Pub Date : 2024-12-01DOI: 10.1016/j.eimce.2024.05.010
Melisa Hernández-Febles , Miguel Ángel Cárdenes Santana , Rafael Granados Monzón , Xerach Bosch Guerra , María José Pena López
Introduction
In Spain, half of new HIV diagnoses are late and a significant proportion of people living with HIV have not yet been diagnosed. Our aim was to evaluate the effectiveness of an automated opportunistic HIV screening strategy in the hospital setting.
Methods
Between April 2022 and September 2023, HIV testing was performed on all patients in whom a hospital admission analytical profile, a pre-surgical profile and several pre-designed serological profiles (fever of unknown origin, pneumonia, mononucleosis, hepatitis, infection of sexual transmission, rash, endocarditis and myopericarditis) was requested. A circuit was started to refer patients the specialists.
Results
6407 HIV tests included in the profiles were performed and 18 (0.3%) new cases were diagnosed (26.4% of diagnoses in the health area). Five patients were diagnosed by hospital admission and pre-surgery profile and 13 by a serological profile requested for indicator entities (fever of unknown origin, sexually transmitted infection, mononucleosis) or possibly associated (pneumonia) with HIV occult infection. Recent infection was documented in 5 (27.8%) patients and late diagnosis in 9 (50.0%), of whom 5 (55.5%) had previously missed the opportunity to be diagnosed.
Conclusions
This opportunistic screening was profitable since the positive rate of 0.3% is cost-effective and allowed a quarter of new diagnoses to be made, so it seems a good strategy that contributes to reducing hidden infection and late diagnosis.
{"title":"Evaluation of a HIV screening strategy in the hospital setting to reduce undiagnosed infection","authors":"Melisa Hernández-Febles , Miguel Ángel Cárdenes Santana , Rafael Granados Monzón , Xerach Bosch Guerra , María José Pena López","doi":"10.1016/j.eimce.2024.05.010","DOIUrl":"10.1016/j.eimce.2024.05.010","url":null,"abstract":"<div><h3>Introduction</h3><div>In Spain, half of new HIV diagnoses are late and a significant proportion of people living with HIV have not yet been diagnosed. Our aim was to evaluate the effectiveness of an automated opportunistic HIV screening strategy in the hospital setting.</div></div><div><h3>Methods</h3><div>Between April 2022 and September 2023, HIV testing<span> was performed on all patients in whom a hospital admission analytical profile, a pre-surgical profile and several pre-designed serological profiles (fever of unknown origin, pneumonia, mononucleosis<span>, hepatitis, infection of sexual transmission, rash, endocarditis and myopericarditis) was requested. A circuit was started to refer patients the specialists.</span></span></div></div><div><h3>Results</h3><div>6407 HIV tests included in the profiles were performed and 18 (0.3%) new cases were diagnosed (26.4% of diagnoses in the health area). Five patients were diagnosed by hospital admission and pre-surgery profile and 13 by a serological profile requested for indicator entities (fever of unknown origin, sexually transmitted infection, mononucleosis) or possibly associated (pneumonia) with HIV occult infection. Recent infection was documented in 5 (27.8%) patients and late diagnosis in 9 (50.0%), of whom 5 (55.5%) had previously missed the opportunity to be diagnosed.</div></div><div><h3>Conclusions</h3><div>This opportunistic screening was profitable since the positive rate of 0.3% is cost-effective and allowed a quarter of new diagnoses to be made, so it seems a good strategy that contributes to reducing hidden infection and late diagnosis.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 577-580"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066248","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 : 2024-12-01DOI: 10.1016/j.eimce.2023.09.004
Yi-Hua Pan , Daniel K. Nomah , Marcos Montoro-Fernandez , Sergio Moreno-Fornés , Yesika Díaz , Jordi Aceitón , Andreu Bruguera , Josep M. Llibre , Pere Domingo , Arkaitz Imaz , Ingrid Vilaró , Vicenç Falcó , Juliana Reyes-Urueña , José M. Miro , Jordi Casabona , the PISCIS Cohort Study Group
Background
The COVID-19 pandemic disrupted healthcare services usage. We estimated the impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV (PLWH) in Catalonia, Spain.
Methods
We accessed public healthcare usage in HIV units, primary care, hospitals, and emergency departments among 17,738 PLWH in the PISCIS cohort from January 1, 2017, to December 31, 2020. We performed an interrupted time series analysis using the autoregressive integrated moving average to estimate the effect of COVID-19 on medical visits and HIV monitoring among PLWH.
