Health information management : journal of the Health Information Management Association of Australia最新文献

{"title":"Impact of clinical note format on diagnostic accuracy and efficiency.","authors":"Evita M Payton, Mark L Graber, Vasil Bachiashvili, Tapan Mehta, P Irushi Dissanayake, Eta S Berner","doi":"10.1177/18333583231151979","DOIUrl":"10.1177/18333583231151979","url":null,"abstract":"<p><strong>Background: </strong>Clinician notes are structured in a variety of ways. This research pilot tested an innovative study design and explored the impact of note formats on diagnostic accuracy and documentation review time.</p><p><strong>Objective: </strong>To compare two formats for clinical documentation (narrative format vs. list of findings) on clinician diagnostic accuracy and documentation review time.</p><p><strong>Method: </strong>Participants diagnosed written clinical cases, half in narrative format, and half in list format. Diagnostic accuracy (defined as including correct case diagnosis among top three diagnoses) and time spent processing the case scenario were measured for each format. Generalised linear mixed regression models and bias-corrected bootstrap percentile confidence intervals for mean paired differences were used to analyse the primary research questions.</p><p><strong>Results: </strong>Odds of correctly diagnosing list format notes were 26% greater than with narrative notes. However, there is insufficient evidence that this difference is significant (75% CI 0.8-1.99). On average the list format notes required 85.6 more seconds to process and arrive at a diagnosis compared to narrative notes (95% CI -162.3, -2.77). Of cases where participants included the correct diagnosis, on average the list format notes required 94.17 more seconds compared to narrative notes (75% CI -195.9, -8.83).</p><p><strong>Conclusion: </strong>This study offers note format considerations for those interested in improving clinical documentation and suggests directions for future research. Balancing the priority of clinician preference with value of structured data may be necessary.</p><p><strong>Implications: </strong>This study provides a method and suggestive results for further investigation in usability of electronic documentation formats.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"183-188"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9394058","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":"A holistic view of facilitators and barriers of electronic health records usage from different perspectives: A qualitative content analysis approach.","authors":"Anna Griesser, Sonja Bidmon","doi":"10.1177/18333583231178611","DOIUrl":"10.1177/18333583231178611","url":null,"abstract":"<p><strong>Background: </strong>Electronic health records (EHR) are seen as a promising endeavour, in spite of policies, designs, user rights and types of health data varying across countries. In many European countries, including Austria, EHR usage has fallen short when compared to the deployment plans.</p><p><strong>Objective: </strong>By adopting a qualitative approach, this research aimed to explore facilitators and barriers experienced by patients and physicians across the entire EHR usage process in Austria.</p><p><strong>Method: </strong>Two studies were conducted: In Study 1, discussions were held with four homogeneously composed groups of patients (<i>N</i> = 30). In Study 2, eight expert semi-structured interviews were conducted with physicians to gain insights into potential facilitators and barriers Austrian physicians face when utilising personal EHR.</p><p><strong>Results: </strong>A wide range of barriers and facilitators were identified along the entire EHR usage spectrum, emerging on three different levels: the micro-level (individual level), the meso-level (level of the EHR system) and the macro-level (level of the health system). EHR literacy was identified as a booster to support EHR adherence. Health providers were identified as crucial gatekeepers with regard to EHR usage.</p><p><strong>Conclusion: </strong>The implications for mutual benefits arising out of EHR usage among the triad of health policymakers, providers and patients for both theory and practice are discussed.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"227-236"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9760030","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 care and data work: Who are the data professionals?","authors":"Claus Bossen, Pernille Scholdan Bertelsen","doi":"10.1177/18333583231183083","DOIUrl":"10.1177/18333583231183083","url":null,"abstract":"<p><strong>Background: </strong>This article reports on a study that investigated data professionals in health care. The topic is interesting and relevant because of the ongoing trend towards digitisation of the healthcare domain and efforts for it to become data driven, which entail a wide variety of work with data.</p><p><strong>Objective: </strong>Despite an interest in data science and more broadly in data work, we know surprisingly little about the people who work with data in healthcare. Therefore, we investigated data work at a large national healthcare data organisation in Denmark.</p><p><strong>Method: </strong>An explorative mixed method approach combining a non-probability technique for design of an open survey with a target population of 300+ and 11 semi-structured interviews, was applied.</p><p><strong>Results: </strong>We report findings relevant to educational background, work identity, work tasks, and how staff acquired competences and knowledge, as well as what these attributes comprised. We found recurring themes of healthcare knowledge, data analytical skills, and information technology, reflected in education, competences and knowledge. However, there was considerable variation within and beyond those themes, and indeed most competences were learned \"on the job\" rather than as part of formal education.