Veterinary medicine (Auckland, N.Z.)最新文献

{"title":"Cannabinoid, Terpene, and Heavy Metal Analysis of 29 Over-the-Counter Commercial Veterinary Hemp Supplements.","authors":"Joseph J Wakshlag, Stephen Cital, Scott J Eaton, Reece Prussin, Christopher Hudalla","doi":"10.2147/VMRR.S248712","DOIUrl":"10.2147/VMRR.S248712","url":null,"abstract":"<p><strong>Purpose: </strong>The use of veterinary low tetrahydrocannabinol (THC) <i>Cannabis sativa</i> (ie, hemp) products has increased in popularity for a variety of pet ailments. Low-THC <i>Cannabis sativa</i> is federally legal for sale and distribution in the USA, and the rise in internet commerce has provided access to interested consumers, with minimal quality control.</p><p><strong>Materials and methods: </strong>We performed an internet word search of \"hemp extract and dog\" or \"CBD product and dog\" and analyzed 29 products that were using low-THC <i>Cannabis sativa</i> extracts in their production of supplements. All products were tested for major cannabinoids including cannabidiol (CBD), ∆9-tetrahydrocannabinol (THC), cannabigerol (CBG), and other minor cannabinoids, as well as their carboxylic acid derivatives (CBDA, THCA, CBGA) using an ISO/IEC 17025 certified laboratory. Products were also tested for major terpenes and heavy metals to understand constituents in the hemp plants being extracted and distributed.</p><p><strong>Results: </strong>All products were below the federal limit of 0.3% THC with variable amounts of CBD (0-88 mg/mL or g). Only two products did not supply a CBD or total cannabinoid concentration on their packaging or website, while 22/29 could supply a certificate of analysis (COA) from a third-party laboratory. Ten of the 27 products were within 10% of the total cannabinoid concentrations of their label claim with a median concentration of 93% of claims (0-154%). Heavy metal contamination was found in 4/29 products, with lead being the most prevalent contaminant (3/29).</p><p><strong>Conclusion: </strong>The products analyzed had highly variable concentrations of CBD or total cannabinoids with only 18 of 29 being appropriately labeled according to current FDA non-medication, non-dietary supplement or non-food guidelines. Owners and veterinarians wanting to utilize CBD-rich <i>Cannabis sativa</i> products should be aware of low-concentration products and should obtain a COA enabling them to fully discuss the implications of use and calculated dosing before administering to pets.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"45-55"},"PeriodicalIF":0.0,"publicationDate":"2020-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/31/vmrr-11-45.PMC7169471.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37882505","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":"Effects of Supplementation with Anti-Inflammatory Compound Extracted from Herbs in Healthy and Obese Cats.","authors":"Motoo Kobayashi,&nbsp;Yuki Okada,&nbsp;Hiromichi Ueno,&nbsp;Takayuki Mizorogi,&nbsp;Kenji Ohara,&nbsp;Koh Kawasumi,&nbsp;Kohei Suruga,&nbsp;Kazunari Kadokura,&nbsp;Yasuyuki Ohnishi,&nbsp;Toshiro Arai","doi":"10.2147/VMRR.S240516","DOIUrl":"https://doi.org/10.2147/VMRR.S240516","url":null,"abstract":"<p><strong>Background: </strong>Obesity has become a serious public health problem all over the world, and prevalence of obesity has increased in cats. Obesity is characterized by continuous low-grade inflammation based on oxidative stress by excessively produced reactive oxygen species (ROS). Supplementation with anti-oxidant and anti-inflammatory compounds is very effective to relieve the obesity condition. A plant extract mixture containing <i>Rhus verniciflua</i> and some other herbs, Rv-PEM01-99, shows anti-oxidant and anti-inflammatory effects in animals. The aim of this study was to evaluate the effects of supplementation with Rv-PEM01-99 as an anti-inflammatory compound in healthy and obese cats.</p><p><strong>Materials and methods: </strong>Ten healthy mix breed cats and four obesity disease cats were used. The healthy cats were randomly divided into control and test groups. Anti-inflammatory compound, Rv-PEM01-99, in which quercetin derivative is the main component, was supplemented to the healthy test group and the obesity disease cats at the dose of 100-120 mg/kg/day (2.5-3.0 mg/kg/day as quercetin) for 4 weeks. Metabolites, hormones and enzymes were measured before and after the compound supplementation.</p><p><strong>Results: </strong>The anti-inflammatory compound supplementation decreased serum amyloid A (SAA) concentrations as inflammatory markers in both healthy and obesity disease cats. In obesity disease cats, plasma total cholesterol concentrations and AST and ALT activities decreased significantly after the compound supplementation.</p><p><strong>Conclusion: </strong>Quercetin derivative seems to have strong anti-inflammatory activities. In the healthy cats, anti-inflammatory compound supplementation decreased plasma NEFA and SAA concentrations. In the obesity disease cats, the compound supplementation may have alleviated obesity disease by relieving inflammation and improvement of lipid metabolism in livers.