American journal of medicine open最新文献

{"title":"Functional Assessment of >18 Years Old Patients at Internal Medicine Ward—Relationship with In-Hospital and 30-Day Mortality","authors":"","doi":"10.1016/j.ajmo.2024.100074","DOIUrl":"10.1016/j.ajmo.2024.100074","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the connection between the items included in the AVD-DezIs score (a questionnaire about basic and instrumental activities of daily living and other topics related to social and personal life) and in-hospital and 30-day mortality after discharge.</p></div><div><h3>Methods</h3><p>Prospective cohort study of hospitalizations in the Internal Medicine ward from 2014 to 2020, including &gt;18 years old patients with a fully completed AVD-DezIs. To identify in-hospital and 30 days mortality, univariate and multivariate logistic models were applied, including random effects if justified.</p></div><div><h3>Results</h3><p>A total of 19,771 episodes of hospitalization were included. In the univariate analysis, except for the presence of isolation and financial insufficiency, all the items were predictors of mortality in-hospital or within 30 days after discharge. In multivariate analysis, older age, male sex, longer hospital stay, higher Charlson score, deficiency in all four activities of daily living, deficiency in meal preparation and housekeeping, presence of pain/depression, immobility, and malnutrition are associated with a higher probability of in-hospital death whereas older age, male gender, higher Charlson score, longer length of hospital stay, deficiency in personal hygiene, ambulation, and eating habits, as well as the presence of incontinence and malnutrition, are associated with a higher probability of 30 days after discharge death.</p></div><div><h3>Discussion/Conclusion</h3><p>Except for isolation and financial insufficiency, all items were individually associated with the outcomes. When they are considered in conjunction and taking into account sex, age, comorbidities and length of stay, the predictive ability of in-hospital and 30 days mortality differed.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000116/pdfft?md5=25099c655348503a4fe1688bc48b862e&pid=1-s2.0-S2667036424000116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096937","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":"Current Communication Practices Between Internal Medicine Subspecialty Fellowship Applicants and Program Directors: A National Survey","authors":"Rahul Kumar Thakur, C. Vegivinti, Barun Ray, Hasiya Yusuf, Abhishek Kumar","doi":"10.1016/j.ajmo.2024.100073","DOIUrl":"https://doi.org/10.1016/j.ajmo.2024.100073","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710514","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":"Post-Acute Sequelae of Covid-19: A System-wise Approach on the Effects of Long-Covid-19","authors":"","doi":"10.1016/j.ajmo.2024.100071","DOIUrl":"10.1016/j.ajmo.2024.100071","url":null,"abstract":"<div><p>The SARS-CoV-2 virus responsible for the COVID-19 pandemic has profoundly impacted global health, economics, and society. This review seeks to encompass an overview of current knowledge on COVID-19, including its transmission, pathogenesis, and clinical presentation related to various systems within the human body. COVID-19 is a highly contagious illness that has rapidly spread worldwide. As of August 4, 2023, the WHO reported over 570 million confirmed cases of COVID-19 and over 6.3 million deaths. Although the virus is most common in adults, children can also be infected. Respiratory droplets that are produced when an infected person coughs or sneezes are the primary transmission mode for COVID-19. Additionally, the virus can be disseminated via contact with contaminated surfaces or objects, as it can remain viable for several hours or days. SARS-CoV-2 is a respiratory virus that enters cells by bonding with the angiotensin-converting enzyme 2 (ACE2) receptor. Once inside the cell, the virus replicates and produces new particles that can infect other cells. Interestingly, the effects of post-acute sequelae of SARS-CoV-2 infection (PASC) encompass more than just respiratory system. The findings presented in the data suggest that PASC significantly impacts multiple organs and their respective physiological processes. In light of these observations, we aim to provide a detailed discussion of the relevant findings in this paper. Through our review, we hope to provide healthcare professionals with a deeper understanding of the effects of PASC on the human body, which could ultimately lead to improved patient outcomes and treatment strategies.