Neurocritical Care最新文献

{"title":"NeuroICU FastTrack: Rapid Disposition of Patients with Intracerebral Hemorrhage from the Emergency Department to Neuro-ICU.","authors":"Nicolle W Davis, Jeannette M Hester, Brandon Allen, Christina Wilson, Anna Khanna, Ashley E Magnuson, Teng J Peng, Katharina M Busl, Amita Singh","doi":"10.1007/s12028-025-02247-8","DOIUrl":"10.1007/s12028-025-02247-8","url":null,"abstract":"<p><strong>Background: </strong>Emergency department length of stay (EDLOS) directly impacts outcomes of critically ill patients, with the risk of in-hospital mortality increasing by nearly 40% when an intensive care unit (ICU) bed is delayed beyond 4 h. Patients with intracerebral hemorrhage (ICH) suffer from worse functional outcomes and higher mortality when EDLOS exceeds 5 h, even for EDLOS exceeding just 1 h. Our goal was to implement an expedited triage pathway to reduce EDLOS of patients with ICH to less than 3 h and evaluate for downstream reduced morbidity and mortality.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of patients with ICH evaluated in the emergency department (ED) at an academic comprehensive stroke center between January 1, 2022, and June 30, 2023. Univariate and multivariate logistic regression analyses were conducted to investigate the association between the NeuroICU FastTrack intervention with EDLOS less than 3 h and the rate of in-hospital mortality.</p><p><strong>Results: </strong>A total of 234 patients with ICH arrived to the ED and were admitted to the neuro-ICU. Post implementation, there was a statistically significant decrease in EDLOS from an average of 6.6 h to 4 h (p < 0.001) and a significant decrease in patient mortality (p = 0.006). There was also a reduction in mortality to 9.3% (p = 0.006) compared to a preintervention mortality rate of 22.9%. Additionally, the morbidity outcome (mRS of 0-2) remained relatively constant in both groups preintervention (23%) to post intervention (28%).</p><p><strong>Conclusions: </strong>Consistent with prior published evidence and National Institute of Neurological Disorders and Stroke recommendations, a shorter EDLOS significantly decreased mortality, but there was no difference in morbidity in our population. The NeuroICU FastTrack process expedited critically ill ICH patient throughput from the ED to the ICU, enhanced bed availability through streamlined procedures, and improved patient outcomes.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"504-511"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Abnormalities Identified on Brain Magnetic Resonance Imaging in Patients with Sepsis.","authors":"Toru Hosokawa, Kosaku Kinoshita, Shingo Ihara, Katsuhiro Nakagawa, Umefumi Iguchi, Tomokazu Mutoh, Nami Sawada, Tsukasa Kuwana, Junko Yamaguchi, Atsushi Sakurai","doi":"10.1007/s12028-025-02235-y","DOIUrl":"10.1007/s12028-025-02235-y","url":null,"abstract":"<p><strong>Background: </strong>Sepsis often codevelops with brain damage, and the mechanisms underlying sepsis-related brain damage have been elucidated. However, only a few studies have reported the diagnostic imaging assessments for brain damage in sepsis. Therefore, in this study, we analyzed the brain magnetic resonance (MR) imaging (MRI) findings of patients with sepsis.</p><p><strong>Methods: </strong>This single-center prospective observational study included 71 patients with sepsis who underwent brain MRI, regardless of the presence or absence of shocks and acute neurological abnormalities. The MR images were classified according to the presence or absence of acute cerebral ischemia and leukoencephalopathy, with normal findings indicating neither condition.</p><p><strong>Results: </strong>The MR images of 18 patients (25.3%) showed acute cerebral ischemia and leukoencephalopathy. Furthermore, 44 patients (62.0%) had only leukoencephalopathy. In terms of patient demographic characteristics and neurological outcomes, significant differences were noted among patients with acute cerebral ischemia findings, those with leukoencephalopathy findings, and those with neither. There were significant differences in age (P = 0.0296), neurological findings (P = 0.0057), number of days in the intensive care unit (P = 0.0239), acute disseminated intravascular coagulation score during hospitalization (P = 0.0363), and the Katz index at discharge or transfer (P = 0.0020) among these groups.</p><p><strong>Conclusions: </strong>Among patients with sepsis, 25.3% showed acute cerebral ischemia findings on brain MRI, regardless of illness severity, including hypoxia and hypotension, and presence of shock. Abnormal MRI findings were also observed in patients without acute brain dysfunction. Importantly, abnormal brain MRI findings were associated with worse neurological outcomes.