Medical Journal of Malaysia最新文献

{"title":"Identifying postoperative cognitive dysfunction after elective coronary artery bypass graft surgery in a tertiary centre in Malaysia.","authors":"S H Rahman, M Mazlan, A Suhaimi, N H M Hashim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Postoperative cognitive dysfunction (POCD) is a significant concern, with incidences reported up to 70% following cardiac surgery. Therefore, we aim to evaluate the incidence of POCD after elective coronary artery bypass graft (CABG) surgery at our single centre over a one-year period from August 2021 to July 2022. We included 34 patients in the study and conducted serial cognitive assessments up to three months post-surgery. Interestingly, our findings indicated an absence of POCD among patients who underwent elective CABG. Reasons contributing to this outcome are multifactorial, which may include the patients' younger age, higher educational levels, lack of pre-existing neurological disorders, meticulous intraoperative cerebral saturation monitoring, and the duration of aortic crossclamp and cardiopulmonary bypass time.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"483-486"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861211","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":"Stunting and its association with feeding problem among under five children: a case-control study in Kuantan district, Malaysia.","authors":"N A Kamaruzaman, A L Musa, H Pasi, I F Osman","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Stunting is the most prevalent form of malnutrition among infants and young children population, both globally and locally. It refers to low height-for-age children and is primarily caused by chronic under nutrition. The objective of this study is to determine the association between stunting and feeding problems and to explore the risk factors for stunting among children aged 6 to 59 months attending health clinics in the Kuantan district.</p><p><strong>Materials and methods: </strong>A case-control study involving 160 children that attended six health clinics in Kuantan from August to October 2021 with a ratio of 1 case: 3 controls. Data were collected from mothers using a questionnaire consisting of sociodemographic and feeding assessment adapted from a validated World Health Organization (WHO) integrated management of childhood illness (IMCI) assessment form. The data was analysed using IBM SPSS version 26.0. Binary logistic regression analysis was used to identify factors associated with stunting. The odds ratio was used to measure the strength of the association between outcome and predictor variables. The significance value was set at p<0.05.</p><p><strong>Results: </strong>Children with identified feeding problems have more than four-time significantly higher risk of becoming stunted (Odds Ratios, OR: 4.2; 95% Confidence Intervals, 95%CI: 1.4, 12.8) as compared to children with no feeding problems. Specifically, children with inadequacy in feeding components; amount, variety and frequency of meal each have significantly six-time higher risk (OR: 6.2; 95%CI: 2.7, 14.5), four-time higher risk (OR: 4.2; 95%CI: 1.4, 12.3), and three-time higher risk (OR: 2.8; 95%CI: 1.1, 6.9), of becoming stunted as compared to children with adequate feeding. Additionally, with a decrease of one week in delivery week, one kilogram in birth weight and one centimetre in maternal height, there is a respectively significant 40.0% (OR: 0.6; 95%CI: 0.4, 0.9), 80.0% (OR: 0.2; 95%CI: 0.1, 0.7) and 11.0% (OR: 0.89; 95%CI: 0.82, 0.98) increase in the risk of become stunted among children.</p><p><strong>Conclusion: </strong>Feeding problems specifically inadequate food amount, food variety and meal frequency not following the recommendation contribute to stunting in young children. Other factors identified are lower maternal height and children with lower birth weight and delivery week. This highlights the need for more excellent detection and intervention of nutritional concerns and risk factors to prevent stunting.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"436-442"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861215","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":"Hirschsprung disease associated enterocolitis: a systematic review and meta-analysis.","authors":"H Poerwosusanta, Y A Saputra, A S Budi, D Aditia, Gunadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Hirschsprung's disease-associated enterocolitis (HAEC) remains a substantial morbidity and mortality risk in Hirschsprung's disease. HAEC is a challenge. Its p athophysiology is still a mystery, and no adequate treatment strategy exists. The aim of the study is to analyse the pre-and post-operative, mortality and complications: strictures, anastomotic leak, constipation and incontinence associated with HAEC.</p><p><strong>Materials and methods: </strong>Adjust to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020; this study met all the requirements and was up-todate. The search approach was online publications between 2013 and 2023 in Pubmed and SagePub. It was decided not to consider review pieces that had already been published and half done. The STATA 18th version was used for metaanalysis.</p><p><strong>Results: </strong>Our search results included 370 PubMed and 149 SagePub articles. Since 2013, 134 PubMed and nine SagePub articles have been obtained, and seven studies have met the criteria.