Acute and Critical Care最新文献

{"title":"Postoperative acute kidney injury and serum creatinine: still central, still limited.","authors":"Ah-Reum Cho","doi":"10.4266/acc.001144","DOIUrl":"10.4266/acc.001144","url":null,"abstract":"","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"183-185"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463752","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":"Real-world experience using multiplex polymerase chain reaction in intensive care unit patients with hospital-acquired and ventilator-associated pneumonia in South Korea.","authors":"Eun Chong Yoon, Sang-Ho Choi, Heungsup Sung, Yong Pil Chong, Euijin Chang, Kyung-Hyun Do, Su Yeon Lee, Dong-Gon Hyun, Jee Hwan Ahn, Jin Won Huh, Chae-Man Lim, Sang-Bum Hong","doi":"10.4266/acc.005100","DOIUrl":"10.4266/acc.005100","url":null,"abstract":"<p><strong>Background: </strong>Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are common among critically ill patients, leading to increased morbidity and mortality rates. Conventional culture-based diagnostics require 48-72 hours, which delays pathogen identification and prolongs the use of broad-spectrum antibiotics. Multiplex polymerase chain reaction (mPCR) enables the rapid detection of pathogens and resistance genes, but its effects on real-world antibiotic decision-making remain unclear.</p><p><strong>Methods: </strong>This retrospective study included patients in the intensive care unit who were diagnosed with HAP or VAP at a tertiary medical center between July 2023 and June 2024. All patients underwent both mPCR and respiratory culture. The primary outcome was the time to the first antibiotic modification based on mPCR or respiratory culture. The secondary outcome was the rate of antibiotic de-escalation from carbapenem or teicoplanin/vancomycin based on mPCR findings.</p><p><strong>Results: </strong>In total, 75 patients were included (median age, 68 years; 61.3% male). mPCR identified bacterial pathogens in 45.3% cases, with a median turnaround time of 281 minutes. The median time to antibiotic modification was 5.8 hours for mPCR versus 122.32 hours for culture (P<0.01). Despite negative mPCR results for gram-negative bacilli, carbapenem therapy was discontinued in only 1 of 24 cases (4.2%). Among 39 patients with negative results for Staphylococcus aureus, vancomycin or teicoplanin was discontinued in only 3 cases (7.7%).</p><p><strong>Conclusions: </strong>mPCR provided faster pathogen identification and earlier antibiotic modifications than conventional respiratory culture. However, antibiotic discontinuation remained uncommon despite negative mPCR results, highlighting challenges in real-world antimicrobial stewardship.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"87-96"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463844","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":"Minimizing discard volume to 2 ml before blood sampling from a central venous catheter: a prospective observational study in India.","authors":"Abinaya Pushparaj, Lakshmi Ramamoorthy, Manu Ayyan S, Rajeswari Murugesan, Hmar Thiak Lalthanthuami","doi":"10.4266/acc.000792","DOIUrl":"10.4266/acc.000792","url":null,"abstract":"<p><strong>Background: </strong>Central venous catheters (CVCs) are essential for the treatment of critically ill patients. The practice of discarding varying volumes of blood before sampling from CVCs is widely adopted globally. However, there is no established consensus regarding the appropriate volume of blood to discard before sampling. Therefore, this study aims to compare serum electrolyte levels and hemogram measurements obtained via direct venous puncture with those derived from the proximal lumen of the CVC using a discard volume of 2 ml.</p><p><strong>Methods: </strong>Using a prospective observational study design, 105 patients from intensive care units of a tertiary care center were selected through a convenience sampling method. The parameters analyzed included serum electrolytes (sodium, potassium, and calcium) and complete blood counts (hemograms). Intraclass correlation and Bland-Altman plot analysis were employed to assess agreement between the two sampling methods.</p><p><strong>Results: </strong>The study showed high agreement between the two methods, with a P-value of <0.001, except for white blood cell. The presence of acidosis as a clinical confounder was the primary reason for the differences in agreement for potassium (P=0.018), hematocrit (P=0.006), mean corpuscular volume (P=0.041), mean corpuscular hemoglobin (P=0.034), mean corpuscular hemoglobin concentration (P=0.031), neutrophil (P=0.045), and eosinophil (P=0.553).</p><p><strong>Conclusions: </strong>This study suggests that discarding 2 ml of blood, rather than 3 ml or more, before routine sampling from CVCs is sufficient and may help to reduce iatrogenic blood loss in critically ill patients.