Rosca","doi":"10.25122/jml-2025-0085","DOIUrl":"10.25122/jml-2025-0085","url":null,"abstract":"<p><p>Postoperative atrial fibrillation (POAF) is a frequent complication of cardiac surgery associated with adverse outcomes. Systemic inflammation is implicated in POAF pathogenesis, suggesting inflammatory biomarkers may have predictive value. This study investigated the predictive capacity of readily accessible inflammatory markers for POAF during the early postoperative period in the cardiac intensive care unit, particularly within the 48-72-hour window when POAF most commonly occurs. In this prospective, single-center study, we enrolled 70 patients undergoing elective cardiac surgery with cardiopulmonary bypass. We measured preoperative and postoperative (24h, 48h) levels of neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-17A (IL-17A). POAF was systematically monitored. We assessed the predictive value of these markers using ROC curve analysis and logistic regression, adjusting for clinical risk factors. The coronary cohort showed that the NLR at both 24 hours and 48 hours were the most discriminative markers for predicting POAF, with PCR at 48 hours achieving a moderate AUC of 0.66. In multivariate regression models, PCR at 48 hours (<i>P</i> = 0.009) and age (<i>P</i> = 0.046) emerged as significant predictors, while NLR and CPB duration were moderately correlated with the occurrence of POAF. In contrast, within the valvular patient subgroup, the NLR again exhibited promising predictive value, along with increased markers of tissue injury such as CK, LDH, and creatinine. Readily accessible postoperative inflammatory markers, particularly NLR at 24 hours and CRP at 48 hours, demonstrated moderate predictive value for POAF in patients undergoing elective cardiac surgery. These markers, especially NLR and CRP, may potentially contribute to improved POAF risk stratification in clinical practice when combined with clinical risk factors. Furthermore, our analysis also indicates that preoperative IL-17A levels may influence the occurrence of POAF. Therefore, alongside CRP and NLR, preoperative IL-17A can be considered a potentially significant marker for atrial fibrillation following cardiac surgery. However, these findings are preliminary and require validation in larger, multi-center studies to confirm their clinical utility and inform preventative strategies.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"494-508"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540548","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":"Syncope due to vitamin-B12 deficiency - case report.","authors":"Josef Finsterer","doi":"10.25122/jml-2024-0305","DOIUrl":"10.25122/jml-2024-0305","url":null,"abstract":"<p><p>To our knowledge, a patient with recurrent syncope due to vitamin B12 deficiency without hematologic manifestations has not been reported before. We present the case of an 83-year-old man who experienced a third episode of syncope, characterized by sudden loss of consciousness without convulsions and rapid recovery. His medical history included ischemic stroke 22 years earlier and multiple bowel resections following cholecystectomy 21 years ago. The examination revealed a severe vitamin B12 deficiency and bradycardia on ECG. The examination for heart disease was inconclusive. The syncope was attributed to a vitamin B12 deficiency and consecutive cardiac autonomic neuropathy (CAN) after other causes for the syncope were sufficiently ruled out. Syncopes did not recur after adequate vitamin B12 supplementation. This case illustrates that partial bowel resection may lead to severe vitamin B12 deficiency, which can result in CAN. Disturbed autonomic innervation of the cardiac conduction system can lead to bradycardia, which, in turn, can result in syncope. Patients with a history of complete or partial bowel resection should undergo regular monitoring of vitamin B12 levels to prevent potentially symptomatic deficiency.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"515-516"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540553","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":"Attitudes of dentists and patients towards the introduction of artificial intelligence in dentistry.","authors":"Iliyan Iliyanov Kostov, Greta Roussanova Yordanova","doi":"10.25122/jml-2024-0382","DOIUrl":"10.25122/jml-2024-0382","url":null,"abstract":"<p><p>This study evaluated the attitudes of dental professionals and patients regarding the use of artificial intelligence (AI) in dental practice. A survey was conducted among dentists, dental students, and patients to assess their trust in AI-generated diagnoses-whether partially or entirely AI-based-and in the direct involvement of AI in treatment. The collected data were statistically processed and analyzed. While approximately 45% of