Kansas journal of medicine最新文献

{"title":"Applications for Machine Learning in Mohs Micrographic Surgery: Increased Efficiency and Accuracy.","authors":"Kevin J Varghese","doi":"10.17161/kjm.vol16.20947","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20947","url":null,"abstract":"Mohs micrographic surgery (MMS) is a precise method of skin cancer treatment via removal in stages for complete resection of malignancy. 1 Machine learning (ML) offers multiple potential applications to the procedure, some of which are discussed here. The first step in MMS is identifying patients who meet criteria for referral, which often is completed via the histologic confirmation of skin cancer. ML may accelerate referral to a Moh’s surgeon by automatically categorizing histologic findings. For example, an image classification system was developed using a cascade of three independently-trained convolutional neural networks (CNN) to sort digitized dermatopathol-ogy slides into categories of basaloid, squamous, melanocytic, and other; this system demonstrated an accuracy of up to 98%. 2 A system such as this would allow a dermatologist who interprets biopsies to review cases of a certain category (i.e., basaloid or squamous) and refer other cases. 2 Clinical dermatologists may identify patients who meet criteria for MMS and direct them to Mohs surgeons in a timelier manner with the assistance of ML.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"246"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/23/16-246.PMC10544879.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169839","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":"The Effects of COVID-19 on General Surgery Residency Programs in the United States.","authors":"Katherine Foerster,&nbsp;Karl Fischer,&nbsp;Michael Nguyen,&nbsp;Brian W Gilbert,&nbsp;Karson R Quinn,&nbsp;Stephen D Helmer,&nbsp;George Philip","doi":"10.17161/kjm.vol16.20094","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20094","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic impacted multiple aspects of surgical education. This survey delineates steps taken by general surgery residency programs to meet changing patient-care needs while continuing to provide adequate education.</p><p><strong>Methods: </strong>A survey was administered to program directors and coordinators of all United States general surgery residency programs to assess the early effects of the pandemic on residents from March 1 through May 31, 2020.</p><p><strong>Results: </strong>Of 303 programs contacted, 132 (43.6%) completed the survey. Residents were asked to work in areas outside of their specialty at 27.3% of programs. Residency curriculum was changed in 35.6% of programs, and 76.5% of programs changed their academic conferences. Resident schedules were altered at a majority of programs to limit resident-patient exposure, increase ICU coverage, or improve resident utilization. Surgical caseloads decreased at 93.8% of programs; 31.8% of those programs reported concerns regarding residents' achieving the minimum case numbers required to graduate.</p><p><strong>Conclusions: </strong>These results provided insight into the restructuring of general surgery residency programs during a pandemic and may be used to establish future pandemic response plans.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"228-233"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/e7/16-228.PMC10544883.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171425","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":"Navigating the Path to Publication: A Guide for the Novice Researcher.","authors":"Mason A Fawcett,&nbsp;Micah K Sinclair","doi":"10.17161/kjm.vol16.21169","DOIUrl":"https://doi.org/10.17161/kjm.vol16.21169","url":null,"abstract":"INTRODUCTION Case reports are some of the most fundamental forms of medical research. Their importance is often under-estimated, and they can be very useful ways to communicate new knowledge. Writing and publishing a case report is an excellent way for new researchers to practice presenting patient information and gain experience in the publication process. They also serve as a conduit for seasoned clinicians to convey their knowledge and experience with unique diagnoses, those which may not be found in text or cohort studies, for others to build on in their treatment strategy. This article serves to provide general information on the logistics of publishing case reports in a medical journal and may be applicable to other types of scientific literature. Significance of Case Reports. Case reports are regarded as some of the oldest ways to communicate medical information, with the earliest forms of case reports dating back to the 17th century.1 While case reports include limited scientifically significant evidence in the hierarchy of medical research, their importance is undeniable. Case reports are excellent ways to investigate new or unique presentations of a disease or treatment processes and have historically been responsible for many significant medical discoveries, such as the identification of Thalomide as a cause of congenital abnormalities in the 1960s.2 Case reports also can be an excellent way for the novice medical researcher to develope familiarity with the process of publishing. Most researchers are eager for research and publication opportunities early in their career and case reports can facilitate this process.3 Additionally, for seasoned clinicians, there are a variety of situations that benefit from publication in the form of a case report as seen in Table 1.","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/e8/16-247.PMC10544869.