International Journal of Academic Medicine最新文献

{"title":"The effect of reported penicillin allergy on length of stay for patients admitted to internal medicine services: A retrospective cohort study","authors":"Susan Evenhouse, Jingwen Zhang, Samuel O. Schumann","doi":"10.4103/ijam.ijam_48_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_48_22","url":null,"abstract":"Introduction: Penicillin allergy is the most common medication allergy reported in the United States; however, >90% of these patients can tolerate penicillins. Reported penicillin allergy is associated with increased morbidity and mortality for patients. This retrospective, observational study evaluates the effect of reported penicillin allergy on length of stay (LOS) for adult patients admitted to the internal medicine services of a tertiary care, academic medical center. Materials and Methods: We evaluated adult patients admitted to internal medicine services from June 2014 to June 2019 comparing those who reported penicillin allergy to those who did not. Patients who did not receive antibiotics were excluded. Univariate analyses were performed on multiple demographic and clinical variables between patients who do and do not report a penicillin allergy. Multivariable linear regression was used to model the effect of reported penicillin allergy on LOS. Results: 14,144 patients were admitted to internal medicines services during the study period, with 8697 patients receiving an antibiotic during their admission. 10.5% of these patients reported a penicillin allergy. The unadjusted mean LOS for patients who report penicillin allergy was 10.4 days, while the unadjusted mean LOS for patients who do not report penicillin allergy was 9.3 days. Adjusting for covariates, the estimated LOS for patients who report penicillin allergy was 11.1 days, while the estimated LOS for patients who do not report penicillin allergy was 9.5. Conclusions: A reported penicillin allergy is associated with an increase in estimated LOS of 1.6 days. The following core competencies are addressed in this article: Systems-based practice, Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"67 - 72"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41570308","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":"Sensitizing first-year medical undergraduate students to principles of leadership: A cross-sectional experience at a teaching hospital","authors":"S. Padhi, M. Taywade, S. Giri, Gitanjali Batmanabane","doi":"10.4103/ijam.ijam_65_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_65_22","url":null,"abstract":"Introduction: Literature on implementation leadership program in undergraduate (UG) medical education is lacking in the Asian continent. We aim to describe our experience in sensitizing the 1st year undergraduate medical students (UGMS) toward the principles of leadership in a medical institution. Materials and Methods: Each year, one hundred 1st year UGMS were sensitized towards leadership principles and core domains through interactive sessions, focus group discussions, and short lectures. The students were asked to reflect on the sessions' activities as well as their follow-up usefulness in their day-to-day activities through a structured questionnaire shared through Google forms. Results: A high proportion (75%) of students reported an improved perception or knowledge toward leadership principles and practices. Leadership attributes such as team building, decision making, confidence building, motivation, and managing crisis were reported to be very useful by 77.8%, 74.1%, 69.1%, 64.2%, and 61.7% of students, respectively. On follow-up, students described this sensitization exercise to be useful in their academic (16/52, 30.76%), organizational (10/52, 19.2%), sports (6/52, 11.53%), short-term research (4/52, 7.7%) activities, and editorial responsibilities (3/52, 5.7%). Conclusion: The leadership sensitization workshop helps students adjust to the medical school's environment; and this may be incorporated in the UG curriculum to strengthen students' leadership potential. The following core competencies are addressed in this article: Systems-based practice, Interpersonal and communication skills, Professionalism.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"60 - 66"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43029352","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":"Post-COVID symptoms and recovery times in hospitalized mild and moderate COVID-19 patients","authors":"R. Khot, Aastha Patil, B. Rathod, S. Kumbhalkar, P. Joshi","doi":"10.4103/ijam.ijam_95_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_95_22","url":null,"abstract":"Settings and Design: Retrospective online cross-sectional analytical study. Introduction: Infection with SARS-CoV-2 virus led to COVID-19 pandemic with varied clinical manifestations and multisystem involvement, which persisted beyond acute stage. To evaluate the post discharge symptoms in hospitalized mild and moderate COVID-19 patients during the initial phase of pandemic. Factors associated with post-COVID symptoms and delayed recovery times were determined. Materials and Methods: One hundred and thirty-two hospitalized patients of mild or moderate COVID-19 infection diagnosed by a positive real-time polymerase chain reaction, responded to an online questionnaire. They were followed up monthly, telephonically for post-COVID symptoms and recovery times. Microsoft Excel-Student's t-test, Fischer's exact test, Chi-square test. Results: The mean age of the patients was 51.14 ± 13.78 years with male: female ratio, 1: 0.29. 