Pub Date : 2023-04-27DOI: 10.29074/ascls.2020002428
V. Freeman, K. Brown, JoAnn Parker Fenn, Karen Fong, J. Genzen, Nancy Goodyear, Mary Lunz Houston, Terry Taff, P. Tanabe
{"title":"Status of Medical Laboratory Science Faculty and Programs","authors":"V. Freeman, K. Brown, JoAnn Parker Fenn, Karen Fong, J. Genzen, Nancy Goodyear, Mary Lunz Houston, Terry Taff, P. Tanabe","doi":"10.29074/ascls.2020002428","DOIUrl":"https://doi.org/10.29074/ascls.2020002428","url":null,"abstract":"","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129103755","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}
Pub Date : 2023-04-27DOI: 10.29074/ascls.2020003004
S. Travis Altheide, C. Pinion
{"title":"Isolation of Airborne, Antimicrobial-resistant Bacteria Associated With Livestock","authors":"S. Travis Altheide, C. Pinion","doi":"10.29074/ascls.2020003004","DOIUrl":"https://doi.org/10.29074/ascls.2020003004","url":null,"abstract":"","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127216458","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}
Pub Date : 2020-08-01DOI: 10.29074/ascls.120.002287
B. Ketelsen
Thrombotic Thrombocytopenia Pupura (TTP) is a disease that is classified by abnormal functioning of the ADAMTS13 protease. ADAMTS13 protease impairment can be caused by genetic mutations at the gene level or through autoantibodies that are formed within the circulation. Congenital mutations account for about 5-10% of the TTP population while the acquired version is more common. The acquired version of TTP is due to inhibitory and non-inhibitory autoantibodies that affect the ADAMTS13 protease. Both congenital and acquired TTP are treated through transfusion therapy with therapeutic plasma exchange (TPE). TPE is used to remove the autoantibodies and any mutated ADAMTS13 proteases in the circulation while providing the addition of normal functioning ADAMTS13 to the circulation.
{"title":"Molecular Action of ADAMTS13 and Transfusion Therapies of Thrombotic Thrombocytopenia Pupura","authors":"B. Ketelsen","doi":"10.29074/ascls.120.002287","DOIUrl":"https://doi.org/10.29074/ascls.120.002287","url":null,"abstract":"Thrombotic Thrombocytopenia Pupura (TTP) is a disease that is classified by abnormal functioning of the ADAMTS13 protease. ADAMTS13 protease impairment can be caused by genetic mutations at the gene level or through autoantibodies that are formed within the circulation. Congenital mutations account for about 5-10% of the TTP population while the acquired version is more common. The acquired version of TTP is due to inhibitory and non-inhibitory autoantibodies that affect the ADAMTS13 protease. Both congenital and acquired TTP are treated through transfusion therapy with therapeutic plasma exchange (TPE). TPE is used to remove the autoantibodies and any mutated ADAMTS13 proteases in the circulation while providing the addition of normal functioning ADAMTS13 to the circulation.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124561544","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}
Pub Date : 2020-08-01DOI: 10.29074/ascls.120.002246
T. C. Davis, M. Jamerson, Sarah A. Marrs, Ronsard Daniel, C. Biddle
Infection control concerns abound in the surgical anesthesia workstation placing patients and providers at significant, documented risk as a result of many factors including provider hand hygiene lapses, equipment design and complexity, and challenging disinfection. We performed a trial to mitigate cross-contamination involving 30 general anesthesia surgical cases matched 1:1 as control (no intervention) or intervention group (condom-like barriers to four anesthesia workstation components that are frequently touched and contaminated, and very difficult to disinfect). Wraps were removed at case end, then replaced with fresh ones before the start of the subsequent case. Baseline culture samples were obtained prior to the first surgical case of the day in each room, then performed on cases that followed in each room over a 3-day period. Baseline colony formation units density was equivalent in both conditions with total density significantly lower in the covered/wrapped (Mean Rank = 5.81) vs uncovered condition (Mean Rank = 11.19) at p