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"174-182"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463747","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":"Rehabilitation during extracorporeal membrane oxygenation: bridging the gap between life support and functional recovery.","authors":"Jin Ho Jang, Eunjeong Choi, Eunjeong Son, Seong Hoon Yoon, Hee Yun Seol, Seung Eun Lee, Woo Hyun Cho, Doosoo Jeon, Yun Seong Kim, Hye Ju Yeo","doi":"10.4266/acc.003250","DOIUrl":"10.4266/acc.003250","url":null,"abstract":"<p><p>Rehabilitation during extracorporeal membrane oxygenation (ECMO) has become a promising intervention to mitigate the profound physical and functional decline that occurs with prolonged critical illness. With the wider adoption of ECMO, interest has grown in integrating early mobilization into routine care practices to preserve muscle mass, reduce intensive care unit-acquired weakness, and improve long-term patient outcomes. Emerging observational data indicate that structured rehabilitation protocols-including passive and active mobilization-are feasible and safe, including for individuals undergoing femoral cannulation. Nevertheless, multiple obstacles, including patient instability, technical constraints, staffing limitations, and gaps in clinical knowledge, impede broader implementation. Although the theoretical rationale and initial data are compelling, further robust randomized controlled trials are essential to establish the definitive efficacy, best-practice protocols, and cost-effectiveness of rehabilitation interventions in ECMO-supported patients.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"12-32"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463875","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":"Hemostatic resuscitation in patients with trauma-induced coagulopathy: a narrative review.","authors":"Junsik Kwon, Byung Hee Kang","doi":"10.4266/acc.003525","DOIUrl":"10.4266/acc.003525","url":null,"abstract":"<p><p>Hemorrhage remains a leading cause of preventable death in trauma, emphasizing the importance of early bleeding control. In addition to mechanical hemostasis, effective management of trauma-induced coagulopathy (TIC) plays a critical role in improving outcomes. TIC is a multifactorial condition with diverse phenotypes, involving complex pathophysiology. These variations complicate early diagnosis and targeted treatment. In the prehospital setting, phenotype-based management is not feasible; thus, empirical strategies have been adopted. Administration of tranexamic acid and prehospital whole blood transfusion have shown clinical benefit in selected trauma populations. Upon hospital arrival, fixed-ratio massive transfusion protocols and whole blood resuscitation provide broad support for coagulopathic states and have proven effective in reducing early mortality. However, these approaches may not fully account for individual variation in coagulation profiles. Viscoelastic assays allow real-time evaluation of coagulation status and offer the potential for individualized, goal-directed therapy. While some studies suggest improved outcomes with viscoelastic-guided resuscitation, evidence of clear superiority over conventional methods remains limited. Further research is needed to determine the optimal resuscitation strategy and integrate both empirical and precision-based approaches in TIC management.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"47-57"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463564","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":"Trajectories of mean arterial pressure/norepinephrine equivalent dose index in patients with septic shock receiving low-dose hydrocortisone: a retrospective cohort study in Thailand.","authors":"Auttawut Chalermwutanon, Sawangjit Saejaow, Veerapong Vattanavanit","doi":"10.4266/acc.000125","DOIUrl":"10.4266/acc.000125","url":null,"abstract":"<p><strong>Background: </strong>We aimed to analyze the trajectories of the mean arterial pressure/norepinephrine equivalent dose (MAP/NEQ) index in patients with septic shock treated with low-dose hydrocortisone and to determine the association of these trajectories with mortality.</p><p><strong>Methods: </strong>A retrospective cohort of 203 patients with septic shock receiving low-dose hydrocortisone was examined. MAP and NEQ data were collected from electronic health records, and groupbased trajectory modeling was employed to identify distinct patterns in the MAP/NEQ index over the initial 72 hours of treatment. Univariable and multivariable logistic regression analyses were conducted to assess the associations of MAP/NEQ index trajectories with clinical variables and in-hospital mortality.</p><p><strong>Results: </strong>The overall in-hospital mortality rate was 56.2%. Three MAP/NEQ index trajectory patterns were identified: unchanged (76.8%), gradually increased (14.3%), and rapidly increased (8.9%). The shock reversal rates were 50% for the unchanged group, 89.7% for the gradually increased group, and 100% for the rapidly increased group. Compared with the unchanged group, both gradually and rapidly increased groups were associated with significantly lower mortality, with adjusted odds ratios of 0.15 (95% CI, 0.05-0.40; P<0.001) and 0.29 (95% CI, 0.09-0.92; P=0.035), respectively.