Acta medica Indonesiana最新文献

{"title":"Factors Associated with Hepatitis B and Hepatitis C among Infected Patients in Indonesia and Their Knowledge and Attitude: A Multicenter Observational Study.","authors":"Juferdy Kurniawan, Gita Aprilicia, Hery Djagat Purnomo, Cecilia O Permatawedi, Ulfa Kholili, Tehar Karo-Karo, Haris Widita, Aritantri Darmayani, Arif Nur Widodo, Nenny Agustanti, Saptino Miro, Suyata Suyata, Fauzi Yusuf, Catharina Triwikatmani, Syifa Mustika, Rini R Bachtiar, Fandy Gosal, I Ketut Mariadi, Irsan Hasan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections are global health problems, including in Indonesia. The purpose of this study was to assess the knowledge and attitudes about HBV and HCV infection among infected patients in Indonesia.</p><p><strong>Methods: </strong>This cross-sectional study used a questionnaire survey. The questionnaire was adapted and translated into Indonesian language, and trialed with 27 HBV and 27 HCV patients. The final validated questionnaire was later used in the target population. Patients diagnosed with Hepatitis B or Hepatitis C were included. The patients were enrolled from November 2019 until February 2020 in sixteen multicenter locations. Multivariate analysis with logistic regression was conducted to determine the factors that are associated with the knowledge and attitude among HBV and HCV patients toward their illness.</p><p><strong>Results: </strong>A total of 931 HBV patients and 254 HCV patients were included in this survey. The proportion of infected patients with adequate knowledge of Hepatitis B and Hepatitis C was 72.1% and 53.9%, respectively. Positive attitudes about Hepatitis B and Hepatitis C were 28.5% and 41.3%, respectively. Multivariate analysis revealed that higher education level, higher income level, diagnosis duration of more than 5 years, and receiving of antiviral therapy were independent factors associated with adequate knowledge about Hepatitis B among HBV patients. Among HCV patients, independent factors associated with adequate knowledge about Hepatitis C were being married, higher education level, higher income level, and receiving antiviral therapy. Moreover, older age and receiving of antiviral therapy were independent factors associated with positive attitudes towards Hepatitis B among HBV patients. However, only higher education level was found to be an independent factor associated with positive attitudes towards Hepatitis C among HCV patients.</p><p><strong>Conclusion: </strong>The knowledge and attitude of patients regarding HBV and HCV were quite low among infected patients in Indonesia.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618968","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 Relationship Between Appropriateness of Antibiotic Use Based on the Gyssens Algorithm and Mortality: A Retrospective Cohort Study in Indonesian Tertiary Hospital.","authors":"Fadrian Fadrian, Gestina Aliska, Widya Nur Utami","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Some studies have reported that antibiotic use as therapy and prophylaxis in hospitals is inappropriate in approximately 9% to 64% of cases. The Gyssens algorithm is used for qualitative evaluation by assessing the appropriate antibiotic use. This study aimed to determine and evaluate the quality of antibiotic use in inpatients at Dr. M. Djamil Central General Hospital by using the Gyssens algorithm.</p><p><strong>Methods: </strong>This was a retrospective cohort study at Dr. M. Djamil Central General Hospital from January to December 2021. We collected data from the medical records of inpatients who received antibiotics using a random sampling technique, and the number of patients from each department was calculated through a preliminary survey.</p><p><strong>Results: </strong>There were three hundred and sixty samples from the population that met the inclusion and, adults (59.4%), patients treated for >14 days (38.9%), patients discharged with improvement (66.9%), and patients diagnosed with pneumonia (49.5%). Most antibiotics were appropriate (56.5%), with ceftriaxone being the most commonly used antibiotic (199 cases ). Appropriate antibiotic use (Gyssens 0) is mostly found in the Internal Medicine Department Meanwhile, antibiotic use without indications (Gyssens V) is mostly found in the Surgery Department. A significant correlation was found betweenthe appropriateness of antibiotic administration patient outcomes after discharge from the hospital (p < 0.05). There was an increase in the risk of death in inappropriate antibiotic use (Gyssens I-IV) and antibiotic use without indications (Gyssens V) by 1.96 and 4.05 times, respectively.</p><p><strong>Conclusion: </strong>There are many cases of inappropriate antibiotic use in Dr. M. Djamil Central General Hospital; therefore, education regarding appropriate antibiotic use is necessary.