JNMA; journal of the Nepal Medical Association最新文献

{"title":"Perinatal Transmission of Dengue in a Neonate: A Case Report.","authors":"Binita Chemjong, Luna Amatya, Binaya Raj Ghimire, Ganesh Dangal, Sonu Bharati, Sunita Maharajan","doi":"10.31729/jnma.8771","DOIUrl":"10.31729/jnma.8771","url":null,"abstract":"<p><p>Vertical transmission of dengue is rare. However, the rapid rise of dengue infection is a risk in pregnancy which can lead to preterm delivery, low birth weight, stillbirth, miscarriage, neonatal morbidity and mortality. Here, we present a case of perinatal transmission of dengue in a term neonate who presented with fever on second day of life and desaturation without respiratory distress. Laboratory findings showed thrombocytopenia, dengue antigen NS1/IgM positive and treatment was started. There was positive maternal history of dengue 10 days prior to delivery. Hence, early investigations with prompt interventions was done leading to uneventful recovery.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"700-701"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629313","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":"Assessment of Quality of Sleep and Daytime Sleepiness in Medical Professionals and Students in a Medical College : A Descriptive Crosssectional Study.","authors":"Sundar Pandey, Aabishkar Parajuli, Deepak Paudel, Deepak Aryal, Anmol Singh Shrestha, Mahesh Raj Ghimire, Kapil Neupane, Dipim Gautam, Bikash Poudel","doi":"10.31729/jnma.8780","DOIUrl":"10.31729/jnma.8780","url":null,"abstract":"<p><strong>Introduction: </strong>Poor sleep quality is a global public health issue particularly more prevalent in medical professionals and students. Despite various health and occupational risks, research is still lacking regarding the quality of sleep and its related factors among medical professionals and students in our region. Therefore, our study aimed to estimate the prevalence of poor sleep quality in this population.</p><p><strong>Methods: </strong>This observational cross-sectional study was conducted among medical professionals and students of Devdaha Medical College from December 2023 to June 2024 after ethical approval from the Institutional Review Board. Data regarding sleep quality and excessive daytime sleepiness were collected using the Pittsburg Sleep Quality Index (PQSI) and Epworth Sleepiness Scale with premade questionnaires in Google Forms.</p><p><strong>Results: </strong>Among 395 participants, 260 (65.83%) were in the age group 20-25 years and 200 (50.63%) were nursing students. The prevalence of poor sleep quality was 146 (36.96%; 95% CI: 32.19%-42.93%) and the global mean score of PSQI was calculated to be 5.12. Out of the total participants, 255 (64.55%) had excessive daytime sleepiness, 84 (21.26%) participants had one or more sleep problems out of which, snoring was in 40 (10.12%) participants.</p><p><strong>Conclusions: </strong>About one-third of the study population poor sleep quality and day time sleepiness was reported in more than half of the respondents.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"627-632"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629305","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":"Effect of Interpregnancy Interval on Pregnancy Outcome in a Tertiary Care Centre: A Descriptive Cross-sectional Study.","authors":"Poonam Koirala, Ishita Koirala, Sunita Pun, Shweta Karna","doi":"10.31729/jnma.8775","DOIUrl":"10.31729/jnma.8775","url":null,"abstract":"<p><strong>Introduction: </strong>Interpregnancy interval has a major impact on the maternal and fetal health worldwide. Women with short interpregnancy interval show higher rates of low birth weight and preterm babies. So this study aimed to study the effect of interpregnancy interval on pregnancy outcomes.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care center after taking ethical approval from Institutional Review Committee (Reference number: 229/080/081(6-11)E2). Data from September 1^st, 2023 to January 30^th, 2024 was collected. All multigravida women with singleton pregnancy after 28 weeks of gestation who delivered in our hospital with previous birth were enrolled in the study. Point estimate and 95% Confidence Interval were calculated. The data was entered and analyzed using IBM SPSS Statistics version 26.0.</p><p><strong>Results: </strong>Among the women, 31 (3.57%) women had short interpregnancy interval ≤18 months whereas 836 (96.43%) had interpregnancy interval of >18 months. The mean age of the women was 28 years. Previous cesarean section was common indication of cesarean section 27 (87.09%) among women with short interpregnancy interval. These women had higher rates of preterm and low birth weight babies 11(35.58%) and 15(48.38%).</p><p><strong>Conclusions: </strong>Women with short interpregnancy interval ≤18 months had higher preterm births and low birth weight babies. Pregnancy induced hypertension, hypothyroidism and gestational diabetes were increased in women with interpregnancy interval of >18 months.