Biochemia medica最新文献

{"title":"Spurious life-threatening hypermagnesemia caused by a preanalytical error in an intensive care unit: a case report.","authors":"Tara Rolić, Inja Pavlić, Ivana Sarić","doi":"10.11613/BM.2026.031001","DOIUrl":"https://doi.org/10.11613/BM.2026.031001","url":null,"abstract":"<p><p>Accurate measurement of electrolytes is essential in critically ill patients. Magnesium (Mg) concentrations are particularly vulnerable to preanalytical errors, which may lead to life-threatening misinterpretation. A 57-year-old woman was admitted to the intensive care unit (ICU) due to acute decompensated heart failure and atrial fibrillation. On the second day of ICU hospitalization, serum samples analyzed in the emergency laboratory revealed critically low sodium (Na), potassium (K), and chloride (Cl) concentrations, accompanied by extremely elevated Mg concentrations that were considered incompatible with life. Given the discrepancy between life-threateningly high Mg concentrations and the patient's stable clinical condition, as confirmed by clinicians, who reported no signs of hyporeflexia, respiratory depression, or other symptoms of Mg toxicity, the laboratory medicine professional (LMP) initiated urgent communication with the clinical staff and recommended repeating the blood draw and all analyses. A reflex glucose measurement revealed a markedly elevated concentration (55.4 mmol/L), indicating contamination with a glucose infusion. The repeated analysis showed Mg and other electrolyte concentrations within reference ranges. Further investigation confirmed that blood sampling had been performed from the same arm and venous catheter through which infusion was being administered. The abnormal laboratory findings were explained by a preanalytical error caused by blood sampling during active infusion. This case emphasizes the importance of appropriate documentation of ongoing intravenous therapy and blood sampling conditions, as well as communication between the LMP and clinical staff. Awareness of preanalytical variables is essential to prevent misinterpretation of laboratory results and inappropriate patient treatment.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"031001"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804265","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":"Beyond accuracy: how often and in which direction diagnostic tests err.","authors":"Farrokh Habibzadeh","doi":"10.11613/BM.2026.030101","DOIUrl":"10.11613/BM.2026.030101","url":null,"abstract":"<p><p>Diagnostic tests are commonly evaluated using sensitivity, specificity, predictive values, likelihood ratios, and receiver operating characteristic (ROC) curve analysis. Although essential, these measures do not fully answer two practical questions frequently raised in clinical medicine: how often a test makes mistakes, and whether those mistakes are predominantly false positive or false negative. This article introduces two complementary measures that address these questions: the number needed to misdiagnose (NNM), which expresses the frequency of diagnostic error in intuitive clinical terms, and the misdiagnosis direction index (MDI), which indicates whether errors are mainly false positive or false negative. A weighted MDI is also introduced for unequal clinical harms of errors. Together with conventional indices such as Youden's index, these measures provide a broader framework for interpreting diagnostic performance.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030101"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121654","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":"Moving percentage of failed delta checks: a novel patient-based quality control model.","authors":"Niyazi Samet Yilmaz, Bayram Sen, Sena Turkmen, Hikmet Can Çubukçu, Ozlem Gulbahar","doi":"10.11613/BM.2026.030701","DOIUrl":"https://doi.org/10.11613/BM.2026.030701","url":null,"abstract":"<p><strong>Introduction: </strong>For measurands with a low index of individuality (II), delta check is crucial. If delta percentage change (DPC) values in different patients consecutively exceed the reference change value (RCV), it may indicate an analytical problem. Similarly to moving sum (MovSuM), percentage of DPCs exceeding RCV can be used as a quality control model by comparing it with a certain threshold. This study aimed to develop a novel patient-based quality control (PBQC) model using delta checks and evaluate its performance.</p><p><strong>Materials and methods: </strong>The study was performed at Gazi University Biochemistry Laboratory. The model was tested on creatinine (measured on Advia Chemistry Systems using the alkaline picrate method), with pooled-CV_a = 2.5%, CV_i = 4.7%, and RCV = 19%. If DPC > RCV, it was counted as a violation, <i>i.e.</i> failed delta check (FDC). The percentage of violations was calculated for every 20 consecutive patients with previous results over the past year. Similarly to MovSuM, when a new result is added, moving percentage of failed delta checks (MPFDC) removes the oldest data and calculates the percentage of violations continuously. Moving percentage of failed delta checks thresholds determined as 35%/30% (for positive/negative direction). After excluding dialysis patients and patients without previous results, and previous results measured with different systems, we applied truncation (truncation limits: < 27 and > 362 μmol/L). The remaining 5484 results were divided into 55 batches.