{"title":"Innovative Approach to Moderating Risk of Nosocomial Infection During Anesthesia","authors":"T. C. Davis, M. Jamerson, Sarah A. Marrs, Ronsard Daniel, C. Biddle","doi":"10.29074/ascls.120.002246","DOIUrl":"https://doi.org/10.29074/ascls.120.002246","url":null,"abstract":"Infection control concerns abound in the surgical anesthesia workstation placing patients and providers at significant, documented risk as a result of many factors including provider hand hygiene lapses, equipment design and complexity, and challenging disinfection. We performed a trial to mitigate cross-contamination involving 30 general anesthesia surgical cases matched 1:1 as control (no intervention) or intervention group (condom-like barriers to four anesthesia workstation components that are frequently touched and contaminated, and very difficult to disinfect). Wraps were removed at case end, then replaced with fresh ones before the start of the subsequent case. Baseline culture samples were obtained prior to the first surgical case of the day in each room, then performed on cases that followed in each room over a 3-day period. Baseline colony formation units density was equivalent in both conditions with total density significantly lower in the covered/wrapped (Mean Rank = 5.81) vs uncovered condition (Mean Rank = 11.19) at p","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133444480","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}
Pub Date : 2020-08-01DOI: 10.29074/ascls.120.002261
Larry J. Smith
This review describes classical thrombotic thrombocytopenic purpura (TTP), discusses the pathogenesis of acquired and congenital TTP, describes clinical and laboratory manifestations observed in patients, and lists treatment options for managing patients with TTP. TTP is a rare hematologic disorder characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). It results from a congenital or acquired deficiency of ADAMTS13 in plasma. Most cases are due to an autoimmune mechanism that interferes with ADAMTS13, however rare inherited forms of TTP have been described (Upshaw-Shulman syndrome, USS). It is still considered a life-threatening disease with a mortality rate of 10-20%. Severe deficiency of ADAMTS13 (
{"title":"Pathophysiology of Thrombotic Thrombocytopenia Purpura","authors":"Larry J. Smith","doi":"10.29074/ascls.120.002261","DOIUrl":"https://doi.org/10.29074/ascls.120.002261","url":null,"abstract":"This review describes classical thrombotic thrombocytopenic purpura (TTP), discusses the pathogenesis of acquired and congenital TTP, describes clinical and laboratory manifestations observed in patients, and lists treatment options for managing patients with TTP. TTP is a rare hematologic disorder characterized by thrombocytopenia and microangiopathic hemolytic anemia (MAHA). It results from a congenital or acquired deficiency of ADAMTS13 in plasma. Most cases are due to an autoimmune mechanism that interferes with ADAMTS13, however rare inherited forms of TTP have been described (Upshaw-Shulman syndrome, USS). It is still considered a life-threatening disease with a mortality rate of 10-20%. Severe deficiency of ADAMTS13 (","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129911572","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}
Pub Date : 2020-08-01DOI: 10.29074/ascls.120.002253
B. Ketelsen
Thrombotic thrombocytopenic purpura (TTP) is a multi-faceted disease for a clinical laboratory with diagnosis data and treatment spread across many different laboratory sections. Encompassing results from hematology, chemistry, molecular, and coagulation sections with treatment from the transfusion medicine/Blood Bank section of the laboratory, clinicians are able to accurately diagnosis and treat TTP.
{"title":"An Overview of the Laboratory's Role in the Diagnosis and Treatment of Thrombotic Thrombocytopenic Purpura","authors":"B. Ketelsen","doi":"10.29074/ascls.120.002253","DOIUrl":"https://doi.org/10.29074/ascls.120.002253","url":null,"abstract":"Thrombotic thrombocytopenic purpura (TTP) is a multi-faceted disease for a clinical laboratory with diagnosis data and treatment spread across many different laboratory sections. Encompassing results from hematology, chemistry, molecular, and coagulation sections with treatment from the transfusion medicine/Blood Bank section of the laboratory, clinicians are able to accurately diagnosis and treat TTP.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"251 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123023941","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}
Pub Date : 2020-08-01DOI: 10.29074/ascls.120.002279
K. Doig, S. Mcquiston
Laboratory diagnosis of thrombotic thrombocytopenic purpura (TTP) often begins with routine laboratory tests; a complete blood count (CBC), clinical chemistry panel, and urinalysis. The classical findings may include anemia with schistocytes, thrombocytopenia, reticulocytosis or polychromasia, bilirubinemia, dark urine, and hemoglobinuria without red blood cells in the sediment. Additional findings including decreased haptoglobin can identify fragmentation as the cause for the hemolysis. The hemolysis in TTP arises from increased shear stress on red blood cells in arterioles and capillaries narrowed by microthrombi. Hemoglobinemia and schistocytes may generate spurious results in hematology analyzers that require correction before results can be released to the patient chart.
