JAMMI最新文献

{"title":"Group B streptococcal leptomeningitis, ventriculitis, right cerebellitis, and cerebritis in an immunocompetent patient.","authors":"Julia A Cahill,&nbsp;Calvin Li,&nbsp;Patrick Hp Wong","doi":"10.3138/jammi-2021-0023","DOIUrl":"https://doi.org/10.3138/jammi-2021-0023","url":null,"abstract":"<p><strong>Background: </strong>Group B streptococcal (GBS) meningitis is uncommon in non-puerperal adults outside of significant immunocompromise or structural abnormalities.</p><p><strong>Case presentation: </strong>We describe a relatively healthy 62-year-old man with GBS bacteremia, abnormal lumbar puncture, and MRI-confirmed leptomeningitis, ventriculitis, right cerebellitis, and cerebritis who presented without overt symptoms of meningitis.</p><p><strong>Diagnosis: </strong>The suspected source of infection was a high-inoculum genitourinary infection in the setting of hydronephrosis and recent cystoscopy. We performed a literature review of previous cases and clusters of GBS meningitis.</p><p><strong>Discussion: </strong>With increasing recognition of invasive GBS infection among adult patients, and in light of our patient's atypical presentation, we propose that an index of suspicion for GBS meningitis be maintained, even for patients who would traditionally have been considered at lower risk.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"7 1","pages":"75-80"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9603013/pdf/jammi-2021-0023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670072","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":"Antibiotic prescribing patterns among patients admitted to an academic teaching hospital for COVID-19 during the first wave of the pandemic in Toronto: A retrospective, controlled study.","authors":"Miranda So,&nbsp;Andrew M Morris,&nbsp;Alexander M Walker","doi":"10.3138/jammi-2021-0020","DOIUrl":"https://doi.org/10.3138/jammi-2021-0020","url":null,"abstract":"<p><strong>Background: </strong>Empirical antibiotics are not recommended for coronavirus disease 2019 (COVID-19).</p><p><strong>Methods: </strong>In this retrospective study, patients admitted to Toronto General Hospital's general internal medicine from the emergency department for COVID-19 between March 1 and August 31, 2020 were compared with those admitted for community-acquired pneumonia (CAP) in 2020 and 2019 in the same months. The primary outcome was antibiotics use pattern: prevalence and concordance with COVID-19 or CAP guidelines. The secondary outcome was antibiotic consumption in days of therapy (DOT)/100 patient-days. We extracted data from electronic medical records. We used logistic regression to model the association between disease and receipt of antibiotics, linear regression to compare DOT.</p><p><strong>Results: </strong>The COVID-19, CAP 2020, and CAP 2019 groups had 67, 73, and 120 patients, respectively. Median age was 71 years; 58.5% were male. Prevalence of antibiotic use was 70.2%, 97.3%, and 90.8% for COVID-19, CAP 2020, and CAP 2019, respectively. Compared with CAP 2019, the adjusted odds ratio (aOR) for receiving antibiotics was 0.23 (95% CI 0.10 to 0.53, <i>p</i> = 0.001) and 3.42 (95% CI 0.73 to 15.95, <i>p</i> = 0.117) for COVID-19 and CAP 2020, respectively. Among patients receiving antibiotics within 48 hours of admission, compared with CAP 2019, the aOR for guideline-concordant combination regimens was 2.28 (95% CI 1.08 to 4.83, <i>p</i> = 0.031) for COVID-19, and 1.06 (95% CI 0.55 to 2.05, <i>p</i> = 0.856) for CAP 2020. Difference in mean DOT/100 patient-days was -24.29 (<i>p</i> = 0.009) comparing COVID-19 with CAP 2019, and +28.56 (<i>p</i> = 0.003) comparing CAP 2020 with CAP 2019.</p><p><strong>Conclusions: </strong>There are opportunities for antimicrobial stewardship to address unnecessary antibiotic use.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"7 1","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9603018/pdf/jammi-2021-0020.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40670073","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":"Association between initial symptoms and subsequent hospitalization in outpatients with COVID-19: A cohort study.","authors":"Alice Zhabokritsky,&nbsp;Nick Daneman,&nbsp;Scott MacPhee,&nbsp;Jose Estrada-Codecido,&nbsp;Aimee Santoro,&nbsp;Adrienne Kit Chan,&nbsp;Philip Wai-Hei Lam,&nbsp;Andrew Simor,&nbsp;Jerome Allen Leis,&nbsp;Samira Mubareka,&nbsp;Nisha Andany","doi":"10.3138/jammi-2021-0012","DOIUrl":"https://doi.org/10.3138/jammi-2021-0012","url":null,"abstract":"<p><strong>Background: </strong>Most individuals with coronavirus disease 2019 (COVID-19) experience mild symptoms and are managed in the outpatient setting. The aim of this study was to determine whether self-reported symptoms at the time of diagnosis can identify patients at risk of clinical deterioration.