Intensive Care Medicine Experimental最新文献

{"title":"How to minimize mechanical power during controlled mechanical ventilation.","authors":"Ben Fabry","doi":"10.1186/s40635-024-00699-4","DOIUrl":"10.1186/s40635-024-00699-4","url":null,"abstract":"<p><p>High intrapulmonary pressures, large tidal volumes, and elevated respiratory rates during controlled mechanical ventilation can lead to barotrauma, volutrauma, and atelectrauma. Mechanical power-defined as the product of the pressure-volume integral and respiratory rate-consolidates these three risk factors into a single, intuitive parameter. Several studies have demonstrated that higher mechanical power correlates with an increased risk of lung injury and mortality, prompting the suggestion that mechanical power should be minimized. However, under the constraint of maintaining a fixed alveolar minute ventilation and positive end-expiratory pressure (PEEP), it remains unclear how to adjust respiratory rate and tidal volume to minimize mechanical power. This study provides an analytical solution to this optimization problem. Accordingly, only the elastic component of mechanical power should be targeted for minimization. Regardless of lung elastance or resistance, or the mode and settings of the ventilator, the elastic power is minimized at a tidal volume equal to twice the anatomic dead space, or approximately 4.4 ml/kg of body weight.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"114"},"PeriodicalIF":2.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799878","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":"Reply to: The pressure gradient for venous return and its derivatives are ambiguous measures.","authors":"Anders Aneman, Markus Benedikt Skrifvars, Koen Ameloot","doi":"10.1186/s40635-024-00698-5","DOIUrl":"10.1186/s40635-024-00698-5","url":null,"abstract":"","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"113"},"PeriodicalIF":2.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11621281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785575","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":"Effect of fluid and driving pressure on cyclical \"on-off\" flow of pulmonary microcirculation during mechanical ventilation.","authors":"Siyi Yuan, Xiangyu Chen, Liangyu Mi, Yi Chi, Haoping Huang, Bo Liu, Chaofu Yue, Zeming Zhao, Longxiang Su, Yun Long, Şakir Akin, Can Ince, Huaiwu He","doi":"10.1186/s40635-024-00689-6","DOIUrl":"10.1186/s40635-024-00689-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify the cyclical \"on-off\" flow of pulmonary microcirculation during inspiration and expiration by sidestream dark field imaging (SDF) technology in vivo and investigate the effects of volume status and driving pressure on cyclical \"on-off\" flow of microcirculation.</p><p><strong>Methods: </strong>24 ARDS-modeled rabbits were randomly divided into high-driving pressure group (HDP group) and low-driving pressure group (LDP group). Lung microcirculation measurements were performed using the SDF microscope at two timepoints (T1 CVP 2-4 mmHg, T2 CVP 8-10 mmHg). From T1 to T2, 10 ml/kg saline was infused to increase CVP. The cyclical \"on-off\" pulmonary microcirculation was quantitatively assessed by the change of microcirculation between expiration and inspiration.</p><p><strong>Results: </strong>Proportion of perfused vessels (PPV), microvascular flow index (MFI), perfused vessel density (PVD), and total vessel density (TVD) at expiration were significantly higher than inspiration in the HDP group. The HDP group has a higher ΔPPV and ΔPVD. After fluid loading, ΔPPV and ΔMFI decreased. TNF-α, IL-6, Ang-2, and vWF levels in the HDP group were higher. The HDP group also has a higher lung wet-weight/body weight ratio, lung wet-to-dry weight ratio, and more severe damage of pulmonary capillaries than the LDP group.</p><p><strong>Conclusions: </strong>The difference in alveolar perfused microcirculation between inspiration and expiration defined as cyclical \"on-off flow\" can be detected. High driving pressure can enhance the cyclical \"on-off\" flow, and fluid loading can relieve it. High driving pressure can potentially cause injury to pulmonary capillaries due to the phenomenon of \"on-off\" flow, thereby exacerbating ARDS.