Oman Medical Journal最新文献

{"title":"Miliaria Crystallina with Hypernatremia in a Newborn.","authors":"Chetan Khare, Vimesh Parmar, Jerene Mathews, Roshan Chanchlani","doi":"10.5001/omj.2024.122","DOIUrl":"10.5001/omj.2024.122","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e685"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670476","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":"Assessment of Quality of Life and Behavioral Problems in Children with Central Precocious Puberty.","authors":"Shaymaa Raafat, Esraa Abdelaal, Ihsan Mowafi, Mona Khalil","doi":"10.5001/omj.2024.100","DOIUrl":"10.5001/omj.2024.100","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to estimate the impact of central precocious puberty (CPP) on psychosocial aspects in the cohort of children and to assess whether these aspects changed after treatment with gonadotropin-releasing hormone (GnRH) analogues.</p><p><strong>Methods: </strong>A case-control study enrolled 30 CPP children and 30 normal controls. The CPP group was assessed with emphasis on anthropometric measurements (Tanner staging for pubertal changes). The hormonal profile included gonadotropins, estradiol or testosterone, and GnRH stimulation test. The instruments used for neuropsychological assessment included the Arabic version of the pediatric quality of life inventory TM 4.0, the Child Behavior Checklist (CBCL), and IQ testing.</p><p><strong>Results: </strong>The mean study group age was 5.1 ± 2.3 years compared to 5.2 ± 2.2 years in the control group; 29 patients and 29 controls (96.7%) were females. CPP children had significantly lower scores than controls in health-related quality of life (QoL) domains except school functioning without significant changes in CBCL scores and cognitive function. There was a statistically significant improvement in these scores after they were treated with GnRH analogues for a year.</p><p><strong>Conclusions: </strong>There are significant aberrations in CPP children's QoL with no effect on behavior or cognition. After treatment with GnRH analogues for a year, QoL and CBCL T-scores showed a significant improvement.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e670"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803813","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":"Outcome of Type 1 Tympanoplasty in Al Nahdha Hospital and Influencing Factors: A Retrospective Study.","authors":"Noor Al Busaidi, Mohammed Al Rahbi","doi":"10.5001/omj.2024.106","DOIUrl":"10.5001/omj.2024.106","url":null,"abstract":"<p><strong>Objectives: </strong>The management for chronic suppurative otitis media is tympanoplasty. The aim of the surgery is to prevent recurrent ear discharge and improve hearing. Several influencing factors are presumed to affect the outcome of tympanoplasty; however, their effect is considered controversial. No study in Oman evaluates the success rate of this surgery. Therefore, this study aimed to evaluate the anatomical and functional outcome of type 1 tympanoplasty in Al Nahdha Hospital, Oman, from 2010 to 2020. In addition, we sought to assess various factors that might have influenced the outcome and add our experience to the literature.</p><p><strong>Methods: </strong>We conducted a retrospective study that included all patients who had undergone type 1 tympanoplasty in Al Nahdha Hospital. The demographic data for patients were collected, in addition to the preoperative findings, pre- and postoperative air-bone gap (ABG) in a pure tone audiometry, the surgical approaches, and the type of grafts used. The success rate was defined as intact tympanic membrane six months after the surgery, and hearing improvement success was assessed by closure of ABG closure of 10 dB or more.</p><p><strong>Results: </strong>The total number of patients was 345, 40.6% were male, and 59.4% were female. The graft success rate was 84.3%. The average preoperative ABG was 26.1 ± 9.5, and the average postoperative ABG was 14.4 ± 9.3 with a gain of 11.7. This was statistically significant with a <i>p</i>-value of < 0.001. Hearing improvement (≥ 10 dB gain in ABG) was seen in 201 (67.0%) patients. There was no statistically significant difference in the hearing improvement and graft success rate when compared with influencing factors, including age, gender, perforation size, and surgical approach. However, there was a statistically significant difference between the types of graft used, where cartilage graft showed better hearing improvement than temporalis fascia graft.