80.35% had post-acute COVID symptoms. Most frequent symptoms were cough in 37.9%, breathlessness in 36.4% and fatigue in 34.8%. New onset symptoms were insomnia in 16.67%, anxiety in10.6%, depression in 9.8%, loss of libido in 5.3%. Long COVID syndrome occurred in four patients. The factors significantly associated with post-COVID symptoms were older age, comorbidities, longer hospitalization, and moderate COVID infection, whereas delayed recovery times were associated with older age, female gender, and moderate COVID illness. Conclusions: Post-COVID symptoms occur in majority of the patients. Persistent symptoms are dry cough, dyspnea, fatigue, anosmia, and ageusia. They are significantly associated with older age, underlying comorbidities, prolonged hospitalization, and moderate COVID infection. Complete recovery occurs in most patients but delayed recovery is seen in females, elderly, and moderate COVID infection. Few may develop long COVID syndrome. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"39 - 46"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45225099","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":"Therapeutic impact of letrozole and clomiphene citrate for ovulation induction in Iraqi female patients with polycystic ovary syndrome","authors":"H. Najim, W. Al-khfajy, Z. Albasry, A. Al-taie","doi":"10.4103/ijam.ijam_90_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_90_22","url":null,"abstract":"Introduction: Clomiphene citrate (CC) is the most commonly used ovulation induction agent in women with polycystic ovary syndrome (PCOS). Letrozole has attracted attention for its ovulation induction effects as a safe, potentially better alternative to CC. The aim of this study was to compare the therapeutic efficacy of letrozole in comparison to CC for ovulation induction in female patients with PCOS in Baghdad Province, Iraq. Materials and Methods: A prospective, randomized, controlled study was carried out on 166 female patients diagnosed with anovulatory infertility due to PCOS and randomly assigned into two groups. Group A included ninety-four participants who received CC. Group B included 85 participants who received letrozole. The main outcomes were the ovulation induction and therapeutic outcomes of CC and letrozole, including endometrial thickness, number of mature follicles, pregnancy rate, number of stimulated cycles and mono-ovulation rate. Results: Endometrial thickness improved significantly more with CC than with letrozole (8.08 ± 1.28 vs. 7.66 ± 1.41; P = 0.05), as did the number of mature follicles (3.07 ± 1.23 vs. 1.97 ± 0.83; P = 0.0001). Nevertheless, Group B patients reported a higher significant rate compared to Group A regarding pregnancy rate (62% vs. 38%; P < 0.01), number of stimulated cycles (91% vs. 78%; P < 0.05), and mono-ovulation rate (29% vs. 5.75%; P = 0.0001). Conclusion: Letrozole is preferable to CC in terms of a higher pregnancy rate as well as mono-follicles' ability to decrease the risk of multiple pregnancies, which is clearly observed with CC. The higher success of letrozole over CC is thought to be related to the higher ovulation rate per cycle. The following core competencies are addressed in this article: Patient care and procedural skills, medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"47 - 52"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49228166","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":"What's new in academic international medicine? The importance of effective disaster management","authors":"G. Udod, L. Gruffi","doi":"10.4103/ijam.ijam_21_23","DOIUrl":"https://doi.org/10.4103/ijam.ijam_21_23","url":null,"abstract":"","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"1 - 3"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41939764","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 community-based study on willingness and predictors to receive precautionary dose of COVID-19 vaccine in Puducherry","authors":"Senkadhirdasan Dakshinamurthy, Lalithambigai Chellamuthu, Govindaraj Rajendran","doi":"10.4103/ijam.ijam_79_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_79_22","url":null,"abstract":"Introduction: World Health Organization has proposed yearly boosters for high-risk adults and biannual boosters for the general population. Research on the acceptance of current COVID-19 immunization has been done, but only a little information is available on booster dose acceptance in India. The objectives of this study were to assess the willingness to receive precautionary doses of the vaccine among adults and to identify the sociodemographic predictors to receive precautionary doses of the vaccine among adults who have been fully vaccinated against COVID-19 in Puducherry. Methods: A community-based, cross-sectional study was conducted for 2 months in the field practice area of a private medical college in Puducherry. Individuals, ≥18 years residing for >6 months in the selected villages/wards and willing to give consent were included in the study. Individuals with absolute/relative contraindications for COVID-19 vaccination were excluded from the study. The sample size was 632, and a multistage sampling technique was employed. A semi-structured questionnaire was utilized for face-to-face interviews. Results: Among 632, 86.4% were vaccinated with two doses of COVID-19 vaccines. Out of 609 adults who have been fully vaccinated against COVID-19, 83.6% exhibited willingness to receive precautionary doses of the vaccine. Common factors influencing willingness to receive precautionary doses of the vaccine among adults who have been fully vaccinated against COVID-19 which were fear of postvaccine complications in 37%, less awareness about the precautionary dose among 14%, waiting for others to get vaccinated first in 7%, and 2% expressed as their personal desire for not being vaccinated. Education and socioeconomic status of the individuals were found to be significantly associated (P < 0.05) with the willingness to receive precautionary doses. Gender, marital status, and residence of the study population were significantly associated with higher odds for willingness to receive precautionary doses. Conclusion: Most of the adult population in this study completed the second dose of the COVID-19 vaccine and were willing to receive a third dose. