JMIR dermatology最新文献

{"title":"Nutrition, Obesity, and Seborrheic Dermatitis: Systematic Review.","authors":"Emily Woolhiser, Noah Keime, Arya Patel, Isaac Weber, Madeline Adelman, Robert P Dellavalle","doi":"10.2196/50143","DOIUrl":"10.2196/50143","url":null,"abstract":"<p><strong>Background: </strong>Pathogenesis of seborrheic dermatitis involves lipid secretion by sebaceous glands, Malassezia colonization, and an inflammatory response with skin barrier disruption. Each of these pathways could be modulated by diet, obesity, and nutritional supplements. Current treatment options provide only temporary control of the condition; thus, it is essential to recognize modifiable lifestyle factors that may play a role in determining disease severity.</p><p><strong>Objective: </strong>This study aimed to summarize published evidence on diet, nutritional supplements, alcohol, obesity, and micronutrients in patients with seborrheic dermatitis and to provide useful insights into areas of further research.</p><p><strong>Methods: </strong>A literature search of Scopus, PubMed, and MEDLINE (Ovid interface) for English language papers published between 1993 and 2023 was conducted on April 16, 2023. Case-control studies, cohort studies, and randomized controlled trials with 5 or more subjects conducted on adult participants (>14 years) were included, case reports, case series, and review papers were excluded due to insufficient level of evidence.</p><p><strong>Results: </strong>A total of 13 studies, 8 case-control, 3 cross-sectional, and 2 randomized controlled trials, involving 13,906 patients were included. Seborrheic dermatitis was correlated with significantly increased copper, manganese, iron, calcium, and magnesium concentrations and significantly lower serum zinc and vitamin D and E concentrations. Adherence to the Western diet was associated with a higher risk for seborrheic dermatitis in female patients and an increased consumption of fruit was associated with a lower risk of seborrheic dermatitis in all patients. The prebiotic Triphala improved patient satisfaction and decreased scalp sebum levels over 8 weeks. Most studies find associations between regular alcohol use and seborrheic dermatitis, but the association between BMI and obesity on seborrheic dermatitis severity and prevalence is mixed.</p><p><strong>Conclusions: </strong>This review sheds light on specific promising areas of research that require further study, including the need for interventional studies evaluating serum zinc, vitamin D, and vitamin E supplementation for seborrheic dermatitis. The negative consequences of a Western diet, alcohol use, obesity, and the benefits of fruit consumption are well known; however, to fully understand their specific relationships to seborrheic dermatitis, further cohort or interventional studies are needed.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023417768; https://tinyurl.com/bdcta893.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e50143"},"PeriodicalIF":0.0,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894952","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":"Geographic Disparities in Online Searches for Psoriasis Biologics in the United States: Google Trends Analysis.","authors":"Annie Chang, Ross O'Hagan, Jade N Young, Nancy Wei, Nicholas Gulati","doi":"10.2196/56406","DOIUrl":"10.2196/56406","url":null,"abstract":"","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e56406"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861847","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":"An Exploration of Dutch Dermatologists' Experience and Satisfaction With Teledermatology: Sociotechnical and Complex Adaptive System Perspective.","authors":"Femke van Sinderen, Craig Kuziemsky, Monique W Jaspers, Linda W Peute","doi":"10.2196/56723","DOIUrl":"10.2196/56723","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Despite the global upscale of teledermatology during the COVID-19 pandemic, persistent barriers, such as the poor anamnesis and photo quality, hinder its effective use in practice. Understanding Dutch dermatologists' experiences and satisfaction with using the teledermatology system in the Dutch health care system is needed. A holistic evaluation may provide valuable insight to understand how barriers interrelate which is deemed necessary for the innovation of teledermatology in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Guided by a complex adaptive system perspective, this study aims to understand Dutch dermatologists' experience and satisfaction with their training, support communication, interaction, and usage of a teledermatology platform of a Dutch digital hospital during the COVID-19 pandemic, uncovering insights to improve teledermatology services for the future.