</p><p><strong>Conclusion: </strong>Disorders of intestinal motility in the aganglionic segment and accumulation of faeces disrupt the balanced microbiota population, which are factors of preoperative HAEC. Major congenital anomalies and low birth weight worsen pre-operative HAEC. Pre-operative HAEC can continue and affect the post-operative. Constipation and fecal incontinence are still the main challenges after HSCR surgery.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"477-482"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861210","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 clinical audit on the diagnosis and management of infective endocarditis in a tertiary heart centre in Malaysia.","authors":"Y H Ho, C T Lim, C Z F Chua, H H Chua, T K Ong","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Infective endocarditis (IE) has a high mortality rate in developing countries including Malaysia. This clinical audit aims to identify the shortcomings in the diagnosis and management of IE patients in a local tertiary centre to implement changes for improvement.</p><p><strong>Materials and methods: </strong>This retrospective audit had two cycles - the first includes all IE patients in Sarawak Heart Centre, Malaysia from January 2020 to December 2022 with different parameters (blood culture, echocardiogram, the appropriateness of antibiotics and surgery) assessed against Malaysian Clinical Practice Guideline (CPG); and reaudit from July 2023 to December 2023. Interventions before re-audit include presentation at different hospital levels and continuing medical education.</p><p><strong>Results: </strong>Fifty patients were recruited (37 in the first cycle, 13 in the second cycle). The median age was 48.5 years with male predominance. Valve prosthesis (12.0%) and rheumatic heart disease (10.0%) were the commonest predisposing factors. Native mitral (44.0%) and aortic valves (28.0%) were most commonly involved. Twenty-eight (56.0%) patients were culture-positive. In the first cycle, most parameters (culture technique 0.0%, vegetation measured 54.1%, empirical 5.4%, culture-guided 29.7% antibiotics therapy, indicated surgery 0.0%) did not achieve the expected standard except timeliness of echocardiograms and blood culture incubation period. After initial interventions, all parameters showed statistically significant improvement (culture technique p<0.001, echocardiography p<0.001, empirical p<0.001, culture-guided p=0.021, surgery p<0.001) during the re-audit.</p><p><strong>Conclusion: </strong>Compliance with clinical practice guidelines (CPG) on IE management was suboptimal during the first audit but improved after interventions. Hence, regular continuing medical education (CME) is essential, and a written hospital protocol may be useful. Regular audits alongside multidisciplinary teamwork are crucial efforts.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"388-392"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861188","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 randomised controlled trial study on the effectiveness of high-fidelity simulation in enhancing skills among undergraduate medical students.","authors":"B Pal, S V Chong, A W Thein, A G M Tay, H H K Soe, S Pal","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>High-fidelity simulation (HFS) provides a high level of interactivity and realistic experience for the learner by means of using full scale computerised patient simulators. It imitates clinical experience in a controlled and safe environment that closely resembles reality. The purpose of this study was to compare the efficacy of HFS versus video-assisted lecture (VAL) based education in enhancing and consolidating retention of skills among undergraduate medical students.</p><p><strong>Materials and methods: </strong>A randomised controlled trial (RCT) study involving 111 undergraduate medical students was conducted where the competency of skills was assessed by objective structured clinical examination (OSCE) in the first, fourth and seventh/eighth weeks. A cohort of 12-14 students was enrolled for each session. The randomisation of the participants into control (VAL-based teaching) and intervention (HFS-based teaching) groups was achieved by implementing the computer-based random sequence generation method. VAL-based teaching module was a fully interactive face-to-face teaching session where a prerecorded video clip was used. The video clip detailed the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression on a high-fidelity patient simulator (METIman). HFS-based teaching module was delivered as a fully interactive hands-on training session conducted on the same METIman to demonstrate the diagnosis of tension pneumothorax in an acute medical emergency and its management by performing needle decompression. OSCE scores were compared as the denominator of learning (enhancement and retention of skills) between two groups who underwent training with either VAL-based or HFS-based teachings. The OSCE assessments were used to evaluate the participants' performance as a group. These scores were used to compare the enhancement and medium-term retention of skills between the groups. The outcome was measured with the mean and standard deviation (SD) for the total OSCE scores for skills assessments. We used General Linear Model two-way mixed ANOVA to ascertain the difference of OSCE marks over assessment time points between the control and the intervention groups. ANCOVA and two-way mixed ANOVA were used to calculate the effect size and the partial Eta squared. p value less than 0.05 was taken to be statistically significant.