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 671 outpatients with laboratory-confirmed COVID-19 diagnosed in Toronto between March 1 and October 16, 2020. We examined the association between patients' baseline characteristics and self-reported symptoms at the time of diagnosis and the risk of subsequent hospitalization.</p><p><strong>Results: </strong>Of 671 participants, 26 (3.9%) required hospitalization. Individuals aged 65 years or older were more likely to require hospitalization (odds ratio [OR] 5.29, 95% CI 2.19 to 12.77), whereas those without medical comorbidities were unlikely to be hospitalized (OR 0.02, 95% CI 0.00 to 0.17). After adjusting for age and presence of comorbidities, sputum production (adjusted OR [aOR] 5.01, 95% CI 1.97 to 12.75), arthralgias (aOR 4.82, 95% CI 1.85 to 12.53), diarrhea (aOR 4.56, 95% CI 1.82 to 11.42), fever (aOR 3.64, 95% CI 1.50 to 8.82), chills (aOR 3.62, 95% CI 1.54 to 8.50), and fatigue (aOR 2.59, 95% CI 1.04 to 6.47) were associated with subsequent hospitalization.</p><p><strong>Conclusions: </strong>Early assessment of symptoms among outpatients with COVID-19 can help identify individuals at risk of clinical deterioration. Additional studies are needed to determine whether more intense follow-up and early intervention among high-risk individuals can alter the clinical trajectory of and outcomes among outpatients with COVID-19.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"259-268"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629262/pdf/jammi-2021-0012.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668473","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":"Susceptibilities of invasive <i>Neisseria meningitidis</i> strains to agents used for prophylaxis and to penicillin G.","authors":"Carrie Phillips,&nbsp;David Jm Haldane","doi":"10.3138/jammi-2020-0034","DOIUrl":"https://doi.org/10.3138/jammi-2020-0034","url":null,"abstract":"Background\u0000The antimicrobial susceptibility of isolates of Neisseria meningitidis to agents used for chemoprophylaxis and to penicillin G was determined.\u0000\u0000\u0000Methods\u0000Fifty N. meningitidis strains detected in Nova Scotia between 2004 and 2018 were included. The isolates were originally isolated from sites that might prompt chemoprophylaxis (27 blood, 18 cerebrospinal fluid [CSF], 3 CSF-blood, and 2 conjunctiva). Minimal inhibitory concentrations (MICs) were determined to azithromycin, ciprofloxacin, minocycline, rifampin, trimethoprim-sulfamethoxazole, and penicillin G, using a diffusion gradient strip on Mueller-Hinton agar with 5% sheep blood in 5% CO2 for 20-24 hours.\u0000\u0000\u0000Results\u0000All isolates remained susceptible to azithromycin, ciprofloxacin, minocycline, and rifampin, but there was 26% resistance to trimethoprim-sulfamethoxazole. There was a rise in penicillin MIC of the isolates over the study period.\u0000\u0000\u0000Conclusion\u0000In our province, N. meningitidis isolates causing invasive infection remain susceptible to commonly used antimicrobial agents used for chemoprophylaxis. Significant resistance to trimethoprim-sulfamethoxazole is present and the degree of susceptibility to penicillin G is lessening.","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629260/pdf/jammi-2020-0034.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668439","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":"<i>Clostridium septicum</i> myonecrosis in a pediatric patient with a self-reported penicillin allergy.","authors":"Parmvir Parmar,&nbsp;Joshua Feder,&nbsp;Anne Pham-Huy","doi":"10.3138/jammi-2020-0039","DOIUrl":"https://doi.org/10.3138/jammi-2020-0039","url":null,"abstract":"<p><p>Infections with <i>Clostridium septicum</i> are especially rare in pediatric patients. <i>C. septicum</i> is the most common cause of spontaneous myonecrosis and is usually associated with comorbid malignancy. Treatment of choice for cases of <i>C. septicum</i> myonecrosis is prompt and thorough surgical debridement and antimicrobial therapy with high dose penicillin. The experience and management of <i>C. septicum</i> infections in patients who are unable to take penicillin are not well described, and the optimal duration of therapy is largely unknown. We describe a case of spontaneous myonecrosis in a 14-year-old receiving cytotoxic chemotherapy for Burkitt's lymphoma who had an anecdotal history of a penicillin allergy. Her infection was initially treated with ceftazidime and metronidazole in concert with debridement but was ultimately cured with 3 weeks of intravenous penicillin therapy following a graded penicillin challenge in hospital. We observed a delayed inflammatory tissue response to a <i>C. septicum</i> skin, soft tissue infection that temporally corresponded to neutrophil reconstitution in our patient with severe neutropenia. Our experience demonstrates that <i>C. septicum</i> myonecrosis can present indolently and progress rapidly and highlights the need for clinical vigilance and repeat \"second-look\" surgeries. Our case also emphasizes the importance of de-labelling penicillin allergies.