The Journal of the Association of Physicians of India最新文献

{"title":"Cardiac Magnetic Resonance Imaging Study on Cardiovascular Involvement >60 Days Post COVID-19 Recovery.","authors":"Nihar Mehta, Tanushree Somir Banerjee, Chandresh O Karnavat, Rajesh M Parikh, Ritu Kashikar, Shraddha Sinhasan, Shruti Tandan-Pardasani, Susheel Bindroo, Anand Bhabhor, Indraneil Raut, Nimish Shah, Shrinivas B Desai, Munira Kapadia, Maherra Desai, Aarshee Kapoor","doi":"10.59556/japi.74.1609","DOIUrl":"https://doi.org/10.59556/japi.74.1609","url":null,"abstract":"<p><strong>Context: </strong>This study evaluates individuals who have recovered from coronavirus disease 2019 (COVID-19) for cardiac manifestations at least 60 days postrecovery, using cardiac magnetic resonance (CMR) imaging. Native T1, native T2, and late gadolinium enhancement (LGE) were used as parameters to detect potential cardiac pathologies.</p><p><strong>Aim: </strong>To study the incidence and nature of cardiac manifestations in long COVID using CMR.</p><p><strong>Study design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>A total of 54 COVID-19-recovered patients and 50 healthy matched controls (age- and sex-based) underwent CMR using a 3 T scanner. Pathologies were assessed through native T1 and T2 mapping and LGE imaging. Data analysis was conducted using SPSS version 23.</p><p><strong>Results: </strong>Only 1 patient (1.85%) showed midmyocardial LGE in the basal and midinferior segments, along with raised native T1 and T2 values. The remaining 53 recovered patients (98.15%) revealed no LGE or elevated T1/T2 values compared to controls. Native T1 and T2 values did not significantly differ between the post-COVID participants and healthy controls. Mild concentric hypertrophy was observed in six patients, which appeared incidental and unrelated to COVID-19. None of the patients exhibited elevated troponin T levels.</p><p><strong>Conclusion: </strong>In this study, CMR imaging did not find a significant increase in cardiac manifestations that may be attributed to long COVID in patients who had recovered from COVID-19 compared with uninfected controls. We believe the incidence of cardiovascular comorbidities related to long COVID syndrome is much lower in the Indian population than reported in Western literature. These findings are reassuring and may help alleviate concerns among the Indian population regarding long-term cardiovascular involvement of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664387","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":"Curricular Integration of Point-of-care Ultrasound in Medical Education in India: An Immediate Need.","authors":"Sushrut Ingawale, Vineet Upadhyaya, Vineet Chandak","doi":"10.59556/japi.74.1592","DOIUrl":"https://doi.org/10.59556/japi.74.1592","url":null,"abstract":"<p><p>Point-of-care ultrasound (POCUS) has become an essential bedside imaging tool in modern medical practice, enabling rapid, real-time, and cost-effective assessment for cardiac, pulmonary, abdominal, and vascular conditions, as well as guidance for invasive procedures. Its value is well established in emergency and critical care settings, yet formal POCUS training is currently absent from the undergraduate as well as postgraduate medical curriculum in India. This gap persists despite the widespread applicability of POCUS across clinical disciplines and its proven role in improving diagnostic accuracy and patient safety. Major barriers to POCUS integration in Indian medical education include limited awareness among physicians, inadequate infrastructure and equipment, lack of trained faculty, curriculum deficiencies, and regulatory challenges. Additional constraints, such as limited time during clinical rounds and the absence of standardized quality assurance, further hinder adoption. This article highlights the urgent need for structured and uniform POCUS education within the competency-based medical education (CBME) framework. It proposes the \"POCUS Megaphone Strategy,\" a comprehensive approach encompassing problem identification, curriculum and faculty development, trainee-focused training programs, infrastructural strengthening, and policy-level advocacy. Integrating standardized POCUS training under the National Medical Commission will equip future Indian physicians with essential bedside imaging skills and significantly enhance the quality and safety of patient care.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"82-84"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664491","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 Darwinization of Diabetes.","authors":"Sanjay Kalra, Agam Vora, Mangesh Tiwaskar, Nishant Raizada, Madhur Verma, Nitin Kapoor","doi":"10.59556/japi.74.1562","DOIUrl":"https://doi.org/10.59556/japi.74.1562","url":null,"abstract":"<p><p>Diabetes is a dynamic disease, an ever-evolving entity. In existence for centuries, the prevalence of diabetes has increased manifold over the past few decades.¹ This evolution is associated with a change in classification, clinical features, comorbidities, complications, and clinical management strategies. These changes are what we describe as the Darwinization of diabetes. Charles Darwin was one of the most important scientists in human history. His research forms the basis of evolutionary biology. His hypothesis on natural selection, created along with Alfred Wallace, is accepted as the most important mechanism of evolution.