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173517","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":"Patient Polypharmacy use Following a Multi-Disciplinary Dementia Care Program in a Memory Clinic: A Retrospective Cohort Study.","authors":"Jaime Perales-Puchalt, Crystal Burkhardt, Jordan Baker, Colin Cernik, Ryan Townley, Michelle Niedens, Jeffrey M Burns, Dinesh Pal Mudaranthakam","doi":"10.17161/kjm.vol16.20976","DOIUrl":"10.17161/kjm.vol16.20976","url":null,"abstract":"<p><strong>Introduction: </strong>Dementia increases the risk of polypharmacy. Timely detection and optimal care can stabilize or delay the progression of dementia symptoms, which may in turn reduce polypharmacy. We aimed to evaluate the change in polypharmacy use among memory clinic patients living with dementia who participated in a dementia care program compared to those who did not. We hypothesized that patients in the dementia care program would reduce their use of polypharmacy compared to those who were not in standard care.</p><p><strong>Methods: </strong>We retrospectively analyzed data extracted from electronic medical records from a university memory clinic. Data from a total of 381 patients were included in the study: 107 in the program and 274 matched patients in standard care. We used adjusted odds ratios to assess the association between enrollment in the program and polypharmacy use at follow-up (five or more concurrent medications), controlling for baseline polypharmacy use and stratified polypharmacy use by prescription and over-the-counter (OTC).</p><p><strong>Results: </strong>The two groups did not differ in the use of five or more overall and prescription medications at follow-up, controlling for the use of five or more of the respective medications at baseline and covariates. Being in the program was associated with a three-fold lower odds of using five or more OTC medications at follow-up (adjusted odds ratio = 0.30; p <0.001; 95% Confidence interval = 0.15-0.58) after controlling for using five or more OTC medications at baseline and covariates.</p><p><strong>Conclusions: </strong>Dementia care may reduce polypharmacy of OTC medications, potentially reducing risky drug-drug interactions. More research is needed to infer causality and understand how to reduce prescription medication polypharmacy.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"237-241"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/85/16-237.PMC10544887.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151466","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":"Cocaine Induced Aneurysmal Dilation of Left Main Coronary Artery.","authors":"Lawrence Zhou,&nbsp;Rajeev Seecheran,&nbsp;Abhiram Challa,&nbsp;Rhythm Vasudeva,&nbsp;Wassim Shaheen","doi":"10.17161/kjm.vol16.20048","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20048","url":null,"abstract":"244 Cocaine Induced Aneurysmal Dilation of Left Main Coronary Artery Lawrence Zhou, M.D.1,2, Rajeev Seecheran, M.D., MHA1,3, Abhiram Challa, M.D.1,3, Rhythm Vasudeva, M.D., M.S.1,2, Wassim Shaheen, M.D.4 1University of Kansas School of Medicine-Wichita, Wichita, KS 2Department of Medicine-Pediatrics 3Department of Internal Medicine 4Heartland Cardiology, Wichita, KS Department of Cardiology Received April 27, 2023; Accepted for publication Aug. 24, 2023; Published online Sept. 25, 2023 https://doi.org/10.17161/kjm.vol16.20048","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"244-245"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/7f/16-244.PMC10544888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41159363","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":"Prehospital Clinical Decision-Making for Medication Administration for Behavioral Emergencies.","authors":"Lieu Nguyen Lowrie,&nbsp;Leah Duncan,&nbsp;Dustie Angela Samuels,&nbsp;Elizabeth Ablah,&nbsp;Samuel Ofei-Dodoo","doi":"10.17161/kjm.vol16.20261","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20261","url":null,"abstract":"<p><strong>Introduction: </strong>Prehospital behavioral emergency protocols provide guidance on when a medication may be necessary for prehospital behavioral emergency. However, the final decision of which medication to administer to a patient is made independently by paramedics. The authors evaluated circumstances in a prehospital behavioral emergency when paramedics considered chemical restraints, and factors that go into choosing which medications to administer.