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"112"},"PeriodicalIF":2.8,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768469","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":"Human liver stem cells and derived extracellular vesicles protect from sepsis-induced acute lung injury and restore bone marrow myelopoiesis in a murine model of sepsis.","authors":"Andrea Costamagna, Chiara Pasquino, Sara Lamorte, Victor Navarro-Tableros, Luisa Delsedime, Vito Fanelli, Giovanni Camussi, Lorenzo Del Sorbo","doi":"10.1186/s40635-024-00701-z","DOIUrl":"10.1186/s40635-024-00701-z","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a condition with high mortality and morbidity, characterized by deregulation of the immune response against the pathogen. Current treatment strategies rely mainly on antibiotics and supportive care. However, there is growing interest in exploring cell-based therapies as complementary approaches. Human liver stem cells (HLSCs) are pluripotent cells of mesenchymal origin, showing some advantages compared to mesenchymal stem cells in terms of immunomodulatory properties. HSLC-derived extracellular vesicles (EVs) exhibited a superior efficacy profile compared to cells due to their potential to get through biological barriers and possibly to avoid tumorigenicity and showed to be effective in vivo and ex vivo models of liver and kidney disease. The potential of HLSCs and their EVs in recovering damage to distal organs due to sepsis other than the kidney remains unknown. This study aimed to investigate the therapeutic potential of the intravenous administration of HSLCs or HSLCs-derived EVs in a murine model of sepsis.</p><p><strong>Results: </strong>Sepsis was induced by caecal ligation and puncture (CLP) on C57/BL6 mice. After CLP, mice were assigned to receive either normal saline, HLSCs or their EVs and compared to a sham group which underwent only laparotomy. Survival, persistence of bacteraemia, lung function evaluation, histology and bone marrow analysis were performed. Administration of HLSCs or HLSC-EVs resulted in improved bacterial clearance and lung function in terms of lung elastance and oedema. Naïve murine hematopoietic progenitors in bone marrow were enhanced after treatment as well. Administration of HLSCs and HLSC-EVs after CLP to significantly improved survival.</p><p><strong>Conclusions: </strong>Treatment with HLSCs or HLSC-derived EVs was effective in improving acute lung injury, dysmyelopoiesis and ultimately survival in this experimental murine model of lethal sepsis.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"111"},"PeriodicalIF":2.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768471","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":"Cerebral capillary oxygen diffusion: exploring the concept of intracapillary hemoglobin conformational changes.","authors":"Gurgen Harutyunyan, Varsenik Harutyunyan Jaghatspanyan, Garnik Harutyunyan Jaghatspanyan, Emma Martirosyan, Artur Cherkezyan, Armen Varosyan, Suren Soghomonyan","doi":"10.1186/s40635-024-00691-y","DOIUrl":"10.1186/s40635-024-00691-y","url":null,"abstract":"<p><p>The mechanisms of oxygen diffusion in brain capillaries have not been fully clarified to date. According to the laws of physics, the well-documented phenomenon of hyperoxemia-induced excessive increases in brain tissue oxygen pressure (PbtO2) contradicts traditional models of cerebral capillary oxygen diffusion. Circulating models predict a significant drop in oxygen pressure (PO2), and some of them foresee the presence of hypoxic or anoxic corners near the capillary end, regardless of high PbtO2 levels. We propose that the cerebral intracapillary transformation of hemoglobin from the relaxed (R) to the tense (T) quaternary conformational state, driven by deoxygenation and an overload of negative allosteric effectors, and characterized by a lower, more hyperbolic dissociation curve, mitigates the oxygen pressure difference across cerebral capillaries, ensuring a homogeneous pericapillary distribution of oxygen. The hemoglobin R to T state transition is responsible for the high PbtO2 levels observed in viable cerebral tissue during hyperoxemia.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"110"},"PeriodicalIF":2.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142750870","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":"Open-lung ventilation versus no ventilation during cardiopulmonary bypass in an innovative animal model of heart transplantation.","authors":"Varun Karnik, Sebastiano Maria Colombo, Leah Rickards, Silver Heinsar, Louise E See Hoe, Karin Wildi, Margaret R Passmore, Mahe Bouquet, Kei Sato, Carmen Ainola, Nicole Bartnikowski, Emily S Wilson, Kieran Hyslop, Kris Skeggs, Nchafatso G Obonyo, Charles McDonald, Samantha Livingstone, Gabriella Abbate, Andrew Haymet, Jae-Seung Jung, Noriko Sato, Lynnette James, Benjamin Lloyd, Nicole White, Chiara Palmieri, Mark Buckland, Jacky Y Suen, David C McGiffin, John F Fraser, Gianluigi Li Bassi","doi":"10.1186/s40635-024-00669-w","DOIUrl":"10.1186/s40635-024-00669-w","url":null,"abstract":"<p><p>Open-lung ventilation during cardiopulmonary bypass (CPB) in patients undergoing heart transplantation (HTx) is a potential strategy to mitigate postoperative acute respiratory distress syndrome (ARDS). We utilized an ovine HTx model to investigate whether open-lung ventilation during CPB reduces postoperative lung damage and complications. Eighteen sheep from an ovine HTx model were included, with ventilatory interventions randomly assigned during CPB: the OPENVENT group received low tidal volume (V_T) of 3 mL/kg and positive end-expiratory pressure (PEEP) of 8 cm