Acute and Critical Care最新文献

{"title":"Retraction: A deep learning model for estimating sedation levels using heart rate variability and vital signs: a retrospective cross-sectional study at a center in South Korea.","authors":"You Sun Kim, Bongjin Lee, Wonjin Jang, Yonghyuk Jeon, June Dong Park","doi":"10.4266/acc.2024.01200.r1","DOIUrl":"https://doi.org/10.4266/acc.2024.01200.r1","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555279","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}

{"title":"Engagement and Perspectives regarding the family conference process when considering discontinuation of life-sustaining treatments among critical care specialist nurses: a nationwide cross-sectional survey in Japan.","authors":"Akane Kato, Yuta Tanaka, Yoshiyuki Kizawa, Hiroaki Yamase, Asami Tado, Junko Tatsuno, Mitsunori Miyashita","doi":"10.4266/acc.003096","DOIUrl":"10.4266/acc.003096","url":null,"abstract":"<p><strong>Background: </strong>Recognizing the importance of multidisciplinary collaboration during treatment family conferences is increasing in critical care settings. We aimed to elucidate how critical care specialist nurses engage in the family conference process in terms of the actual discussions held, the recommended topics, and their perspectives regarding transfer of critical care patients to general wards.</p><p><strong>Methods: </strong>This self-administered nationwide survey was conducted between October and December 2020, targeting a random sample of 740 critical care specialist nurses. An anonymous questionnaire based on established guidelines and pilot tests was used to assess the level of engagement with the family conference process, content of discussions, considerations regarding withholding or withdrawing treatment, and perspectives concerning patient care location and discontinuation of life-sustaining treatments among the surveyed nurses.</p><p><strong>Results: </strong>Of the 396 returned questionnaires (response rate, 51.9%), 384 were analyzed. Less than 35% of the nurses consistently participated in family conferences and ensured that decisions regarding withholding or withdrawing life-sustaining treatments were re-evaluated following the conferences. Discussions focused predominantly on the patients' physical aspects, whereas the nurses believed that patients' values and preferences should be discussed. More than 70% of the nurses supported transferring patients from critical care settings to general wards for end-of-life scenarios.</p><p><strong>Conclusions: </strong>Critical care specialist nurses in Japan exhibit limited engagement in family conferences and often fail to address their patients' values and preferences. Educational programs and enhanced interprofessional collaborations are warranted to improve nurse involvement in family conferences and ensure continuity of care between critical care and general ward settings.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128878","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":"Clinical decision guidance by an automated, brachial cuff-based cardiac output assessment in patients with shock under treatment: a pilot study in Athens, Greece.","authors":"Dimitrios Xanthis, Panagiotis Kanatas, Dimitrios Mouziouras, Antonios A Argyris, Pavlos Vernikos, Georgia Mastakoura, Elpida Athanasopoulou, Theodore G Papaioannou, Athanase D Protogerou","doi":"10.4266/acc.001728","DOIUrl":"10.4266/acc.001728","url":null,"abstract":"<p><strong>Background: </strong>Cardiac output (CO) estimation in patients in intensive care units (ICUs) by a non-invasive, automated, oscillometric, cuff-based apparatus (Mobil-O-Graph [MG]) is reproducible with acceptable accuracy versus thermodilution. In this pilot study, we tested the hypothesis that clinical decisions based on the MG device are in agreement with those based on invasive measurements using a Swan-Ganz catheter (SGC).</p><p><strong>Methods: </strong>Hemodynamic monitoring using an SGC and an MG was performed on 20 consenting critically ill patients in shock and under treatment, hospitalized in ICU. Retrospectively, three ICU physicians were asked to determine the need for blood transfusion, inotropes, fluids, diuretics, oxygen, and vasoconstrictive agents. Decisions (defined as \"need for action\" or \"no action\") were based: (i) on SGC-acquired data and standard ICU monitoring (SIM); (ii) on MG-acquired data and SIM; (iii) SIM only. The decisions were compared using Cohen's kappa agreement coefficient and Wilcoxon's nonparametric test.</p><p><strong>Results: </strong>The overall number of decisions, as well as the subanalysis of \"need for action\" decisions, based either on information from an SGC or MG, were comparable. The significant positive kappa agreement coefficients indicated moderate to strong agreement. MG-derived decisions agreed with SGC-derived decisions to a significantly higher degree compared with SIM-based decisions.