Journal of General and Family Medicine最新文献

{"title":"Educational strategies related to information science and technology for medical students: General medicine physicians' perspective","authors":"Kiyoshi Shikino MD, PhD, HPED, FACP,&nbsp;Masaki Tago MD, PhD, FACP,&nbsp;Takashi Watari MD, DTMH, MS, MCTM,&nbsp;Yosuke Sasaki MD, PhD,&nbsp;Hiromizu Takahashi MD, PhD,&nbsp;Taro Shimizu MD, PhD, MPH, MBA, FACP","doi":"10.1002/jgf2.656","DOIUrl":"10.1002/jgf2.656","url":null,"abstract":"<p>The Model Core Curriculum for Medical Education in Japan was revised in 2022. It aimed to reflect changes in the nature of medical care, including the advancement of medical technology through the use of information science and technology and artificial intelligence in the Society 5.0 era. We summarize recommendations for good practice regarding learning strategies from the perspective of general medicine.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.656","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135634174","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":"Brown crusts on infant owing to contact dermatitis associated with ethanol disinfection","authors":"Yuki Matsuhisa MD,&nbsp;Tsuneaki Kenzaka MD, PhD,&nbsp;Hideo Hirose MD, PhD,&nbsp;Tadao Gotoh MD","doi":"10.1002/jgf2.657","DOIUrl":"10.1002/jgf2.657","url":null,"abstract":"<p>A 2-year-old girl developed dermatitis with atypical brown crusts after ethanol disinfection. Since many Oriental people have genetically reduced acetaldehyde dehydrogenase type 2 (ALDH2) activity, ethanol disinfection causes acetaldehyde to accumulate in the skin, resulting in dermatitis.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.657","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135636448","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":"Protecting the primary care physicians' well-being","authors":"Kiyoshi Shikino MD, PhD, MHPE, FACP,&nbsp;Akemi Ando MD, PhD,&nbsp;Yutaro Okamoto MD,&nbsp;Asako Miyazawa MD, PhD,&nbsp;Taku Harada MD, PhD","doi":"10.1002/jgf2.654","DOIUrl":"https://doi.org/10.1002/jgf2.654","url":null,"abstract":"<p>Seminar participants collaborated as a team to improve their organization, work environment, and labor issues using the Plan-Do-Check-Act (PDCA) cycle. The PDCA cycle helps healthcare providers identify risks and hazards in their work environment and address daily issues. It guides them in planning and executing improvements while enabling progress tracking and encouraging further considerations for implementation.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.654","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109176013","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":"Relationship between nurses' perceptions of the benefits/challenges of nursing and degree of interprofessional and intraprofessional collaboration in all-inclusive services combining day services, overnight stays and home-visit nursing for the older people living at home","authors":"Nobuko Katahira PhD, RN,&nbsp;Satomi Maruo DSN, RN","doi":"10.1002/jgf2.655","DOIUrl":"10.1002/jgf2.655","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Many countries are experiencing rapid population aging, and the provision of support for older adults with diseases or disabilities to continue living in their communities is a major global challenge. Japan has established multifunctional long-term care in small group homes and home-visit nursing (MLSH) as a service category that integrates medical and care services. These services focus on nursing functions to support continuous, long-term home, and end-of-life care for older adults with high levels of medical care dependency. This study aimed to clarify the relationship between nurses' perceptions of nursing benefits/challenges and the degree of interprofessional collaboration in the context of MLSH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a mail questionnaire survey of MLSH facilities throughout Japan. All facilities in Japan that had been operating for at least 1 year were included. We analyzed 182 responses (response rate: 36.0%; valid response rate: 98.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Comparison of scores representing the degree of interprofessional collaboration perceived by nurses showed the highest score was for colleague nurses (3.9 ± 0.5) and the lowest was for external care managers (2.5 ± 0.9). Compared with the weak collaboration group, the strong collaboration group had higher perceptions of the benefits of nursing and lower perceptions of the challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The results of this study suggest that strong collaboration allows teams to achieve sufficient effects of care while reducing related challenges. It may be necessary to promote collaboration with external professionals to appropriately manage service users' worsened conditions and improve the quality of care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068761","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":"Author reply to “How to distinguish crowned dens syndrome from acute meningitis?”","authors":"Hiroki Isono MD, MBA, PhD,&nbsp;Haruka Kuno MD,&nbsp;Takunori Hozumi MD,&nbsp;Ken Emoto MD,&nbsp;Sho Nishiguchi MD, PhD,&nbsp;Masahiro Sakai MD,&nbsp;Madoka Ito MD,&nbsp;Koichi Kitamura MD,&nbsp;Kazuhito Hirose MD,&nbsp;Eiji Hiraoka MD, PhD,&nbsp;Naoto Ishimaru MD, PhD,&nbsp;Hiroyuki kobayashi MD, PhD,&nbsp;Yasuharu Tokuda MD, MPH","doi":"10.1002/jgf2.647","DOIUrl":"https://doi.org/10.1002/jgf2.647","url":null,"abstract":"<p>We thank the reader for his knowledgeable comments on our study.