Journal of Medical Sciences and Health最新文献

{"title":"Detection of Biofilm Production and Antibiotic Resistance Pattern in Clinical Isolates from Orthopaedic Implants Associated Infections","authors":"R Shakthi, D Venkatesha","doi":"10.46347/jmsh.v9i2.23.5","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.5","url":null,"abstract":"Introduction: Orthopaedic Implant associated infection is the major problem which leads to implant failure and economic burden to the patient. Implant-associated infections are due to the formation of biofilm at the implantation site leading to multidrug resistant organism. Aim: This study was done to evaluate the causative organisms, their antibiotic sensitivity pattern and their ability to form biofilm over the Implants used in Orthopaedic surgeries. Material and methods: This study was carried out in the department of Microbiology, Adichunchanagiri institute of Medical sciences from September 2019 to August 2022. Swabs from 100 patients who had undergone orthopaedic implant or prosthetic surgery and presented with signs and symptoms of infection were collected and processed as per standard procedures. All the isolates were subjected to detect biofilm production by Congo red agar method, MRSA detection by Cefoxitin disc diffusion test, vancomycin resistant Enterococcus by using Vancomycin (Minimum inhibitory concentration) MIC strips and Extended spectrum β lactamases (ESBL) production by phenotypic confirmatory combined-disc test. Results: Out of the 100 samples processed, culture positivity was observed in 72 specimens. Among them, Staphylococcus aureus 19(26%) was the predominant isolate and 44 (61%) are biofilm producers. 17 (89%) were MRSA (Methicillin resistance Staphylococcus aureus) strains and 15(37%) were ESBL producing strains. Conclusion: The appropriate pre- and post- operative care should be taken to prevent orthopaedic implant associated infections. Staphylococcus spp was the commonest isolate and its ability to produce biofilm indicates the need for an appropriate antibiotic policy and screening for MRSA carriers to reduce the infection. Keywords: Orthopaedic implant, Infection, Biofilm, MRSA, ESBL","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"208 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872457","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 Cross-sectional Observational Study of the Etio-pathology, Socioeconomic Distribution and Clinical Pictures of Ectopic Pregnancy in a Tertiary Medical College and Hospital in Bankura, West Bengal, India","authors":"Anirban Talukder, Sougata Kumar Burman, Gairik Bera, Jayeeta Mukherjee, Mousumi Maji, Debojyoti Santra","doi":"10.46347/jmsh.v9i2.23.136","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.136","url":null,"abstract":"Background: Ectopic pregnancy or abnormal implantation of embryo is one of the foremost causes of mortality and morbidity in women of reproductive age worldwide. Its serious consequences can be effectively averted by early diagnosis and timely intervention. This study aimed at determining the incidence, predisposing socio-economic factors and etiolo-pathology, and assessment of various clinical manifestations and treatment modalities of ectopic pregnancy. Methods: This observational cross- sectional survey was conducted in the department of obstetrics and gynaecology BSMCH, Bankura from 1.4.2015 to 31.3.2016. It included 100 patients with admitted with clinically or sonologically confirmed ectopic pregnancy after informed consent, data was collected and analysed thereafter. Results: It was observed that 68% of the cases belonged to 21-30 years of age, 80% with low socio-economic status, 69 % comprised of multigravidas. The typical risk factors detected were history of PID, abortion and previous tubal surgery. The most consistent clinical feature was pain in lower abdomen (98%) followed by amenorrhoea (90%) and vaginal bleeding (82%). 97% of the patients presented with pallor and 23% with shock. In 73% patients cervical motion tenderness could be elicited clinically and adnexal mass in USG was found in 95 %. Urine pregnancy test was positive in all patients and right side was the commonest side of involvement (53%). All the patients underwent surgical intervention. Conclusion: Prompt detection from history, clinical features, USG and appropriate and well-timed management are of utmost importance to enhance better maternal survival and conservation of reproductive capacity. Keywords: Ectopic pregnancy, UPT, PID, Tubal surgery, Adnexal mass, POD fluid, Ampulla","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"73 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815176","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 Acute Inflammatory Biomarkers - Are They Cost Effective and Real Time Early Predictors of Mortality in Acute Pneumonia? - A Prospective Observational Study","authors":"H A Krishnamurthy, G T Roja, S Bharathi","doi":"10.46347/jmsh.v9i2.23.70","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.70","url":null,"abstract":"Introduction: The CT chest and investigations like IL6 and TNFɑ are the most accurate blood biomarkers of inflammatory changes and can be used