Turkish journal of anaesthesiology and reanimation最新文献

{"title":"Medical Jousting in Research Publications: A Call for Ethical Discourse.","authors":"Ashwin Mani, Sukriti Jha, Prakash Gyandev Gondode, Sakshi Duggal","doi":"10.4274/TJAR.2025.251893","DOIUrl":"10.4274/TJAR.2025.251893","url":null,"abstract":"","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"375-376"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691660","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":"The Relationships Between Patients' Demographic Characteristics, Comorbid Diseases, American Society of Anesthesiologists Scores and Inflammation Indexes: A Retrospective Study.","authors":"Ali Genç, Mehtap Gürler Balta, Vildan Kölükçü, Ahmet Tuğrul Şahin, Yunus Emre Şakacı, Hakan Tapar, Tuğba Karaman, Serkan Karaman","doi":"10.4274/TJAR.2025.251959","DOIUrl":"10.4274/TJAR.2025.251959","url":null,"abstract":"<p><strong>Objective: </strong>Parameters that can provide information about patients' current status are very important in preoperative evaluation. The systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) can be easily calculated with a simple hemogram test, and this testing is frequently requested in preoperative preparation. The aim of this research was to examine the relationship between the SII, and SIRI, along with the demographic characteristics and postoperative clinical course of the patient.</p><p><strong>Methods: </strong>In the study, the records of patients who presented to the anesthesia outpatient clinic for preoperative preparation were retrospectively reviewed. In this study, the relationships between the SII, and SIRI and each patients' demographic characteristics, and the American Society of Anesthesiologists (ASA) score, comorbid disease, and length of hospital stay were examined.</p><p><strong>Results: </strong>For the SII value, there was a statistically significant difference between the ASA1 and ASA2 groups and between the ASA2 and ASA3 groups there was no significant difference between the ASA3 and ASA4 groups (<i>P</i> < 0.001, <i>P</i> < 0.001, P=0.17, respectively). There were statistically significant differences between the ASA1 and ASA2, ASA2 and ASA3, and ASA3 and ASA4 groups for the SIRI value (<i>P</i> < 0.001, <i>P</i> < 0.001, <i>P</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>The findings showed relationships between the SII, SIRI, neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio and an increase in patients' ASA scores. In multivariate analysis, some demographic characteristics of the patients, comorbidities, and the postoperative course were found to be independent risk factors predicting SII and SIRI.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"326-333"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576352","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":"The Use of Cisatracurium in Cardiac Surgery.","authors":"Vikas C Roy, Sakshi Mehta, Rajni Bala","doi":"10.4274/TJAR.2025.241876","DOIUrl":"10.4274/TJAR.2025.241876","url":null,"abstract":"<p><p>The introduction of neuromuscular blockers (NMBs) has revolutionized the practice of general anaesthesia, ushering in a new era where anaesthesia is conceptualized as a triad comprising narcosis, analgesia, and muscle relaxation. NMBs play a vital role in surgeries by facilitating tracheal intubation, preventing the movement of body and diaphragm, control of ventilation at normal partial pressure of carbon dioxide and counteraction of narcotic-induced truncal rigidity. However, the absence of specific guidelines for the selection and utilization of particular NMBs in various surgical contexts has led to inconsistencies within the healthcare system. Thus, a deep and thorough understanding of pharmacological aspects of NMBs is required for the selection and usage of particular NMB in clinical setting. Ideal NMBs are characterized by rapid onset, non-cumulative effects, independence from renal or hepatic function for elimination, rapid reversibility, and minimal adverse side effects. Among several NMBs, cisatracurium, an isomer of atracurium is a non-depolarizing intermediate-acting with characteristic features of high potency, smaller dosage requirement, no histamine release, no cardiovascular effects and elimination via organ-independent Hofmann reaction. Innumerable clinical experiments and trials suggest cisatracurium as safe, cost-effective, and better molecule with predictable recovery and no postoperative residual paralysis in comparison to other NMBs such as rocuronium, vecuronium, and pancuronium. In this review, we aimed to provide critical insights on the properties of NMBs first and then focused on the use of cisatracurium in cardiac surgeries.