<span>^{1, 2}</span> We were asked to disclose how the indication for lumbar puncture was determined during this study. Unfortunately, there was no uniform indication for lumbar puncture in this study, neither was data collected on the reason the physician performed the lumbar puncture in each case. This study was a retrospective study, and the decision to perform a lumbar puncture was at the discretion of the examining physician in each hospital. As you mentioned, determining which patients presenting with acute neck pain should undergo lumbar puncture is subjective.</p><p>From the present study, cervical rotation restriction (inability to rotate the neck or pain with even slow neck rotation) may be a characteristic finding of CDS. This is a different physical finding from the Jolt accentuation headache (accentuation of headache by horizontal rotation of the head at a frequency of two to three times per second) observed in meningitis. If cervical rotation restriction with neck pain is less frequent in meningitis, a finding of restricted cervical rotation with neck pain may be diagnostic of CDS and rule out meningitis. We hope that clinical criteria for diagnosing CDS, including cervical rotation restriction, that are distinct from those of meningitis will be developed.</p><p>All authors meet the ICMJE authorship criteria. HI wrote the manuscript, and all of author reviewed and edited the manuscript.</p><p>The authors have stated explicitly that there are no conflicts of interest in connection with this article.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.647","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109164366","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":"How to distinguish crowned dens syndrome from acute meningitis?","authors":"Saori Adachi MD,&nbsp;Toshiki Uchihara MD, PhD,&nbsp;Shuta Toru MD, PhD","doi":"10.1002/jgf2.644","DOIUrl":"https://doi.org/10.1002/jgf2.644","url":null,"abstract":"<p>We read the article by Isono et al.<span>¹</span> with great interest. We were impressed not only by the largest number of cases recruited into this collaborative study but also by the detailed data collection under a unified protocol, which successfully delineated clinical features of crowned dens syndrome (CDS).</p><p>As clarified, neck pain exacerbated by rotation or pressure, accompanied by fever and an elevated inflammatory response on blood tests strongly suggests CDS. However, this clinical picture may mimic acute meningitis with head/neck pain with jolt accentuation especially when accompanied by fever.<span>²</span> For example, one of our patients presented with neck pain accompanied by headache, without fever or loss of consciousness, but an increased cell count on CSF led to the diagnosis of aseptic meningitis. Therefore, neck pain does not preclude the possibility of meningitis. Furthermore, Mizumoto<span>³</span> reported a CDS patient with pleocytosis, which alert the possibility of meningitis even in the presence of CDS. Because it is not yet known when calcification around the dens as a hallmark of CDS appears, persists, or disappears, overreliance on calcification around dens may overlook CDS mimics like meningitis. Indeed, among the CDS patients by Isono and colleagues, 8% had impaired consciousness and 15% underwent lumbar puncture, suggesting that some of these CDS patients may mimic meningitis to warrant an emergent need of lumbar puncture. Although our department of neurology shares this feeling, the major difficulty is how to select candidates for lumbar puncture to rule out possible coexistence of meningitis. It is necessary to establish clinical criteria for CDS in distinction from meningitis, which needs a prospective approach. Before such criteria are available, indication of lumbar puncture may remain relative. Therefore, it is currently very informative if the authors are ready to disclose how the indication of lumbar puncture was decided during this study. This is necessary and helpful to establish reliable management of CDS.</p><p>The authors declare no conflict of interest regarding this submission.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.644","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109164367","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":"Anticipated deaths with physician care (mitori) at home in one town in Japan: A preliminary report","authors":"Nobuyuki Kajiwara MD, PhD,&nbsp;Shinya Suezaki MD,&nbsp;Megumi Okamoto,&nbsp;Yasuo Kuwahara,&nbsp;Masanori Okui MD, PhD,&nbsp;Akiyoshi Nishimura MD, PhD,&nbsp;Hirono Takabayashi MD, PhD","doi":"10.1002/jgf2.648","DOIUrl":"https://doi.org/10.1002/jgf2.648","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There are few reports on the numbers of anticipated deaths (<i>mitori</i> [看取り]) at home in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We used the Japanese death certificate system (<i>shiboukohyou</i> [死亡小票]) for Toyono town citizens who died between 2020 and 2022 and judged a death to constitute <i>mitori</i> when the certificate was not written by a doctor referred from the police.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 756 deaths, 109 (14.4%) were <i>mitori</i> at home. Deaths at home were 144 and <i>mitori</i> at home accounted for 75.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p><i>Shiboukohyou</i> appear to provide numbers of <i>mitori</i> at home. Death certificate should include a space which shows <i>mitori</i> or not.