Spartan medical research journal最新文献

{"title":"When Snoring isn’t just Snoring: Primary Nasopharyngeal Mantle Cell Lymphoma - A Rare Pathology in the Nasopharynx.","authors":"Eytan Keidar, Quynh-Nhu Vu, C. Shermetaro","doi":"10.51894/001c.7959","DOIUrl":"https://doi.org/10.51894/001c.7959","url":null,"abstract":"Snoring is a common complaint in the primary care and otolaryngology clinic with a wide differential diagnosis. Primary nasopharyngeal mantle cell lymphoma is a rare cause of a nasopharyngeal mass, which can commonly manifest as snoring. The patient in this case presented with extensive history of recent worsening snoring as well as nasal congestion over the past several months. Additionally, the patient had previously undergone endoscopic sinus surgery several years prior but was lost to follow up. During nasal endoscopy, a nasopharyngeal mass was visualized with near-complete obstruction of the nasal airway. Intraoperative biopsies indicated MCL which is an uncommon pathology presenting in a rare location. Flow cytometry of the biopsy specimen was CD19+, CD20+, CD5+, and positive for lambda light chains with immunohistochemistry showed strong diffuse cyclin D1 nuclear staining on lymphoid cells. PET/CT and bone marrow biopsy were essential in staging disease, predicting success of treatment, and determining optimal treatment planning. Once the diagnosis was established, R-CHOP therapy alternating with R-DHAP for a total of six cycles. This case report highlights the importance of recognizing new or changing symptoms, appropriate diagnostic workup for lymphoma, as well as one of few case reports describing primary nasopharyngeal mantle cell lymphoma.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43559833","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":"Introducing Osteopathic Curriculum for Family Medicine Physicians in a Community-based Allopathic Residency Program.","authors":"Jacob Turnbull,&nbsp;Dan Merck,&nbsp;Karri MacMillan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Context: </strong>Will increased exposure to osteopathic medicine improve allopathic resident and attending physicians' support of implementing an osteopathic curriculum in graduate medical education? The overall goal of this quality improvement project was to examine the familiarity and interest of allopathically-trained residents and attendings with osteopathic medicine before, and after, a brief educational workshop.</p><p><strong>Methods: </strong>Setting: Mercy Health Saint Mary's Hospital in Grand Rapids, MI. Participants included a sample of 27 Family Medicine (FM) residents and attendings who had been trained in allopathic medical schools. First, a one-hour lecture on \"Foundations of Osteopathic Medicine\" was given. The lecture included a PowerPoint presentation followed by a 15-minute hands-on demonstration of osteopathic diagnosis and treatment. A pre and post-workshop survey modified from another larger study was administered to all attendees. Primary selected outcomes included percentage of allopathic resident participation in attendance and pre-post-workshop response differences.</p><p><strong>Results: </strong>Of the 31 allopathic residents in this community-based FM program, 23 (74.2%) were present for the lecture and completed both a pre and post-workshop survey. A total of 24 (78%) of participants had never attended a previous lecture on osteopathic medicine. Respondents' overall attitude regarding the implementation of an osteopathic curriculum was generally positive after the workshop. Of the 27 participants (23 residents and four attendings) surveyed before the lecture, 23 (85.2%) were initially interested in learning how to perform osteopathic manual treatment (OMT), this increasing to 25 (92.6%) after the workshop. The Mercy Health FM resident respondents were initially first supportive of osteopathic medicine at 59.3%, improving to 77.8% after completing the workshop.</p><p><strong>Conclusions: </strong>These results suggest that many allopathically trained physicians may lack exposure to osteopathic medicine principles. In this allopathic-oriented residency sample setting, a relatively brief workshop increased attendees' interest in osteopathic medicine. Results suggest that initial and refresher exposure to osteopathic medicine content and OMT practices during residency curricula can be used to elicit support from allopathically-trained resident physicians.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 1","pages":"9059"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424607","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":"Introducing Osteopathic Curriculum for Family Medicine Physicians in a Community-based Allopathic Residency Program","authors":"J. Turnbull, D. Merck, Karri MacMillan","doi":"10.51894/001c.9059","DOIUrl":"https://doi.org/10.51894/001c.9059","url":null,"abstract":"CONTEXT Will increased exposure to osteopathic medicine improve allopathic resident and attending physicians’ support of implementing an osteopathic curriculum in graduate medical education? The overall goal of this quality improvement project was to examine the familiarity and interest of allopathically-trained residents and attendings with osteopathic medicine before, and after, a brief educational