Journal of Osteopathic Medicine最新文献

{"title":"Prevalence and quality of medical Spanish education in US osteopathic medical schools: a national survey.","authors":"Kally Dey, Sinibaldo Romero Arocha, Yoon Soo Park, Pilar Ortega","doi":"10.1515/jom-2023-0110","DOIUrl":"10.1515/jom-2023-0110","url":null,"abstract":"<p><strong>Context: </strong>Spanish is the language in the United States with the greatest language-concordant physician deficit. Allopathic medical Spanish programs have proliferated, but the national prevalence of medical Spanish education at osteopathic medical schools has never been evaluated.</p><p><strong>Objectives: </strong>The objectives of this study are to describe the medical Spanish educational landscape at US osteopathic schools and evaluate program adherence to previously established basic standards.</p><p><strong>Methods: </strong>Between March and October 2022, surveys were sent to all 44 member schools of the American Association of Colleges of Osteopathic Medicine (AACOM). For nonrespondents, data were obtained from publicly available websites. Primary surveys were sent to deans or diversity, equity, and inclusion officers at each osteopathic school to determine whether medical Spanish was offered and to identify a medical Spanish leader. Medical Spanish leaders received the secondary survey. The main measures of this study were the prevalence of medical Spanish programs at osteopathic schools and the extent to which existing programs met each of the four basic standards: having a faculty educator, providing a curricular structure, assessing learner skills, and awarding institutional course credit.</p><p><strong>Results: </strong>We gathered medical Spanish information from 90.9 % (40/44) of osteopathic schools. Overall, 88.6 % (39/44) offered medical Spanish, of which 66.7 % (26/39) had formal curricula, 43.6 % (17/39) had faculty educators, 17.9 % (7/39) assessed learner skills, and 28.2 % (11/39) provided course credit. Only 12.8 % (5/39) of osteopathic schools with medical Spanish programs met all basic standards. Urban/suburban schools were likelier to offer medical Spanish than rural schools (p=0.020). Osteopathic schools in states with the highest Spanish-speaking populations were more likely to offer student-run initiatives (p=0.027).</p><p><strong>Conclusions: </strong>Most osteopathic schools provide medical Spanish education, but work is needed to improve consistency, quality, and sustainability. Future research should focus on osteopathic student language proficiency assessment, improve medical Spanish accessibility for students at rural programs, and explore the unique content areas of osteopathic medical Spanish education.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"249-255"},"PeriodicalIF":1.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991318","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":"Research integrity and academic medicine: the pressure to publish and research misconduct.","authors":"Molly Kearney, Maren Downing, Elizabeth A Gignac","doi":"10.1515/jom-2023-0211","DOIUrl":"10.1515/jom-2023-0211","url":null,"abstract":"<p><strong>Context: </strong>This narrative review article explores research integrity and the implications of scholarly work in medical education. The paper describes how the current landscape of medical education emphasizes research and scholarly activity for medical students, resident physicians, and faculty physician educators. There is a gap in the existing literature that fully explores research integrity, the challenges surrounding the significant pressure to perform scholarly activity, and the potential for ethical lapses by those involved in medical education.</p><p><strong>Objectives: </strong>The objectives of this review article are to provide a background on authorship and publication safeguards, outline common types of research misconduct, describe the implications of publication in medical education, discuss the consequences of ethical breaches, and outline possible solutions to promote research integrity in academic medicine.</p><p><strong>Methods: </strong>To complete this narrative review, the authors explored the current literature utilizing multiple databases beginning in June of 2021, and they completed the literature review in January of 2023. To capture the wide scope of the review, numerous searches were performed. A number of Medical Subject Headings (MeSH) terms were utilized to identify relevant articles. The MeSH terms included \"scientific misconduct,\" \"research misconduct,\" \"authorship,\" \"plagiarism,\" \"biomedical research/ethics,\" \"faculty, medical,\" \"fellowships and scholarships,\" and \"internship and residency.\" Additional references were accessed to include medical school and residency accreditation standards, residency match statistics, regulatory guidelines, and standard definitions.</p><p><strong>Results: </strong>Within the realm of academic medicine, research misconduct and misrepresentation continue to occur without clear solutions. There is a wide range of severity in breaches of research integrity, ranging from minor infractions to fraud. Throughout the medical education system in the United States, there is pressure to publish research and scholarly work. Higher rates of publications are associated with a successful residency match for students and academic promotion for faculty physicians. For those who participate in research misconduct, there is a multitude of potential adverse consequences. Potential solutions to ensure research integrity exist but are not without barriers to implementation.