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge, Interpersonal and communication skills, and Professionalism.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"4 - 10"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49493578","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":"Diet adherence and factors associated with nonadherence among Type 2 diabetics at an urban health center in Tamil Nadu, India","authors":"J. Selvam, P. Thangaraj, K. Hemalatha, Pandi Subbian","doi":"10.4103/ijam.ijam_10_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_10_22","url":null,"abstract":"Introduction: Diabetes is a slow epidemic causing threat to public health worldwide. Several studies have been done to assess the medication adherence among patients with diabetes. The present study has focused on dietary adherence and attempted to identify factors associated with nonadherence to a diabetic diet. Materials and Methods: A cross-sectional study was conducted among 284 patients with type 2 diabetes visiting the outpatient department of an urban health-care center in Tamil Nadu, India. A semi-structured questionnaire was used for data collection. Summary of Diabetes Self-Care Activities tool was used to assess adherence for medication and physical activity while Perceived Dietary Adherence Questionnaire tool was used to assess the adherence to diabetic diet. Results: The dietary adherence was high in only 4.2% (95% confidence interval [CI]: 2.20–7.26) of the patients with diabetes while 73.2% (95% CI: 67.69–73.30) and 22.5% (95% CI: 17.81–27.84) had medium and low adherence to diabetic diet, respectively. Adherence to medication and exercise were 91.5% and 63.4%, respectively. The duration of diabetes, higher body mass index, presence of comorbidity, history of diabetic complication, and adherence to exercise were associated with better compliance to diet while socioeconomic status was not. Conclusion: The present study has identified poor adherence to diabetic diet in spite of good medication adherence. The practice of spacing of carbohydrate food and intake of Omega-3 fats needs to be improved while the consumption of food rich in other fats should be decreased. Dietary fiber intake can also be better. The findings can help plan future study to identify barriers to diet adherence and also effective methods to improve dietary practices among the patients with diabetes. The following core competencies are addressed in this article: Medical knowledge, Patient care, Systems-based practice, Practice-based learning and improvement.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"25 - 30"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43323984","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 effect of social media addiction on burnout among health-care students and professionals in Saudi Arabia","authors":"H. Badri, K. Aboalshamat, I. Abdouh, B. Quronfulah, M. Mahmoud, M. Rajeh, A. Badawoud, Abdullah M Alzhrani","doi":"10.4103/ijam.ijam_72_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_72_22","url":null,"abstract":"Introduction: The rapid growth of information technology and the widespread use of smartphones has created the perfect environment for social media addiction, a condition that affects all members of society, including health-care students and professionals. Current evidence suggests that the direct and indirect effects of social media addiction on human health could include, among other things, burnout. This study aimed to investigate the possible relationship between social media addiction and burnout among health-care students and professionals in Saudi Arabia. Materials and Methods: A cross-sectional study design was used with an online questionnaire distributed to health-care students and professionals via social media platforms. A convenience sampling method was used to collect the data. The questionnaire consisted of three sections measuring demographic variables, social media addiction, and burnout. Results: The 789 participants who completed the questionnaire had a mean age of 25.77 years (± 8.26) and came from 22 cities in Saudi Arabia. Students had significantly higher scores for social media addiction than interns/residents (P = 0.018) or specialists/consultants (P < 0.001). Participants were found to experience different levels of burnout, reporting no/mild burnout (34.98%), moderate burnout (35.49%), high levels of burnout (23.83%), and severe burnout (5.7%). A significant direct relationship between social media addiction and burnout was found (F [1,787] = 91.877, P < 0.001, R2 = 0.105). Conclusion: The findings provide insight into the prevalence of social media addiction and burnout among health-care students and professionals and the possible association between two variables. There is a need for further research comparing the correlation between social media addiction and burnout in different groups (i.e., students, interns/residents, and specialists/consultants), as well as identifying factors that affect social media addiction and burnout among these groups. The following core competencies are addressed in this article: Medical knowledge, Interpersonal and communication skills, and Professionalism.