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"325-329"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629257/pdf/jammi-2020-0039.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668438","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":"Proposed framework for a national set of reporting measures in Canada in response to the COVID-19 pandemic.","authors":"Mona Khalid,&nbsp;Edgar Akuffo-Addo,&nbsp;Andrew M Morris,&nbsp;Dominik Mertz,&nbsp;Adam S Komorowski","doi":"10.3138/jammi-2021-0010","DOIUrl":"https://doi.org/10.3138/jammi-2021-0010","url":null,"abstract":"<p><p>An effective strategy to control the ongoing coronavirus disease 2019 (COVID-19) pandemic takes into account inputs from many domains, including community epidemiology, surveillance and testing, contact tracing capacity, support for vulnerable populations, and health care system strain. Provincial and federal governments currently lack a universal approach to presenting relevant pandemic data from these domains to the general public in a way that engages them in decision making and promotes adherence to policies. We propose a framework to analyze COVID-19 pandemic data on an ongoing basis using inputs from these five domains, which can be scaled to the local public health unit, provincial, or national level. Data analysis was qualitative and semi-quantitative because there was a paucity of publicly available data on surveillance and testing, contact tracing, and health care system strain, which limited our ability to perform internal and external validation of our model. We urge the federal government to mandate a core set of reporting items across local, provincial, and federal jurisdictions that may then be used to perform validation and implementation of our proposed framework.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"245-258"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629254/pdf/jammi-2021-0010.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668432","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":"<i>Enterococcus gallinarum</i> endophthalmitis and meningitis in an allogeneic hematopoietic stem cell transplant patient: A case report and literature review.","authors":"Daniel Zp Friedman,&nbsp;Supavit Chesdachai,&nbsp;Fnu Shweta,&nbsp;Maryam Mahmood","doi":"10.3138/jammi-2021-0016","DOIUrl":"https://doi.org/10.3138/jammi-2021-0016","url":null,"abstract":"<p><p>Endogenous endophthalmitis caused by <i>Enterococcus gallinarum</i>, an organism with intrinsic resistance to vancomycin, has rarely been reported. We present a case of persistent <i>E. gallinarum</i> bacteremia in a female recipient of hematopoietic stem cell transplant (HSCT) complicated by endophthalmitis and meningoventriculitis, resulting in a fatal outcome despite treatment with intravenous ampicillin and daptomycin. Treatment of endophthalmitis often presents a challenge due to the lack of options for antimicrobials with reliable ocular penetration. Therapeutic decisions can become particularly complex with the involvement of drug-resistant pathogens and host characteristics that limit the choice of antimicrobials due to drug toxicity. This case illustrates a rare manifestation of an opportunistic pathogen.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"313-318"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629259/pdf/jammi-2021-0016.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40683790","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":"Randomized controlled trial of chlorhexidine gluconate, intranasal mupirocin, rifampin, and doxycycline versus chlorhexidine gluconate and intranasal mupirocin alone for the eradication of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) colonization.","authors":"Lucy Y Eum,&nbsp;Stefanie Materniak,&nbsp;Paula Duffley,&nbsp;Sameh El-Bailey,&nbsp;George R Golding,&nbsp;Duncan Webster","doi":"10.3138/jammi-2020-0049","DOIUrl":"https://doi.org/10.3138/jammi-2020-0049","url":null,"abstract":"<p><strong>Background: </strong>Several decolonization regimens have been studied to prevent recurrent methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections. Clinical equipoise remains with regard to the role of MRSA decolonization. We compared initial MRSA clearance and subsequent MRSA recolonization rates over a 12-month period after standard decolonization (using topical chlorhexidine gluconate, and intranasal mupirocin) or systemic decolonization (using topical chlorhexidine gluconate, intranasal mupirocin, oral rifampin, and oral doxycycline).</p><p><strong>Methods: </strong>MRSA-colonized patients were randomized to receive either standard or systemic decolonization. Follow-up with MRSA screening was obtained at approximately 3, 6, and 12 months after completion of therapy. Kaplan-Meier survival curves were calculated and assessed for significant differences using log-rank tests.