Avicenna Journal of Medicine最新文献

{"title":"Curricular Redundancy in Medical Undergraduate Course: Critical Insights from Various Stakeholders in Medical Institutes in India.","authors":"Pradip B Barde, Naresh Parmar, Vinay Chitturi, Gaurav Sharma, Rajesh Kathrotia, Krupal Joshi, Manisha Naithani, Vivek Kumar Sharma","doi":"10.1055/s-0044-1791843","DOIUrl":"10.1055/s-0044-1791843","url":null,"abstract":"<p><p><b>Background</b>  Medical education is continuously evolving to keep pace with the dynamic field of medicine. This study addresses the issue of curricular redundancy in medical education, highlighting the necessity for periodic reviews to eliminate outdated or irrelevant topics. <b>Method</b>  A descriptive qualitative approach was employed, involving participants from various medical schools across India. An online questionnaire was used to gather data on redundant topics, suggested replacements, and improvements in the curriculum for both didactic and non-didactic subjects, along with inputs related to assessment and evaluation methods. Content analysis was used for thematic identification and qualitative interpretation. <b>Results</b>  Out of 71 respondents from a wide geographic distribution, 30% were female, and 70% were male, with an age range of 17 to 36 years. Participants expressed concerns about redundant theoretical (32%) and practical (51%) topics. Qualitative analysis highlighted the need for integrating different subjects and placing a stronger focus on practical clinical skills. Participants emphasized the importance of a curriculum that keeps pace with advancements in medicine, such as genomics and artificial intelligence, while also addressing mental health. Specifically, they suggested combining anatomy and surgery courses, incorporating more active learning techniques, and utilizing ongoing assessments to gauge progress. <b>Conclusion</b>  The study highlights the necessity of eliminating curricular redundancy in medical education. Recommendations include developing a flexible curriculum, emphasizing region-specific content, and implementing a formative assessment system. Additionally, the importance of faculty development and stakeholder involvement in curriculum design is emphasized. <b>Key Message</b> Key insights for updating the medical undergraduate curriculum include the following:Developing a flexible curriculum.Emphasizing region-specific content.Implementing formative assessments.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"167-174"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711204","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":"Characterization of Nonsmall Cell Lung Carcinoma in Limited Biopsy Samples and Identifying Optimal Immunohistochemical Marker Combinations in Resource-Constrained Setup: An Institutional Experience.","authors":"Ankita Grover, Md Ali Osama, Shashi Dhawan","doi":"10.1055/s-0044-1791560","DOIUrl":"10.1055/s-0044-1791560","url":null,"abstract":"<p><p><b>Background</b>  The incorporation of immunohistochemical markers in the analysis of small biopsy samples, as outlined in the fourth edition of the World Health Organization Blue books, represents a noteworthy advancement in the diagnosis of advanced-stage lung carcinoma. This improved the histological classification for poorly differentiated nonsmall cell lung carcinomas (NSCLCs), especially in small biopsy specimens. Despite challenges in obtaining viable cells from diminutive tumor samples, a focused immunohistochemical panel effectively distinguishes histological types in most NSCLC. This preserves tissue for subsequent molecular testing. <b>Material and Methods</b>  This study examined 130 consecutive lung biopsy cases initially diagnosed as NSCLC, including various biopsy types (transbronchial, endobronchial, ultrasound-guided, computed tomography-guided). Carcinomas were categorized based on specific characteristics, such as glands and/or mucin for adenocarcinomas, keratinization and/or intercellular bridges for squamous cell carcinomas, and recognition of poorly differentiated NSCLC. Cases lacking clear morphological attributes underwent reclassification using immunohistochemical markers (TTF1, Napsin A, p63, and p40). <b>Results</b>  TTF1 exhibited superior sensitivity (97.56%) and specificity (96.77%) for adenocarcinoma compared with Napsin A, with sensitivity and specificity at 90.24 and 93.3%, respectively. p63 and p40 demonstrated 100% sensitivity for squamous cell carcinoma, with p40 being more specific than p63 (100% vs. 82.92%). Using TTF1 and p63 as a conventional panel, 87% of cases were subtyped. However, the combination of TTF1 and p40 achieved accurate classification in 94.66% (71/75) of cases, and all four markers allowed subtype identification in 97.2% (73/75) of cases. <b>Conclusion</b>  In a resource-constrained setting, subtyping NSCLC in small biopsy can be effectively accomplished using a minimal panel consisting of TTF1 and p40 immunohistochemical markers.