{"title":"Laboratory findings in hematology, clinical chemistry, and urinalysis for patients with thrombotic thrombocytopenic purpura","authors":"K. Doig, S. Mcquiston","doi":"10.29074/ascls.120.002279","DOIUrl":"https://doi.org/10.29074/ascls.120.002279","url":null,"abstract":"Laboratory diagnosis of thrombotic thrombocytopenic purpura (TTP) often begins with routine laboratory tests; a complete blood count (CBC), clinical chemistry panel, and urinalysis. The classical findings may include anemia with schistocytes, thrombocytopenia, reticulocytosis or polychromasia, bilirubinemia, dark urine, and hemoglobinuria without red blood cells in the sediment. Additional findings including decreased haptoglobin can identify fragmentation as the cause for the hemolysis. The hemolysis in TTP arises from increased shear stress on red blood cells in arterioles and capillaries narrowed by microthrombi. Hemoglobinemia and schistocytes may generate spurious results in hematology analyzers that require correction before results can be released to the patient chart.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114053831","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}
Pub Date : 2020-03-03DOI: 10.29074/ascls.119.002154
Kendal Beazer, Kenton Cummins
The medical field is in dire need of more qualified medical laboratory scientists (MLS) and medical laboratory technicians (MLT). Medical laboratory educational programs are diminishing, and medical staff in hospitals are unaware of the unequivocal value trained lab scientists bring to the quality of their patients’ lab results. The national need for more qualified laboratory testing personnel is outpacing the supply. A survey to determine current marketing trends and methods was sent out to 469 program directors of MLS and/or MLT programs, with a 35% response rate. Responses were compared with proven marketing methods to give marketing suggestions relevant to the MLS field. This paper describes the research in how MLS programs currently market themselves. Explanations of marketing techniques are discussed with the intent to help simplify marketing efforts for a more effective marketing strategy. This study showed that medical and clinical laboratory educational programs nationwide should increase marketing and promote the MLS value to local communities.
{"title":"Effective Marketing Strategies for a Medical Laboratory Science Program","authors":"Kendal Beazer, Kenton Cummins","doi":"10.29074/ascls.119.002154","DOIUrl":"https://doi.org/10.29074/ascls.119.002154","url":null,"abstract":"The medical field is in dire need of more qualified medical laboratory scientists (MLS) and medical laboratory technicians (MLT). Medical laboratory educational programs are diminishing, and medical staff in hospitals are unaware of the unequivocal value trained lab scientists bring to the quality of their patients’ lab results. The national need for more qualified laboratory testing personnel is outpacing the supply. A survey to determine current marketing trends and methods was sent out to 469 program directors of MLS and/or MLT programs, with a 35% response rate. Responses were compared with proven marketing methods to give marketing suggestions relevant to the MLS field. This paper describes the research in how MLS programs currently market themselves. Explanations of marketing techniques are discussed with the intent to help simplify marketing efforts for a more effective marketing strategy. This study showed that medical and clinical laboratory educational programs nationwide should increase marketing and promote the MLS value to local communities.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114194478","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}
Pub Date : 2020-03-03DOI: 10.29074/ascls.119.002105
M. Rock, V. Legrys
The CF Quantum Test (CFQT) showed promise in a previous pilot study, however there was greater imprecision in one patch lot. Following the pilot study, the manufacturer changed their fabricating procedures. Subjects with previously diagnosed CF or subjects who required a sweat test for clinical reasons were invited to undergo the CFQT research test and a conventional sweat test (Macroduct®; collection and chloride analysis via the ChloroChek®; chloridometer). Previously diagnosed CF (n= 41) and CRMS (CFTR-related metabolic syndrome)/CFSPID (cystic fibrosis screen positive inconclusive diagnosis) (n= 3) patients and patients who required a sweat test for clinical indications (n=22) were recruited to have bilateral CFQT along with the Macroduct®; test performed on the same day. Pairs of data from each test were plotted as a correlation graph, bias plot and Bland Altman plot. Coefficient of variation (CV) between extremities and QNS rates for both tests were calculated. The CV between left and right extremities was greater in the CFQT (9.5%) compared to the Macroduct®; (4.8%). The QNS (quantity not sufficient) rates of the two tests were comparable (CFQT: 6.8%; Macroduct®;: 6.0%). There was greater imprecision with the CFQT results. The diagnostic agreement between the two tests was 100% positive percent agreement (95% CI: 90–100%), 100% negative percent agreement (95% CI: 80–100%), 67% intermediate percent agreement (95% CI: 30%–80%), and 92% overall percent agreement (95% CI: 80–100%). This follow-up study demonstrated that the CFQT is not analytically nor diagnostically reliable. (Clinicaltrials.gov identifier NCT01345617)
