Malawi Medical Journal最新文献

{"title":"State of the health workforce in Africa 2026: a glass half full or half empty.","authors":"Adamson S Muula","doi":"10.4314/mmj.v38i2.1","DOIUrl":"https://doi.org/10.4314/mmj.v38i2.1","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"38 2","pages":"60"},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765444","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":"Pancreatic Morphological Patterns on MRI in Individuals With Suspected Type 5 Diabetes: An Exploratory Case Series From Mzuzu Central hospital, Malawi.","authors":"Yingpu Zhu, Arnold Kayira, Blessed Kondowe, Patrick Manda, Junyi Ren, Jingping Zhang","doi":"10.4314/mmj.v38i2.13","DOIUrl":"https://doi.org/10.4314/mmj.v38i2.13","url":null,"abstract":"<p><strong>Purpose: </strong>Type 5 diabetes mellitus (T5DM), recently proposed as a diabetes phenotype associated with chronic undernutrition, remains poorly characterized regarding pancreatic structural changes. This study aimed to describe pancreatic MRI morphological features in individuals with clinically suspected T5DM from a resource-limited African setting.</p><p><strong>Methods: </strong>This retrospective case series included four individuals with clinically suspected T5DM from Mzuzu Central Hospital, Malawi. Clinical characteristics, nutritional history, and routine abdominal MRI findings were reviewed. Pancreatic morphology was assessed using manual segmentation of axial T2-weighted PROPELLER images, with segmentation-derived pancreatic area and volume obtained.</p><p><strong>Results: </strong>Four individuals (two females and two males; age range, 10-35 years) were included. All patients had a lean body habitus (BMI range, 16.4-18.3 kg/m²), childhood nutritional deprivation history, and no documented diabetic ketoacidosis or recurrent ketosis. MRI demonstrated a consistent morphological pattern characterized by relative preservation of the pancreatic head and uncinate process with reduction of the distal pancreas. Three patients showed thinning of the pancreatic body and tail, while the youngest patient demonstrated a shortened pancreatic tail not reaching the splenic hilum. Pancreatic body diameter ranged from 7.6 to 11.6 mm, with segmentation-derived pancreatic volume ranging from 16.9 to 27.3 cm³.</p><p><strong>Conclusion: </strong>Individuals with clinically suspected T5DM demonstrated a recurrent pancreatic MRI pattern of preserved head morphology with reduced body and tail structures. These preliminary findings suggest that MRI-based pancreatic morphological assessment may provide additional structural information for malnutrition-associated diabetes phenotyping, particularly in settings with limited metabolic characterization.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"38 2","pages":"146-150"},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759358","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":"Diagnostic value of cervical vascular ultrasound combined with CT angiography in carotid artery plaque in patients with cerebral infarction.","authors":"Jingjiao Qian, Hanwen Shi, Pingping Ye, Danni Wang, Linfeng Tang, Xiaojuan Zhou, Guang Yang","doi":"10.4314/mmj.v38i2.8","DOIUrl":"https://doi.org/10.4314/mmj.v38i2.8","url":null,"abstract":"<p><strong>Objective: </strong>To clarify diagnostic value of cervical vascular ultrasound (CVUS) combined with CT angiography (CTA) in carotid artery plaque in patients with cerebral infarction.</p><p><strong>Methods: </strong>A total of 110 patients with cerebral infarction upon admission to our hospital from January 2021 to December 2023 received enrollment and performed CVUS and CTA examination. Digital subtraction angiography (DSA) received application as the gold standard to compare the diagnostic efficiency of different detection methods.</p><p><strong>Results: </strong>DSA examination was performed on the bilateral carotid arteries (220 carotid arteries) of 110 patients, and 194 plaques were detected, including 73 soft plaques, 93 hard plaques and 28 mixed plaques. A total of 174 carotid artery stenosis cases were detected, including 73 mild stenosis cases, 42 moderate stenosis cases, 36 severe stenosis cases and 23 complete stenosis cases. The accuracy rate of CVUS combined with CTA in detecting carotid artery plaque was 93.81% (182/194), higher than that of CVUS (75.77%, 147/194) and CTA (76.80%, 149/194), with significance (P<0.05). The accuracy of CVUS combined with CTA in detecting carotid artery stenosis was 94.83% (165/174) higher than that of CVUS (78.74%, 137/174) and CTA (84.48%, 147/174), with significance (P<0.05).</p><p><strong>Conclusion: </strong>CVUS combined with CTA has a high diagnostic accuracy for carotid artery plaque lesions in patients with cerebral infarction, providing the basis for clinical diagnosis and follow-up treatment.