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000086/pdfft?md5=90e44376f2a7c6c7ea0ed46ebfedf703&pid=1-s2.0-S2667036424000086-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141398128","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":"In-Hospital Mortality by Race and Ethnicity Among Hospitalized COVID-19 Patients Using Data From the US National COVID Cohort Collaborative","authors":"Antonije Lazic ,&nbsp;J. Mick Tilford ,&nbsp;Bradley C. Martin ,&nbsp;Mandana Rezaeiahari ,&nbsp;Anthony Goudie ,&nbsp;Ahmad Baghal ,&nbsp;Melody Greer","doi":"10.1016/j.ajmo.2024.100070","DOIUrl":"10.1016/j.ajmo.2024.100070","url":null,"abstract":"<div><h3>Background</h3><p>Studies examining racial and ethnic disparities in-hospital mortality for patients hospitalized with COVID-19 had mixed results. Findings from patients within academic medical centers (AMCs) are lacking, but important given the role of AMCs in improving health equity.</p></div><div><h3>Objective</h3><p>The purpose of this study is to assess whether minority patients hospitalized with COVID-19 in National COVID Cohort Collaborative (N3C) institutions, which consist predominantly of AMCs, have higher mortality rates relative to White patients.</p></div><div><h3>Design</h3><p>A retrospective analysis of patients hospitalized with COVID-19 was performed. Logistic regression analysis was used to test the primary hypothesis. A separate analysis tested whether there were differences by race and ethnicity during the delta variant phase of the pandemic.</p></div><div><h3>Patients</h3><p>All hospitalized patients with COVID-19 who were above 17 years old were categorized by race and ethnicity as Black, Hispanic, Asian, White, Other, and Unknown.</p></div><div><h3>Main Measures</h3><p>In-hospital mortality for patients with a known hospital outcome formed the primary outcome measure. Race and ethnicity were the primary independent variables.</p></div><div><h3>Key Results</h3><p>There were 103,702 in-hospital Covid-19 admissions with 14,207 (13.7%) hospital deaths. Unadjusted in-hospital mortality for White patients was approximately 26% higher than for Black patients. After multivariable adjustment, none of the racial and ethnic groups had significantly different odds of in-hospital mortality compared to White patients. Only Hispanic patients had an odds ratio greater than one that was insignificant (OR = 1.06; 95% CI = 0.92-1.20). Findings for the delta variant phase were similar with the exception of the unknown category (OR = 1.90; 95% CI = 1.05-3.46).</p></div><div><h3>Conclusions</h3><p>Disparities in-hospital mortality outcomes by race or ethnicity were not found in COVID-19 patients hospitalized in AMCs. AMCs are expected to lead health delivery systems in eliminating disparities associated with structural racism. The null findings are consistent with the hypothesis of no difference in hospital outcomes by race or ethnicity in academic medical centers.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000074/pdfft?md5=690f44a2017665216f759b672885906b&pid=1-s2.0-S2667036424000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140768313","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 Metabolic Syndrome Among Emerging Adult Cannabis Users by Race/Ethnicity: Analysis of the 2009-2018 National Health and Nutrition Examination Surveys","authors":"Amrit Baral MBBS, MPH ,&nbsp;Jingxin Liu MPH ,&nbsp;Sandra Garcia-Davis MPH ,&nbsp;Bria-Necole A. Diggs MSPH ,&nbsp;Lizelh Ayala BA ,&nbsp;Anurag Aka ,&nbsp;Yash S. Agrawal ,&nbsp;Sarah E. Messiah PhD, MPH, FTOS ,&nbsp;Denise C. Vidot PhD","doi":"10.1016/j.ajmo.2024.100069","DOIUrl":"10.1016/j.ajmo.2024.100069","url":null,"abstract":"<div><h3>Background</h3><p>Association between cannabis use and metabolic syndrome (MetS) has been documented; yet variation by race/ethnicity is understudied. We examined cannabis use and MetS by race/ethnicity among emerging adults (18-25 years old), the age group with the highest prevalence of cannabis use.</p></div><div><h3>Methods</h3><p>Data from 18- to 25-year-olds who completed the National Health and Nutrition Examination Survey (2009-2018) were analyzed. Current cannabis use was defined as ≥1 day of use in the last 30 days. MetS was defined using standardized guidelines as ≥3 of the following: elevated fasting glucose, triglycerides, systolic (SBP) and/or diastolic blood pressure (DPB), waist circumference, and/or low high-density lipoprotein (HDL) cholesterol. Logistic regression was used to examine the association between current cannabis use (CCU) and MetS, adjusting for covariates.</p></div><div><h3>Results</h3><p>Of 3974 respondents, 48.8% were female, mean age 21.1 years (SD = 2.4), 56.7% non-Hispanic white, 20.4% Hispanic, and 14.0% non-Hispanic black (NHB). Hispanics had the highest MetS prevalence (7.9%) and lowest CCU prevalence (23.5%). NHB had highest CCU prevalence (33.4%, <em>P</em> &lt; .0001) and lowest MetS prevalence (4.8%, <em>P</em> = .2543). CCUs had a higher mean SBP (<em>P =</em> .020) and Hispanics (<em>P</em> = .002) than never users. Conversely, NHB CCUs exhibited lower mean SBP than NHB never users (<em>P</em> = .008). CCUs had 42% reduced odds of MetS than never users (AOR: 0.58, 95% CI: 0.35-0.95). Among NHB, CCUs had 78% lower likelihood of having MetS than never users (AOR: 0.22, 95% CI: 0.06-0.81).