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A web-based questionnaire was sent in December 2021 to Dutch dermatologists who (1) had an active teledermatology platform account, and (2) responded to a teledermatology consultation between October 1, 2019, and September 30, 2021. The questionnaire consisted of the validated Store-and-Forward Telemedicine Service User-satisfaction Questionnaire (SAF-TSUQ) questionnaire, and new questions regarding; demographics of teledermatologists, the use of teledermatology during the COVID-19 pandemic, the performance of teledermatology by general practitioners (GP), and the role of dermatologists in the teledermatology process. The open-ended questions were analyzed by a grounded theory approach guided by a sociotechnical model and complemented by a complex adaptive system perspective. A panel discussion with 3 dermatologists was performed to provide additional insight into the responses to the questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We obtained responses from 25 out of the 249 (10%) invited dermatologists. Overall, dermatologists had a positive experience with teledermatology. Interestingly, teledermatology use frequency remained unaffected by the COVID-19 pandemic. However, the insufficient quality and incompleteness of the clinical content (photos and anamneses information) of the teledermatology consultation impacted the efficiency of the teledermatology workflow. Dermatologists expressed the need for improvement to avoid time-consuming processes or physical referrals. The panel discussion enriched and confirmed the responses, suggesting solutions like mandatory fields for the GPs for a complete anamnesis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dutch Dermatologists view teledermatology as a valuable tool to provide access to dermatology care. However, improvements regarding the quality and completeness of the provided clinical content are necessary for the effectiveness and efficiency of the complex teledermatology system in Dutch health care. This could increase both the dermatologists' satisfaction and the quality of","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e56723"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11316153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768279","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":"NVIDIA's \"Chat with RTX\" Custom Large Language Model and Personalized AI Chatbot Augments the Value of Electronic Dermatology Reference Material.","authors":"Maged N Kamel Boulos, Robert Dellavalle","doi":"10.2196/58396","DOIUrl":"10.2196/58396","url":null,"abstract":"<p><p>This paper demonstrates a new, promising method using generative artificial intelligence (AI) to augment the educational value of electronic textbooks and research papers (locally stored on user's machine) and maximize their potential for self-study, in a way that goes beyond the standard electronic search and indexing that is already available in all of these textbooks and files. The presented method runs fully locally on the user's machine, is generally affordable, and does not require high technical expertise to set up and customize with the user's own content.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e58396"},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11306952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763048","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":"Assessing the Relationship Between Vitiligo and Major Depressive Disorder Severity: Cross-Sectional Study.","authors":"Amr Molla, Raed Jannadi, Hamza Alayoubi, Haya Altouri, Maryam Balkhair, Dareen Hafez","doi":"10.2196/60686","DOIUrl":"10.2196/60686","url":null,"abstract":"<p><strong>Background: </strong>Vitiligo, a common dermatological disorder in Saudi Arabia, is associated with significant psychological impacts. This study explores the relationship between vitiligo and the severity of major depressive disorder (MDD), highlighting the broader implications on mental health among affected individuals.</p><p><strong>Objective: </strong>We aim to assess the prevalence and predictors of depression among adult patients with vitiligo, and to examine the relationship between MDD severity and vitiligo.</p><p><strong>Methods: </strong>Using a cross-sectional design, the research used the vitiligo area severity index and the Patient Health Questionnaire-9 to measure the extent of vitiligo and depression severity, respectively. This study involved 340 diagnosed patients with vitiligo from various health care settings. Logistic and ordinal regression analysis were applied to evaluate the impact of sociodemographic variables and vitiligo types on MDD severity.