</p><p><strong>Conclusions: </strong>Pressure in the world of academic medicine to publish contributes to the potential for research misconduct and authorship misrepresentation. Lapses in research integrity can result in a wide range of potentially adverse consequences for the offender, their institution, the scientific community, and the public. If adopted, universal research integrity policies and procedures could make major strides in eliminating research misconduct in the realm of academic medicine.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"187-194"},"PeriodicalIF":1.5,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973832","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 association of folate deficiency with clinical and radiological severity of knee osteoarthritis.","authors":"Majid Abedi, Hasan Mollashahi Javan, Asal Khosravi, Reza Rohani, Ghasem Mohammadsharifi","doi":"10.1515/jom-2023-0030","DOIUrl":"10.1515/jom-2023-0030","url":null,"abstract":"<p><strong>Context: </strong>Folate deficiency is often observed in patients with inflammatory diseases, raising questions about its role in knee osteoarthritis (OA) progression.</p><p><strong>Objectives: </strong>This study aimed to assess the association of folate deficiency with the clinical and radiological severity of knee OA.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted from January 1, 2019 to January 1, 2020. Primary knee OA patients referred to orthopedic clinics in Zabol, Iran were included. Radiographic severity was gauged utilizing the Kellgren-Lawrence (KL) classification. For clinical severity, patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. IBM SPSS v.27 facilitated the statistical analysis.</p><p><strong>Results: </strong>Forty-nine knee OA patients, averaging 67.45±13.44 years in age, were analyzed. Spearman correlation analysis revealed a negative correlation between folate levels and both WOMAC and KL scores. The correlation was stronger between folate and KL score (Spearman correlation coefficient: -0.75) than between folate and WOMAC total score (Spearman correlation coefficient: -0.46). Additionally, a significantly higher KL score was observed in patients with folate deficiency (p=0.004).</p><p><strong>Conclusions: </strong>Our study highlights a significant correlation between folate deficiency and increased severity of OA, which is evident in radiological and clinical assessments. These findings suggest that folate plays a key role in OA pathogenesis and could be a modifiable factor in its management.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"213-218"},"PeriodicalIF":1.5,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708078","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":"Use of person-centered language in obesity-related publications across sports medicine journals: a systematic review of adherence to person-centered language guidelines in sports medicine.","authors":"Jason Webb, Kaylee Mach, Trey Gooch, Arjun Reddy, Michael Anderson, Jeremy Scott, Jake Checketts, Lance Walker, Micah Hartwell","doi":"10.1515/jom-2023-0254","DOIUrl":"10.1515/jom-2023-0254","url":null,"abstract":"<p><strong>Context: </strong>Stigmatizing language or non-person-centered language (non-PCL) has been shown to impact patients negatively, especially in the case of obesity. This has led many associations, such as the American Medical Association (AMA) and the International Committee of Medical Journal Editors (ICMJE), to enact guidelines prohibiting the use of stigmatizing language in medical research. In 2018, the AMA adopted person-centered language (PCL) guidelines, including a specific obesity amendment to which all researchers should adhere. However, little research has been conducted to determine if these guidelines are being followed.</p><p><strong>Objectives: </strong>Our primary objective was to determine if PCL guidelines specific to obesity have been properly followed in the sports medicine journals that are interacted with most frequently.</p><p><strong>Methods: </strong>We searched within PubMed for obesity-related articles between 2019 and 2022 published in the top 10 most-interacted sports medicine journals based on Google Metrics data. A predetermined list of stigmatizing and non-PCL terms/language was searched within each article.</p><p><strong>Results: </strong>A total of 198 articles were sampled, of which 58.6 % were found to be not compliant with PCL guidelines. The most common non-PCL terms were \"obese\" utilized in 49.5 % of articles, followed by \"overweight\" as the next most common stigmatizing term at 40.4 %. Stigmatizing labels such as \"heavy, heavier, heaviness,\" \"fat\" as an adjective, and \"morbid\" appeared in articles but at a lower rate.</p><p><strong>Conclusions: </strong>Our study shows that there is a severe lack of adherence to PCL guidelines in the most-interacted sports medicine journals. Negative associations between stigmatizing language and individuals with obesity will only persist if a greater effort is not made to change this. All journals, including the most prestigious ones, should adopt and execute PCL guidelines to prevent the spread of demeaning language in the medical community.