Kufa Medical Journal最新文献

{"title":"Usefulness of Phase Sensitive Inversion Recovery MRI Sequence in the Detection of Cortical Lesions in Multiple Sclerosis","authors":"Rezq Ahmed Shakir, H. Al-Tameemi, Hayder K Hasson, Zahraa Ayad Zahraa Ayad, Raaed Hamza Jawad, Haider Abd AlRouda Jassim","doi":"10.36330/kmj.v20i1.14765","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.14765","url":null,"abstract":"Background: The presence of cerebral cortical lesions in multiple sclerosis has an important clinical impact on the prognosis of the disease and associated disability. However, the accurate detection of cortical lesions using conventional magnetic resonance imaging sequences remains challenging. The study aims to assess the value of phase-sensitive inversion recovery sequence in the detection of cortical lesions in multiple sclerosis patients and to evaluate their relation with clinical subtypes, duration, and clinical disability of the disease. Patients and Methods: Seventy cases, 51 females and 19 males, of multiple sclerosis, confirmed by McDonald criteria, were enrolled in this cross-sectional study and phase-sensitive inversion recovery images, axial and coronal sections, were obtained for each patient in every MRI session. Cortical lesions were subclassified into intracortical, leukocortical, and juxtacortical. Clinical disability was assessed using the extended disability status scale. The number of detected cortical lesions on phase-sensitive inversion recovery images was calculated and compared with that detected on conventional T2-weighted and fluid-attenuated inversion recovery images. Results: The number of cortical lesions detected on phase-sensitive inversion recovery was lesser compared to the T2-weighted sequence, a total of 1151 versus 1258 lesions respectively. The T2-weighted sequence was significantly better in the detection of leukocortical and juxtacortical. On the other hand, phase-sensitive inversion recovery was better than fluid-attenuated inversion recovery in detecting intracortical, while fluid-attenuated inversion recovery was better in detecting juxtacortical, and both sequences detected the same number of leukocortical lesions. The overall number of detected cortical lesions showed a statistically significant correlation only with the extended disability status scale and not with the clinical subtype or duration of multiple sclerosis. Conclusion: phase-sensitive inversion recovery detected more intracortical lesions and fewer juxtacortical lesions than fluid-attenuated inversion recovery, cortical lesions were significantly correlated with the degree of clinical disability of multiple sclerosis.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337268","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":"Investigating the Panton-Valentine Leukocidin Gene in Methicillin-Resistant Staphylococcus aureus from Diabetic Foot Infections","authors":"Abbas Hussein Al-salami, Majida Malik Al-shammari, Majid Hadi Al-Kalabi","doi":"10.36330/kmj.v20i1.15375","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.15375","url":null,"abstract":"Background: Methicillin-resistant Staphylococcus aureus is a significant pathogen associated with multidrug infections among diabetic foot infections. The Panton-Valentine Leukocidin (pvl) gene is an MRSA marker frequently present in community-acquired infections; it causes deep skin and soft tissue infections and osteomyelitis. Objectives: This study aimed to detect the prevalence of the PVL gene in MRSA isolates. Materials and methods: A cross-sectional study conducted from August 2023 to January 2024 investigated MRSA in 150 patients with DFIs at As-in Al-Manathira Hospital in Al-Najaf, Iraq. The S. aureus isolates were diagnosed using the Vitek® 2 technique. Methicillin-resistant S. aureus isolates were detected by a phenotypic method depending on cefoxitin disk diffusion and confirmed by a genotypic method by PCR targeting the mecA, and then the pvl gene was investigated. The genotypic methods employed particularly primers targeting the macA gene and pvl gene using the monoplex PCR technique. Results: The findings demonstrated that 95 (93.1%) of the 102 S. aureus isolates were resistant to cefoxitin, and according to the findings of the molecular study, only 96 (94.11%) isolates showed the mecA gene. Regarding the pvl gene, 97 (95.09%) of isolates produced positive findings. Conclusions: Diabetic foot infections exhibited a significantly high presence of the pvl gene within MRSA strains. These were confirmed using PCR, the gold standard method for detecting the mecA gene associated with methicillin resistance.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"6 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337073","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":"Shear-Wave Elastographic Evaluation of Splenic Stiffness in Patients with Chronic Liver Diseases as A Predictor of the Oesophageal Varices Grade","authors":"Ahmed Faaz Nasser, H. Al-Tameemi","doi":"10.36330/kmj.v20i1.15362","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.15362","url":null,"abstract":"Background: Chronic Liver disease (CLD) is a global public health problem and one of the leading causes of mortality worldwide with many complications like portal hypertension (PH) and esophageal varices (EV). Researchers have investigated the role of shear-wave elastography (SWE) as a non-invasive method to assess patients with cirrhosis and PH. However, studies