</p><p><strong>Conclusions: </strong>Clinical decisions in the ICU setting based on MG data were in acceptable agreement with SGC-based decisions. Larger studies are required to confirm this finding. MG devices may provide a simple, operator-independent, low-cost, first-line bedside method for simultaneous continuous monitoring of blood pressure and CO levels in critically ill patients outside the ICU.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":"273-281"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128815","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":"Prospective external validation of a deep-learning-based early-warning system for major adverse events in general wards in South Korea.","authors":"Taeyong Sim, Eun Young Cho, Ji-Hyun Kim, Kyung Hyun Lee, Kwang Joon Kim, Sangchul Hahn, Eun Yeong Ha, Eunkyeong Yun, In-Cheol Kim, Sun Hyo Park, Chi-Heum Cho, Gyeong Im Yu, Byung Eun Ahn, Yeeun Jeong, Joo-Yun Won, Hochan Cho, Ki-Byung Lee","doi":"10.4266/acc.000525","DOIUrl":"10.4266/acc.000525","url":null,"abstract":"<p><strong>Background: </strong>Acute deterioration of patients in general wards often leads to major adverse events (MAEs), including unplanned intensive care unit transfers, cardiac arrest, or death. Traditional early warning scores (EWSs) have shown limited predictive accuracy, with frequent false positives. We conducted a prospective observational external validation study of an artificial intelligence (AI)-based EWS, the VitalCare - Major Adverse Event Score (VC-MAES), at a tertiary medical center in the Republic of Korea.</p><p><strong>Methods: </strong>Adult patients from general wards, including internal medicine (IM) and obstetrics and gynecology (OBGYN)-the latter were rarely investigated in prior AI-based EWS studies-were included. The VC-MAES predictions were compared with National Early Warning Score (NEWS) and Modified Early Warning Score (MEWS) predictions using the area under the receiver operating characteristic curve (AUROC), area under the precision-recall curve (AUPRC), and logistic regression for baseline EWS values. False-positives per true positive (FPpTP) were assessed based on the power threshold.</p><p><strong>Results: </strong>Of 6,039 encounters, 217 (3.6%) had MAEs (IM: 9.5%, OBGYN: 0.26%). Six hours prior to MAEs, the VC-MAES achieved an AUROC of 0.918 and an AUPRC of 0.352, including the OBGYN subgroup (AUROC, 0.964; AUPRC, 0.388), outperforming the NEWS (0.797 and 0.124) and MEWS (0.722 and 0.079). The FPpTP was reduced by up to 71%. Baseline VC-MAES was strongly associated with MAEs (P<0.001).</p><p><strong>Conclusions: </strong>The VC-MAES significantly outperformed traditional EWSs in predicting adverse events in general ward patients. The robust performance and lower FPpTP suggest that broader adoption of the VC-MAES may improve clinical efficiency and resource allocation in general wards.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 2","pages":"197-208"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267552","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":"Impact of the National Early Warning Score-based sepsis response system on hospital-onset sepsis in a tertiary hospital in South Korea.","authors":"Dong-Gon Hyun, Sohyeon Lee, Sunhui Choi, Jeongsuk Son, So-Hee Park, Sang-Bum Hong, Chae-Man Lim","doi":"10.4266/acc.000625","DOIUrl":"10.4266/acc.000625","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of electronic medical record-based alert systems, response protocols for sepsis diagnosis, and treatment in hospitalized patients remains unclear. This study aimed to determine whether the introduction of an electronic medical record-based sepsis response protocol (SRP) along with a 24/7 operating rapid response system affects the prognosis for patients with hospital-onset sepsis.</p><p><strong>Methods: </strong>In August 2022, a SRP based on the National Early Warning Score was implemented in the electronic medical record system at Asan Medical Center. We retrospectively analyzed patients screened by the detection system for 1 year after the SRP implementation. Patients of the first 6 months (preliminary group) and those of the second 6 months (SRP group) were matched 1:1 based on propensity scores. The primary outcome was 30-day mortality.</p><p><strong>Results: </strong>Of the 608 hospitalized patients screened by the system, 176 were assigned to each group after 1:1 propensity score matching. Patients in the SRP group were significantly more likely to receive blood cultures (58.5%) compared with the preliminary group (45.5%) (P=0.019). The SRP group showed a lower 30-day mortality risk (hazard ratio, 0.56; 95% CI, 0.36-0.86; P=0.017) compared to the preliminary group. A restricted cubic spline curve showed that SRP survival benefit began to manifest after the first 4 months (P=0.036).</p><p><strong>Conclusions: </strong>Alongside an existing rapid response system, the National Early Warning Score-based SRP in the electronic medical record reduced mortality for hospital-onset sepsis within 1 year.