² A similar situation occurs with diabetes.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"11-12"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664624","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":"Pregnancy Outcomes in Patients with Tuberculosis: A Systematic Review and Meta-analysis.","authors":"Hemlata Sharma, Swati Garg, Saurabh Sharma, Urvashi Sharma, Ashok Kumar","doi":"10.59556/japi.74.1608","DOIUrl":"10.59556/japi.74.1608","url":null,"abstract":"<p><strong>Background and objectives: </strong>Tuberculosis (TB) is an important global health problem, especially for pregnant women, a vulnerable group. This systematic review and meta-analysis was conducted in this group to obtain cumulative results in a collective effort toward the World Health Organization (WHO) End TB Strategy.</p><p><strong>Methodology: </strong>The databases Ovid MEDLINE, Embase, PubMed, ScienceDirect, Scopus, and Cochrane Central Register of Controlled Trials were searched for the last 10 years till 14^th January 2025. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in this analysis. Pregnancy outcomes in terms of maternal complications and perinatal complications, including observed mortality, were considered for analysis.</p><p><strong>Results: </strong>A total of 9,873 records were identified through database searching, and 15 studies, including 3,045 pregnant women with TB, were selected for final analysis. The pooled mean maternal age was 27.6 years, and more than half of TB cases were diagnosed antenatally. Among pregnancy-related complications, fetal growth restriction, pregnancy-induced hypertension, oligohydramnios, and gestational diabetes were seen in 19, 15, 11, and 10% of cases, respectively. Low birth weight, preterm birth, small for age, and low Apgar score (<7) had pooled prevalences of 30, 22, 20, and 13%, respectively. Maternal mortality and neonatal mortality showed pooled prevalences of 0.05 [95% confidence interval (CI): 0.03-0.08] and 5% (95% CI: 3-8%), respectively. Low to moderate heterogeneity was found among observations.</p><p><strong>Interpretation and conclusion: </strong>This systematic review and meta-analysis showed continued maternal and perinatal adverse outcomes in pregnant women with TB even in the current era, highlighting the need to optimize healthcare.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664554","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":"From Clinic to Community: A Public Health Framework for Metabolic Dysfunction-associated Steatotic Liver Disease Prevention in India.","authors":"Shambo Samrat Samajdar, Sanjay Bandyopadhyay, Shashank R Joshi","doi":"10.59556/japi.74.1511","DOIUrl":"https://doi.org/10.59556/japi.74.1511","url":null,"abstract":"<p><strong>Background: </strong>India is witnessing a rapid rise in metabolic dysfunction-associated steatotic liver disease (MASLD), driven by the country's expanding population with obesity, type 2 diabetes (T2D), and other metabolic comorbidities. Despite this growing burden, structured liver disease screening is absent from routine noncommunicable disease (NCD) services at the primary care level.</p><p><strong>Problem: </strong>A majority of MASLD diagnoses in India occur only after progression to advanced fibrosis or cirrhosis, even among individuals regularly engaged with healthcare systems for diabetes or hypertension. Primary health centers (PHCs) and community health centers (CHCs) currently lack standardized protocols for liver risk stratification, leading to critical missed opportunities for early intervention.</p><p><strong>Approach: </strong>This article outlines a scalable, systems-integrated model for community-based liver care, piloted at the All India Institute of Medical Sciences (AIIMS), Rishikesh. The model incorporates noninvasive fibrosis scoring tools (FIB-4, APRI), selective deployment of nurse-led FibroScan services, maternal hepatitis B virus screening, lifestyle modification strategies, and digital follow-up systems-seamlessly embedded within existing maternal health and NCD platforms. Insights: A real-world vignette from an urban diabetes outreach program in Kolkata illustrates the diagnostic gap: a high-risk patient remained undiagnosed for MASLD despite multiple healthcare encounters. International experiences, such as the Gwent model in Wales, further reinforce the feasibility of decentralized hepatology through community triage, nurse-led services, and simplified biochemical tools.</p><p><strong>Conclusion: </strong>India stands at a pivotal moment in redefining hepatology as a preventive, public health-oriented discipline. By embedding liver screening within existing NCD frameworks, leveraging task-sharing, and mobilizing digital infrastructure and public-private partnerships, India can develop a replicable model for early MASLD detection and intervention. This community hepatology framework-if scaled nationally-has the potential to position India as a global leader in MASLD prevention for low- and middle-income countries.