</p><p><strong>Conclusions: </strong>The graft success rate of type 1 tympanoplasty in Al Nahdha Hospital was 84.3%, and closure of ABG was 11.7. The percentage of patients who had improvement in ABG closure of ≥ 10 dB was 67.0%. These results are comparable with the results of other published studies. Factors that are presumed to influence the outcome of type 1 tympanoplasty were not statistically significant, which is consistent with other studies. Cartilage graft was found to give a better closure of ABG, which was statistically significant. We recommend that further studies be conducted within a more extended follow-up period and address more factors to achieve a better insight pertaining to the outcome of type 1 tympanoplasty.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e675"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605946","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":"Detection of Hemoglobin Constant Spring by Capillary Electrophoresis and High-performance Liquid Chromatography: A Study in Kelantan, Malay.","authors":"Sumaiyah Adzahar, Nabilah Rameli, Suryati Hussin, Nik Fatma Fairuz Nik Mohd Hassan, Wan Norhasanah Wan Yusoff, Shafini Mohamed Yusoff, Rosnah Bahar","doi":"10.5001/omj.2024.96","DOIUrl":"10.5001/omj.2024.96","url":null,"abstract":"<p><strong>Objectives: </strong>Hemoglobin Constant Spring (Hb CS) is one of the most common non-deletion types of alpha (α) thalassemia in Southeast Asia. The nature of this abnormal globin gene is unstable, labile, and present in minute amounts in the peripheral blood, leading to underdiagnosis. This study aimed to determine the prevalence of Hb CS among the Kelantan population in Malaysia, compare the levels of Hb CS detected by capillary electrophoresis (CE) among three groups of Hb CS (heterozygous, homozygous, and compound heterozygous), and evaluate the efficacy of CE and high-performance liquid chromatography (HPLC) in detecting Hb CS.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using data collected from secondary school students in Kelantan from 2017 to 2018 who participated in a thalassemia screening program conducted by the Ministry of Health, Malaysia. Hb analysis was performed using an automated CE system (CAPILLARYS 2 Flex-Piercing System Sebia) and HPLC (VARIANT II, Bio-rad Laboratories). DNA analysis was used multiplex polymerase chain reaction and multiplex amplification refractory mutation system to detect deletion and non-deletion α-thalassemia.</p><p><strong>Results: </strong>Termination codon CS mutation was confirmed among 376 (99.5%) samples with a peak value in zone 2 of CE. Heterozygous Hb CS was the most common type, detected in 344 samples (91.5%), followed by compound heterozygous Hb CS in 31 samples (8.2%) and one sample (0.3%) of homozygous Hb CS.</p><p><strong>Conclusions: </strong>The diagnosis of Hb CS is most accurately achieved by combining CE and HPLC methods, with confirmation by DNA molecular study, although the latter is more expensive.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e669"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11914713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658093","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":"Safety of COVID-19 Vaccination in Patients with Rheumatic and Musculoskeletal Diseases: A Cross-sectional Study in Egypt.","authors":"Nevin Hammam, Doaa Mosad, Amira M Ibrahim, Yousra H Abdel-Fattah, Hany M Aly, Hanan M El-Saadany, Maha Nassr, Abdelhafeez Moshrif, Hanan M Fathi, Samah I Nasef, Faten Ismail, Rawhya R El Shereef, Osman Hammam, Mervat I Abd-Elazeem, Enas A Abdelaleem, Abdelrahman Mohamed Elsayed, Samar Tharwat, Tamer A Gheita","doi":"10.5001/omj.2024.107","DOIUrl":"10.5001/omj.2024.107","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the incidence and associated risk factors of adverse events following COVID-19 vaccination in patients with inflammatory and non-inflammatory rheumatic and musculoskeletal diseases (I-RMD and NI-RMD, respectively).</p><p><strong>Methods: </strong>The Egyptian College of Rheumatology COVID-19 Study Group investigated physician-reported data (ECR-VaXurvey3) of RMD patients vaccinated against COVID-19 from December 2021 to June 2022, including their demographics, vaccination type, RMD diagnosis, treatments, post-vaccine flares, and other adverse events. The control group consisted of healthy, vaccinated individuals.</p><p><strong>Results: </strong>The ECR-VaXurvey3 included 890 vaccinated RMD patients, predominantly women (73.3%) with a mean age of 44.4 ± 12.1 years, and 172 controls. The RMD group comprised 816 (91.7%) with I-RMD and 74 (8.3%) with NI-RMD. The frequency of adverse events was comparable between the RMD and control groups. In RMD patients, injection site pain (59.9%) was the most reported adverse event. Post-vaccination COVID-19 infections and disease flares were reported in 2.9% and 12.1% of I-RMD patients and in 8.1% and 9.5% of NI-RMD patients (<i>p =</i> 0.018 and <i>p =</i> 0.497, respectively). The severity of prior COVID-19 infection (odds ratio (OR) = 2.4, 95% CI: 1.0-5.8; <i>p =</i> 0.040) and azathioprine use (OR = 2.6, 95% CI: 1.1-5.9; <i>p =</i> 0.024) were associated with higher post-vaccine adverse events, while biologic use was associated with fewer adverse events (OR = 0.5, 95% CI: 0.3-0.8; p = 0.010).