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"38 2","pages":"111-115"},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764368","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":"Clinical effects of adjunctive spleen- and kidney-invigorating Chinese herbal therapy combined with highly active antiretroviral treatment on immune recovery and nutritional status in people living with HIV.","authors":"Lei Zhang, Yili Ren, Zhan Zhang, Beibei Zhang, Chenkai Xu","doi":"10.4314/mmj.v38i2.4","DOIUrl":"10.4314/mmj.v38i2.4","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether adding a spleen- and kidney-invigorating Chinese herbal decoction to highly active antiretroviral therapy (HAART) improves immune recovery and nutritional status in people living with HIV.</p><p><strong>Methods: </strong>Forty adults living with HIV were randomly allocated to receive either standard HAART alone or HAART plus a Chinese herbal decoction composed of astragalus, Chinese yam, dangshen, poria cocos, white atractylodes rhizome, radix pseudostellariae, and rehmannia glutinosa. Immune indices (CD4⁺, CD8⁺ T cells, Th17 cells), inflammatory cytokines (interferon-γ [IFN-γ], tumor necrosis factor-α [TNF-α]), hematological and nutritional parameters (hemoglobin, serum albumin), adverse drug reactions, and Medical Outcomes Study HIV Health Survey (MOS-HIV) scores were compared between groups.</p><p><strong>Results: </strong>Compared with HAART alone, HAART plus Chinese herbal decoction produced more marked immune reconstitution. At 6-12 months, the combination group had higher CD4⁺ counts (37.58 ± 3.76 vs 30.25 ± 3.02 cells/µL, P < 0.0001), lower CD8⁺ counts (22.41 ± 2.25 vs 28.62 ± 2.65 cells/µL, P < 0.0001), and higher Th17 levels (2.26 ± 0.23 vs 1.89 ± 0.19 cells/µL, P < 0.0001). IFN-γ and TNF-α concentrations were significantly reduced, while hemoglobin (126.87 ± 12.68 vs 116.32 ± 11.65 g/L, P = 0.009), serum albumin (38.82 ± 3.84 vs 32.45 ± 3.26 g/L, P < 0.0001), and MOS-HIV scores (80.36 ± 8.07 vs 72.58 ± 7.25, P = 0.0026) were higher in the combination group. The incidence of adverse reactions was similar between the two groups.</p><p><strong>Conclusion: </strong>Adjunctive use of a spleen- and kidney-invigorating Chinese herbal decoction with HAART may help restore the balance of T-lymphocyte subsets, attenuate systemic inflammation, enhance immune function, and improve nutritional status in patients with acquired immune deficiency syndrome.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"38 2","pages":"81-86"},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759279","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":"The Role of Computer Anxiety and Computer Experience in Digital Health Systems Adoption among Healthcare Workers in Malawi.","authors":"Mayamiko Nkoloma, Harry Gombachika, Alfred Maluwa","doi":"10.4314/mmj.v38i2.7","DOIUrl":"https://doi.org/10.4314/mmj.v38i2.7","url":null,"abstract":"<p><strong>Introduction: </strong>While computer experience is often considered a key determinant of digital health adoption, psychological factors such as computer anxiety may play an equally important role. This study examined the relative contributions of computer experience and computer anxiety to digital health adoption intention among healthcare workers in Malawi.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 615 healthcare workers in Malawi. The primary outcome variable was digital health adoption intention, while key explanatory variables included computer anxiety and Computer experience. Internal consistency was assessed using Cronbach's alpha. Bivariate associations were examined using Welch's t-tests and chi-square tests, while Pearson correlation analysis was used to assess relationships among key variables. Hierarchical linear regression models were estimated to evaluate the independent effects of computer experience and computer anxiety on digital health adoption intention.</p><p><strong>Results: </strong>Participants reported high digital health adoption intention (mean = 6.52, SD = 1.02) and relatively low computer anxiety (mean = 2.08, SD = 1.33). Compared with healthcare workers with low digital health system adoption intention, those with high adoption intention were more likely to have received DHS training (42.3% vs. 32.8%, p = 0.021), reported longer computer use experience (9.2 vs. 7.9 years, p = 0.010), and exhibited lower computer anxiety scores (1.77 vs. 2.49, p < 0.001). In hierarchical regression analyses, computer experience variables explained only 1.1% of the variation in adoption intention (R² = 0.011), whereas computer anxiety alone explained 6.9% (R² = 0.069). After adjusting for computer experience, age, gender, qualification, occupation, and experience, computer anxiety remained the only significant predictor of adoption intention (β = -0.212, 95% CI: -0.277 to -0.147, p < 0.001).