</p><p><strong>Conclusion: </strong><i>Becoming</i> a professional working with data in health care can be the result of different career paths. The most recurring work identity was that of \"data analyst\"; however, a wide variety of responses indicated that a stable data worker identity has not yet developed.</p><p><strong>Implications: </strong>The findings present implications for educational policy makers and healthcare managers.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"243-251"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870582","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 importance of SNOMED CT concept specificity in healthcare analytics.","authors":"Luke Roberts, Sadie Lanes, Oliver Peatman, Phil Assheton","doi":"10.1177/18333583221144662","DOIUrl":"10.1177/18333583221144662","url":null,"abstract":"<p><strong>Background: </strong>Healthcare data frequently lack the specificity level needed to achieve clinical and operational objectives such as optimising bed management. Pneumonia is a disease of importance as it accounts for more bed days than any other lung disease and has a varied aetiology. The condition has a range of SNOMED CT concepts with different levels of specificity.</p><p><strong>Objective: </strong>This study aimed to quantify the importance of the specificity of an SNOMED CT concept, against well-established predictors, for forecasting length of stay for pneumonia patients.</p><p><strong>Method: </strong>A retrospective data analysis was conducted of pneumonia admissions to a tertiary hospital between 2011 and 2021. For inclusion, the primary diagnosis was a subtype of bacterial or viral pneumonia, as identified by SNOMED CT concepts. Three linear mixed models were constructed. Model One included known predictors of length of stay. Model Two included the predictors in Model One and SNOMED CT concepts of lower specificity. Model Three included the Model Two predictors and the concepts with higher specificity. Model performances were compared.</p><p><strong>Results: </strong>Sex, ethnicity, deprivation rank and Charlson Comorbidity Index scores (age-adjusted) were meaningful predictors of length of stay in all models. Inclusion of lower specificity SNOMED CT concepts did not significantly improve performance (ΔR² = 0.41%, <i>p</i> = .058). SNOMED CT concepts with higher specificity explained more variance than each of the individual predictors (ΔR² = 4.31%, <i>p</i> < .001).</p><p><strong>Conclusion: </strong>SNOMED CT concepts with higher specificity explained more variance in length of stay than a range of well-studied predictors.</p><p><strong>Implications: </strong>Accurate and specific clinical documentation using SNOMED CT can improve predictive modelling and the generation of actionable insights. Resources should be dedicated to optimising and assuring clinical documentation quality at the point of recording.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"157-165"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9103819","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":"Alpha NSW: What would it take to create a state-wide paediatric population-level learning health system?","authors":"Michael Hodgins, Nora Samir, Susan Woolfenden, Nan Hu, Francisco Schneuer, Natasha Nassar, Raghu Lingam","doi":"10.1177/18333583231176597","DOIUrl":"10.1177/18333583231176597","url":null,"abstract":"<p><strong>Background: </strong>The health and well-being of children in the first 2000 days has a lasting effect on educational achievement and long-term chronic disease in later life. However, the lack of integration between high-quality data, analytic capacity and timely health improvement initiatives means practitioners, service leaders and policymakers cannot use data effectively to plan and evaluate early intervention services and monitor high-level health outcomes.</p><p><strong>Objective: </strong>Our exploratory study aimed to develop an in-depth understanding of the system and clinical requirements of a state-wide paediatric learning health system (LHS) that uses routinely collected data to not only identify where the inequities and variation in care are, but also to also inform service development and delivery where it is needed most.</p><p><strong>Method: </strong>Our approach included reviewing exemplars of how administrative data are used in Australia; consulting with clinical, policy and data stakeholders to determine their needs for a child health LHS; mapping the existing data points collected across the first 2000 days of a child's life and geospatially locating patterns of key indicators for child health needs.</p><p><strong>Results: </strong>Our study identified the indicators that are available and accessible to inform service delivery and demonstrated the potential of using routinely collected administrative data to identify the gap between health needs and service availability.</p><p><strong>Conclusion: </strong>We recommend improving data collection, accessibility and integration to establish a state-wide LHS, whereby there is a streamlined process for data cleaning, analysis and visualisation to help identify populations in need in a timely manner.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"217-226"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11401336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9815339","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":"For-profit versus non-profit cybersecurity posture: breach types and locations in healthcare organisations.","authors":"Martin Ignatovski","doi":"10.1177/18333583231158886","DOIUrl":"10.1177/18333583231158886","url":null,"abstract":"<p><strong>Background: </strong>The implementation of emerging technologies has resulted in an increase of data breaches in healthcare organisations, especially during the COVID-19 pandemic. Health information and cybersecurity managers need to understand if, and to what extent, breach types and locations are associated with their organisation's business type.