evaluating the role of splenic stiffness (SS) have shown variable results. Aim of the study:  This study aims to assess the SS in a patient with CLD compared to controlled cases and to evaluate its role in the prediction of EV grade. Material and Methods. The study included 60 participants; 30 patients diagnosed with CLD by the clinical, laboratory, and radiological investigation, who underwent upper gastrointestinal endoscopy; and 30 control health individuals. The mean splenic size, SS, and platelet counts were measured for all participants. Mean SS was compared between two groups, and then its validity in differentiated between low and high-risk groups of EV was assessed. Results. Patients with CLD and controls were significantly different in SS values with cut-off value of 12.49 Kpa. Among CLD patients, the low and high-risk EV subgroups were significant different in SS values with cut-off value of 15.125 KPa. Compared with splenic size and platelet count, SS had the highest accuracy (93.3%) in predicting high-grade EV. Conclusion. Patients with CLD showed higher SS values than control with stepwise increase in SS with increasing grade of EV.  SS can accurately predict high-risk groups of EV hence may help decrease patients' burden by avoiding unnecessary endoscopy.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"17 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336252","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":"Effect of Depressive Symptoms on Weight among Adults at Al-Najaf Province: A case-control Study","authors":"Mohammed Abbas Mohammed, Salam Jasim Mohammed","doi":"10.36330/kmj.v20i1.16222","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.16222","url":null,"abstract":"Background: Obesity and major depression disorder are two of the most common diseases in the world. They are also big problems because they have a very strong effect on people's health and well-being, but also because of their high morbidity and mortality rates and socioeconomic effect. Aim of the study: This study to study the association between obesity and depression, and to explore the link between body mass index and socio-demographic characteristics. Patients and methods: A case-control study utilized a random sample of 300 subjects (100 obese group and 200 normal weight group) attending diabetes and endocrinology center at Al- Najaf province. All subjects have been taken randomly from adult individuals with age range between (18-60) years in Al-Najaf province. The data were collected from October to the February. The obtained data analyzed by Version 28 of the Statistical Package for the Social Sciences (SPSS).  Results: The current study found a significant association between obesity and depression, indicates that those with moderate/severe depression scores are more likely to be obese than those with mild depression or no depression (odds ratio = 2.306 times, 95% CI: 1.360-3.910). With (p = 0.002). The relationship between obesity and socio-demographic factors, this study found positive association between obesity and exercise (p = 0.001) and family history of obesity (p = 0.037), while the other characteristics were not significant. Conclusions: The current study concluded that those who had moderate or severe depression symptoms were more likely for developing obesity than those who had a mild or no depression symptoms.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"5 43","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337083","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 Prevalence of Hashimoto's Thyroiditis among Rheumatoid Arthritis Patients","authors":"Baneen Ali Diab, Rana Fadhil Obaid","doi":"10.36330/kmj.v20i1.14270","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.14270","url":null,"abstract":"Background: Rheumatoid arthritis is an inflammatory illness that affects the entire body but its cause is unknown. There has been a considerable debate about the relation between thyroid gland and Rheumatoid arthritis. Aim of the study: To determine the frequency of Hashimoto's thyroiditis in patients with Rheumatoid Arthritis and determine whether patients with Rheumatoid arthritis are at higher risk of Hashimoto's thyroiditis. Patients and methods: This study is a cross-sectional observational study done in the governorate of Najaf from September 2022 to February 2023 involving 140 participants diagnosed with Rheumatoid arthritis, determined by rheumatologist doctors in line with ACR/EULAR 2010 Criteria and serological testing. Patients including 16 males and 124 females, ranging between the ages of 20 and 60. All participants underwent complete clinical and laboratory assessments. The data were collected during the direct patient interview and the information from the questionnaire, verbal approval has been received from the study participant.  Results: The frequency of Hashimoto's disease in the selected patients of rheumatoid arthritis (N=140), was 45 (32.14%), While euthyroidism (Rheumatoid arthritis patients without Hashimoto’s) was 95(67.9%). Hashimoto's disease included subclinical 9 (6.4%) and overt Hashimoto's thyroiditis 36(25.7%). Conclusions: HT is frequent among patients with RA. Therefore, there is a need of screening of thyroid hormone dysfunction as well as presence of Anti-TPO antibodies as markers of HT in RA patients particularly in young patients, females, and those with high disease activity. The association was a significance among RA patients with HT and ACCP, BMI, and ESR.