</p><p><strong>Results: </strong>After applying positive and negative errors of 15%, median number of patients affected before error detection (MNPed) was 34 and 29, respectively. Median time until error detection was 18 minutes. Sensitivity and specificity were 96% and 86%, respectively.</p><p><strong>Conclusions: </strong>Moving percentage of failed delta checks, a novel RCV-based PBQC model, has high sensitivity and rapid error detection, suitable for measurands with low II.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030701"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804328","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":"Forensic integrity of blood alcohol sampling in the emergency department, Part II: Establishing quality goals of turnaround time with Monte Carlo simulation.","authors":"Cristiano Ialongo","doi":"10.11613/BM.2026.030704","DOIUrl":"https://doi.org/10.11613/BM.2026.030704","url":null,"abstract":"<p><strong>Introduction: </strong>In the emergency department (ED), the turnaround time (TAT) for forensic blood alcohol sampling is a critical determinant of legal admissibility. Due to the pharmacokinetics of ethanol, delays in sampling lead to metabolic decay, potentially resulting in pharmacokinetic false negatives (FN_pk). This study aims to establish objective, evidence-based quality goals for intra-ED TAT using Monte Carlo simulation to preserve forensic reliability.</p><p><strong>Materials and methods: </strong>Data were collected from 121 forensic cases at a major metropolitan university hospital in 2025. A Monte Carlo simulation (N = 50,000 iterations) was performed to model the probability of FN_pk based on ethanol elimination rate (β), analytical imprecision (CV), and extra-ED <i>versus</i> intra-ED TAT components. Probability density functions (PDFs) were fitted using Weibull and Gamma distributions to characterize observed clinical and logistical data.</p><p><strong>Results: </strong>The simulation revealed a baseline P(FN_pk) of 7.0% for the intra-ED phase, increasing to 7.6% when including extra-ED transport. Quality goals were derived for three tiers: optimal (TAT_95%) at 134 minutes, acceptable (TAT_80%) at 214 minutes, and minimum (TAT_60%) at 273 minutes. Regression analysis showed that for every 1% increase in assay CV, the TAT quality goal erodes by 2.7 to 3.3 minutes. The logistic process was found efficient, with an Index of Logistic Reliability (I_LR) of 86.4%.</p><p><strong>Conclusions: </strong>Monte Carlo simulation effectively translates pharmacokinetic variables into actionable forensic quality goals. Current ED performance requires process improvement, particularly in the request-transmission phase, to minimize FN_pk and ensure forensic equity.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030704"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804235","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":"Forensic integrity of blood alcohol sampling in the emergency department, Part I: Epidemiology and factors affecting turnaround time.","authors":"Maria Sapio, Anna Criniti, Simona Giglio, Gioacchino Galardo, Orietta Gandini, Antonio Angeloni, Cristiano Ialongo","doi":"10.11613/BM.2026.030703","DOIUrl":"https://doi.org/10.11613/BM.2026.030703","url":null,"abstract":"<p><strong>Introduction: </strong>Drink-driving remains a leading global cause of road traffic fatalities. In Italy, the determination of blood alcohol concentration (BAC) in injured drivers relies on coordination between law enforcement and emergency departments (ED) to ensure legally admissible evidence. Because ethanol undergoes continuous metabolic decay, any delay in blood sampling can lead to underestimated values or \"pharmacokinetic false negatives\".</p><p><strong>Materials and methods: </strong>A retrospective study was conducted throughout 2025 on 115 drivers admitted to a major university hospital following road accidents. Preanalytical turnaround time (TAT), categorized into intra-ED and extra-ED intervals, was assessed against variables like clinical severity (triage code), temporal patterns (duty shifts/weekends), and licensure status. Serum alcohol concentration (SAC) that is used to screen BAC was measured with the enzymatic methods.</p><p><strong>Results: </strong>The population was predominantly male (77.4%) with a median age of 36 years. While the median intra-ED TAT was 139 minutes and remained stable across various clinical and temporal factors, the overall preanalytical TAT (from accident to sampling) reached a median of 204 minutes. The only statistically significant association concerned SAC at ED admission with ED duty shift (P = 0.045), and with day of the week (P = 0.035).