Canadian Journal of Infectious Diseases最新文献

{"title":"Invasive Streptococcus pneumoniae infection causing hemolytic uremic syndrome in children: Two recent cases.","authors":"Otto G Vanderkooi,&nbsp;James D Kellner,&nbsp;Andrew W Wade,&nbsp;Tajdin Jadavji,&nbsp;Julian P Midgley,&nbsp;Thomas Louie,&nbsp;Gregory J Tyrell","doi":"10.1155/2003/219027","DOIUrl":"https://doi.org/10.1155/2003/219027","url":null,"abstract":"<p><strong>Introduction: </strong>Streptococcus pneumoniae is an uncommon cause of hemolytic uremic syndrome (HUS) with a unique pathophysiology that differs from Shiga toxin-related HUS.</p><p><strong>Methods: </strong>Case descriptions for each patient are provided. Each strain of S pneumoniae was subjected to a pulsed-field gel electrophoresis (PFGE) analysis, Shiga toxin assay and polymerase chain reaction to detect Shiga toxin genes. A review of the current literature was conducted.</p><p><strong>Case presentations: </strong>Two patients with S pneumoniae-related HUS that presented to the Alberta Children's Hospital, Calgary, Alberta, within four weeks of each other in 2001 are described. Both presented with pneumonia and empyema with associated HUS. Both patients required dialysis, one patient for 10 days and the other for 18 days. Neither patient demonstrated evidence of Shiga toxin-related disease. S pneumoniae isolated from blood or pleural fluid was penicillin susceptible. One isolate was serotype 3 and the other was serotype 14. The two strains had different PFGE patterns. Both patients recovered well with no persistent renal dysfunction.</p><p><strong>Conclusions: </strong>S pneumoniaecontinues to be an uncommon but important cause of HUS. Most cases can be confirmed or at least considered probable without performing a renal biopsy.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"339-43"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/219027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192887","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 two alternative sample transport and fixation methods in the microbiological diagnosis of bacterial vaginosis.","authors":"Erica Eason,&nbsp;Baldwin Toye,&nbsp;George A Wells,&nbsp;Mary Senterman","doi":"10.1155/2003/312429","DOIUrl":"https://doi.org/10.1155/2003/312429","url":null,"abstract":"<p><strong>Background: </strong>The standard method for specimen collection and transport for microbiological diagnosis of bacterial vaginosis is an air-dried smear of vaginal secretions, promptly heat- or alcohol-fixed, Gram-stained and scored by Nugent's criteria.</p><p><strong>Objective: </strong>TWO ALTERNATIVE METHODS ARE EVALUATED: sending a swab in transport medium to be smeared and Gram-stained in the laboratory two days later; and sending a smear of vaginal secretions sprayed with cytological fixative to the laboratory for Gram staining seven days later.</p><p><strong>Methods: </strong>One hundred fifty-two women aged 18 years and older who attended a hospital colposcopy clinic or a community healthy sexuality clinic were studied. This was a prospective study: three vaginal swabs were taken from each patient and handled as described above. Each slide was blindly and independently interpreted by two microbiology technologists. The sensitivity, specificity and coefficient of agreement of the transported swab and cytologically fixed methods were compared with the air-dried smear method.</p><p><strong>Results: </strong>Smears from swabs in transport medium and cytologically fixed smears both had 90% sensitivity and 97% specificity for bacterial vaginosis compared with diagnosis from air-dried smears. Cohen's kappa was 0.88 (95% CI 0.79 to 0.97) for each method. Inter-rater reliability assessed over all slides (all sampling techniques) was excellent (kappa 0.94).</p><p><strong>Conclusions: </strong>For the diagnosis of bacterial vaginosis, both alternative techniques provide results equivalent to air-dried direct smears. A vaginal smear sprayed with cytological fixative provides immediate fixation of material to the slide, permits delays in swab transport and avoids the requirement for transport at a controlled temperature imposed by swabs.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"322-6"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/312429","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192884","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":"Witnesses.","authors":"Lindsay Nicolle","doi":"10.1155/2003/819080","DOIUrl":"https://doi.org/10.1155/2003/819080","url":null,"abstract":"","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"310"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/819080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192881","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 retrospective analysis of practice patterns in the treatment of methicillin-resistant Staphylococcus aureus skin and soft tissue infections at three Canadian tertiary care centres.","authors":"John M Conly,&nbsp;H Grant Stiver,&nbsp;Karl A Weiss,&nbsp;Debbie L Becker,&nbsp;Andrew J Rosner,&nbsp;Elizabeth Miller","doi":"10.1155/2003/103682","DOIUrl":"https://doi.org/10.1155/2003/103682","url":null,"abstract":"<p><strong>Background: </strong>Methicillin-resistant Staphylococcus aureus (MRSA) infections are increasingly being encountered and pose an increasing burden to the health care system in Canada.</p><p><strong>Objective: </strong>To elucidate and characterize the factors influencing the current MRSA treatment patterns in patients with skin and soft tissue infections (SSTIs) before linezolid became available on the Canadian market.