</p><p><strong>Conclusions: </strong>In patients with septic shock treated with low-dose hydrocortisone, gradually and rapidly increased MAP/NEQ index trajectories were associated with significantly lower mortality risks and higher rates of shock reversal compared to those with unchanged trajectories. These findings highlight the importance of monitoring the MAP/NEQ index to guide treatment and improve septic shock outcomes.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"107-116"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463849","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":"Failure of early creatinine recovery predicts poor survival after emergency surgery for bowel perforation or infarction.","authors":"Hyun Il Kim, Min Hong Lee, Byung Jun Jeon, Yoon Mo Kim, Mi Kyung Oh, Min Gyu Kim","doi":"10.4266/acc.003625","DOIUrl":"10.4266/acc.003625","url":null,"abstract":"<p><strong>Background: </strong>Early postoperative recovery of kidney function is critical in emergency bowel surgery. This study evaluated the prognostic value of preoperative creatinine elevation (PCE) and early creatinine recovery (ECR).</p><p><strong>Methods: </strong>A total of 424 patients underwent emergency surgery for bowel perforation or ischemia from January 2019 to December 2024. Sixteen trauma-related cases (including procedure-related injuries) were excluded, leaving 408 patients for analysis. Of these, 35 patients with end-stage renal disease or chronic kidney disease-either pre-existing or newly diagnosed during hospitalization-were excluded. ECR was defined as a decrease in serum creatinine to <1.3 mg/dl by postoperative day (POD) 3. PCE was defined as serum creatinine >1.3 mg/dl. Associations with postoperative complications and 30-day mortality were estimated using multivariable logistic regression and reported as adjusted odds ratios (aORs) with 95% CIs.</p><p><strong>Results: </strong>PCE occurred in 18.5% (69/373) of the tested patients; among these, 58.0% (40/69) achieved ECR by POD 3. Failure of ECR was associated with severe complications (93.1% vs. 27.5%, P<0.001) and higher mortality (72.4% vs. 7.5%, P<0.001). In multivariable analysis, ECR failure independently predicted complications (aOR, 28.71; 95% CI, 5.44-151.57) and 30-day mortality (aOR, 32.37; 95% CI, 7.74-135.40; P<0.001 for both).</p><p><strong>Conclusions: </strong>Failure to achieve ECR is independently associated with poor survival after emergency laparotomy for peritonitis. This finding supports the use of a creatinine-based checkpoint to trigger intensified monitoring and targeted rescue interventions.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"126-135"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463474","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":"Prognostic validation and risk stratification of the Society for Cardiovascular Angiography and Interventions cardiogenic shock classification in a large, real-world intensive care unit cohort in South Korea.","authors":"Haechan Cho, Jeehoon Kang, Minju Han, Huijin Lee, Hyun-Jai Cho","doi":"10.4266/acc.004500","DOIUrl":"10.4266/acc.004500","url":null,"abstract":"<p><strong>Background: </strong>Cardiogenic shock (CS) imparts a high mortality rate, yet a standardized classification of its severity remains lacking. The Society for Cardiovascular Angiography and Interventions (SCAI) proposed a five-stage classification scheme to improve risk stratification, but its prognostic value in real-world intensive care unit (ICU) populations is still insufficiently validated.</p><p><strong>Methods: </strong>We retrospectively analyzed 3,074 adults admitted to the medical and cardiovascular ICUs under the Division of Cardiology at a tertiary academic medical center between 2010 and 2019. SCAI shock stages (A-E) were assigned at admission using data on hemodynamic instability, hypoperfusion, clinical deterioration, and refractory shock. The primary outcome was ICU mortality.</p><p><strong>Results: </strong>ICU mortality rates across stages A-E were 0.5%, 4.3%, 5.2%, 18.8%, and 53.2% (P<0.001). Compared to stage A, higher stages were independently associated with mortality (adjusted odds ratio, 3.93-31.58). The discriminatory ability of the SCAI CS classification was moderate (area under the receiver operating characteristic curve [AUROC], 0.787) but improved markedly with the addition of Acute Physiology and Chronic Health Evaluation II scores (AUROC, 0.929).</p><p><strong>Conclusions: </strong>The SCAI CS classification offers clear, incremental risk stratification of ICU mortality. When combined with global severity scores, it provides superior prognostic accuracy, supporting its routine use in the management and study of CS.