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"11 - 17"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47066467","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":"Effectiveness of coronavirus disease-19 vaccination on disease transmission, hospitalization, and clinical outcomes in adults in North India","authors":"R. Agrawal, Yogesh Agrawal, Manu Saini, Yogesh Singh, S. Mathur, A. Tak","doi":"10.4103/ijam.ijam_68_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_68_22","url":null,"abstract":"Introduction: Covaxin and Covishield vaccines have been rapidly rolled out in India to curb the Coronavirus disease-19 (COVID-19) pandemic. The present study tested the effectiveness of COVID-19 vaccination in adults in North India. Effectiveness was tested by considering disease transmission and post-COVID outcomes in infected individuals. Materials and Methods: This study was conducted in the Department of Physiology at MGM College, Jaipur (Rajasthan, India), after approval from the Ethics Committee. Vaccinated and nonvaccinated groups were compared for disease transmission, hospitalization, and clinical outcomes. Researchers collected data using questionnaires circulated through Google forms. The association between attributes was tested using the Chi-squared test. The significance level was considered at 5%. Results: Vaccination significantly reduced disease transmission of COVID-19 (χ2 = 4.51; P = 0.034). However, no significant differences were seen in the Reverse transcription polymerase chain reaction positivity, chest computed tomography findings, and hospitalization. Similarly, COVID-related symptoms and their severity did not differ significantly between the two groups. The proportion of vaccinated individuals increases with age (χ2 = 41.68; P < 0.001). Youths and older adults were vaccinated once and twice, respectively (χ2 = 41.77; P < 0.001). The severity of adverse effects postimmunization (AEFI) was similar in all age groups (χ2 = 13.22; P < 0.21). Males and females were equally vaccinated (χ2 = 1.13; P < 0.288). However, males took two doses compared to females (χ2 = 6,57; P < 0.01). Adverse effects postimmunization were more severe in females than males (χ2 = 13.10; P < 0.001). Researchers found no association between the number of vaccine doses and the severity of AEFIs (χ2 = 16.42; P = 0.06). Conclusion: The present study concludes the beneficial effect of vaccination in reducing disease transmission. However, vaccination showed no effectiveness in mitigating other COVID-related outcomes. The following core competencies are addressed in this article: Medical knowledge, systems-based practice, practice-based learning, and improvement.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"18 - 24"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42371144","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":"Sciatica masquerading parathyroid carcinoma","authors":"P. Nellaiappar, Zahir Hussain, N. Parvathy, N. Venkatesh, A. Ramalingam","doi":"10.4103/ijam.ijam_53_22","DOIUrl":"https://doi.org/10.4103/ijam.ijam_53_22","url":null,"abstract":"Primary hyperparathyroidism is detected in the Western world in an asymptomatic stage due to routine calcium screening. In India, patients are still diagnosed with various symptoms such as bone disease and renal disease and only 5.6% are in the asymptomatic stage. A 48-year-old female came with complaints of right hip pain of 1-month duration. She had low back pain a year ago radiating to both thighs. The pain was not suggestive of inflammatory arthritis, and the autoimmune profile was negative. The pain progressively worsened, and the patient became bedridden. General examination revealed left-sided neck swelling that moved with deglutition. Right lower-limb movement was restricted by severe pain. Magnetic resonance imaging of the lumbar spine revealed a diffuse altered signal intensity involving the entire spine, bilateral pelvis, and femur with hypointense on both T1 and T2 images suggestive of marrow infiltrative disorder. Her serum calcium was 12.7 mg/dl and serum phosphorus was 1.9 mg/dl. The patient's alkaline phosphatase was 2919 IU/L. Her parathyroid hormone level was 2095 pg/ml. The patient was diagnosed to have hyperparathyroidism. 99mTc-sestamibi parathyroid single-photon emission computed tomography–computed tomography was suggestive of left superior parathyroid adenoma. The surgical endocrinologist did a left superior parathyroidectomy. Postoperatively, she developed hypocalcemia. It was managed with intravenous calcium infusion, oral calcium, and oral calcitriol. Six weeks after surgery, the pain in the right hip decreased significantly, and she was able to walk without support. Histopathological examination of the removed parathyroid was suggestive of parathyroid carcinoma. The following core competencies are addressed in this article: Practice-based learning and improvement, Medical knowledge.","PeriodicalId":36495,"journal":{"name":"International Journal of Academic Medicine","volume":"9 1","pages":"31 - 34"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70738616","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}