GMS German Medical Science最新文献

{"title":"Predicting the development of gender-specific premature mortality for Germany by 2030.","authors":"Doris Bardehle","doi":"10.3205/000289","DOIUrl":"https://doi.org/10.3205/000289","url":null,"abstract":"<p><p>Germany has set itself the goal of reducing the premature mortality of under 70-year-old men to 190/100,000 and of women to 100/100,000 (age-standardized) by 2030. This is in line with the targets of the United Nations (UN) Sustainable Development Goals (SDG) (2015-2030) to reduce premature mortality by 34% for both men and women during this period. For the years 2010 to 2018, the premature mortality of 0-69-year-old men and women was calculated and standardized to the European population. On this basis, two linear trend calculations were made and compared with each other: 1. with the data of the target for Germany up to the year 2030, and 2. with the real figures achieved so far. The goal of reducing premature mortality by 34% within 15 years can, according to the current trend, only be achieved to 13.5% for men and 5.2% for women. Conclusions will be drawn from this as to how premature mortality can be reduced more significantly.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"19 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25540626","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":"Idiopathic scrotal hematoma in a neonate.","authors":"Sylvia Gkantseva-Patsoura,&nbsp;George Katsaras,&nbsp;Petroula Georgiadou,&nbsp;Nektarios Lainakis,&nbsp;Eirini Liovarou,&nbsp;Rita Theofanopoulos,&nbsp;Martha Theodoraki","doi":"10.3205/000288","DOIUrl":"https://doi.org/10.3205/000288","url":null,"abstract":"<p><p><b>Background:</b> Neonatal scrotal hematoma is considered a surgical emergency in the neonatal period. Up to recently, immediate surgical exploration was considered the gold standard for the diagnosis and treatment in the underlying causes. <b>Objective:</b> In this article, we present a case of idiopathic scrotal hematoma in a neonate. <b>Method:</b> It was managed conservatively with clinical and ultrasonographic follow-up. <b>Result:</b> The hematoma had gradually subsided, and any surgical intervention was avoided to the neonate. <b>Conclusion:</b> With good clinical and imaging follow-up, some cases could be managed nonoperatively.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"19 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2021-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7894276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25414766","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":"Mucinous adenocarcinoma of renal pelvis in a young male: a diagnostic challenge.","authors":"Pooja Gupta,&nbsp;Deepti Agarwal,&nbsp;Sharma Shruti,&nbsp;Mithlesh Chandra","doi":"10.3205/000287","DOIUrl":"https://doi.org/10.3205/000287","url":null,"abstract":"<p><p>Primary mucinous adenocarcinoma of the renal pelvis is an extremely rare tumor with only a handful of cases reported to date. Clinical and radiological features are not specific, and hence, histopathological examination holds the key for definitive diagnosis. This tumor has mainly been described in the elderly population, with less than five cases reported in individuals aged <35 years. Here, we report a case of primary mucinous adenocarcinoma of the renal pelvis in a young male. A 31-year-old male presented with a history of right-sided flank pain for the past year. On examination, he had right-sided costovertebral tenderness. Computed tomography (CT) scan revealed the presence of a hyperdense mass lesion in the right renal pelvis with severe hydronephrosis and cortical thinning. Because of the non-functioning status, right nephrectomy was performed. To our surprise, histopathology showed the presence of mucinous adenocarcinoma of the renal pelvis with carcinoma in situ of the ureter. This case describes a rare presentation of primary mucinous adenocarcinoma of the renal pelvis, and highlights the importance of histopathological examination in reaching the correct diagnosis.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2020-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38693862","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":"GPs' perspective on End-of-Life Care - an evaluation based on the German version of the General Practice End of Life Care Index.","authors":"Katharina van Baal,&nbsp;Sophie Schrader,&nbsp;Birgitt Wiese,&nbsp;Siegfried Geyer,&nbsp;Stephanie Stiel,&nbsp;Nils Schneider,&nbsp;Gabriele Müller-Mundt,&nbsp;Kambiz Afshar","doi":"10.3205/000286","DOIUrl":"https://doi.org/10.3205/000286","url":null,"abstract":"<p><p><b>Objective:</b> General practitioners (GPs) play a key role in the provision of general outpatient palliative care (AAPV) for the majority of patients at the end of life. The aim of this study was to evaluate the quality of End-of-Life Care (EoLC) from a GPs' perspective using the German version of the General Practice End of Life Care Index (GP-EoLC-I). <b>Methods:</b> Between autumn 2018 and spring 2019, all registered and eligible GPs in two counties in Lower Saxony (n=190) were asked to participate in a survey on EoLC