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"117-125"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463895","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":"Predictive value of resting energy expenditure and oxygen consumption of breathing for ventilator weaning in surgical intensive care patients in Viet Nam: a cross-sectional study.","authors":"Vu Hoang Phuong, Nguyen Huu Tu, Tran Viet Duc, Hoang Thi Hong, Do Thanh Duc, Pham Quang Minh","doi":"10.4266/acc.001150","DOIUrl":"10.4266/acc.001150","url":null,"abstract":"<p><strong>Background: </strong>Patients being weaned from mechanical ventilation are evaluated using portable metabolic carts to measure oxygen consumption (V̇O2) and carbon dioxide production (V̇CO2) to determine resting energy expenditure (REE) and oxygen cost of breathing (OCOB). The purpose of this study was to investigate the cutoff threshold and the predictive values of OCOB and REE variation in such patients at a surgical critical care unit.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from March 2023 to February 2024. A total of 58 patients who were at least 18 years old and receiving orotracheal ventilation for more than 48 hours met the criteria for weaning. The relationship among OCOB, variation in resting energy expenditure (ΔREE) index, and weaning results was examined. Calculations were performed to determine the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, specificity, and positive and negative predictive values (PPV and NPV).</p><p><strong>Results: </strong>The overall weaning success rate was 72.4% (42/58). Compared to the failure group, the successful weaning group had significantly lower median values of ∆REE and OCOB (6.3% and 6.93% vs. 15.64% and 16.21%, P=0.002, respectively). According to ROC analysis, weaning success was predicted when ∆REE ≤8.28% (AUC, 0.768) or OCOB ≤9.1% (AUC, 0.762).</p><p><strong>Conclusions: </strong>Both OCOB and ∆REE can be used to predict a successful outcome of ventilator weaning, with a criterion of OCOB ≤9.1% or ∆REE ≤8.28% in surgical critical care patients.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"97-106"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463886","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":"Metagenomics profiling of the lower respiratory tract microbiome and relevant respiratory pathogens in pediatric intensive care unit patients: a pilot exploratory study in Egypt.","authors":"May Sherif Soliman, Amira Muhammad Abbas, HebatAllah Fadel Algebaly, Amani Ali El-Kholy, Noha Salah Soliman","doi":"10.4266/acc.003816","DOIUrl":"10.4266/acc.003816","url":null,"abstract":"<p><strong>Background: </strong>Lower respiratory tract infections (LRTIs) are a leading cause of mortality in children. These infections disrupt the equilibrium of lower respiratory tract (LRT) microbiota, allowing respiratory pathogens to dominate. The conventional culture method has limitations in describing complex microbiomes and may fail in the detection of respiratory pathogens. In the present study, we sought to use the advanced technology of 16S metagenomics next-generation sequencing (16SmNGS) to characterize the LRT microbiome among children with LRTIs and to identify the underlying respiratory pathogens that commonly evade detection by traditional culture.</p><p><strong>Methods: </strong>Twenty LRT specimens from hospitalized children with LRTIs were analyzed using 16SmNGS, as well as standard microbiological culture.</p><p><strong>Results: </strong>The 16SmNGS taxonomical analysis revealed the highest relative abundances for Streptococcus (27.7%) and Escherichia (13.3%) genera, which belong to the phyla of Firmicutes (45.4%) and Proteobacteria (45.3%), respectively. Streptococcus pneumoniae (45%), Escherichia coli (45%), Pseudomonas aeruginosa (15%), Staphylococcus aureus (10%), Acinetobacter baumannii (5%), and Haemophilus influenzae (5%) were the primary respiratory pathogens. Conventional culture failed to detect growth in 100%, 77.7%, and 55.5% of 16SmNGS-positive specimens for H. influenza, S. pneumoniae, and E. coli, respectively.</p><p><strong>Conclusions: </strong>The 16SmNGS technique revealed a predominance of Streptococcus and Escherichia genera belonging to the phyla of Firmicutes and Proteobacteria in pediatric LRTIs. In this exploratory study, 16SmNGS was able to enhance the identification of significant respiratory pathogens, particularly those difficult to isolate in culture. However, to rule out contamination by flora, it is advisable not to interpret metagenomics results independently from culture, clinical, and radiological data. In addition, further clinical correlations are desired to reach appropriate clinical decisions.</p>","PeriodicalId":44118,"journal":{"name":"Acute and Critical Care","volume":"41 1","pages":"136-147"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463756","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}