workshop. METHODS Setting: Mercy Health Saint Mary’s Hospital in Grand Rapids, MI. Participants included a sample of 27 Family Medicine (FM) residents and attendings who had been trained in allopathic medical schools. First, a one-hour lecture on “Foundations of Osteopathic Medicine” was given. The lecture included a PowerPoint presentation followed by a 15-minute hands-on demonstration of osteopathic diagnosis and treatment. A pre and post-workshop survey modified from another larger study was administered to all attendees. Primary selected outcomes included percentage of allopathic resident participation in attendance and pre-post-workshop response differences. RESULTS Of the 31 allopathic residents in this community-based FM program, 23 (74.2%) were present for the lecture and completed both a pre and post-workshop survey. A total of 24 (78%) of participants had never attended a previous lecture on osteopathic medicine. Respondents’ overall attitude regarding the implementation of an osteopathic curriculum was generally positive after the workshop. Of the 27 participants (23 residents and four attendings) surveyed before the lecture, 23 (85.2%) were initially interested in learning how to perform osteopathic manual treatment (OMT), this increasing to 25 (92.6%) after the workshop. The Mercy Health FM resident respondents were initially first supportive of osteopathic medicine at 59.3%, improving to 77.8% after completing the workshop. CONCLUSIONS These results suggest that many allopathically trained physicians may lack exposure to osteopathic medicine principles. In this allopathic-oriented residency sample setting, a relatively brief workshop increased attendees’ interest in osteopathic medicine. Results suggest that initial and refresher exposure to osteopathic medicine content and OMT practices during residency curricula can be used to elicit support from allopathically-trained resident physicians.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42157540","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":"Effectiveness of Hands-Only Cardiopulmonary Resuscitation Teaching on Lay Bystander Attitudes Toward Future Resuscitation","authors":"Jenna R. Nofzinger, E. Kakish, Nael O. Bahhur, Joseph J Ryno, M. Pillai, J. Debelly, Corion Jones","doi":"10.51894/001c.8749","DOIUrl":"https://doi.org/10.51894/001c.8749","url":null,"abstract":"CONTEXT It is estimated that there are approximately 1,000 sudden cardiac events occurring daily outside of the hospital setting in the US. OBJECTIVES The objectives of this pilot project were to determine lay participants’ ability to remember the steps of hands-only cardiopulmonary resuscitation (HOCPR) following a 30-minute instructional session regarding proper technique and their willingness to perform bystander CPR (BCPR) on victims of sudden cardiac arrest outside in the community. SAMPLE AND SETTING A nine-item survey questionnaire that was created by the authors was first administered to a sample of 75 adults who had volunteered at their institutions’ emergency department. Inclusion criteria included all adults over the age of eighteen years. OUTCOME MEASURES To gauge whether basic HOCPR training improved bystander preparedness and willingness to provide assistance to a victim of sudden cardiac event. METHODS After IRB approval, participants were shown a one-minute video by the American Heart Association (AHA) and provided a 30-minute demonstration of key HOCPR skills on a mannequin. A post-instruction nine-item survey was sent by mail/email or administered by phone at one month after training to assess participants’ retention of HOCPR knowledge and attitude. RESULTS The initial survey responses showed 75 (100%) were able to recall the basic steps of HOCPR, with 59 (79%) “very likely” to help provide BCPR. Not needing to provide breaths made 57 (76%) of lay participants more willing to assist a person in need. A subgroup of 31 (41%) of the initial 75 participants were lost to follow-up. Out of the 44 (59%) who completed the one-month survey, 44 (100%) of participants remembered the primary HOCPR steps and technique. A subgroup of 32 (73%) one-month respondents indicated that they were more likely to assist victims if rescue breathing was not required, and 11 (25%) had reportedly tried to teach family and friends about HOCPR. CONCLUSIONS These results indicate that of those involved in the survey, the majority could recall the correct steps and be willing to provide HOCPR. These results could help in shaping community outreach and training programs designed to improve the rate and quality of response to victims of sudden cardiac arrest.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49419466","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":"Relationship between BI-RADS and the Results of the Wire-Guided Percutaneous Localization for Non-Palpable Breast Lesions.","authors":"Mohamad Dughayli, Jason DeFatta, Ayda Dashtaei, Amber Peace, Fadi Baidoun, Gregory Olson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to evaluate the relationship between Breast Imaging Reporting and Data System and surgical biopsies that may increase effectiveness of wire-guided percutaneous localizations for non-palpable breast lesions.