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"675-680"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629310","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":"Reliability and Validity Evidences of Tej Emotional and Behavioral Problem Checklist (TEJ-CL) for Child Mental Health Assessment in Nepal.","authors":"Suraj Shakya, Sabitri Sthapit, Mita Rana, Arun Raj Kunwar, Shital Bhandary","doi":"10.31729/jnma.8785","DOIUrl":"10.31729/jnma.8785","url":null,"abstract":"<p><strong>Introduction: </strong>The Tej Emotional and Behavioral Problem Checklist (TEJ-CL) was developed in Nepalese context to aid assessment of childhood emotional and problems of children. This study aimed to evaluate TEJ-CL's factor structure, reliability, and validity evidences as an add-on and symptom monitoring test.</p><p><strong>Methods: </strong>This cross-sectional validation study included guardians of 320 children (age 5-17 years) from tertiary mental health centers in Kathmandu as referred group, along with 601 children from two schools (private and community) in Kathmandu as non-referred group. IRC was obtained ethical approval (ref: 183 (6-11-E)2/073/074 and ref: 776). TEJ-CL, an 89-item parent-reported questionnaire, served as the index test, while referral status acted as the reference standard. Factor structure, internal consistency, test-retest/cross-informant correlations and criterion validity evidence was assessed using principal component analysis, coefficient alpha, spearman's rank correlation and linear regression models, respectively.</p><p><strong>Results: </strong>Analysis was done using 179 referred and 412 non-referred individuals based on non-missing data. Principal component analysis in referred sample reduced the number of items of questionnaire to 65 from 89 and indicated six factors: externalizing behavioral issues, anxiety/worries, upset/sadness, somatic concern, miscellaneous syndrome, and severe issues with coefficient alpha ranging from .62 to .95. As criterion validity evidence, referred children showed significantly higher scores than non-referred children across composite and factor scores, except for anxiety/worries factor. Similarly, regression analyses within the referred group demonstrated significant associations between factor scores and specific diagnoses.</p><p><strong>Conclusions: </strong>Reliability and validity estimate of questionnaire is comparable to similar empirically based scales. Future research should focus on assessing the tool's generalizability and improving discriminatory indexes.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"646-654"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629328","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":"Vitamin D Deficiency among Blood Transfusion Dependent Beta Thalassemia Children Admitted to Tertiary Level Pediatric Hospital in Nepal: A Descriptive Cross-sectional Study.","authors":"Anil Kumar Shrestha, Sangay Chultim Sherpa, Bindu Gyawali, Manisha Sharma, Santosh Adhikari, Suchitra Shrestha, Susan Bhattarai, Sagar Thapa, Devashish Sharma, Prajwal Paudel, Sushil Gyawali","doi":"10.31729/jnma.8779","DOIUrl":"10.31729/jnma.8779","url":null,"abstract":"<p><strong>Introduction: </strong>Children with beta thalassemia are on regular blood transfusions, which could result in iron deposition in the liver causing decreased synthesis of Vitamin D-25OH. There are limited publications on the association of Vitamin D deficiency with blood transfusion-dependent thalassemia in the Nepalese population. This study aims to determine the prevalence of Vitamin D deficiency among blood transfusion-dependent beta-thalassemia patients.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study conducted among beta-thalassemia major patients under 15 years of age, receiving regular blood transfusion, from July 17, 2022, to July 16, 2023, after attaining ethical approval from Ethical Review Committee, (reference number 155). Data were collected using convenience sampling, and descriptive analyses were performed using Microsoft Excel and Statistical Package for Social Sciences (SPSS) 2024.</p><p><strong>Results: </strong>A total of 127 blood transfusion-dependent beta-thalassemia major patients were included in the study, of whom 82 (64.56%) were female. Among these patients, 104 (81.88%) were aged between 5 and 14 year. Among 127, 41 (32.28%) had Vitamin D insufficiency, and 31 (24.40%) had Vitamin D deficiency. There were 12 (9.44%) underweight children.</p><p><strong>Conclusions: </strong>Vitamin D deficiency was seen in more than half of the children with blood transfusion dependent beta thalassemia major.