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"307-314"},"PeriodicalIF":1.4,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708079","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":"Medical malpractice liability in large language model artificial intelligence: legal review and policy recommendations.","authors":"David O Shumway, Hayes J Hartman","doi":"10.1515/jom-2023-0229","DOIUrl":"10.1515/jom-2023-0229","url":null,"abstract":"<p><p>The emergence of generative large language model (LLM) artificial intelligence (AI) represents one of the most profound developments in healthcare in decades, with the potential to create revolutionary and seismic changes in the practice of medicine as we know it. However, significant concerns have arisen over questions of liability for bad outcomes associated with LLM AI-influenced medical decision making. Although the authors were not able to identify a case in the United States that has been adjudicated on medical malpractice in the context of LLM AI at this time, sufficient precedent exists to interpret how analogous situations might be applied to these cases when they inevitably come to trial in the future. This commentary will discuss areas of potential legal vulnerability for clinicians utilizing LLM AI through review of past case law pertaining to third-party medical guidance and review the patchwork of current regulations relating to medical malpractice liability in AI. Finally, we will propose proactive policy recommendations including creating an enforcement duty at the US Food and Drug Administration (FDA) to require algorithmic transparency, recommend reliance on peer-reviewed data and rigorous validation testing when LLMs are utilized in clinical settings, and encourage tort reform to share liability between physicians and LLM developers.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"287-290"},"PeriodicalIF":1.4,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139651855","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":"Perception of opioids among medical students: unveiling the complexities and implications.","authors":"Samuel Borgemenke, Nicholas Durstock, Lori DeShetler, Coral Matus, Elizabeth A Beverly","doi":"10.1515/jom-2023-0176","DOIUrl":"10.1515/jom-2023-0176","url":null,"abstract":"<p><strong>Context: </strong>From 2000 to 2019, drug overdoses, combined intentional and unintentional, were the number one cause of death for Americans under 50 years old,with the number of overdoses increasing every year. Between 2012 and 2018, approximately 85 % of all opioid users obtained their opioids through prescriptions from healthcare providers, predominantly physicians. Increased education about the severity of this issue may increase the likelihood of physicians integrating alternative forms of care such as cognitive behavioral approaches, nonopioid therapies, and nonpharmacologic therapies into treatment plans for chronic pain.</p><p><strong>Objectives: </strong>This study investigates medical students' beliefs, experiences, and perceived impact of opioids at Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) and University of Toledo College of Medicine and Life Sciences (UT).</p><p><strong>Methods: </strong>A total of 377 students from OU-HCOM (years 1-4, n=312) and UT (years 1-2, n=65) were surveyed on their beliefs, experiences, and perceived impact of opioids. Multiple t tests were conducted to compare the difference in perceived severity and stigma between participants who were impacted by the epidemic and those who were not. A Kendall rank test was performed to analyze the relationship between the county drug overdose rate and perceived severity for medical students. p <0.05 defined statistical significance for all statistical tests performed in this study.</p><p><strong>Results: </strong>In comparing medical students' personal experiences with the opioid crisis, it was found that many more participants had experiences with an affected classmate or patient (4.1; 95 % CI, 4.0-4.2), as opposed to direct experiences within their family or group of friends (1.9; 95 % CI, 1.8-2.0). However, this group of participants who directly experienced the opioid crisis were found to be more likely to view the crisis as more severe in Ohio's adult population than those without that direct experience (p=0.03, α=0.05). The difference in experience and severity outlook did not make one group of medical students more likely to hold a stigma toward those struggling with opioid addiction (p=0.3, α=0.05). The study did not find a significant relationship between the county drug overdose rate and the perceived severity among medical students (R=0.05, p=0.6, α=0.05).</p><p><strong>Conclusions: </strong>This study gave an insight into the beliefs, experiences, and perceived impact of opioids within a group of 377 medical students. It was shown that differences in background can lead to differences in perception of the crisis. Knowing these differences can lead to beneficial changes in education and curriculum design in medical education.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"195-203"},"PeriodicalIF":1.5,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139643051","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":"Calciphylaxis.","authors":"Nicholas Salupo, Michelle Norris, Jonathan J Taliercio","doi":"10.1515/jom-2023-0236","DOIUrl":"10.1515/jom-2023-0236","url":null,"abstract":"","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"241-242"},"PeriodicalIF":1.5,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571838","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 superficial dissection approach to the sphenopalatine (pterygopalatine) ganglion to emphasize osteopathic clinical relevance.","authors":"Olivia C Matz, Laura J Rudberg-Post, Hannah C Gustafson, Donald G Matz","doi":"10.1515/jom-2023-0076","DOIUrl":"10.1515/jom-2023-0076","url":null,"abstract":"<p><p>The sphenopalatine (pterygopalatine) ganglion (SPG) is the most superficial ganglia to manipulate from the oral cavity. It has parasympathetic and sensory fibers directly affecting the paranasal sinuses as well as the palatine, nasal, pharyngeal, and lacrimal glands. The SPG can be manipulated intraorally by students and physicians utilizing osteopathic manipulative treatment (OMT) to relieve congestion associated with sinusitis, allergies, headaches, and upper respiratory infections. Within osteopathic medical education programs, students have anecdotally had difficulty identifying this ganglion due to its deep anatomic location and lack of direct visualization. In this article, we discuss that cadaveric dissection with a superficial to deep approach to the SPG has the ability to allow medical students and physicians to better understand the three-dimensional location and osteopathic clinical relevance of this ganglion.