</p><p><strong>Methods: </strong>A qualitative research design was used involving paramedics from a Midwestern County in the United States, between November 18 and 26, 2019. A total of 149 paramedics were asked to complete a survey consisting of two open-ended questions to measure their clinical decision-making process and factors considered when selecting a medication from a behavioral emergencies protocol. An immersion-crystallization approach was used to analyze the content of the interviews.</p><p><strong>Results: </strong>There was a 53% (n = 79) response rate. Six major themes emerged regarding the paramedics' decisions to use medication for behavioral emergencies: safety of the patients and paramedics, inability to use calming techniques, severity of the behavioral emergency, inability to assess the patient due to presentation, etiology of the behavioral episode, and other factors, such as age, size, and weight of the patient. Six major themes emerged regarding factors considered when choosing medication for behavioral emergency: etiology of the behavioral emergency, patient presentation, the patients' history and age, desired effect and intended outcome of the medication, and other factors.</p><p><strong>Conclusions: </strong>Emergency medical services (EMS) paramedics relied on several factors, such as safety of all parties involved and etiology of the behavioral emergency in deciding when, and which medication to use in a behavioral emergency. The findings could help EMS administrators to develop protocols, such as how paramedics respond and treat patients with behavioral health emergencies.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"189-193"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/05/b8/16-189.PMC10544877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166109","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 Scoping Review to Assess Risk of Fracture Associated with Anxiolytic Medications.","authors":"Johnathan Dallman, Levi Aldag, Amanda Klass, Morgan Hadley, Steven Clary, Armin Tarakemeh, Rosey Zackula, Tucker Morey, Bryan Vopat","doi":"10.17161/kjm.vol16.20091","DOIUrl":"10.17161/kjm.vol16.20091","url":null,"abstract":"<p><strong>Introduction: </strong>Recent research has focused on evaluating the impact of pharmalogical sources on fracture risk. The purpose of this study was to review the literature on anxiolytic medications that may be associated with an increased risk of fracture.</p><p><strong>Methods: </strong>A search was conducted in MEDLINE and Embase databases to identify primary clinical studies of patients who sustained a fracture while prescribed anxiolytic medications and were published prior to July 2021. Anxiolytics defined by ATC Class N05B, beta blockers, and zolpidem were included. The search terms consisted of variations of the following: (\"Psychotropic Drugs\" or MeSH terms) AND (\"Fracture\" or MeSH terms).</p><p><strong>Results: </strong>Of 3,213 studies, 13 (0.4%) met inclusion criteria and were evaluated. Fractures associated with benzodiazepine were reported in 12 of 13 studies; the highest risk occurred in patients aged 60 years and older (RR=2.29, 95% CI (1.48-4.40)). The ATC Class N05B showed an increased fracture risk for those ≤ 55 years of age that differed by sex: for men (RR=5.42, 95% CI(4.86-6.05)) and for women (RR=3.33, 95% CI (3.03-3.66)). Zolpidem also showed an increase fracture risk (RR=2.29, 95% CI(1.48-3.56)), but only during the first four weeks of treatment. A relative risk of 0.77, 95% CI(0.72-0.83) was observed for beta blockers.</p><p><strong>Conclusions: </strong>Fractures are a mainstay of traumatic injuries and are accompanied by economical, physiological, and psychological hardship. With proper assessment and prophylactic measures, fracture risk can be reduced dramatically. Anxiolytic medications have been described widely to increase fracture risk, such as benzodiazepines in 60+ year old patients, and ATC Class N05B anxiolytics increased fracture risk in 55+ year old men and in 55+ year old women. Yet, some studies showed that at low doses, nitrazepam lowered fracture risk. Other anxiolytic medications, such as zolpidem and beta blockers, also showed a decrease in fracture risk. Ultimately, this scoping review helped to illuminate the inconsistency of anxiolytic fracture risk assessment while simultaneously illustrating the necessary steps to guide future research.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"222-227"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/5e/16-222.PMC10544884.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144042","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":"Outpatient Oncology Fall Risk: A Quality Improvement Project.","authors":"Stephanie Hammontree,&nbsp;Maryellen Potts,&nbsp;Adam Neiberger,&nbsp;Danielle Olds,&nbsp;Daniel English,&nbsp;Jamie S Myers","doi":"10.17161/kjm.vol16.20271","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20271","url":null,"abstract":"<p><strong>Introduction: </strong>Patients receiving cancer treatment are at high risk for falls. No current guidelines or standards of care exist for assessment and prevention of outpatient oncology falls. This quality improvement project's purpose was to 1) describe and evaluate outpatient oncology falls data to determine root cause(s), and develop, implement, and evaluate intervention strategies for future policy refinement, and 2) compare fall rates pre/post implementation of a system-wide Ambulatory Fall Risk Bundle.