participants across all groups supported the use of AI software for data collection and analysis, most agreed that final diagnostic decisions should remain the dentist's responsibility. Confidence in fully AI-generated diagnoses was low, with only 3.8% of dentists, 10.4% of students, and 10.8% of patients expressing trust in such outcomes. Similarly, the level of trust in dental treatment performed by a computer-controlled dental machine was unsatisfactory. A significant difference was observed in preferences for direct dental care: 66.5% of patients favored it, compared to 79.9% of students and 77.4% of practicing dentists. This discrepancy may be attributed to concerns that AI could substantially reduce the clinical involvement of dentists and students, whereas patients fear that relying solely on AI could compromise the personalized aspect of care, requiring them to entrust their treatment entirely to machines. Hybrid solutions are models that synchronize the analytical capabilities of a dental practitioner with the data inferred by AI. The study found that doctors and patients have positive attitudes towards the introduction of AI as an auxiliary tool. Dental practices should invest in software and technological equipment that enable a new level of dental diagnosis with the aid of AI.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"472-477"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540482","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":"Physicians' knowledge and adherence to Centor Criteria for preventing acute rheumatic fever in Jeddah, Saudi Arabia.","authors":"Mohammed Shaikhomer, Jumana Hussain Timraz, Nada Yasser Metwali, Fathima Shamma Bava, Zainab Yusuf, Ruqayyah Ali Ahmed, Husna Irfan Thalib, Syeda Nafeesa Hashim","doi":"10.25122/jml-2024-0397","DOIUrl":"10.25122/jml-2024-0397","url":null,"abstract":"<p><p>Acute rheumatic fever (ARF) is a delayed autoimmune complication of Group A Streptococcal (GAS) pharyngitis and remains a significant public health concern in regions such as Saudi Arabia. Timely treatment with antibiotics guided by the Centor criteria can prevent ARF, yet adherence to these recommended guidelines remains inconsistent among physicians in developing countries. This study aimed to assess the knowledge and adherence of physicians in Jeddah, Saudi Arabia, to the Centor criteria in managing streptococcal pharyngitis as a strategy to prevent ARF. A cross-sectional study was conducted among 105 physicians across various specialties. A structured questionnaire was used to evaluate their adherence and awareness. Data was analyzed using SPSS version 23.0, with chi-square tests to assess the significance (<i>P</i> < 0.05). Only 40% of physicians reported consistent use of the Centor criteria. Female and non-Saudi physicians demonstrated higher rates of adherence. The most compliant were consultants (42.8%), while ENT and family medicine departments demonstrated better adherence to Ministry of Health guidelines. Additionally, physicians with over 15 years of experience demonstrated significantly greater adherence than their less experienced counterparts. Significant gaps were identified in the adherence to the Centor criteria, which were influenced by professional roles and demographic factors. Promoting adherence to national guidelines and standardizing training is crucial for improving ARF prevention in Saudi Arabia.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"449-454"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540551","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":"Comprehensive review of clinical presentation, treatment, and prognostic factors of airway burns.","authors":"Rares-Adrian Giurgiu, Eliza-Maria Bordeanu-Diaconescu, Andreea Grosu-Bularda, Adrian Frunza, Sabina Grama, Cătălina-Ştefania Dumitru, Raducu-Andrei Costache, Carina-Ioana Cristescu, Ioan Lascar, Cristian-Sorin Hariga","doi":"10.25122/jml-2025-0081","DOIUrl":"10.25122/jml-2025-0081","url":null,"abstract":"<p><p>Inhalation injury is a major contributor to poor outcomes in burn patients, increasing the risk of respiratory complications, prolonged hospitalization, and mortality. This review summarizes current knowledge on the pathophysiology, diagnosis, and management of airway burns, based on clinical studies and guidelines. Injuries may be supraglottic, subglottic, or systemic, each leading to inflammation, airway obstruction, and impaired gas exchange. Carbon monoxide and cyanide toxicity further worsen systemic hypoxia. Diagnosis depends on clinical signs, imaging, and bronchoscopy, which remains the gold standard. Treatment involves airway stabilization, ventilatory support, inhaled therapies, and antidotes for toxic exposure. Prognosis is affected by burn extent, systemic response, and comorbidities such as substance abuse. Survivors often experience long-term pulmonary dysfunction, emphasizing the need for early, multidisciplinary intervention.