</p><p><strong>Conclusions: </strong>The observed TAT appears insensitive to environmental stressors, potentially indicating a \"degraded\" baseline performance. This study emphasizes that objective quality goals for TAT cannot rely solely on administrative averages. Instead, they must be grounded in a quantitative relationship between sampling delay and metabolic decay using pharmacokinetic models to mitigate the risk of forensic evidence loss.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030703"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804299","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":"Laboratory diagnostics in personalised medicine - 36th Symposium of the Croatian society of medical biochemistry and laboratory medicine.","authors":"Dunja Rogić, Livija Šimičević, Tamara Žigman, Ivan Bambir, Andrea Vukić Dugac, Duška Tješić-Drinković, Ksenija Fumić, Ivan Lehman, Ivana Rako, Marina Popović, Lana Ganoci, Maja Živković, Alma Mihaljević-Peleš","doi":"10.11613/BM.2026.030501","DOIUrl":"https://doi.org/10.11613/BM.2026.030501","url":null,"abstract":"<p><p>Personalised medicine has become a central paradigm in modern healthcare, aiming to tailor prevention, diagnosis, and therapy to each patient's unique molecular and clinical profile. This paper provides a comprehensive overview of the lectures presented at the 36th annual Symposium of the Croatian society of medical biochemistry and laboratory medicine. It highlights key topics including the role of disease-causing variants in hereditary disorders, the development of cystic fibrosis transmembrane conductance regulator (CFTR) modulators, the evolution of newborn screening programs and spinal muscular atrophy diagnostics, emphasizing early detection and timely initiation of therapy, advances in cancer genetics, pharmacogenetics, and the translation of other laboratory-based innovations into clinical practice. Altogether, these advances reaffirm the central role of laboratory diagnostics as the cornerstone of personalised medicine, bridging genetic discovery with clinical translation and transforming modern healthcare into a predictive, preventive, and truly patient-centred discipline.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030501"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804322","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":"Analytical interference by IgM paraprotein causing platform-dependent electrolyte discrepancies: a case-based laboratory investigation.","authors":"Sheng Wang, Xiaoyong Duan, Yulin Zou, Jianxiong Gui","doi":"10.11613/BM.2026.030901","DOIUrl":"https://doi.org/10.11613/BM.2026.030901","url":null,"abstract":"<p><p>Accurate measurement of serum electrolytes and calcium is essential for clinical management; however, monoclonal immunoglobulins, particularly IgM paraproteins, may cause misleading analytical interference. We report the case of an 85-year-old man admitted for low back pain whose serum sample showed marked inter-platform discordance in sodium and total calcium results. The Hitachi platform reported a \"hypercalcemic crisis\" (total calcium 4.95 mmol/L) and severe hyponatremia (125 mmol/L), whereas the Beckman Coulter AU platform showed only mildly elevated total calcium (2.89 mmol/L) and milder hyponatremia (133 mmol/L). This corresponded to a 71.3% difference in total calcium, despite both platforms using the Arsenazo III method. Direct ion-selective electrode measurements excluded true hyponatremia and hypercalcemia. Dilution studies, polyethylene glycol precipitation, reaction-curve inspection, and simulation experiments confirmed that IgM-related precipitation and optical scattering were the underlying mechanisms. Specifically, platform-specific mixing dynamics determined the magnitude of interference. Recognition of biochemical-clinical discordance and targeted method comparison prompted hematological evaluation and led to a diagnosis of Waldenström macroglobulinemia. This case highlights that unexplained analytical discrepancies may delay recognition of underlying disease if analytical interference is not appropriately investigated.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030901"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804272","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":"Determination of method-specific reference intervals for vitamin B12 and its correlation with holotranscobalamin.","authors":"Ozlem C Madenci, Ebru Ertug, Nazire Aladag, Ferruh K Isman, Ibrahim Yılmaz","doi":"10.11613/BM.2026.030705","DOIUrl":"10.11613/BM.2026.030705","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to compare total serum vitamin B12 measurements across four immunoassay platforms, establish method-specific reference intervals, evaluate the clinical impact of a uniform deficiency cut-off, and assess associations between total vitamin B12 and holotranscobalamin (holoTC).</p><p><strong>Materials and methods: </strong>Residual serum samples from 220 apparently healthy adults undergoing routine health check-ups were analyzed. Total vitamin B12 was measured on Beckman, Abbott, Siemens, and Roche platforms. Beckman analyses used the updated Access Vitamin B12 II calibrator introduced in December 2024. Holotranscobalamin was measured on the Abbott system. Reference intervals were derived using non-parametric methods according to CLSI EP28-A3c guidelines. Method comparison was performed using Passing-Bablok regression and concordance correlation coefficients (CCC), and associations between total vitamin B12 and holoTC were assessed using Spearman correlation analysis.