</p><p><strong>Results: </strong>The two-way mixed ANOVA showed no statistically significant difference in mean OSCE scores between intervention and control groups (p=0.890), although the mean score of the intervention group was better than the control group.</p><p><strong>Conclusion: </strong>Our study demonstrated that HFS was not significantly effective over VAL-based education in enhancing skills and consolidating retention among undergraduate medical students. Further research is needed to determine its suitability for inclusion in the ","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"421-428"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861189","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":"Obtaining assent for research involving children in Malaysia: a position statement from the Academy of Medicine of Malaysia College of Paediatrics.","authors":"E J Khoo, B A Zilfalil, M K Thong, S C Yong, S C Chee, J K Lee, S H Teh, F Taib, F C Cheah","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Academy of Medicine of Malaysia College of Paediatrics acknowledges the role of children in research and this position statement explores the ethical considerations in obtaining assent from minors in the Malaysian context. It highlights the importance in respecting children's agency and navigating cultural complexities. The College proposes flexibility in the minimum age for assent of at least nine years old, while emphasising the need for a tailored assent procedure. Addressing language and cultural diversities and expanding local empirical research on a formal assent process are some building blocks in developing a standardised nationwide process in obtaining assent from children.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"494-497"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861212","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":"Assessing informal caregiver burden as well as knowledge on positioning and feeding of stroke patients in a tertiary hospital in Kelantan, Malaysia.","authors":"A M Mustapa, A Sharif, M H Hanafi, N Mustaffa","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A significant proportion of stroke patients in Malaysia are supported by informal caregivers who often lack sufficient training. This lack of preparation contributes to an escalation in caregiver burden. A cross-sectional study was conducted using Caregiving Knowledge Questionnaire (CKQ-my) and Zarit Burden Interview (ZBI) with convenient sampling. The findings revealed that caregivers had limited knowledge regarding proper positioning, and most of them reported experiencing mild burden. Multiple logistic regression analysis showed that informal caregivers who were also the primary caregivers for severe stroke patients experienced a higher burden. Recognising and understanding the factors that contribute to caregiver burden in stroke cases is essential for developing effective programs to improve the quality of life for both stroke survivors and their informal caregivers.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"487-489"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861191","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":"Oral health assessment of epilepsy patients from a tertiary hospital in Asia.","authors":"M N Mohd Faiz, M S H Abd Rahman, A A A Nurazfalina, T Jennifer, S Nabil, J K Tan, R Rathika, W N N Wan Yahya, W Z Wan Asyraf, C S Khoo, H Rozita, S Zaleha, H J Tan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Oral health problems are frequently overlooked in patients with epilepsy. We evaluate the oral health status of epilepsy patients from a tertiary teaching hospital.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study of epilepsy patients from the neurology clinic, Hospital Canselor Tuanku Muhriz, Kuala Lumpur. The dental assessment included the decayed, missing and filled teeth (DMFT) criteria, as well as the plaque and periodontal status by dentists.</p><p><strong>Results: </strong>A total of 151 patients were recruited. The median age of onset of epilepsy was 16 (IQR 7-30) years, with generalised seizures at 59.6% and focal seizures in 40.4% of patients. Fair or poor oral health was present in 59 (39.1%) and gingivitis was seen in 65 (43%). The median DMFT decayed (D), missing (M) and filled teeth (FT) was 3 (IQR 1- 7). The median age of patients with fair or poor oral health was older (40 years, IQR 31-51) than the patients with excellent or good oral health (33 years, IQR 26-45), (p=0.014). Multivariate logistic regression analysis showed that carbamazepine (Odds Ratios, OR: 3.694; 95% Confidence Intervals, 95%CI: 1.314, 10.384) and hypertension (OR 6.484; 95%CI: 1.011, 41.594) are the risk factors for fair or poor oral health. Phenytoin use is 4.271 times more likely to develop gingivitis (OR 4.271; 95% CI: 1.252, 14.573).</p><p><strong>Conclusion: </strong>Factors that contribute to fair or poor oral health include age, antiseizure medications like phenytoin and carbamazepine, and hypertension. Effective preventive strategies should be implemented to maintain oral health in epilepsy patients.