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"67-69"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664514","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":"Spectrum and Clinical Burden of Drug-induced Ataxia in Low-resource Settings: An Observational Study.","authors":"Jayaram Saibaba, Murugesan P Subramaniam, Arunprakash P Thangavelu, Krithikaa Chitharanjan Rennukaranjan","doi":"10.59556/japi.74.1571","DOIUrl":"https://doi.org/10.59556/japi.74.1571","url":null,"abstract":"<p><strong>Background: </strong>The clinical manifestation of drug-induced ataxia (DIA) is well established clinically but often becomes unrecognized until actual ataxia occurs. DIA may include ataxia as its primary clinical symptom or may be one of multiple manifestations. This study aimed to characterize the development of DIA types and the timing of clinical resolution.</p><p><strong>Materials and methods: </strong>Between January 2016 and March 2025, a prospective observational study of subjects diagnosed with DIA based on the development of ataxia after starting a drug and no prior history of ataxia was conducted. Collected data included the drug involved, timing to onset of symptoms, type of DIA (cerebellar vs sensory), and time required for resolution of symptoms.</p><p><strong>Results: </strong>A total of 63 subjects met the criteria for inclusion in this analysis. Ataxia was most commonly attributed to antiepileptic drugs (AED) (44 subjects, 69.8%), with the remaining 19 subjects having ataxia after the use of chemotherapeutic or other drugs (30.2%). The most frequent drug associated with ataxia was phenytoin (22 subjects). The majority of ataxia experienced by the subjects was of the cerebellar variety (58.7%), whereas only 41.3% experienced a sensory form of ataxia. Symptoms of ataxia following the use of a drug were most commonly noted >72 hours after starting the drug (79.4%). In subjects with symptomatic improvement after intervention, 39.7% of subjects demonstrated improvement within 72 hours after intervention.</p><p><strong>Conclusion: </strong>DIA may typically be caused by AEDs and chemotherapeutic drugs, with symptoms commonly manifesting >72 hours after initiation of drug therapy. Early recognition and treatment of DIA may improve clinical outcomes for individuals diagnosed with DIA.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"15-19"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664597","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":"A Study on Prehospital Factors Determining the Timely Arrival for Thrombolysis among Patients Presenting with Acute Ischemic Stroke at a Tertiary Care Center in South India.","authors":"Naga Srinivas P S, Nidhi Prakash Vadanere, K Mugundhan, Sakthi Velayudham, Malcolm Jeyaraj, P R Sowmini","doi":"10.59556/japi.74.1582","DOIUrl":"https://doi.org/10.59556/japi.74.1582","url":null,"abstract":"<p><strong>Background: </strong>Among ischemic stroke patients, prehospital delay is the most common reason for underutilization of thrombolysis.</p><p><strong>Aims: </strong>The study assessed prehospital factors contributing to delay and timely arrival among study participants.</p><p><strong>Settings and design: </strong>A cross-sectional study was carried out at the casualty department of Government Stanley Medical College and Hospital, South India.</p><p><strong>Materials and methods: </strong>We selected 212 study participants by consecutive sampling. Data were collected by interviewing patients or accompanying family members using a semistructured questionnaire.</p><p><strong>Statistical analysis: </strong>Univariate analysis was followed by multivariate logistic regression to examine prehospital factors contributing to delay and timely arrival. Follow-up of eligible study participants for thrombolysis was performed using the National Institutes of Health Stroke Scale (NIHSS) and American Heart Association (AHA)-2019 checklist.</p><p><strong>Results: </strong>The most common factors contributing to prehospital delay and timely arrival were found to be \"unawareness regarding benefits of timely arrival among patients/relatives (48.7%)\" and \"apprehension of some serious health issue (50%),\" respectively. The distance between the hospital and the place of onset of symptoms, stroke during sleep, mode of transport, National Institutes of Health Stroke Scale (NIHSS), and slurring of speech were found to have significant odds for timely arrival for intravenous thrombolysis (IVT). Among those who arrived on time (n = 60), 13 study participants could not undergo thrombolysis. The most common reason for this was refusal of thrombolysis (4, 6.7%), and other criteria, such as minor neurological deficits (4, 6.7%), rendered them ineligible for it.</p><p><strong>Conclusion: </strong>The study highlights factors associated with timely arrival at the hospital and further reasons for not undergoing IVT despite timely arrival among cases of acute ischemic stroke (AIS). There is also a need to generate awareness and disseminate information on the benefits of IVT, timely arrival, and prehospital factors; provide training in stroke preparedness; and strengthen the referral system to ensure maximum eligibility and utilization.