</p><p><strong>Results: </strong>Total vitamin B12 concentrations differed significantly across platforms, with moderate to good agreement (CCC: 0.81-0.91). Study-derived lower reference limits (LRLs) varied substantially between assays and differed from manufacturer-provided values, most prominently for the Beckman platform. Application of a fixed deficiency cut-off of 148 pmol/L resulted in marked method-dependent differences in deficiency classification. Correlations between total vitamin B12 and holoTC were low to moderate across analytical platforms.</p><p><strong>Conclusions: </strong>Serum vitamin B12 results vary across platforms, causing method-dependent LRLs and inconsistent classification with uniform cut-offs, underscoring the need for method-specific interpretation and improved harmonization. Low-to-moderate correlations reflect that holoTC and total vitamin B12 represent different components of vitamin B12 status and that total vitamin B12 assays differ by platform in reflecting the active fraction.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030705"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121667","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":"Challenges in PT/INR harmonization across the total testing process.","authors":"Jia-Min Zou, Tian-Ji Li, Qi Liu, Yong-Gang Hu","doi":"10.11613/BM.2026.030504","DOIUrl":"10.11613/BM.2026.030504","url":null,"abstract":"<p><p>The International Normalized Ratio (INR), introduced by the World Health Organization in 1983, is central to vitamin K antagonist (VKA) therapy monitoring. However, thromboplastin standardization alone does not ensure harmonized prothrombin time (PT)/INR results. Residual variability arises throughout the testing continuum. In this narrative review, we examine the principal sources of residual PT/INR non-equivalence across the \"vein-to-report\" pathway. Particular attention is devoted to clinical settings in which the assumptions underlying INR calibration are only partially satisfied, including advanced liver disease and exposure to direct oral anticoagulants. We further discuss postanalytical factors, such as determination of the mean normal prothrombin time and system-specific verification of the International Sensitivity Index, as well as quality assurance strategies, including the use of commutable external quality assessment materials and patient-based real-time quality control. Prothrombin time/INR harmonization requires integrating preanalytical practices, recognizing reagent-instrument dependencies, and quality strategies reflecting real-world testing conditions.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030504"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121704","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":"Viral triggers of Guillain-Barré syndrome: implications for laboratory diagnostics.","authors":"Karolina Kłodnicka, Jacek Januszewski, Magdalena Tyczyńska, Barbara Teresińska, Paulina Trzaskacz, Alicja Forma, Jolanta Flieger, Jacek Baj","doi":"10.11613/BM.2026.030502","DOIUrl":"10.11613/BM.2026.030502","url":null,"abstract":"<p><p>Guillain-Barré syndrome (GBS) is a leading cause of acquired acute neuromuscular paralysis and is an immune-mediated disorder of the peripheral nervous system (PNS). Accumulating evidence indi-cates that GBS is often preceded by infectious events that trigger autoimmune responses through mechanisms such as molecular mimicry and autoantibody production. Campylobacter jejuni remains the most common bacterial agent, but viral pathogens also contribute to the development of GBS. This review summarizes the current evidence regarding viruses as triggers of GBS, including herpes-viruses, hepatotropic viruses (A, B, C, and E), human immunodeficiency virus, Zika virus, influenza virus, varicella-zoster virus, and the coronavirus SARS-CoV-2. Emphasis is placed on laboratory test results related to viral GBS, including antiganglioside antibodies, serological markers of recent in-fection, molecular diagnostic methods, and cerebrospinal fluid analysis. From the standpoint of la-boratory medicine, both the clinical diagnosis and the distinction of GBS subtypes can be supported by the identification of recent viral infections and the detection of immunological biomarkers. How-ever, cross-reactivity, extended antibody persistence, and inadequate assay standardization frequently make it difficult to interpret laboratory test results. In patients with probable viral GBS, this review shows the diagnostic significance and limitations of routine laboratory testing. It also highlights the significance of close coordination between laboratory professionals and clinicians.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030502"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121792","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}