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618944","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 Severity, Quality of Life, and Correlated Factors of Chronic Kidney Disease-associated Pruritus between Hemodialysis and Kidney Transplant Patients: A Cross-sectional Study.","authors":"Melody Febriana Andardewi, Lili Legiawati, Danang Tri Wahyudi, Maruhum Bonar Hasiholan Marbun, Larisa Paramitha Wibawa","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease-associated pruritus (CKD-aP) mainly occurs in hemodialysis (HD) patients and could persist in kidney transplant (KT) recipients. This study aims to compare the severity, correlation of various biochemical factors, and quality of life (QoL) concerning pruritus in CKD.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on HD and KT recipients with chronic pruritus, where the 5-Dimensional (5-D) Itch Scale and Dermatology Life Quality Index (DLQI) were used to evaluate pruritus severity and QoL. Results: Among the 60 subjects, 76.7% of HD patients had moderate-to-severe pruritus, whereas in the KT group, 83.3% experienced mild pruritus (p < 0.001). The median DLQI score was 5 (3-6) and 3 (2-4), respectively (p < 0.001). There was a correlation between hs-CRP and the 5-D itch score in the HD group (r = 0.443; p < 0.05), whereas e-GFR was correlated with the 5-D itch score in the KT group (r = -0.424; p < 0.05).</p><p><strong>Conclusion: </strong>Moderate-to-severe pruritus was more common in HD patients. While pruritus in KT recipients had a mild effect on QoL, pruritus in the HD group had a mild-moderate impact on QoL. There was a correlation between hs-CRP and e-GFR and the severity of pruritus in HD and KT recipients, respectively.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618946","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":"Diagnostic Accuracy of Serum Procalcitonin to Diagnose Sepsis in Advanced Solid Tumor Patients with Fever.","authors":"Erni Juwita Nelwan, Reza Nugraha Yulisar, Randy Adiwinata, Ikhwan Rinaldi, Cleopas Martin Rumende, Robert Sinto","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis of infection in advanced solid tumor patients can be challenging since signs and symptoms might be overlapping due to paraneoplastic condition. Delay diagnosis of existing infection can lead to more severe conditions and increased mortality. Procalcitonin (PCT) has been used to support the diagnosis of bacterial infection and sepsis. Unfortunately, PCT also increases in malignancy even without an infection. We investigated the diagnostic accuracy of PCT in advanced solid tumor patients with fever to diagnose sepsis.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in solid advanced tumor patients with fever patients who were admitted to Cipto Mangunkusumo Hospitals, Indonesia between June 2016 and April 2018. Sepsis was defined using 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference criteria. The diagnostic accuracy of PCT was determined using the receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>A total of 194 subjects were enrolled in this study. 60.3% were female with a mean age of 49.47±12.87 years old. 143 patients (73.7%) with advanced solid tumors. Among this latter group, 39 patients (27%) were sepsis. The ROC curve showed that the levels of PCT for sepsis in advanced solid tumor patients with fever were in the area under the curve (AUC) 0.853 (95%CI 0.785 - 0.921). The Cut-off of PCT in advanced solid tumor patients with fever to classify as sepsis was 2.87 ng/mL, with a sensitivity of 79.5%, and a specificity of 79.8%.</p><p><strong>Conclusion: </strong>PCT has good diagnosis accuracy in advanced solid tumor patients with fever to classify as sepsis, however a higher cut-off compared to non-cancerous patients should be used.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618965","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":"Early Experience of Left Bundle Branch Pacing with Lumenless Lead in a Single Center: A Case Series.","authors":"Evan Jim Gunawan, Johan Johan, Dian Andina Munawar, Dian Larasati Munawar, Beny Hartono, Muhammad Munawar","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Left bundle branch pacing (LBBP) has been subject to increasing interest over the last few years due to its capacity for physiological conduction and its advantages compared to His bundle pacing. His bundle pacing has certain limitations, such as a small pacing area for the His bundle, a high threshold that leads to battery depletion, a low R-wave amplitude that may result in atrial or His oversensing, and ventricular signal undersensing. In this case series, four patients (two female and two male) aged 62.2 ± 8.4 years old with symptomatic sick sinus disease and no scar tissue in the interventricular septum underwent LBBP. All LBBPs were done with standard LBBP using a lumenless SelectSecure 3830 lead (Medtronic®, Minneapolis, USA) with a fixed helix. The lead parameters showed a good R-wave amplitudes (13 ± 7.4 mV) and a low threshold  (0.77 ± 0.17 V @ 0.4 ms). All patients were discharged on the next day. During follow-up period of 13.3 ± 12.9 months, all patients were well and no complications were noted. In conclusion, LBBP may be as an alternative of novel conduction pacing techniques and can be done relatively easy and safe, even with limited experience center.