using the German version of the self-assessment questionnaire GP-EoLC-I. The index comprises two subscales: <i>clinical care</i> (13 items) and <i>practice organisation</i> (12 items). The summated index of both subscales measures the quality of EoLC by GPs (25 items; range 14-40). The questionnaire was supplemented by questions on sociodemographic data, indicators for good palliative care (PC) and requirements to improve PC. Quantitative data were analysed by descriptive statistics and free text answers by conventional content analysis according to Hsieh and Shannon. <b>Results:</b> 52 GPs (females: n=16) of 34 practices (single practices: n=26) participated in the study. The mean GP-EoLC-I was 27.5 (SD 4.5). The items revealed potential for improvement: systematic identification of patients with potential PC needs, multidisciplinary case conferences to discuss PC patients, application of care protocols and symptom assessment tools, documentation of patients' wishes and beliefs as well as inclusion of family and carers. Regarding the indicators for good PC, the most relevant indicators from the GPs' perspective were collaboration and coordination, integration of relatives, advance care planning and documentation. As requirements to improve PC, GPs highlighted further training and the use of standardised tools such as instruments to support the systematic identification of PC patients. <b>Conclusions:</b> To our knowledge for the first time in Germany, an internationally tested self-assessment questionnaire measuring the quality of EoLC by GPs was applied. The GP-EoLC-I in this study was slightly lower than the index of GPs in the United Kingdom. Including relatives and family carers, implementing tools to support early identification of PC patients and strengthening cooperation between GPs and other stakeholders in PC may be promising approaches to improve general PC and EoLC in Germany.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc10"},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38693861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The future development of intensive care quality indicators - a methods paper.","authors":"Oliver Kumpf,&nbsp;Monika Nothacker,&nbsp;Jan Braun,&nbsp;Elke Muhl","doi":"10.3205/000285","DOIUrl":"https://doi.org/10.3205/000285","url":null,"abstract":"<p><p><b>Introduction:</b> Medical quality indicators (QI) are important tools in the evaluation of medical quality. Their development is subject to specific methodological requirements, which include practical applicability. This is especially true for intensive care medicine with its complex processes and their interactions. This methods paper presents the status quo and shows necessary methodological developments for intensive care QI. For this purpose, a cooperation with the Association of the Scientific Medical Societies' Institute for Medical Knowledge Management (AWMF-IMWi) was established. <b>Methodology:</b> Review of published German manuals for QI development from guidelines and narrative review of quality indicators with a focus on evidence and consensus-based guideline recommendations. Future methodological adaptations of indicator development for improved operationalization, measurability and pilot testing are presented, and a development process is proposed. <b>Results:</b> The development of intensive care quality indicators in Germany is based on an established process. In the future, additional evaluation criteria (QUALIFY criteria) will be applied to assess the evidence base. In addition, a continuous exchange between the national steering committee of the DIVI responsible for QI development and guideline development groups involved in intensive care medicine is planned. <b>Conclusion:</b> Intensive care quality indicators will have to meet improved methodological requirements in the future by means of an improved development process. Future QI development is intended to improve the structure of the development process, with a focus on scientific evidence and a link to guideline projects. This is intended to achieve the goal of a broad application of QI and to further evaluate its relevance for patient outcome and performance of institutions.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc09"},"PeriodicalIF":0.0,"publicationDate":"2020-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38624364","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":"What do positive and negative experiences of patients, relatives, general practitioners, medical assistants, and nurses tell us about barriers and supporting factors in outpatient palliative care? A critical incident interview study.","authors":"Stephanie Stiel,&nbsp;Helen Ewertowski,&nbsp;Olaf Krause,&nbsp;Nils Schneider","doi":"10.3205/000284","DOIUrl":"https://doi.org/10.3205/000284","url":null,"abstract":"<p><p><b>Background:</b> The strengthening of the general practitioners' (GPs') role in palliative care (PC) has been identified as a top priority in order to improve PC in Germany. This study aims at exploring positive and negative experiences in PC in Germany from the perspectives of patients, relatives, and health care professionals in a