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"147-152"},"PeriodicalIF":1.4,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139545245","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":"Diversity in osteopathic medical school admissions and the COMPASS program: an update.","authors":"Nadege Dady, Steven Toplan, Jeffrey Gardere, Robin Moore, Lorreen Agandi, Ulcha Fergie Ulysse, Aida Aminpour, McKensie Gelvin, Jemima Akinsanya, Kenneth Steier","doi":"10.1515/jom-2023-0114","DOIUrl":"10.1515/jom-2023-0114","url":null,"abstract":"<p><p>In the United States, the 40 colleges of osteopathic medicine and 157 schools of allopathic medicine face challenges in recruiting candidates who are underrepresented in medicine (URiM), and gaps in racial disparity appear to be widening. In this commentary, the authors provide an analysis of the data collected from 8 years of conducting a URiM recruitment and welcoming social events. The event is sponsored by a student special interest group called Creating Osteopathic Minority Physicians Who Achieve Scholastic Success (COMPASS) at the Touro College of Osteopathic Medicine - New York (TouroCOM-NY). The results of the 8-year data analysis supports the conclusion that the COMPASS program has benefited the school environment through increased diversity.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"205-212"},"PeriodicalIF":1.5,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542580","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 effects of osteopathic manipulative treatment on pain and disability in patients with chronic low back pain: a single-blinded randomized controlled trial.","authors":"John M Popovich, Jacek Cholewicki, N Peter Reeves, Lisa A DeStefano, Jacob J Rowan, Timothy J Francisco, Lawrence L Prokop, Mathew A Zatkin, Angela S Lee, Alla Sikorskii, Pramod K Pathak, Jongeun Choi, Clark J Radcliffe, Ahmed Ramadan","doi":"10.1515/jom-2022-0124","DOIUrl":"10.1515/jom-2022-0124","url":null,"abstract":"<p><strong>Context: </strong>The evidence for the efficacy of osteopathic manipulative treatment (OMT) in the management of low back pain (LBP) is considered weak by systematic reviews, because it is generally based on low-quality studies. Consequently, there is a need for more randomized controlled trials (RCTs) with a low risk of bias.</p><p><strong>Objectives: </strong>The objective of this study is to evaluate the efficacy of an OMT intervention for reducing pain and disability in patients with chronic LBP.</p><p><strong>Methods: </strong>A single-blinded, crossover, RCT was conducted at a university-based health system. Participants were adults, 21-65 years old, with nonspecific LBP. Eligible participants (n=80) were randomized to two trial arms: an immediate OMT intervention group and a delayed OMT (waiting period) group. The intervention consisted of three to four OMT sessions over 4-6 weeks, after which the participants switched (crossed-over) groups. The primary clinical outcomes were average pain, current pain, Patient-Reported Outcomes Measurement Information System (PROMIS) 29 v1.0 pain interference and physical function, and modified Oswestry Disability Index (ODI). Secondary outcomes included the remaining PROMIS health domains and the Fear Avoidance Beliefs Questionnaire (FABQ). These measures were taken at baseline (T₀), after one OMT session (T₁), at the crossover point (T₂), and at the end of the trial (T₃). Due to the carryover effects of OMT intervention, only the outcomes obtained prior to T₂ were evaluated utilizing mixed-effects models and after adjusting for baseline values.</p><p><strong>Results: </strong>Totals of 35 and 36 participants with chronic LBP were available for the analysis at T₁ in the immediate OMT and waiting period groups, respectively, whereas 31 and 33 participants were available for the analysis at T₂ in the immediate OMT and waiting period groups, respectively. After one session of OMT (T₁), the analysis showed a significant reduction in the secondary outcomes of sleep disturbance and anxiety compared to the waiting period group. Following the entire intervention period (T₂), the immediate OMT group demonstrated a significantly better average pain outcome. The effect size was a 0.8 standard deviation (SD), rendering the reduction in pain clinically significant. Further, the improvement in anxiety remained statistically significant. No study-related serious adverse events (AEs) were reported.</p><p><strong>Conclusions: </strong>OMT intervention is safe and effective in reducing pain along with improving sleep and anxiety profiles in patients with chronic LBP.</p>","PeriodicalId":36050,"journal":{"name":"Journal of Osteopathic Medicine","volume":" ","pages":"219-230"},"PeriodicalIF":1.4,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404701","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}