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S240516","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37774556","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":"Assessment of a Single Intra-Articular Stifle Injection of Pure Platelet Rich Plasma on Symmetry Indices in Dogs with Unilateral or Bilateral Stifle Osteoarthritis from Long-Term Medically Managed Cranial Cruciate Ligament Disease.","authors":"Kurt P Venator,&nbsp;Christopher W Frye,&nbsp;Lauri-Jo Gamble,&nbsp;Joseph J Wakshlag","doi":"10.2147/VMRR.S238598","DOIUrl":"https://doi.org/10.2147/VMRR.S238598","url":null,"abstract":"<p><strong>Purpose: </strong>The use of platelet-rich plasma (PRP) to treat canine osteoarthritis has gained support within the scientific community. PRP effects on pain control for degenerative joint disease induced by naturally occurring cranial cruciate ligament instability are limited, particularly in a cohort of dogs with chronic instability and osteoarthritis (>12 months), representing a commonly encountered clinical population that often defaults to medical management. The goal of this study was to assess the effects of a single intra-articular PRP injection into an effected stifle in this cohort, to assess response to treatment, quantitative kinetic data as it relates to percent body weight for peak vertical force (PVF) and vertical impulse (VI) were collected, and symmetry indices related to PVF were determined.</p><p><strong>Methods: </strong>Twelve dogs with unilateral or bilateral osteoarthritis with ruptured, non-stabilized cranial cruciate ligaments over 12 months duration were identified. Unilateral injections of 2.5 mL of a PRP preparation into the most severely affected stifle based on kinetic analysis was performed. Repeat pressure-sensitive walkway analysis was conducted monthly for 3 months. Peak vertical force (PVF) and vertical impulse (VI) were normalized to body weight and identified in all four limbs. Previously published symmetry indices regarding PVF were calculated, comparing the treated limb with the contralateral limb, ipsilateral forelimb, and contralateral forelimb.</p><p><strong>Results: </strong>After treatment, hind limb symmetry index (SI) regarding PVF showed improved symmetry, suggesting more weight placement at all-time points after injection of the most affected limb (p < 0.01). Further, PVF asymmetry indices assessing contralateral fore (CFL) and hind limb (CHL) as well as ipsilateral forelimb (IFL) revealing a significant decrease from baseline for CHL at week 4 (p = 0.02), but not weeks 8 and 12. The CFL showed decreased differences in symmetry from baseline at each time point (p = 0.03). There were no statistically significant changes in PVF or VI over time in treated dogs.</p><p><strong>Conclusion: </strong>A single injection of PRP improved kinetics for minimally 4 weeks with some data suggesting an effect for up to 12 weeks. Therefore, PRP might be a viable therapeutic option for instability and inflammation associated with chronic osteoarthritis due to cranial cruciate ligament disease in the non-surgical patient.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"31-38"},"PeriodicalIF":0.0,"publicationDate":"2020-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S238598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37774555","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":"<i>Salmonella</i> Mesenteric Lymphadenitis Causing Septic Peritonitis in Two Dogs.","authors":"Erin M Binagia,&nbsp;Nyssa A Levy","doi":"10.2147/VMRR.S238305","DOIUrl":"https://doi.org/10.2147/VMRR.S238305","url":null,"abstract":"<p><p>This report describes two cases of <i>Salmonella</i> mesenteric lymphadenitis leading to septic peritonitis in two young dogs. The cases were similar in presentation, diagnosis, treatment, and length of hospitalization. Both cases presented with clinical signs of vomiting, abdominal pain, and fever and were treated successfully via surgical debridement, omentalization, and antibiotic therapy. Both cases grew multi-drug resistant <i>Salmonella</i> spp. with resistance to ampicillin sulbactam, which is a common empiric antibiotic choice for cases of canine septic peritonitis. In both cases, the source of <i>Salmonella</i> is proposed to be the raw diet that preceded the septic peritonitis diagnosis. While <i>Salmonella</i> mesenteric lymphadenitis has been reported in humans and pigs, to the authors' knowledge, this is the first report of <i>Salmonella</i> mesenteric lymphadenitis in dogs.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S238305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37729539","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":"Vaccine Protection Against Experimental Challenge Infection with a PPV-27a Genotype Virus in Pregnant Gilts.","authors":"István Kiss,&nbsp;Edit Kovács,&nbsp;Zoltán Zádori,&nbsp;István Mészáros,&nbsp;Attila Cságola,&nbsp;Pál Bajnóczi,&nbsp;Preben Mortensen,&nbsp;Vilmos Palya","doi":"10.2147/VMRR.S236912","DOIUrl":"https://doi.org/10.2147/VMRR.S236912","url":null,"abstract":"<p><strong>Background/introduction: </strong>Porcine parvovirus (PPV), the causative agent of severe reproductive failures in pigs, is present worldwide. The witnessed spread of the virulent 27a type PPV strains since its recognition raised concerns about the efficacy of the available commercial vaccines.