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"293-300"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660389","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":"Continuous Low-dose Epidural Morphine and Ketamine Analgesia Improves Quality of Recovery after Major Lumbar Spine Surgery: A Randomised Controlled Trial.","authors":"Sailaja Karri, Ramamani Mariappan, Gandham Edmond Jonathan, Thenmozhi Mani, Prasadkanna Prabhakar, Jemimah Samuel, Krishnaprabhu Raju","doi":"10.4274/TJAR.2025.251950","DOIUrl":"10.4274/TJAR.2025.251950","url":null,"abstract":"<p><strong>Objective: </strong>The effect of postoperative analgesia on the quality of recovery (QoR) after major lumbar spine surgery is understudied. We hypothesized that continuous epidural morphine and ketamine administration would provide effective analgesia, thereby improving QoR compared to continuous intravenous morphine and ketamine using the QoR-15 questionnaire.</p><p><strong>Methods: </strong>A total of 40 patients were randomised to receive either continuous low-dose epidural morphine and ketamine via an intraoperatively placed epidural catheter (Group A) or intravenous morphine and ketamine using a patient-controlled analgesia system (Group B) for 48 hours. All patients were anaesthetized using standard anaesthesia drugs. The primary outcome was QoR at 24 and 48 hours after surgery using the QoR-15 questionnaire. The secondary outcomes were pain score at various time points during the first 48 hours, rescue analgesic requirements, ambulation time, length of hospital stay, and patient satisfaction.</p><p><strong>Results: </strong>Forty patients were recruited (20 in each group), and all patient data were included in the analysis. The total QoR-15 scores for Group A and Group B at 24 hours were 134.8±6.65 and 128.9±6.12, respectively (P=0.006). The QoR-15 scores at 48 hours for groups A and B were 136.7±6.02 vs 132.10±6.8 (P=0.029), respectively. The pain score was lower in Group A than in Group B at rest and during movement, with P=0.015 and 0.001, respectively, and all the other secondary outcomes were comparable between the groups.</p><p><strong>Conclusion: </strong>Postoperative analgesia with continuous low-dose epidural morphine and ketamine via an intraoperatively placed epidural catheter provides superior QoR after major lumbar spine surgery as compared to intravenous morphine and ketamine.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"341-349"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817511","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":"The Effect of Using Smart Glasses Integrated Ultrasonography in Radial Artery Catheterization: A Prospective Randomized Trial.","authors":"Merve Gözen, Bengi Şafak, Ayşegül Güven, Onat Bermede","doi":"10.4274/TJAR.2025.252052","DOIUrl":"10.4274/TJAR.2025.252052","url":null,"abstract":"<p><strong>Objective: </strong>The use of ultrasonography (USG) in arterial catheterization, in which the comfort of the practitioners and hand-eye coordination are very important, is frequently needed by anesthesiologists in daily practice. We aimed to investigate whether radial artery catheterization with smart glasses-integrated USG would increase success and satisfaction.</p><p><strong>Methods: </strong>One hundred twenty patients who were >18 years old and would have undergone elective surgery with an indication for radial artery catheterization between August and December 2022 were included in this prospective randomized study. Patients who underwent catheterization in the last month and had contraindications were excluded. In the Standard USG Group, catheterizations were performed with standard USG, and in the Smart Glass Group, with smart glasses-integrated USG. Two anesthetists, a junior practitioner with experience with 20-50 catheterizations and a senior practitioner with experience with over 50 catheterizations, performed the catheterizations. The subcutaneous distance, radial artery depth, and diameter in short axis, catheterization time, and ergonomic satisfaction were recorded.</p><p><strong>Results: </strong>Sixty patients in standard USG group and 59 patients in Smart Glass Group, with similar demographics, were included in statistical analysis. The mean first catheterization time by junior practitioners, with smart glasses integrated USG, was shorter than standard USG (49.07±29.91 sec vs. 99.73±75.18 sec, <i>P</i> <0.001). The junior practitioner was more satisfied with smart glasses-integrated USG. There was no significant difference between groups in terms of interventions made by the senior practitioner.</p><p><strong>Conclusion: </strong>Radial artery catheterization with smart glasses integrated USG shortens catheterization time, and increases satisfaction by increasing the comfort of USG use for junior practitioners.