</p><p><strong>Methods: </strong>A retrospective review of a sample of 149 patients who underwent wire-guided localization with wide local excision for non-palpable breast lesions at the authors' institution between January 2013 and April 2016. After IRB approval, sample patients' records were reviewed and data were collected concerning their radiological, histological and surgical characteristics.</p><p><strong>Results: </strong>One (0.67%) complication occurred related to wire migration. There were nine (6.04%) recorded cases of seroma and three (2.01%) cases of hematoma. Breast Imaging Reporting and Data System (BI-RADS) Category 4 was found to have a positive predictive value of 28.4% for breast cancer. Under Category 4 subcategorization 4A, 4B, and 4C, the number of positive lesions were two (6.89%), three (10.34%) and five (17.24%), respectively. Forty (78.43%) of the 51 patients with cancer had negative (i.e., non-cancerous) margins compared to 11 (21.57%) cases that had positive margins after the first procedure.</p><p><strong>Conclusion: </strong>The BI-RADS Category 4 encompasses the majority of lesions, with approximately 70% of such biopsies lesions later found to be benign. A subcategorization of BI-RADS 4 needs further clarification in distinguishing benign vs malignant imaging characteristics. Future retrospective studies designed to identify benign vs. malignant lesions, confirmed by validating prospective studies, will better clarify a new subcategorization of BI-RADS Category 4, thus allowing surgeons and radiologists to make the best surgical recommendations for their patients.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 1","pages":"9061"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424608","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":"Relationship between BI-RADS and the Results of the Wire-Guided Percutaneous Localization for Non-Palpable Breast Lesions","authors":"Mohamad Dughayli, Jason DeFatta, Ayda Dashtaei, Amber Peace, Fadi Baidoun, Gregory W. Olson","doi":"10.51894/001c.9061","DOIUrl":"https://doi.org/10.51894/001c.9061","url":null,"abstract":"INTRODUCTION The aim of this study is to evaluate the relationship between Breast Imaging Reporting and Data System and surgical biopsies that may increase effectiveness of wire-guided percutaneous localizations for non-palpable breast lesions. METHODS A retrospective review of a sample of 149 patients who underwent wire-guided localization with wide local excision for non-palpable breast lesions at the authors’ institution between January 2013 and April 2016. After IRB approval, sample patients’ records were reviewed and data were collected concerning their radiological, histological and surgical characteristics. RESULTS One (0.67%) complication occurred related to wire migration. There were nine (6.04%) recorded cases of seroma and three (2.01%) cases of hematoma. Breast Imaging Reporting and Data System (BI-RADS) Category 4 was found to have a positive predictive value of 28.4% for breast cancer. Under Category 4 subcategorization 4A, 4B, and 4C, the number of positive lesions were two (6.89%), three (10.34%) and five (17.24%), respectively. Forty (78.43%) of the 51 patients with cancer had negative (i.e., non-cancerous) margins compared to 11 (21.57%) cases that had positive margins after the first procedure. CONCLUSION The BI-RADS Category 4 encompasses the majority of lesions, with approximately 70% of such biopsies lesions later found to be benign. A subcategorization of BI-RADS 4 needs further clarification in distinguishing benign vs malignant imaging characteristics. Future retrospective studies designed to identify benign vs. malignant lesions, confirmed by validating prospective studies, will better clarify a new subcategorization of BI-RADS Category 4, thus allowing surgeons and radiologists to make the best surgical recommendations for their patients.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47891782","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 Case of Humoral Hypercalcemia of Malignancy Secondary to Hepatocellular Carcinoma with Fulminant Clinical Course.","authors":"Pamela Castro-Camero, Bumsoo Park, Amit Gupta, Raghavendra Vemulapalli, Maria Shreve","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Hepatocellular carcinoma is one of the most common liver malignancies in the United States. Poor prognosis is associated with paraneoplastic syndromes such as hypercalcemia, hypercholesterolemia, or hypoglycemia. Hypercalcemia as a paraneoplastic syndrome of hepatocellular carcinoma has been rarely reported. We report a mortality case of incidentally diagnosed hepatocellular carcinoma associated with humoral hypercalcemia of malignancy. The patient demonstrated a fulminant disease course with an unexpected fatal outcome within 40 days of initial diagnosis. Our case can suggest importance of early definitive treatment of hepatocellular carcinoma, extremely close monitoring, and aggressive medical treatment when it is associated with humoral hypercalcemia of malignancy.