H₂0, while no ventilation was provided in the NOVENT group as per standard of care. The recipient sheep were monitored for 6 h post-surgery. The primary outcome was histological lung damage, scored at the end of the study. Secondary outcomes included pulmonary shunt, driving pressure, hemodynamics and inflammatory lung infiltration. All animals completed the study. The OPENVENT group showed significantly lower histological lung damage versus the NOVENT group (0.22 vs 0.27, p = 0.042) and lower pulmonary shunt (19.2 vs 32.1%, p = 0.001). In addition, the OPENVENT group exhibited a reduced driving pressure (9.6 cm H₂O vs. 12.8 cm H₂O, p = 0.039), lower neutrophil (5.25% vs 7.97%, p ≤ 0.001) and macrophage infiltrations (11.1% vs 19.6%, p < 0.001). No significant differences were observed in hemodynamic parameters. In an ovine model of HTx, open-lung ventilation during CPB significantly reduced lung histological injury and inflammatory infiltration. This highlights the value of an open-lung approach during CPB and emphasizes the need for further clinical evidence to decrease risks of lung injury in HTx patients.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"109"},"PeriodicalIF":2.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142727965","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":"Target-controlled dialysis for antibiotics (TCD-ABx).","authors":"Alexander Dejaco, Christoph Dorn, Constantin Lier, Daniel Fleischmann, Alexander Kratzer, Katharina Habler, Michael Paal, Michael Gruber, Johanna Rosenberger, Martin G Kees","doi":"10.1186/s40635-024-00696-7","DOIUrl":"10.1186/s40635-024-00696-7","url":null,"abstract":"<p><strong>Background: </strong>Effective antimicrobial therapy is an essential part of intensive care medicine and renal replacement therapy is an important and common intervention which significantly affects the pharmacokinetics of many antimicrobials. This is especially critical for substances with a narrow therapeutic range, creating a dilemma of weighing the risk of toxicity from increased drug exposure against risk of ineffective treatment and promotion of antimicrobial resistance. To address this problem, we investigate a target-controlled dialysis by in vitro experiments - a novel technique in which drug is spiked into the dialysis solution to make use of the physicochemical properties of renal replacement therapy for solute transport, with the goal to reduce the risk of inadequate drug exposure.</p><p><strong>Methods: </strong>Five antibiotics (ceftazidime, meropenem, piperacillin/tazobactam, vancomycin, flucloxacillin) were dialyzed in an in vitro model of continuous veno-venous hemodialysis using 1 L of bovine serum albumin solution as simulated patient plasma compartment. This was done with and without antibiotics in target concentrations added to the dialysis solution, mimicking three clinically relevant scenarios: (i) target-controlled dialysis in a subject with sub-therapeutic drug levels, (ii) target-controlled dialysis in a subject with supra-therapeutic drug levels, and (iii) traditional dialysis of drugs starting at the target concentration. Drug levels were quantified by high-performance liquid chromatography. Additionally, the stability over 24 h of all antibiotics in two typical dialysis solutions was assessed.</p><p><strong>Results: </strong>Our data shows that with target-controlled dialysis, antibiotic concentrations will change in the desired direction towards the target concentration, depending on the patients' unbound drug levels in relation to the concentration in the dialysis solution. The desired target concentrations can be induced and maintained, regardless of the initial concentration. Furthermore, the stability tests revealed only a minor and clinically irrelevant loss in drug concentration (all < 10.2%) after 12 h.</p><p><strong>Conclusions: </strong>We outlined the mechanistic plausibility and provided experimental evidence of the feasibility of the target-controlled dialysis concept, which could help to maintain therapeutic concentrations of many time-dependent antibiotics in critically ill patients under renal replacement therapy. The required stability in dialysis solutions was shown for a set of important antibiotics. The next step will be the prudent application of this concept to patients in clinical trials.