to stage the severity and outcome of acute pneumonia. . Getting all the above mentioned investigations in a financially poor patients is not always possible. There are not much studies to look for the association between early raise in serum acute inflammatory bio markers and the prediction of mortality in acute pneumonia. So this study is under taken to know the association between significant raise in serum acute inflammatory biomarkers like hs CRP, LDH, ferritin, NLR, WBCs count in predicting the mortality of acute pneumonia in comparison with the serum IL6,q-SOFA score and CT chest severity score. Materials & Method: All patients underwent standardized workup, including complete blood count, blood biochemistry, ferritin, hs-CRP, LDH,IL6,CT scan of chest ,q-SOFA score assessment and electrocardiogram. All the biochemical investigations were done on day 1 and day 5 of admission to the hospital. The patients were followed-up for the whole in hospital stay duration. Results: All the measured serum acute inflammatory bio markers, IL6, NLR, WBCs count, q-SOFA score and chest CT severity score were significantly elevated in patients with death due to acute pneumonia than the survived ones. [p value-0.01] Conclusion: This study proves that, the early raise in serum acute inflammatory biomarkers have got real and cost effective predictive value and are non-inferior to total WBCs count, NLR,IL6, q- SOFA score and chest CT severity score in assessing the mortality of acute pneumonia. Keywords: Acute Pneumonia, Acute inflammatory bio markers, CT scan of Chest, IL6, NLR (Neutrophils to Lymphocytes ratio), q-SOFA score, WBCs count","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872465","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":"Learning Style Preferences and Its Effect on Academic Performance Among Undergraduate Medical Students at Government Medical College, Palakkad","authors":"Shilu Mariam Zachariah, S Karthikeyan, K S Deepak","doi":"10.46347/jmsh.v9i2.22.4","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.4","url":null,"abstract":"Introduction: Learners have their own preferences in receiving and processing information. Finding out different learning styles of students is important to provide students with a better learning experience. Aims: To find out the different learning styles of students and association of gender and academic performance with learning styles. Methods and Material: A cross-sectional study was conducted among 100 medical students using convenience sampling method. The questionnaire used in the study was Honey and Mumford Learning Style Questionnaire. Learning styles were accordingly described as Activist, Theorist, Pragmatist and Reflector. Socio-demographic variables like age and gender as well as previous university examination score of the students were also collected. The data was analysed in terms of proportions, chi-square test and one-way ANOVA. Results: Out of 100 students, 74% were females and the remaining 16% were males. The highest mean value of the scores was found for reflector style of learning (15.59±2.4) followed by pragmatist (13.4±2.6). The lowest mean score was found for activist style of learning (12.26±3.0). 51.1% of students showed very strong inclination for activist learning style, 40% of students showed a strong inclination for reflector learning style, 45.6% had a moderate preference for theorist learning style and 55.6% of students had a moderate preference for pragmatist learning style. Conclusions: The students had more preference for activist and reflector learning styles. Gender and previous academic performance did not show any significant association with the learning styles. Keywords: Learning styles, Honey and Mumford questionnaire, Activist, Theorist, Pragmatist Reflector, academic performance","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"6 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869832","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":"Comparison of Maternal and Foetal Outcome between Normal and Abnormal Amniotic Fluid Index in the Third Trimester of Pregnancy - A Longitudinal Analytical Study in A Tertiary Level Medical College of Suburban West Bengal, India","authors":"Gairik Bera, Sougata Kumar Burman, Mousumi Maji, Jayeeta Mukherjee, Anirban Talukder, Manidip Pal","doi":"10.46347/jmsh.v9i2.22.518","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.518","url":null,"abstract":"Background: Amniotic fluid (AF) is the protective liquid present in the amniotic sac of a gravid uterus. Amniotic fluid has nutritive, protective and diagnostic functions. Amniotic Fluid Index (AFI) is most popular and reliable method for quantifying amniotic fluid, till date. AFI is one of the major parameters of foetal biophysical profile (BPP) that can predict perinatal and maternal outcomes. Periodical scanning of foetus is utmost essential during antenatal visits, especially in high-risk pregnancies, but there is no definite standard protocol regarding its frequency.Methods: This study was conducted in the department of Obstetrics & Gynaecology, College of Medicine & JNM Hospital, Kalyani, Nadia, India. This longitudinal analytical study