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 1","pages":"8983"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184457","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":"A Case of Humoral Hypercalcemia of Malignancy Secondary to Hepatocellular Carcinoma with Fulminant Clinical Course","authors":"Pamela A. Castro-Camero, Bumsoo Park, Amit Gupta, Raghavendra C Vemulapalli, Maria E. Shreve","doi":"10.51894/001c.8983","DOIUrl":"https://doi.org/10.51894/001c.8983","url":null,"abstract":"Hepatocellular carcinoma is one of the most common liver malignancies in the United States. Poor prognosis is associated with paraneoplastic syndromes such as hypercalcemia, hypercholesterolemia, or hypoglycemia. Hypercalcemia as a paraneoplastic syndrome of hepatocellular carcinoma has been rarely reported. We report a mortality case of incidentally diagnosed hepatocellular carcinoma associated with humoral hypercalcemia of malignancy. The patient demonstrated a fulminant disease course with an unexpected fatal outcome within 40 days of initial diagnosis. Our case can suggest importance of early definitive treatment of hepatocellular carcinoma, extremely close monitoring, and aggressive medical treatment when it is associated with humoral hypercalcemia of malignancy.","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45959394","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":"Do Not Let it Be the Last: End-of-Life Care Decisions in the Primary Care Clinic","authors":"My-Trang T. Dang, Zohair Ahmed, Jason M. Betcher, Saloni H Kadakia, Samuel J Wisniewski, J. W. Sealey","doi":"10.51894/001c.9204","DOIUrl":"https://doi.org/10.51894/001c.9204","url":null,"abstract":"CONTEXT For many patients, end-of-life care (EOLC) wishes are unknown and are generally only brought up during healthcare crises. During such healthcare episodes, loved ones are often distraught, and as such, can find it difficult to focus on details surrounding the event. The best place for these discussions may be in non-acute settings including primary care clinics. The purpose of this study was to examine how well a sample of patients (N = 177) in three Michigan-based primary care teaching clinics thought they and their loved ones were prepared in terms of having their EOLC wishes known. METHODS Prospective data were collected from three Internal Medicine teaching clinics in the Metro-Detroit area through an anonymous written survey addressing EOLC issues in a 16-item cross-sectional study. Respondents were adult patients at one of three participating primary care clinics. Perceived preparedness for EOLC was measured by: 1) possibly having had a prior EOLC discussion with a healthcare provider 2) having created an Advance Directive, such as a Durable Power of Attorney (DPOA) or Living Will with medical decision preferences, 3) reported preferences for quality versus quantity of life, and 4) preferences for CPR and other specific life-sustaining interventions. RESULTS In this sample, 77 (43.5%) of 177 respondents had discussed their EOLC wishes with a provider. Regarding Advance Directives, 63/177 (35.6%) had established a DPOA, and 59/177 (22%) had made a Living Will. The majority of respondents preferred quality over quantity of life. The most difficult EOLC questions included the decision for CPR, tracheostomy, and PEG tube placement. CONCLUSIONS Based on these results, EOLC discussions probably occur infrequently in the primary care or other healthcare settings. Most survey responses indicated that sample patients were unprepared concerning the details of future EOLC decisions. Engagement of such discussions should be a part of routine visits in the primary care clinic and should be re-visited when there is a change in a patient’s health. Further larger-scale studies using validated surveys are required in this vitally important area of practice. Key Words: advance care planning, end-of-life care conversations, primary care","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47934376","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 Unusual Suspect: Gadobenate-Dimeglumine Induced Kounis Syndrome.","authors":"Faiza Choudhry, Michael Fackler, Mithil Patel, Vijay Patel, Jelena Arnautovic","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A myocardial bridge has traditionally been considered a benign condition characterized by an atypical intramyocardial route of a segment of one of the major coronary arteries. However, the clinical complications of myocardial bridges can be dangerous. These potential complications include acute coronary syndromes, arrhythmias, ventricular dysfunction, and sudden death. Myocardial bridges are suspected to be adjuvant of Kounis syndrome, which is defined as an acute coronary syndrome caused by an allergic reaction. Due to high epidemiologic prevalence, clinical suspicion of a myocardial bridge should be considered in atypical and typical presentations of chest pain, especially in patients with low-risk factors for atherosclerotic disease. A male in their late 30's presented with non-ST elevation myocardial infarction suspected to be secondary to Kounis syndrome after gadobenate dimeglumine contrast media was used for an imaging study. His clinical presentation was further complicated when he was found to have a mid-left anterior descending coronary artery myocardial bridge.</p>","PeriodicalId":74853,"journal":{"name":"Spartan medical research journal","volume":"4 1","pages":"8999"},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25424606","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}