</p><p><strong>Methods: </strong>To address this question, vaccinated pregnant gilts were challenged with a PPV-27a-like virus strain and parameters related to vaccine efficacy were compared.</p><p><strong>Results: </strong>The K22 vaccine strain of Parvoruvax^® (PVX) was characterized as \"Kresse-like\" based on the epitope mapping data. Vaccination of the gilts induced a low level of antibody responses. Based on foetal mortality, the number of sows which had challenge virus-affected foetuses, the percent of PPV positive piglets/litters plus their PPV genome and viral load PVX outscored the other vaccinated groups.</p><p><strong>Conclusion: </strong>Stronger protection was provided by the \"Kresse-like\" K22 PPV strain-based vaccine than by the NADL-2 and NADL-like strain-based commercial vaccines against a PPV-27a cluster strain challenge. Vaccine-induced antibody levels as measured pre-challenge were not found to be an accurate indicator of protection.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2020-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S236912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37725808","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":"Erratum: Canine Degenerative Lumbosacral Stenosis: Prevalence, Impact and Management Strategies [Corrigendum].","authors":"","doi":"10.2147/VMRR.S247481","DOIUrl":"https://doi.org/10.2147/VMRR.S247481","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2147/VMRR.S180448.].</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2020-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S247481","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37683197","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":"Transsphenoidal Surgery in Canines: Safety, Efficacy and Patient Selection.","authors":"Yasushi Hara","doi":"10.2147/VMRR.S175995","DOIUrl":"https://doi.org/10.2147/VMRR.S175995","url":null,"abstract":"<p><p>Pituitary-dependent hyperadrenocorticism (PDH) is the cause of approximately 80-85% of naturally occurring cases of hyperadrenocorticism(HAC) in canines and is triggered by an adrenocorticotropic hormone (ACTH)-producing pituitary adenoma or hyperplasia of the corticotroph in the pituitary anterior lobe or intermediate lobe. Transsphenoidal surgery(TSS) is an effective treatment that can directly remove pituitary tumors that cause PDH in canines under a single course of general anesthesia. However, careful evaluations of the definitive diagnosis, adenoma size and growth rate, relationship with surrounding tissue, general condition, and neurosurgical procedural skill involved in each case are important to determine TSS suitability. The basic principle is to confirm that the present HAC case is PDH, that is, an ACTH-producing adenoma or the hyperplasia of the corticotroph originating from either the pituitary anterior or intermediate lobe. Evaluations based on endocrinology, particularly plasma ACTH concentration, and imaging diagnosis, particularly MRI is essential for definitive diagnosis. Enlarged pituitary tumors can shorten the post-TSS survival time, increase the recurrence rate of clinical symptoms, and increase the risk for developing permanent central diabetes insipidus. Therefore, complete removal of adenomas of up to Grade IIIA according to the MRI-based classification system is relatively easy to achieve with TSS, and long-term remission and survival can be expected.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"11 ","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S175995","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37611417","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":"Contagious Agalactia In Sheep And Goats: Current Perspectives.","authors":"Maryne Jaÿ,&nbsp;Florence Tardy","doi":"10.2147/VMRR.S201847","DOIUrl":"10.2147/VMRR.S201847","url":null,"abstract":"<p><p>Contagious agalactia (CA) is a disease caused equally by four <i>Mycoplasma</i> species, in single or mixed infections. Clinical signs are multiple, including mastitis, arthritis, keratoconjunctivitis, pneumonia, and septicemia, non-specific, and expressed differently depending whether sheep or goats are affected, on causative mycoplasmas as well as type of husbandry. CA has been reported worldwide and its geographic distribution maps to that of small ruminant breeding areas. However, as current diagnostic tests are expensive and difficult to implement, it is certainly underdiagnosed and prevalence data are only available for a few countries. CA control relies on vaccines, chemotherapy and good herd management practices. It requires long-term commitment but is often unsuccessful, with frequent clinical relapses. The persistence of the etiological agents, despite their overall susceptibility to antimicrobials, comes from their genetic plasticity and capacity to escape the host immune response. The existence of asymptomatic carriers and the numerous sources of infections contribute to rapid spread of the disease and complicate the control and prevention efforts. Here we review all these aspects in order to highlight recent progress made and identify gaps in knowledge or tools needed for better disease management. Discussion also underlines the detrimental effect of contagious agalactia on small ruminant welfare.