</p><p><strong>Objective: </strong>To investigate if breach type and breach location are associated with business type, and if so, investigate how these factors affect information systems and protected health information in for-profit versus non-profit organisations.</p><p><strong>Method: </strong>The quantitative study was performed using chi-square tests for association and post-hoc comparison of column proportions analysis on an archival data set of reported healthcare data breaches from 2020 to 2022. Data from the Department of Health and Human Services website was retrieved and each organisation classified as for-profit or non-profit.</p><p><strong>Results: </strong>For-profit organisations experienced a significantly higher number of breaches due to theft, and non-profit organisations experienced a significantly higher number of breaches due to unauthorised access. Furthermore, the number of breaches that occurred on laptops and paper/films was significantly higher in for-profit organisations.</p><p><strong>Conclusion: </strong>While the threat level of hacking techniques is the same in for-profit and non-profit organisations, certain breach types are more likely to occur within specific breach locations based on the organisation's business type. To protect the privacy and security of medical information, health information and cybersecurity managers need to align with industry-leading frameworks and controls to prevent specific breach types that occur in specific locations within their environments.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"198-205"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9320512","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":"Using <i>personal health records</i> for medication continuity during transition of care: An observational study.","authors":"Martina Francis, Peter Francis, Meredith Makeham, Melissa T Baysari, Asad E Patanwala, Jonathan Penm","doi":"10.1177/18333583241270215","DOIUrl":"https://doi.org/10.1177/18333583241270215","url":null,"abstract":"<p><p><b>Background:</b> National Personal Health Records (PHRs) have been proposed to improve the transfer of medication-related information during transition of care. <b>Objective:</b> To evaluate the concordance between the medications captured in the Australian national PHR, My Health Record (MyHR), and the pharmacist obtained best possible medication history (BPMH) for patients upon hospital admission. <b>Method:</b> This prospective observational study used a convenience sample of hospital patients. For newly admitted patients, the investigating pharmacist obtained a BPMH and then compared it to the medication list captured in MyHR. Upon comparison, the medications were categorised into either complete match, partial match or mismatch. Medications with a complete or partial match were grouped together. Medications with deviations were then assessed for risk based on their potential consequence, and reported descriptively. A multivariable logistic regression was conducted to assess the factors associated with a drug being mismatched. <b>Results:</b> A total of 82 patients were recruited, with a cumulative total of 1,207 medications documented. Of the 1,207 medications, 714 (59.2%) medications were documented as a complete/partial match. The remaining 493 (40.8%) medications were mismatched. Of the 493 mismatched medications, 442 (89.7%) were deemed low-risk deviations and 51 (10.3%) were deemed high-risk. A medication was more likely to be mismatched, rather than completely/partially matched, if it was a regular non-prescription medication, or \"when-required\" prescription medication, or \"when required\" non-prescription medication, or if it was administered parenterally. <b>Conclusion:</b> National PHRs may be a secondary source to either confirm a patient's medication history or be used as a starting point for a BPMH.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"18333583241270215"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057494","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":"Enhancing nursing home quality through electronic health record implementation.","authors":"Rohit Pradhan, Neeraj Dayama, Michael Morris, Kimberly Elliott, Holly Felix","doi":"10.1177/18333583241274010","DOIUrl":"https://doi.org/10.1177/18333583241274010","url":null,"abstract":"<p><p><b>Background:</b> The quality of care in nursing homes (NHs) in the United States has long been a matter of policy concern. Although electronic health records (EHRs) are argued to improve quality, implementation has lagged due to various factors such as financial constraints and limited research on their impact on NH quality. <b>Objective:</b> This study examined the relationship between EHR implementation and NH quality using Donabedian's structure-process-outcome model. <b>Method:</b> Data on EHR implementation were collected via a 2018 survey of all Federally certified Arkansas NHs (<i>n</i> = 223). Of the 63 responding NHs, 48 reported EHR implementation. Survey data were merged with secondary sources such as Certification and Survey Provider Enhanced Reporting. A total of 744 NH-years for the period 2008-2020 were included in the final sample. A pre-post negative binomial panel data regression was used to examine the relationship between EHR implementation (dichotomous variable) and NH deficiencies (dependent count variable) with facility/community-level control variables. Results were reported as incidence rate ratios (IRR). <b>Results:</b> NHs that had implemented EHR experienced an 18% reduction in the rate of deficiencies compared to those without EHR systems (IRR = 0.82, 95% CI [0.70, 0.99], <i>p</i> = 0.035). <b>Conclusion:</b> EHR implementation had a favourable impact on NH quality. <b>Implications:</b> Past research suggests that higher NH quality may be associated with improved financial performance. Therefore, EHR implementation has the potential to address two critical challenges: enhancing care quality and improving financial outcomes. However, government financial incentives may be necessary to address the high-cost of implementing EHR systems.