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":"186-196"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128998","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":"Excessive fluid resuscitation is associated with intensive care unit mortality in Pakistani patients with dengue shock syndrome.","authors":"Moiz Salahuddin, Rameesha Khalid, Sadaf Hanif, Filza Naeem, Rameen Aijaz, Akbar Shoukat Ali","doi":"10.4266/acc.004008","DOIUrl":"10.4266/acc.004008","url":null,"abstract":"<p><strong>Background: </strong>The mortality of severe dengue infections is approximately 23%. In the management of dengue shock syndrome (DSS), aggressive fluid resuscitation is recommended. The primary objective of our study was to assess the factors associated with 30-day mortality in DSS patients.</p><p><strong>Methods: </strong>Adult patients >18 years old, who were admitted with DSS were included. DSS was diagnosed in patients who required vasopressors or had lactic acidosis >4 mmol/L. Patients were divided into three different groups based on cumulative fluid balance at death or extubation: group I (<3.5 L), group II (3.5-8.0 L), and group III (>8.0 L).</p><p><strong>Results: </strong>A total of 135 patients with DSS was included, with an overall 30-day mortality of 74.8%. The average Sequential Organ Failure Assessment (SOFA) score on intensive care unit admission was 12.2. Mechanical ventilation was required in 112 patients (83.0%), with 61 patients (45.2%) being intubated without a noninvasive ventilation trial. Respiratory failure was the most common reason for requiring intubation (65 patients, 48.2%). In survivors, the median cumulative fluid balance was 1,493 ml (interquartile range [IQR], 0-4,501 ml), whereas that in the mortality group was 7,797 ml (IQR, 3,700-13,600 ml). On multivariate analysis, SOFA score (odds ratio [OR], 1.220; 95% CI, 1.011-1.472; P=0.038) and having received >8.0 L cumulative fluid balance (OR, 6.682; 95% CI, 1.808-24.689; P=0.004) were associated with increased risk of mortality.</p><p><strong>Conclusions: </strong>DSS patients have high mortality rates. High SOFA scores and >8.0 L cumulative fluid balance may indicate worse outcomes.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":"235-243"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128949","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 nutrition support team on 28-day mortality in Korean patients with acute respiratory failure.","authors":"Inhan Lee, Junghyun Kim, Mihyun Ku, Yurim Choi, Sohyun Park, Jihyeon Bang, Joohae Kim","doi":"10.4266/acc.003312","DOIUrl":"10.4266/acc.003312","url":null,"abstract":"<p><strong>Background: </strong>Providing optimal nutrition to patients with acute respiratory failure is difficult because nutritional requirements vary according to disease severity and comorbidities. In 2021, the National Medical Center initiated a protocol for screening upon admission and regular monitoring by a multidisciplinary nutritional support team (NST), for all patients in the medical intensive care unit (ICU). This study aimed to evaluate the effects of routine NST monitoring and active intervention on the clinical outcomes of patients with acute respiratory failure.</p><p><strong>Methods: </strong>Patients with acute respiratory failure requiring high-flow nasal cannula, non-invasive ventilation, or mechanical ventilation were included. The primary outcome was 28-day mortality after ICU admission. Secondary outcomes included the supplied/target calorie ratio, supplied/target protein ratio on day 7, and complications.</p><p><strong>Results: </strong>In total, 152 patients were included in the analysis. The patients were divided into a pre-monitoring (n=96) and post-monitoring groups (n=56). More patients in the post-monitoring group received NST intervention and had earlier initiation of enteral feeding. In survival analysis, 28-day mortality was significantly lower in post-monitoring group (adjusted hazard ratio, 0.42; 95% CI, 0.24-0.74). The ratio of achievement for required calories and protein on day 7 was higher, but not significantly, in the post-monitoring group. No significant differences were observed in the incidence of complications.</p><p><strong>Conclusions: </strong>Regular NST monitoring in the ICU could have contributed to a reduced risk of 28-day mortality in critically ill patients with acute respiratory failure.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":"313-321"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003538","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":"Clinical applications of blood gas analysis: a comparative review of arterial and venous blood gas monitoring in critical care.","authors":"Gyeo Ra Lee","doi":"10.4266/acc.000900","DOIUrl":"10.4266/acc.000900","url":null,"abstract":"<p><p>Blood gas analysis is an essential diagnostic tool used for assessing acid-base balance, ventilation, and oxygenation in critically ill patients. Arterial blood gas analysis (ABGA) remains the gold standard, primarily due to its accuracy in measuring oxygenation. Venous blood gas analysis (VBGA), in contrast, serves as a less invasive alternative and is particularly useful for evaluating acid-base status and metabolic function. Important parameters such as oxygen saturation of central venous blood (ScvO₂) and venous-to-arterial carbon dioxide pressure difference (∆pv-aCO₂) provide critical insights into hemodynamic status, cardiac output, and tissue perfusion. Although VBGA cannot replace ABGA for the precise assessment of oxygenation, it remains a valuable tool in clinical scenarios involving hemodynamic monitoring, shock management, and critical care decision-making.