{"title":"THE CF QUANTUM SWEAT TEST: NOT READY FOR CLINICAL USE","authors":"M. Rock, V. Legrys","doi":"10.29074/ascls.119.002105","DOIUrl":"https://doi.org/10.29074/ascls.119.002105","url":null,"abstract":"The CF Quantum Test (CFQT) showed promise in a previous pilot study, however there was greater imprecision in one patch lot. Following the pilot study, the manufacturer changed their fabricating procedures. Subjects with previously diagnosed CF or subjects who required a sweat test for clinical reasons were invited to undergo the CFQT research test and a conventional sweat test (Macroduct®; collection and chloride analysis via the ChloroChek®; chloridometer). Previously diagnosed CF (n= 41) and CRMS (CFTR-related metabolic syndrome)/CFSPID (cystic fibrosis screen positive inconclusive diagnosis) (n= 3) patients and patients who required a sweat test for clinical indications (n=22) were recruited to have bilateral CFQT along with the Macroduct®; test performed on the same day. Pairs of data from each test were plotted as a correlation graph, bias plot and Bland Altman plot. Coefficient of variation (CV) between extremities and QNS rates for both tests were calculated.\u0000The CV between left and right extremities was greater in the CFQT (9.5%) compared to the Macroduct®; (4.8%). The QNS (quantity not sufficient) rates of the two tests were comparable (CFQT: 6.8%; Macroduct®;: 6.0%). There was greater imprecision with the CFQT results. The diagnostic agreement between the two tests was 100% positive percent agreement (95% CI: 90–100%), 100% negative percent agreement (95% CI: 80–100%), 67% intermediate percent agreement (95% CI: 30%–80%), and 92% overall percent agreement (95% CI: 80–100%). This follow-up study demonstrated that the CFQT is not analytically nor diagnostically reliable. (Clinicaltrials.gov identifier NCT01345617)","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129519650","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}
Pub Date : 2020-01-21DOI: 10.29074/ascls.119.001875
S. Altheide
The late 1800s through the early 1900s saw the rapid development of growth media containing various substrates, i.e. carbohydrates, to identify and differentiate microbes isolated from clinical specimens. However, during the 1950s, an evolution of diagnostic services occurred created by a growing population with access to health insurance and the subsequent requirement for quality healthcare. The utilization of miniaturized, multi-test kits provided the first significant advancement of the biochemical, growth-based approach needed to handle the increased demand for clinical services. These testing kits provided reductions in labor and material costs associated with making, maintaining, inoculating, and reading tubed and plated media, while also reducing the time required to identify microbial isolates. The trend to improve laboratory efficiency and quality continued with the incorporation of automation and computers throughout the 1970s. Automated systems greatly increased the testing capacity of laboratories by allowing the simultaneous determination of identification and antimicrobial susceptibilities from one inoculum, and by further reducing the time to identification to hours instead of days. Within just the last 10-15 years, development and integration of a new growth-based approach for identification has occurred in the form of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The mass spectrometric approach provides the lowest cost per analysis and fastest time to identification after isolation of any current technique available in the microbiology laboratory. As healthcare costs and demand continue to increase, and more hospitals look to consolidate laboratories, fully automated facilities incorporating mass spectrometry for identification, along with molecular methods, will become commonplace.
{"title":"Biochemical and Culture-Based Approaches to Identification in the Diagnostic Microbiology Laboratory","authors":"S. Altheide","doi":"10.29074/ascls.119.001875","DOIUrl":"https://doi.org/10.29074/ascls.119.001875","url":null,"abstract":"The late 1800s through the early 1900s saw the rapid development of growth media containing various substrates, i.e. carbohydrates, to identify and differentiate microbes isolated from clinical specimens. However, during the 1950s, an evolution of diagnostic services occurred created by a growing population with access to health insurance and the subsequent requirement for quality healthcare. The utilization of miniaturized, multi-test kits provided the first significant advancement of the biochemical, growth-based approach needed to handle the increased demand for clinical services. These testing kits provided reductions in labor and material costs associated with making, maintaining, inoculating, and reading tubed and plated media, while also reducing the time required to identify microbial isolates. The trend to improve laboratory efficiency and quality continued with the incorporation of automation and computers throughout the 1970s. Automated systems greatly increased the testing capacity of laboratories by allowing the simultaneous determination of identification and antimicrobial susceptibilities from one inoculum, and by further reducing the time to identification to hours instead of days. Within just the last 10-15 years, development and integration of a new growth-based approach for identification has occurred in the form of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The mass spectrometric approach provides the lowest cost per analysis and fastest time to identification after isolation of any current technique available in the microbiology laboratory. As healthcare costs and demand continue to increase, and more hospitals look to consolidate laboratories, fully automated facilities incorporating mass spectrometry for identification, along with molecular methods, will become commonplace.","PeriodicalId":263458,"journal":{"name":"American Society for Clinical Laboratory Science","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114781947","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}
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