primary care setting. <b>Methods:</b> Between March 2017 and August 2017, a total of 16 interviews with patients, relatives, GPs, medical assistants, and nurses were conducted. The Critical Incident Technique (CIT) was used to explore factors that influence excellent versus undesirable events in PC provision. Two researchers independently defined and counted critical incidents (CIs) from interview transcripts, performed a thematic analysis, and clustered the CIs into dimensions. <b>Results:</b> In summary, 16 interviews contained 280 CIs, divided into 130 positive and 150 negative CIs. The thematic analysis resulted in seven content domains, with each including positive and negative CIs, respectively: 1) way of care provision, 2) availability of care providers, structures, medication, and aids, 3) general formal conditions of care provision, 4) bureaucracy, 5) working practices in health care teams, 6) quality and outcome of care provision, and 7) communication. <b>Conclusions:</b> The results raise awareness for the aspects that lead to successful or undesirable PC experiences, observed from different perspectives. They open up the potential for primary PC improvement. Future research will facilitate development and implementation of more tailored interventions in order to improve generalists' PC.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38623363","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":"Transverse vs. median laparotomy in peritonitis and staged lavage: a single center case series.","authors":"Sven Petersen,&nbsp;Alice Deder,&nbsp;Axel Prause,&nbsp;Christopher Pohland,&nbsp;Dominik Richter,&nbsp;Thomas Mansfeld,&nbsp;Gero Puhl","doi":"10.3205/000283","DOIUrl":"https://doi.org/10.3205/000283","url":null,"abstract":"<p><p><b>Background:</b> Staged lavage was first introduced in the 1970s and now serves as a therapeutic option for septic patients with peritonitis. A central aspect of this treatment concept is leaving the abdomen open after a wide incision. To evaluate the influence of transverse vs. median access to the abdomen in staged lavage, data from the authors' patients were analyzed. <b>Methods:</b> To evaluate patients with peritonitis, prospective intensive care data were examined together with data on the surgical details. The main aspects covered here were the surgical details of the lavage (namely, transverse vs. median laparotomy), number of lavages, fascia closure, wound-healing disorders, and observed lethality, in combination with the preoperatively evaluated SAPS-II score, expected hospital lethality, patient age, and the Mannheim Peritonitis Index. <b>Results:</b> Between January 2008 and December 2018, 522 patients were treated with open abdomen and staged lavage. The mean age of the patients was 66.0 years (standard deviation (SD) 15.9 years). A median incision was used in 140 cases, and transverse laparotomy was performed in 382. The mean SAPS-II score was 46.5 (SD 15.7), expected lethality was 39.6% (SD 26.3%), and observed lethality was 19.9%. On average, two lavages were performed after the index operation. Transverse incision was significantly less likely to cause wound-healing disorder (p=0.03), and fascial dehiscence was observed less frequently in the transverse laparotomies group than in median incisions in the statistical trend (p=0.06). <b>Conclusion:</b> In summary, staged lavage reduced expected lethality in patients with peritonitis. Transverse incision caused wound-healing disorders and fascial dehiscence less often. Therefore, the indication for transverse laparotomy should be generous, as this form of treatment is advantageous in case of peritonitis.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38419717","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":"Psychosocial burden of healthcare professionals in times of COVID-19 - a survey conducted at the University Hospital Augsburg.","authors":"Giulia Zerbini,&nbsp;Alanna Ebigbo,&nbsp;Philipp Reicherts,&nbsp;Miriam Kunz,&nbsp;Helmut Messman","doi":"10.3205/000281","DOIUrl":"https://doi.org/10.3205/000281","url":null,"abstract":"<p><p><b>Objective:</b> The outbreak of COVID-19 was declared a pandemic by the WHO in March 2020. Studies from China, where the virus first spread, have reported increased psychological strain in healthcare professionals. The aim of this study was to investigate the psychosocial burden of physicians and nurses depending on their degree of contact with COVID-19 patients. In addition, we explored which supportive resources they used and which supportive needs they experienced during the crisis. <b>Methods:</b> Data were collected between March and April 2020 at the University Hospital Augsburg. A total of 75 nurses and 35 physicians, working either in a special COVID-19 ward or in a regular ward, took part in the survey. The participants filled in two standardized questionnaires (the Patient Health Questionnaire, PHQ; and the Maslach Burnout Inventory, MBI), and reported their fear of a COVID-19 infection and stress at work on a 10-point Likert scale. Finally, they answered three open-ended questions about causes of burden, supportive resources and needs during the