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336192","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":"Evaluating the Effect of Copper Oxide Nanoparticles after Added to the Maxillofacial Silicone on the Adherence of Staphylococcus Epidermidis","authors":"Ahmed Jameel Mashloosh, Faiza M. Abdul-Ameer","doi":"10.36330/kmj.v20i1.14459","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.14459","url":null,"abstract":"Background: Maxillofacial defects may arise from congenital, developmental, traumatic, or surgical procedures. The presence of such defects may adversely affect an individual's appearance and function, resulting in an inability to lead a typical life and impacting their psychological well-being. Surgical reconstruction is often regarded as the primary therapeutic option in such instances. However, it may not be feasible in numerous cases due to various unfavorable conditions. Consequently, the need for maxillofacial prosthesis reconstruction becomes obligatory. Purpose: This study assesses the antibacterial efficacy of copper oxide nanoparticles at different rates against Staphylococcus epidermidis after incorporation into maxillofacial silicone. Methods: A pilot study was first conducted in Iraq and copper oxide nanoparticles were added to VST50F silicone elastomer in different five percentages (0.01 wt%, 0.02 wt%, 0.03 wt%, 0.04 wt%, and 0.05 wt%). Thirty specimens were prepared and grouped into six groups: one control group and five experimental groups, and then the best effective two percentages (0.03 wt% and 0.04 wt%) were selected for the main study. Thirty specimens for the main study were divided into three groups: control group (A) and two experimental groups (B and C). A statistical analysis was done with an ANOVA and the Games-Howell multiple comparison test (P < 0.05). The data's normal distribution and homogeneity were assessed. Field emission scanning electron microscopy (FES-EM) and Fourier transform infrared spectroscopy (FTIR) were also conducted. Results: The statistical analysis showed a significant difference between all groups with P < 0.05. There was a significant difference between control group A and experimental groups B and C with P < 0.05, as well as between experimental groups B and C (P < 0.05). FESEM showed that nanoparticles were distributed well within the silicone matrix. FTIR spectra proved no chemical reaction to occurr between the copper oxide nanoparticles and VST50F silicone. Conclusion: Incorporating copper oxide nanoparticles into VST50F maxillofacial silicone improved their antibacterial efficacy against Staphylococcus epidermidis.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337686","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 Age on Right Ventricular Systolic Function Using Traditional Echocardiographic Measures","authors":"Elham Hussien Manhal Al-Obaidi, Asaad Hasan Noaman Al-Aboodi","doi":"10.36330/kmj.v20i1.15055","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.15055","url":null,"abstract":"Background: In a wide range of clinical settings, comprehensive evaluation of the right ventricle has become increasingly essential. Measures of right ventricle systolic function, including fractional area change, tissue Doppler, S velocity, tricuspid annular plane systolic excursion, show a significant variation in previous studies and different data known regarding how these measurements change with age. Aim of the study: The aim of this study is to evaluate the effects of age on right ventricle systolic function by using conventional 2D echocardiographic assessment. Patients and methods: Comprehensive transthoracic echocardiography examinations were performed on 103 healthy adult volunteers, mean age 37.1±11.9 years (range: 20-66), to determine age related changes in right ventricle dimensions and function. Results: The assessment of right ventricle function demonstrates slightly significant differences in tricuspid annular plane systolic excursion (r= -.197, p = .047), and FAC (r= -.241, p = .015), among age groups, with a non-significant very small negative relationship between age and tissue Dopplers (r= -.0925, p = .355). Conclusions: This study has demonstrated that age-adjusted measures are required for the evaluation of right ventricle function. Further, the conventional techniques may ignore mild or slight changes leading to underestimated assessment which regarded as a fundamental challenge for their use; so, the use of advanced techniques which allow early identification of right ventricle dysfunction are recommended since they can detect subclinical dysfunction before anomalies revealed by traditional echocardiography occur. ","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"5 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336621","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":"Estimate the Prevalence of Depression in Type 2 Diabetes Patients","authors":"Zahraa M. Hussein AL-Khaqani, Thanaa Shams Al-Deen Al-Turaihi","doi":"10.36330/kmj.v20i1.16115","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.16115","url":null,"abstract":"Background: Diabetes is a chronic disease characterized by high blood sugar levels, resulting from insulin resistance and the destruction of pancreatic beta cells. This disease is associated with several serious complications that are sometimes life-threatening to patients. One of these complications is that it