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"350-356"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081893","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":"Artificial Intelligence in Anaesthesiology: Current Applications, Challenges, and Future Directions.","authors":"Burhan Dost, Engin İhsan Turan, Muhammed Enes Aydın, Ali Ahıskalıoğlu, Madan Narayanan, Resul Yılmaz, Alessandro De Cassai","doi":"10.4274/TJAR.2025.252320","DOIUrl":"10.4274/TJAR.2025.252320","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly transforming anaesthesiology through advances in machine learning, deep learning, and large language models. AI-driven tools now contribute to nearly every phase of perioperative care, including preoperative risk stratification, intraoperative monitoring, imaging interpretation, airway assessment, regional anaesthesia, and critical care. Applications such as automated American Society of Anesthesiologists classification, prediction of postoperative complications and intensive care unit needs, electroencephalography-based depth-of-anaesthesia estimation, and proactive haemodynamic management are reshaping clinical decision-making. AI-augmented echocardiography enhances chamber recognition and functional measurements, whereas computer vision systems support airway evaluation and ultrasound-guided regional anaesthesia by providing real-time anatomical identification and facilitating training. In critical care, AI models facilitate the early detection of sepsis, organ dysfunction, and haemodynamic instability, while improving workflow efficiency and resource allocation. AI is increasingly used in academic writing, data processing, and medical education, offering opportunities for personalised learning and simulation but raising concerns about accuracy and hallucinations. In this review, we aimed to summarise the current applications of AI in anaesthesiology, highlight the methodological, ethical, and practical challenges that limit its integration, and discuss future directions for its safe and effective adoption in perioperative care.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"282-292"},"PeriodicalIF":0.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12728456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757907","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":"The Application of Regional Anaesthesia in Türkiye: National Survey Study.","authors":"Elvin Kanat, Zeynep Çağıran, Nezih Sertöz","doi":"10.4274/TJAR.2025.251900","DOIUrl":"10.4274/TJAR.2025.251900","url":null,"abstract":"<p><strong>Objective: </strong>This study was designed to determine why anaesthesiologists working in various institutions in our country prefer current regional anaesthesia methods and to evaluate the use and prevalence of ultrasonography in these methods.</p><p><strong>Methods: </strong>A questionnaire created on SurveyMonkey.com was sent electronically or face-to-face to anaesthesiology and reanimation physicians working in different provinces of our country, and they were asked to fill it out. The survey was intended to be administered to at least 200 volunteer anaesthesiologists. The questionnaire consisted of 34 questions, including demographic characteristics, neuraxial block and peripheral nerve block (PNB) applications, drug choices, preferences in paediatric cases, training, and safety measures.</p><p><strong>Results: </strong>A total of 215 anaesthesiologists participated in our questionnaire. 39.2% were working in a university hospital, and 38.2% were working in a training and research hospital. PNB training was received by 89.2% of the participants during specialty training. For analgesic purposes, the interscalene block was preferred for shoulder surgery (57.4%), the axillary block for elbow, forearm, and hand surgery (49.8%), the erector spinae plane block for thoracic surgery (33.8%), and the transverse abdominis and rectus block for open abdominal surgery (51.5%).</p><p><strong>Conclusion: </strong>Regional anaesthesia is an essential part of multimodal analgesia and is used both as an anaesthetic and analgesic in routine practice. In recent years, many new techniques have been utilized as a result of advancements. However, for these to be implemented in practice, up-to-date information should be closely followed, and anaesthetists should be supported in terms of training and equipment.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"217-225"},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112253","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":"The Role of microRNA in Anaesthetics-induced Brain Injury: A Narrative Review.","authors":"Elvan Öçmen, Bilge Karaçiçek, Burak İbrahim Arıöz, Hale Aksu, Şermin Genç","doi":"10.4274/TJAR.2025.241739","DOIUrl":"10.4274/TJAR.2025.241739","url":null,"abstract":"<p><p>Anaesthetics are commonly used agents during medical interventions and surgeries. Exposure to anaesthetic agents in late intrauterine life or early childhood may cause neurodegeneration in developing brains. Neuroapoptosis and neural inhibition provided by several mechanisms and microRNAs (miRNAs) have crucial roles in this milieu. miRNAs have critical roles in response to anaesthetic exposure. Through this review, we performed a systematic search of the PubMed database for studies on the role of anaesthetics in the brain and their relation with miRNAs. The terms \"anesthetic\", \"miRNA\", and \"brain\" were searched. Here we summarized the roles and interactions of miRNAs under exposure to anaesthetics <i>in vivo</i> and <i>in vitro</i> studies. Anaesthetic agents studied included sevoflurane, isoflurane, ketamine, and propofol. Many microRNAs were identified to have regulatory roles in anaesthesia-induced neurotoxicity. The literature study supports the idea that miRNAs play crucial functions in neuroprotection and neurotoxicity in anaesthesia administration. The exact role and implication of miRNA in anaesthesia neurotoxicity needs to be elucidated to gain more knowledge about the area. Several gaps in knowledge should be filled by conducting basic, clinical, and translational analyses in the future to decipher the definite role of miRNAs and their functions in the context of anaesthesia-induced neurotoxicity.