</p></div><div><h3>Conclusions</h3><p>Cannabis use impacts MetS and blood pressure differently by race/ethnicity. Current cannabis use was associated with lower odds of MetS overall and among NHB. Further research is warranted to investigate how administration routes, dosages, and usage duration affect MetS.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000062/pdfft?md5=9810d409e384ee92c515f6bfca1b6736&pid=1-s2.0-S2667036424000062-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140406861","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":"Long COVID Definition, Symptoms, Risk Factors, Epidemiology and Autoimmunity: A Narrative Review","authors":"Paweł Kozłowski ,&nbsp;Aleksandra Leszczyńska ,&nbsp;Olga Ciepiela","doi":"10.1016/j.ajmo.2024.100068","DOIUrl":"10.1016/j.ajmo.2024.100068","url":null,"abstract":"<div><p>The virus called SARS-CoV-2 emerged in 2019 and quickly spread worldwide, causing COVID-19. It has greatly impacted on everyday life, healthcare systems, and the global economy. In order to save as many lives as possible, precautions such as social distancing, quarantine, and testing policies were implemented, and effective vaccines were developed. A growing amount of data collected worldwide allowed the characterization of this new disease, which turned out to be more complex than other common respiratory tract infections. An increasing number of convalescents presented with a variety of nonspecific symptoms emerging after the acute infection. This possible new global health problem was identified and labelled as long COVID. Since then, a great effort has been made by clinicians and the scientific community to understand the underlying mechanisms and to develop preventive measures and effective treatment. The role of autoimmunity induced by SARS-CoV-2 infection in the development of long COVID is discussed in this review. We aim to deliver a description of several conditions with an autoimmune background observed in COVID-19 convalescents, including Guillain-Barré syndrome, antiphospholipid syndrome and related thrombosis, and Kawasaki disease highlighting a relationship between SARS-CoV-2 infection and the development of autoimmunity. However, further studies are required to determine its true clinical significance.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000050/pdfft?md5=b8465550885db14b0128e04893017f45&pid=1-s2.0-S2667036424000050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139874674","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":"Smoking Increases Mortality Risk Among African Americans With Chronic Kidney Disease","authors":"Srikanta Banerjee ,&nbsp;Jagdish Khubchandani ,&nbsp;W. Sumner Davis","doi":"10.1016/j.ajmo.2024.100066","DOIUrl":"10.1016/j.ajmo.2024.100066","url":null,"abstract":"<div><h3>Background</h3><p>Smoking and chronic kidney disease (CKD) have a disproportionately high prevalence among African American (AA) adults, but their impact on mortality among AA adults is not well known.</p></div><div><h3>Methods</h3><p>Given the lack of evidence in published literature on specific factors affecting the relationship between CKD and mortality among AA adults, we examined the influence of smoking on mortality among AA adults with CKD. National Health and Nutrition Examination Survey (NHANES, 1999-2010) data were analyzed with study participants prospectively followed up for mortality analysis through December 31, 2019, using National Death Index (NDI) death certificate records.</p></div><div><h3>Results</h3><p>A total of 6,108 AA adults were included in the study sample, with more than two-fifths (44.9%) being smokers and 6.3% having CKD. AA individuals with CKD had 2.22 (95% CI = 1.38-3.57) times the risk of cardiovascular mortality, but when stratified by smoking, AA individuals with CKD who were current smokers had 3.21 times the risk of cardiovascular mortality. Similarly, in AA with CKD, the risk of all-cause mortality was 3.53 (95% CI = 1.31-9.47), but when stratified by smoking status, AA individuals with CKD who were current smokers had 5.54 times the risk of all-cause mortality.</p></div><div><h3>Conclusions</h3><p>Smoking and CKD are highly prevalent in AA individuals and frequently cooccur, leading to higher rates of mortality. Smoking cessation interventions should be a priority in collaborative care models and interdisciplinary care teams for AA with CKD and current smoker status.