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"108"},"PeriodicalIF":2.8,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11599528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of mitochondrial function and its prognostic role in sepsis: a literature review.","authors":"Wagner Nedel, Nathan Ryzewski Strogulski, Afonso Kopczynski, Luis Valmor Portela","doi":"10.1186/s40635-024-00694-9","DOIUrl":"10.1186/s40635-024-00694-9","url":null,"abstract":"<p><p>Sepsis is characterized by a dysregulated and excessive systemic inflammatory response to infection, associated with vascular and metabolic abnormalities that ultimately lead to organ dysfunction. In immune cells, both non-oxidative and oxidative metabolic rates are closely linked to inflammatory responses. Mitochondria play a central role in supporting these cellular processes by utilizing metabolic substrates and synthesizing ATP through oxygen consumption. To meet fluctuating cellular demands, mitochondria must exhibit adaptive plasticity underlying bioenergetic capacity, biogenesis, fusion, and fission. Given their role as a hub for various cellular functions, mitochondrial alterations induced by sepsis may hold significant pathophysiological implications and impact on clinical outcomes. In patients, mitochondrial DNA concentration, protein expression levels, and bioenergetic profiles can be accessed via tissue biopsies or isolated peripheral blood cells. Clinically, monocytes and lymphocytes serve as promising matrices for evaluating mitochondrial function. These mononuclear cells are highly oxidative, mitochondria-rich, routinely monitored in blood, easy to collect and process, and show a clinical association with immune status. Hence, mitochondrial assessments in immune cells could serve as biomarkers for clinical recovery, immunometabolic status, and responsiveness to oxygen and vasopressor therapies in sepsis. These characteristics underscore mitochondrial parameters in both tissues and immune cells as practical tools for exploring underlying mechanisms and monitoring septic patients in intensive care settings. In this article, we examine pathophysiological aspects, key methods for measuring mitochondrial function, and prominent studies in this field.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"107"},"PeriodicalIF":2.8,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710054","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":"Predictors of intradialytic hypotension in critically ill patients undergoing kidney replacement therapy: a systematic review.","authors":"Rafaella Maria C Lyrio, Etienne Macedo, Raghavan Murugan, Arnaldo A da Silva, Tess M Calcagno, Estevão F Sampaio, Rafael H Sassi, Rogério da Hora Passos","doi":"10.1186/s40635-024-00695-8","DOIUrl":"10.1186/s40635-024-00695-8","url":null,"abstract":"<p><strong>Background: </strong>This systematic review aims to identify predictors of intradialytic hypotension (IDH) in critically ill patients undergoing kidney replacement therapy (KRT) for acute kidney injury (AKI).</p><p><strong>Methods: </strong>A comprehensive search of PubMed was conducted from 2002 to April 2024. Studies included critically ill adults undergoing KRT for AKI, excluding pediatric patients, non-critically ill individuals, those with chronic kidney disease, and those not undergoing KRT. The primary outcome was identifying predictive tools for hypotensive episodes during KRT sessions.</p><p><strong>Results: </strong>The review analyzed data from 8 studies involving 2873 patients. Various machine learning models were assessed for their predictive accuracy. The Extreme Gradient Boosting Machine (XGB) model was the top performer with an area under the receiver operating characteristic curve (AUROC) of 0.828 (95% CI 0.796-0.861), closely followed by the deep neural network (DNN) with an AUROC of 0.822 (95% CI 0.789-0.856). All machine learning models outperformed other predictors. The SOCRATE score, which includes cardiovascular SOFA score, index capillary refill, and lactate level, had an AUROC of 0.79 (95% CI 0.69-0.89, p < 0.0001). Peripheral perfusion index (PPI) and heart rate variability (HRV) showed AUROCs of 0.721 (95% CI 0.547-0.857) and 0.761 (95% CI 0.59-0.887), respectively. Pulmonary vascular permeability index (PVPI) and mechanical ventilation also demonstrated significant diagnostic performance. A PVPI ≥ 1.6 at the onset of intermittent hemodialysis (IHD) sessions predicted IDH associated with preload dependence with a sensitivity of 91% (95% CI 59-100%) and specificity of 53% (95% CI 42-63%).</p><p><strong>Conclusion: </strong>This systematic review shows how combining predictive models with clinical indicators can forecast IDH in critically ill AKI patients undergoing KRT, with validation in diverse settings needed to improve accuracy and patient care strategies.</p>","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"106"},"PeriodicalIF":2.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11582124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681674","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":"Is passive leg raising clinically useful in predicting intradialytic hypotension?","authors":"Martin Ruste, Jean-Luc Fellahi, Matthias Jacquet-Lagrèze","doi":"10.1186/s40635-024-00683-y","DOIUrl":"10.1186/s40635-024-00683-y","url":null,"abstract":"","PeriodicalId":13750,"journal":{"name":"Intensive Care Medicine Experimental","volume":"12 1","pages":"105"},"PeriodicalIF":2.8,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675799","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}