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"187-196"},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017154","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":"Anaesthesia Management of a Case with Hereditary Angioedema for Whom Tracheal Dilatation was Planned.","authors":"Muharrem Uçar, Mukadder Şanlı, Sezai Aktürk, İlham Gülçek, Feray Akgül Erdil","doi":"10.4274/TJAR.2025.241584","DOIUrl":"10.4274/TJAR.2025.241584","url":null,"abstract":"<p><p>Hereditary angioedema (HAE) causes recurrent angioedema attacks in the oropharynx, larynx, face, and other regions due to bradykinin overproduction as a result of C1 esterase inhibitor deficiency. Surgical interventions requiring general anaesthesia might trigger HAE attacks. Laryngeal angioedema is the most important cause of perioperative mortality. Tracheal dilatation was performed by rigid bronchoscopy in our patient with type 1 HAE, because of tracheal stenosis due to prolonged intubation, which occurred after the attack. The patient was administered 2x500 IU C1 esterase inhibitor approximately 24 hours before rigid bronchoscopy. No complication developed after the first procedure. Two months later, tracheal dilatation was repeated and 2x500 IU C1 esterase inhibitor was administered. While the patient was followed up in the intensive care unit, significant oedema developed in the facial area, especially the tongue and lips, approximately 10 hours after the procedure. Our patient also had stridor due to airway obstruction. The patient was treated with 1000 IU C1 esterase inhibitor and 3 units of fresh frozen plasma (FFP). After FFP, edema started to regress. The patient was discharged after symptoms improved. The patient should be monitored in the intensive care unit for a minimum of 48 hours to monitor for postoperative laryngeal oedema.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"277-279"},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081912","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":"Comparative Analysis of King Vision aBlade Video Laryngoscopy and Direct Laryngoscopy for Endotracheal Intubation in Paediatric Age Group: a Prospective Randomized Study.","authors":"Mamta Harjai, Chaya Devi D, Sujeet Rai, Shilpi Misra, Tanveer Roshan Khan","doi":"10.4274/TJAR.2025.251902","DOIUrl":"10.4274/TJAR.2025.251902","url":null,"abstract":"<p><strong>Objective: </strong>Paediatric airway management is challenging due to anatomical differences, making effective endotracheal intubation crucial during surgery. While direct laryngoscopy (DL) has been the standard method, video laryngoscopy (VL) has emerged as a promising alternative. This study compared the effectiveness of King Vision aBlade non-channeled VL (KVL) with Miller/Macintosh DL for intubation in children.</p><p><strong>Methods: </strong>In this prospective, randomized, single-blinded study, 150 children aged 2-10 years undergoing elective surgery were randomly assigned to either Group DL (n = 75) or Group KVL (n = 75). Data was collected on intubation success, time, glottic view, external maneuvers, and hemodynamic parameters [heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), peripheral oxygen saturation (SpO₂)] at various intervals.</p><p><strong>Results: </strong>The mean age of patients was similar in both groups (<i>P</i>=0.15). The DL group had a higher success rate on the first attempt (<i>P</i> < 0.001) and shorter intubation times (9.97±3.12 sec vs. 14.35±2.99 sec, <i>P</i> < 0.001) compared to KVL. Although KVL provided a better glottic view, this difference was not statistically significant (<i>P</i>=0.059). Hemodynamic parameters (SBP, DBP) were significantly higher in the DL group post-intubation (<i>P</i> < 0.05), with no significant differences in HR or SpO₂ between groups. The DL group required more external maneuvers for intubation (<i>P</i>=0.022).</p><p><strong>Conclusion: </strong>DL showed a higher success rate, faster intubation times, and greater hemodynamic stability compared to KVL. While KVL offered better glottic views, it had longer intubation times and lower success rates. Further studies with larger sample sizes are recommended to validate these findings.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":" ","pages":"249-255"},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12519913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627187","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}