can depression accompanies patients with type 2 diabetes, as it is a Major Depressive Disorder (MDD), and the most important symptoms are social isolation, sleep disturbances, lack of appetite, loss of desire, and passion for daily activities. Opinions differed about the origin of the emergence of this psychological disorder in terms of the involvement of multiple factors, including internal, and some of them are external to causing this disorder. In this study, we will shed light on one of the complications associated with diabetes, which is depression. Method and Results: This cross-sectional study included the selection of 128 individuals diagnosed with type 2 diabetes from the Diabetes and Endocrinology Center located in Najaf, Iraq from July 2023 to January 2024. The study included 43 men and 85 women. The ages of the participants ranged from 30 to 75 years. Patients were randomly selected during their visit to the center. Results: 31(24.2%) individuals did not manifest any symptoms of depression 75.78% suffered from depression, most of the depressed people were women, and the difference between the sexes was statistically significant p-value (0. 002). Conclusion; Our study highlights a striking connection between type 2 diabetes and depression, with a significantly higher incidence of depression in diabetic patients. Additionally, the fact that females are more likely to suffer from depression compared to males also calls for further research into other factors that could potentially exacerbate mental health issues in type 2 diabetes women.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"4 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337118","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":"Meningioma as a Rare Presentation","authors":"Mais Almumen, Liqaa Mohammed Muslim, Ammar Saeed Rasheed","doi":"10.36330/kmj.v20i1.14672","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.14672","url":null,"abstract":"Background: The most common extra axial primary central nervous system (CNS) tumor is meningioma, accounting for 36% of all CNS tumors. On neuroradiologic and gross assessment, the typical meningioma is lobulated. Cystic variants, although uncommon, are well recognized, and possibly be confused with metastatic or glial tumors. Case presentation: A 40-year-old female patient complaining of headache, Magnetic resonance imaging (MRI) revealed frontoparietal brain cystic lesion with intracystic nodule, given the differential diagnosis of low-grade gliomas, hemangioblastoma, pleomorphic xanthoastrocytoma, pilocytic astrocytoma and rarely meningioma. The histopathological slides showed the diagnosis of meningothelial meningioma (WHO/Mayo Clinic_ Grade I). Immunohistochemistry (IHC) was performed for epithelial membrane antigen (EMA) showing positive membranous stain but IHC staining for glial fibrillary acetic protein (GFAP) was negative for the cytoplasm.  Conclusions: Patient with cystic meningioma was reported. There is no absolute test for preoperatively distinguishing it from the most prevalent other gliomas. So avoiding any extra cost and time loss, angiographic assessment and cooperation with a histopathologist are of clinical importance for the identification of these possibly curable neoplasms.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"4 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141337319","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 Correlation between Serum Levels of Progranulin and Inflammatory Markers in Patients with Chronic Obstructive Pulmonary Disease","authors":"Fatima Ali Abdulwahed Alkyoon, Falah Mahdi Dananah","doi":"10.36330/kmj.v20i1.15052","DOIUrl":"https://doi.org/10.36330/kmj.v20i1.15052","url":null,"abstract":"Back ground: the Chronic Obstructive Pulmonary Disease (COPD) is a chronic Inflammatory disease of the airways and/ or parenchyma usually characterized by progressive irreversible airflow with accompanying respiratory symptoms like dyspnea, cough, production of sputum, and/or exacerbations. The pathophysiology Of COPD involves bronchitis and /or emphysema, the effect of inflammation occurs in the lung and also have systemic effect, most common causes is tobacco smoking, occupational pollution, indoor pollution. Progranulin (PGRN) is defined as precursor of pleiotropic glycosylated protein, it has significant role in process of inflammation, angiogenesis, neoplasia, cell development, cell cycle, embryogenesis, wound healing, modification of autoimmune process, highly found in several type of cells like respiratory epithelial cells. Objective: The aim is to study relationship between serum level of PGRN and inflammatory markers in COPD patients. Material and method: A case control study composed of 40 patients with COPD and 45 controls, demographic characteristic, pulmonary function test, blood investigation include CRP-titer, WBC and plasma PGRN were measured and made comparison of data in cases with controls, data collected were statically analysis by SPSS. Result: The study showed that, there was no significant correlation between serum progranulin level, WBC and C-Reactive Protein titer in COPD patients (P value >0.05). Conclusions: It was concluded that PGRN level in COPD patients don’t correlate with CRP titer level or with WBC.","PeriodicalId":507092,"journal":{"name":"Kufa Medical Journal","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141336088","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}