Results
A non-significant decrease of 17.1% (95% CI: [−29.4, 0.4]) in overall medical visits was observed during the lockdown, followed by a steady resumption until the end of 2020. Three health facilities presented statistically significant declines in visits during the lockdown: HIV units (−44.8% [−56.7, −23.6]), hospitals (−40.4% [−52.8, −18.1]), and emergency departments (−36.9% [−47.0, −21.9]); thereafter, the visits have begun to increase steadily but not to previous levels as of December 2020. In contrast, primary care visits remained unchanged during the lockdown by 1.9% (95% CI: −13.5, 23.9). CD4 cell (54.2% [95% CI: −64.4, −36.0]) and HIV RNA viral load (53.1% [95% CI: −62.9, −36.1]) laboratory monitoring reduced significantly during the lockdown.
Conclusion
COVID-19 lockdowns significantly disrupted in-person healthcare services usage among PLWH. The reduction in healthcare utilization however did not affect primary care services. Despite services gradually rebounding to pre-pandemic levels, it is imperative to effectively prepare for future pandemics and implement measures to ensure continuous provision of care to PLWH during pandemic lockdowns.
{"title":"The impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV in Catalonia, Spain: A population-based cohort study","authors":"Yi-Hua Pan , Daniel K. Nomah , Marcos Montoro-Fernandez , Sergio Moreno-Fornés , Yesika Díaz , Jordi Aceitón , Andreu Bruguera , Josep M. Llibre , Pere Domingo , Arkaitz Imaz , Ingrid Vilaró , Vicenç Falcó , Juliana Reyes-Urueña , José M. Miro , Jordi Casabona , the PISCIS Cohort Study Group","doi":"10.1016/j.eimce.2023.09.004","DOIUrl":"10.1016/j.eimce.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic disrupted healthcare services usage. We estimated the impact of the COVID-19 pandemic on healthcare services utilization among people living with HIV (PLWH) in Catalonia, Spain.</div></div><div><h3>Methods</h3><div>We accessed public healthcare usage in HIV units, primary care, hospitals, and emergency departments among 17,738 PLWH in the PISCIS cohort from January 1, 2017, to December 31, 2020. We performed an interrupted time series analysis using the autoregressive integrated moving average to estimate the effect of COVID-19 on medical visits and HIV monitoring among PLWH.</div></div><div><h3>Results</h3><div>A non-significant decrease of 17.1% (95% CI: [−29.4, 0.4]) in overall medical visits was observed during the lockdown, followed by a steady resumption until the end of 2020. Three health facilities presented statistically significant declines in visits during the lockdown: HIV units (−44.8% [−56.7, −23.6]), hospitals (−40.4% [−52.8, −18.1]), and emergency departments (−36.9% [−47.0, −21.9]); thereafter, the visits have begun to increase steadily but not to previous levels as of December 2020. In contrast, primary care visits remained unchanged during the lockdown by 1.9% (95% CI: −13.5, 23.9). CD4 cell (54.2% [95% CI: −64.4, −36.0]) and HIV RNA viral load (53.1% [95% CI: −62.9, −36.1]) laboratory monitoring reduced significantly during the lockdown.</div></div><div><h3>Conclusion</h3><div>COVID-19 lockdowns significantly disrupted in-person healthcare services usage among PLWH. The reduction in healthcare utilization however did not affect primary care services. Despite services gradually rebounding to pre-pandemic levels, it is imperative to effectively prepare for future pandemics and implement measures to ensure continuous provision of care to PLWH during pandemic lockdowns.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 555-562"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466706","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.07.004
Óscar Porto Fuentes , María Trigás Ferrín , Joaquín Manuel Serrano Arreba , Olaya Alonso Juarros
{"title":"Emphysematous osteomyelitis of the hip and iliac bone: Serious infection with a characteristic radiographic finding","authors":"Óscar Porto Fuentes , María Trigás Ferrín , Joaquín Manuel Serrano Arreba , Olaya Alonso Juarros","doi":"10.1016/j.eimce.2024.07.004","DOIUrl":"10.1016/j.eimce.2024.07.004","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 601-602"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879881","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.07.006
Ana Verónica Halperin , Marta Pérez-Abeledo , Cristina Galeano , Juan Carlos Sanz
{"title":"A case of bacteremia by Streptococcus pseudopneumoniae","authors":"Ana Verónica Halperin , Marta Pérez-Abeledo , Cristina Galeano , Juan Carlos Sanz","doi":"10.1016/j.eimce.2024.07.006","DOIUrl":"10.1016/j.eimce.2024.07.006","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 604-605"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759803","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 : 2024-12-01DOI: 10.1016/j.eimce.2023.06.008
José María Gutiérrez-Urbón , Eva Campelo-Sánchez , Sara Cobo-Sacristán , Marcelo Domínguez-Cantero , María Victoria Gil-Navarro , Sonia Luque , María Eugenia Martínez-Núñez , Beatriz Mejuto , Francisco Moreno-Ramos , Leonor Periañez-Párraga , Carmen Rodríguez-González , Teresa Rodríguez-Jato , members of the Pharmaceutical Care Group for Patients with Infectious Diseases (AFinf) of the Spanish Society of Hospital Pharmacy (SEFH)
Introduction
Audits for monitoring the quality of antimicrobial prescribing are a main tool in antimicrobial stewardship programs; however, interobserver reliability has not been conclusively assessed. Our objective was to measure the level of agreement between pharmacists and physicians on the appropriateness of antimicrobials prescribing in hospitals.