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"621-626"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629330","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":"Prevalence of Depression among Geriatric Population in a Rural Municipality of Nepal: A Descriptive Cross-sectional Study.","authors":"Maheshor Kaphle, Rajesh Karki, Anjana Thapa, Ramesh Bhatt","doi":"10.31729/jnma.8781","DOIUrl":"10.31729/jnma.8781","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is a major public health concern among the elderly, affecting their quality of life and overall well-being. Despite the increasing elderly population in Nepal, data on the prevalence of depression in rural areas is limited. Therefore, this study aims to assess the prevalence of depression among the geriatric population.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among individuals aged 60 years and above in three randomly selected wards of Shivapuri Rural Municipality. Respondents were selected using consecutive sampling. The Nepali version of the Geriatric Depression Scale (GDS-15) was administered through face-to-face interviews. Ethical approval was obtained from the Institutional Review Committee (Reference number 080/81-437). Descriptive analysis was conducted for categorical variables using the Statistical Package for the Social Sciences (SPSS).</p><p><strong>Results: </strong>The overall prevalence of geriatric depression was 115 (28.75%; 95% CI: 24.36%-33.46%), with a mean depression score of 3.54±3.17. Among those with depression, majority reported mild depression 79 (68.70%) reported mild depression, 79 (31.22%) were male, 88 (30.66%) were under 75 years of age, 46 (35.66%) self-rated their health as not good, 16 (32.66%) had COPD and 33 (30%) were hypertensive elderly.</p><p><strong>Conclusions: </strong>About one third of the elderly reported of having depression and more than 50% had mild depression. The depresson was more in age group less than 75 years, male, married and in nuclear family.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 278","pages":"633-638"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629314","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":"Hypertensive Retinopathy among Hypertensive Patients in a Tertiary Care Centre: A Descriptive Cross-sectional Study.","authors":"Anjila Basnet, Nilshan Rai, Shambhu Kumar Sahani, Anil Pathak, Bishal Nepali","doi":"10.31729/jnma.8761","DOIUrl":"10.31729/jnma.8761","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension manifests in the eyes as retinopathy, choroidopathy, and optic neuropathy of which retinopathy can be used as a predictor for systemic morbidities and mortalities. The study aims to determine the prevalence of hypertensive retinopathy among hypertensive patients visiting the outpatient Department of Ophthalmology in a tertiary care center.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted among hypertensive patients from 4^th April to 19^th November 2023 after obtaining ethical approval from the Institutional Review Committee (Reference number: 2079/80/96). A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval.</p><p><strong>Results: </strong>Among 161 hypertensive patients, hypertensive retinopathy was present in 70 (43.48%) (35.82-51.14, 95% Confidence Interval). Grade I hypertensive retinopathy accounted for 35 (50%) followed by Grade II Hypertensive Retinopathy in 17 (24.29%), Grade III Hypertensive Retinopathy in 14 (20%) and Grade IV Hypertensive Retinopathy in 4 (5.71%) in the study participants.</p><p><strong>Conclusions: </strong>The prevalence of hypertensive retinopathy was found to be higher than other studies done in similar settings.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 277","pages":"597-601"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629316","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":"Migration of Medical Doctors from Nepal: Analyzing Trends and Policy Implications.","authors":"Lochan Karki, Bikrant Dhakal, Kailash Kumar Bhandari, Suzit Bhusal, Ashlesha Chaudhary","doi":"10.31729/jnma.8750","DOIUrl":"10.31729/jnma.8750","url":null,"abstract":"<p><p>One way migration of health care professionals especially from low-income countries like Nepal has become a concerning issue where the already fragile health system of the country faces challenges of losing skilled health care professionals to high-income countries. This trend analysis provides insights into the dynamics of Nepal's healthcare workforce migration, it offers a tailored understanding of factors influencing migration patterns, and its impact on the genera! population of the country and globally. It helps formulate targeted policies for workforce retention, resource planning, and addressing the country's healthcare needs and comparison with the global context. Analyzing the migration trends of medical professionals enhances medical literature by offering a comprehensive understanding of the factors affecting healthcare systems, public health, economics, education, and policy development. This knowledge plays a vital role in shaping future policies in the field of medicine in Nepal.