</p><p><strong>Methods: </strong>A retrospective study collected demographic, treatment and resource use data on patients hospitalized at one of three geographically distinct tertiary care facilities, where MRSA SSTI treatment was initiated with intravenous (IV) vancomycin. Analysis of opportunities for IV-to-oral switch therapy was based on eligibility criteria.</p><p><strong>Results: </strong>Of 89 patients identified over a 43-month period, the mean (+/-SD) durations of anti-infective treatment and hospitalization were 22.4+/-21 days and 28.9+/-20.8 days, respectively. An infected surgical wound was most common, representing 62.9% of infections. The mean duration of vancomycin treatment was 19.5 days and the mean number of 1 g doses received was 29.0+/-32.9. The majority of patients (55.1%) initiated vancomycin therapy a mean of 5.4+/-8.9 days after confirmation of MRSA. Of the 70% of patients meeting criteria for IV-to-oral switch therapy, only 10% received oral treatment. The most common reason cited for not switching was lack of an effective oral alternative. Analysis of switch therapy criteria found that IV treatment continued for a mean of 13 days despite the appropriateness of the oral route.</p><p><strong>Conclusions: </strong>Considerable variation exists in treatment patterns for MRSA infections. Improvements in the initiation of therapy and the use of IV-to-oral switch therapy may improve care and reduce the duration of hospitalization for MRSA SSTIs.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"315-21"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/103682","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192883","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":"Staphylococcus aureus: The persistent pathogen.","authors":"B Lynn Johnston,&nbsp;John M Conly","doi":"10.1155/2003/274084","DOIUrl":"https://doi.org/10.1155/2003/274084","url":null,"abstract":"1Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia; 2Departments of Pathology and Laboratory Medicine, Medicine, and Microbiology and Infectious Diseases, University of Calgary, Calgary, Alberta Correspondence: Dr Lynn Johnston, Department of Medicine, Room 5014 ACC, Queen Elizabeth II Health Sciences Centre, 1278 Tower Road, Halifax, Nova Scotia B3H 2Y9. Telephone 902-473-5553, fax 902-473-7394, e-mail ljohnsto@dal.ca I the last issue of this journal, the recent emergence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) was reviewed (1). Even with all of the attention paid to the increasing prevalence of methicillin resistance, it is instructive to reflect on the importance of S aureus as a pathogen, regardless of antimicrobial susceptibility, and on the management of S aureus bacteremia. Laupland et al (2) recently examined the epidemiology of invasive S aureus (ISA) infections in a population-based surveillance study within the Calgary Health Region from May 1999 to May 2000. The incidence of ISA infection was 28.4 cases/100,000 persons, with an incidence rate for bacteremia of 17.9 cases/100,000 persons. Of the invasive infections, 46% were nosocomial, and 24% of community-acquired infections were health care-related. Only seven of the 264 patients were infected with MRSA. Patient groups at risk for ISA were those undergoing hemodialysis or peritoneal dialysis; diabetics; injection drug users; alcoholics, and those with HIV; heart disease; chronic obstructive pulmonary disease; stroke; cancer and solid organ transplants. These groups may simply reflect patients with high intensity of exposure to the health care system and instrumentation. The case fatality rate was 19%. Independent risk factors for death in multivariable analysis were bacteremia, respiratory focus of infection, receipt of empiric antimicrobials within 8 h, older age and hypotension. The authors speculated that receipt of empiric antimicrobials within 8 h was a marker for a patient with a greater severity of illness and an inherent higher risk for death. Similar findings were reported by Morin and Hadler (3). In a 1998 population-based study of S aureus bacteremia in Connecticut, the incidence rate was 17 cases/100,000 persons; just slightly lower than the pneumococcal bacteremia rate of 21.2 cases/100,000 persons. Over half (52%) of the 402 cases were hospital-acquired and 62% of the community-acquired cases had some type of contact with the health care system in the previous year. In the remaining community-acquired cases, 85% of the patients had an underlying medical condition. The case fatality rate was 11%, lower than that reported in most studies. Evidence suggests that the rates of nosocomial and communityacquired S aureus bacteremia have risen over time, no doubt related to the increasing complexity of patient problems and the invasive devices used in providing care. In a 12-year study, staphylococci were t","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 6","pages":"311-4"},"PeriodicalIF":0.0,"publicationDate":"2003-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/274084","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192882","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":"Food safety and foodborne disease in 21st century homes.","authors":"Elizabeth Scott","doi":"10.1155/2003/363984","DOIUrl":"https://doi.org/10.1155/2003/363984","url":null,"abstract":"<p><p>Over the past decade there has been a growing recognition of the involvement of the home in several public health and hygiene