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7E","pages":"e9-e17"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664612","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":"Assessing the Impact of the District Residency Program on Pre- and Paraclinical Postgraduate Training in India.","authors":"Nitin Chintaman Gawari, Gampa Sarjanya, Sujata Prakash Shingare, Yasir Hassan","doi":"10.59556/japi.74.1564","DOIUrl":"https://doi.org/10.59556/japi.74.1564","url":null,"abstract":"<p><p>Since 2023, the National Medical Commission's District Residency Program (DRP) has been placing postgraduate residents in district hospitals for 3 months, with the intention of strengthening primary healthcare and exposing young doctors to real-world community health challenges. The vision behind the program is admirable: to make future specialists more aware of ground-level healthcare issues while improving district-level services.^1,2.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"95-96"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics Treatment Approaches and Survival Outcomes in Secondary Hemophagocytic Lymphohistiocytosis: A Retrospective Observational Study.","authors":"Amratansh Varshney, Pratibha Satish Phadke, Anusree Prabhakaran, Dipak Patade, Yash Bhalani, Abhishek Kumar","doi":"10.59556/japi.74.1607","DOIUrl":"https://doi.org/10.59556/japi.74.1607","url":null,"abstract":"<p><strong>Background: </strong>Hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal syndrome characterized by immune hyperactivation and a cytokine storm, leading to fever, cytopenia, organomegaly, and multiorgan dysfunction. Given its high morbidity and mortality, prompt diagnosis and treatment are essential. Currently, there are no established markers to predict outcomes in secondary hemophagocytic lymphohistiocytosis (sHLH).</p><p><strong>Materials and methods: </strong>This retrospective study aimed to identify prognostic factors in patients with sHLH, specifically evaluating the prognostic role of absolute neutrophil count (ANC) and serum ferritin level. The study also examined the impact of dexamethasone and etoposide on the treatment of these patients.</p><p><strong>Results: </strong>HLH remission was achieved in 64 patients (71.1%). Forty-seven out of those 64 patients survived and were discharged home, while 17 patients died in the hospital. HLH remission was not achieved in 26 patients (28.9%), of whom 25 patients died in the hospital. ANC at diagnosis and lower nadir ANC during the hospital stay significantly correlated with mortality (<i>p</i> = 0.001 and 0.017, respectively). Serum ferritin levels, however, were not a significant prognostic marker (<i>p</i> = 0.396). Treatment with dexamethasone was associated with better outcomes in patients with sHLH.</p><p><strong>Conclusion: </strong>sHLH should be considered in patients with treatment-resistant bicytopenia or pancytopenia. Lower ANC at diagnosis and nadir ANC during hospitalization are associated with increased mortality, suggesting that ANC is a potential indicator for early immunochemotherapy. Serum ferritin level is not a significant prognostic marker. Early diagnosis and dexamethasone treatment help achieve HLH remission, which improves outcomes in sHLH. These findings highlight the need for prospective studies to better understand sHLH prognostic markers and therapeutic strategies, especially in intensive care settings, where mortality remains high.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7E","pages":"e18-e24"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664529","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":"Navigating Bone Health in Epilepsy-A Detailed Review of Anticonvulsant-induced Osteomalacia: Its Mechanisms and Therapeutic Strategies.","authors":"Sundar Sri Mk, Karthickeyan Krishnan","doi":"10.59556/japi.74.1597","DOIUrl":"https://doi.org/10.59556/japi.74.1597","url":null,"abstract":"<p><p>Anticonvulsants are the drugs given for managing epilepsy and some other types of neurological disorders; however, their long-term use is increasingly suspected of causing adverse skeletal outcomes, including osteomalacia. Osteomalacia is a condition marked by defective mineralization of bone, leading to bone softening, bone pain, muscle weakness, and predisposition to fractures. The disruption of vitamin D metabolism, impaired calcium absorption, and altered bone turnover are mechanisms attributed to several commonly used anticonvulsants, especially enzyme-inducing agents such as phenytoin, carbamazepine, and phenobarbital, in contributing to osteomalacia. Hence, this review aims to provide detailed information about the pathophysiology, clinical manifestations, diagnosis, and treatment of anticonvulsant-induced osteomalacia. The review places further emphasis on the importance of regular monitoring of bone health in individuals receiving long-term antiepileptic treatment, supplementation, lifestyle interventions, and interprofessional care. A proper understanding of this preventable complication will certainly help healthcare providers to minimize the impact in these patients and improve outcomes.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"74 7","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664540","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}