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618966","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":"Expert Panel Recommendations on the Clinical Practice Guidelines for the Diagnosis and Management of Invasive Candidiasis in Indonesia.","authors":"Anna Rozaliyani, Erni Juwita Nelwan, Mardiastuti Wahid, Dita Aditianingsih, Mulya Rahma Karyanti, Siti Pratiekauri, Adityo Susilo, Fathiyah Isbaniyah, Heidy Agustin, Yulia Rosa Saharman, Robiatul Adawiyah, Findra Setianingrum, Vera Irawany, Rudyanto Sedono, Debbie Latupeirissa, Nina Dwi Putri, Winda Sofvina, Mulyati Tugiran","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Invasive candidiasis (IC) ranks among the primary causes of deadly fungal infections. The frequency of IC rises alongside increasing number of patients with altered immune systems, critically ill, chronic diseases, and various medical procedures. The disease causes high morbidity and mortality, as well as prolonged stay and increases hospital costs. The diagnosis and management of IC in Indonesia is still a challenge. Laboratory facilities in identifying pathogenic fungi and susceptibility tests to antifungals are still limited. Clinical awareness and financial support from health policymakers are also insufficient. Early diagnosis is essential for proper treatment to reduce morbidity and mortality rates. Initiated by the Indonesian Pulmonary Mycoses Centre (IPMC), several expert representatives from six medical professional organizations in Indonesia have agreed to set up a meeting series to prepare a joint draft on the diagnosis and management of IC. The expert panel aimed to achieve a consensus on the clinical practice guidelines for diagnosing and treating IC in Indonesia.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618967","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":"High-Dose Vitamin D3 and Tonsillectomy as Therapeutic Management in Henoch-Schönlein Purpura Following Hepatitis B Vaccination: A Rare Case Report.","authors":"Agus Joko Susanto, Felizia Alika Yusman, Fatna Andika Wati, Yeremia Suryo Pratama","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Henoch-Schönlein purpura (HSP) is an immunoglobulin A (IgA)-mediated systemic vasculitis, which is one of the rare adverse reactions to hepatitis B vaccination. Low vitamin D levels were found to be present in the majority of HSP patients.A 19-year-old woman was admitted with a purpuric rash on bilateral lower limbs and joint pain on her left index finger in January 2020. A previous history of rash occurred one week after the patient received her first dose of recombinant hepatitis-B vaccination. Routine hematological examination, creatinine, urinalysis, C3, and C4 showed normal results. HBsAg, Anti-HCV, and ANA tests were negative, and anti-HBs were elevated. Vitamin D is very low. The patient was diagnosed with HSP and given mycophenolate mofetil, methylprednisolone, vitamin D3, and folic acid. Within 1 month of therapy, the rash still occurred frequently, so mycophenolate mofetil was changed to mycophenolic acid, the dose of methylprednisolone was increased and fexofenadine was administered. In the next 3 months, the rash has improved. However, patients reported knee joint pain and hair loss. In May 2021, the patient underwent tonsillectomy due to acute exacerbation of chronic tonsillitis. Thereafter, the patient reported that the rash had completely resolved and never worsened, and the vitamin D assay was normal.Hepatitis B vaccination is one of the etiologies of HSP, although it is rare, so it is important to ask about the vaccination history in patients with suspected HSP. Correction of vitamin D and performing tonsillectomy provide better treatment results in HSP cases in this patient.