included 356 patients, among whom 151 (42.4%) were in oligohydramnios group, 174 (48.9%) in normal group and 31 (8.7%) in polyhydramnios group.Results: The data revealed oligohydramnios was strongly associated with caesarean section (p = 0.0010). In oligohydramnios group, IUGR was found in 37 (24.5%) patients (p = 0.0297). Meconium-stained liquor was almost similar in all three categories i.e. 15 (10.0%) in oligohydramnios group, 18 (10.3%) in normal group and 5 (16.1%) in polyhydramnios group, respectively. There was higher SNCU admission among babies delivered by mothers with oligohydramnios (p = 0.0369). There was no statistically significant difference in 1 and 5 minutes APGAR scores among normal and abnormal AFI groups. Conclusions: It was inferred that LSCS, IUGR baby and SNCU admission rates were more in oligohydramnios group compared to other categories. The perinatal death was 3.3% with oligohydramnios compared to 1.7% with normal liqour. The results from this study emphasize on the importance of AFI among the various means of antepartum surveillance and predictors of foetal outcome. Keywords: Oligohydramnios, Polyhydramnios, Foetal Outcome, IUGR, AFI","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"370 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871638","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":"COVID-19 Vaccination-Associated Spontaneous Heparin-Induced Thrombocytopenia Syndrome","authors":"Prakash Vishnu, David M Aboulafia","doi":"10.46347/jmsh.v9i2.22.525","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.525","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has emerged as the deadliest outbreak in recent American history, surpassing the estimated U.S. fatalities from the 1918 influenza pandemic. Since its identification in December 2019 in Wuhan, China, COVID-19 has contributed to the death of nearly six million people worldwide. The United States (U.S.) Food and Drug Administration (FDA) initially issued emergency use authorization for three vaccines for prevention of COVID-19, and currently two have received full FDA approval. Herein, we report a case of severe thrombocytopenia in a man following heterologous booster vaccination with the Pfizer-BioNTech COVID-19 vaccine with concomitant presence of a heparin-P4 antibody but without proximate heparin exposure. The degree of thrombocytopenia was severe, but the patient had a natural recovery of platelet count over the next 2 weeks without need for any immunomodulatory therapies. This is the first case report of COVID vaccine-associated heparin-induced thrombocytopenia (HIT)-like platelet disorder without proximate heparin exposure, also called spontaneous HIT syndrome. Keywords: Thrombocytopenia, Cor","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"29 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135815171","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":"Improving Healthcare Providers’ Adherence to Foot Exams for Type-II Diabetic Patients in a Primary Care Clinic","authors":"Angela Allen","doi":"10.46347/jmsh.v9i2.22.429","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.429","url":null,"abstract":"Foot wounds are complications of type II diabetes mellitus (T2DM), which may be prevented with proper foot assessments. Diabetic foot exams are not consistently performed despite evidence-based screening tools available. Objective: To determine if the implementation of an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen would impact the number of diabetic foot exams performed among T2DM patients at a primary care level. Method: A quantitative quasi-experiment design was used to implement an electronic medical record (EMR) alert using Inlow’s 60-Second Diabetic Foot Screen to impact the frequencies of diabetic foot exams. Sample size was 65, n=35 in the comparative group and n= 30 in the implementation group. Population consisted of male and female patients ages 18 years and older, diagnosed with T2DM within the last two years, no previous diabetic foot exams or received foot care education, did not perform self-reported foot inspections, and were able to read, write, and speak English. A chi square test was run to analyze the frequencies of foot exams between groups. Results: A Pearson’s chi-square showed a statistically significant increase in the foot exams X2 (1, N=65) = 5.286, p= 0.02 using an EMR alert with Inlow’s 60-Second Diabetic Foot screen. Conclusion: EMR alerts increase performance of diabetic foot exams. Recommendations include sustainment of the program, dissemination of results, and further investigation of the impact of EMR alerts. Keywords: Diabetes, Foot screening, EMR alert","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870134","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":"Concordance Between Core Needle Biopsy and Surgical Specimens in Determining Molecular Biological Subtypes of Breast Cancer by Immunohistochemistry","authors":"Oisika Dutta, Anadi Roy Chowdhury, Niladri Sarkar, Suman Ghosh","doi":"10.46347/jmsh.v9i2.23.53","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.53","url":null,"abstract":"Background: Breast carcinoma is the most common malignancy