Methods
A national multicenter, cross-sectional study was conducted of patients who were receiving antimicrobials one day of April 2021. Hospital participation was voluntary, and the study population was randomly selected. Pharmacists and physicians performed a simultaneous, independent assessment of the quality of antimicrobial prescriptions. The observers used an assessment method by which all indicators of the quality of antimicrobial use were considered. Finally, an algorithm was used to rate overall antimicrobial prescribing as appropriate, suboptimal, inappropriate, or not assessable. Gwet's AC1 coefficient was used to assess interobserver agreement.
Results
In total, 101 hospitals participated, and 411 hospital antimicrobial prescriptions were reviewed. The strength of agreement was moderate regarding the overall quality of prescribing (AC1 = 0.51; 95%CI = [0.44–0.58]). A very good level of agreement (AC1 > 0.80) was observed between pharmacists and physicians in all indicators of the quality, except for duration of treatment, rated as good (AC1 = 0.79; 95%CI = [0.75–0.83]), and registration on the medical record, rated as fair (AC1 = 0.34; 95%CI = [0.26–0.43]). The agreement was greater in critical care, onco-hematology, and pediatric units than in medical and surgery units.
Conclusions
In this point prevalence study, a moderate level of agreement was observed between pharmacists and physicians in the evaluation of the appropriateness of antimicrobials prescribing in hospitals.
{"title":"Agreement between pharmacists and physicians on the assessment of appropriateness of antimicrobial prescribing","authors":"José María Gutiérrez-Urbón , Eva Campelo-Sánchez , Sara Cobo-Sacristán , Marcelo Domínguez-Cantero , María Victoria Gil-Navarro , Sonia Luque , María Eugenia Martínez-Núñez , Beatriz Mejuto , Francisco Moreno-Ramos , Leonor Periañez-Párraga , Carmen Rodríguez-González , Teresa Rodríguez-Jato , members of the Pharmaceutical Care Group for Patients with Infectious Diseases (AFinf) of the Spanish Society of Hospital Pharmacy (SEFH)","doi":"10.1016/j.eimce.2023.06.008","DOIUrl":"10.1016/j.eimce.2023.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Audits for monitoring the quality of antimicrobial prescribing are a main tool in antimicrobial stewardship programs; however, interobserver reliability has not been conclusively assessed. Our objective was to measure the level of agreement between pharmacists and physicians on the appropriateness of antimicrobials prescribing in hospitals.</div></div><div><h3>Methods</h3><div>A national multicenter, cross-sectional study was conducted of patients who were receiving antimicrobials one day of April 2021. Hospital participation was voluntary, and the study population was randomly selected. Pharmacists and physicians performed a simultaneous, independent assessment of the quality of antimicrobial prescriptions. The observers used an assessment method by which all indicators of the quality of antimicrobial use were considered. Finally, an algorithm was used to rate overall antimicrobial prescribing as appropriate, suboptimal, inappropriate, or not assessable. Gwet's AC1 coefficient was used to assess interobserver agreement.</div></div><div><h3>Results</h3><div>In total, 101 hospitals participated, and 411 hospital antimicrobial prescriptions were reviewed. The strength of agreement was moderate regarding the overall quality of prescribing (AC1<!--> <!-->=<!--> <!-->0.51; 95%CI<!--> <!-->=<!--> <!-->[0.44–0.58]). A very good level of agreement (AC1<!--> <!-->><!--> <!-->0.80) was observed between pharmacists and physicians in all indicators of the quality, except for duration of treatment, rated as good (AC1<!--> <!-->=<!--> <!-->0.79; 95%CI<!--> <!-->=<!--> <!-->[0.75–0.83]), and registration on the medical record, rated as fair (AC1<!--> <!-->=<!--> <!-->0.34; 95%CI<!--> <!-->=<!--> <!-->[0.26–0.43]). The agreement was greater in critical care, onco-hematology, and pediatric units than in medical and surgery units.</div></div><div><h3>Conclusions</h3><div>In this point prevalence study, a moderate level of agreement was observed between pharmacists and physicians in the evaluation of the appropriateness of antimicrobials prescribing in hospitals.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 546-554"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429755","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 : 2024-12-01DOI: 10.1016/j.eimce.2024.09.001
Adrian Sanchez-Montalva , José Antonio Caminero , Mª Remedio Guna , Teresa Rodrígo Sanz , Ramón Rabuñal , Joan Pau Millet , José Antonio Gullón-Blanco , Luis Anibarro , Guillermo Perez-Mendoza , Juan Francisco Medina , Verónica González-Galán , Eva Tabernero , on behalf of the Writing committee of the Spanish MDR TB consortium (in alphabetical order)
The Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) have developed together Clinical Practice Guidelines (GPC) on the management of people affected by tuberculosis (TB) resistant to drugs with activity against Mycobacterium tuberculosis. These clinical practice guidelines include the latest updates of the SEPAR regulations for the diagnosis and treatment of drug-resistant TB from 2017 to 2020 as the starting point. The methodology included asking relevant clinical questions based on PICO methodology, a literature search focusing on each question, and a systematic and comprehensive evaluation of the evidence, with a summary of this evidence for each question. Finally, recommendations were developed and the level of evidence and the strength of each recommendation for each question were established in concordance with the GRADE approach. Of the recommendations made, it is worth highlighting the high quality of the existing evidence for the use of nucleic acid amplification techniques (rapid genotypic tests) as initial tests for the detection of the M. tuberculosis genome and rifampicin resistance in people with presumptive signs or symptoms of pulmonary TB; and for the use of an oral combination of anti-TB drugs based on bedaquiline, delamanid (pretomanid), and linezolid, with conditional fluoroquinolone supplementation (conditioned by fluoroquinolone resistance) for six months for the treatment of people affected by pulmonary multidrug-resistant tuberculosis (MDR-TB). We also recommend directly observed therapy (DOT) or video-observed treatment for the treatment of people affected by DR-TB.
{"title":"Executive summary: Clinical practice guidelines on the management of resistant tuberculosis of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC)","authors":"Adrian Sanchez-Montalva , José Antonio Caminero , Mª Remedio Guna , Teresa Rodrígo Sanz , Ramón Rabuñal , Joan Pau Millet , José Antonio Gullón-Blanco , Luis Anibarro , Guillermo Perez-Mendoza , Juan Francisco Medina , Verónica González-Galán , Eva Tabernero , on behalf of the Writing committee of the Spanish MDR TB consortium (in alphabetical order)","doi":"10.1016/j.eimce.2024.09.001","DOIUrl":"10.1016/j.eimce.2024.09.001","url":null,"abstract":"<div><div>The Spanish Society of Pneumology and Thoracic Surgery (SEPAR) and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) have developed together Clinical Practice Guidelines (GPC) on the management of people affected by tuberculosis (TB) resistant to drugs with activity against <em>Mycobacterium tuberculosis.</em> These clinical practice guidelines include the latest updates of the SEPAR regulations for the diagnosis and treatment of drug-resistant TB from 2017 to 2020 as the starting point. The methodology included asking relevant clinical questions based on PICO methodology, a literature search focusing on each question, and a systematic and comprehensive evaluation of the evidence, with a summary of this evidence for each question. Finally, recommendations were developed and the level of evidence and the strength of each recommendation for each question were established in concordance with the GRADE approach. Of the recommendations made, it is worth highlighting the high quality of the existing evidence for the use of nucleic acid amplification techniques (rapid genotypic tests) as initial tests for the detection of the <em>M. tuberculosis</em> genome and rifampicin resistance in people with presumptive signs or symptoms of pulmonary TB; and for the use of an oral combination of anti-TB drugs based on bedaquiline, delamanid (pretomanid), and linezolid, with conditional fluoroquinolone supplementation (conditioned by fluoroquinolone resistance) for six months for the treatment of people affected by pulmonary multidrug-resistant tuberculosis (MDR-TB). We also recommend directly observed therapy (DOT) or video-observed treatment for the treatment of people affected by DR-TB.</div></div>","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 10","pages":"Pages 588-596"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759801","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 : 2024-11-01DOI: 10.1016/j.eimce.2024.06.008
Ivonne Andrea Torres Jiménez , Sara de Miguel García , Julio Sempere García , Juan Carlos Sanz Moreno
{"title":"Recurrent invasive pneumococcal disease (RIPD) in an immunocompromised patient","authors":"Ivonne Andrea Torres Jiménez , Sara de Miguel García , Julio Sempere García , Juan Carlos Sanz Moreno","doi":"10.1016/j.eimce.2024.06.008","DOIUrl":"10.1016/j.eimce.2024.06.008","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 9","pages":"Pages 533-535"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577830","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 : 2024-11-01DOI: 10.1016/j.eimce.2024.05.002
{"title":"Necrotizing fasciitis from a spider bite?","authors":"","doi":"10.1016/j.eimce.2024.05.002","DOIUrl":"10.1016/j.eimce.2024.05.002","url":null,"abstract":"","PeriodicalId":72916,"journal":{"name":"Enfermedades infecciosas y microbiologia clinica (English ed.)","volume":"42 9","pages":"Pages 529-530"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140909691","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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