crisis. <b>Results:</b> Nurses working in the COVID-19 wards reported higher levels of stress, exhaustion, and depressive mood, as well as lower levels of work-related fulfilment compared to their colleagues in the regular wards. Physicians reported similar scores independent of their contact with COVID-19 patients. The most common causes for burden were job strain and uncertainty about the future. Psychosocial support as well as leisure time were listed as important resources, and a better infrastructure adjustment to COVID-19 at the hospital (e.g. sufficient staff, keeping teams and working schedules stable) as suggestion for improvement. <b>Conclusions:</b> Our findings indicate that especially nurses working in COVID-19 wards are affected psychologically by the consequences of the pandemic. This might be due to a higher workload and longer time in direct contact with COVID-19 patients, compared to physicians.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc05"},"PeriodicalIF":0.0,"publicationDate":"2020-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7314868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38093667","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":"Guideline-conform translation and cultural adaptation of the Addenbrooke's Cognitive Examination III into German.","authors":"Björn Weiss,&nbsp;Julius J Grunow,&nbsp;Max Rosenthal,&nbsp;David Hilfrich,&nbsp;Rudolf Mörgeli,&nbsp;Bruno Neuner,&nbsp;Friedrich Borchers,&nbsp;Antje Kraft,&nbsp;Henning Krampe,&nbsp;Claudia Denke,&nbsp;Claudia D Spies","doi":"10.3205/000280","DOIUrl":"https://doi.org/10.3205/000280","url":null,"abstract":"<p><p><b>Objective:</b> Age-related disorders, such as dementia, significantly contribute to the global burden of disease. Adequate screening in the primary care setting is critical for early detection and proper management. The Addenbrooke's Cognitive Examination III (ACE-III) is an open-source neuropsychological test with superior diagnostic quality in comparison to the Mini-Mental State Examination (MMSE). Our aim was to perform a guideline-conform English-German translation and cultural adaptation of the ACE-III in order to enable implementation in German-speaking countries. <b>Methods:</b> The translation and cultural adaptation were performed in accordance with the \"Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures\" from the International Society for Pharmacoeconomics and Outcome Research (ISPOR) (Wild et al. 2005). Four separate English-German translations were compiled into one German consensus translation, which was then translated back into English and compared to the original English version. After comparison, the German consensus translation was revised with emphasis on the identified differences between the English original version and the English translated version. This revised German consensus translation was subsequently evaluated for clinical applicability on a 5-point scale (0 - not applicable; 5 - applicable without any restrictions) by 20 practitioners experienced in the field of neuropsychological testing, using an anonymized, paper-based 22-item survey. <b>Results:</b> Nineteen of the 20 practitioners (95.0%) rated the German ACE-III translation as overall applicable. The median rating was 4.0 [IQR (4.0/5.0)]. When evaluating survey items assessing the applicability of the individual 19 subtests of the ACE-III, all of them (100%) were rated as applicable with a median rating of 4.5 [IQR (4.1/4.9)]. <b>Conclusion:</b> The German ACE-III translation in its current form is generally applicable and can be utilized for clinical and scientific purposes.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc04"},"PeriodicalIF":0.0,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37878347","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":"Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis.","authors":"Sebastian Rauer,&nbsp;Stephan Kastenbauer,&nbsp;Heidelore Hofmann,&nbsp;Volker Fingerle,&nbsp;Hans-Iko Huppertz,&nbsp;Klaus-Peter Hunfeld,&nbsp;Andreas Krause,&nbsp;Bernhard Ruf,&nbsp;Rick Dersch","doi":"10.3205/000279","DOIUrl":"https://doi.org/10.3205/000279","url":null,"abstract":"<p><p>Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3-15% of infections and can manifest as polyradiculitis, meningitis and (rarely) encephalomyelitis. This S3 guideline is directed at physicians in private practices and clinics who treat Lyme neuroborreliosis in children and adults. Twenty AWMF member societies, the Robert Koch Institute, the German Borreliosis Society and three patient organisations participated in its development. A systematic review and assessment of the literature was conducted by the German Cochrane Centre, Freiburg (Cochrane Germany). The main objectives of this guideline are to define the disease and to give recommendations for the confirmation of a clinically suspected diagnosis by laboratory testing, antibiotic therapy, differential diagnostic testing and prevention.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"18 ","pages":"Doc03"},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37878351","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}