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"18333583241274010"},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057485","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":"Factors influencing the use of big data within healthcare services: a systematic review.","authors":"Mohsen Khosravi, Seyyed Morteza Mojtabaeian, Zahra Zare","doi":"10.1177/18333583241270484","DOIUrl":"https://doi.org/10.1177/18333583241270484","url":null,"abstract":"<p><p><b>Background:</b> The emergence of big data holds the promise of aiding healthcare providers by identifying patterns and converting vast quantities of data into actionable insights facilitating the provision of precision medicine and decision-making. <b>Objective:</b> This study aimed to investigate the factors influencing use of big data within healthcare services to facilitate their use. <b>Method:</b> A systematic review was conducted in February 2024, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Database searches for articles published between 01 January 2020 and 18 February 2024 and included PubMed, Scopus, ProQuest and Cochrane Library. The Authority, Accuracy, Coverage, Objectivity, Date, Significance ( AACODS) checklist was used to evaluate the quality of the included articles. Subsequently, a thematic analysis was conducted on the findings of the review, using the Boyatzis approach. <b>Results:</b> A final selection of 46 studies were included in this systematic review. A significant proportion of these studies demonstrated acceptable quality, and the level of bias was deemed satisfactory. Thematic analysis identified seven major themes that influenced the use of big data in healthcare services. These themes were grouped into four primary categories: performance expectancy, effort expectancy, social influence, and facilitating conditions. Factors associated with \"effort expectancy\" were the most highly cited in the included studies (67%), while those related to \"social influence\" received the fewest citations (15%). <b>Conclusion:</b> This study underscored the critical role of \"effort expectancy\" factors, particularly those under the theme of \"data complexity and management,\" in the process of using big data in healthcare services. <b>Implications:</b> Results of this study provide groundwork for future research to explore facilitators and barriers to using big data in health care, particularly in relation to data complexity and the efficient and effective management of big data, with significant implications for healthcare administrators and policymakers.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"18333583241270484"},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019730","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":"A scoping review of the educator role performed by Health Information Managers in health workplace-based education: The practitioner Health Information Manager-educator.","authors":"Jenn Lee, James Boyd, Hanan Khalil","doi":"10.1177/18333583241263989","DOIUrl":"https://doi.org/10.1177/18333583241263989","url":null,"abstract":"<p><strong>Background: </strong>Health Information Managers (HIMs) play a crucial role in the management and governance of health information ensuring the accuracy, confidentiality and accessibility of health data for clinical care and business operational purposes. This role also extends to education and training in the workplace.</p><p><strong>Objective: </strong>The aim of this scoping review was to explore and elucidate the role played by HIMs when they undertake a health workplace-based (healthcare organisation or service) educational role and/or functions as evidenced in the existing body of literature.</p><p><strong>Method: </strong>A scoping review of the literature to investigated the importance of the educator role for HIM health workplace-based educators. A three-step search strategy was designed to ensure a comprehensive exploration of relevant research.</p><p><strong>Results: </strong>Of 63 articles assess for eligibility, 14 were included in the final analysis. All included articles acknowledged the importance of the HIM-educator workplace-based role. Half of the included articles had been published within the last 7 years. Only 8 of the 14 articles provided some description of HIM-educator attributes, suggesting that these characteristics remain unexplored.</p><p><strong>Discussion: </strong>Findings from this scoping review have shed light on the limitations within the current available literature concerning the attributes of HIM health workplace-based educators. The findings also highlight an important gap in knowledge concerning the qualities of these HIM-educators.</p><p><strong>Conclusion: </strong>This identified gap in the literature signals a need for further exploration and investigation into the specific attributes, skills, and characteristics that define effective HIM-educators undertaking a health workplace-based educational role.</p>","PeriodicalId":73210,"journal":{"name":"Health information management : journal of the Health Information Management Association of Australia","volume":" ","pages":"18333583241263989"},"PeriodicalIF":0.0,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989696","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}