among women around the world. Core needle biopsy provides samples that are adequate in size thus allowing a histological diagnosis of breast carcinomas. CNB specimens can also be used for the immunohistochemical (IHC) assays of hormone receptors. Aims: To evaluate the concordance of ER, PR, HER2 Neu and Ki-67 in core needle biopsy and surgical specimens obtained by Modified radical mastectomy (MRM). Methods: A cross-sectional observational study was conducted in the Department of Pathology in association with the Department of Surgery at Murshidabad Medical College and Hospital for a duration of one and a half years. Patients undergoing Core needle biopsy of the breast who have been diagnosed with breast carcinoma on the basis of histopathology report and subsequently planned for MRM who have given consent for the study were included in this study. The samples were classified according to the immunohistochemical staining into four molecular subtypes: Luminal A, Luminal B, HER 2 Neu enriched, and triple-negative subtype depending on the expression of ER, PR, HER 2 Neu, and Ki-67. Result: The most common molecular subtype of breast carcinoma in both CNB and MRM specimens was the Triple-negative subtype. Conclusion: CNB has been found to be a reliable diagnostic tool that can help in determining Histopathological biomarkers for ER, PR positive, and HER2 Neu positive or negative tumors and it has also been found that retesting these markers again on the surgical specimens may not be necessary. Keywords: Core needle biopsy, Breast carcinoma, Molecular subtyping, Immunohistochemistry","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870553","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":"OSPE as a Method of Learning and Assessment for Undergraduate Practical Pathology versus Traditional Learning and Assessment","authors":"Reeta Dhar, Almas Dalvi, Shilpi Sahu, Manisha Tambekar, Bansi Kotecha","doi":"10.46347/jmsh.v9i2.22.445","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.445","url":null,"abstract":"Introduction: Objective Structured Practical Examination (OSPE) is an effective method for formative and summative assessment of undergraduate students during practical examination. Aim: The aim of the study was to study the effectiveness of OSPE in the subject of Pathology and to evaluate them on the basis of these parameters, provide feedback on performance, evaluate on basis of practical skills and measure minimal competences. Materials and methods: This study was conducted among a total of 120 M.B.B.S. students during their second year of MBBS course. OSPE based practical examination was carried out followed by a close ended questionnaire to evaluate student’s perception regarding the same. Results: OSPE was seen as a useful exercise by 83 % of the students. Feedback from the undergraduate students put forward that 17 % students felt that OSPE was an objective tool in evaluating practical skills. Conclusion: OSPE is a more valid and beneficial learning tool according to the students as well as faculty. Keywords: Objective structured practical examination, Pathology, Medical education, Teaching tool","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"207 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872461","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":"Comparative Study to Determine Antimicrobial Property of Neem Leaves (Azadirachta indica) Extracts Using Various Solvents Obtained from Two Geographical Area","authors":"S. Megha, .. Indradhanush, D. Venkatesha","doi":"10.46347/jmsh.v9i1.22.317","DOIUrl":"https://doi.org/10.46347/jmsh.v9i1.22.317","url":null,"abstract":"Background: Plants have been the basis for many medicinal compounds that are used in modern-day medicine, screening for medicinal plants for bioactive compounds is a way of identifying and developing new antimicrobials that are less expensive and with improved safety and efficacy. Objective: The objective of this study was to investigate the in vitro antimicrobial activity of Azadirachta indica (neem) using leaf extracts of Ethanol, Petroleum ether, and Ethyl acetate and testing them on E.coli, Klebsiella, S.aureus, MRSA and C.albicans. Materials & Methods: Minimum inhibitory concentration (MIC) was found using the serial dilution method and antimicrobial susceptibility testing (AST) was done using the disc diffusion method. Results: Ethanolic extract showed better results against Klebsiella and S.aureus, Ethyl acetate extract showed better results against E.coli and MRSA, whereas both ethanolic and petroleum ether extract showed activity against C.albicans. 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assay showed that all the extracts have antioxidant property and variations were noted in the antimicrobial activity on comparing samples taken from different locations. Conclusion: Further studies are needed into the bioactive compounds of neem in order to explore their antimicrobial activity. Keywords: Antimicrobial susceptibility, Azadirachta indica, Ethanol, Ethyl acetate, Disc diffusion, MIC, Petroleum ether","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49317901","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}