</p><p><strong>Conclusions: </strong>The findings of the study suggest that interventions aimed at reducing computer anxiety play a critical role in improving the acceptance and sustainability of digital health systems in resource-constrained healthcare settings.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"38 2","pages":"102-110"},"PeriodicalIF":0.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759844","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":"A Comparative Analysis of Physical and Mobile Phone Tracing in Clinical Trials in Lilongwe, Malawi.","authors":"Noah Mancuso, Wiza Kumwenda, Nelecy Chome, Emmanuel Singogo, Irving Hoffman, Debbie Kamwendo, Innocent Mofolo, Francis Martinson, Maganizo B Chagomerana, Gift Werekhwe, Mina C Hosseinipour","doi":"10.4314/mmj.v37i4.6","DOIUrl":"10.4314/mmj.v37i4.6","url":null,"abstract":"<p><strong>Background: </strong>Patient retention is important for proper adherence to clinical trial protocols. Mobile-phone and physical tracing have been implemented at clinics across Malawi to improve retention but tracing effectiveness and attitudes towards tracing have not been sufficiently studied.</p><p><strong>Methods: </strong>In a site-specific phone retention pilot study embedded within the HIV Prevention Trials Network (HPTN) 052 study in Lilongwe, Malawi, all tracing records and additional semi-structured questionnaires from 50 participants were used to obtain attitudes towards tracing efforts and methods. During a retrospective evaluation study at UNC Project, over 20,000 tracing records were analyzed across 49 studies from 2011 to 2019. Success in reaching participants, bringing participants to clinic, and overall tracing costs were analyzed.</p><p><strong>Results: </strong>In the phone retention pilot study, 47 participants (94%) had positive attitudes towards tracing and 41 (82%) preferred mobile-phone tracing. Of all tracing attempts in the phone retention pilot study, mobile-phone tracing (232/309, 75%) was more successful than physical tracing (147/244, 60%) in reaching patients, and the cost of mobile-phone tracing was less ($4.21 versus $36.63 per tracing attempt). During the retrospective study period, mobile-phone tracing (7808/9522, 82%) was more successful than physical tracing (7742/10606, 73%) in returning patients to the clinic. Mobile-phone tracing saved approximately $32.08 and 92 minutes per tracing attempt.</p><p><strong>Conclusion: </strong>Mobile-phone tracing is acceptable, feasible, and efficient for clinical trials in Lilongwe, Malawi. Mobile-phone tracing can be used to strengthen patient engagement and improve collection of primary-outcome data for clinical trials.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"37 4","pages":"236-242"},"PeriodicalIF":0.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513313","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":"Malawi's health professionals must understand relevant legislations, terms and norms.","authors":"Adamson S Muula","doi":"10.4314/mmj.v37i4.1","DOIUrl":"10.4314/mmj.v37i4.1","url":null,"abstract":"","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"37 4","pages":"209-210"},"PeriodicalIF":0.8,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513069","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":"Individualized Care in The Covid-19 Pandemic: Perceptions of Patients and Nurses.","authors":"Hatice Erdoğan, Özlem İbrahimoğlu, Füsun Afşar, Sena Melike Özdamar Taşcı","doi":"10.4314/mmj.v37i4.3","DOIUrl":"10.4314/mmj.v37i4.3","url":null,"abstract":"<p><strong>Aim: </strong>Individualized care is patient-centred and personalized care. The Covid-19 disease affects the individualized care perceptions of both patients and nurses. The aim of this study was to determine the individualized care perceptions of patients and nurses in the Covid-19 pandemic.</p><p><strong>Methods: </strong>This descriptive study was conducted between December 2020 and March 2021 with 154 nurses working in Covid-19 clinics and intensive care units of a training and research hospital in Istanbul/Turkey and 213 patients hospitalized due to Covid-19. The data were collected with \"Patient Information Form\" and \"Individualized Care Scale-B-Patient\" for patients, and \"Nurse Information Form\" and \"Individualized Care Scale-B-Nurse\" for nurses.</p><p><strong>Results: </strong>While 64.3% (n=137) of the patients considered that they received individualized care, only 45.5% (n=70) of the nurses stated that they believed they provided individualized care to their patients. The mean individualized care scale scores of patients and nurses were 4.02±0.93 and 4.15±0.44, respectively, and it was determined that there was no significant difference between the scale scores of patients and nurses.