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"158-166"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711233","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":"Treatment of a Large Gluteal Hydatid Cyst in Syria Using a Manual Negative Pressure Wound Therapy Device (PragmaVAC).","authors":"M Netfagi, H Alshaer, A Abbara, M Hariri","doi":"10.1055/s-0044-1788773","DOIUrl":"10.1055/s-0044-1788773","url":null,"abstract":"<p><p>The lungs and liver are the most common sites of hydatid cysts, but they may also be found in other organs. We report the case of a lady in her 50s who presented to a hospital in northwest Syria with a large swelling in the right gluteal region. This was diagnosed as a gluteal abscess, and an incision and drainage were performed. Intraoperatively, a hydatid cyst germinal membrane was noted. She had the required imaging to exclude other cysts, which revealed a liver hydatid cyst of 7.5 cm, which was treated with PAIR (puncture, aspiration, injection, and re-aspiration) and albendazole. The residual wound was closed using a manual vacuum-assisted closure (VAC) pump for seven days. A key lesson is that a hydatid cyst in the gluteal muscles, though rare, should be considered in the differential diagnosis. We also show that the innovative use of a manual VAC pump can be used to support closure of large hydatid cyst cavities in muscles.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"179-181"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710383","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 Association of Smartphone Usage with Sleep Disturbances among Medical Students.","authors":"Mohammed Alhafi, Rashed Matrood, Mohammad Alamoudi, Yazzed Alshaalan, Mohammed Alassafi, Aamir Omair, AbeerAl Harthi, Laila Layqah, Mutaz Althobaiti, Jinan Shamou, Salim Alawi Baharoon","doi":"10.1055/s-0044-1788772","DOIUrl":"10.1055/s-0044-1788772","url":null,"abstract":"<p><p><b>Background</b>  Smartphones have become an important and vital instrument that all medical students utilize, but the usage of such devices has been found to be connected to sleep disturbances. The aim of this study was to estimate the prevalence and the relationship between smartphone addiction and poor sleep quality among medical students. <b>Methods</b>  A cross-sectional study was conducted among the fifth- and sixth-year medical students at King Saud bin Abdulaziz University for Health Sciences in Riyadh, Saudi Arabia. A self-administered questionnaire was distributed to investigate the relation between smartphone usage and sleep disturbances. The questionnaires included demographic details, Pittsburgh Sleep Quality Index (PSQI) and smartphone addiction scale short version (SAS-SV). <b>Results</b>  All 251 respondents had smartphones that were utilized for social media, communication, studying, etc. Most of the students were identified as smartphone addicts (65%), and 75% of the students had poor sleep quality. Sleep quality was found to be poor in 145 (85%) students with smartphone addiction. Smartphone addiction was significantly associated with poor sleep quality (odds ratio [OR]: 4.271; 95% confidence interval [CI]: 2.300-7.933; <i>p</i>  < 0.001). Gender and academic year were not significant predictors of poor sleep quality with <i>p</i> -values of 0.668 and 0.361, respectively. Smartphone addiction was significantly more prevalent among female students (80%) compared to male students (60%; <i>p</i>  = 0.004), with the mean addiction score of 43.5 ± 11.5 and 33.5 ± 9.1, respectively ( <i>p</i>  < 0.001). <b>Conclusion</b>  Our study shows a significant association between smartphone addiction and poor sleep quality. It is strongly recommended that counseling services be provided to medical students to assist those suffering from smartphone addiction and sleep difficulties.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711257","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":"Dengue-Related Hemophagocytic Lymphohistiocytosis in an Adult: A Case Report and Brief Update.","authors":"Anju Dinkar, Jitendra Singh, Nilesh Kumar, Kailash Kumar, Santosh Kumar Singh","doi":"10.1055/s-0044-1788687","DOIUrl":"10.1055/s-0044-1788687","url":null,"abstract":"<p><p>Dengue virus is an arbovirus transmitted through the bite of infected Aedes mosquitoes. Many unusual clinical features are being reported in dengue. Dengue complicated with hemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal condition. Here, we report an 18-year-old otherwise healthy female with dengue fever complicated with HLH. The diagnosis was made by fulfilling the clinical and laboratory criteria of HLH. She was managed successfully with a methylprednisolone pulse regimen. Our case highlights the importance of early recognition of complications and prompt treatment for a better outcome.