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618970","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":"Periendoscopic Care Continuum in Acute Cholangitis Caused By Common Bile Duct Stone.","authors":"Rabbinu Rangga Pribadi, Vesri Yoga, Manu Tandan, Abdul Aziz Rani, Dadang Makmun","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute cholangitis (AC) is a biliary tract infection with in-hospital mortality rates reaching up to 14.7%. The underlying condition is biliary obstruction caused by benign and malignant etiologies, as well as bacteriobilia, with commom bile duct (CBD) stone being one of the most common causes. Currently, the diagnosis is validated using Tokyo Guidelines 2018 criteria. Acute cholangitis due to CBD stone should be managed in a comprehensive manner, i.e., periendoscopic care continuum, consisting of pre-endoscopic care, endoscopic management, and post-endoscopic care. Pre-endoscopic care is primarily comprised of supportive therapy, antibiotic administration, optimal timing of endoscopic retrograde cholangiopancreatography (ERCP), pre-ERCP preparation, and informed consent. Endoscopic management is biliary decompression with stone extraction facilitated via ERCP procedure. Selective biliary cannulation should be performed meticulously. Bile aspiration and minimal bile duct contrast injection should be done to minimize the worsening of biliary infection. Endoscopic biliary sphincterotomy, endoscopic papillary balloon dilatation, and/or endoscopic papillary large balloon dilatation are all safe procedures that can be used in AC. Special precautions must be undertaken in critical and severe acute cholangitis patients who may not tolerate bleeding, in whom endoscopic biliary sphincterotomy may be postponed to decrease the risk of bleeding, and biliary decompression may be only attempted without CBD stone extraction. Nasobiliary tubes and plastic biliary stents are equally effective and safe for patients who have only undergone biliary decompression. In post-endoscopic care, management of adverse events and observation of therapy response are mandatory.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141618938","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":"Validation of Drug Resistance in Pneumonia (DRIP) Score as Empirical Antibiotic Failure Predictor in Community-Acquired Pneumonia Patients in Cipto Mangunkusumo Hospital.","authors":"Rohayat Bilmahdi Simanjuntak, Khie Chen Lie, Cleopas Martin Rumende, Murdani Abdullah, Hamzah Shatri, Soekamto Koesnoe, Leonard Nainggolan, Aulia Rizka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The incidence of CAP due to Drug-Resistant Pathogen (DRP) requires broad-spectrum antibiotic therapy, Drugs Resistance in Pneumonia (DRIP) score can predict these cases. The use of the DRIP score can prevent antibiotic failure and long hospitalization, but validation is needed so that the DRIP score can be used according to the local community at Cipto Mangunkusumo National Central Public Hospital.</p><p><strong>Methods: </strong>This research is a retrospective cohort study in CAP patients who were hospitalized during the period January 2019 to June 2020. Data were taken from medical records. Failure of empiric antibiotics occurs when one of these criteria is found: patient mortality, ICU transfer, and escalation of antibiotics as well as length of stay.</p><p><strong>Results: </strong>480 patients met the criteria. There were 331 patients (69%) with a DRIP score of <4 and 149 patients (31%) with a DRIP score of≥4. A total of 283 patients (59%) of antibiotic failures were detailed in 174 patients with a DRIP score <4 and 109 patients DRIP score ≥4. DRIP calibration using the Hosmer-Lemeshow test obtained p-value= 0.667 (p>0.05). AUC observations on the ROC curve obtained 0.651 (95% CI; 0.601-0.700).</p><p><strong>Conclusion: </strong>The DRIP score has low accuracy performance and calibration value in predicting empirical antibiotic failure and poor discriminatory value.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334261","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":"Gaucher Disease: A First Reported Adult Case in Indonesia.","authors":"Ardhi Rahman Ahani, Cosphiadi Irawan, Agnes Stephanie Harahap, Klara Yuliarti, Maria Francisca Ham, Faramitha Nur Izzaty, Damayanti Rusli Sjarif","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 44-year-old female presented with a distended abdomen and fatigue. On physical examination, prominent splenomegaly was found. The laboratory investigations revealed pancytopenia and decreased albumin-globulin ratio. The abdominal ultrasonography revealed splenomegaly, cholelithiasis, and cystitis, and the bone survey showed osteopenia. Differential diagnoses included leukemia, multiple myeloma, and myelofibrosis therefore bone marrow puncture was performed. However, histopathologic examination found Gaucher-like cells in the bone marrow aspiration. The finding of CD68 positivity in Gaucher-like cells by using the immunohistochemistry staining supporting Gaucher disease. To confirm the diagnosis, an examination of glucocerebroside substrate from the patient's blood plasma was performed. Glucosylsphingosine, a deacylated form of glucosylceramide, was markedly elevated. Therefore, the diagnosis of Gaucher disease was confirmed. This is the first reported adult Gaucher case diagnosed in Indonesia.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140334283","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}