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"10 ","pages":"229-247"},"PeriodicalIF":0.0,"publicationDate":"2019-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S201847","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37529279","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":"Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Rupture in Canines: Patient Selection and Reported Outcomes.","authors":"Andy Nanda,&nbsp;Eric C Hans","doi":"10.2147/VMRR.S204321","DOIUrl":"https://doi.org/10.2147/VMRR.S204321","url":null,"abstract":"<p><p>Cranial cruciate ligament (CCL) rupture is one of the most common causes of pelvic limb lameness in dogs. In a CCL deficient stifle, joint lameness develops from cranial tibial translation in relation to the distal femoral condyles. The tibial plateau leveling osteotomy (TPLO) is a well-described surgical procedure that neutralizes tibiofemoral shear force by altering the tibial plateau via a proximal tibial osteotomy, and subsequently restores normal limb function. Current literature for the TPLO was reviewed and used to describe the optimal patient selection and to report clinical outcome with the TPLO in comparison to other surgical options for CCL rupture. The clinical outcomes reported to date, particularly those utilizing objective outcome data, support the TPLO as being able to consistently return dogs to normal limb function with a low risk for long-term morbidity. The TPLO procedure was found to be widely applicable to dogs ranging from small breed to large and giant breed, and does not appear to have some of the limitations that exist with alternative surgical options. This review concludes that the TPLO is an excellent treatment option for any dog with CCL rupture due to the excellent long-term outcome and high rate of owner satisfaction previously reported. Despite these conclusions, it is important to remember that treatment selection for CCL rupture remains dependent on multiple considerations including patient factors, surgeon experience, and costs.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"10 ","pages":"249-255"},"PeriodicalIF":0.0,"publicationDate":"2019-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S204321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37529278","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":"<i>Toxoplasma gondii</i> And <i>Neospora caninum</i> In Brain Tissue Of Rodents In North-West Iran.","authors":"Naser Nazari,&nbsp;Saeedeh Shojaee,&nbsp;Mehdi Mohebali,&nbsp;Aref Teimouri,&nbsp;Keyghobad Ghadiri,&nbsp;Saber Raeghi,&nbsp;Mohammad Reza Shiee,&nbsp;Yousef Azarakhsh,&nbsp;Arezoo Bozorgomid","doi":"10.2147/VMRR.S224664","DOIUrl":"https://doi.org/10.2147/VMRR.S224664","url":null,"abstract":"<p><strong>Purpose: </strong>Rodents live in proximity to humans and domestic animals. These creatures can serve as reservoir hosts for many zoonotic parasites; therefore, they increase the risk of human infections. The aim of this study was to investigate <i>Toxoplasma gondii</i> and <i>Neospora caninum</i> in rodents caught in Meshgin-Shahr District, Iran.</p><p><strong>Patients and methods: </strong>In a cross-sectional study, brain samples were collected from 70 rodents caught in Meshgin-Shahr District during March and December 2015. The specimens were examined for exposure to <i>T. gondii</i> and <i>N. caninum</i> with molecular methods.</p><p><strong>Results: </strong>Seventy rodents were caught, including 50 <i>Meriones persicus</i>, 11 <i>Mus musculus</i> and 9 <i>Cricetulus migratorius</i>. Thirty rodents were female and 40 were males. Using PCR (B1 gene), <i>T. gondii</i> was detected in 7.1% (5/70) of the rodents while <i>N. caninum</i> was not detected. The prevalence of <i>Toxoplasma</i> infection was higher in female rodents (4.28%) compared to male rodents (2.86%), but the difference was not significant.</p><p><strong>Conclusion: </strong>The results showed a low risk of <i>T. gondii</i> and <i>N. caninum</i> among rodents. Finally, further research is needed to understand the role of these rodent species in the transmission of the above protozoan pathogens to humans and livestock in this area.</p>","PeriodicalId":75300,"journal":{"name":"Veterinary medicine (Auckland, N.Z.)","volume":"10 ","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/VMRR.S224664","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37518718","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}