</p><p><strong>Conclusions: </strong>Adverse events following COVID-19 vaccinations in patients with RMD are comparable to controls.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e676"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803772","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":"A Comprehensive Analysis of Inactive Hepatitis B Infection in a Cohort of Omani Patients.","authors":"Halima H Al Shuaili, Bushra Al Mashikhi, Ahmed Al Sinani, Said A Al Busafi","doi":"10.5001/omj.2024.104","DOIUrl":"10.5001/omj.2024.104","url":null,"abstract":"<p><strong>Objectives: </strong>Inactive hepatitis B carriers constitute a considerable proportion of chronic hepatitis B virus (HBV)-infected patients. Understanding the clinical features of this often overlooked population is essential to inform patient management strategies. Our study aimed to describe the sociodemographic and clinical features of inactive HBV carriers presenting to a tertiary center in Muscat, Oman.</p><p><strong>Methods: </strong>We conducted a retrospective, descriptive study among 375 adult Omani patients with inactive HBV infections presenting to the Sultan Qaboos University Hospital between January 2017 and December 2018. Relevant data were collected from electronic patient records. Liver fibrosis status was determined using two-dimensional shear-wave elastography.</p><p><strong>Results: </strong>A total of 200 patients met the study inclusion criteria and were included in the analysis. Of these, 53.0% were male, and the mean age was 45.0 ± 9.3 years. Most (77.5%) were aged 32-50 years and were therefore born before 1990, the year of initiation of the national HBV vaccination program. A family history of HBV infection was reported in 29.0%, while 25.0% were obese. Severe fibrosis and cirrhosis were observed in 16.0% and 3.0% of the cohort, respectively.</p><p><strong>Conclusions: </strong>A large number of inactive Omani HBV carriers were born before the implementation of the national HBV vaccination program in Oman, and just under one-third had a family history of HBV infection. Notably, despite being considered inactive carriers, 19.0% displayed radiological features of severe fibrosis or cirrhosis. Screening for high-risk inactive HBV infection is essential to ensure early management and improved patient outcomes.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e673"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586661","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":"Community Knowledge and Attitude Towards the Emergency Triage System at a Tertiary Hospital in Oman.","authors":"Zainab Al Siyabi, Amal Al Shibli, Abdullah Al Reesi, Sanjay Jaju, Mahmood Al Jufaili","doi":"10.5001/omj.2024.102","DOIUrl":"10.5001/omj.2024.102","url":null,"abstract":"<p><strong>Objectives: </strong>There is a dearth of research in Oman regarding public knowledge and attitudes regarding the triage protocols for prioritizing patients for emergency care. This study aimed to investigate this at the emergency department (ED) of a tertiary referral hospital in Muscat, Oman.</p><p><strong>Methods: </strong>This cross-sectional study was conducted from September to November 2019. Adult Omanis visiting the hospital's outpatient clinics or the ED during this period were selected using a consecutive convenience sampling strategy. A self-administered questionnaire was designed and used to assess the participants' knowledge and attitudes regarding the triage process used in the ED.</p><p><strong>Results: </strong>A total of 572 Omani adults participated in the survey (response rate: 77.3%). The majority were female (56.8%). Most participants were educated to high school or bachelor's degree level (74.7%). Overall, less than half of the sample (41.8%) demonstrated adequate knowledge of proper ED utilization, with male participants (<i>p =</i> 0.005) and those with a history of previous ED visits (<i>p =</i> 0.001) demonstrating significantly better knowledge than their respective counterparts. Knowledge of the factors used to make triaging decisions ranged from 28.5% (patient's medical history) to 67.3% (vital signs). Most participants agreed that the triage system helped to prioritize emergency cases (84.8%), improved the quality of ED care (80.9%), and reduced overcrowding (76.2%). Although 59.1% still preferred to visit the ED for non-emergent indications to receive same-day care, 48.4% stated they would accept redirection to a primary health center if requested.