</p><p><strong>Results: </strong>The prevalence of MDD was 58.8% (200/340) of participants. Depression severity varied notably: 18.2% (62/340) of patients experienced mild depression, 17.9% (61/340) moderate, 11.8% (40/340) moderately severe, and 10.9% (37/340) severe depression. Female patients had higher odds of severe depression than male patients (adjusted odds ratio [aOR] 3.14, 95% CI 1.93-5.1; P<.001). Age was inversely related to depression severity, with patients aged older than 60 years showing significantly lower odds (aOR 0.1, 95% CI 0.03-0.39; P<.001). Lower income was associated with higher depression severity (aOR 10.2, 95% CI 3.25-31.8; P<.001). Vitiligo types also influenced depression severity; vulgaris (aOR 5.3, 95% CI 2.6-10.9; P<.001) and acrofacial vitiligo (aOR 2.8, 95% CI 1.5-5.1; P<.001) were significantly associated with higher depression levels compared to focal vitiligo.</p><p><strong>Conclusions: </strong>The findings suggest that vitiligo contributes to an increased risk of severe depression, highlighting the need for integrated dermatological and psychological treatment approaches to address both the physical and mental health aspects of the disease.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":" ","pages":"e60686"},"PeriodicalIF":0.0,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11282388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141422097","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":"Efficacy of an Artificial Intelligence App (Aysa) in Dermatological Diagnosis: Cross-Sectional Analysis.","authors":"Shiva Shankar Marri, Warood Albadri, Mohammed Salman Hyder, Ajit B Janagond, Arun C Inamadar","doi":"10.2196/48811","DOIUrl":"10.2196/48811","url":null,"abstract":"<p><strong>Background: </strong>Dermatology is an ideal specialty for artificial intelligence (AI)-driven image recognition to improve diagnostic accuracy and patient care. Lack of dermatologists in many parts of the world and the high frequency of cutaneous disorders and malignancies highlight the increasing need for AI-aided diagnosis. Although AI-based applications for the identification of dermatological conditions are widely available, research assessing their reliability and accuracy is lacking.</p><p><strong>Objective: </strong>The aim of this study was to analyze the efficacy of the Aysa AI app as a preliminary diagnostic tool for various dermatological conditions in a semiurban town in India.</p><p><strong>Methods: </strong>This observational cross-sectional study included patients over the age of 2 years who visited the dermatology clinic. Images of lesions from individuals with various skin disorders were uploaded to the app after obtaining informed consent. The app was used to make a patient profile, identify lesion morphology, plot the location on a human model, and answer questions regarding duration and symptoms. The app presented eight differential diagnoses, which were compared with the clinical diagnosis. The model's performance was evaluated using sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and F₁-score. Comparison of categorical variables was performed with the χ² test and statistical significance was considered at P<.05.</p><p><strong>Results: </strong>A total of 700 patients were part of the study. A wide variety of skin conditions were grouped into 12 categories. The AI model had a mean top-1 sensitivity of 71% (95% CI 61.5%-74.3%), top-3 sensitivity of 86.1% (95% CI 83.4%-88.6%), and all-8 sensitivity of 95.1% (95% CI 93.3%-96.6%). The top-1 sensitivities for diagnosis of skin infestations, disorders of keratinization, other inflammatory conditions, and bacterial infections were 85.7%, 85.7%, 82.7%, and 81.8%, respectively. In the case of photodermatoses and malignant tumors, the top-1 sensitivities were 33.3% and 10%, respectively. Each category had a strong correlation between the clinical diagnosis and the probable diagnoses (P<.001).</p><p><strong>Conclusions: </strong>The Aysa app showed promising results in identifying most dermatoses.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e48811"},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494525","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":"PatientsLikeMe and Online Patient Support Communities in Dermatology.","authors":"Mindy D Szeto, Michelle Hook Sobotka, Emily Woolhiser, Pritika Parmar, Jieying Wu, Lina Alhanshali, Robert P Dellavalle","doi":"10.2196/50453","DOIUrl":"10.2196/50453","url":null,"abstract":"<p><p>Online patient-oriented platforms such as PatientsLikeMe (PLM) offer a venue for individuals with various diagnoses to share experiences and build community, though they may not be representative of the larger patient population. This potentially limits generalizability and raises concerns about the spread of misinformation, emphasizing the need for informed use and health care provider engagement.