</p><p><strong>Conclusion: </strong>In this study, the individualized care perceptions of Covid-19 patients and nurses providing care were found to be quite high considering the conditions in the pandemic process. It is believed that improving the working conditions of nurses and overcoming barriers to provide individualized care will improve the quality of care.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"37 4","pages":"216-224"},"PeriodicalIF":0.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513122","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":"Contact Dermatitis among Hospital Cleaners in Dar es Salaam: Prevalence and Associated Factors.","authors":"Shufaa N Mitawa, Ezra J Mrema, Khadija A Shebe, Zuhura I Kimera, Hussein H Mwanga","doi":"10.4314/mmj.v37i4.4","DOIUrl":"10.4314/mmj.v37i4.4","url":null,"abstract":"<p><strong>Background: </strong>Cleaners are a high-risk group for contact dermatitis in healthcare settings due to frequent exposure to cleaning agents, gloves, and wet work, yet they remain understudied in Tanzania. This study investigated the prevalence of contact dermatitis and its associated factors among hospital cleaners in Dar es Salaam, Tanzania.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between March and July 2022 among hospital cleaners from three regional referral hospitals and one national hospital. Data were collected using the Standardized Nordic Occupational Questionnaire. Modified Poisson regression was applied to estimate prevalence ratios (PRs) with 95% confidence intervals (CIs). Contact dermatitis was defined as the presence of two or more skin symptoms affecting the hands, wrists, or forearms within the past 12 months.</p><p><strong>Results: </strong>A total of 323 cleaners took part in the study. The median age was 26 years (range 18-64), and 65% were female. The prevalence of contact dermatitis was 48.9%. The most frequently reported symptoms were itching (48.6%), dry skin (44.6%), and rashes (22.0%). Work-related factors positively associated with contact dermatitis included use of floor-cleaning products (aPR = 1.70, 95% CI: 1.18-2.44), bleach (aPR = 1.64, 95% CI: 1.22-2.22), handwashing >10 times a day (aPR = 1.63, 95% CI: 1.12-2.35), and latex glove use (aPR = 1.61, 95% CI: 1.29-2.01). Prevalence varied across hospitals. Individual factors such as age, sex, smoking, and allergy history were not significantly associated with disease.</p><p><strong>Conclusions: </strong>Contact dermatitis is highly prevalent among hospital cleaners in Dar es Salaam, with its occurrence mainly associated with occupational exposures rather than individual susceptibility. Preventive measures should prioritize safer cleaning products, improved hand hygiene practices, appropriate glove use, and tailored skin protection programs.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"37 4","pages":"225-230"},"PeriodicalIF":0.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512881","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":"Circulating CD16+ CD56+ Natural Killer Cells in Colorectal Cancer and Their Correlation with Survival.","authors":"Gülcin Sahingoz Erdal, Nilgun Isiksacan, Tamay Seda Tasci, Murat Cıkot, Pınar Kasapoglu Atar, Nursel Kocamaz","doi":"10.4314/mmj.v37i4.8","DOIUrl":"10.4314/mmj.v37i4.8","url":null,"abstract":"<p><strong>Background: </strong>Natural killer cells, which play a role in the innate immune system, are cells in the early defence system against infections and tumours. The aim of this study was to investigate the role of NK cells in stage 3 colorectal cancer (CRC) and their relationships to serum carcinoembryonic antigen (CEA) levels, obesity, and survival.</p><p><strong>Method: </strong>CD16+CD56+ NK cells were analyzed by flow cytometry in newly diagnosed stage 3 CRC patients and healthy controls. Associations with survival, obesity, and serum CEA were evaluated.</p><p><strong>Results: </strong>The rate of NK cells was found to be lower in the CRC patients than in the healthy control subjects. The reduced NK cell rate was associated with reduced survival. A negative correlation was determined between NK cells and age, serum CEA levels, and obesity at the time of diagnosis.</p><p><strong>Conclusion: </strong>As the study results suggest that the NK cell rate could be effective in predicting prognosis in stage 3 CRC patients, they could also be of guidance for further studies with larger patient populations.</p>","PeriodicalId":18185,"journal":{"name":"Malawi Medical Journal","volume":"37 4","pages":"250-254"},"PeriodicalIF":0.9,"publicationDate":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12976442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512885","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}