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"443-451"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861213","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":"Perceptions of climate change and associated health impacts among communities in Johor River Basin, Malaysia.","authors":"Y C Kwa, N Suboh, D S W Kay, C I S Lee, C L Walsh, M L Goodson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>As climate change is threatening every region of the world, extreme weather events resultant of global warming is occurring at increasing rate and scale in Malaysia. Weather-related disasters such as flood and haze pose critical challenges to the infrastructure and raise public health concerns in the country, especially when main economic sectors rely heavily on climate variability. Public perception on environmental issues is crucial for development of pro-environmental policies. Among studies conducted to understand public awareness regarding global warming, reports of perception on the health impacts were very limited. Taking this limitation into account, this study was designed to examine the perception on the health impacts of climate change among the diverse communities living in the Johor River Basin.</p><p><strong>Materials and methods: </strong>The cross-sectional study was conducted through cloud-data-based digital questionnaires completed by randomly selected residents in the Johor River Basin (n=647). Data was analysed with descriptive statistics using SPSS 27 (IBM®) Software. Comparisons between indigenous and non-indigenous communities were performed using Chi square analysis.</p><p><strong>Results: </strong>Respondents in this study consisted of indigenous people (n=79) and non-indigenous people (n=568). Indigenous respondents generally perceived more frequent occurrence of extreme weather events in the next 20 years, even for the phenomena unfamiliar in Malaysian settings. All respondents showed similar concerns for health impacts of global warming, although the non-indigenous respondents perceived the risk further into the future (25 years) compared to the indigenous respondents who perceived current or imminent (<10 years) risks. Intense concerns for self, children, family members and community were shown by nearly all indigenous respondents (97-99%), while the non-indigenous people in this study expressed stronger concerns at country level and for future generations. During the last haze episode, most indigenous respondents (85%) did not notice any change in air quality nor discomfort among family members, in contrast 70% of the nonindigenous respondents claimed to have suffered from breathing problems themselves as well as others in the family. All respondents were concerned about air quality in their surroundings, indigenous people were concerned for the near future (<10 years), and non-indigenous people were concerned for the next 25 years.</p><p><strong>Conclusion: </strong>In this study, respondents were generally concerned about the health impacts of unimpeded global warming. There was significant difference in perceptions between indigenous and non-indigenous respondents. The findings were useful, complemented with further studies, to improve understanding of public awareness and to help develop relevant education programmes accessible for wider audience.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"397-407"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861214","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":"Two-year retrospective review of lens-induced glaucoma in Hospital Taiping, Perak, Malaysia.","authors":"A R Zulaikha, L C Fhun, S L Ng, M Shahidatul-Adha","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Delayed cataract surgery has long been known to cause lens-induced glaucoma (LIG). This study examined the demographic and clinical profile, ocular characteristics and outcomes of LIG in a tertiary referral centre in Malaysia.</p><p><strong>Materials and methods: </strong>Data from the National Eye Database (Malaysia) for cataract surgery performed at Hospital Taiping, Perak, between January 2019 and December 2020 were reviewed. The medical records of patients with LIG were retrieved to obtain demographic data, clinical profiles and visual outcomes.</p><p><strong>Results: </strong>Of 3233 patients who underwent cataract surgery at Hospital Taiping, Perak, between 2019 and 2020, 25 underwent emergency surgery for LIG. However, only 24 patients fulfilling the diagnostic criteria for LIG were included in the study: 14 (58.33%) patients with phacomorphic and 10 (41.6%) patients with phacolytic glaucoma. The mean age of the patients was 66±12 years. Women and men were equally affected. Most patients were Malay (75%), followed by Chinese (16.67%) and Indian (8.33%). The anterior chamber depth (ACD) was significantly shallow with a mean value of 2.72 mm. Nineteen (79.1%) patients presented with visual acuity of worse than counting fingers. The mean intraocular pressure (IOP) at presentation was 47.5±13.66mmHg, which improved to 15.08±8.09mmHg postoperatively. A best-corrected visual acuity of 6/15 and better was achieved in 20 patients (83.33%) despite glaucomatous optic neuropathy being present in 41.67% of the cases. The majority (58.3%) of surgeries were performed via extracapsular cataract extraction, while six (25%) of our patients underwent successful phacoemulsification. Seven (29.17%) patients had intraocular complications: five with zonular dialysis and two with posterior capsule rupture. Of these seven cases, four ended up with intracapsular cataract extraction, leaving two of them aphakic.</p><p><strong>Conclusion: </strong>Prompt cataract surgery is paramount in all LIG cases to reduce IOP and achieve better visual outcomes. Despite the promising prognosis associated with early surgical intervention, patients should be counselled about the potential for a guarded visual prognosis from complicated surgery and its long-term complications.</p>","PeriodicalId":39388,"journal":{"name":"Medical Journal of Malaysia","volume":"79 4","pages":"452-456"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861219","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}