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e50453"},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11237783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141461170","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":"Gender Parity Analysis of the Editorial Boards of Influential Dermatology Journals: Cross-Sectional Study.","authors":"Mindy D Szeto, Torunn E Sivesind, Lori S Kim, Katie A O'Connell, Kathryn A Sprague, Yvonne Nong, Daniel M Strock, Annie L Cao, Jieying Wu, Lauren M Toledo, Sophia M Wolfe, Wyatt Boothby-Shoemaker, Robert P Dellavalle","doi":"10.2196/40819","DOIUrl":"10.2196/40819","url":null,"abstract":"<p><p>This study underscores the persistent underrepresentation of women in academic dermatology leadership positions by examining the gender composition of editorial boards across top dermatology journals, emphasizing the urgent need for proactive strategies to promote diversity, equity, and inclusion.</p>","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e40819"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077349","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":"Assessing the Application of Large Language Models in Generating Dermatologic Patient Education Materials According to Reading Level: Qualitative Study.","authors":"Raphaella Lambert, Zi-Yi Choo, Kelsey Gradwohl, Liesl Schroedl, Arlene Ruiz De Luzuriaga","doi":"10.2196/55898","DOIUrl":"10.2196/55898","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Dermatologic patient education materials (PEMs) are often written above the national average seventh- to eighth-grade reading level. ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT are large language models (LLMs) that are responsive to user prompts. Our project assesses their use in generating dermatologic PEMs at specified reading levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the ability of select LLMs to generate PEMs for common and rare dermatologic conditions at unspecified and specified reading levels. Further, the study aims to assess the preservation of meaning across such LLM-generated PEMs, as assessed by dermatology resident trainees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The Flesch-Kincaid reading level (FKRL) of current American Academy of Dermatology PEMs was evaluated for 4 common (atopic dermatitis, acne vulgaris, psoriasis, and herpes zoster) and 4 rare (epidermolysis bullosa, bullous pemphigoid, lamellar ichthyosis, and lichen planus) dermatologic conditions. We prompted ChatGPT-3.5, GPT-4, DermGPT, and DocsGPT to \"Create a patient education handout about [condition] at a [FKRL]\" to iteratively generate 10 PEMs per condition at unspecified fifth- and seventh-grade FKRLs, evaluated with Microsoft Word readability statistics. The preservation of meaning across LLMs was assessed by 2 dermatology resident trainees.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The current American Academy of Dermatology PEMs had an average (SD) FKRL of 9.35 (1.26) and 9.50 (2.3) for common and rare diseases, respectively. For common diseases, the FKRLs of LLM-produced PEMs ranged between 9.8 and 11.21 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). For rare diseases, the FKRLs of LLM-produced PEMs ranged between 9.85 and 11.45 (unspecified prompt), between 4.22 and 7.43 (fifth-grade prompt), and between 5.98 and 7.28 (seventh-grade prompt). At the fifth-grade reading level, GPT-4 was better at producing PEMs for both common and rare conditions than ChatGPT-3.5 (P=.001 and P=.01, respectively), DermGPT (P&lt;.001 and P=.03, respectively), and DocsGPT (P&lt;.001 and P=.02, respectively). At the seventh-grade reading level, no significant difference was found between ChatGPT-3.5, GPT-4, DocsGPT, or DermGPT in producing PEMs for common conditions (all P&gt;.05); however, for rare conditions, ChatGPT-3.5 and DocsGPT outperformed GPT-4 (P=.003 and P&lt;.001, respectively). The preservation of meaning analysis revealed that for common conditions, DermGPT ranked the highest for overall ease of reading, patient understandability, and accuracy (14.75/15, 98%); for rare conditions, handouts generated by GPT-4 ranked the highest (14.5/15, 97%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;GPT-4 appeared to outperform ChatGPT-3.5, DocsGPT, and DermGPT at the fifth-grade FKRL for both common and rare conditions, although both ChatGPT-3.5 and DocsGPT performed better than GPT-4 at the sevent","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e55898"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11140271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960950","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":"Online Patient Attitudes Toward Cutaneous Immune-Related Adverse Events Attributed to Nivolumab and Pembrolizumab: Sentiment Analysis.","authors":"Camille M Powers, Andrew K Yang, Hannah Verma, Jeremy Orloff, Austin J Piontkowski, Nicholas Gulati","doi":"10.2196/53792","DOIUrl":"10.2196/53792","url":null,"abstract":"","PeriodicalId":73553,"journal":{"name":"JMIR dermatology","volume":"7 ","pages":"e53792"},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11099803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853789","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}