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"437-445"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryptogenic Encephalitis: The New Abnormal.","authors":"Chiara Risso, Romain Sonneville","doi":"10.1007/s12028-025-02289-y","DOIUrl":"10.1007/s12028-025-02289-y","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"378-381"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Antiseizure Medication Prophylaxis and Outcomes in Hospitalized Adults with Acute Brain Injuries.","authors":"David Cheng, Marta Bento Fernandes, M Brandon Westover, Lidia Moura, Sahar F Zafar","doi":"10.1007/s12028-025-02345-7","DOIUrl":"https://doi.org/10.1007/s12028-025-02345-7","url":null,"abstract":"<p><strong>Background: </strong>There is low-quality evidence for antiseizure medication (ASM) prophylaxis in acute brain injuries. We examined ASM prophylaxis patterns and explored the association with hospital outcomes in acute brain injury.</p><p><strong>Methods: </strong> We analyzed the PINC AI Healthcare Database with data from more than 1,400 US hospitals. We included adults aged ≥ 18 years admitted for at least 2 days with acute brain injury (International Classification of Diseases codes for ischemic stroke [IS], hemorrhagic stroke [HS], and traumatic brain injury [TBI]) and excluded potential prevalent users and patients with epilepsy/seizures. Index date was the second day of admission. The ASM prophylaxis cohort received levetiracetam or phenytoin on the index date; the control cohort did not receive any ASM on the index date. Outcomes were time-to-mortality and time-to-home discharge.</p><p><strong>Results: </strong>In total, 739,213 patients were eligible: 568,254 with IS, 86,842 with HS, and 84,117 with TBI. ASM prophylaxis was prescribed in 10,959/568,254 (2%) patients with IS, 31,970/86,842 (37%) patients with HS, and 38,331/84,117 (46%) patients with TBI. Patients on prophylaxis more frequently received mechanical ventilation, craniectomies/craniotomies, vasopressors, and anesthetics. After adjusting for markers of illness severity, prophylaxis was associated with mortality (IS: hazard ratio [HR] 2.02, 95% confidence interval [CI] 1.89-2.16; HS: HR 0.83; 95% CI 0.79-0.87; TBI: HR 0.97, 95% CI 0.89-1.06). Prophylaxis was associated with lower home discharge (IS: HR 0.40, 95% CI 0.37-0.42; HS: HR 0.61, 95% CI 0.58-0.64; TBI: HR 0.69, 95% CI 0.68-0.72). Across all acute brain injuries, mechanical ventilation exhibited strong association with outcomes.</p><p><strong>Conclusions: </strong>Antiseizure medication prophylaxis was higher in TBI and HS compared with IS. Markers of illness severity (e.g., mechanical ventilation, neurosurgical procedures) were associated with more frequent prophylaxis. Prophylaxis exhibited differential associations with mortality (higher in IS, lower in HS and TBI). Prophylaxis was associated with lower home discharge across all acute brain injuries. We hypothesize that neurologic severity and critical illness severity are primary drivers of outcomes. However, the independent association of ASMs with outcomes warrants further investigation.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145207027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Paroxysmal Sympathetic Hyperactivity on Prognosis in Patients with Severe Intracerebral Hemorrhage.","authors":"Fan Yang, Guang Feng, Bingsha Han, Jingzhou Li, Jinsong Chen","doi":"10.1007/s12028-025-02258-5","DOIUrl":"10.1007/s12028-025-02258-5","url":null,"abstract":"<p><strong>Background: </strong>Paroxysmal sympathetic hyperactivity (PSH) is characterized by episodes of excessive sympathetic activity and is associated with poor outcomes in brain injuries, yet its impact on severe intracerebral hemorrhage (ICH) remains unclear. This study investigates the association between PSH and clinical outcomes in patients with severe ICH.</p><p><strong>Methods: </strong>We conducted a prospective observational cohort study of patients with severe ICH from January 2018 to December 2022. Severe ICH was defined as ICH with a Glasgow Coma Scale score ≤ 8 on admission, indicating significant neurological impairment. Patients were assessed for PSH using the PSH-Assessment Measure, and categorized into probable, possible, and unlikely PSH groups. Propensity score matching was used to adjust for baseline differences among three groups. The primary outcome was the 90-day mortality rate. Secondary outcomes included a favorable functional outcome at 90 days, defined by a modified Rankin Scale score of 0-2. Statistical analyses were performed using Cox proportional hazards regression and Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>After