</p><p><strong>Conclusions: </strong>This study's findings revealed the necessity of increasing awareness of appropriate indications for ED visits in Oman, as well as specific factors used in the ED triage process. This would help to ensure appropriate health resource utilization, avoid ED overcrowding and lengthy wait times, and increase overall levels of patient satisfaction and confidence in the healthcare system.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e672"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803819","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":"Disease Activity in Rheumatoid Arthritis Patients Stratified by Hemoglobin Levels: A Multi-center Study.","authors":"Maryam Salah Al-Mazedi, Rajesh Rajan, Adeeba Al-Herz, Ahmad Alsaber, Mohammed Al-Jarallah, Raja Dashti, Parul Setiya, Khulood Saleh, Adel Al-Awadhi, Waleed Al-Kandari, Eman Hasan, Khaled Mokaddem, Aqeel Ghanem, Ahmad Alenizi, Kobalava D Zhanna, Laura Al Obaid","doi":"10.5001/omj.2024.101","DOIUrl":"10.5001/omj.2024.101","url":null,"abstract":"<p><strong>Objectives: </strong>Hemoglobin (Hb) level and its relation to rheumatoid arthritis (RA) is multifactorial. The primary aim of this study was to examine the association between Hb levels and disease activity in patients with RA.</p><p><strong>Methods: </strong>This retrospective study obtained data from adult RA patients with Hb reports from the Kuwait Registry for Rheumatic Diseases. Patients were recruited from four public hospitals in Kuwait between February 2013 and February 2022. The cohort was stratified into two groups: Hb ≤ 110 g/L and Hb > 110 g/L. Demographic, treatment, clinical, and laboratory characteristics were used to compare the two Hb groups. Multivariate and univariate statistical analyses were used to analyze the data.</p><p><strong>Results: </strong>The total number of patients visited (N_v) was 11 393 and consecutive patients with RA diagnoses and Hb data (N_p) were 1584. Both N_v and N_p were included in the study. Of these, 72.5% (n = 8260) had high Hb levels and 27.5% (n = 3133) had low Hb levels. The average age of the cohort was 55.9 ± 12.5 years. Logistic regression analysis revealed that a greater number of non-Kuwaiti patients had anemia than Kuwaiti patients [adjusted odds ratio (aOR) = 1.34, 95% CI: 1.16-1.56; <i>p</i> < 0.001). Patients who received biologic treatment were more likely to be non-anemic [aOR = 1.33, 95% CI: 1.23-1.45; <i>p</i> < 0.001). Additionally, the study demonstrated that patients with anemia had greater odds of acquiring Disease Activity Score -28 joint count (DAS-28) ≥ 3.2 versus DAS-28 < 3.2 [aOR = 0.74, 95% CI: 0.61-0.90; <i>p</i> = 0.002].</p><p><strong>Conclusions: </strong>Lower Hb levels in RA are an independent predictor of disease activity.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e671"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803822","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":"Odontoid Synchondrosis Fracture with Brown-Séquard Syndrome in a Two-year-old Child: A Case Report.","authors":"Fatima Siddiqui, Marya Hameed, Samia Abdul Qudoos, Hina Hanif, Suneeta Bansari","doi":"10.5001/omj.2024.29","DOIUrl":"10.5001/omj.2024.29","url":null,"abstract":"<p><p>Brown-Séquard Syndrome (BSS) in children is a rare but serious neurological condition that can develop following damage to one-half of the spinal cord due to odontoid synchondrosis fracture. We report a case of a two-year-old girl who presented with difficulty moving her neck, gait abnormalities, and right-side weakness. She had a history of a fall from bed three months earlier. Computed tomography scan and magnetic resonance imaging revealed an incomplete fracture of C2 vertebra, resulting in focal kyphosis and posterior impingement over the craniocervical junction along with significant cord thinning. Considering the patient's age and the incomplete nature of the fracture, a conservative approach was taken, and the patient underwent immobilization in a cervical collar for an extended period, followed by physiotherapy.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e678"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684390","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":"Unusual Cause of Coagulopathy in a Child.","authors":"Yusriya Al Rawahi, Yasser Wali, Dafalla Rahmatalla, Laila Al Yazidi","doi":"10.5001/omj.2024.84","DOIUrl":"10.5001/omj.2024.84","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e684"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649518","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}