issues. Perhaps the best understood of these issues is the role of the home in the transmission and acquisition of foodborne disease. The incidence of foodborne disease is increasing globally. Although foodborne disease data collection systems often miss the mass of home-based outbreaks of sporadic infection, it is now accepted that many cases of foodborne illness occur as a result of improper food handling and preparation by consumers in their own kitchens. Some of the most compelling evidence has come from the international data on Salmonella species and Campylobacter species infections.By its very nature, the home is a multifunctional setting and this directly impacts upon the need for better food safety in the home. In particular, the growing population of elderly and other immnocompromised individuals living at home who are likely to be more vulnerable to the impact of foodborne disease is an important aspect to consider. In addition, some developed nations are currently undergoing a dramatic shift in healthcare delivery, resulting in millions of patients nursed at home. Other aspects of the home that are unique in terms of food safety are the use of the home as a daycare centre for preschool age children, the presence of domestic animals in the home and the use of the domestic kitchen for small-scale commercial catering operations. At the global level, domestic food safety issues for the 21st century include the continued globalization of the food supply, the impact of international travel and tourism, and the impact of foodborne disease on developing nations.A number of countries have launched national campaigns to reduce the burden of foodborne disease, including alerting consumers to the need to practice food safety at home. Home hygiene practice and consumer hygiene products are being refined and targeted to areas of risk, including preventing the onward transmission of foodborne illness via the inanimate environment. It has been said that food safety in the home is the last line of defense against foodborne disease, and it is likely that this will remain true for the global population in the foreseeable future.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 5","pages":"277-80"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/363984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192878","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":"The changing pattern of nontuberculous mycobacterial disease.","authors":"Joseph O Falkinham","doi":"10.1155/2003/323058","DOIUrl":"https://doi.org/10.1155/2003/323058","url":null,"abstract":"<p><p>Nontuberculous mycobacteria are human opportunistic pathogens whose source of infection is the environment. These include both slow-growing (eg, Mycobacterium kansasii and Mycobacterium avium) and rapid-growing (eg, Mycobacterium abscessus and Mycobacterium fortuitum) species. Transmission is through ingestion or inhalation of water, particulate matter or aerosols, or through trauma. The historic presentation of pulmonary disease in older individuals with predisposing lung conditions and in children has been changing. Pulmonary disease in elderly individuals who lack the classic predisposing lung conditions is increasing. Pulmonary disease and hypersensitivity pneumonitis have been linked with occupational or home exposures to nontuberculous mycobacteria. There has been a shift from Mycobacterium scrofulaceum to M avium in children with cervical lymphadenitis. Further, individuals who are immunosuppressed due to therapy or HIV-infection are at a greatly increased risk for nontuberculous mycobacterial infection. The changing pattern of nontuberculous mycobacterial disease is due in part to the ability of these pathogens to survive and proliferate in habitats that they share with humans, such as drinking water. The advent of an aging population and an increase in the proportion of immunosuppressed individuals suggest that the prevalence of nontuberculous mycobacterial disease will increase.</p>","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 5","pages":"281-6"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/323058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192879","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":"The Red Book is coming to town.","authors":"","doi":"10.1155/2003/871829","DOIUrl":"https://doi.org/10.1155/2003/871829","url":null,"abstract":"","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 5","pages":"252-3"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/871829","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192971","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":"The emergence of methicillin-resistant Staphylococcus aureus as a community-acquired pathogen in Canada.","authors":"John M Conly,&nbsp;B Lynne Johnston","doi":"10.1155/2003/197126","DOIUrl":"https://doi.org/10.1155/2003/197126","url":null,"abstract":"The majority of strains of Staphylococcus aureus encountered in the community setting are sensitive to methicillin, with methicillin-resistant S aureus (MRSA) encountered most frequently in the hospital setting. However, there has been a significant increase in the occurence of infections caused by community-acquired methicillin-resistant S aureus (CAMRSA) in different areas of the world during the last 10 years. In light of this, it was considered timely to review the steadily increasing reports of CA-MRSA and examine the threat of this newly emerging pathogen and its consequences from a Canadian perspective. The emergence of CA-MRSA is a recent