propensity score matching, 177 patients (59 in each group) were analyzed. The 90-day mortality rate was significantly higher (P < 0.01) in the probable PSH group (67.8%), compared with possible (47.5%) and unlikely PSH groups (35.6%). The Kaplan-Meier survival curve further illustrates a significantly increased risk of 90-day mortality in the probable PSH group (Log rank test P < 0.01). Multivariate Cox proportional hazards regression analysis confirmed that, after adjusting for confounders, the presence of probable PSH (hazard ratio 3.86, 95% confidence interval 2.17-6.87; P < 0.01) was independently associated with a higher risk of 90-day mortality. Functional outcomes at 90 days were poorer in the probable PSH group.</p><p><strong>Conclusions: </strong>Probable PSH is significantly associated with worse outcomes in severe ICH, underscoring the importance of early recognition and targeted management strategies.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"590-597"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Machine Learning Models in Predicting Intensive Care Unit Discharge for Neurosurgical Patients Undergoing Craniotomy: A Big Data Analysis.","authors":"Taghi Khaniyev, Efecan Cekic, Muhammet Abdullah Koc, Ilke Dogan, Sahin Hanalioglu","doi":"10.1007/s12028-025-02246-9","DOIUrl":"10.1007/s12028-025-02246-9","url":null,"abstract":"<p><strong>Background: </strong>Predicting intensive care unit (ICU) discharge for neurosurgical patients is crucial for optimizing bed sources, reducing costs, and improving outcomes. Our study aims to develop and validate machine learning (ML) models to predict ICU discharge within 24 h for patients undergoing craniotomy.</p><p><strong>Methods: </strong>The 2,742 patients undergoing craniotomy were identified from Medical Information Mart for Intensive Care dataset using diagnosis-related group and International Classification of Diseases codes. Demographic, clinical, laboratory, and radiological data were collected and preprocessed. Textual clinical examinations were converted into numerical scales. Data were split into training (70%), validation (15%), and test (15%) sets. Four ML models, logistic regression (LR), decision tree, random forest, and neural network (NN), were trained and evaluated. Model performance was assessed using area under the receiver operating characteristic curve (AUC), average precision (AP), accuracy, and F1 scores. Shapley Additive Explanations (SHAP) were used to analyze importance of features. Statistical analyses were performed using R (version 4.2.1) and ML analyses with Python (version 3.8), using scikit-learn, tensorflow, and shap packages.</p><p><strong>Results: </strong>Cohort included 2,742 patients (mean age 58.2 years; first and third quartiles 47-70 years), with 53.4% being male (n = 1,464). Total ICU stay was 15,645 bed days (mean length of stay 4.7 days), and total hospital stay was 32,008 bed days (mean length of stay 10.8 days). Random forest demonstrated highest performance (AUC 0.831, AP 0.561, accuracy 0.827, F1-score 0.339) on test set. NN achieved an AUC of 0.824, with an AP, accuracy, and F1-score of 0.558, 0.830, and 0.383, respectively. LR achieved an AUC of 0.821 and an accuracy of 0.829. The decision tree model showed lowest performance (AUC 0.813, accuracy 0.822). Key predictors of SHAP analysis included Glasgow Coma Scale, respiratory-related parameters (i.e., tidal volume, respiratory effort), intracranial pressure, arterial pH, and Richmond Agitation-Sedation Scale.</p><p><strong>Conclusions: </strong>Random forest and NN predict ICU discharge well, whereas LR is interpretable but less accurate. Numeric conversion of clinical data improved performance. This study offers framework for predictions using clinical, radiological, and demographic features, with SHAP enhancing transparency.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"512-529"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Performance of the Brain4care System for Noninvasive Detection of Intracranial Hypertension.","authors":"Gustavo Frigieri, Thauan Leandro Gonçalves, Gabriela Nagai Ocamoto, Rodrigo de Ap Andrade, Bruno Cezar de Padua, Danilo Cardim","doi":"10.1007/s12028-025-02273-6","DOIUrl":"10.1007/s12028-025-02273-6","url":null,"abstract":"<p><strong>Background: </strong>Noninvasive methods for detecting intracranial hypertension (IH) are of growing importance in clinical settings. This study evaluates the clinical performance of the brain4care (B4C) System, which captures pulsatile cranial expansions that reveal a surrogate intracranial pressure (ICP) waveform and subsequently derives the P2/P1 ratio and time-to-peak (TTP) parameters to predict IH.