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"175-178"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711277","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 First Observational Study of Acute Medical Unit in Qatar.","authors":"Abdel-Naser Elzouki, Phool Iqbal, Mohammed Zahid, Ijaz Kamal, Anand Kartha, Mustafa Al-Tekreti, Dabia Al-Muhanadi, Ahmed Al-Mohamed","doi":"10.1055/s-0044-1788996","DOIUrl":"10.1055/s-0044-1788996","url":null,"abstract":"<p><p><b>Background</b>  Acute medical unit (AMU) is a dedicated facility to treat patients with acute medical conditions requiring a short hospital stay (< 72 hours) with the support of a multidisciplinary team led by a medical consultant. We aim to present a study of the AMU model of care from Qatar to provide insight into its effects on patient care and management. <b>Methods</b>  Retrospective data from AMU facility at Hamad General Hospital (HGH), Doha, Qatar, was collected from January 2019 to December 2020 from the electronic patient record. The data were analyzed for demographic characteristics of the patients, length of stay (LOS), readmission rate, and postdischarge follow-up. The effectiveness of the AMU system was studied closely from this data. An extensive literature search was also performed for comparative results analysis in other AMU facilities outside Qatar. <b>Results</b>  Total admissions under the AMU facility were 8,371 from january2019 to December 2020. The 28 days readmission rate was 10.25 and 9.9% in 2019 and 2020, respectively. The average LOS was approximately 3.2 days. Around 88.7% of the patients were discharged home, 7.8% were admitted to medical wards due to longer stays, and 0.5% left against medical advice. Most of the patients admitted under AMU were 18 to 60 years old. The top primary diagnoses of admissions were minor stroke, transient ischemic attack, chest infection, urinary tract infections, and gastrointestinal and liver diseases. The most common comorbidities were hypertension, diabetes, acute kidney injury, and chronic kidney disease. A total of 2,858 patients were booked for a follow-up visit in the postdischarge clinic on discharge from the AMU for the year 2019 and 2020. The analysis of these followed up patients showed 73% of patients were discharged from clinic after first visit while the readmission from clinic was on only 1% (28 patients for year 2019 and 2020). <b>Conclusion</b>  Attentive patient care under AMU with a designated multidisciplinary medical team led by an internal medicine consultant is the cornerstone for the success of the AMU unit. This unit has proven very helpful for the smooth disposition of patients from the emergency department with reduced LOS, readmission rate, and overall mortality.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 3","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710231","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":"Clearing the Skepticism about Subclinical Hypothyroidism: Is It Beneficial to Treat Patients with Thyroid-Stimulating Hormone >4.5 and <10 mIU/L?","authors":"Hafsa Bushra, Murtaza Rashid","doi":"10.1055/s-0044-1788040","DOIUrl":"https://doi.org/10.1055/s-0044-1788040","url":null,"abstract":"Abstract Subclinical hypothyroidism (SCH) is a heterogeneous clinical condition ranging from asymptomatic to wide variety of clinical manifestations, which are often nonspecific. Being a common laboratory finding, clinicians often face the dilemma of whether to treat or not. Threshold of 10 mIU/L of thyroid-stimulating hormone (TSH) is often used as a cutoff limit to offer treatment. However, still, debate remains on whether to treat less than 10 mIU/L considering special clinical conditions like pregnancy. Whether SCH exists, is screening needed in asymptomatic individuals, is treating asymptomatic cases beneficial or harmful and what threshold level of TSH to be considered for treatment are all potential questions that need to be answered.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680927","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":"Investigation of Correlation between Communication Skills and Self-Reported Elder Mistreatment in Family Abuse.","authors":"Sogra Zarei, Mohammad Esmaeilpour-Bandboni, Roya Mansour-Ghanaei, Iman Alizadeh","doi":"10.1055/s-0044-1787300","DOIUrl":"10.1055/s-0044-1787300","url":null,"abstract":"<p><p><b>Introduction</b>  In today's world, old age has become an important global phenomenon following the increase in life expectancy and the decrease in birth rates. Communication skills are an important requirement in old age. Changing role of the family and existing tensions, mental pressures, and modern life undermine the social position of the elderly and lead to abuse of the elderly by family members. The goal of the present study is to determine the relationship between communication skills and family self-reported domestic abuse among older adult in Iran. <b>Materials and Methods</b>  For this cross-sectional-analytical study, 153 elderly adult people admitted in hospitals of the Guilan province were randomly selected. The research instruments were the following questionnaires: demographic characteristics, abbreviated mental test (AMT), the Persian version of Domestic Elder Abuse Questionnaire, family mistreatment of the elderly (Heravy), and