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.648","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109162430","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":"Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan","authors":"Takayuki Ando MD, MPH,&nbsp;Takashi Sasaki PhD,&nbsp;Yukiko Abe BA,&nbsp;Yoshinori Nishimoto MD, PhD,&nbsp;Takumi Hirata MD, MPH, PhD,&nbsp;Junji Haruta MD, PhD,&nbsp;Yasumichi Arai MD, PhD","doi":"10.1002/jgf2.651","DOIUrl":"https://doi.org/10.1002/jgf2.651","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Care fragmentation, characterized by the uncoordinated involvement of multiple healthcare providers, leads to inefficient and ineffective healthcare, posing a significant challenge in managing patients with multimorbidity. In this context, “polydoctoring,” where patients see multiple specialists, emerges as a crucial aspect of care fragmentation. This study seeks to develop an indicator to assess polydoctoring, which can subsequently enhance the management of multimorbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline survey data from the Kawasaki Aging and Wellbeing Project (KAWP) involving independent community-dwelling older adults aged 85–89 were utilized in this cross-sectional study. Polydoctoring measure was defined as the number of regularly visited facilities (RVFs). The association of RVF with the Fragmentation of Care Index (FCI) and the outcome measures of polypharmacy and ambulatory care costs were examined as indicators of care fragmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis comprised 968 participants, with an average of 4.70 comorbid chronic conditions; 65.3% of the participants had two or more RVFs, indicating polydoctoring. A significant correlation between RVF and FCI was observed. Modified Poisson regression analyses revealed associations between higher RVF and increased prevalence ratio of polypharmacy. Likewise, a higher RVF was associated with higher outpatient medical costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RVF was significantly correlated with FCI, polypharmacy, and higher outpatient medical costs. Unlike complex indices, RVF is simple and intuitively comprehensible. Further research is needed to evaluate the impact of care fragmentation on patient outcomes, considering factors such as RVF thresholds, patient multimorbidity, and social support. Understanding the influence of polydoctoring can enhance care quality and efficiency for patients with multimorbidity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.651","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109173093","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 impact of patients' social backgrounds assessment on nursing care: Qualitative research","authors":"Junki Mizumoto MD,&nbsp;Daisuke Son MD, PhD,&nbsp;Masashi Izumiya MD, PhD,&nbsp;Shoko Horita MD, PhD,&nbsp;Masato Eto MD, PhD","doi":"10.1002/jgf2.650","DOIUrl":"https://doi.org/10.1002/jgf2.650","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although nurses are expected to address the social determinants of health (SDH) in clinical settings, the perspectives of front-line nurses on the integration of SDH into their clinical practice remain unclear. Understanding the dynamism of this integration and its outcomes can yield crucial insights into effective nursing care. This study aims to elucidate the integration and adoption of tool-based SDH assessment nursing programs and their impacts on daily nursing care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted qualitative research at a small community-based hospital in Japan, where a tool-based program characterized by social background interviews and documentation was implemented. Nurses at the hospital were recruited via purposive and snowball sampling. After hypothesis generation, semi-constructed in-depth online interviews were conducted. Each interview lasted between 30 and 50 min. The data were analyzed via thematic analysis using the framework approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 16 nurses participated. Participants' incorporation of the novel SDH assessment program was bolstered by prior learning and their recognition of its practical value. Institutional support and collaborative teamwork further facilitated the adoption of this innovation. Enhanced knowledge about the social contexts of their patients contributed to increased respect, empathy, and self-affirmation among participants, consequently enhancing the quality of nursing care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Through team-based learning, reflection, and support, nurses can integrate a tool-based SDH assessment program into their daily nursing practice. This program has the potential to empower nurses to deliver more holistic care and redefine their professional identity. Further research is warranted to assess patient-reported outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109173092","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":"Disseminated cryptococcosis in a geriatric man following high-dose systemic steroid therapy for severe COVID-19 pneumonia","authors":"Hinako Nawa MD,&nbsp;Dai Akine MD,&nbsp;Tomohiro Tamura MD, PhD,&nbsp;Koyumi Saito MD,&nbsp;Takayuki Kaburagi MD,&nbsp;Teppei Sasahara MD, PhD","doi":"10.1002/jgf2.652","DOIUrl":"https://doi.org/10.1002/jgf2.652","url":null,"abstract":"<p>An 88-year-old man was treated with high-dose systemic steroid therapy for COVID-19 and idiopathic interstitial pneumonia months before admission to the hospital because of swelling and redness in his left arm. <i>Cryptococcus neoformans</i> was detected in his blood sample on day eight of admission, and despite antifungal therapy, he died on day 43. Clinicians should be vigilant about the risk of prolonged immunosuppression as a side effect of high-dose systemic steroid usage for COVID-19.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"109172785","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}