</p><p><strong>Results: </strong>Of 98 enrolled patients (25 standard decolonization, 73 systemic decolonization), 24 patients (7 standard decolonization, 17 systemic decolonization) did not complete the study. Univariate analysis showed a marginally significant difference in the probability of remaining MRSA-negative post-treatment (<i>p</i> = 0.043); patients who received standard decolonization had a 31.9% chance of remaining MRSA-negative compared with a 49.9% chance among those who received systemic decolonization. With multivariate analysis, there was no difference in the probability of remaining MRSA-negative between systemic and standard decolonization (<i>p</i> = 0.165). Initial MRSA clearance was more readily achieved with systemic decolonization (79.1%; 95% CI 32.4% to 71.6%) than with standard decolonization (52.0%; 95% CI 69.4% to 88.8%; <i>p</i> = 0.0102).</p><p><strong>Conclusions: </strong>Initial MRSA clearance is more readily achieved with systemic decolonization than with standard decolonization. There is no significant difference in the probability of sustained MRSA clearance.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"296-306"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629256/pdf/jammi-2020-0049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668475","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":"Local incidence of Jarisch-Herxheimer reaction in pregnancy following penicillin treatment for syphilis: A case series.","authors":"Amreet Dhaliwal,&nbsp;Alison A Lopez,&nbsp;Jared Bullard,&nbsp;Vanessa Poliquin","doi":"10.3138/jammi-2021-0001","DOIUrl":"https://doi.org/10.3138/jammi-2021-0001","url":null,"abstract":"<p><strong>Background: </strong>The literature suggests that the Jarisch-Herxheimer (J-H) reaction following antimicrobial treatment of syphilis is common and may precipitate uterine activity. Local practice is to transfer syphilitic parturients beyond gestational age of viability from rural locations to a tertiary care centre for treatment. Study objectives were to delineate local incidence and risk factors for the J-H reaction among pregnant women receiving treatment for syphilis.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on pregnant women diagnosed with syphilis and treated during pregnancy at a tertiary care centre between 2012 and 2018. J-H reaction was defined as having ≥1 of the following symptoms within 24 hours of antibiotic treatment: fever (temperature ≥38°C), clinical description of a painful or itchy skin lesion, headache, hypotension (systolic blood pressure <90 mmHg), uterine contractions, or fetal heart rate decelerations. Descriptive statistical analysis was performed with mean and median used as measures of central tendency for continuous and categorical data, respectively.</p><p><strong>Results: </strong>Fifty-eight charts were eligible for inclusion. Mean maternal age was 25.1 (SD 5.6) years, and mean gestational age was 20.4 (SD 9.5) weeks when syphilis was diagnosed. One patient (1/58, 1.7%) met J-H reaction criteria. Mean gestational age at delivery was 37.1 (SD 3.4) weeks. One stillbirth (1.7%) was identified.</p><p><strong>Conclusions: </strong>The J-H reaction is less common at our centre than the literature suggests. Further research is important to identify risk factors associated with J-H reaction to optimize resource allocation in the context of treatment of syphilis during pregnancy.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"319-324"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629255/pdf/jammi-2021-0001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668474","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":"Polymicrobial <i>Clostridioides difficile</i> lung empyema.","authors":"Parmvir Parmar,&nbsp;Sarah Hosseini,&nbsp;Kathryn N Suh,&nbsp;Derek MacFadden","doi":"10.3138/jammi-2020-0040","DOIUrl":"https://doi.org/10.3138/jammi-2020-0040","url":null,"abstract":"<p><p><i>Clostridioides (Clostridium) difficile</i> is a well-known cause of enteritis and antibiotic-associated diarrhea. Extraintestinal <i>C. difficile</i> infection is uncommon, with most extraintestinal infections involving the intra-abdominal cavity and anatomic structures adjacent to the colon. Empyema secondary to <i>C. difficile</i> is especially rare, with only a handful of cases reported in the medical literature. A standard antibiotic treatment regimen for <i>C. difficile</i> empyema does not currently exist, and data chronicling successful treatment is limited. We present the case of an 80-year-old woman with a polymicrobial <i>C. difficile</i> empyema who was successfully treated with multiple chest tube insertions and intravenous vancomycin.</p>","PeriodicalId":36782,"journal":{"name":"JAMMI","volume":"6 4","pages":"330-332"},"PeriodicalIF":0.0,"publicationDate":"2021-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629263/pdf/jammi-2020-0040.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40668434","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}