</p><p><strong>Methods: </strong>This was a retrospective study conducted across multiple centers that included a total of 124 patients. Invasively monitored ICP and noninvasive B4C waveforms were recorded simultaneously from patients with acute brain injuries. Data were analyzed using specific cutoff values for the estimated P2/P1 ratio (ranging from 0.8 to 1.4) and TTP (at 0.3) to assess their diagnostic accuracy. Sensitivity and specificity for detecting IH (ICP > 20 mm Hg) were determined based on these metrics.</p><p><strong>Results: </strong>The estimated P2/P1 ratio demonstrated a sensitivity of 92% and specificity of 19% at a threshold of 0.8, indicating high sensitivity for ruling out IH. At a ratio of 1.4, the specificity improved to 90%, suggesting its effectiveness for assessing IH. For TTP, a threshold of 0.3 was identified as the optimal cutoff, offering a specificity of 92%.</p><p><strong>Conclusions: </strong>The B4C System provides a viable, noninvasive approach to assessing IH. The study underscores the clinical utility of the P2/P1 ratio and TTP in detecting and ruling out IH, offering a significant alternative to invasive ICP monitoring methods.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"628-635"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grading Scores for Identifying Patients at Risk of Delayed Cerebral Ischemia and Neurological Outcome in Spontaneous Subarachnoid Hemorrhage: A Comparison of Receiver Operator Curve Analysis.","authors":"Alessia Degrassi, Caren Conticello, Hassane Njimi, Giacomo Coppalini, Fernando Oliveira, Alberto Diosdado, Marco Anderloni, Lise Jodaitis, Sophie Schuind, Fabio Silvio Taccone, Elisa Gouvêa Bogossian","doi":"10.1007/s12028-025-02270-9","DOIUrl":"10.1007/s12028-025-02270-9","url":null,"abstract":"<p><strong>Background: </strong>Numerous grading scales were proposed for subarachnoid hemorrhage (SAH) to assess the likelihood of unfavorable neurological outcomes (UO) and the risk of delayed cerebral ischemia (DCI). We aimed to validate the Hemorrhage, Age, Treatment, Clinical Status, and Hydrocephalus (HATCH) score and the VASOGRADE, a simple grading scale for prediction of DCI after aneurysmal SAH.</p><p><strong>Methods: </strong>This was a retrospective single-center study of patients with nontraumatic SAH (January 2016 to December 2021) admitted to the intensive care unit. We performed a receiver operating characteristic (ROC) curve analysis to assess the discriminative ability of the HATCH and the VASOGRADE to identify patients who had UO at 3 months (defined as Glasgow Outcome Scale score of 1-3), hospital mortality, and DCI and compared their performance with the World Federation of Neurosurgical Surgeons, the modified Fisher, the Sequential Organ Failure Assessment, and the Acute Physiology and Chronic Health Evaluation II scales. We performed a multivariate logistic regression analysis to assess the association between HATCH and UO at 3 months and between VASOGRADE and DCI.</p><p><strong>Results: </strong>We included 262 consecutive patients with nontraumatic SAH. DCI was observed in 82 patients (31.3%), whereas 78 patients (29.8%) died during hospital stay and 133 patients (51%) had UO at 3 months. HATCH was independently associated with UO (odds ratio 1.61, 95% confidence interval [CI] 1.36-1.90) and had an area under the ROC curve (AUROC) of 0.83 (95% CI 0.77-0.88), comparable to the Acute Physiology and Chronic Health Evaluation II (AUROC 0.84, 95% CI 0.79-0.89) and Sequential Organ Failure Assessment (AUROC 0.83, 95% CI 0.77-0.88).</p><p><strong>Conclusions: </strong>Hemorrhage, Age, Treatment, Clinical Status, and Hydrocephalus and VASOGARDE scores had a good performance to predict UO or in-hospital mortality and DCI, respectively; however, their performance did not outperform nonspecific routinely used scores.</p>","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"616-627"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Stroke Alert that Wasn't: Lessons Learned from Meningitis-Associated Vasospasm.","authors":"Julian L Moran, Erika J Sigman, Catherine S W Albin","doi":"10.1007/s12028-025-02291-4","DOIUrl":"10.1007/s12028-025-02291-4","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"695-698"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experimental Analysis of Echogenic Signals Appearing in Optic Nerve Ultrasound.","authors":"Hans-Christian Hansen, Jan-Peter Sperhake, Jakob Matschke, Benjamin Ondruschka, Knut Helmke","doi":"10.1007/s12028-024-02057-4","DOIUrl":"10.1007/s12028-024-02057-4","url":null,"abstract":"","PeriodicalId":19118,"journal":{"name":"Neurocritical Care","volume":" ","pages":"682-684"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}