</p><p><strong>Methods: </strong>Retrospective data were used to describe and categorize fall incidence for the University of Kansas Cancer Center over 12 months. Further analyses were conducted to describe fall rates per 10,000 kept appointments pre/post implementation of an Ambulatory Fall Risk Bundle protocol. Semi-structured interviews were conducted with medical assistants and nurse managers to evaluate the initiative's impact, staff satisfaction, and recommendations for refinement.</p><p><strong>Results: </strong>The initial 12-month assessment yielded 58 patient falls retained for further analyses. Most patients were receiving chemotherapy (46, 79%). Common contributing symptoms included dizziness/ faintness and weakness (25, 43%). Tripping/falling over a hazard (12, 24%) and falls during transfer (10, 5.8%) also were cited. Subsequent analyses of fall rates indicated no change. Recommendations resulting from the qualitative interviews included: orthostatic vital sign protocol implementation, redesign of the electronic medical record fall risk alert, stakeholder involvement in protocol development, staff training, and related patient education strategies, and the procurement of additional assistive devices/equipment.</p><p><strong>Conclusions: </strong>System-related policy and culture change, investment in physical and human resource enhancements, and evidence-based protocols are needed to improve outpatient oncology fall rates.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"200-206"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/24/6c/16-200.PMC10544871.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171424","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":"Parental Vaccine Hesitancy in a COVID-19 World: A Qualitative Study of Midwestern Parents' Decisions Regarding COVID-19 Vaccination for Their Children.","authors":"Simon D Beatty,&nbsp;Jamison B Macke,&nbsp;Kellie M Griffin,&nbsp;Jennifer A Villwock","doi":"10.17161/kjm.vol16.20049","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20049","url":null,"abstract":"<p><strong>Introduction: </strong>With the launch of the SARS-CoV-2 (COVID-19) vaccines, a new cohort of people exists who do not consider themselves to be completely vaccine-hesitant, but are specifically COVID-19 vaccine hesitant (CVH). There is a need to learn from CVH parents, to ensure their concerns are addressed, and allow them to comfortably vaccinate their children against the COVID-19 virus.</p><p><strong>Methods: </strong>Surveys were used to identify CVH parents. Using semistructured interviews, we assessed the attitudes of CVH parents toward COVID-19 vaccination in children. An inductive coding method was used to analyze transcripts and develop themes.</p><p><strong>Results: </strong>Fourteen parents were interviewed. Seven (50%) had received the COVID-19 vaccine even though they had doubts. Six reported that education about mRNA vaccine production was helpful in deciding to get vaccinated. Parents were reluctant regarding pediatric vaccination due to lack of long-term studies and concerns about adverse impact on childhood development. Personal physicians were the most trusted source of information and direct conversations with them were the most influential, as opposed to public health leaders like the U.S. Centers for Disease Control and Prevention and the National Institutes of Health.</p><p><strong>Conclusions: </strong>Our findings suggested that physicians are among the most trusted sources of information regarding the COVID-19 vaccine for CVH parents. Rather than use broad public health messaging and advertising to increase rates of vaccination, further investigation into training health professionals on how to counsel CVH patients effectively may be a higher impact area of opportunity to improve vaccine response rates.</p>","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"194-199"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/d1/16-194.PMC10544882.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41166062","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 Persistent Postictal and Inter-ictal Delirium.","authors":"Vy Le,&nbsp;Kylee Wollard,&nbsp;Ricky W Lee,&nbsp;Kamalakar Surineni","doi":"10.17161/kjm.vol16.20116","DOIUrl":"https://doi.org/10.17161/kjm.vol16.20116","url":null,"abstract":"214 A Case of Persistent Postictal and Inter-ictal Delirium Vy Le, D.O.1,2, Kylee Wollard1, Ricky W. Lee, M.D.3,4, Kamalakar Surineni, M.D.1,2 1University of Kansas School of Medicine-Wichita, Wichita, KS 2Department of Psychiatry and Behavioral Sciences 3Department of Internal Medicine 4Ascension Via Christi, Wichita, KS Received April 19, 2023; Accepted for publication July 12, 2023; Published online Aug. 24, 2023 https://doi.org/10.17161/kjm.vol16.20116","PeriodicalId":94121,"journal":{"name":"Kansas journal of medicine","volume":"16 ","pages":"214-217"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/93/16-214.PMC10544873.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171234","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}