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 277","pages":"614-617"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629318","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":"Cesarean Section under General Anesthesia over 10 Years at Tertiary Care Center: A Descriptive Cross-sectional Study.","authors":"Smriti Basnet, Prabineshwor Prasad Lekhak, Prabin Subedi, Sushila Lama Moktan","doi":"10.31729/jnma.8738","DOIUrl":"10.31729/jnma.8738","url":null,"abstract":"<p><strong>Introduction: </strong>The global surge in cesarean deliveries necessitates safe anesthetic practices to optimize outcomes. While the neuraxial block is the preferred method, specific conditions warrant general anesthesia. This study is aimed to determine the prevalence of cesarean sections under general anesthesia at a tertiary care center.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted on cesarean sections performed between April 14, 2013, and April 13, 2023, at a tertiary care center. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20092023/01). Total sampling was done. Data for the past ten years were manually collected from hospital records using a self-structured proforma and analyzed using Microsoft Excel 2018 and IBM SPSS version 26. The point estimate and 95% confidence interval were calculated for the study.</p><p><strong>Results: </strong>In this study, there were 216 (2.98%) (95% CI: 2.59-3.38%) cesarean sections under general anesthesia in 10 years. Notably, among them, there were 103 (47.69%) primigravida, nullipara 130 (60.19%), 135 (62.50%) with no living children, and 161 (74.54%) without any past abortions. In most cases, 182 (84.26%) were emergency procedures and 34 (15.74%) were elective. Fetal bradycardia with distress was the primary indication observed in 121 (56.02%) cases, followed by 32 (14.81%) maternal requests. Additionally, 21 (2.66%) cases were found initially planned as cesarean sections under subarachnoid block but were converted to general anesthesia. The prevalence in this study was found within the recommended limits.</p><p><strong>Conclusions: </strong>The findings highlight that the majority of these procedures were emergency cases, predominantly due to fetal distress, with a notable proportion involving primigravida and nulliparous women.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 277","pages":"592-596"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629265","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":"Household and Environmental Typhoid Fever Transmission in Bandar Lampung City, Indonesia: A Case-Control Study.","authors":"Prayudhy Yushananta, Muflichah Febriani Eka Putri","doi":"10.31729/jnma.8744","DOIUrl":"10.31729/jnma.8744","url":null,"abstract":"<p><strong>Introduction: </strong>Typhoid fever is an endemic disease that causes substantial morbidity and mortality in low and middle-income countries. A case-control study was conducted to understand the risk factors for typhoid fever.</p><p><strong>Methods: </strong>The study applied the case-control method to compare past exposure between participants who had typhoid fever (cases) and participants who did not have typhoid fever (controls) after obtaining ethical approval (No. 244/KEPK-TJK/III/2023). We identified and surveyed patients with typhoid fever confirmed by blood culture. Control subjects were randomly selected neighbors of cases with no history of typhoid fever. Both cases and controls were interviewed at home. During the visit, a structured observation of their living environment was performed. Multivariable analysis was applied using logistic regression and odds ratio to evaluate the relationship between exposure and risk of typhoid fever. Data collected was entered into Statistical Package for Social Science (SPSS) after being checked for completeness, edited, and coded.</p><p><strong>Results: </strong>The study found that typhoid fever was significantly associated with not washing hands with soap (Adjusted Odds Ratio = 6.08; 95% CI 2.43 - 15.21), eating unwashed raw vegetables (Adjusted Odds Ratio = 4.63; 95% CI 1.62 - 11.73); eating mobile food (Adjusted Odds Ratio = 10.89; 95% CI 4.08 - 29.05); eating street food (Adjusted Odds Ratio = 3.28; 95% CI 1.27 - 8.45); no access to safe drinking water (Adjusted Odds Ratio = 6.08; 95% CI 2.11 - 17.52); no access to healthy latrines (Adjusted Odds Ratio = 3.59; 95% CI 1.47 - 8.78).</p><p><strong>Conclusions: </strong>The study found that typhoid fever was associated with inadequate food and personal hygiene, and poor housing.</p>","PeriodicalId":520657,"journal":{"name":"JNMA; journal of the Nepal Medical Association","volume":"62 277","pages":"564-569"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629268","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}