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 2","pages":"153-159"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267548","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 impact of enteral feeding intolerance on the prognosis of patients with septic shock in South Korea.","authors":"Hyun-Jun Park, Yoon Hae Ahn, Hong Yeul Lee, Sang-Min Lee, Jinwoo Lee","doi":"10.4266/acc.000700","DOIUrl":"10.4266/acc.000700","url":null,"abstract":"<p><strong>Background: </strong>While enteral feeding intolerance (EFI) is associated with worse clinical outcomes in critically ill patients, the relationship between the number of days of EFI and mortality outcomes remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed adult patients admitted to the medical intensive care unit (ICU) with septic shock at a tertiary referral center. EFI was defined as the presence of vomiting, abdominal distension, pain, diarrhea, or radiographic evidence of ileus. EFI status was assessed daily, and we evaluated the prognostic impact of total number of EFI days during the first 3 days of enteral feeding on clinical outcomes.</p><p><strong>Results: </strong>A total of 94 patients were included in the analysis, with 77 (81.9%) experiencing EFI. During the first 3 days of enteral feeding, 25 patients (26.6%) experienced EFI for 1 day, 22 patients (23.4%) experienced EFI for 2 days, and 30 patients (31.9%) experienced EFI for all 3 days. The total number of EFI days was identified as an independent risk factor of 90-day mortality (adjusted hazard ratio, 1.400; 95% CI 1.021-1.919). Higher total EFI days was significantly associated with increased ICU mortality (P for trend=0.036), in-hospital mortality (P for trend=0.007), 30-day mortality (P for trend=0.004), and 90-day mortality (P for trend=0.006).</p><p><strong>Conclusions: </strong>An increase in the total number of EFI days was significantly associated with mortality outcomes in patients with septic shock, suggesting that EFI may serve as a useful indicator for predicting outcomes in this population.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"40 2","pages":"304-312"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267568","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":"Classification of postoperative fever patients in the intensive care unit following intra-abdominal surgery: a machine learning-based cluster analysis using the Medical Information Mart for Intensive Care (MIMIC)-IV database, developed in the United States.","authors":"Sang Mok Lee, Hongjin Shim","doi":"10.4266/acc.004464","DOIUrl":"10.4266/acc.004464","url":null,"abstract":"<p><strong>Background: </strong>Postoperative fever is common. However, it can sometimes indicate severe complications such as sepsis or pneumonia. Intensive care unit (ICU) patients who have undergone abdominal surgery have a higher risk of postoperative fever due the physical severity of this type of surgery. Nevertheless, determining when more aggressive or invasive management of fever is necessary remains a challenge.</p><p><strong>Methods: </strong>We analyzed the Medical Information Mart for Intensive Care (MIMIC)-IV and MIMIC-IV-Note databases, which are open critical care big databases from a single institute in the United States. From this, we selected ICU patients who developed fever after intra-abdominal surgery and classified these patients into two groups using cluster analysis based on diverse variables from the MIMIC-IV databases. Following this cluster analysis, we assessed differences among the identified groups.</p><p><strong>Results: </strong>Of 2,858 ICU stays after intra-abdominal surgery, 331 postoperative fever cases were identified. These patients were clustered into two groups. Group A included older patients with a higher mortality rate, while group B consisted of younger patients with a lower mortality rate.</p><p><strong>Conclusions: </strong>Postoperative ICU patients with a fever could be classified into two distinct groups, a high-risk group and low-risk group. The high-risk patient group was characterized by older age, higher Sequential Organ Failure Assessment (SOFA) score, and more unstable hemodynamic status, indicating the need for aggressive management. Clustering postoperative fever patients by clinical variables can support medical decision-making and targeted treatment to improve patient outcomes.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":" ","pages":"293-303"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12151741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000852","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}