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"405-410"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540484","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":"Interview with Professor Marc Fisher, past president of the World Stroke Organisation, at the 3^rd National Neurology Forum in Bucharest, Romania.","authors":"Stefana-Andrada Dobran, Alexandra Gherman","doi":"10.25122/jml-2025-1002","DOIUrl":"https://doi.org/10.25122/jml-2025-1002","url":null,"abstract":"","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"402-404"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540549","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":"Control of type 2 diabetes in patients with cancer and chronic pro-inflammatory cytokines during the COVID-19 pandemic.","authors":"Delia Andreea Lespezeanu, Florin Dan Ungureanu, Bogdan Circiumariu, Ciprian Constantin, Cristian Serafinceanu, Florentina Ionita Radu, Alin Kraft, Nicolae Bacalbasa","doi":"10.25122/jml-2025-0061","DOIUrl":"10.25122/jml-2025-0061","url":null,"abstract":"<p><p>Patients with cancer and severe COVID-19 pneumonia treated with injectable azithromycin and anakinra frequently develop dysglycemia, necessitating initiation of sulfonylurea therapy (gliquidone or glimepiride). We retrospectively reviewed adults (≥30 years) with diabetes and cancer who were hospitalised for COVID-19 at the Central Military Hospital Bucharest and the Matei Bals National Institute between March 2020 and August 2022. All patients completed a 14-day course of azithromycin + anakinra and survived to discharge. Glycaemic control was achieved with fixed-dose gliquidone 30 mg or glimepiride 2, 3, or 6 mg, chosen according to each patient's inflammatory-cardiac profile. Central insulin resistance may lead to the risk of cardiometabolic syndrome through the increase of inflammatory markers (TNF-alpha and PAI-1), treated with gliquidone, in 50 patients with cancer infected with COVID-19, who were dependent on developing immunothrombosis. Peripheral insulin resistance leads to the risk of cardiovascular events through the increase of inflammatory markers, IL-6 and Il-1, treated with glimepiride, in 50 patients with cancer infected with COVID-19.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"428-439"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540485","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":"Distal pulmonary epithelial maturation in preterm infants: does the lung of the preterm infant continue its functional pulmonary development postnatally?","authors":"Raluca Chirculescu, Paul Cristian Balanescu, Gheorghe Peltecu","doi":"10.25122/jml-2025-0072","DOIUrl":"10.25122/jml-2025-0072","url":null,"abstract":"<p><p>Disruption of pulmonary development caused by premature birth before the achievement of functional pulmonary maturation culminates in respiratory distress syndrome, primarily due to surfactant deficiency. Furthermore, the severity of this syndrome intensifies, particularly in the case of extremely premature neonates. This investigation aimed to evaluate the presence of postnatal pulmonary functional maturation in premature neonates. In pursuit of this objective, we conducted immunohistochemical assays for surfactant and Napsin A within the pulmonary tissue of 67 preterm neonates, with gestational ages ranging from 23 to 35 weeks, whose lifespans varied between one day and 149 days. The two immunohistochemical markers were evaluated within the pulmonary distal epithelium, and their expression was interpreted in relation to various pre- and postnatal factors. The examination was performed on tissue microarrays, sectioned at 5 micrometers, and the assessment of the immunohistochemical markers was interpreted from photographs captured under the optical microscope. Our investigation revealed that all neonates, regardless of their gestational age or lifespan, demonstrated the presence of surfactant within the pulmonary tissue. The intensity of Napsin A expression exhibited a positive correlation with gestational age, duration of oxygen therapy/mechanical ventilation, administration of antenatal corticosteroids, and maternal infections during pregnancy. In summary, our research demonstrated that mechanical ventilation, through the dynamic process of alveolar distension, promotes surfactant production within the distal lung epithelium. Antenatal treatment with corticosteroids and maternal antenatal infections enhances pulmonary function, facilitating surfactant production.</p>","PeriodicalId":16386,"journal":{"name":"Journal of Medicine and Life","volume":"18 5","pages":"478-486"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540486","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}