Queendom Communication Skill Test-Revise (QCSTR). The data were analyzed by SPSS software (version 22) using descriptive (frequency distribution tables, mean, and standard deviation [SD]) and analytical statistics (Mann-Whitney, Kruskal-Wallis, and Spearman's correlation tests) considering the significance level of 0.05. <b>Results</b>  A majority of the elderly were men (51%), were in the age group of 60 to 69 years (72.5%) and married (75.5%), did not hold high school diploma (88.8%), had four to five children (41.2%) with low income (75.9%), and suffered from chronic diseases (68.6%). The mean score of communication skills was 129.09 ± 12.60. The mean score of domestic elder abuse was 2.89 ± 3.97. Communication skills have a significant relationship with age and marital status, but not with sex, education level, income, and chronic disease. There is an inverse correlation between communication skills and domestic elder_abuse ( <i>p</i>  < 0.001, <i>r</i>  = -0.468). <b>Conclusion</b>  Communication skills are one of the influential factors of domestic violence. Therefore, to prevent or reduce the amount of violence, it is recommended that family members increase the communication skills of the elderly.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 2","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493716","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":"Burden of Chronic Hemodialysis on the Ability to Work: Time for Action.","authors":"Fayez AlHejaili, Muhammad N Hashmi, Abdulkareem Alsuwaida, Ghada A Ankawi, Shahad A ALMehaideb, Anas A Alsuwaida, Mohammed T AlZahrani, Ali E Shehadah, Hatem A AlNasser","doi":"10.1055/s-0044-1786869","DOIUrl":"10.1055/s-0044-1786869","url":null,"abstract":"<p><p><b>Background</b>  Understanding the factors that contribute to unemployment will help in the design of creative resolutions to enable hemodialysis patients to return to a productive life. <b>Methods</b>  We examined employment among 625 patients aged 18 to 60 years who were on hemodialysis in 8 dialysis units. <b>Results</b>  Overall employment was low among patients on chronic hemodialysis at 49.7%. Unemployment was significantly higher in women than in men (86.6% vs 17.1%, <i>p</i>  < 0.0001). The employment rate was 70.5% for those with no diabetes and hypertension, 29.5% for those with diabetes, and 25.9% for those with diabetes and hypertension. Furthermore, the results of the Cox regression showed that the variables of gender, level of education, capability of driving, and diabetes were related to employment of patients. <b>Conclusions</b>  The majority of patients on hemodialysis are unemployed or exit paid employment due to early retirement. Patients with diabetes and women are a vulnerable population with a higher unemployment rate.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"14 2","pages":"110-114"},"PeriodicalIF":0.0,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11216803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493715","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":"Rheumatic Diseases Amidst Conflict in Northwest Syria: Unveiling Health Challenges and Implications","authors":"Wasim Zakaria, Yousef Ibrahim","doi":"10.1055/s-0044-1786826","DOIUrl":"https://doi.org/10.1055/s-0044-1786826","url":null,"abstract":"\u0000 Background The ongoing conflict in Syria has significantly affected the health care system, particularly in the realm of rheumatology. The purpose of this study is to assess the current state of rheumatic diseases in the northwestern region of Syria, where the health care infrastructure has been severely impacted.\u0000 Methods This was a retrospective study reviewing all patients with rheumatologic conditions seen in internal medicine clinics in northwest Syria between September 2019 and February 2022. Baseline demographic data and diagnoses were collected retrospectively, without any data duplication, from outpatient clinic records. The study also reviewed the availability of investigations and drugs in the northwestern region of Syria.\u0000 Results We analyzed data from 488 patients (average age: 37.4; 63% female) diagnosed with rheumatic diseases. The most prevalent condition was connective tissue disorders (25.6%), with osteoarthritis (12.1%) and rheumatoid arthritis (8.2%) following. The ongoing conflict has led to a significant shortage of rheumatologists, with only three serving a population of 5.5 million. Furthermore, the conflict has disrupted the provision and quality of rheumatology diagnostic tests, reducing patient accessibility. The dearth of medications and increased costs have compounded the complexity of health care for those with rheumatic diseases.\u0000 Conclusions This study highlights the urgent need for improved health care services and proposes solutions to address gaps in rheumatic care in northwest Syria.","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":"6 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969103","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}