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000037/pdfft?md5=4ac350e814300c0876572dd0f8b1a5ab&pid=1-s2.0-S2667036424000037-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139686964","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":"Digital Health Tools: Are They Effective for Managing Diabetes in the Elderly During the Digital Era?","authors":"Sarah Herawangsa ,&nbsp;Iwal Reza Ahdi ,&nbsp;Zulvikar Syambani Ulhaq MD, PhD","doi":"10.1016/j.ajmo.2024.100067","DOIUrl":"10.1016/j.ajmo.2024.100067","url":null,"abstract":"","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000049/pdfft?md5=f9de770c4c737aaed3e133a7bdf3e7aa&pid=1-s2.0-S2667036424000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883594","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":"Healthcare Workers on the Frontlines of War: Essential Roles and Responsibilities","authors":"Yash Sailesh Kumar ,&nbsp;Jasmine Shanthi Kamath","doi":"10.1016/j.ajmo.2024.100064","DOIUrl":"10.1016/j.ajmo.2024.100064","url":null,"abstract":"<div><p>This article explores the indispensable roles and responsibilities of healthcare workers on the frontlines of war, where they grapple with the profound challenges posed by conflict. In the midst of decimated healthcare infrastructure, these professionals become pivotal in delivering urgent medical care while facing significant risks. Beyond immediate healing, healthcare workers navigate the psychological toll of war, addressing widespread trauma and limited mental health support. They emerge as advocates for peace, documenting atrocities, and contribute to postwar recovery by rebuilding healthcare systems, providing psychosocial support, and participating in public health initiatives. This article illuminates the multifaceted impact of conflict on healthcare, underscoring the urgency for international cooperation and the safeguarding of healthcare workers in addressing the complex and pressing intersection of health and war.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000013/pdfft?md5=2c47f14adcb9be2de38ca43eb3c1b46a&pid=1-s2.0-S2667036424000013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632051","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":"Collective Weakness and Fluidity in Weakness Status Associated With Basic Self-Care Limitations in Older Americans","authors":"Ryan McGrath ,&nbsp;Brenda M. McGrath ,&nbsp;Soham Al Snih ,&nbsp;Peggy M. Cawthon ,&nbsp;Brian C. Clark ,&nbsp;Halli Heimbuch ,&nbsp;Mark D. Peterson ,&nbsp;Yeong Rhee","doi":"10.1016/j.ajmo.2024.100065","DOIUrl":"10.1016/j.ajmo.2024.100065","url":null,"abstract":"<div><h3>Aims</h3><p>To examine the associations of (1) absolute and normalized weakness cut-points, (2) collective weakness categories, and (3) changes in weakness status on future activities of daily living (ADL) limitations in older Americans.</p></div><div><h3>Methods</h3><p>The analytic sample included 11,656 participants aged ≥65 years from the 2006-2018 waves of the RAND Health and Retirement Study. ADL were self-reported. A handgrip dynamometer was used to measure handgrip strength (HGS). Males were classified as weak if their HGS was &lt;35.5 kg (absolute), &lt;0.45 kg/kg (body mass normalized), or &lt;1.05 kg/kg/m² (body mass index [BMI] normalized); females were considered weak if their HGS was &lt;20.0 kg, &lt;0.337 kg/kg, or &lt;0.79 kg/kg/m². Participants were similarly categorized as being below 1, 2, or all 3 absolute and normalized cut-points. These collective categories were also used to classify observed changes in weakness status over time (onset, persistent, progressive, recovery).</p></div><div><h3>Results</h3><p>Older Americans below absolute and normalized weakness cut-points had greater future ADL limitations odds: 1.34 (95% confidence interval [CI]: 1.22-1.47) for absolute, 1.36 (CI: 1.24-1.50) for BMI normalized, and 1.56 (CI: 1.41-1.73) for body mass normalized. Persons below 1, 2, or 3 cut-points had 1.36 (CI: 1.19-1.55), 1.60 (CI: 1.41-1.80), and 1.70 (CI: 1.50-1.92) greater odds for future ADL limitations, respectively. Those in each changing weakness classification had greater future ADL limitation odds: 1.28 (CI: 1.01-1.62) for onset, 1.53 (CI: 1.22-1.92) for persistent, 1.72 (CI: 1.36-2.19) for progressive, and 1.34 (CI: 1.08-1.66) for recovery.</p></div><div><h3>Conclusions</h3><p>The presence of weakness, regardless of cut-point and change in status over time, was associated with greater odds for future ADL limitations.</p></div>","PeriodicalId":72168,"journal":{"name":"American journal of medicine open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667036424000025/pdfft?md5=e9c785730e602212ab3af9119f9050ae&pid=1-s2.0-S2667036424000025-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632303","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}