phenomenon, raising considerable concern because this type of S aureus would cause infections difficult to treat in the outpatient setting and would markedly increase the need for vancomycin hydrochloride therapy. Staphylococci are amongst the most hardy of the nonspore forming bacteria and can survive significant adverse environmental conditions. They can be easily cultured from dessicated clinical material, even after several months, are relatively heat-resistant and can tolerate high salt concentrations. S aureus is one of the most prevalent of this genus and has been a recognized pathogen in humans for centuries (1). The natural history of colonization of this bacterium with respect to the life cycle of humans is remarkable (2,3). Shortly after birth, many neonates become colonized through human or inanimate contact, often on the skin, umbilical stump or gastrointestinal tract. As the years progress, children and adults become colonized and can become carriers – either intermittent or chronic. The usual reservoir is the anterior nares, although other sites such as the groin, axillae and perineal area have been described as well. Approximately 20% to 40% of the adult population may be colonized at any given time, depending on a number of local and epidemiological factors. On an individual basis, about 30% of the adult population will be chronic carriers, 50% will be intermittent carriers and another 20% do not seem to become colonized. If the mucous membranes or the skin barrier are breached from trauma or surgical intervention, S aureus may enter the soft tissues and establish an invasive infection. Given this background and the virtual absence of a non-human reservoir, it is readily apparent why S aureus continues to be a major human pathogen that infects","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 5","pages":"249-51"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/197126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192970","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":"Shoulder pain, paralysis and fever: Dog attack or infection?","authors":"Mark A Miller","doi":"10.1155/2003/960161","DOIUrl":"https://doi.org/10.1155/2003/960161","url":null,"abstract":"Correspondence: Dr Mark A Miller, Division of Infectious Diseases, Sir Mortimer B Davis Jewish General Hospital, 3755 Cote-Ste-Catherine #G-139, Montreal, Quebec H3T 1E2. Telephone 514-340-8294, fax 514-340-7546, e-mail mmiller@lab.jgh.mcgill.ca CASE PRESENTATION A 22-year-old homosexual male presented to the Infectious Diseases clinic with a one-week history of fever and muscle pains. He had no significant past medical history and was on no medications except for narcotic analgesics prescribed for back pain two months earlier. At that time, a dog had jumped on his back while working at his job as an animal technician in a research laboratory, causing him to turn suddenly and experience sudden mid-back pain. He was seen by the occupational health office and prescribed shortterm narcotics and bed rest. His social history was significant as he had recent unprotected anal sex with an anonymous male approximately one week before the work accident. Over the eight weeks following the dog ‘attack’, the patient gradually developed severe fatigue, muscle aches and pains in areas not related to his back injury (ie, arms, legs), sweats and fevers up to 39.5°C. He attributed these symptoms to his back injury and to side effects of the narcotics. He presented to the clinic after two weeks of fever and myalgias because his fever persisted and he felt that his shoulder and arm pains were worse. He denied any sore throat, diarrhea, abdominal pain, headache, urinary symptoms or other problems. On examination, he complained of mid-back and bilateral shoulder pain and looked obviously ill. He was diaphoretic, but warm. His temperature was 39.0°C, his pulse was 90 beats/min and his respiratory rate was normal. The oropharynx was normal and there was no adenopathy. Chest and cardiovascular exam were both normal. Abdominal exam revealed moderate splenomegaly but no hepatomegaly and no masses or tenderness. There were no rashes. A limited neurological examination was normal but muscle tenderness was present. Laboratory studies showed mildly elevated levels of alanine aminotransferase (139 U/L), aspartate aminotransferase (83 U/L) and lactate dehydrogenase (481 U/L) with normal levels of bilirubin and creatine kinase. The hemogram showed normal red cell indices and platelets but an elevated white blood cell count of 11.5×109/L and 12% atypical lymphocytes. Serological markers for hepatitis B, hepatitis A Immunoglobulin M, hepatitis C, Toxoplasma gondii, HIV and Epstein-Barr virus (EBV) (heterophile antibodies) were negative. In addition, HIV p24 antigenemia was absent. A presumptive diagnosis of mononucleosis due to either EBV or cytomegalovirus (CMV) was made and the patient was told to rest at home. The patient returned to the clinic ten days later, complaining of severe upper arm and shoulder pain, and an inability to “move” his left arm. He attributed this problem to his back injury and had increased his analgesic intake. The physical examination was unchanged from ","PeriodicalId":31111,"journal":{"name":"Canadian Journal of Infectious Diseases","volume":"14 5","pages":"289-90"},"PeriodicalIF":0.0,"publicationDate":"2003-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2003/960161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27192880","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}